4101
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Walker E, Lo K, Tham S, Pahl M, Lomiwes D, Cooney J, Wohlers M, Gopal P. New Zealand Bitter Hops Extract Reduces Hunger During a 24 h Water Only Fast. Nutrients 2019; 11:nu11112754. [PMID: 31766216 PMCID: PMC6893682 DOI: 10.3390/nu11112754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/06/2019] [Accepted: 11/09/2019] [Indexed: 12/19/2022] Open
Abstract
Intermittent fasting improves metabolic and cardiac health. However, increased hunger towards the end of the fasting period may affect compliance and limit its application. Our aim was to determine the effect of anorexigenic agent co-therapy on subjective ratings of appetite during the 16–24 h period of a day-long water-only intermittent fast. Thirty adult men were recruited and required to fast for 24 h from 18:00 h to 18:00 h on the same day of the week for three subsequent weeks. Treatments of either a placebo or one of two doses (high dose; HD: 250 mg or low dose; LD: 100 mg) of a bitter hops-based appetite suppressant (Amarasate®) were given twice per day at 16 and 20 h into the fast. From 18–24 h of the 24 h fast, both the HD and LD treatment groups exhibited a statistically significant (p < 0.05) > 10% reduction in hunger. Additionally, the expected lunchtime increase in hunger that was present in the placebo group (12:00 h) was absent in both the HD and LD groups. These data suggest that appetite suppressant co-therapy may be useful in reducing hunger during intermittent fasting, and show that bitter compounds may regulate appetite independently of meal timing.
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Affiliation(s)
- Edward Walker
- The New Zealand Institute for Plant and Food Research Limited, Auckland 1025, New Zealand; (K.L.); (M.P.); (M.W.)
- Correspondence: ; Tel.: +64-9925-7050
| | - Kim Lo
- The New Zealand Institute for Plant and Food Research Limited, Auckland 1025, New Zealand; (K.L.); (M.P.); (M.W.)
| | - Sze Tham
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand; (S.T.); (D.L.); (P.G.)
| | - Malcolm Pahl
- The New Zealand Institute for Plant and Food Research Limited, Auckland 1025, New Zealand; (K.L.); (M.P.); (M.W.)
| | - Dominic Lomiwes
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand; (S.T.); (D.L.); (P.G.)
| | - Janine Cooney
- The New Zealand Institute for Plant and Food Research Limited, Hamilton 3240, New Zealand;
| | - Mark Wohlers
- The New Zealand Institute for Plant and Food Research Limited, Auckland 1025, New Zealand; (K.L.); (M.P.); (M.W.)
| | - Pramod Gopal
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand; (S.T.); (D.L.); (P.G.)
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4102
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Diani M, Perego S, Sansoni V, Bertino L, Gomarasca M, Faraldi M, Pigatto PDM, Damiani G, Banfi G, Altomare G, Lombardi G. Differences in Osteoimmunological Biomarkers Predictive of Psoriatic Arthritis among a Large Italian Cohort of Psoriatic Patients. Int J Mol Sci 2019; 20:ijms20225617. [PMID: 31717649 PMCID: PMC6888436 DOI: 10.3390/ijms20225617] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022] Open
Abstract
(1) Background: In literature it is reported that 20–30% of psoriatic patients evolve to psoriatic arthritis over time. Currently, no specific biochemical markers can either predict progression to psoriatic arthritis or response to therapies. This study aimed to identify osteoimmunological markers applicable to clinical practice, giving a quantitative tool for evaluating pathological status and, eventually, to provide prognostic support in diagnosis. (2) Methods: Soluble (serum) bone and cartilage markers were quantified in 50 patients with only psoriasis, 50 psoriatic patients with psoriatic arthritis, and 20 healthy controls by means of multiplex and enzyme-linked immunoassays. (3) Results: Differences in the concentrations of matrix metalloproteases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), receptor activator of nuclear factor kappa-B- ligand (RANK-L), procollagen type I N propeptide (PINP), C-terminal telopeptide of type I collagen (CTx-I), dickkopf-related protein 1 (DKK1), and sclerostin (SOST) distinguished healthy controls from psoriasis and psoriatic arthritis patients. We found that MMP2, MMP12, MMP13, TIMP2, and TIMP4 distinguished psoriasis from psoriatic arthritis patients undergoing a systemic treatment, with a good diagnostic accuracy (Area under the ROC Curve (AUC) > 0.7). Then, chitinase-3-like protein 1 (CHI3L1) and MMP10 distinguished psoriasis from psoriatic arthritis not undergoing systemic therapy and, in the presence of onychopathy, MMP8 levels were higher in psoriasis than in psoriatic arthritis. However, in these latter cases, the diagnostic accuracy of the identified biomarkers was low (0.5 < AUC < 0.7). (4) Conclusions. By highlighting never exploited differences, the wide osteoimmunological biomarkers panel provides a novel clue to the development of diagnostic paths in psoriasis and psoriasis-associated arthropathic disease.
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Affiliation(s)
- Marco Diani
- Department of Dermatology and Venereology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (M.D.); (P.D.M.P.); (G.A.)
| | - Silvia Perego
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (S.P.); (V.S.); (M.G.); (M.F.); (G.B.); (G.L.)
| | - Veronica Sansoni
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (S.P.); (V.S.); (M.G.); (M.F.); (G.B.); (G.L.)
| | - Lucrezia Bertino
- Department of Clinical and Experimental Medicine, section of Dermatology, University of Messina, 98122 Messina, Italy;
| | - Marta Gomarasca
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (S.P.); (V.S.); (M.G.); (M.F.); (G.B.); (G.L.)
| | - Martina Faraldi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (S.P.); (V.S.); (M.G.); (M.F.); (G.B.); (G.L.)
| | - Paolo Daniele Maria Pigatto
- Department of Dermatology and Venereology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (M.D.); (P.D.M.P.); (G.A.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milano, Italy
| | - Giovanni Damiani
- Department of Dermatology and Venereology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (M.D.); (P.D.M.P.); (G.A.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milano, Italy
- Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA
- Young Dermatologists Italian Network, Centro Studi GISED, 24121 Bergamo, Italy
- Correspondence: ; Tel.: +39-0266214068
| | - Giuseppe Banfi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (S.P.); (V.S.); (M.G.); (M.F.); (G.B.); (G.L.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Gianfranco Altomare
- Department of Dermatology and Venereology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (M.D.); (P.D.M.P.); (G.A.)
