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2.
Adv Exp Med Biol ; 1121: 41-55, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31392651

RESUMO

AIM: The 14 years' Prevention Education Program PEP was started 1994 among first graders, their siblings and parents living in the half million city Nuremberg (Germany). The aim of prospective family-based observational study was early detection and lifestyle intervention of traditional cardiovascular risk factors. SUBJECTS AND METHODS: Out of 3370 families 24,927 adults and 23,740 children participated in the PEP Family Heart study. Anthropometric parameters including blood pressure and fasting lipids were measured. Because these variables change specifically because of natural growth and development in 3-18 years old children we had to calculate age-and gender-specific growth curves using the LMS method. Non-overweight (normal weight) is defined as BMI < 85th percentile (pctl), overweight as BMI 85th to <95th percentile, obesity as BMI ≥ 95th percentile and severe obesity as ≥ 120% of the 95th pctl. Prehypertension is categorized as the ≥90th to <95th pctl or ≥120/80 mm Hg and hypertension as ≥95th pctl on ≥3 occasions. MAIN RESULTS: 1. Cardiovascular risk (CVD) factor screening in school children predicted CVD risk in parents. 2. The growths curves for auscultatory systolic (SBP) and diastolic (DBP) blood pressure of non-overweight 8713 boys and 8138 girls nearly identical with the percentile curves of all 11,328 boys and 10,723 girls. 3. The shapes of the 10 lipid percentile curves between the 3rd and 97th pctl differ considerably by age and gender. 4. The wais-to-height ratio (WHtR) percentiles as a measure for abdominal adiposity vary substantially by age and gender 5. Among overweight and obese ≥85th pctl the percentile curves of body fat increase steeply until age 10 years and then decrease slowly in boys whereas the BF% percentile curves in girls increase continuously until age 18 years 6. The prevalence of hypertension increased strongly in severe obesity at the 99th pctl, more steeply beyond 120% of the 95th pctl to 59.1% in boys and 56% in girls. 7. The association between hypertension and normal weight, overweight and obesity increased in boys from 0,5, via 2,7 to 4,3 and in girls from 0,4 via 2,1 to 5,9. 8. Between 2000 and 2007 mean blood pressure decreased from 138.3 ± 18.5 mm Hg to 124.0 ± 13.8 mm Hg in fathers and from 119.1 ± 2.8 mm Hg to 110.4 ± 11.2 mm Hg in mothers. 9. After 1 year weighed dietary protocols demonstrate in 166 fathers a decrease of all six nutrional components like daily energy consumption from 2423 to 2307 Kcal, from 98 g to 91 g fat, from 260 g to 252 g carbohydrates, from 88 g to 84 g protein, cholesterol from 362 mg to 339 mg and alcohol from 19 g to 17 g per day and in 237 mothers from 1915 Kcal to 1830 Kcal, from 79 g to 73 g total fat, from 216 g to 212 g carbohydrates, from 66 g to 64 g protein, from 299 g to 244 mg cholesterol. 10. Sustained intensive individual and family-based lifestyle counseling in daily life in terms of healthy diet, less sedentary behavior and more leisure time physical activity slightly improved the CVD risk factor profiles in parents and their children already after 1 year.


Assuntos
Doenças Cardiovasculares , Dieta , Estilo de Vida , Adolescente , Adulto , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Criança , Pré-Escolar , Exercício , Família , Feminino , Alemanha , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco
3.
Rev Col Bras Cir ; 46(3): e20192180, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389525

RESUMO

OBJECTIVE: to characterize the profile of potential and effective organ donors, and to identify the factors related to non-donation. METHODS: the data was collected from the Organization of Organ Donation forms during the period of January 2013 to April 2018. The statistical analysis was done by the Biostatistic Service of the School of Medical Sciences of UNICAMP. RESULTS: the study analyzed 1,772 potential donors; the male gender was predominant (57.39%). Vascular injuries (n=996) were the main cause of brain death. The family refusal (42.8%) was the leading cause of non-donation of organs. There was statistical difference between donors and non-donors in regard to the mean age and mean systolic blood pressure. There was also a relationship between the donation of organs and the absence of diabetes and smoking. CONCLUSION: the majority of effective organ donors were young males. The main causes of brain death (BD) and family refusal of organ donation were cerebrovascular disorder and no desire to donate organs after death, respectively. Alcoholics and males were more frequently found in traumatic causes of BD. Therefore, initiatives for population awareness and discussion among the families regarding organ donation can lead to increase the number of effective organ donors.


