Assessment of Self-Management Treatment Needs Among COPD Helpline Callers.

Telephone quitlines are an effective population-based strategy for smoking cessation, particularly among individuals with tobacco-related diseases such as chronic obstructive pulmonary disease (COPD). Expanding quitline services to provide COPD-focused self-management interventions is potentially beneficial; however, data are needed to identify specific treatment needs in this population. We conducted a telephone-based survey (N = 5,772) to examine educational needs, behavioral health characteristics, and disease-related interference among individuals with COPD who received services from the American Lung Association (ALA) Lung Helpline. Most participants (73.7%) were interested in COPD-focused information, and few had received prior instruction in breathing exercises (33.9%), energy conservation (26.5%), or airway clearing (32.1%). About one-third of participants engaged in regular exercise, 16.3% followed a special diet, and 81.4% were current smokers. Most participants (78.2%) reported COPD-related interference in daily activities and 30.8% had been hospitalized within the past six months for their breathing. Nearly half of participants (45.4%) reported current symptoms of anxiety or depression. Those with vs. without anxiety/depression had higher rates of COPD-related interference (83.9% vs. 73.5%, p < .001) and past six-month hospitalization (33.4% vs. 28.3%, p < .001). In conclusion, this survey identified strong interest in disease-focused education; a lack of prior instruction in specific self-management strategies for COPD; and behavioral health needs in the areas of exercise, diet, and smoking cessation. Anxiety and depression symptoms were common and associated with greater disease burden, underscoring the importance of addressing coping with negative emotions. Implications for self-management treatments that target multiple behavioral needs of COPD patients are discussed.

Metabolic Fate of Branched-Chain Amino Acids During Adipogenesis, in Adipocytes From Obese Mice and C2C12 Myotubes.

Branched-chain amino acid (BCAA) catabolism is regulated by the branched-chain aminotransferase (BCAT2) and the branched-chain α-keto acid dehydrogenase complex (BCKDH). BCAT2 and BCKDH expression and activity are modified during adipogenesis and altered in adipose tissues of mice with genetic or diet-induced obesity. However, little is known about how these modifications and alterations affect the intracellular metabolic fate of BCAAs during adipogenesis, in adipocytes from mice fed a control or high-fat diet or in C2C12 myotubes. Here, we demonstrate that BCAAs are mainly incorporated into proteins during the early stages of adipocyte differentiation. However, they are oxidized and incorporated into lipids during the late days of differentiation. Conversely, 92% and 97% of BCAA were oxidized, 1.6% and 6% were used for protein synthesis and 1.2% and 1.5% were incorporated into lipids in adipocytes from epididymal and subcutaneous adipose tissue, respectively. All three pathways were decreased in adipocytes from mice fed a high-fat diet. In C2C12 myotubes, leucine is mainly used for protein synthesis and palmitate is incorporated into lipids. Interestingly, leucine decreased both palmitate oxidation and its incorporation to lipids and proteins; and palmitate increased leucine oxidation and decreased its incorporation to lipids and proteins in a dose-dependent manner. These results demonstrate that BCAA metabolic fate differs between the early and late stages of adipocyte differentiation and in adipocytes from mice fed a control or high-fat diet; and that leucine affects the metabolic fate of palmitate and vice versa in C2C12 myotubes. J. Cell. Biochem. 118: 808-818, 2017. © 2016 Wiley Periodicals, Inc.

Multidisciplinary care meeting practices across diverse international settings.

PURPOSE: Multidisciplinary care (MDC) meetings improve the quality of cancer care by providing a space for interdisciplinary communication. The Pediatric Oncology Facility Integrated Local Evaluation (PrOFILE) tool assesses MDC meetings as part of the Service Integration module. We aimed to evaluate the characteristics of MDC meetings at institutions that completed PrOFILE. METHODS: From 2019 to 2021, 112 institutions from 23 countries collected data by utilizing the abbreviated version of PrOFILE. Within a secondary data analysis, we descriptively analyzed the characteristics of MDC meetings stratified by income level. RESULTS: Participating institutions were located in low-income countries (LICs) (n = 6), lower-middle-income countries (LMICs) (n = 34), upper-middle-income countries (UMICs) (n = 55), and high-income countries (HICs) (n = 17). Of the 112 participating facilities, 79% reported having MDC meetings. The existence of an MDC varied with income, with 50% of LICs and 100% of HICs hosting MDCs. The frequency of MDC meetings also differed, with 100% of MDCs in LICs occurring weekly, while 53% of MDCs in HICs occurred monthly. Specialties regularly represented at MDC meetings across all participating institutions were hematology/oncology (93%), pathology (52%), radiology (60%), general surgery (57%), and radiation oncology (51%). All MDC meetings in LICs reported representation from these specialties. Availability of test results and discussion of new cases did not vary with income. Residual disparities were identified for the following characteristics: discussion of new and interesting cases, inclusion of patient preferences, and ability to meet urgently. CONCLUSIONS: The existence and components of a functional MDC meeting may vary between countries' income levels. Variation in certain components, such as access to tests, may be due to differences in resource distribution, but other factors such as inclusion of patient preferences and ability to meet urgently can be optimized in all settings to foster high-quality teamwork and communication.