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (S.P.); (V.S.); (M.G.); (M.F.); (G.B.); (G.L.)
- Department of Physiology and Pharmacology, Gdańsk University of Physical Education and Sport, 80336 Gdańsk, Poland
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4103
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Lichtenegger P, Schiefer J, Graf A, Berlakovich G, Faybik P, Baron DM, Baron-Stefaniak J. The association of pre-operative anaemia with survival after orthotopic liver transplantation. Anaesthesia 2019; 75:472-478. [PMID: 31701527 PMCID: PMC7078747 DOI: 10.1111/anae.14918] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 12/15/2022]
Abstract
Anaemia is common in patients with end-stage liver disease. Pre-operative anaemia is associated with greater mortality after major surgery. We analysed the association of pre-operative anaemia (World Health Organization classification) with survival and complications after orthotopic liver transplantation using Cox and logistic regression models. We included patients undergoing their first orthotopic liver transplantation between 2004 and 2016. Out of 599 included patients, 455 (76%) were anaemic before transplantation. Pre-operative anaemia was not associated with the survival of 485/599 (81%) patients to 1 year after liver transplantation, OR (95%CI) 1.04 (0.64-1.68), p = 0.88. Pre-operative anaemia was associated with higher rates of intra-operative blood transfusions and acute postoperative kidney injury on multivariable analysis, OR (95%CI) 1.70 (0.82-2.59) and 1.72 (1.11-2.67), respectively, p < 0.001 for both. Postoperative renal replacement therapy was associated with pre-operative anaemia on univariate analysis, OR (95%CI) 1.87 (1.11-3.15), p = 0.018.
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Affiliation(s)
- P Lichtenegger
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - J Schiefer
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - A Graf
- Section for Medical Statistics, Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - G Berlakovich
- Division of Transplantation, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - P Faybik
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - D M Baron
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - J Baron-Stefaniak
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
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4104
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Factors Associated with Sleep Disorders among Methadone-Maintained Drug Users in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224315. [PMID: 31698771 PMCID: PMC6887969 DOI: 10.3390/ijerph16224315] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022]
Abstract
Sleep quality among heroin-dependent patients receiving methadone maintenance treatment (MMT) is not fully investigated in Vietnam. This study explored the prevalence of poor sleep quality in methadone-maintained patients and associated factors. This cross-sectional included 395 MMT patients at three clinics in Nam Dinh province, Vietnam. The Pittsburgh Sleep Quality Index (PSQI) was employed to measure patients’ sleep quality. Sociodemographic, clinical, behavioral, psychological, and social support characteristics were collected. Multivariate Logistic and Generalized Linear Regression models were applied to identify associated factors. Among 395 patients, 26.6% had poor sleep quality according to the PSQI scale. People having jobs were less likely to have poor sleep quality and lower PSQI scores compared to unemployed patients. Those having spouses had lower PSQI scores than single patients. High depression, anxiety, and stress scores were associated with poor sleep quality and high PSQI scores. A longer duration of MMT increased the likelihood of experiencing poor sleep quality. Patients smoking tobacco daily or concurrently using drugs had lower PSQI scores than those that did not. This study highlights a moderate prevalence of poor sleep quality among Vietnamese MMT patients. Regular evaluation, appropriate psychological management, and social support, as well as the provision of employment opportunities, potentially improve the sleep quality of methadone-maintained patients.
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4105
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Emotion, Psychological Well-Being and Their Influence on Resilience. A Study with Semi-Professional Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214192. [PMID: 31671532 PMCID: PMC6861950 DOI: 10.3390/ijerph16214192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/24/2019] [Accepted: 10/26/2019] [Indexed: 01/07/2023]
Abstract
The objective of the present study is to analyze the influence of coaches on emotional intelligence and on levels of anxiety, motivation, self-esteem, and resilience among athletes. Five-hundred forty-seven semi-professional athletes between the ages of 16 and 19 participated in this study. Various statistical analyses were conducted which explain the causal relationships between the variables. The results, obtained using a structural equations model, find that while autonomy support positively predicts emotional intelligence, perceived control predicts it negatively. Moreover, emotional intelligence positively predicts self-esteem and self-determined motivation, but negatively predicts anxiety. Other results show that self-esteem positively predicts self-determined motivation, whereas anxiety predicts it negatively. Finally, self-determined motivation positively predicts resilience. Indeed, the study demonstrates the influence and the importance of coaches in relation to the emotional intelligence, psychological well-being, and motivational processes of adolescent athletes when the latter engage in their respective sports. These results help to better understand how different behavioral, emotional, and social aspects belonging to the athlete interrelate with one another during competition.
