27801
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Fat Intake Reduction Strategies among Children and Adults to Eliminate Obesity and Non-Communicable Diseases in the Eastern Mediterranean Region. CHILDREN-BASEL 2018; 5:children5070089. [PMID: 29966315 PMCID: PMC6069461 DOI: 10.3390/children5070089] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 06/20/2018] [Accepted: 06/23/2018] [Indexed: 01/11/2023]
Abstract
Non-communicable diseases (NCDs) are the leading cause of mortality globally with an estimated 39.5 million deaths per year (72% of total death) in 2016, due to the four major NCDs: cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. In the Eastern Mediterranean Region (EMR), almost 68% of all deaths are attributed to NCDs commonly known as chronic or lifestyle-related diseases. Two-thirds of NCD premature deaths are linked to 4 shared modifiable behavioral risk factors: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. These unhealthy behaviours lead to 4 key metabolic/biological changes; raised blood pressure, overweight/obesity, high blood glucose levels/diabetes, and hyperlipidemia (high levels of fat in the blood), that increase the risk of NCDs. Globally, countries are already working towards agreed global goals on maternal and infant nutrition and on the prevention of NCDs. In both fields the goals include halting the increase in overweight and obesity and reducing NCD diet-related risk factors including reducing saturated fatty acids (SFAs) and trans fatty acids (TFAs) intake. The objective of this review is to present an up-to-date overview of the current fat (SFAs and TFAs) intake reduction initiatives in countries of the Eastern Mediterranean Region (EMR) by highlighting national and regional programs, strategies and activities aiming at decreasing the intakes of dietary fat (SFA and TFA). The literature review shows that the average intake of SFA is estimated to be 10.3% of the total energy intake (EI), exceeding the WHO (World Health Organization) upper limit of 10%. The average TFA intake is estimated at 1.9% EI, which also exceeds the WHO upper limit of 1% EI. The highest SFAs intake was reported from Djibouti, Kuwait, Saudi-Arabia, Lebanon and Yemen, while the highest TFAs intakes were reported from Egypt and Pakistan. If countries of the EMR receive immediate public health attention, that toll of NCD-related morbidity and mortality would be considerably decreased through the implantation of evidence-based preventive interventions. In this context, reductions in SFAs and TFAs intakes have been highlighted as cost-effectives strategies that may hamper the growth of the NCD epidemic.
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27802
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Ho EC, Ong WMW, Li K, Zhang H, Bei YTE, Medapati SVR, Seneviratna A. Factors influencing degree of hearing loss at presentation, hearing aid choice, and usage in first time hearing aid users in Singapore. Int J Audiol 2018; 57:776-783. [DOI: 10.1080/14992027.2018.1476781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Eu Chin Ho
- Department of Otorhinolaryngology, Head & Neck Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Warren Ming Wu Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - KeXin Li
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - HanYu Zhang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yen Tze Eileen Bei
- Department of Otorhinolaryngology, Head & Neck Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Aruni Seneviratna
- Clinical Research Unit, Clinical Research & Innovation Office, Tan Tock Seng Hospital, Singapore
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27803
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Pulmonary hypertension: the unaddressed global health burden. THE LANCET RESPIRATORY MEDICINE 2018; 6:577-579. [PMID: 30072105 DOI: 10.1016/s2213-2600(18)30268-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 06/13/2018] [Indexed: 12/25/2022]
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27804
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French MD, Evans D, Fleming FM, Secor WE, Biritwum NK, Brooker SJ, Bustinduy A, Gouvras A, Kabatereine N, King CH, Rebollo Polo M, Reinhard-Rupp J, Rollinson D, Tchuem Tchuenté LA, Utzinger J, Waltz J, Zhang Y. Schistosomiasis in Africa: Improving strategies for long-term and sustainable morbidity control. PLoS Negl Trop Dis 2018; 12:e0006484. [PMID: 29953454 PMCID: PMC6023105 DOI: 10.1371/journal.pntd.0006484] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | - Darin Evans
- United States Agency for International Development, Washington, DC, United States of America
| | - Fiona M. Fleming
- Schistosomiasis Control Initiative, Imperial College London, London, United Kingdom
| | - W. Evan Secor
- Centers of Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nana-Kwadwo Biritwum
- Bill and Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Simon J. Brooker
- Bill and Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Amaya Bustinduy
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anouk Gouvras
- Global Schistosomiasis Alliance, London, United Kingdom
| | | | - Charles H. King
- Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Maria Rebollo Polo
- Expanded Special Program for Elimination of NTDs (ESPEN), World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | | | | | | | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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27805
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Moazeni-Roodi A, Hashemi M. Association between miR-124-1 rs531564 polymorphism and risk of cancer: An updated meta-analysis of case-control studies. EXCLI JOURNAL 2018; 17:608-619. [PMID: 30108465 PMCID: PMC6088220 DOI: 10.17179/excli2018-1419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 06/25/2018] [Indexed: 12/23/2022]
Abstract
Many studies examined the association between miR-124-1 rs531564 polymorphism and the risk of some human cancers, but the findings remain controversial. This update meta-analysis aimed to validate the association between rs531564 polymorphism of miR-124-1 and cancer risk. Eligible studies including 6,502 cancer cases and 7,213 controls were documented by searching Web of Science, PubMed, Scopus, and Google scholar databases. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were estimated to quantitatively evaluate the association between rs531564 variant and cancer risk. The results indicated that rs531564 variant significantly decreased the risk of cancer in homozygous codominant (OR=0.54, 95 % CI=0.43-0.69, p<0.00001, GG vs CC), dominant (OR=0.84, 95 % CI=0.72-0.99, p=0.03, CG+GG vs CC), recessive (OR=0.65, 95 % CI=0.54-0.78, p<0.00001, GG vs CG+CC), and allele (OR=0.84, 95 % CI=0.73-0.96, p=0.008, G vs C) genetic model. Stratified analysis by cancer type revealed that rs531564 variant was associated with gastric cancer, cervical cancer, esophageal squamous cell carcinoma and colorectal cancer risk. In summary, the findings of this meta-analysis support an association between miR-124-1 rs531564 polymorphism and cancer risk. Larger and well-designed studies are required to estimate this association in detail.
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Affiliation(s)
| | - Mohammad Hashemi
- Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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27806
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Chen Y, Michalak M, Agellon LB. Importance of Nutrients and Nutrient Metabolism on Human Health. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2018; 91:95-103. [PMID: 29955217 PMCID: PMC6020734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Nutrition transition, which includes a change from consumption of traditional to modern diets that feature high-energy density and low nutrient diversity, is associated with acquired metabolic syndromes. The human diet is comprised of diverse components which include both nutrients, supplying the raw materials that drive multiple metabolic processes in every cell of the body, and non-nutrients. These components and their metabolites can also regulate gene expression and cellular function via a variety of mechanisms. Some of these components are beneficial while others have toxic effects. Studies have found that persistent disturbance of nutrient metabolism and/or energy homeostasis, caused by either nutrient deficiency or excess, induces cellular stress leading to metabolic dysregulation and tissue damage, and eventually to development of acquired metabolic syndromes. It is now evident that metabolism is influenced by extrinsic factors (e.g., food, xenobiotics, environment), intrinsic factors (e.g., sex, age, gene variations) as well as host/microbiota interaction, that together modify the risk for developing various acquired metabolic diseases. It is also becoming apparent that intake of diets with low-energy density but high in nutrient diversity may be the key to promoting and maintaining optimal health.
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Affiliation(s)
- Yiheng Chen
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, Canada
| | - Marek Michalak
- Department of Biochemistry, University of Alberta, Edmonton, AB, Canada
| | - Luis B. Agellon
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, Canada,To whom all correspondence should be addressed:Luis B. Agellon, McGill University, School of Human Nutrition, 21111 Lakeshore Road, Ste. Anne de Bellevue, QC H9X 3V9 Canada; Tel: (514) 398-7862;
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27807
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Instability of personal human metabotype is linked to all-cause mortality. Sci Rep 2018; 8:9810. [PMID: 29955084 PMCID: PMC6023858 DOI: 10.1038/s41598-018-27958-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/13/2018] [Indexed: 12/17/2022] Open
Abstract
Disruption of metabolic homeostasis is an important factor in many diseases. Various metabolites have been linked to higher risk of morbidity and all-cause mortality using metabolomics in large population-based cohorts. In these studies, baseline metabolite levels were compared across subjects to identify associations with health outcomes, implying the existence of 'healthy' concentration ranges that are equally applicable to all individuals. Here, we focused on intra-individual changes in metabolite levels over time and their link to mortality, potentially allowing more personalized risk assessment. We analysed targeted metabolomics data for 134 blood metabolites from 1409 participants in the population-based CARLA cohort at baseline and after four years. Metabotypes of the majority of participants (59%) were extremely stable over time indicated by high correlation between the subjects' metabolite profiles at the two time points. Metabotype instability and, in particular, decrease of valine were associated with higher risk of all-cause mortality in 7.9 years of follow-up (hazard ratio (HR) = 1.5(95%CI = 1.0-2.3) and 0.2(95%CI = 0.1-0.3)) after multifactorial adjustment. Excluding deaths that occurred in the first year after metabolite profiling showed similar results (HR = 1.8(95%CI = 1.1-2.8)). Lower metabotype stability was also associated with incident cardiovascular disease (OR = 1.2(95%CI = 1.0-1.3)). Therefore, changes in the personal metabotype might be a valuable indicator of pre-clinical disease.
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27808
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Patton GC, Olsson CA, Skirbekk V, Saffery R, Wlodek ME, Azzopardi PS, Stonawski M, Rasmussen B, Spry E, Francis K, Bhutta ZA, Kassebaum NJ, Mokdad AH, Murray CJL, Prentice AM, Reavley N, Sheehan P, Sweeny K, Viner RM, Sawyer SM. Adolescence and the next generation. Nature 2018; 554:458-466. [PMID: 29469095 DOI: 10.1038/nature25759] [Citation(s) in RCA: 192] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/18/2018] [Indexed: 12/30/2022]
Abstract
Adolescent growth and social development shape the early development of offspring from preconception through to the post-partum period through distinct processes in males and females. At a time of great change in the forces shaping adolescence, including the timing of parenthood, investments in today's adolescents, the largest cohort in human history, will yield great dividends for future generations.
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Affiliation(s)
- George C Patton
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Craig A Olsson
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia.,Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria 3220, Australia
| | - Vegard Skirbekk
- Centre for Fertility and Health, Norwegian Institute of Public Health, Nydalen, Oslo 0403, Norway.,Columbia University, New York, New York 10032, USA
| | - Richard Saffery
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia
| | - Mary E Wlodek
- The University of Melbourne, Department of Physiology, Parkville, Victoria 3010, Australia
| | - Peter S Azzopardi
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Maternal and Child Health Program, International Development Discipline, Burnet Institute, Melbourne, Victoria 3004, Australia.,Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia 5000, Australia
| | - Marcin Stonawski
- Department of Demography, Cracow University of Economics, Cracow 31-510, Poland.,European Commission, Joint Research Centre, Centre for Advanced Studies, Ispra, Varese 21027, Italy
| | - Bruce Rasmussen
- Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, Victoria 3000, Australia
| | - Elizabeth Spry
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia.,Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria 3220, Australia
| | - Kate Francis
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Zulfiqar A Bhutta
- SickKids Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada.,Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Nicholas J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA.,Division of Pediatric Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, Washington 98105, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA
| | - Andrew M Prentice
- MRC Unit The Gambia, Fajara, Gambia.,MRC International Nutrition Group, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Nicola Reavley
- The University of Melbourne, Melbourne School of Population and Global Health, Parkville, Victoria 3010, Australia
| | - Peter Sheehan
- Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, Victoria 3000, Australia
| | - Kim Sweeny
- Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, Victoria 3000, Australia
| | - Russell M Viner
- UCL Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Susan M Sawyer
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
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27809
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Edmondson DG, Hu B, Norris SJ. Long-Term In Vitro Culture of the Syphilis Spirochete Treponema pallidum subsp. pallidum. mBio 2018; 9:e01153-18. [PMID: 29946052 PMCID: PMC6020297 DOI: 10.1128/mbio.01153-18] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 05/30/2018] [Indexed: 12/26/2022] Open
Abstract
Investigation of Treponema pallidum subsp. pallidum, the spirochete that causes syphilis, has been hindered by an inability to culture the organism continuously in vitro despite more than a century of effort. In this study, long-term logarithmic multiplication of T. pallidum was attained through subculture every 6 to 7 days and periodic feeding using a modified medium (T. pallidum culture medium 2 [TpCM-2]) with a previously described microaerobic, rabbit epithelial cell coincubation system. Currently, cultures have maintained continuous growth for over 6 months with full retention of viability as measured by motility and rabbit infectivity. This system has been applied successfully to the well-studied Nichols strain of T. pallidum, as well as to two recent syphilis isolates, UW231B and UW249B. Light microscopy and cryo-electron microscopy showed that in vitro-cultured T. pallidum retains wild-type morphology. Further refinement of this long-term subculture system is expected to facilitate study of the physiological, genetic, pathological, immunologic, and antimicrobial susceptibility properties of T. pallidum subsp. pallidum and closely related pathogenic Treponema species and subspecies.IMPORTANCE Syphilis, a sexually transmitted disease with a global distribution, is caused by a spiral-shaped bacterium called Treponema pallidum subspecies pallidum Previously, T. pallidum was one of the few major bacterial pathogens that had not been cultured long-term in vitro (in a test tube), greatly hindering efforts to better understand this organism and the disease that it causes. In this article, we report the successful long-term cultivation of T. pallidum in a tissue culture system, a finding that is likely to enhance our ability to obtain new information applicable to the diagnosis, treatment, and prevention of syphilis.
