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1.
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46779

RESUMO

New research in mice suggests that "remodeling" an unhealthy microbiome into a healthy one could stave off chronic disease by improving cholesterol.


Assuntos
Doença Crônica , Microbioma Gastrointestinal
2.
BMC Ophthalmol ; 19(1): 174, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395040

RESUMO

BACKGROUND: A patient's health literacy is fundamental for navigating the health system and managing disease. This study aimed to compare the health literacy levels of patients with chronic retinal disease in Denmark. METHODS: This cross-sectional questionnaire study used the validated HLS-EU-Q16 questionnaire to determine the health literacy of 225 patients with age-related macular degeneration (AMD), diabetic macular edema (DME) or retinal vein occlusion (RVO), receiving intravitreal treatment at the retinal clinic, Zealand University Hospital, Denmark. Patients were consecutively included as participants for the study. All patients had the option of having the survey read aloud to them. RESULTS: Health literacy levels between the patient groups did not differ significantly, however, the proportion of patients with poor health literacy was high-65% of AMD patients, 73% of DME patients, and 63% of patients with RVO. CONCLUSIONS: Low health literacy of patients with retinal disease signify a need for more health literacy research in the field of retinal diseases, to secure that patients have the timely and appropriate knowledge and competencies to manage their condition.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Alfabetização em Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto/normas , Doenças Retinianas/psicologia , Acuidade Visual , Idoso , Doença Crônica , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/diagnóstico , Estudos Retrospectivos , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo , Tomografia de Coerência Óptica
3.
Implement Sci ; 14(1): 76, 2019 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382994

RESUMO

BACKGROUND: Translating research into practice is an important issue for implementing health interventions effectively for Indigenous communities. He Pikinga Waiora (HPW) is a recent implementation framework that provides a strong foundation for designing and implementing health interventions in Indigenous communities for non-communicable diseases around community engagement, culture-centred approach, systems thinking and integrated knowledge translation. This study addresses the following research question: How are the elements of the HPW Implementation Framework reflected in studies involving the implementation of a non-communicable disease health intervention in an Indigenous community? METHODS: A systematic review was conducted using multiple databases. Studies were included if they involved the implementation or evaluation of a health intervention targeting non-communicable diseases for Indigenous communities in Australia, Canada, New Zealand or the United States of America. Published quantitative and qualitative literature from 2008 to 2018 were included. Methodological appraisal of the included articles was completed using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. Data on the population, topic, methods, and outcomes were detailed for each individual study. Key data extracted included the HPW elements along with study characteristics, who delivered the intervention and health outcomes. Data analysis involved a qualitative synthesis of findings as guided by a coding scheme of the HPW elements. RESULTS: Twenty-one studies were included. Health topics included diabetes, nutrition, weight loss, cancer and general health. The key themes were as follows: (a) two thirds of studies demonstrated high levels of community engagement; (b) from the culture-centred approach, two-thirds of studies reflected moderate to high levels of community voice/agency although only a third of the studies included structural changes and researcher reflexivity; (c) about a quarter of studies included multi-level outcomes and activities consistent with systems thinking, 40% had individual-level outcomes with some systems thinking, and 33% included individual-level outcomes and limited systems thinking; and (d) almost 40% of studies included high levels of end user (e.g., policy makers and tribal leaders) engagement reflective of integrated knowledge translation, but nearly half had limited end-user engagement. CONCLUSIONS: The HPW Implementation Framework is a comprehensive model for potentially understanding implementation effectiveness in Indigenous communities. The review suggests that the studies are reflective of high levels of community engagement and culture-centredness. The long-term sustainability and translation of evidence to practice may be inhibited because of lower levels of systems thinking and integrated knowledge translation. REGISTRATION: Not registered.