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4106
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Caffeine enhances the anti-tumor effect of 5-fluorouracil via increasing the production of reactive oxygen species in hepatocellular carcinoma. Med Oncol 2019; 36:97. [DOI: 10.1007/s12032-019-1323-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/15/2019] [Indexed: 01/19/2023]
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4107
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Choi F, Lehmer L, Ekelem C, Mesinkovska NA. Dietary and metabolic factors in the pathogenesis of hidradenitis suppurativa: a systematic review. Int J Dermatol 2019; 59:143-153. [PMID: 31651051 DOI: 10.1111/ijd.14691] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/10/2019] [Accepted: 09/20/2019] [Indexed: 12/13/2022]
Abstract
Hidradenitis suppurativa (HS) is a systemic recalcitrant inflammatory condition characterized by debilitating lesions with high morbidity. Its known association with obesity and smoking indicate correlation with other environmental factors, such as diet, suggesting a larger role for lifestyle modifications in disease treatment. This study seeks to assess the contribution of weight loss and dietary intake in HS management. A primary literature search was conducted using PubMed, Web of Science, and CINAHL in November 2018 to include association and intervention studies on the influence of diet and weight on HS. Twenty-five articles were included. Meta-analysis of nine case-control studies across Asia, Europe, and the United States showed that HS patients are four times more likely to be obese compared to the general population; random effects pooled odds ratio 4.022 (2.667-6.065), P < 0.001. Five articles assessed weight-loss interventions and revealed mixed findings. The remaining articles included three association studies on micronutrient levels, eight dietary intervention studies, and one article analyzing both micronutrient association and dietary intervention. Included articles in this systematic review reveal that low serum zinc and vitamin D levels are associated with increased lesion count in HS. Supplementation of zinc, vitamin D, vitamin B12, or exclusion of dairy or brewer's yeast can be effective in partial or complete lesion resolution. Reviewed data show that weight loss from bariatric surgery may lead to HS improvement but often results in more severe malnutrition that worsens or even leads to new onset HS post bariatric surgery. Future reporting is needed to conclusively determine the role of diet in HS.
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Affiliation(s)
- Franchesca Choi
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA.,Kaohsiung Medical University, School of Medicine, Kaohsiung, Taiwan
| | - Larisa Lehmer
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Chloe Ekelem
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
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4108
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Tomaszek K, Muchacka-Cymerman A. Sex Differences in the Relationship between Student School Burnout and Problematic Internet Use among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4107. [PMID: 31653105 PMCID: PMC6862502 DOI: 10.3390/ijerph16214107] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Internet has many positive sides, but it can also have a negative impact on human emotional-cognitive and behavioral functioning, especially during adolescence. To the most common consequences, the authors add addiction of the teenager to the Internet. This addiction is related to many negative physical and mental problems, including depression, substance abuse and social isolation. METHODS In the study, SSBS (Student School Burnout Scale) was used to measure the level of burnout, and the level of Internet addiction was measured using PUI (Internet Addiction Test). The research was carried out among 230 individuals aged 17-20 years. RESULTS The results of the research showed that higher level of school burnout is related to higher Internet addiction indicators, and connection was stronger in the male group. Gender significantly predicted Internet addiction and moderated the link between school burnout and Internet addiction. Hierarchical multiple regression analyses confirmed different predictors of Internet addiction for male and female students. However, for both groups, higher burnout due to parents was a significant predictor of Internet addiction (IA). DISCUSSION Internet addiction was predicted by school burnout, appearing as a result of parental pressure for high school achievements. In addition, school burnout and school-related characteristics have greater prediction power of Internet addiction and its indicators in a male group.
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Affiliation(s)
- Katarzyna Tomaszek
- Department of Psychosomatic, Institute of Psychology, Pedagogical University of Cracow, Podchorążych 2, 30-084 Kraków, Poland.
| | - Agnieszka Muchacka-Cymerman
- Department of Psychosomatic, Institute of Psychology, Pedagogical University of Cracow, Podchorążych 2, 30-084 Kraków, Poland.
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4109
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Garbarino S, Magnavita N. Sleep problems are a strong predictor of stress-related metabolic changes in police officers. A prospective study. PLoS One 2019; 14:e0224259. [PMID: 31639178 PMCID: PMC6804978 DOI: 10.1371/journal.pone.0224259] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/25/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Previous studies have shown that workers chronically exposed to occupational stress have an increased risk of metabolic syndrome (MetS) and sleep problems (SPs). The purpose of this study was to verify whether SPs mediate the relationship between stress and MetS. METHOD A 5-year prospective cohort study included 242 police officers from a rapid response unit engaged exclusively in maintaining law and order. Perceived stress levels were measured repeatedly with the demand-control-support and the effort-reward-imbalance questionnaires; insomnia symptoms were assessed with the Pittsburgh Sleep Quality Index; excessive daytime sleepiness was measured using the Epworth Sleepiness Scale. MetS and its components were evaluated at baseline and at follow-up. RESULTS During 5-year follow-up period, 26 new cases of MetS were identified. Both occupational stress and SPs were significantly related to incident cases of MetS. Insomnia symptoms showed a highly significant association with MetS (aOR 11.038; CI95% 2.867-42.493). Mediation analysis confirmed that SPs mediate the relationship between stress and MetS. A reciprocal relationship was found between job stress and SPs. Work-related stress was a significant predictor of insomnia symptoms, short sleep duration, sleep dissatisfaction, and sleepiness. Compared to the reference group, police officers with SPs at baseline had significantly higher odds of reporting high stress at follow-up. CONCLUSION SPs play a mediating role in the relationship between occupational stress and MetS. Prevention of MetS must include the control of stress factors and an increase in the resilience of workers, but correct sleep hygiene is also an essential factor.