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Affiliation(s)
- Diane G Edmondson
- Department of Pathology and Laboratory Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Bo Hu
- Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Steven J Norris
- Department of Pathology and Laboratory Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
- Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
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27810
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Naish KR, Vedelago L, MacKillop J, Amlung M. Effects of neuromodulation on cognitive performance in individuals exhibiting addictive behaviour: a systematic review protocol. Syst Rev 2018; 7:90. [PMID: 29945682 PMCID: PMC6020343 DOI: 10.1186/s13643-018-0749-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 05/31/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Individuals with substance use and addictive disorders often display greater risk-taking behaviour, higher impulsivity, and altered reward processing compared to individuals without these disorders. While it is not known whether cognitive biases precede or result from addictive behaviour, they likely influence addiction-related decision-making, and may facilitate pathological behaviour. There is evidence that cognitive functions-including those shown to be altered in substance use and addictive disorders-can be influenced by neuromodulation techniques (specifically, transcranial direct current stimulation and transcranial magnetic stimulation). Much of this work has been conducted in healthy populations, however, making it unclear whether these methods can be used effectively to modulate cognitive functioning in individuals with substance use and addictive disorders. The purpose of the current review is to shed light on the potential effectiveness and feasibility of neuromodulation as a means to improve cognitive deficits in substance use disorders. METHODS The review will identify and evaluate studies that have examined the effects of transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS) on cognitive task performance in individuals with chronic substance use or dependence. Relevant studies will be identified through searches in PubMed, PsycINFO, Scopus, and Embase, and narrative review will be used to explore evidence that these techniques can be used successfully to modulate cognitive performance in populations exhibiting addictive behaviour. Assessing individual cognitive domains in turn (e.g. risk-taking, impulsivity, attention), we will critically evaluate the validity and reliability of relevant studies and draw conclusions about the strength of evidence for effective use of neuromodulation in that domain. This protocol is not yet registered with PROSPERO. DISCUSSION To determine whether neuromodulation holds promise as an effective treatment for neurocognitive deficits in substance use and addictive disorders, it is essential to look carefully at previous studies using this approach in addiction samples. This review will provide an objective and informative description of what is currently known about the efficacy of these techniques, shed light on the feasibility and potential challenges of using neuromodulation in individuals who exhibit addictive behaviour, and identify the most valuable next steps for future research.
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Affiliation(s)
- Katherine R. Naish
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton and McMaster University, 100 West 5th Street, Hamilton, Ontario L8P 3R2 Canada
| | - Lana Vedelago
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton and McMaster University, 100 West 5th Street, Hamilton, Ontario L8P 3R2 Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton and McMaster University, 100 West 5th Street, Hamilton, Ontario L8P 3R2 Canada
- Centre for Medicinal Cannabis Research, Michael G. DeGroote School of Medicine, McMaster University, L8S 4K1 Hamilton, Ontario Canada
- Department for Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th, L8N 3K7 Hamilton, Ontario Canada
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton and McMaster University, 100 West 5th Street, Hamilton, Ontario L8P 3R2 Canada
- Centre for Medicinal Cannabis Research, Michael G. DeGroote School of Medicine, McMaster University, L8S 4K1 Hamilton, Ontario Canada
- Department for Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th, L8N 3K7 Hamilton, Ontario Canada
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27811
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The Untapped Pharmacopeic Potential of Helminths. Trends Parasitol 2018; 34:828-842. [PMID: 29954660 DOI: 10.1016/j.pt.2018.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/29/2018] [Accepted: 05/31/2018] [Indexed: 02/06/2023]
Abstract
The dramatic rise in immunological disorders that occurs with socioeconomic development is associated with alterations in microbial colonization and reduced exposure to helminths. Excretory-secretory (E/S) helminth products contain a mixture of proteins and low-molecular-weight molecules representing the primary interface between parasite and host. Research has shown great pharmacopeic potential for helminth-derived products in animal disease models and even in clinical trials. Although in its infancy, the translation of worm-derived products into therapeutics is highly promising. Here, we focus on important key aspects in the development of immunomodulatory drugs, also highlighting novel approaches that hold great promise for future development of innovative research strategies.
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27812
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Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. MEDICINES 2018; 5:medicines5030063. [PMID: 29941854 PMCID: PMC6164863 DOI: 10.3390/medicines5030063] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/13/2018] [Accepted: 06/21/2018] [Indexed: 12/20/2022]
Abstract
Within the last 10 years, the percentage of low back pain (LBP) prevalence increased by 18%. The management and high cost of LBP put a tremendous burden on the healthcare system. Many risk factors have been identified, such as lifestyle, trauma, degeneration, postural impairment, and occupational related factors; however, as high as 95% of the cases of LBP are non-specific. Currently, LBP is treated pharmacologically. Approximately 25 to 30% of the patients develop serious side effects, such as drowsiness and drug addiction. Spinal surgery often does not result in a massive improvement of pain relief. Therefore, complementary approaches are being integrated into the rehabilitation programs. These include chiropractic therapy, physiotherapy, massage, exercise, herbal medicine and acupuncture. Acupuncture for LBP is one of the most commonly used non-pharmacological pain-relieving techniques. This is due to its low adverse effects and cost-effectiveness. Currently, many randomized controlled trials and clinical research studies have produced promising results. In this article, the causes and incidence of LBP on global health care are reviewed. The importance of treatment by acupuncture is considered. The efforts to reveal the link between acupuncture points and anatomical features and the neurological mechanisms that lead to acupuncture-induced analgesic effect are reviewed.
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27813
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Nafade V, Nash M, Huddart S, Pande T, Gebreselassie N, Lienhardt C, Pai M. A bibliometric analysis of tuberculosis research, 2007-2016. PLoS One 2018; 13:e0199706. [PMID: 29940004 PMCID: PMC6016906 DOI: 10.1371/journal.pone.0199706] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/12/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) research is a key component of the End TB Strategy. To track research output, we conducted a bibliometric analysis of TB research from the past decade. METHODS The Web of Science database was searched for publications from January 2007 to December 2016 with "tuberculosis" in the title. References were analysed using the R bibliometrix package. A year-stratified 5% random subset was drawn to extract funding sources and identify research areas. FINDINGS The annual growth rate of publications was 7.3%, and was highest (13.1%) among Brazil, Russia, India, China and South Africa (BRICS). The USA was the most productive country, with 18.4% of references, followed by India (9.7%), China (7.3%), England (6.5%), and South Africa (3.9%). In the subset analysis, the most common research area was 'fundamental research' (33.8%). Frequently acknowledged funders were US and EU-based, with China and India emerging as top funders. Collaborations appeared more frequently between high-income countries and low/medium income countries (LMICs), with fewer collaborations among LMICs. CONCLUSION The past decade has seen a continued increase in TB publications. While USA continues to dominate research output and funding, BRICS countries have emerged as major research producers and funders. Collaborations among BRICS would enhance future TB research productivity.
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Affiliation(s)
- Vaidehi Nafade
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- McGill International TB Centre, McGill University, Montreal, Canada
| | - Madlen Nash
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- McGill International TB Centre, McGill University, Montreal, Canada
| | - Sophie Huddart
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- McGill International TB Centre, McGill University, Montreal, Canada
| | - Tripti Pande
- McGill International TB Centre, McGill University, Montreal, Canada
| | | | | | - Madhukar Pai
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- McGill International TB Centre, McGill University, Montreal, Canada
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27814
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Probst C, Parry CDH, Wittchen HU, Rehm J. The socioeconomic profile of alcohol-attributable mortality in South Africa: a modelling study. BMC Med 2018; 16:97. [PMID: 29936909 PMCID: PMC6016129 DOI: 10.1186/s12916-018-1080-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 05/18/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Globally, illness and life expectancy follow a social gradient that puts people of lower socioeconomic status (SES) at higher risk of dying prematurely. Alcohol consumption has been shown to be a factor contributing to socioeconomic differences in mortality. However, little evidence is available from low- and middle-income countries. The objective of this study was to quantify mortality attributable to alcohol consumption in the adult (15+ years) general population of South Africa in 2015 by SES, age, and sex. METHODS A comparative risk assessment was performed using individual and aggregate data from South Africa and risk relations reported in the literature. Alcohol-attributable fractions (AAFs) and alcohol-attributable mortality rates were estimated for cause-specific mortality by SES, sex, and age. Monte Carlo simulation techniques were used to calculate 95% uncertainty intervals (UI). RESULTS Overall, approximately 62,300 (95% UI 27,000-103,000) adults died from alcohol-attributable causes in South Africa in 2015, with 60% of deaths occurring in people in the low and 15% in the high SES groups. Age-standardized, alcohol-attributable mortality rates per 100,000 adults were highest for the low SES group (727 deaths, 95% UI 354-1208 deaths) followed by the middle (377 deaths, 95% UI 165-687 deaths) and high SES groups (163 deaths, 95% UI 71-289 deaths). The socioeconomic differences were highest for mortality from infectious diseases. People of low SES had a lower prevalence of current alcohol use but heavier drinking patterns among current drinkers. Among men, AAFs were elevated at low and middle SES, particularly for the middle and higher age groups (35+). Among women, AAFs differed less across SES groups and, in the youngest age group (15-34), women of high SES had elevated AAFs. CONCLUSIONS Alcohol use contributed to vast socioeconomic differences in mortality. Where observed, elevated AAFs for people of low and middle SES arose from higher levels of consumption among current drinkers and not from the prevalence of current alcohol use per se. The findings can direct preventive measures and interventions on those at highest risk. Future research is needed to investigate socioeconomic differences in the risk functions relating alcohol use to cause-specific mortality.
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Affiliation(s)
- Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, M5S 2S1, Canada.
- Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, Tygerberg, 7505, South Africa
- Department of Psychiatry, Stellenbosch University, Cape Town, Tygerberg, 7505, South Africa
| | - Hans-Ulrich Wittchen
- Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Research Group Clinical Psychology and Psychotherapy, Psychiatric University Hospital, Ludwig-Maximilians-University, Nußbaumstraße 7, 80336, Munich, Germany
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, M5S 2S1, Canada
- Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Addiction Policy, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
- Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada
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27815
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Huang S, Li J, Wu Y, Ranjbar S, Xing A, Zhao H, Wang Y, Shearer GC, Bao L, Lichtenstein AH, Wu S, Gao X. Tea Consumption and Longitudinal Change in High-Density Lipoprotein Cholesterol Concentration in Chinese Adults. J Am Heart Assoc 2018; 7:JAHA.118.008814. [PMID: 29941658 PMCID: PMC6064891 DOI: 10.1161/jaha.118.008814] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background The relation between tea consumption and age‐related changes in high‐density lipoprotein cholesterol (HDL‐C) concentrations remains unclear, and longitudinal human data are limited. The aim of current study was to examine the relation between tea intake and longitudinal change in HDL‐C concentrations. Methods and Results Baseline (2006) tea consumption was assessed via a questionnaire, and plasma HDL‐C concentrations were measured in 2006, 2008, 2010, and 2012 among 80 182 individuals (49±12 years of age) who did not have cardiovascular diseases or cancer, or did not use cholesterol‐lowering agents both at baseline (2006) and during the follow‐up period (2006–2012). The associations between baseline tea consumption and rate of change in HDL‐C concentrations were examined using generalized estimating equation models. Tea consumption was inversely associated with a decreased rate of HDL‐C concentrations (P‐trend <0.0001) in the fully adjusted model. The adjusted mean difference in the HDL‐C decreased rate was 0.010 (95% confidence interval, 0.008, 0.012) mmol/L per year for tea consumers versus nonconsumers (never or less than once/month group). Interactions between tea consumption and age, sex, lifestyle scores, and metabolic syndrome (all P‐interaction <0.0001) were identified. The associations between greater tea consumption and slower decrease in HDL‐C concentrations were more pronounced in men, individuals aged 60 or older, individuals with a lower lifestyle score, and individuals with metabolic syndrome (all P‐trend <0.0001). Conclusions Tea consumption was associated with slower age‐related decreases in HDL‐C concentrations during 6 years of follow‐up. Clinical Trial Registration URL: http://www.chictr.org. Unique identifier: ChiCTR‐TNRC‐11001489.
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Affiliation(s)
- Shue Huang
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA
| | - Junjuan Li
- Department of Nephrology, Kailuan Hospital, Tangshan, China
| | - Yuntao Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Sareh Ranjbar
- Department of Agriculture, University of Kentucky, Lexington, KY
| | - Aijun Xing
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Haiyan Zhao
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Yanxiu Wang
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Gregory C Shearer
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA
| | - Le Bao
- Department of Statistics, The Pennsylvania State University, State College, PA
| | - Alice H Lichtenstein
- Jean Mayer U.S. Department of Agriculture (USDA) Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA
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27816
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Kaddoura T, Au A, Kawchuk G, Uwiera R, Fox R, Zemp R. Non-invasive spinal vibration testing using ultrafast ultrasound imaging: A new way to measure spine function. Sci Rep 2018; 8:9611. [PMID: 29941980 PMCID: PMC6018395 DOI: 10.1038/s41598-018-27816-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/11/2018] [Indexed: 11/17/2022] Open
Abstract
Ultrafast ultrasound imaging is used to capture driven spinal vibrations as a new method for non-invasive spinal testing in living subjects. Previously, it has been shown that accelerometer-based vibration testing in cadaveric models can reveal the presence, location and magnitude of spinal pathology. However, this process remains an invasive procedure as current non-invasive sensors are inadequate. In this paper, the ability of non-invasive ultrafast ultrasound to quantify in vivo vertebral vibration response across a broad range of frequencies (10–100Hz) in anesthetized pig models is investigated. Close agreement with invasive accelerometer measurements is achieved using the non-invasive ultrasound method, opening up unique opportunities to investigate spinal pathologies.
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Affiliation(s)
- Tarek Kaddoura
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Alberta, Canada.
| | - Anthony Au
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Greg Kawchuk
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Uwiera
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Fox
- Department of Agricultural, University of Alberta, Food and Nutritional Science, Edmonton, Alberta, Canada
| | - Roger Zemp
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Alberta, Canada
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27817
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Vinatier C, Domínguez E, Guicheux J, Caramés B. Role of the Inflammation-Autophagy-Senescence Integrative Network in Osteoarthritis. Front Physiol 2018; 9:706. [PMID: 29988615 PMCID: PMC6026810 DOI: 10.3389/fphys.2018.00706] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022] Open
Abstract
Osteoarthritis is the most common musculoskeletal disease causing chronic disability in adults. Studying cartilage aging, chondrocyte senescence, inflammation, and autophagy mechanisms have identified promising targets and pathways with clinical translatability potential. In this review, we highlight the most recent mechanistic and therapeutic preclinical models of aging with particular relevance in the context of articular cartilage and OA. Evidence supporting the role of metabolism, nuclear receptors and transcription factors, cell senescence, and circadian rhythms in the development of musculoskeletal system degeneration assure further translational efforts. This information might be useful not only to propose hypothesis and advanced models to study the molecular mechanisms underlying joint degeneration, but also to translate our knowledge into novel disease-modifying therapies for OA.
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Affiliation(s)
- Claire Vinatier
- INSERM, UMR 1229, Regenerative Medicine and Skeleton, University of Nantes, ONIRIS, Nantes, France.,University of Nantes, UFR Odontologie, Nantes, France
| | - Eduardo Domínguez
- Biofarma Research Group, Center for Research in Molecular Medicine and Chronic Diseases, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jerome Guicheux
- INSERM, UMR 1229, Regenerative Medicine and Skeleton, University of Nantes, ONIRIS, Nantes, France.,University of Nantes, UFR Odontologie, Nantes, France.,CHU Nantes, PHU4 OTONN, Nantes, France
| | - Beatriz Caramés
- Grupo de Biología del Cartílago, Servicio de Reumatología. Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Sergas, A Coruña, Spain
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27818
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Dixon SJ, Chidiac P. Editorial overview: Musculoskeletal: New therapeutic targets and delivery systems. Curr Opin Pharmacol 2018; 40:ix-xi. [PMID: 29933940 DOI: 10.1016/j.coph.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S Jeffrey Dixon
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry; and Bone and Joint Institute, The University of Western Ontario, London, Canada.
| | - Peter Chidiac
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry; and Bone and Joint Institute, The University of Western Ontario, London, Canada
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27819
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Martens DS, Nawrot TS. Ageing at the level of telomeres in association to residential landscape and air pollution at home and work: a review of the current evidence. Toxicol Lett 2018; 298:42-52. [PMID: 29944903 DOI: 10.1016/j.toxlet.2018.06.1213] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/06/2018] [Accepted: 06/19/2018] [Indexed: 12/13/2022]
Abstract
Studies suggest that leukocyte telomere length is an index of systemic ageing. Here, we discuss telomere length as a marker of biological ageing in relation to residential landscape (greenness), residential air pollution and work-related exposures. Telomere lengths are memories of cumulative oxidative and inflammatory stress, and show to have inverse associations with the risk of non-communicable diseases. For this reason, telomeres are considered as markers of biological ageing. Studies at birth, in children, young adulthood, and elderly show that residential green space, lower traffic exposure and long-term lower exposure to particulate air pollution are associated with longer telomeres. Work-related exposures including exposure to toxic metals, polycyclic aromatic hydrocarbons and particulate matter are associated with shorter telomeres for a given age. In contrast to chronic exposures, evidence is present of the observation that recent exposure is associated with longer telomeres. Our overview shows that the magnitude of residential and work-related environmental factors on telomere length are often as important as many classical lifestyle factors.
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Affiliation(s)
- Dries S Martens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium; Department of Public Health & Primary Care, Leuven University, Leuven, Belgium.
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27820
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Extending the global worm index and its links to human development and child education. PLoS Negl Trop Dis 2018; 12:e0006322. [PMID: 29927931 PMCID: PMC6013015 DOI: 10.1371/journal.pntd.0006322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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27821
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Suter MB, Pagani O. Should age impact breast cancer management in young women? Fine tuning of treatment guidelines. Ther Adv Med Oncol 2018; 10:1758835918776923. [PMID: 29977348 PMCID: PMC6024273 DOI: 10.1177/1758835918776923] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 04/12/2018] [Indexed: 01/12/2023] Open
Abstract
Despite breast cancer being uncommon in young women, it is still the most frequent cancer diagnosed in women aged 15–39 years, and the leading cause of death in this age group in high-income countries, after accidents and self-injury. The present review summarizes the most recent guidelines and offers an expert perspective on the many challenges associated with treatment of young women with breast cancer. We will especially focus on early breast cancer, exploring the specificities of the diagnostic process, imaging techniques, locoregional and systemic treatments, and the added value of dedicated multidisciplinary teams. Specific differences in adjuvant treatment between premenopausal and postmenopausal women, especially regarding endocrine therapy, will be addressed in detail. Research questions and current gaps in important fields, such as the paucity of age-specific data regarding antihuman epidermal growth factor receptor 2 (anti-HER2) therapy and gene panels such as OncotypeDX or MAMMAPRINT will be highlighted. A consistent part of this review is dedicated to the issues defining ‘young women’, such as fertility preservation, managing long-term side effects of oncological treatments and genetic counselling, by detailing current strategies and future perspectives.
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Affiliation(s)
| | - Olivia Pagani
- Institute of Oncology and Breast Unit of Southern Switzerland, Bellinzona, Switzerland
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27822
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Chansa C, Sundewall J, Östlund N. Effect of currency exchange rate fluctuations on Aid Effectiveness in the Health Sector in Zambia. Health Policy Plan 2018; 33:811-820. [DOI: 10.1093/heapol/czy046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Collins Chansa
- Institute of Public Health, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg, Germany
- World Bank, Zambia Country Office, Atlas Mara House, Church Road, Lusaka, Zambia
| | - Jesper Sundewall
- Karolinska Institutet, Department of Public Health Sciences, Centre for Global Health, Stockholm, Sweden
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27823
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Palmer MJ, Barnard S, Perel P, Free C. Mobile phone-based interventions for improving adherence to medication prescribed for the primary prevention of cardiovascular disease in adults. Cochrane Database Syst Rev 2018; 6:CD012675. [PMID: 29932455 PMCID: PMC6513181 DOI: 10.1002/14651858.cd012675.pub2] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major cause of disability and mortality globally. Premature fatal and non-fatal CVD is considered to be largely preventable through the control of risk factors via lifestyle modifications and preventive medication. Lipid-lowering and antihypertensive drug therapies for primary prevention are cost-effective in reducing CVD morbidity and mortality among high-risk people and are recommended by international guidelines. However, adherence to medication prescribed for the prevention of CVD can be poor. Approximately 9% of CVD cases in the EU are attributed to poor adherence to vascular medications. Low-cost, scalable interventions to improve adherence to medications for the primary prevention of CVD have potential to reduce morbidity, mortality and healthcare costs associated with CVD. OBJECTIVES To establish the effectiveness of interventions delivered by mobile phone to improve adherence to medication prescribed for the primary prevention of CVD in adults. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, and two other databases on 21 June 2017 and two clinical trial registries on 14 July 2017. We searched reference lists of relevant papers. We applied no language or date restrictions. SELECTION CRITERIA We included randomised controlled trials investigating interventions delivered wholly or partly by mobile phones to improve adherence to cardiovascular medications prescribed for the primary prevention of CVD. We only included trials with a minimum of one-year follow-up in order that the outcome measures related to longer-term, sustained medication adherence behaviours and outcomes. Eligible comparators were usual care or control groups receiving no mobile phone-delivered component of the intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. We contacted study authors for disaggregated data when trials included a subset of eligible participants. MAIN RESULTS We included four trials with 2429 randomised participants. Participants were recruited from community-based primary care or outpatient clinics in high-income (Canada, Spain) and upper- to middle-income countries (South Africa, China). The interventions received varied widely; one trial evaluated an intervention focused on blood pressure medication adherence delivered solely through short messaging service (SMS), and one intervention involved blood pressure monitoring combined with feedback delivered via smartphone. Two trials involved interventions which targeted a combination of lifestyle modifications, alongside CVD medication adherence, one of which was delivered through text messages, written information pamphlets and self-completion cards for participants, and the other through a multi-component intervention comprising of text messages, a computerised CVD risk evaluation and face-to-face counselling. Due to heterogeneity in the nature and delivery of the interventions, we did not conduct a meta-analysis, and therefore reported results narratively.We judged the body of evidence for the effect of mobile phone-based interventions on objective outcomes (blood pressure and cholesterol) of low quality due to all included trials being at high risk of bias, and inconsistency in outcome effects. Of two trials targeting medication adherence alongside other lifestyle modifications, one reported a small beneficial intervention effect in reducing low-density lipoprotein cholesterol (mean difference (MD) -9.2 mg/dL, 95% confidence interval (CI) -17.70 to -0.70; 304 participants), and the other found no benefit (MD 0.77 mg/dL, 95% CI -4.64 to 6.18; 589 participants). One trial (1372 participants) of a text messaging-based intervention targeting adherence showed a small reduction in systolic blood pressure (SBP) for the intervention arm which delivered information-only text messages (MD -2.2 mmHg, 95% CI -4.4 to -0.04), but uncertain evidence of benefit for the second intervention arm that provided additional interactivity (MD -1.6 mmHg, 95% CI -3.7 to 0.5). One study examined the effect of blood pressure monitoring combined with smartphone messaging, and reported moderate intervention benefits on SBP and diastolic blood pressure (DBP) (SBP: MD -7.10 mmHg, 95% CI -11.61 to -2.59; DBP: -3.90 mmHg, 95% CI -6.45 to -1.35; 105 participants). There was mixed evidence from trials targeting medication adherence alongside lifestyle advice using multi-component interventions. One trial found large benefits for SBP and DBP (SBP: MD -12.45 mmHg, 95% CI -15.02 to -9.88; DBP: MD -12.23 mmHg, 95% CI -14.03 to -10.43; 589 participants), whereas the other trial demonstrated no beneficial effects on SBP or DBP (SBP: MD 0.83 mmHg, 95% CI -2.67 to 4.33; DBP: MD 1.64 mmHg, 95% CI -0.55 to 3.83; 304 participants).Two trials reported on adverse events and provided low-quality evidence that the interventions did not cause harm. One study provided low-quality evidence that there was no intervention effect on reported satisfaction with treatment.Two trials were conducted in high-income countries, and two in upper- to middle-income countries. The interventions evaluated employed between three and 16 behaviour change techniques according to coding using Michie's taxonomic method. Two trials evaluated interventions that involved potential users in their development. AUTHORS' CONCLUSIONS There is low-quality evidence relating to the effects of mobile phone-delivered interventions to increase adherence to medication prescribed for the primary prevention of CVD; some trials reported small benefits while others found no effect. There is low-quality evidence that these interventions do not result in harm. On the basis of this review, there is currently uncertainty around the effectiveness of these interventions. We identified six ongoing trials being conducted in a range of contexts including low-income settings with potential to generate more precise estimates of the effect of primary prevention medication adherence interventions delivered by mobile phone.