Assuntos
Família , Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Adulto , Idoso , Morte Encefálica , Causas de Morte , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade
5.
Stud Health Technol Inform ; 266: 70-75, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31397304

RESUMO

A healthy and active lifestyle can significantly improve the well-being and quality of life; however, some elderly people struggle to stay motivated and engaged with any form of exercise. The project Elaine (Elderly, AI and New Experiences) addresses this problem by seeking to improve the quality of life of the elderly through exergames. Currently, the project explores a novel approach in the field of health informatics called asynchronous exergaming. This approach, a new trend in games in the health domain, allows the elderly to workout at their own pace, and in their own time, with their physical activity linked asynchronously to a game. This paper presents the study protocol for Solitaire Fitness, a new asynchronous exergame developed by the team. The game aims at increasing the motivation of the elderly to engage in physical exercise whilst helping to maintain their cognitive abilities. It also describes the protocol for the trial. The result of this research has the potential to benefit elderly that need nudging to be motivated to exercise, health care providers treating people with sedentary lifestyles and researchers investigating ways to encourage the elderly to exercise.


Assuntos
Exercício , Jogos de Vídeo , Idoso , Envelhecimento , Humanos , Estilo de Vida , Qualidade de Vida , Comportamento Sedentário
6.
Arq Gastroenterol ; 56(2): 202-208, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31460587

RESUMO

BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal diseases. GERD generates significant impairment in patients' quality of life and it is associated to relevant medical resources utilization. A better understanding of GERD pathophysiology in the past five decades has favored the evolution of therapeutic strategies from non-drug interventions and antacids to more efficacious and safer alternatives. OBJECTIVE: To summarize data about the historical evolution of GERD management in Brazil, focusing on medical therapy and addressing evidence on efficacy and safety of drug classes currently recommended. METHODS: A narrative review was conducted by systematizing information about discoveries on GERD pathophysiology. We also addressed efficacy and safety of medications currently used to reduce symptoms and improve endoscopic healing of esophageal lesions. A structured search on Pubmed was performed to identify systematic reviews and meta-analysis investigating GERD outcomes positively impacted by proton pump inhibitors (PPIs), the first choice of pharmacotherapy for the disease. RESULTS: The chronological development of therapeutic measures for GERD in Brazil evolved from lifestyle interventions with relative poor effect on symptoms related to esophageal acid exposure, particularly heartburn, to effective and safe pharmacological interventions such as histamine H2-receptor antagonists and PPIs. In the present days, some drug classes play a minor role in disease management, namely prokinetics and antacids, due to their reduced efficacy and relevant safety concerns (particularly with prokinetics). The main challenge for prescribers and researchers seems to be finding long-acting acid suppressants strategies able to ameliorate patients' symptoms and quality of life, thereafter, reducing medical resource consumption. The dual delayed-release PPI dexlansoprazole seems to respond for some of the limitations other PPIs have. CONCLUSION: Recognizing the historical evolution of GERD management can help care providers to better understand therapeutic options for their patients, as well as focus on unmet needs that deserve further attention. PPIs are still the first choice therapy, with good evidence in favor of their efficacy, despite some safety concerns. However, as with any medical intervention, it is recommended to prescribe PPIs for patients with clear indication, using adequate dosing and monitoring for adverse events.