Outcomes of a mobile medical unit for low-threshold buprenorphine access targeting opioid overdose hot spots in Chicago.

INTRODUCTION: Opioid overdoses in Chicago are unevenly distributed, affecting medically underserved neighborhoods most acutely. Innovations in reaching patients perceived to be hard-to-reach (e.g., unstably housed, marginalized), especially in these underserved neighborhoods, are urgently needed to combat the overdose crisis. This study characterizes the pilot year of a mobile medical unit partnership between a large urban academic center and a community-based harm reduction organization in Chicago. METHODS: This is a retrospective cohort study of all patients who were seen on a mobile medical unit focused on providing low-threshold buprenorphine and primary care in areas with high opioid overdose rates on Chicago's West Side. Treatment episodes were accrued between July 1, 2021, and June 30, 2022 in the first year of operation. The main outcomes were number of patients seen, demographic characteristics of patients, and reason(s) for visit over time. RESULTS: The study saw 587 unique patients on the mobile medical unit between July 1, 2021, and June 30, 2022. Approximately 64.6 % were African American, and more than half lacked active insurance or could not confirm insurance status at the time of visit. The most common reason for initial visit was COVID-19 vaccination (42.4 %), and the most common reason for follow-up visit was buprenorphine treatment (51.0 %). Eleven patients initially presented for other health concerns and later returned to initiate buprenorphine. CONCLUSIONS: The mobile medical unit successfully reached nearly 600 patients in traditionally medically underserved Chicago neighborhoods with the highest overdose rates. The mobile unit's integrated approach met a variety of health needs, including buprenorphine initiation, with a unique opportunity for postoverdose initiation. Several patients initiated buprenorphine after presenting for different health concerns, showing the potential of an integrated approach to build on past mobile outreach programs and reach people with opioid use disorder who are not yet ready to initiate treatment.

Attitudes towards homosexual and lesbians among Puerto Rican Public Health graduate students.

The objective of this study is to identify the attitude toward the homosexuals and lesbians among graduate students of General Public Health and Health Education Program at School of Public Health, Medical Sciences Campus of the University of Puerto Rico. A descriptive-92 graduate students of the correlational design was used to carry out the study participated in the study General Public Health and Health Education programs. The data collection was collected through a self-administered questionnaire. Descriptive and inferential statistics (Chi-square and t-test student) were used to data analysis. The 82.6% of the participants had a prejudiced attitude toward the homosexuals and the lesbians. The 79.3% presented a low distance level. There is a significant association among the social distance, homosexual and lesbian educational exposure and the years of studies. To develop appropriate strategies to foment the acceptance and eliminate the prejudice toward the homosexuals and lesbians in the participants, what will impact in a better way of providing quality health services.

Proceso de consentimiento informado en cirugías programadas en un hospital militar / Informed consent process for scheduled surgeries in a military hospital

El objetivo de este trabajo fue identificar, en el proceso de consentimiento informado, los aspectos que intervinieron en la información y la decisión de operarse, específicamente en pacientes militares y civiles de ortopedia y cirugía general en el Hospital Militar Central de Bogotá, Colombia, entre octubre y diciembre de 2009. Se realizó un estudio de corte transversal, en el que se aplicaron 386 encuestas semiestructuradas a pacientes dados de alta. Se encontró que el 38.3% de los encuestados identificó el consentimiento informado como un único momento, relacionado con la “firma de un documento para autorizar la cirugía”. Además se halló que el grado militar del paciente estuvo asociado con dársele o no información acerca de la cirugía y del consentimiento informado. El respeto por los individuos resulta indiscutible y su reconocimiento está expreso en todas las leyes; con base en ello se plantea que el derecho al consentimiento informado está catalogado entre los más importantes Derechos Humanos. Se propone que durante el proceso de consentimiento informado el respeto por los militares enfermos y el reconocimiento de sus derechos y deberes, independientemente de su rango militar, promueva que la relación médico–paciente sea lo más ética posible.