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Affiliation(s)
- Melissa J Palmer
- London School of Hygiene and Tropical MedicineDepartment of Population HealthLondonUK
| | | | - Pablo Perel
- London School of Hygiene and Tropical MedicineDepartment of Population HealthLondonUK
| | - Caroline Free
- London School of Hygiene & Tropical MedicineClinical Trials Unit, Department of Population HealthKeppel StreetLondonUKWC1E 7HT
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27824
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Habs M, Binder K, Krauss S, Müller K, Ernst B, Valentini L, Koller M. A Balanced Risk-Benefit Analysis to Determine Human Risks Associated with Pyrrolizidine Alkaloids (PA)-The Case of Herbal Medicinal Products Containing St. John's Wort Extracts (SJW). Nutrients 2018; 10:E804. [PMID: 29932143 PMCID: PMC6073194 DOI: 10.3390/nu10070804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/08/2018] [Accepted: 06/19/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Pyrrolizidine alkaloids (PA) exist ubiquitously in our environment. More than 6000 plants, about 3% of the world’s flowering plants, are known to synthesize PA. As a consequence, many herbal ingredients, including St. John’s wort (SJW), are contaminated with PA that can possess acute and subchronic toxic effects as well as mutagenic and genotoxic properties. Therefore, the possible benefits of SJW as an herbal remedy against depression need to be weighed against the possible risks of unwanted PA intake. METHODS We searched the literature regarding the current knowledge on PA and evaluated the evidence on the antidepressant effects of quantified SJW extract based on a Cochrane Review and the current practice guidelines on depression. Risks are depicted in form of a risk ladder and benefits in form of an icon array. RESULTS Evidence from clinical studies indicates that quantified SJW extract is an effective treatment option for mild to moderate depression with fewer side effects than conventional antidepressants. Health statistics from different countries do not quantify cases of death caused by PA intake. However, deaths due to suicide, often triggered by depression, are common (11 in 1000 in Germany in 2015) and rank between fatalities due to liver diseases (16 in 1000) and household accidents (10 in 1000). CONCLUSIONS Quantified SJW extract is a safe and effective treatment option, and its potential of treating depression outweighs the (hypothetical) risk of unwanted PA intake.
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Affiliation(s)
- Michael Habs
- Faculty of Medicine, LMU-University of Munich, 80336 Munich, Germany.
| | - Karin Binder
- Didactics of Mathematics, University of Regensburg, 93053 Regensburg, Germany.
| | - Stefan Krauss
- Didactics of Mathematics, University of Regensburg, 93053 Regensburg, Germany.
| | - Karolina Müller
- Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany.
| | - Brigitte Ernst
- General Medicine Unit, University Hospital Regensburg, 93053 Regensburg, Germany.
| | - Luzia Valentini
- Institute of Evidence-Based Dietetics, University of Applied Sciences Neubrandenburg, 17033 Neubrandenburg, Germany.
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany.
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27825
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Levy D, Labastida-Ramirez A, MaassenVanDenBrink A. Current understanding of meningeal and cerebral vascular function underlying migraine headache. Cephalalgia 2018; 39:1606-1622. [PMID: 29929378 DOI: 10.1177/0333102418771350] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The exact mechanisms underlying the onset of a migraine attack are not completely understood. It is, however, now well accepted that the onset of the excruciating throbbing headache of migraine is mediated by the activation and increased mechanosensitivity (i.e. sensitization) of trigeminal nociceptive afferents that innervate the cranial meninges and their related large blood vessels. OBJECTIVES To provide a critical summary of current understanding of the role that the cranial meninges, their associated vasculature, and immune cells play in meningeal nociception and the ensuing migraine headache. METHODS We discuss the anatomy of the cranial meninges, their associated vasculature, innervation and immune cell population. We then debate the meningeal neurogenic inflammation hypothesis of migraine and its putative contribution to migraine pain. Finally, we provide insights into potential sources of meningeal inflammation and nociception beyond neurogenic inflammation, and their potential contribution to migraine headache.
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Affiliation(s)
- Dan Levy
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Alejandro Labastida-Ramirez
- Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Antoinette MaassenVanDenBrink
- Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus University Medical Center, Rotterdam, The Netherlands
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27826
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Tripathy JP. Research priorities in non-communicable diseases in developing countries: time to go beyond prevalence studies. Public Health Action 2018; 8:98-99. [PMID: 29946529 DOI: 10.5588/pha.18.0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- J P Tripathy
- 1 International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,2 The Union, Paris, France
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27827
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Ruan Y, Guo Y, Zheng Y, Huang Z, Sun S, Kowal P, Shi Y, Wu F. Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. BMC Public Health 2018; 18:778. [PMID: 29925336 PMCID: PMC6011508 DOI: 10.1186/s12889-018-5653-9] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/01/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is one of the leading causes of death worldwide. Our study aimed to investigate the prevalence of two conditions, angina and stroke, and relevant risk factors among older adults in six low- and middle- income countries(LMICs). METHODS The data was from World Health Organization (WHO) Study on global AGEing and adult Health (SAGE) Wave 1 in China, Ghana, India, Mexico, Russian Federation and South Africa. Presence of CVD was based on self-report of angina and stroke. Multivariate logistic regression was performed to examine the relationship between CVD and selected variables, including age, sex, urban/rural setting, household wealth, and risk factors such as smoking, alcohol drinking, fruit/vegetable intake, physical activity and BMI. RESULTS The age standardized prevalence of angina ranged from 9.5 % (South Africa) to 47.5 % (Russian Federation), and for stoke from 2.0% (India) to 6.1 % (Russia). Hypertension was associated with angina in China, India and Russian Federation after adjustment for age, sex, urban/rural setting, education and marital status (OR ranging from 1.3 [1.1-1.6] in India to 3.8 [2.9-5.0] in Russian Federation), furthermore it was a risk factor of stroke in five countries except Mexico. Low or moderate physical activity were also associated with angina in China, and were also strongly associated with stroke in all countries except Ghana and India. Obesity had a stronger association with angina in Russian Federation and China(ORs were 1.5[1.1-2.0] and 1.2 [1.0-1.5] respectively), and increased the risk of stroke in China. Smoking was associated with angina in India and South Africa(ORs were 1.6[1.0-2.4] and 2.1 [1.2-3.6] respectively ), and was also a risk factor of stroke in South Africa. We observed a stronger association between frequent heavy drinking and stroke in India. Household income was associated with reduced odds of angina in China, India and Russian Federation, however higher household income was a risk factor of angina in South Africa. CONCLUSION While the specific mix of risk factors contribute to disease prevalence in different ways in these six countries - they should all be targeted in multi-sectoral efforts to reduce the high burden of CVD in today's society.
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Affiliation(s)
- Ye Ruan
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China
| | - Yanfei Guo
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China
| | - Yang Zheng
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China
| | - Zhezhou Huang
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China
| | - Shuangyuan Sun
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China
| | - Paul Kowal
- World Health Organization, Geneva, Switzerland
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Yan Shi
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China
| | - Fan Wu
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, China
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27828
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Maertens de Noordhout C, Van Oyen H, Speybroeck N, Devleesschauwer B. Changes in health in Belgium, 1990-2016: a benchmarking analysis based on the global burden of disease 2016 study. BMC Public Health 2018; 18:775. [PMID: 29925365 PMCID: PMC6011511 DOI: 10.1186/s12889-018-5708-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/13/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Despite increasing of the Belgian health expenditures, several indicators related to population health showed poor results. The objectives of this study were to perform an in-depth analysis of the secular trend of Belgian health status using the Global Burden of Disease (GBD) 2016 study results for Belgium, and to compare these results with other European countries. METHODS We collected results of the Global Burden of Disease 2016 study through the GBD results and visualization tools. We benchmarked Belgian GBD results with the other initial members of the European Union (EU15). RESULTS Belgium performed significantly better in 2016 than in 1990 in terms of age-standardized (AS) Year of Life Lost (YLL) rates but not significantly different in terms of AS Year Lived with Disability (YLD) and Disability-Adjusted Life Year (DALY) rates. The contribution of AS YLDs to total of AS DALYs increased from 1990 (42%) to 2016 (54%). Although AS YLD and DALY rates did not seem to differ between Belgium and the EU15 from 1990 to 2016, the ranking of Belgium among the EU15 in terms of AS DALY and YLL rates was worse in 2016 than in 1990. Belgium had significantly higher AS YLL rates for lower respiratory infections (B: 264 AS YLLs [95% uncertainty interval [UI] 231-301] per 100,000; EU15: 188 AS YLLs [95%UI 168-212] per 100,000), chronic obstructive pulmonary disease (B: 368 AS YLLs [95%UI 331-407] per 100,000; EU15: 285 AS YLLs [95%UI 258-316] per 100,000) and tracheal, bronchus, and lung cancer (B: 785 AS YLLs [95%UI 699-879] per 100,000; EU15: 613 AS YLLs [95%UI 556-674] per 100,000). CONCLUSION Belgium's ranking among the EU15 in terms of AS YLL and DALY rates decreased from 1990 to 2016. Significant health gains appear possible by acting on risk factors directly linked to a significant part of the Belgian burden of diseases, i.e., alcohol and tobacco consumption, and high body mass index. National burden of disease estimates can help defining Belgian health targets and are necessary as external validity of GBD results is not always guaranteed.