Assuntos
Terapia Comportamental/métodos , Medicina Baseada em Evidências , Refluxo Gastroesofágico/terapia , Estilo de Vida , Antiácidos/uso terapêutico , Antieméticos/uso terapêutico , Antagonistas dos Receptores Histamínicos H2/uso terapêutico , Humanos , Inibidores da Bomba de Prótons/uso terapêutico
8.
S D Med ; 72(4): 168-173, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31436930

RESUMO

BACKGROUND: Obesity prevalence is higher among rural populations than urban, including youth. Reduced physical activity levels are associated with childhood obesity. It could be assumed that the obesity disparity between rural and urban children is attributable, in part, to differences in physical activity levels; however, previous research quantifying and comparing physical activity levels between rural and urban youth are mixed. Lifestyle may be more important than geographic location in determining physical activity levels. Therefore, the objective of this study was to compare sex and lifestyle group (Hutterite vs. non-Hutterite) differences in physical activity in a free-living, rural pediatric population. METHODS: Youth (n=58) were instructed to wear accelerometers for seven days. Mean percent time in light, moderate or vigorous activity during waking hours was calculated. Two-way ANOVAs and multiple regression models were used for analyses. RESULTS: Percent time in vigorous activity was significantly greater for Hutterite males than Hutterite females, and Hutterite males had greater percent time in vigorous activity and moderate plus vigorous activity than non-Hutterite males. CONCLUSIONS: There is evidence to support differences in rural lifestyles to be associated with differences in physical activity levels between children living in the same geographic location, particularly among males. Active transportation and having a safe environment for unstructured outdoor play may account for activity and lifestyle differences between the two rural groups.


Assuntos
Estilo de Vida , Obesidade Pediátrica , População Rural , Adolescente , Criança , Exercício , Feminino , Humanos , Masculino , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Prevalência , População Rural/estatística & dados numéricos , População Urbana
9.
Implement Sci ; 14(1): 81, 2019 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412894

RESUMO

BACKGROUND: The National Diabetes Prevention Program (National DPP) is rapidly expanding in an effort to help those at high risk of type 2 diabetes prevent or delay the disease. In 2012, the Centers for Disease Control and Prevention funded six national organizations to scale and sustain multistate delivery of the National DPP lifestyle change intervention (LCI). This study aims to describe reach, adoption, and maintenance during the 4-year funding period and to assess associations between site-level factors and program effectiveness regarding participant attendance and participation duration. METHODS: The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation from October 2012 to September 2016. Multilevel linear regressions were used to examine associations between participant-level demographics and site-level strategies and number of sessions attended, attendance in months 7-12, and duration of participation. RESULTS: The six funded national organizations increased the number of participating sites from 68 in 2012 to 164 by 2016 across 38 states and enrolled 14,876 eligible participants. By September 2016, coverage for the National DPP LCI was secured for 42 private insurers and 7 public payers. Nearly 200 employers were recruited to offer the LCI on site to their employees. Site-level strategies significantly associated with higher overall attendance, attendance in months 7-12, and longer participation duration included using self-referral or word of mouth as a recruitment strategy, providing non-monetary incentives for participation, and using cultural adaptations to address participants' needs. Sites receiving referrals from healthcare providers or health systems also had higher attendance in months 7-12 and longer participation duration. At the participant level, better outcomes were achieved among those aged 65+ (vs. 18-44 or 45-64), those who were overweight (vs. obesity), those who were non-Hispanic white (vs. non-Hispanic black or multiracial/other races), and those eligible based on a blood test or history of gestational diabetes mellitus (vs. screening positive on a risk test). CONCLUSIONS: In a time of rapid dissemination of the National DPP LCI the findings of this evaluation can be used to enhance program implementation and translate lessons learned to similar organizations and settings.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Promoção da Saúde/organização & administração , Centers for Disease Control and Prevention (U.S.) , Guias como Assunto , Promoção da Saúde/economia , Humanos , Ciência da Implementação , Estilo de Vida , Avaliação de Programas e Projetos de Saúde , Estados Unidos
10.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 1025-1030, jul.-set. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005844