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Affiliation(s)
- Sergio Garbarino
- Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- State Police Health Service Department, Ministry of the Interior, Rome, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI), Genoa, Italy
| | - Nicola Magnavita
- Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman/Child & Public Health, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
- * E-mail:
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4110
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Damiani G, Pacifico A, Linder DM, Pigatto PDM, Conic R, Grada A, Bragazzi NL. Nanodermatology-based solutions for psoriasis: State-of-the art and future prospects. Dermatol Ther 2019; 32:e13113. [PMID: 31600849 DOI: 10.1111/dth.13113] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/04/2019] [Indexed: 12/24/2022]
Abstract
Nanodermatology is an emerging, multidisciplinary science, arising from the convergence of nanotechnology, pharmacology, physics/biophysics, chemistry/biochemistry, chemical engineering, material science, and clinical medicine. Nanodermatology deals with (a) skin biology, anatomy, and physiology at the nanoscale ("skin nanobiology"), (b) diagnosis performed by means of novel diagnostic devices, assisted by nanobiotechnologies ("nanodiagnosis"), and (c) treatment through innovative therapeutic agents, including phototherapy ("photonanotherapy"/"photonanodermatology") and systemic/topical drug administration ("nanotherapy") at the nanoscale, and drug delivery-such as transdermal or dermal drug delivery (TDDD/DDD)-enhanced and improved by nanostructures and nanodrugs ("nanodrug delivery"). Nanodermatology, as a super-specialized branch of dermatology, is a quite recent specialty: the "Nanodermatology Society" founded by the eminent dermatologist Dr. Adnan Nasir, was established in 2010, with the aim of bringing together different stakeholders, including dermatologists, nanotechnology scientists, policy-makers and regulators, as well as students and medical residents. Psoriasis has a prevalence of 2-3% worldwide and imposes a severe clinical and societal burden. Nanodermatology-based solutions appear promising for the proper treatment and management of psoriasis, assisting and enhancing different steps of the process of health-care delivery: from the diagnosis to the therapeutics, paving the way for a personalized approach, based on the specific dysregulated biomarkers.
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Affiliation(s)
- Giovanni Damiani
- Young Dermatologists Italian Network (YDIN), Centro Studi GISED, Bergamo, Italy.,Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | | | | | - Paolo D M Pigatto
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Rosalynn Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Ayman Grada
- Department of Dermatology, Laboratory of Cutaneous Wound Healing, Boston University School of Medicine, Boston, Massachusetts
| | - Nicola L Bragazzi
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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4111
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Khamisy-Farah R, Adawi M, Jeries-Ghantous H, Bornstein J, Farah R, Bragazzi NL, Odeh M. Knowledge of Human Papillomavirus (HPV), Attitudes and Practices Towards Anti-HPV Vaccination Among Israeli Pediatricians, Gynecologists, and Internal Medicine Doctors: Development and Validation of an Ad Hoc Questionnaire. Vaccines (Basel) 2019; 7:E157. [PMID: 31640127 PMCID: PMC6963669 DOI: 10.3390/vaccines7040157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV) is a highly widespread virus which is responsible for one of the most common sexually transmitted infections. Two main preventative strategies exist: anti-HPV vaccination and cervical screening. Health-care workers play a key role in promoting public health campaigns; however, vaccine hesitancy is an often under-recognized challenge. To investigate the overall knowledge of HPV and HPV-related issues, as well as the attitudes and practices of health professionals towards recommending the anti-HPV vaccine, an ad hoc knowledge, attitudes, and practices (KAP) questionnaire was developed and validated in a sample of 139 Israeli pediatricians, gynecologists, and internal medicine doctors. The KAP questionnaire was found to be psychometrically valid and sound (with an rKR-20 coefficient of 0.74 for the second part and a Cronbach's alpha of 0.85 for the third part). Furthermore, the present study confirmed the importance of health-care providers in recommending the immunization practice. Parents that had been strongly advised by health-care providers to vaccinate their children accepted immunization for their girls (odds ratio (OR) 1.09 (95% CI 1.04-1.14)) and boys (OR 1.06 (95% CI 1.02-1.10)), had a lower probability of deciding to postpone the immunization appointment (OR 0.81 (95% CI 0.66-0.98)), had fewer doubts and concerns about the vaccine (OR 0.69 (95% CI 0.54-0.89)), and had a lower probability of refusing the vaccination (OR 0.93 (95% CI 0.86-0.99)). Interestingly, the use of new, emerging tools such as ad hoc websites, applications, and other interactive devices reduced vaccine hesitancy (OR 0.90 (95% CI 0.82-0.99)) and concerns about the side-effects of the vaccine (OR 0.92 (95% CI 0.86-0.99)). However, among Israeli health-care workers, knowledge was generally moderate, with updated information lacking in about 30% of surveyed health-care providers and approximately 20% of them not recommending the anti-HPV vaccine among boys. This study has practical implications for policy- and decision-makers in that they should be aware of the overall level of knowledge among health-care workers and should implement ad hoc educational interventions to address gaps in knowledge and help medical providers routinely recommend the anti-HPV vaccine both to male and female children and adolescents.
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Affiliation(s)
- Rola Khamisy-Farah
- Clalit Health Service, Akko, Azrieli Faculty of Medicine, Bar-Ilan University, Safed 13100, Israel.
| | - Mohammad Adawi
- Department of Medicine, Baruch Padeh Medical Center, Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan 5290002, Israel.
| | - Haneen Jeries-Ghantous
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya 22100, Galilee, Israel.
- Faculty of Medicine, Bar Ilan University, Safed 13100, Israel.
| | - Jacob Bornstein
- Department of Internal Medicine B, Ziv Medical Center, Safed-Israel, Azrieli Faculty of Medicine, Bar-Ilan University, Safed 13100, Israel.
| | - Raymond Farah
- Department of Internal Medicine B, Ziv Medical Center, Safed-Israel, Azrieli Faculty of Medicine, Bar-Ilan University, Safed 13100, Israel.
| | - Nicola Luigi Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON M3J 1P3, Canada.
| | - Marwan Odeh
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya 22100, Galilee, Israel.
- Faculty of Medicine, Bar Ilan University, Safed 13100, Israel.