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Affiliation(s)
- C. Maertens de Noordhout
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte B1.30.15, 1200 Brussels, Belgium
| | - H. Van Oyen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - N. Speybroeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte B1.30.15, 1200 Brussels, Belgium
| | - B. Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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27829
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Yiu KC, Rohwer A, Young T. Integration of care for hypertension and diabetes: a scoping review assessing the evidence from systematic reviews and evaluating reporting. BMC Health Serv Res 2018; 18:481. [PMID: 29925356 PMCID: PMC6011271 DOI: 10.1186/s12913-018-3290-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/11/2018] [Indexed: 12/26/2022] Open
Abstract
Background With the rise in pre-mature mortality rate from non-communicable disease (NCD), there is a need for evidence-based interventions. We evaluated existing systematic reviews on effectiveness of integration of healthcare services, in particular with focus on delivery of care designed to improve health and process outcomes in people with multi-morbidity, where at least one of the conditions was diabetes or hypertension. Methods We searched MEDLINE, EMBASE, Cochrane Library, and Health Evidence to November 8, 2016 and consulted experts. One review author screened titles, abstracts and two review authors independently screened short listed full-texts and selected reviews for inclusion. We considered systematic reviews evaluating integration of care, compared to usual care, for people with multi-morbidity. One review author extracted data and another author verified it. Two review authors independently evaluated risk of bias using ROBIS and AMSTAR. Inter-rater reliability was analysed for ROBIS and AMSTAR using Cohen’s kappa and percent agreement. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used to assess reporting. Results We identified five systematic reviews on integration of care. Four reviews focused on comorbid diabetes and depression and two covered hypertension and comorbidities of cardiovascular disease, depression, or diabetes. Interventions were poorly described. The health outcomes evaluated included risk of all-cause mortality, measures of depression, cholesterol levels, HbA1c levels, effect of depression on HbA1c levels, symptom improvement, systolic blood pressure, and hypertension control. Process outcomes included access and utilisation of healthcare services, costs, and quality of care. Overall, three reviews had a low and medium risk of bias according to ROBIS and AMSTAR respectively, while two reviews had high risk of bias as judged by both ROBIS and AMSTAR. Findings have demonstrated that collaborative care in general resulted in better health and process outcomes when compared to usual care for both depression and diabetes and hypertension and diabetes. Conclusions Several knowledge gaps were identified on integration of care for comorbidities with diabetes and/or hypertension: limited research on this topic for hypertension, limited reviews that included primary studies based in low-middle income countries, and limited reviews on collaborative care for communicable and NCDs. Electronic supplementary material The online version of this article (10.1186/s12913-018-3290-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristy C Yiu
- McMaster University, 1280, Hamilton, ON, L8S 4L8, Canada
| | - Anke Rohwer
- Centre of Evidence Based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa
| | - Taryn Young
- Centre of Evidence Based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa.
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27830
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Blagev DP, Collingridge DS, Rea S, Press VG, Churpek MM, Carey K, Mularski RA, Zeng S, Arjomandi M. Stability of Frequency of Severe Chronic Obstructive Pulmonary Disease Exacerbations and Health Care Utilization in Clinical Populations. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2018; 5:208-220. [PMID: 30584584 DOI: 10.15326/jcopdf.5.3.2017.0183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Rationale: Although chronic obstructive pulmonary disease (COPD) exacerbation frequency is stable in research cohorts, whether severe COPD exacerbation frequency can be used to identify patients at high risk for future severe COPD exacerbations and/or mortality is unknown. Methods: Severe COPD exacerbation frequency stability was determined in 3 distinct clinical cohorts. A total of 17,450 patients with COPD in Intermountain Healthcare were categorized based on the number of severe COPD exacerbations per year. We determined whether exacerbation frequency was stable and whether it predicted mortality. These findings were validated in 83,134 patients from the U.S. Veterans Affairs (VA) nationwide health care system and 3326 patients from the University of Chicago Medicine health system. Results: In the Intermountain Healthcare cohort, the majority (84%, 14,706 patients) had no exacerbations in 2009 and were likely to remain non-exacerbators with a significantly lower 6-year mortality compared with frequent exacerbators (2 or more exacerbations per year) (25% versus 57%, p<0.001). Similar findings were noted in the VA health system and the University of Chicago Medicine health system. Non-exacerbators were likely to remain non-exacerbators with the lowest overall mortality. In all cohorts, frequent exacerbator was not a stable phenotype until patients had at least 2 consecutive years of frequent exacerbations. COPD exacerbation frequency predicted any cause mortality. Conclusions: In clinical datasets across different organizations, severe COPD exacerbation frequency was stable after at least 2 consecutive years of frequent exacerbations. Thus, severe COPD exacerbation frequency identifies patients across a health care system at high risk for future COPD-related health care utilization and overall mortality.
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Affiliation(s)
- Denitza P Blagev
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center, Murray, Utah.,Division of Respiratory, Critical Care, and Sleep Medicine, Department of Medicine, University of Utah, Salt Lake City
| | - Dave S Collingridge
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center, Murray, Utah.,Office of Research, Intermountain Healthcare, Salt Lake City, Utah
| | - Susan Rea
- Office of Research, Intermountain Healthcare, Salt Lake City, Utah.,Homer Warner Center for Informatics Research, Murray, Utah
| | - Valerie G Press
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medicine, Chicago, Illinois
| | - Matthew M Churpek
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medicine, Chicago, Illinois
| | - Kyle Carey
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medicine, Chicago, Illinois
| | - Richard A Mularski
- Kaiser Permanente Center for Health Research - Northwest, Portland, Oregon.,Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland
| | - Siyang Zeng
- Division of Pulmonary and Critical Care Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California.,Division of Pulmonary, Critical Care Allergy, Immunology and Sleep Medicine, Department of Medicine, University of California, San Francisco
| | - Mehrdad Arjomandi
- Division of Pulmonary and Critical Care Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California.,Division of Pulmonary, Critical Care Allergy, Immunology and Sleep Medicine, Department of Medicine, University of California, San Francisco
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27831
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Coulibaly JT, Ouattara M, Barda B, Utzinger J, N'Goran EK, Keiser J. A Rapid Appraisal of Factors Influencing Praziquantel Treatment Compliance in Two Communities Endemic for Schistosomiasis in Côte d'Ivoire. Trop Med Infect Dis 2018; 3:tropicalmed3020069. [PMID: 30274465 PMCID: PMC6073597 DOI: 10.3390/tropicalmed3020069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/09/2018] [Accepted: 06/14/2018] [Indexed: 01/12/2023] Open
Abstract
Over the past decade, a significant reduction in the prevalence of schistosomiasis has been achieved, partially explained by the large-scale administration of praziquantel. Yet, the burden of schistosomiasis remains considerable, and factors influencing intervention coverage are important. This study aimed to deepen the understanding of low treatment coverage rates observed in two schistosomiasis-endemic villages in Côte d’Ivoire. The research was conducted in August 2015, in Moronou and Bigouin, two villages of Côte d’Ivoire that are endemic for Schistosoma haematobium and S. mansoni, respectively. After completion of a clinical trial, standard praziquantel treatment (single 40 mg/kg oral dose) was offered to all village inhabitants by community health workers using a house-to-house approach. Factors influencing treatment coverage were determined by a questionnaire survey, randomly selecting 405 individuals. The overall treatment coverage rate was only 47.6% (2730/5733) with considerable intervillage heterogeneity (27.7% in Bigouin (302/1091) versus 52.3% in Moronou (2428/4642)). Among the 200 individuals interviewed in Moronou, 50.0% were administered praziquantel, while only 19.5% of the 205 individuals interviewed in Bigouin received praziquantel. The main reasons for low treatment coverage were work-related (agricultural activities), the bitter taste of praziquantel and previous experiences with adverse events. The most suitable period for treatment campaigns was reported to be the dry season. More than three-quarter of the interviewees who had taken praziquantel (overall, 116/140; Moronou, 84/100; Bigouin, 32/40) declared that they would not participate in future treatments (p < 0.001). In order to enhance praziquantel treatment coverage, careful consideration should be given to attitudes and practices, such as prior or perceived adverse events and taste of praziquantel, and appropriate timing, harmonized with agricultural activities. Without such understanding, breaking the transmission of schistosomiasis remains a distant goal.
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Affiliation(s)
- Jean T Coulibaly
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Beatrice Barda
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
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27832
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Integrated HIV-injury programming: an underutilized intersection to engage young adults in HIV care in low and middle-income countries. AIDS 2018; 32:1377-1379. [PMID: 29762167 DOI: 10.1097/qad.0000000000001876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: Adolescents/young adults, and especially men, are high-risk key populations that have been systematically missed by HIV services in low and middle-income countries (LMICs). Because these groups are also more likely to suffer injuries in LMICs, there are significant opportunities to engage these hard-to-reach persons via integrated HIV-injury programming provided during commonly sought acute/emergency care treatments of injuries. However, current facilities based HIV testing and treatment programs have failed to adequately capture these high-risk individuals. As such, research to address the knowledge gaps in HIV care delivery among the injured is needed and has great potential to inform interventions that would identify and treat adolescents/young adults, many of whom have the greatest individual and societal margins for long-term benefits with HIV care globally.
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27833
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Macpherson RA, Lane TJ, Collie A, McLeod CB. Age, sex, and the changing disability burden of compensated work-related musculoskeletal disorders in Canada and Australia. BMC Public Health 2018; 18:758. [PMID: 29914425 PMCID: PMC6007009 DOI: 10.1186/s12889-018-5590-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/23/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The objectives of this study were (1) to identify age and sex trends in the disability burden of compensated work-related musculoskeletal disorders (MSDs) in Canada and Australia; and (2) to demonstrate a means of comparing workers' compensation data internationally. METHODS All non-fatal, work-related MSD claims with at least one day of compensated time-loss were extracted for workers aged 15-80 during a 10-year period (2004-2013) using workers' compensation data from five Canadian and eight Australian jurisdictions. Disability burden was calculated for both countries by sex, age group, and injury classification, using cumulative compensated time-loss payments of up to two years post-injury. RESULTS A total of 1.2 million MSD claims were compensated for time-loss in the Canadian and Australian jurisdictions during 2004-2013. This resulted in time-loss equivalent to 239,345 years in the Canadian jurisdictions and 321,488 years in the Australian jurisdictions. The number of time-loss years declined overall among male and female workers, but greater declines were observed for males and younger workers. The proportion of the disability burden grew among older workers (aged 55+), particularly males in the Canadian jurisdictions (Annual Percent Change [APC]: 7.2, 95% CI 6.7 to 7.7%) and females in the Australian jurisdictions (APC: 7.5, 95% CI 6.2 to 8.9%). CONCLUSIONS The compensated disability burden of work-related MSDs is shifting towards older workers and particularly older females in Australia and older males in Canada. Employers and workers' compensation boards should consider the specific needs of older workers to reduce injuries and time off work. Comparative research made possible through research-stakeholder partnerships offers a unique opportunity to use existing administrative data to identify long-term trends in disability burden. Future research can apply similar approaches for estimating long-term trends in occupational health.
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Affiliation(s)
- Robert A. Macpherson
- Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Tyler J. Lane
- Insurance, Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC Australia
| | - Alex Collie
- Insurance, Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC Australia
| | - Christopher B. McLeod
- Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
- Institute for Work & Health, Toronto, ON Canada
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27834
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Campelo Y, Ombredane A, Vasconcelos AG, Albuquerque L, Moreira DC, Plácido A, Rocha J, Hilarion Fokoue H, Yamaguchi L, Mafud A, Mascarenhas YP, Delerue-Matos C, Borges T, Joanitti GA, Arcanjo D, Kato MJ, Kuckelhaus SAS, Silva MPN, Moraes JD, Leite JRSA. Structure⁻Activity Relationship of Piplartine and Synthetic Analogues against Schistosoma mansoni and Cytotoxicity to Mammalian Cells. Int J Mol Sci 2018; 19:E1802. [PMID: 29921756 PMCID: PMC6032158 DOI: 10.3390/ijms19061802] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 02/23/2018] [Accepted: 02/27/2018] [Indexed: 01/11/2023] Open
Abstract
Schistosomiasis, caused by helminth flatworms of the genus Schistosoma, is an infectious disease mainly associated with poverty that affects millions of people worldwide. Since treatment for this disease relies only on the use of praziquantel, there is an urgent need to identify new antischistosomal drugs. Piplartine is an amide alkaloid found in several Piper species (Piperaceae) that exhibits antischistosomal properties. The aim of this study was to evaluate the structure–function relationship between piplartine and its five synthetic analogues (19A, 1G, 1M, 14B and 6B) against Schistosoma mansoni adult worms, as well as its cytotoxicity to mammalian cells using murine fibroblast (NIH-3T3) and BALB/cN macrophage (J774A.1) cell lines. In addition, density functional theory calculations and in silico analysis were used to predict physicochemical and toxicity parameters. Bioassays revealed that piplartine is active against S. mansoni at low concentrations (5⁻10 µM), but its analogues did not. In contrast, based on 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and flow cytometry assays, piplartine exhibited toxicity in mammalian cells at 785 µM, while its analogues 19A and 6B did not reduce cell viability at the same concentrations. This study demonstrated that piplartine analogues showed less activity against S. mansoni but presented lower toxicity than piplartine.