RESUMO

Objetivo: Descrever as condições do estilo de vida e riscos à saúde de um grupo de adolescentes e jovens participantes de um Núcleo de Atenção à Saúde do Adolescente (NASA). Métodos: Estudo descritivo de abordagem qualitativa realizado com 13 adolescentes e jovens cadastrados no NASA de um município da Baixada Litorânea do estado do Rio de Janeiro, por meio de questionários padronizados autoaplicáveis. Resultados: Foram identificados hábitos alimentares inadequados; precocidade das relações sexuais e uso irregular de preservativo; ausência de atividade física e situações constrangedoras vivenciadas na escola. Conclusão: O estudo aponta situações de riscos à saúde que demandam estratégias preventivas, sobretudo de promoção da saúde. Faz-se necessária a implementação de ações intersetoriais locais voltadas para a redução de vulnerabilidades com ênfase nos eixos temáticas de alimentação, sexualidade, atividade física, prevenção da violência e cultura da paz


Introduction: The occurrence of transmissible and non-communicable diseases related to lifestyle has acquired relevance in the juvenile phase. The objective was to describe aspects of the lifestyle of participants of a Teen Health Care Center. Materials and methods: Descriptive study of qualitative approach carried out with 13 adolescents and young people registered in the Adolescent Health Care Center of a city of Baixada Litorânea, state of Rio de Janeiro, Brazil, using standardized self-administered questionnaires. Results: Inappropriate eating habits; Precocity of the onset of sexual intercourse and irregular use of condoms; Absence of regular physical activity and embarrassing situations experienced at school were identified. Discussion: The commitment in these aspects of lifestyle indicates that there are situations of health risks that demand new preventive strategies besides the educational actions with the young public. Conclusions: There is a need for planning and implementation of local intersectoral actions at primary and secondary health care levels aimed at reducing youth vulnerabilities on inadequate feeding, sexual precocity, irregular physical activity and school violence


Introducción: La aparición de las enfermedades transmisibles y no transmisibles relacionadas con el estilo de vida ha obtenido relevancia en la fase juvenil. El objetivo fue describir aspectos del estilo de vida de participantes de un Núcleo de Atención a la Salud del Adolescente. Materiales y métodos: Estudio descriptivo del abordaje cualitativo realizado con 13 adolescentes y jóvenes registrados en el Núcleo de Atención a la Salud del Adolescente de un municipio de la Baixada Litoral del estado de Río de Janeiro, Brasil, por medio de cuestionarios estandarizados autoaplicables. Resultados: Se identificaron hábitos alimenticios inadecuados; Precocidad del inicio de las relaciones sexuales y uso irregular de preservativo; Ausencia de actividad física regular y situaciones embarazosas vivenciadas en la escuela. Discusión: El compromiso en estos aspectos del estilo de vida apunta que existen situaciones de riesgos a la salud que demandan nuevas estrategias preventivas además de las acciones educativas con el público joven. Conclusiones: Hay necesidad de planificación y realización de acciones intersectoriales locales en niveles de atención primaria y secundaria en salud que estén dirigidas a reducir las vulnerabilidades juveniles sobre alimentación inadecuada, precocidad sexual, actividad física irregular y violencia escolar


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Fatores de Risco , Saúde do Adolescente , Estilo de Vida , Comportamento Sexual , Drogas Ilícitas , Higiene/educação , Comportamento Alimentar , Promoção da Saúde
11.
Einstein (Sao Paulo) ; 17(3): eAO4619, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31271609

RESUMO

OBJECTIVE: To determine sociodemographic characteristics, lifestyle perception and physical activity levels in obese prebariatric surgery patients. METHODS: A quantitative, cross-sectional study. The sample comprised 96 male and female morbidly obese prebariatric surgery patients. Questionnaires addressing sociodemographic profile, lifestyle perception and physical activity levels were applied. RESULTS: Patients were aged 40.3±11.45 years. Inadequate levels of physical activity were reported by 47.8% of patients; most respondents (79.2%) attributed scores defined as inadequate to the physical activity domain of the lifestyle questionnaire. Time spent on physical activity practice per week differed significantly between patients reporting being physically active or physically inactive in adolescence (p=0.046). CONCLUSION: Most obese prebariatric surgery patients perceive their lifestyle as inadequate, in spite of eligibility for bariatric surgery. Results also indicate that physical activity practice and nutrition are the domains with greatest impacts on patient lifestyle, and that physical activity practice in adolescence may contribute to adoption of a more active behavior in adulthood, which may represent a vital tool for health promotion in patients undergoing bariatric surgery.