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4112
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4113
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Purba A, Demou E. The relationship between organisational stressors and mental wellbeing within police officers: a systematic review. BMC Public Health 2019; 19:1286. [PMID: 31615479 PMCID: PMC6792329 DOI: 10.1186/s12889-019-7609-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Occupational stressors in police work increase the risk for officer mental health morbidities. Officers' poor mental wellbeing is harmful to the individual, can affect professionalism, organisational effectiveness, and public safety. While the impact of operational stressors on officers' mental wellbeing is well documented, no review has systematically investigated organisational stressor impacts. This study aimed to conduct a systematic review to assess the relationship between organisational stressors and police officer mental wellbeing. METHODS Systematic review conducted following PRISMA and Cochrane Collaboration guidelines. Literature search was undertaken from 1990 to May 2017 on four databases (EBSCOHOST Medline/SocINDEX/PsycINFO/OVID Embase) and grey literature. Included articles were critically appraised and assessed for risk of bias. Narrative and evidence syntheses were performed by specific mental health outcomes. RESULTS In total, 3571 results were returned, and 15 studies met the inclusion criteria. All included studies were published in English between 1995 and 2016, had cross-sectional study designs, spanned across four continents and covered 15,150 officers. Strong evidence of significant associations was identified for organisational stressors and the outcomes of: occupational stress, psychiatric symptoms/psychological distress, emotional exhaustion and personal accomplishment. The organisational stressors most often demonstrating consistently significant associations with mental health outcomes included lack of support, demand, job pressure, administrative/organisational pressure and long working-hours. CONCLUSIONS This review is the first to systematically examine organisational stressors and mental health in police officers. Organisational stressors that can be targeted by interventions and policy changes to secure officer wellbeing, a healthy work environment, and benefits to the organisation and the public are identified.
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Affiliation(s)
- Amrit Purba
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G2 3AX UK
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4114
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What to Do about Childhood Obesity? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203902. [PMID: 31618822 PMCID: PMC6843535 DOI: 10.3390/ijerph16203902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 10/10/2019] [Indexed: 11/17/2022]
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4115
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Caso F, Navarini L, Carubbi F, Picchianti-Diamanti A, Chimenti MS, Tasso M, Currado D, Ruscitti P, Ciccozzi M, Annarumma A, Laganà B, Perricone R, Afeltra A, Giacomelli R, Scarpa R, Costa L. Mediterranean diet and Psoriatic Arthritis activity: a multicenter cross-sectional study. Rheumatol Int 2019; 40:951-958. [PMID: 31605152 DOI: 10.1007/s00296-019-04458-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/27/2019] [Indexed: 12/22/2022]
Abstract
Diet is a modifiable factor implicated in chronic systemic inflammation, and the mediterranean dietary pattern is considered to be a healthy model in terms of morbidity and mortality. The main aim of this study was to evaluate the adherence to the mediterranean diet in patients with Psoriatic Arthritis (PsA) and its impact on disease activity. A cross-sectional observational study was conducted in a cohort of 211 consecutive PsA patients. We evaluated PsA activity by disease activity index for PSoriatic Arthritis (DAPSA) and composite psoriatic disease activity index (CPDAI). The NCEP-ACT III criteria were used to identify subjects with MetS, and in each subject, we evaluated body mass index (BMI). A validated 14-item questionnaire for the assessment of adherence to the mediterranean diet (PREDIMED) was recorded for all the enrolled subjects. Patients showed a median age of 55 (48-62) and disease duration was 76 (36-120) months. 27.01% of patients were classified as having MetS. The median of the mediterranean diet score (MDS) was 7 (6-9). A moderate adherence to mediterranean diet was found in 66.35% of the entire cohort; 15.64% and 18.01% of the patients showed low- and high adherence to the dietary pattern, respectively. We found a negative association between DAPSA and adherence to mediterranean diet (B = - 3.291; 95% CI - 5.884 to - 0.698). DAPSA was positively associated with BMI (B = 0.332; 95% CI 0.047-0.618) and HAQ ( B = 2.176; 95% CI 0.984-3.368). Results from our study evidenced that in PsA patients, higher levels of disease activity as measured by DAPSA correlated with low adherence to mediterranean diet, suggesting potential benefit of antinflammatory properties of this dietary pattern.
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Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy.
| | - Luca Navarini
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Francesco Carubbi
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea Picchianti-Diamanti
- Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, 00185, Rome, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Marco Tasso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy
| | - Damiano Currado
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Piero Ruscitti
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Massimo Ciccozzi
- Unit of Clinical Laboratory Science, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Antonio Annarumma
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy
| | - Bruno Laganà
- Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, 00185, Rome, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Antonella Afeltra
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Roberto Giacomelli
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy
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4116
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The Effectiveness of Intermittent Fasting to Reduce Body Mass Index and Glucose Metabolism: A Systematic Review and Meta-Analysis. J Clin Med 2019; 8:jcm8101645. [PMID: 31601019 PMCID: PMC6832593 DOI: 10.3390/jcm8101645] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 12/14/2022] Open
Abstract
The effects of an intermittent fasting diet (IFD) in the general population are still controversial. In this study, we aimed to systematically evaluate the effectiveness of an IFD to reduce body mass index and glucose metabolism in the general population without diabetes mellitus. Cochrane, PubMed, and Embase databases were searched to identify randomized controlled trials and controlled clinical trials that compared an IFD with a regular diet or a continuous calorie restriction diet. The effectiveness of an IFD was estimated by the weighted mean difference (WMD) for several variables associated with glucometabolic parameters including body mass index (BMI) and fasting glucose. The pooled mean differences of outcomes were calculated using a random effects model. From 2814 studies identified through a literature search, we finally selected 12 articles (545 participants). Compared with a control diet, an IFD was associated with a significant decline in BMI (WMD, −0.75 kg/m2; 95% CI, −1.44 to −0.06), fasting glucose level (WMD, −4.16 mg/dL; 95% CI, −6.92 to −1.40), and homeostatic model assessment of insulin resistance (WMD, −0.54; 95% CI, −1.05 to −0.03). Fat mass (WMD, −0.98 kg; 95% CI, −2.32 to 0.36) tended to decrease in the IFD group with a significant increase in adiponectin (WMD, 1008.9 ng/mL; 95% CI, 140.5 to 1877.3) and a decrease in leptin (WMD, −0.51 ng/mL; 95% CI, −0.77 to −0.24) levels. An IFD may provide a significant metabolic benefit by improving glycemic control, insulin resistance, and adipokine concentration with a reduction of BMI in adults.