Assuntos
Doença Crônica/terapia , Assistência à Saúde/organização & administração , Serviços de Saúde do Indígena/organização & administração , Doença Crônica/etnologia , Acesso aos Serviços de Saúde , Humanos
4.
Medicine (Baltimore) ; 98(33): e16847, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415411

RESUMO

The aim of the present study was to explore the application and its effect of mobile medical treatment to chronic disease health management in physical examination population, and to provide references for comprehensive intervention and management of chronic diseases.From January to December 2016, 300 medical examiners in a general hospital health management center were randomly divided into health management group (155 cases) and control group (145 cases). The control group completed routine physical examination and health-risk assessment and provided corresponding reports, repeated annual physical examination and health-risks assessment. In addition to the routine physical examination and health-risk assessment, the health management group reminded the examiners to pay attention to their lifestyle and dietary habits by moving online and offline dynamic health interventions and provide targeted guidance for high-risk population such as diabetes, obesity, hypertension, etc. A review was made after 2 years. The clinical indexes and chronic disease behavior of patients before and after management were compared, and the effect was evaluated by statistical analysis.After management, all the clinical indexes were significantly improved, and the patients' dietary structure, bad living habits, psychologic state, and other chronic disease behaviors were obviously improved. The proportion of patients with high risk of hypertension, diabetes, and obesity in health management group was significantly lower than that before intervention and control group (P < .05).Using mobile network online, offline dynamic health intervention model can reduce the risk of common chronic diseases in health management objects, this health management model of chronic disease is worth popularizing.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Dieta Saudável/estatística & dados numéricos , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Doença Crônica/prevenção & controle , Diabetes Mellitus/epidemiologia , Feminino , Dieta Saudável/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade , Medição de Risco/métodos , Telemedicina
8.
Surg Clin North Am ; 99(5): 815-821, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446910

RESUMO

Palliative care is an interdisciplinary field that focuses on optimizing quality of life for patients with serious, life-limiting illnesses and includes aggressive management of pain and symptoms; psychological, social, and spiritual support; and discussions of advance care planning, including treatment decision making and complex care coordination. Early palliative care is associated with increased quality of life, decreased symptom burden, decreased health care expenditures, and improved caregiver outcomes. This article discusses integrating interdisciplinary palliative care into surgical practice, and some current models of using and expanding palliative care skill sets in surgery, including training initiatives for both physicians and nurses.


Assuntos
Cuidados Paliativos/organização & administração , Equipe de Assistência ao Paciente , Assistência Perioperatória , Doença Crônica , Humanos , Qualidade de Vida , Assistência Terminal
10.
Stud Health Technol Inform ; 264: 920-924, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438058

RESUMO

Understanding the progression of chronic diseases, such as chronic obstructive pulmonary disease (COPD), is important to inform early diagnosis, personalized care, and health system management. Data from clinical and administrative systems have the potential to advance this understanding, but traditional methods for modelling disease progression are not well-suited to analyzing data collected at irregular intervals, such as when a patient interacts with a healthcare system. We applied a continuous-time hidden Markov model to irregularly-spaced healthcare utilization events and patient-level characteristics in order to analyze the progression through discrete states of 76,888 patients with COPD. A 4-state model allowed classification of patients into interpretable states of disease progression and generated insights about the role of comorbidities, such as cardiovascular diseases, in accelerating severe trajectories. These results can improve the understanding of the evolution of COPD and point to new hypotheses about chronic disease management and comorbidity.


Assuntos
Doenças Cardiovasculares , Doença Pulmonar Obstrutiva Crônica , Doença Crônica , Comorbidade , Progressão da Doença , Humanos
11.
Stud Health Technol Inform ; 264: 935-939, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438061

RESUMO

Chronic diseases are the leading cause of morbidity, disability and mortality worldwide. It is well established that the majority of chronic diseases can be prevented by targeting modifiable lifestyle-related risk factors. Thus, early risk assessment and mitigation at the individual level can significantly reduce the health and economic burden of chronic diseases. Lifetime health has emerged as a potential paradigm to assist individuals to avoid harmful lifestyle-related habits to reduce the risk of chronic morbidity. In this paper, we leverage eHealth and Quantified Self technologies, novel health data visualizations, and artificial intelligence methods to develop a digital-based lifetime health platform (PRISM) to empower individuals to self-assess, self-monitor, and self-manage their risks for multiple chronic diseases and associated morbidities.