Assuntos
Cirurgia Bariátrica , Exercício/fisiologia , Estilo de Vida , Atividade Motora/fisiologia , Obesidade Mórbida/cirurgia , Cuidados Pré-Operatórios/estatística & dados numéricos , Adulto , Índice de Massa Corporal , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autoimagem , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
12.
Medicine (Baltimore) ; 98(26): e16060, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261513

RESUMO

The purpose of this study was to investigate the association between objectively-measured lifestyle factors and health factors in patients with knee osteoarthritis (OA).In this cross-sectional study, 52 patients with knee OA were examined. Lifestyle factors were measured using a wearable smartwatch (step counts, walking distance, calorie consumption, sleep hours) and by self-report (eating speed). Body mass index (BMI), waist circumference, blood pressure, muscle strength of knee extensor and hip abductor, knee pain, symptoms, daily living function, sports recreation function, quality of life by knee injury and OA outcome score (KOOS) were measured to obtain data on health factors. Correlations and regression analysis were used to analyze the relationship between lifestyle factors and health factors.KOOS subscales (pain, symptom, daily living function) and hip abductor strength were positively correlated with daily step count, which was the only independently contributing lifestyle factor. Additionally, knee pain duration and diastolic blood pressure were negatively correlated with daily step count. BMI and waist circumference showed no correlation with physical activity data, but were negatively correlated with sleep duration and eating speed.The findings of this study contribute to expanding the knowledge on how lifestyle habits of older patients with knee OA contribute to their health status. Daily step counts were associated with knee OA-related pain, symptom, function in daily living, duration of knee pain, blood pressure, and strength of hip abductor. BMI and waist circumference were associated with sleep duration and eating speed.


Assuntos
Nível de Saúde , Estilo de Vida , Osteoartrite do Joelho/epidemiologia , Acelerometria , Idoso , Artralgia/epidemiologia , Artralgia/etiologia , Artralgia/fisiopatologia , Pressão Sanguínea , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Exercício , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Sono , Circunferência da Cintura
13.
Expert Opin Drug Saf ; 18(9): 829-840, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31304808

RESUMO

Introduction: Efficient antiretroviral-treatment (ART) generally allows control of HIV infection. However, persons-living-with-HIV (PLWH), when aging, present a high prevalence of metabolic diseases. Area covered: Altered adiposity, dyslipidemias, insulin resistance, diabetes, and their consequences are prevalent in PLWH and could be partly related to ART. Expert opinion: At first, personal and lifestyle factors are involved in the onset of these complications. The persistence of HIV in tissue reservoirs could synergize with some ART and enhance metabolic disorders. Altered fat repartition, diagnosed as lipodystrophy, has been related to first-generation nucleoside-reverse-transcriptase-inhibitors (NRTIs) (stavudine zidovudine) and some protease inhibitors (PIs). Recently, use of some integrase-inhibitors (INSTI) resulted in weight/fat gain, which represents a worrisome unresolved situation. Lipid parameters were affected by some first-generation NRTIs, non-NRTIs (efavirenz) but also PIs boosted by ritonavir, with increased total and LDL-cholesterol and triglycerides. Insulin resistance is common associated with abdominal obesity. Diabetes incidence, high with first-generation-ART (zidovudine, stavudine, didanosine, indinavir) has declined with contemporary ART close to that of the general population. Metabolic syndrome, a dysmetabolic situation with central obesity and insulin resistance, and liver steatosis are common in PLWH and could indirectly result from ART-associated fat gain and insulin resistance. All these dysmetabolic situations increase the atherogenic cardiovascular risk.