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Affiliation(s)
- Yuri Campelo
- Núcleo de Pesquisa em Biodiversidade e Biotecnologia, Biotec, Universidade Federal do Piauí, UFPI, Parnaíba-PI, 64202-020 Brazil.
- Programa de Pós-Graduação em Biotecnologia, RENORBIO, Ponto focal Universidade Federal do Piauí, UFPI, Teresina, PI, 64049-550, Brazil.
- Instituto de Educação Superior do Vale do Parnaíba, FAHESP/IESVAP, Parnaíba-PI, 64212-790, Brazil.
| | - Alicia Ombredane
- Laboratório de Nanobiotecnologia, Instituto de Biologia, Campus Darcy Ribeiro, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
| | - Andreanne G Vasconcelos
- Área de Morfologia, Faculdade de Medicina, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
| | - Lucas Albuquerque
- Laboratorio de Imunologia, Faculdade de Medicina, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
| | - Daniel C Moreira
- Área de Morfologia, Faculdade de Medicina, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
| | - Alexandra Plácido
- LAQV/REQUIMTE, GRAQ, Instituto Superior de Engenha do Porto, ISEP, Porto 4200-072, Portugal.
| | - Jefferson Rocha
- Programa de Pós-Graduação em Biotecnologia, RENORBIO, Ponto focal Universidade Federal do Piauí, UFPI, Teresina, PI, 64049-550, Brazil.
| | - Harold Hilarion Fokoue
- Laboratório de Avaliação e Síntese de Substâncias Bioativas, Universidade Federal do Rio de Janeiro, CCS, Cidade Universitária, Rio de Janeiro-RJ 21941-902, Brasil.
| | - Lydia Yamaguchi
- Instituto de Química, Universidade de São Paulo, São Paulo-SP 01005-010, Brazil.
| | - Ana Mafud
- Instituto de Física de São Carlos, Universidade de São Paulo-SP 01005-010, Brazil.
| | - Yvonne P Mascarenhas
- Instituto de Física de São Carlos, Universidade de São Paulo-SP 01005-010, Brazil.
| | - Cristina Delerue-Matos
- LAQV/REQUIMTE, GRAQ, Instituto Superior de Engenha do Porto, ISEP, Porto 4200-072, Portugal.
| | - Tatiana Borges
- Laboratorio de Imunologia, Faculdade de Medicina, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
| | - Graziella A Joanitti
- Laboratório de Nanobiotecnologia, Instituto de Biologia, Campus Darcy Ribeiro, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
| | - Daniel Arcanjo
- Núcleo de Pesquisas em Plantas Medicinais, NPPM, Universidade Federal do Piauí, UFPI, Parnaíba-PI 64202-020, Brazil.
| | - Massuo J Kato
- Instituto de Química, Universidade de São Paulo, São Paulo-SP 01005-010, Brazil.
| | - Selma A S Kuckelhaus
- Área de Morfologia, Faculdade de Medicina, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
| | - Marcos P N Silva
- Núcleo de Pesquisa em Doenças Negligenciadas, Universidade de Guarulhos, Guarulhos-SP 07023-070, Brazil.
| | - Josué de Moraes
- Núcleo de Pesquisa em Doenças Negligenciadas, Universidade de Guarulhos, Guarulhos-SP 07023-070, Brazil.
| | - José Roberto S A Leite
- Núcleo de Pesquisa em Biodiversidade e Biotecnologia, Biotec, Universidade Federal do Piauí, UFPI, Parnaíba-PI, 64202-020 Brazil.
- Área de Morfologia, Faculdade de Medicina, Universidade de Brasília, UnB, Brasília-DF 70910-900, Brazil.
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27835
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Wang Y, Wu X. SMOC1 silencing suppresses the angiotensin II-induced myocardial fibrosis of mouse myocardial fibroblasts via affecting the BMP2/Smad pathway. Oncol Lett 2018; 16:2903-2910. [PMID: 30127878 PMCID: PMC6096163 DOI: 10.3892/ol.2018.8989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/27/2018] [Indexed: 12/28/2022] Open
Abstract
SPARC-related modular calcium binding 1 (SMOC1) represents a vital member of the SPARC matricellular protein family that regulates cell matrix interaction through binding to cell-surface receptors. The present study aimed to investigate the roles and molecular mechanisms of SMOC1 silencing on the fibrosis of myocardial fibroblasts (MFBs). Cell Counting kit-8 and flow cytometry assays were performed to determine cell viability and reactive oxygen species (ROS) content, respectively. ELISA was performed to detect the expression of associated cytokines and matrix proteins. Western blot analysis and reverse transcription-quantitative polymerase chain reaction assays were used to evaluate the expression of associated proteins and mRNAs, respectively. The results revealed that SMOC1 silencing suppressed the cell viability of angiotensin II (Ang II)-treated MFBs. SMOC1 silencing reduced the ROS content and oxidative stress in MFBs in response to Ang II. Furthermore, SMOC1 silencing downregulated the expression levels of fibrosis-associated proteins in Ang II-treated MFBs. SMOC1 silencing affected the bone morphogenetic protein 2 (BMP2)/Smad signaling pathway in Ang II-treated MFBs. In conclusion, the results of the present study suggested that SMOC1 silencing suppressed the Ang II-induced myocardial fibrosis of mouse MFBs through affecting the BMP2/Smad signaling pathway.
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Affiliation(s)
- Yize Wang
- Department of Cardiology, Yiyang Central Hospital, Yiyang, Hunan 413000, P.R. China
| | - Xianming Wu
- Department of Cardiology, Yiyang Central Hospital, Yiyang, Hunan 413000, P.R. China
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27836
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Resurrección DM, Moreno-Peral P, Gómez-Herranz M, Rubio-Valera M, Pastor L, Caldas de Almeida JM, Motrico E. Factors associated with non-participation in and dropout from cardiac rehabilitation programmes: a systematic review of prospective cohort studies. Eur J Cardiovasc Nurs 2018; 18:38-47. [PMID: 29909641 DOI: 10.1177/1474515118783157] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although evidence exists for the efficacy of cardiac rehabilitation programmes to reduce morbidity and mortality among patients with cardiovascular disease, cardiac rehabilitation programmes are underused. We aimed systematically to review the evidence from prospective cohort studies on factors associated with non-participation in and/or dropping out from cardiac rehabilitation programmes. METHODS MedLine, Embase, Scopus, Open Grey and Cochrane Database were searched for relevant publications from inception to February 2018. Search terms included (a) coronary heart disease and other cardiac conditions; (b) cardiac rehabilitation and secondary prevention; and (c) non-participation in and/or dropout. Databases were searched following the PRISMA statement. Study selection, data extraction and the assessment of study quality were performed in duplicate. RESULTS We selected 43 studies with a total of 63,425 patients from 10 different countries that met the inclusion criteria. Factors associated with non-participation in and dropout from cardiac rehabilitation were grouped into six broad categories: intrapersonal factors, clinical factors, interpersonal factors, logistical factors, cardiac rehabilitation programme factors and health system factors. We found that clinical factors, logistical factors and health system factors were the main factors assessed for non-participation in cardiac rehabilitation. We also found differences between the factors associated with non-participation and dropout. CONCLUSIONS Several factors were determinant for non-participation in and dropout from cardiac rehabilitation. These findings could be useful to clinicians and policymakers for developing interventions aimed at improving participation and completion of cardiac rehabilitation, such as E-health or home-based delivery programmes. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) identifier: CRD42016032973.
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Affiliation(s)
| | - Patricia Moreno-Peral
- 2 SAMSERAP Group, Primary Care Prevention and Health Promotion Research Network (RedIAPP), Spain.,3 SAMSERAP Group, Instituto de Investigación Biomédica de Malaga (IBIMA), Spain
| | | | - Maria Rubio-Valera
- 5 Research and Development Unit, Institut de Recerca Sant Joan de Déu, Spain.,6 Grupo PRISMA, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Spain
| | - Luis Pastor
- 7 Unidad Clínica de Cardiología, Hospital Nuestra Señora de Valme, Spain
| | | | - Emma Motrico
- 1 Departamento de Psicología, Universidad Loyola Andalucía, Spain.,2 SAMSERAP Group, Primary Care Prevention and Health Promotion Research Network (RedIAPP), Spain
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27837
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Cromwell EA, Roy S, Sankara DP, Weiss A, Stanaway J, Goldberg E, Pigott DM, Larson H, Vollset SE, Krohn K, Foreman K, Hotez P, Bhutta Z, Bekele BB, Edessa D, Kassembaum N, Mokdad A, Murray CJL, Hay SI. Slaying little dragons: the impact of the Guinea Worm Eradication Program on dracunculiasis disability averted from 1990 to 2016. Gates Open Res 2018; 2:30. [PMID: 30234196 PMCID: PMC6139381 DOI: 10.12688/gatesopenres.12827.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/20/2022] Open
Abstract
Background: The objective of this study was to document the worldwide decline of dracunculiasis (Guinea worm disease, GWD) burden, expressed as disability-adjusted life years (DALYs), from 1990 to 2016, as estimated in the Global Burden of Disease study 2016 (GBD 2016). While the annual number of cases of GWD have been consistently reported by WHO since the 1990s, the burden of disability due to GWD has not previously been quantified in GBD. Methods: The incidence of GWD was modeled for each endemic country using annual national case reports. A literature search was conducted to characterize the presentation of GWD, translate the clinical symptoms into health sequelae, and then assign an average duration to the infection. Prevalence measures by sequelae were multiplied by disability weights to estimate DALYs. Results: The total DALYs attributed to GWD across all endemic countries (n=21) in 1990 was 50,725 (95% UI: 35,265-69,197) and decreased to 0.9 (95% UI: 0.5-1.4) in 2016. A cumulative total of 12,900 DALYs were attributable to GWD from 1990 to 2016. Conclusions: Using 1990 estimates of burden propagated forward, this analysis suggests that between 990,000 to 1.9 million DALYs have been averted as a result of the eradication program over the past 27 years.
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Affiliation(s)
- Elizabeth A Cromwell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Sharon Roy
- Centers for Disease Controls and Prevention, Atlanta, GA, USA
| | | | | | - Jeffrey Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Ellen Goldberg
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Heidi Larson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Kristopher Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Kyle Foreman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Peter Hotez
- College of Medicine, Baylor University, Houston, TX, USA
| | | | | | | | - Nicholas Kassembaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Ali Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Seattle, WA, USA.,Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
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27838
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Socio-economic status and chronic disease in the West Bank and the Gaza Strip: in and outside refugee camps. Int J Public Health 2018; 63:875-882. [DOI: 10.1007/s00038-018-1122-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 05/17/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022] Open
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27839
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Narloch JL, Farber SH, Sammons S, McSherry F, Herndon JE, Hoang JK, Yin FF, Sampson JH, Fecci PE, Blackwell KL, Kirkpatrick JP, Kim GJ. Biopsy of enlarging lesions after stereotactic radiosurgery for brain metastases frequently reveals radiation necrosis. Neuro Oncol 2018; 19:1391-1397. [PMID: 28472527 DOI: 10.1093/neuonc/nox090] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Stereotactic radiosurgery (SRS) offers excellent local control for brain metastases (BM) with low rates of toxicity. Radiation necrosis (RN) may occur after treatment and is challenging to distinguish from local recurrence (LR). We evaluated enlarging brain lesions following SRS that were subsequently biopsied to differentiate RN versus LR. Methods This study reviewed patients receiving SRS for BM between 2008 and 2012 who underwent a biopsy for suspicion of RN versus LR on MRI. Data collection included demographics, radiation parameters, imaging findings, and post-biopsy pathology. Kaplan-Meier methods determined overall survival. Fisher's exact test assessed for association between lesion biopsy result and variables of interest. Results Thirty-four patients with 35 biopsied BM were included. Lesions were biopsied a median of 8.8 months after SRS. Most patients had primary lung cancer (11; 31.4%). Eleven (31.4%) biopsies were positive for LR and 24 (68.6%) showed RN only. Median overall survival was longer for patients with RN (31.0 mo) than for patients with LR (14.5 mo; P = 0.135). Time from SRS to biopsy was significantly different between RN and LR groups; 10 lesions (52.5%) biopsied ≤9 months after SRS showed LR, whereas 1 lesion (6.3%) biopsied >9 months after SRS showed LR (P = 0.004). For 16 (65.7%) lesions, management was changed or directed by the biopsy results. Conclusions Stereotactic biopsy for accessible enlarging lesions after SRS appears diagnostically valuable in patients with few lesions and changes clinical management. RN should be suspected in patients with an enlarging lesion more than 9 months post-SRS.