Assuntos
Multimorbidade , Medição de Risco , Telemedicina , Doença Crônica , Humanos , Fatores de Risco
12.
Stud Health Technol Inform ; 264: 1694-1695, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438297

RESUMO

We developed a comprehensive health and social-need assessment system to evaluate the diverse needs of elders with chronic illnesses in the community and to enhance the connection of their needs to health and social services. A comprehensive needs-assessment tool and profiles were integrated into the ICT system. We found that care managers could assess elders' needs comprehensively and connect those needs to suitable health and social services systematically.


Assuntos
Determinação de Necessidades de Cuidados de Saúde , Autocuidado , Idoso , Doença Crônica , Sistemas de Informação em Saúde , Humanos
13.
Rev Col Bras Cir ; 46(3): e20192181, 2019 Aug 15.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31432983

RESUMO

OBJECTIVE: to evaluate the long-term results of the correction of chronic anal fissures (CAF) in patients without anal hypertonia using the technique of anoplasty with skin tag flap. METHODS: we conducted a prospective study of CAF patients refractory to conservative treatment without anal hypertonia, subjected to anoplasty with the use of anal plicoma to cover the bloody area. We confirmed the absence of anal hypertonia through rectal exam and electromanometry. We applied a visual pain questionnaire and the Cleveland Clinic fecal incontinence score before and after surgery. RESULTS: we followed 15 patients with chronic anal fissure for a mean period of 29 months (12-56). The mean age was 41 years (29-69) and the duration of symptoms ranged from six months to five years. Healing occurred between three and six weeks for 13 patients (86.7%). The other two patients underwent debridement and new anoplasty successfully. No plicoma necrosis or anal stenosis occurred in any patient. The anal incontinence score did not change after the procedure, and all patients reported reduced pain. After 12 months of follow-up, none of the patients presented recurrence or anal incontinence, and 93.3% (14/15) of the patients were very satisfied. CONCLUSION: fissurectomy and anoplasty with the use of sentinel plie is a safe technique that results in improvement in pain without change of fecal continence and with high satisfaction rates.


Assuntos
Fissura Anal/cirurgia , Retalhos Cirúrgicos , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Resultado do Tratamento
14.
Vet Immunol Immunopathol ; 214: 109893, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31378220

RESUMO

Differentiation between canine chronic enteropathy (CCE) and intestinal lymphoma is a diagnostic challenge as histopathology might fail to yield unequivocal results. Detection of clonal rearrangements of the T-cell-receptor gamma (TCRG) chain and IG heavy chain (IGH) V-J genes offer a useful solution. In this retrospective study, histopathology samples of 35 CCE patients and 7 healthy Beagle dogs underwent clonality testing. Patients suffered either from inflammatory bowel disease (IBD), food responsive diarrhea (FRD) or protein loosing enteropathy secondary to IBD (PLE/IBD). Healthy Beagles served as controls (CO). Canine IBD activity index (CIBDAI) and histopathological WSAVA-grading differed significantly (p<0.001) between groups. CIBDAI improved significantly after appropriate therapy (p < 0.0001). Intestinal biopsies of all CO showed polyclonal patterns for B- and T-cell primers. All samples from CCE patients showed polyclonal patterns for the B-cell primers. Targeting TCRG, 4 patients showed a monoclonal or oligoclonal pattern of the lymphocytic infiltrates in the duodenum and/or colon. Clinical improvement was observed in all dogs. Although a small cell lymphoma cannot be excluded in view of the short follow up duration, a false positive result, in the sense of a canonical rearrangement or unspecific amplification due to a antigenic stimulation in a non-neoplastic inflammatory process is possible.