Assuntos
Fármacos Anti-HIV/efeitos adversos , Infecções por HIV/tratamento farmacológico , Doenças Metabólicas/induzido quimicamente , Tecido Adiposo/efeitos dos fármacos , Fármacos Anti-HIV/administração & dosagem , Dislipidemias/induzido quimicamente , Dislipidemias/epidemiologia , Glucose/metabolismo , Humanos , Estilo de Vida , Metabolismo dos Lipídeos/efeitos dos fármacos , Doenças Metabólicas/epidemiologia , Fatores de Risco
14.
Stud Health Technol Inform ; 262: 360-363, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349342

RESUMO

This paper presents a mid-fidelity prototype of a mobile application for self-management of the chronic disease Multiple Sclerosis (MS). The study focuses on newly diagnosed young Norwegians with MS and wants to deliver IT solutions for a healthier lifestyle. An analysis of a social media platform, interview with medical staff, a social media focus group interview and one case study where utilized to gather data alongside with design iterations. A high-fidelity prototype is being implemented with main functionalities: health, training, patient notes for next medical appointment, disease related life and work issues, and a reward point system.


Assuntos
Aplicativos Móveis , Esclerose Múltipla , Autogestão , Humanos , Estilo de Vida , Esclerose Múltipla/terapia , Noruega , Adulto Jovem
15.
Artigo em Chinês | MEDLINE | ID: mdl-31327189

RESUMO

Objective:The aim of this study is to investigate the predisposing factors and the effect of healthy education on recurrence of vestibular migraine (VM), so as to provide a scientific basis for increasing the knowledge rate and reducing the recurrence rate of VM patients. Method: Questionnaires, memory diary, regular follow-up, etc. were used to understand the possible predisposing factors of VM patients. Self-assessment depression scale (SDS) and self-assessment anxiety scale (SAS) were used to evaluate patients' mental and psychological status, and visual analogue scale (VAS) was used to evaluate the severity of vertigo. Health education was conducted for VM patients through face-to-face consultation, material distribution, modern multimedia and other methods. The knowledge rate, anxiety and fear psychological state, recurrence frequency of vertigo, duration and severity of vertigo were compared before and after the healthy education. Result:Of 103 cases of the object of study, 100 patients (97.1%) with different degree of sleep disorders, 96 cases (93.2%) had a clear family history with vertigo or dizziness headache, 90 cases (87.4%) had history of motion sickness, 90 cases (87.4%) had confined space history of intolerance, 82 cases (79.6%), recurrent cause psychological anxiety, fear, 80 cases (77.7%), lack of exercise, 79 cases (76.7%) under pressure from life or work, 53 (51.5%) had food preference, 8 cases (7.8%) think much rain attacks more frequent when humid climate,seven (6.8%) reported more episodes during the spring or spring/summer exchanges.After health education, patients were followed up for 6 months to 2 years with a median of 15 months, and their knowledge rate of VM was increased from 12.6% (13 cases) to 98% (101 cases).The psychological ratio of anxiety and fear decreased from 79.6% (82 cases) to 7.8% (8 cases).The SAS score decreased from 47.9±4.4 to 45.5±4.2, and the SDS score decreased from 39.7±3.6 to 38.2±3.8.The unhealthy lifestyle and eating habits (lack of exercise, stress, and eating preferences at least 1 item)decreased from 89.4% (92 cases) to 32.1% (33 cases).The recurrence rate of 83.5% (86 cases) of the patients was reduced by 1 time or more, and the rate of no recurrence increased from 1% (1 case) to 15.5% (16 cases) within half a year.The duration of the attack was reduced by 20% or more in 48.5%(50 cases),The mean duration of the attack declined from (17.4±1.4) hours before healthy education to (10.5±0.9) hours after healthy education.The VAS score of 86.4%(89 cases) with recurrence severity decreased by 2 points or more. The average VAS score before and after education was (6.6±0.1) points and (4.5±0.1) points respectively.The above differences were statistically significant (P<0.01) compared with those before and after education.Conclusion: Sleep disorder, airtight space intolerance, excessive stress, lack of exercise, and dietary preference may be related factors to trigger VM attacks. Healthy education can significantly improve the awareness of VMs, and promote patients to change their lifestyle and eating habits. It can significantly improve patients' anxiety and fear psychological state, reduce the frequency of attack, shorten the duration of attack, and reduce the severity of selfassessment, which is worthy of clinical promotion.