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Affiliation(s)
- Jessica L Narloch
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - S Harrison Farber
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Sarah Sammons
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Frances McSherry
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - James E Herndon
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Jenny K Hoang
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Fang-Fang Yin
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - John H Sampson
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Peter E Fecci
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Kimberly L Blackwell
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - John P Kirkpatrick
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Grace J Kim
- Breast Cancer Program, Duke Cancer Institute, Clinical Research Training Program, Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Division of Hematology-Oncology, Department of Medicine, Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Division of Neuroradiology, Department of Radiology, Department of Radiation Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
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27840
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Damnjanović K, Graeber J, Ilić S, Lam WY, Lep Ž, Morales S, Pulkkinen T, Vingerhoets L. Parental Decision-Making on Childhood Vaccination. Front Psychol 2018; 9:735. [PMID: 29951010 PMCID: PMC6008886 DOI: 10.3389/fpsyg.2018.00735] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 04/26/2018] [Indexed: 11/13/2022] Open
Abstract
A growing number of parents delay vaccinations or are deciding not to vaccinate their children altogether. This increases the risk of contracting vaccine-preventable diseases and disrupting herd immunity, and also impairs the trust in the capacities of health care systems to protect people. Vaccine hesitancy is related to a range of both psychological and demographic determinants, such as attitudes toward vaccinations, social norms, and trust in science. Our aim is to understand those determinants in parents, because they are a special group in this issue-they act as proxy decision makers for their children, who are unable to decide for themselves. The fact that deciding to vaccinate is a socially forced choice that concerns a child's health makes vaccine-related decisions highly important and involving for parents. This high involvement might lead to parents overemphasizing the potential side effects that they know to be vaccine-related, and by amplifying those, parents are more focused on the potential outcomes of vaccine-related decisions, which can yield specific pattern of the outcome bias. We propose two related studies to investigate factors which promote vaccine hesitancy, protective factors that determine parental vaccination decisions, and outcome bias in parental vaccination intentions. We will explore demographic and psychological factors, and test parental involvement related to vaccine hesitancy using an online battery in a correlation panel design study. The second study is an experimental study, in which we will investigate the moderating role of parents' high involvement in the specific domain of vaccination decision making. We expect that higher involvement among parents, compared to non-parents, will shape the pattern of the proneness to outcome bias. The studies will be conducted across eight countries in Europe and Asia (Finland, Germany, Hong Kong, the Netherlands, Serbia, Slovenia, Spain, and the United Kingdom), rendering findings that will aid with understanding the underlying mechanisms of vaccine hesitancy and paving the way for developing interventions custom-made for parents.
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Affiliation(s)
- Kaja Damnjanović
- Laboratory for Experimental Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Johanna Graeber
- Department of Psychology, Faculty of Philosophy, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Sandra Ilić
- Laboratory for Experimental Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Wing Y. Lam
- Faculty of Social Sciences, School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Žan Lep
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Sara Morales
- Faculty of Psychology, University of Basque Country, Bilbao, Spain
| | - Tero Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Loes Vingerhoets
- Department of Psychology, Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, Netherlands
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27841
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Rajkumar S, Clark ML, Young BN, Benka-Coker ML, Bachand AM, Brook RD, Nelson TL, Volckens J, Reynolds SJ, L’Orange C, Good N, Koehler K, Africano S, Osorto Pinel AB, Peel JL. Exposure to household air pollution from biomass-burning cookstoves and HbA1c and diabetic status among Honduran women. INDOOR AIR 2018; 28:10.1111/ina.12484. [PMID: 29896912 PMCID: PMC6292747 DOI: 10.1111/ina.12484] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 06/08/2018] [Indexed: 05/05/2023]
Abstract
Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle-income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross-sectional study of 142 women (72 with traditional stoves and 70 with cleaner-burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24-hour average kitchen and personal fine particulate matter [PM2.5 ] mass and black carbon) with glycated hemoglobin (HbA1c) levels and diabetic status based on HbA1c levels. The prevalence ratio (PR) per interquartile range increase in pollution concentration indicated higher prevalence of prediabetes/diabetes (vs normal HbA1c) for all pollutant measures (eg, PR per 84 μg/m3 increase in personal PM2.5 , 1.49; 95% confidence interval [CI], 1.11-2.01). Results for HbA1c as a continuous variable were generally in the hypothesized direction. These results provide some evidence linking household air pollution with the prevalence of prediabetes/diabetes, and, if confirmed, suggest that the global public health impact of household air pollution may be broader than currently estimated.
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Affiliation(s)
- Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Bonnie N. Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Megan L. Benka-Coker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Annette M. Bachand
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Robert D. Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Domino’s Farms, 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105, USA
| | - Tracy L. Nelson
- Department of Health and Exercise Science, Colorado State University, 215D Moby Complex B Wing, Fort Collins, CO 80523, USA
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
- Department of Mechanical Engineering, Colorado State University, 306 Scott Bioengineering Building, Fort Collins, CO 80523, USA
| | - Stephen J. Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
- Mountain and Plains ERC, Colorado School of Public Health, 13001 E. 17th Place, Mail Stop B119, Aurora, CO 80045, USA
| | - Christian L’Orange
- Department of Mechanical Engineering, Colorado State University, 306 Scott Bioengineering Building, Fort Collins, CO 80523, USA
| | - Nicholas Good
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
| | - Kirsten Koehler
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland 21205, USA
| | - Sebastian Africano
- Trees, Water & People, 633 Remington Street, Fort Collins, CO 80524, USA
| | - Anibal B. Osorto Pinel
- Trees, Water & People, 633 Remington Street, Fort Collins, CO 80524, USA
- Asociación Hondureña para el desarrollo, Calle Principal, Casa No. 2245, Tegucigalpa, Honduras
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Campus Delivery 1681, Fort Collins, CO 80523, USA
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27842
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Troeger C, Colombara DV, Rao PC, Khalil IA, Brown A, Brewer TG, Guerrant RL, Houpt ER, Kotloff KL, Misra K, Petri WA, Platts-Mills J, Riddle MS, Swartz SJ, Forouzanfar MH, Reiner RC, Hay SI, Mokdad AH. Global disability-adjusted life-year estimates of long-term health burden and undernutrition attributable to diarrhoeal diseases in children younger than 5 years. LANCET GLOBAL HEALTH 2018; 6:e255-e269. [PMID: 29433665 PMCID: PMC5861379 DOI: 10.1016/s2214-109x(18)30045-7] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 11/30/2017] [Accepted: 01/26/2018] [Indexed: 12/12/2022]
Abstract
Background Diarrhoea is a leading cause of death and illness globally among children younger than 5 years. Mortality and short-term morbidity cause substantial burden of disease but probably underestimate the true effect of diarrhoea on population health. This underestimation is because diarrhoeal diseases can negatively affect early childhood growth, probably through enteric dysfunction and impaired uptake of macronutrients and micronutrients. We attempt to quantify the long-term sequelae associated with childhood growth impairment due to diarrhoea. Methods We used the Global Burden of Diseases, Injuries, and Risk Factors Study framework and leveraged existing estimates of diarrhoea incidence, childhood undernutrition, and infectious disease burden to estimate the effect of diarrhoeal diseases on physical growth, including weight and height, and subsequent disease among children younger than 5 years. The burden of diarrhoea was measured in disability-adjusted life-years (DALYs), a composite metric of mortality and morbidity. We hypothesised that diarrhoea is negatively associated with three common markers of growth: weight-for-age, weight-for-height, and height-for-age Z-scores. On the basis of these undernutrition exposures, we applied a counterfactual approach to quantify the relative risk of infectious disease (subsequent diarrhoea, lower respiratory infection, and measles) and protein energy malnutrition morbidity and mortality per day of diarrhoea and quantified the burden of diarrhoeal disease due to these outcomes caused by undernutrition. Findings Diarrhoea episodes are significantly associated with childhood growth faltering. We found that each day of diarrhoea was associated with height-for-age Z-score (–0·0033 [95% CI −0·0024 to −0·0041]; p=4·43 × 10−14), weight-for-age Z-score (–0·0077 [–0·0058 to −0·0097]; p=3·19 × 10−15), and weight-for-height Z-score (–0·0096 [–0·0067 to −0·0125]; p=7·78 × 10−11). After addition of the DALYs due to the long-term sequelae as a consequence of undernutrition, the burden of diarrhoeal diseases increased by 39·0% (95% uncertainty interval [UI] 33·0–46·6) and was responsible for 55 778 000 DALYs (95% UI 49 125 400–62 396 200) among children younger than 5 years in 2016. Among the 15 652 300 DALYs (95% UI 12 951 300–18 806 100) associated with undernutrition due to diarrhoeal episodes, more than 84·7% are due to increased risk of infectious disease, whereas the remaining 15·3% of long-term DALYs are due to increased prevalence of protein energy malnutrition. The burden of diarrhoea has decreased substantially since 1990, but progress has been greater in long-term (78·7% reduction [95% UI 69·3–85·5]) than in acute (70·4% reduction [95% UI 61·7–76·5]) DALYs. Interpretation Diarrhoea represents an even larger burden of disease than was estimated in the Global Burden of Disease Study. In order to adequately address the burden of its long-term sequelae, a renewed emphasis on controlling the risk of diarrhoea incidence may be required. This renewed effort can help further prevent the potential lifelong cost on child health, growth, and overall potential. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
- Christopher Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Danny V Colombara
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Puja C Rao
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ibrahim A Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alexandria Brown
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Richard L Guerrant
- Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Eric R Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Karen L Kotloff
- Departments of Pediatrics and Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kavita Misra
- Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - William A Petri
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - James Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Mark S Riddle
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Scott J Swartz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
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27843
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Koh W, Kang K, Lee YJ, Kim MR, Shin JS, Lee J, Lee JH, Shin KM, Ha IH. Impact of acupuncture treatment on the lumbar surgery rate for low back pain in Korea: A nationwide matched retrospective cohort study. PLoS One 2018; 13:e0199042. [PMID: 29894499 PMCID: PMC5997340 DOI: 10.1371/journal.pone.0199042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/30/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Low back pain (LBP) is a globally prevalent disorder with high social significance. Invasive surgical procedures are increasingly being used to treat LBP despite a lack of solid evidence supporting their long-term benefits. This nationwide retrospective cohort study investigated the association between acupuncture treatment and lumbar surgery rate in patients with LBP. METHODS Using the National Health Insurance Service Sample Cohort Database for 2002-2013, we identified newly diagnosed LBP patients in Korea between 2004 and 2010 and divided them into an acupuncture group and control group according to whether or not they received acupuncture. Propensity scores based on age, sex, income, and Charlson Comorbidity Index were matched between the two study groups. The lumbar surgery rate in the two years following the first visit (control group) or the first acupuncture session (acupuncture group) was calculated. In addition to the overall analysis, stratified analyses were also conducted in different age, sex, and income strata. Sensitivity analyses were further performed using varying definitions of acupuncture treatment. RESULTS After matching, 130,089 subjects were included in each study group. The lumbar surgery rate was significantly lower in the acupuncture group than in the control group (hazard ratio [HR] 0.633, 95% confidence interval [CI] 0.576-0.696). Decrease in HR was consistently observed in the acupuncture group for all age strata, except for patients in their 20s (HR 1.031, 95% CI 0.804-1.323). HR for lumbar surgery tended to be further reduced in the older age groups upon acupuncture treatment, with no apparent sex-related differences. Lowered HR in the acupuncture group was continuously observed across all income groups; the higher income group showed a tendency of greater decrease. Sensitivity analyses showed that the number of acupuncture sessions had no major impact on the likelihood of lumbar surgery, but also that more intensive acupuncture treatment was associated with further reduction in lumbar surgery rates. CONCLUSION The present results found that administration of acupuncture treatment is associated with lower lumbar surgery rates for LBP patients in Korea. Prospective studies are warranted in the future to further investigate the effect of acupuncture treatment on lumbar surgery incidence.