Assuntos
Doenças do Cão/diagnóstico , Doenças do Cão/genética , Enteropatias Perdedoras de Proteínas/genética , Enteropatias Perdedoras de Proteínas/veterinária , Animais , Biópsia , Estudos de Casos e Controles , Doença Crônica , Diagnóstico Diferencial , Cães , Feminino , Rearranjo Gênico do Linfócito T , Doenças Inflamatórias Intestinais/imunologia , Intestinos/patologia , Linfoma/diagnóstico , Linfoma/veterinária , Masculino , Enteropatias Perdedoras de Proteínas/diagnóstico , Receptores de Antígenos de Linfócitos T gama-delta/genética , Estudos Retrospectivos
15.
Medicine (Baltimore) ; 98(32): e16041, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393343

RESUMO

The purpose of this study was to assess whether the asymmetry of cervical multifidus muscles occurred in radiculopathy patients, and if it did, whether it was related to the chronicity of unilateral cervical radiculopathy by assessing the cross-sectional area (CSA) of multifidus muscles using magnetic resonance imaging (MRI).This study used a retrospective design and was conducted from January 2013 to August 2016. Seventy-seven patients (age 18-65) who had unilateral neck pain, symptom duration of 3 months to 1 year, and who were diagnosed with unilateral 6th cervical radiculopathy by electrodiagnostic testing, were included in study. The CSA of cervical multifidus muscles was measured at the midpoint between the lower margin of the upper vertebra and upper margin of the lower vertebra on axial MRI. Relative CSA (rCSA), which is the ratio of the CSA of muscles to that of the lower margin of C5 vertebra was also obtained.At the C4-5 and C6-7 levels, CSA and rCSA of cervical multifidus muscles showed no statistically difference between the affected and unaffected sides. At the C5-6 level, multifidus muscles were significantly smaller in the affected side (at the C5-6 level, P value of CSA.007 and P value of rCSA.102).The atrophy of multifidus muscles ipsilateral to cervical radiculopathy was observed in patients who had chronic unilateral cervical radiculopathy.


Assuntos
Vértebras Cervicais/patologia , Cervicalgia/patologia , Músculos Paraespinais/patologia , Radiculopatia/patologia , Adulto , Idoso , Doença Crônica , Estudos Transversais , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Lancet ; 394(10198): 596-603, 2019 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-31395442

RESUMO

Family health history (FHH) is the most useful means of assessing risk for common chronic diseases. The odds ratio for risk of developing disease with a positive FHH is frequently greater than 2, and actions can be taken to mitigate risk by adhering to screening guidelines, genetic counselling, genetic risk testing, and other screening methods. Challenges to the routine acquisition of FHH include constraints on provider time to collect data and the difficulty in accessing risk calculators. Disease-specific and broader risk assessment software platforms have been developed, many with clinical decision support and informatics interoperability, but few access patient information directly. Software that allows integration of FHH with the electronic medical record and clinical decision support capabilities has provided solutions to many of these challenges. Patient facing, electronic medical record, and web-enabled FHH platforms have been developed, and can provide greater identification of risk compared with conventional FHH ascertainment in primary care. FHH, along with cascade screening, can be an important component of population health management approaches to overall reduction of risk.


Assuntos
Doença Crônica , Anamnese/métodos , Medição de Risco/métodos , Registros Eletrônicos de Saúde , Humanos , Razão de Chances , Software
17.
Kardiologiia ; 59(8): 88-96, 2019 Aug 08.
Artigo em Russo | MEDLINE | ID: mdl-31397234

RESUMO

Chronic heart failure is the cause of hospitalization of every fifth cardiological patient. Number of patients with heart failure symptoms that have preserved or intermediate left ventricle ejection fraction increases, i.e. grows portion of diastolic heart failure grows. Gray scale myocardial strain techniques provide an opportunity to detect myocardial dysfunction on early stages when absence of clinically significant symptoms are absent and conventional echocardiography is not informative. The goal of this study is to review parameters of myocardial strain and its clinical applicability in patients with chronic heart failure.