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Xiu MH, Wang DM, Du XD, Chen N, Tan SP, Tan YL, Yang FD, Cho RY, Zhang XY. Interaction of BDNF and cytokines in executive dysfunction in patients with chronic schizophrenia. Psychoneuroendocrinology 2019; 108:110-117. [PMID: 31255950 DOI: 10.1016/j.psyneuen.2019.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/15/2019] [Accepted: 06/11/2019] [Indexed: 12/21/2022]
Abstract
Multiple lines of evidence indicate that patients with chronic schizophrenia (SCZ) display executive dysfunction across the illness course. However, the potential molecular pathophysiologic mechanisms remain poorly elucidated. Neurodevelopmental changes caused by alterations of inflammatory mediators and neurotrophins have been shown to occur in the earliest stages of SCZ, and be associated with executive dysfunction (ED) in SCZ. Therefore, the current study was to investigate whether the interplay between BDNF and inflammatory mediators was involved in the disruption of executive function of long-term hospitalized patients with chronic SCZ. Serum cytokines and BDNF levels were measured in 112 long-term hospitalized patients with chronic SCZ and 44 healthy normal controls. Executive functions were assessed by verbal fluency tests (VFT), the Stroop word-color test (Stroop), and the Wisconsin card sorting tests (WCST).The results showed that the patients had higher IL-2, IL-6, IL-8, but lower TNF-α and BDNF compared to control subjects. In the patient group, BDNF was positively associated with IL-2 and IL-8 levels, while lower BDNF levels were correlated with ED measured by VFT and WCST tests. Multiple stepwise regression analyses confirmed that BDNF × IL-8 and BDNF × TNF-α were factors influencing the total score of VFT, while BDNF × IL-8 and BDNF × TNF-α were recognized as influencing factors for WCST scores. Our results suggest complex interactions between BDNF and cytokines were involved in the pathophysiology of executive function impairments in patients with SCZ.
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Affiliation(s)
- Mei Hong Xiu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dong Mei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang Dong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Nan Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shu Ping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Fu De Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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4118
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de Assis LVM, Moraes MN, Castrucci AMDL. The molecular clock in the skin, its functionality, and how it is disrupted in cutaneous melanoma: a new pharmacological target? Cell Mol Life Sci 2019; 76:3801-3826. [PMID: 31222374 PMCID: PMC11105295 DOI: 10.1007/s00018-019-03183-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/13/2019] [Accepted: 06/05/2019] [Indexed: 02/07/2023]
Abstract
The skin is the interface between the organism and the external environment, acting as its first barrier. Thus, this organ is constantly challenged by physical stimuli such as UV and infrared radiation, visible light, and temperature as well as chemicals and pathogens. To counteract the deleterious effects of the above-mentioned stimuli, the skin has complex defense mechanisms such as: immune and neuroendocrine systems; shedding of epidermal squamous layers and apoptosis of damaged cells; DNA repair; and pigmentary system. Here we have reviewed the current knowledge regarding which stimuli affect the molecular clock of the skin, the consequences to skin-related biological processes and, based on such knowledge, we suggest some therapeutic targets. We also explored the recent advances regarding the molecular clock disruption in melanoma, its impact on the carcinogenic process, and its therapeutic value in melanoma treatment.
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Affiliation(s)
- Leonardo Vinícius Monteiro de Assis
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, R. do Matão, Trav. 14, No. 101, São Paulo, 05508-090, Brazil
| | - Maria Nathalia Moraes
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, R. do Matão, Trav. 14, No. 101, São Paulo, 05508-090, Brazil
- School of Health Science, University Anhembi Morumbi, São Paulo, Brazil
| | - Ana Maria de Lauro Castrucci
- Laboratory of Comparative Physiology of Pigmentation, Department of Physiology, Institute of Biosciences, University of São Paulo, R. do Matão, Trav. 14, No. 101, São Paulo, 05508-090, Brazil.
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4119
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Abstract
Generated and collected data have been rising with the popularization of technologies such as Internet of Things, social media, and smartphone, leading big data term creation. One class of big data hidden information is causality. Among the tools to infer causal relationships, there is Delay Transfer Entropy (DTE); however, it has a high demanding processing power. Many approaches were proposed to overcome DTE performance issues such as GPU and FPGA implementations. Our study compared different parallel strategies to calculate DTE from big data series using a heterogeneous Beowulf cluster. Task Parallelism was significantly faster in comparison to Data Parallelism. With big data trend in sight, these results may enable bigger datasets analysis or better statistical evidence.