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Affiliation(s)
- Wonil Koh
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Kyungwon Kang
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Me-riong Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- University of Science & Technology (UST), Korean Medicine Life Science, Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyung-Min Shin
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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27844
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Mortimer R, Nachiappan S, Howlett DC. Carotid artery stenosis screening: where are we now? Br J Radiol 2018; 91:20170380. [PMID: 29770736 DOI: 10.1259/bjr.20170380] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Stroke poses a significant burden on healthcare and is the second largest cause of death globally. Both medical and surgical interventions to reduce the risk of stroke in asymptomatic patients have been shown to be effective but identifying the target at risk population is more problematic. Screening for carotid artery stenosis offers one pathway for this, as there is some correlation between risk of stroke and extent of stenosis. Identification of patients who are at risk of cardiovascular disease as well as stroke, allows initiation of effective medical treatment of modifiable risk factors to address this risk. In addition, carotid intima-media thickness is a way of assessing systemic atherosclerosis and may be valuable in risk stratification of patients for cardiovascular disease. Given the low prevalence of stenosis in the general population and the risks associated with undergoing surgical intervention, population wide screening is not recommended. This recommendation has not changed over the last 15 years, since the last major studies evaluating management and outcomes were published. However, both medical and surgical/endovascular treatments have advanced over that time. Further studies are underway to compare current treatments for the appropriate management of both symptomatic and asymptomatic patients with stenosis. Two of these trials, ECST-2 and CREST-2, are expected to be completed in the next 2-4 years and the results may initiate changes in the recommendations. The use of carotid intima-media thickness alongside traditional risk scores is controversial and more research is required in this area.
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Affiliation(s)
- Rebecca Mortimer
- 1 Emergency Department, East Sussex Healthcare Trust , Eastbourne , UK
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27845
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Abstract
In addition to its role in gastric conditions,
Helicobacter pylori has been found to contribute to the development of several non-gastric issues in recent years. Eradication therapy is the only effective management strategy to minimize the
H. pylori-related gastric cancer and extra-gastric complications. For an effective “test and treat” strategy, diagnosis and therapy are both important. Because the infection is usually asymptomatic, patient selection is a critical issue for timely diagnosis and many clinical and demographic factors should be considered. Clarithromycin and metronidazole resistance rates also need to be considered while eradication therapy is offered. In this report, we discuss the issues which must be taken into account for the correct and timely diagnosis and for the antibiotic therapy-based management of
H. pylori infection.
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Affiliation(s)
- Shamshul Ansari
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita, 879-5593, Japan
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita, 879-5593, Japan.,Department of Medicine-Gastroenterology, Baylor College of Medicine, 2002 Holcombe Boulevard, Houston, TX, 77030, USA
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27846
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Meireles DP, Santos IS, Alencar AP, Lotufo PA, Benseñor IM, Goulart AC. Prognostic value of carotid intima-media in the short- and long-term mortality in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Echocardiography 2018; 35:1351-1361. [PMID: 29886570 DOI: 10.1111/echo.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND AND AIMS Atherosclerotic in carotids can determinate a poor prognosis in individuals after acute coronary syndrome (ACS). Thus, we aimed to evaluate mortality associated to carotid intima media thickness (CIMT) in the participants from the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. METHODS Carotid intima media thickness was evaluated by B-mode ultrasound for mortality risk assessment in 180 days, 1-3 years. We performed Kaplan-Meier survival curves and Cox logistic regression models to evaluate all-cause, cardiovascular (CVD) and coronary heart disease (CHD) mortality by CIMT tertiles in crude, age and sex- and multivariate models. RESULTS Among 644 ACS individuals (median age 61-year old), we observed a median CIMT of 0.74 mm. Besides aging, low education, hypertension, diabetes, and dyslipidemia were associated with the 3rd tertile of CIMT values. During 3 years of follow-up, we observed 65 deaths (10.1%), crude case-fatality rates were progressively higher across the CIMT tertiles in all periods, being the highest rates observed in participants with the highest CIMT (3rd tertile) (180-day: 6.6% vs 1-year: 9.0% vs 2-year:12.3% vs 3-year:16.0%, P < .05). In crude analyses, lowest survival rates (all-cause, CVD and CHD, p log-rank values <0.005) and higher hazard ratios of dying for all-cause and CVD (from 1 to 3 years) and for CHD (2 and 3 years) were observed. However, we kept no significant results after adjusting for age. CONCLUSION Carotid intima media thickness was mainly influenced by aging. CIMT was not a good predictor of all-cause, CVD or CHD mortality in the ERICO study.
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Affiliation(s)
- Danilo P Meireles
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Airlane P Alencar
- Institute of Mathematics and Statistics, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil
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27847
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Blagev DP, Collingridge DS, Rea S, Horne BD, Press VG, Churpek MM, Carey KA, Mularski RA, Zeng S, Arjomandi M. The Laboratory-Based Intermountain Validated Exacerbation (LIVE) Score Identifies Chronic Obstructive Pulmonary Disease Patients at High Mortality Risk. Front Med (Lausanne) 2018; 5:173. [PMID: 29942803 PMCID: PMC6004514 DOI: 10.3389/fmed.2018.00173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/17/2018] [Indexed: 01/06/2023] Open
Abstract
Background: Identifying COPD patients at high risk for mortality or healthcare utilization remains a challenge. A robust system for identifying high-risk COPD patients using Electronic Health Record (EHR) data would empower targeting interventions aimed at ensuring guideline compliance and multimorbidity management. The purpose of this study was to empirically derive, validate, and characterize subgroups of COPD patients based on routinely collected clinical data widely available within the EHR. Methods: Cluster analysis was used in 5,006 patients with COPD at Intermountain to identify clusters based on a large collection of clinical variables. Recursive Partitioning (RP) was then used to determine a preferred tree that assigned patients to clusters based on a parsimonious variable subset. The mortality, COPD exacerbations, and comorbidity profile of the identified groups were examined. The findings were validated in an independent Intermountain cohort and in external cohorts from the United States Veterans Affairs (VA) and University of Chicago Medicine systems. Measurements and Main Results: The RP algorithm identified five LIVE Scores based on laboratory values: albumin, creatinine, chloride, potassium, and hemoglobin. The groups were characterized by increasing risk of mortality. The lowest risk, LIVE Score 5 had 8% 4-year mortality vs. 56% in the highest risk LIVE Score 1 (p < 0.001). These findings were validated in the VA cohort (n = 83,134), an expanded Intermountain cohort (n = 48,871) and in the University of Chicago system (n = 3,236). Higher mortality groups also had higher COPD exacerbation rates and comorbidity rates. Conclusions: In large clinical datasets across different organizations, the LIVE Score utilizes existing laboratory data for COPD patients, and may be used to stratify risk for mortality and COPD exacerbations.
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Affiliation(s)
- Denitza P Blagev
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center, Murray, UT, United States.,Division of Respiratory, Critical Care, and Sleep Medicine, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Dave S Collingridge
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center, Murray, UT, United States.,Office of Research, Intermountain Healthcare, Salt Lake City, UT, United States
| | - Susan Rea
- Office of Research, Intermountain Healthcare, Salt Lake City, UT, United States.,Homer Warner Center for Informatics Research, Murray, UT, United States
| | - Benjamin D Horne
- Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, United States.,Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Valerie G Press
- Section of General Internal Medicine, Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
| | - Matthew M Churpek
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
| | - Kyle A Carey
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
| | - Richard A Mularski
- Kaiser Permanente Center for Health Research-Northwest, Portland, OR, United States.,Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Siyang Zeng
- Division of Pulmonary and Critical Care Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States.,Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Mehrdad Arjomandi
- Division of Pulmonary and Critical Care Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States.,Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, United States
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27848
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Bagg MK, McLachlan AJ, Maher CG, Kamper SJ, Williams CM, Henschke N, Wand BM, Moseley GL, Hübscher M, O'Connell NE, van Tulder MW, Nikolakopoulou A, McAuley JH. Paracetamol, NSAIDS and opioid analgesics for chronic low back pain: a network meta-analysis. Cochrane Database Syst Rev 2018. [DOI: 10.1002/14651858.cd013045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Matthew K Bagg
- Neuroscience Research Australia; Sydney NSW Australia
- University of New South Wales; Prince of Wales Clinical School; Sydney NSW Australia
- University of New South Wales; New College Village; Sydney NSW Australia
| | - Andrew J McLachlan
- University of Sydney; Faculty of Pharmacy; A15 - Pharmacy Room N405 Sydney NSW Australia 2006
- Concord Repatriation General Hospital; Centre for Education and Research on Ageing; Sydney NSW Australia
| | - Christopher G Maher
- University of Sydney; Sydney School of Public Health; Level 10 North, King George V Building, Missenden Road, Camperdown Sydney NSW Australia 2050
| | - Steven J Kamper
- University of Sydney; Sydney School of Public Health; Level 10 North, King George V Building, Missenden Road, Camperdown Sydney NSW Australia 2050
| | - Christopher M Williams
- University of Newcastle; School of Medicine and Public Health; Longworth Ave Callaghan New South Wales (NSW) Australia 2308
- Hunter Medical Research Institute; New Lambton NSW Australia 2305
| | | | - Benedict M Wand
- The University of Notre Dame Australia Fremantle; School of Physiotherapy; 19 Mouat Street (PO Box 1225) Perth West Australia Australia 6959
| | - G L Moseley
- Neuroscience Research Australia; Sydney NSW Australia
- University of South Australia; Sansom Institute for Health Research; Adelaide Australia
| | | | - Neil E O'Connell
- Brunel University London; Health Economics Research Group, Institute of Environment, Health and Societies, Department of Clinical Sciences; Kingston Lane Uxbridge Middlesex UK UB8 3PH
| | - Maurits W van Tulder
- Vrije Universiteit; Department of Health Sciences, Faculty of Science and Amsterdam Movement Science institute; Amsterdam Netherlands
| | - Adriani Nikolakopoulou
- University of Bern; Institute of Social and Preventive Medicine (ISPM); Bern Switzerland
| | - James H McAuley
- Neuroscience Research Australia; Sydney NSW Australia
- University of New South Wales; School of Medical Sciences; Sydney NSW Australia
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27849
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27850
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Grant C, Williams B, Driscoll T. Historical trends in publications in the International Journal of Epidemiology. Int J Epidemiol 2018; 47:938-941. [PMID: 29893853 DOI: 10.1093/ije/dyy109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to provide a detailed insight into the nature of the content published in the International Journal of Epidemiology (IJE) over its history. METHODS This study reviewed five complete volumes of the IJE at 10-year intervals (1976, 1986, 1996, 2006 and 2016). Information was extracted for 628 articles considered to be most representative of the content of the IJE, with detailed information analysed for 435 articles identified as original research articles. RESULTS Over time, the number of articles published per issue and per year increased and the number of authors per article increased. Cohort studies were consistently the most common study type. The majority of first authors and two-thirds of the populations studied were from high-income countries, although there was a clear trend over time towards more studies investigating multiple countries. Within original research articles, neoplasms (17%), infectious and parasitic diseases (14%) and diseases of the circulatory system (12%) were the most common disease type studied in original research articles (but the study topics varied between low-income and high-income countries); and socioeconomic factors (17%), environmental factors (15%) and biological factors and behaviours (both 12%) were the most common study factors. The topics of articles generally had good correlation with the global burden of disease, both overall and within geographical regions studied, but mental health and musculoskeletal disorders were notable omissions. CONCLUSIONS Working to increase publications from low- and middle-income groups, and studies covering areas such as mental health and musculoskeletal disorders, should be considered.
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Affiliation(s)
- Caitlin Grant
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia
| | - Bridget Williams
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia
| | - Tim Driscoll
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia
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