Assuntos
Insuficiência Cardíaca Diastólica , Insuficiência Cardíaca , Disfunção Ventricular Esquerda , Doença Crônica , Ecocardiografia , Humanos , Volume Sistólico , Função Ventricular Esquerda
18.
Medicine (Baltimore) ; 98(33): e16630, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415356

RESUMO

BACKGROUND: Asthma is a chronic inflammatory disease characterized by recurrent attacks of breathlessness and wheezing, which often worsen at night or in the early morning and vary from person to person in severity and frequency. Chuankezhi injection (CKZ), as a new Chinese medicine, was recently found to have a good clinical effect on asthma. Whereas neither systematic nor meta-analysis of randomized controlled trials (RCTs) explain the efficacy of CKZ in treating asthma. Therefore, we provide a protocol to evaluate the efficacy and safety of CKZ for asthma. METHODS: From inception until April 2019, a systematic and comprehensive literature search will be conducted in both 4 Chinese databases and 3 English databases. RCTs will be included related to CKZ for asthma. We will assess the quality of the included trials in accordance with the risk of bias tools in Cochrane manual 5.1.0. We will use the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method to assess the certainty of the estimated evidence. Data analysis will be performed using the STATA 15.0. RESULTS: This systematic review aims to assess the effectiveness and safety of CKZ for the treatment of asthma, in order to provide evidence for the clinical practice of Chinese medicine. This protocol will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. The results of this meta-analysis will be submitted to a peer-reviewed journal once it is completed. CONCLUSION: The consequence of this study will furnish proof to evaluate if CKZ is effective in the treatment of asthma. PROSPERO REGISTRATION NUMBER: ROSPERO CRD42019134458.


Assuntos
Asma/tratamento farmacológico , Medicamentos de Ervas Chinesas/administração & dosagem , Adulto , Doença Crônica , Feminino , Humanos , Injeções , Masculino , Metanálise como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
19.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46684

RESUMO

Pesquisa do Ministério da Saúde mostra que número de obesos no país aumentou 67,8% entre 2006 e 2018. Ao mesmo tempo, a população passou a adquirir hábitos mais saudáveis


Assuntos
Obesidade , Comportamento Sedentário , Comportamento Alimentar , Doença Crônica
20.
Medicine (Baltimore) ; 98(26): e16217, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261576

RESUMO

BACKGROUND: Athletes with chronic ankle instability (CAI) often develop complications such as pain, instability, and reduced postural control and balance stability, all of which affect athletic performance. This study investigated the effects of a 4° medal wedge intervention on static and dynamic balance in athletes with CAI. METHODS: The participants were 24 healthy and 25 CAI athletes. Participants received a 4° medial wedge applied at the rear foot insole and completed the experiment measurements before and after the wedge intervention. The main outcome measures included the area and path length of the center of pressure when participants performed single-leg standing balance in the closed eye condition and the dynamic balance scores of a multiple single-leg hop stabilization test. RESULTS: The single-leg standing balance significantly improved in CAI (P = .027) and control groups (P = .005) after the medial wedge intervention. The dynamic balance scores significantly decreased from 53.00 ±â€Š25.22 to 41.24 ±â€Š21 48 (P = .015) in CAI group after medial wedge intervention. CONCLUSION: Wearing a 4° medial wedge applied at the rear foot insole improved static and dynamic balance immediately in athletes with CAI. We suggest that clinicians may provide the foot insole to improve balance deficit in athletes having CAI.


Assuntos
Articulação do Tornozelo , Traumatismos em Atletas/terapia , Órtoses do Pé , Instabilidade Articular/terapia , Transtornos das Sensações/terapia , Traumatismos em Atletas/complicações , Doença Crônica , Desenho de Equipamento , Feminino , Calcanhar , Humanos , Instabilidade Articular/complicações , Masculino , Transtornos das Sensações/etiologia , Resultado do Tratamento , Adulto Jovem
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