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4120
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Giboin LS, Wolff W. The effect of ego depletion or mental fatigue on subsequent physical endurance performance: A meta-analysis. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.peh.2019.100150] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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4121
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Bello AK, Kurzawa J, Osman MA, Olah ME, Lloyd A, Wiebe N, Habib S, Qarni U, Shojai S, Pauly RP. Impact of Ramadan fasting on kidney function and related outcomes in patients with chronic kidney disease: a systematic review protocol. BMJ Open 2019; 9:e022710. [PMID: 31446401 PMCID: PMC6720242 DOI: 10.1136/bmjopen-2018-022710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Fasting during the month of Ramadan is a significant Islamic religious practice that involves abstinence from food, drink and medication from dawn to dusk. As just under a quarter of the world's population identifies as Muslim, the effect of fasting on chronic conditions, such as chronic kidney disease (CKD) is a topic of broad relevance. To date, the information in this area has been mixed, with many limitations of previous studies. This study aims to synthesise the evidence of the effect of Ramadan fasting on changes on kidney function, risk factors, episodes of acute kidney injury and impact on the quality of life in patients with CKD or kidney transplant. METHODS AND ANALYSIS A systematic review of the literature will be conducted, using electronic databases such as MEDLINE, Embase, Global Health, CINAHL and Scopus. Original research and grey literature on the effect of Ramadan fasting in adult patients with CKD or renal transplantation will be included. Two reviewers will independently screen articles for inclusion in the review and independently assess the methodology of included studies using a customised checklist. Mean difference or risk ratio will be reported for continuous or dichotomous outcomes and results will be pooled using a random-effects model where heterogeneity is reasonable. If possible, subgroups (CKD status, setting, season and risk of bias) will be analysed for effect modification with fasting and the outcomes of interest. Risk of bias will be assessed using the Downs and Black checklist. ETHICS AND DISSEMINATION The results will be disseminated using a multifaceted approach to engage all stakeholders (patients, practitioners and community leaders). Research ethics board approval is not required as this is a systematic review of previously published research. PROSPERO REGISTRATION NUMBER CRD42018088973.
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Affiliation(s)
- Aminu K Bello
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Julia Kurzawa
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mohamed A Osman
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle E Olah
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Anita Lloyd
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Syed Habib
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Uwais Qarni
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Soroush Shojai
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert P Pauly
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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4122
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Alam I, Gul R, Chong J, Tan CTY, Chin HX, Wong G, Doggui R, Larbi A. Recurrent circadian fasting (RCF) improves blood pressure, biomarkers of cardiometabolic risk and regulates inflammation in men. J Transl Med 2019; 17:272. [PMID: 31426866 PMCID: PMC6700786 DOI: 10.1186/s12967-019-2007-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/31/2019] [Indexed: 12/22/2022] Open
Abstract
Background The effects of fasting on health in non-human models have been widely publicised for a long time and emerging evidence support the idea that these effects can be applicable to human practice. Methods In an open label longitudinal follow-up, a cohort of 78 adult men (aged 20 to 85 years) who fasted for 29 consecutive days from sunrise to sunset (16 h fasting—referred to as recurrent circadian fasting) in Pakistan, were studied. The primary outcomes of the fasting study was weight loss/recovery and the associated changes in blood pressure and circulating levels of surrogate markers linked to organ and system functions—including cardiovascular, metabolic and inflammation. Post-fasting outcomes include the regulation of physiological biomarkers. Results Recurrent circadian fasting with weight loss reduced blood pressure (140.6 vs. 124.2 mmHg) and markers of cardiovascular risk (~ 4-fold for resistin; triglycerides: p < 0.0001). Reduced glycemia (p < 0.0001) and the associated changes in the regulation of ketosis (β-hydroxybutyrate) were accompanied by a metabolic shift (PPARβ, osteoprotegerin), suggesting the involvement of the different physiological systems tested. Elevated orexin-A levels (p = 0.0183) in participants indicate sleep disturbance and circadian adaptation. All participants had CRP level < 2 mg/l during the fasting period and a similar trend was observed for TNFα. While most SASP molecules were decreased after the fasting period, heightened levels of IL-8 and IL-6 suggest that some inflammatory markers may be elevated by recurrent circadian fasting. Importantly, older adults reveal similar or more substantial benefits from fasting. Conclusions Recurrent circadian fasting is beneficial at the cardiometabolic and inflammatory levels, especially for at-risk individuals—this is contingent on compliance towards the recommended dietary behaviour, which controls carbohydrate and caloric intake. These benefits from fasting may be particularly beneficial to older adults as they often exhibit abnormal cardiovascular, metabolic and inflammatory signatures. Electronic supplementary material The online version of this article (10.1186/s12967-019-2007-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iftikhar Alam
- Department of Community Health Sciences, Clinical Nutrition Program, College of Applied Medical Sciences, King Saud University, King Abdullah Street, Riyadh, Kingdom of Saudi Arabia.,Department of Human Nutrition and Dietetics, Bacha Khan University, Charsaddah, KPK, Pakistan
| | - Rahmat Gul
- Department of Human Nutrition and Dietetics, Bacha Khan University, Charsaddah, KPK, Pakistan
| | - Joni Chong
- Biology of Aging Laboratory, Singapore Immunology Network, Agency for Science Technology and Research, 8A Biomedical Grove, Singapore, 138648, Singapore
| | - Crystal Tze Ying Tan
- Biology of Aging Laboratory, Singapore Immunology Network, Agency for Science Technology and Research, 8A Biomedical Grove, Singapore, 138648, Singapore
| | - Hui Xian Chin
- Biology of Aging Laboratory, Singapore Immunology Network, Agency for Science Technology and Research, 8A Biomedical Grove, Singapore, 138648, Singapore
| | - Glenn Wong
- Biology of Aging Laboratory, Singapore Immunology Network, Agency for Science Technology and Research, 8A Biomedical Grove, Singapore, 138648, Singapore
| | - Radhouene Doggui
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, National Institute of Nutrition and Food Technology (INNTA), Tunis, Tunisia
| | - Anis Larbi
- Biology of Aging Laboratory, Singapore Immunology Network, Agency for Science Technology and Research, 8A Biomedical Grove, Singapore, 138648, Singapore. .,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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4123
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Rhyu HS, Park KS. Effects of Telephone Follow-Up Intervention on %Body Fat, Inflammatory Cytokines, and Oxidative Stress in Obese Hispanic Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162854. [PMID: 31405086 PMCID: PMC6719102 DOI: 10.3390/ijerph16162854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/05/2023]
Abstract
This study investigated whether 10 month telephone follow-up intervention effectively stabilizes reductions in %body fat, and markers of inflammation and oxidative stress obtained from summer camp in obese Hispanic children. Fifty-six obese children (19 SUTI: summer camp and 10 months of follow-up telephone intervention, 18 SU: summer camp intervention only, and 19 CON: no intervention) completed this study. Anthropometric data and blood samples were obtained before (PRE), after 8 weeks of summer camp, and a 10month follow-up telephone intervention to measure markers of inflammation and oxidative stress. Eight weeks of summer camp significantly reduced %body fat, and levels of tumor necrosis factor-alpha, C-reactive protein and 8-hydroxydeoxyguanosine. It also elevated levels of adiponectin and total antioxidant status in SUTI and SU (p < 0.05). However, results of the 10month follow-up measurement were reverted back to PRE in SU, whereas the results for SUTI remained different to PRE (p < 0.05). Results confirm that levels of inflammation and oxidative stress are correlated to changes in %body fat, indicating that fat loss is effective in preventing and managing obesity-associated disorders. It is suggested that a telephone intervention is an effective follow-up tool for stabilizing reductions in %body fat as well as levels of inflammation and oxidative stress that were obtained from an intensive summer camp program in obese Hispanic children.