Indicaciones para realizar extracciones seriadas en el tratamiento ortodóntico en dentición mixta. Investigación documental / Indications for serial extractions in orthodontic treatment in mixed dentition. Documentary research

La extracción seriada es un recurso necesario para prevenir anomalías causadas por la discrepancia entre el tamaño de los dientes y longitud del arco, durante la etapa de transición de dentición mixta a permanente. Las extracciones seriadas han sido criticadas a menudo como un mal procedimiento y en realidad sino se aplican correctamente pueden ser más nocivas que beneficiosas por lo cual es necesario iniciar la evaluación para su realización a través de un diagnóstico adecuado utilizando registros diagnósticos que permitan analizar el caso de cada paciente, asimismo es necesario mencionar en este apartado las diferentes indicaciones tanto generales como específicas y las contraindicaciones para realizar extracciones seriadas. Todo unido a una serie de fundamentos básicos para los cuales se indica su realización. Concluyendo que los pacientes en los cuales están indicado la realización de extracción seriada son: macrodoncia y micrognatismo ántero posterior y transversal, mesogresión de premolares y molares, la pérdida temprana o prematura de uno o ambos caninos con la resultante discrepancia de la línea media dentaria, erupción lingual de incisivos laterales, pérdida unilateral de canino deciduo y desplazamiento hacia el mismo lado, caninos que hacen erupción en sentido mesial sobre los incisivos laterales, Maloclusión clase I con protrusión dentoalveolar maxilar ­ mandibular, Maloclusión clase I con apiñamiento anterior severo con patrón facial ortognático y relación favorable overjet y overbite en los dientes incisivos, Maloclusión clase II con protrusión dentoalveolar del maxilar y Angulo gonial alto (hiperdivergente).

Serial extraction is a necessary resource to prevent anomalies caused by the discrepancy between tooth size and arch length, during the transition stage from mixed to permanent dentition. Serial extractions have often been criticized as a bad procedure and in reality, if not applied correctly, they can be more harmful than beneficial, which is why it is necessary to start the evaluation for its realization through an adequate diagnosis using diagnostic records that allow analyzing the case of each patient, it is also necessary to mention in this section the different general and specific indications and the contraindications for performing serial extractions. All together with a series of basic foundations for which its realization is indicated. Concluding that the patients in whom serial extraction is indicated are: anteroposterior and transverse macrodontia and micrognathism, mesogression of premolars and molars, early or premature loss of one or both canines with the resulting discrepancy of the dental midline, lingual eruption of lateral incisors, unilateral loss of deciduous canine and displacement to the same side, canines that erupt mesially over the lateral incisors, Class I malocclusion with maxillary-mandibular dentoalveolar protrusion, Class I malocclusion with severe anterior crowding with facial pattern orthognathic and favorable overjet and overbite relationship in incisor teeth, class II malocclusion with maxillary dentoalveolar protrusion and high gonial angle (hyperdivergent).

La investigación quirúrgica vista a través de los trabajos libres presentados en al XVII Congreso Nacional de Cirugía General en 1993 / Surgical research as analyzed through the free papaers presented at the XVII National Congress of General surgery. Mexico, in 1993

Objetivo. Evaluar la calidad de la investigación quirúrgica en México, mediante el análisis de los trabajos libres presentados en el XVII Congreso Nacional de Cirugía General en 1993 y compararla con los resultados de un análisis similar de los trabajos del Congreso de 1992. Diseño. Estudio retrospectivo, observacional, comparativo y descriptivo. Sede. Asociación Mexicana de Cirugía General. Material y métodos. Se revisaron los contenidos de los resúmenes de los 247 trabajos libres, analizándose las siguientes variables. procedencia del resumen: lugar e institución; tipo de la institución: estatal o privada; tipo de trabajo: clínico, quirúrgico o experimental; tipo de la investigación: prospectiva o retrospectiva, observacional o experimental; características de la investigación: con o sin grupo control, con o sin prueba estadística. Se emplearon los siguientes métodos estadísticos: diferencia de proporciones, Ji cuadrada e intervalo de confianza. Resultados. De los 247 trabajos libres, 169 (68.4 por ciento) procedían del Distrito Federal y 73 (29.5) de los estados, de ellos, Jalisco fue el mayor proveedor con 28. El Instituto Mexicano del Seguro Social (IMSS), la Secretaría de Salud (SS) y el Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), ocuparon los 3 primeros sitios como fuente de origen de los trabajos libres con los siguientes porcentajes: 32, 24 y 16 por ciento, respectivamente. El 47 por ciento (117 trabajos) correspondieron a una investigación de tipo encuesta descriptiva,l 12.4 por ciento (30 trabajos) a revisión de casos y sólo un 12.5 por ciento (31) fueron de tipo experimental. La proporción entre estudios descriptivos/estudios experimentales entre el D.F y los estados fue de 0.242 en el área metropolitana, de 0.31 en los estados, lo que dio una diferencia de proporciones de -0.07, con grado de libertad de 0.88 (N.S.) y un intervalo de confianza de -0.20 a 0.05. En 60 trabajos (24.3 por ciento) no se empleó ninguna prueba estadística; fue descriptiva en 180 (72.9 por ciento), en 24 (9 por ciento) se utilizaron otras pruevas como t de Student, Ji cuadrada, etc. Conclusión. La investigación quirúrgica en México continúa centralizada en el Distrito Federal, es realizada principalmente en instituciones estatales de salud, mayoritariamente retrospectivamente, descriptiva y observacional, sólo un 12 por ciento es de tipo experimental