Assuntos
Transtornos de Enxaqueca/prevenção & controle , Educação de Pacientes como Assunto , Ansiedade , Tontura/prevenção & controle , Humanos , Estilo de Vida , Fatores de Risco , Vertigem/prevenção & controle
16.
Medicine (Baltimore) ; 98(30): e16446, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348246

RESUMO

BACKGROUND: The global prevalence of Irritable bowel syndrome (IBS) is estimated to be as high as 15% and a number of different non-pharmacological and pharmacological treatments have been used to manage IBS in clinical practice, which poses great challenges for clinicians to make appropriate decisions. Hence, a systematic review and network meta-analysis on all available pharmacological and non-pharmacological treatments for IBS is needed to provide reliable evidence. METHODS: We will search the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane IBD Group Specialized Trials Register, MEDLINE, EMBASE, and Chinese Biomedical medicine (CBM) from inception to 31, May 2019. Randomized controlled trials of pharmacological and nonpharmacological interventions for IBS will be included. Study quality will be assessed on the basis of the methodology and categories described in the Cochrane Collaboration Handbook. Primary outcomes are global or clinical improvement and quality of life. A Bayesian network meta-analysis would be performed, and relative ranking of agents would be assessed. A node splitting method will be used to examine the inconsistency between direct and indirect comparisons when a loop connecting 3 arms exists. RESULTS: Researchers will rank the effectiveness and safety of the potentials interventions for IBS according the characteristics of patients by conducting an advanced network meta-analysis based on Bayesian statistical model, and interpret the results by using GRADE approach. CONCLUSION: The conclusion of our study will provide updated evidence to rank the effectiveness and safety of pharmacological and non-pharmacological interventions for IBS. ETHICS AND DISSEMINATION: Ethical approval is not applicable since this study is a network meta-analysis based on published trials. PROTOCOL REGISTRATION NUMBER: CRD42018083844.


Assuntos
Terapias Complementares/métodos , Dieta , Fármacos Gastrointestinais/uso terapêutico , Síndrome do Intestino Irritável/terapia , Psicoterapia/métodos , Humanos , Estilo de Vida , Meta-Análise em Rede , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 657-660, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288333

RESUMO

Obesity, related cardiometabolic disorders (including high blood pressure, dyslipidemia and high fasting glucose etc.) and unhealthy lifestyles are now epidemic. These cardiovascular risk factors can track from childhood into adulthood, thereby increasing risk of cardiovascular disease in adulthood. Thus, it is important and necessary to establish children cohort study, to examine the effects of childhood cardiovascular risk factors on abnormal subclinical cardiovascular structure and function in adolescence and adulthood, then to take specific and effective measures for prevention, intervention and control. This will have important public health implications for the prevention of adult cardiovascular disease.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Criança , Estudos de Coortes , Humanos , Estilo de Vida , Obesidade/epidemiologia , Fatores de Risco
20.
Adv Exp Med Biol ; 1166: 47-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31301045

RESUMO

Compared to other cells, sperm undergo dramatic remodeling of their chromatin during late spermiogenesis in which approximately 95% of histones are removed and replaced with protamines. Despite this large-scale remodeling, key developmental genes, some miRNA genes, and imprinted genes retain their association with histone. The developmental genes have a unique epigenetic signature, termed bivalency, that poises the genes for embryonic activation. Anomalies in that epigenetic poising signature, either in the form of DNA methylation aberrations, improper protamination, or altered histone modifications, are associated with infertility and reduced embryogenesis capability. Additionally, some small noncoding RNAs are retained, while others are actively added to the sperm and appear to affect embryogenesis. Therefore, initial studies have begun to formulate pathways by which the sperm epigenome can be used as a diagnostic tool in the clinic. While in their infancy, these assays likely portend improved diagnostics and added information for patients and clinicians. Recent studies also highlight the possibility that the sperm epigenome can be used to evaluate lifestyle and environmental risks to the patient and potentially to the offspring.


Assuntos
Epigênese Genética , Técnicas de Reprodução Assistida , Espermatozoides , Cromatina/metabolismo , Meio Ambiente , Humanos , Estilo de Vida , Masculino , Fatores de Risco , Espermatogênese
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