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Affiliation(s)
- Hyun-Seung Rhyu
- Major of Sports Coaching, Department of Physical Education, Jungwon University, Chungbuck 28024, Korea
| | - Kyung-Shin Park
- College of Nursing and Health Sciences, Texas A&M International University, Laredo, TX 78041, USA.
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4124
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Moderate-Vigorous Physical Activity and Clinical Parameters in Adults with Type 2 Diabetes Mellitus: A Report from the Walking with Diabetes Study. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2019. [DOI: 10.2478/rjdnmd-2019-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background and aims: This study investigate the effects of increases in moderate-vigorous physical activity (MVPA) on several clinical parameters in Indonesian type 2 diabetes mellitus (T2DM) patients.
Material and methods: This study used clinical and physical activity data of forty-two T2DM patients who completed a 6 month-free-living physical activity program, the Walking with Diabetes Study. Upon completion of the program, participants were categorised into a group with increases in MVPA (the MVPA+ group, n=24) or a group with steady/decreases in MVPA (the control group, n=18). High density lipoprotein, triglyceride, routine hematology profiles, blood pressure, body mass index, weight/hip ratio and self-reported MVPA, at baseline, 3 and 6 months were retrospectively analysed. Generalized estimating equation adjusted for age and sex were conducted to assess group and time effects on the clinical parameters.
Results: Hemoglobin (p <0.01), erythrocytes (p<0.05), hematocrits (p<0.001) and thrombocytes (p<0.05) were higher in the MVPA+ group. The 1h and 2h-erythrocyte sedimentation rate (ESR) increased in both groups across time (p<0.001). No changes between groups across time were found for other parameters.
Conclusions: Increases in MVPA improve several hematology parameters in T2DM patients, but it does not have protective effects in controlling systemic inflammation in T2DM patients.
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4125
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Shail MS. Using Micro-learning on Mobile Applications to Increase Knowledge Retention and Work Performance: A Review of Literature. Cureus 2019; 11:e5307. [PMID: 31511813 PMCID: PMC6716752 DOI: 10.7759/cureus.5307] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Micro-learning is an educational teaching method used to train users on multiple platforms. This article will provide a brief introduction to the concepts of short-term and long-term memory, and explain how micro-learning can be used to increase retention in learners. Micro-lessons can aid in negating the Ebbinghaus forgetting curve and can use reintroduction to keep retention at significantly higher levels. This process also speeds up the learning process overall because students avoid the phenomenon of mental fatigue. The article cites studies suggesting mental fatigue can cause serious cognitive decline in individual performance. By breaking complex courses into manageable smaller lessons, micro-learning preserves the neurotransmitter cascade for steady neurochemical performance. By using mobile devices, students can pause and continue their micro-lessons with ease. The mobile application also gives them the opportunity to continually check on their performance, and adjust their learning accordingly. Micro-learning on mobile devices also keeps engagement levels high because it utilizes different forms of media to keep users captivated.
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Affiliation(s)
- Mrigank S Shail
- Medicine, Xavier University School of Medicine, Toronto, CAN
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4126
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Bragazzi NL, Prasso G, Re TS, Zerbetto R, Del Puente G. A reliability and content analysis of Italian language anorexia nervosa-related websites. Risk Manag Healthc Policy 2019; 12:145-151. [PMID: 31534378 PMCID: PMC6682172 DOI: 10.2147/rmhp.s193088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 07/11/2019] [Indexed: 12/13/2022] Open
Abstract
Objective Internet represents a major source of information related to health issues, increasingly used by providers. Indeed, there are numerous websites concerning eating and weight disorders, such as anorexia nervosa. The aim of the current investigation was to systematically perform a reliability and content analysis of Italian language anorexia nervosa-related websites. Methods Reliability of the anorexia nervosa website pages was assessed using the Health on the Net Foundation Code of Conduct Standards (HonCode®) certification mark. A comprehensive content analysis (thematic cluster analysis, correspondence analysis of emerging themes and topics, density and degree-centrality analysis, and co-word analysis) was performed using the commercial software T-Lab. Results 402 unique website pages were included and analyzed in the current study. Statistically significant differences related to the accomplishment or less to the items of the HonCode® certificate mark were found for all items, except for confidentiality and webmaster/additional contact. From the thematic cluster analysis, four clusters were identified: namely, treatment (26.6%), vomiting (24.7%), weight (24.4%) and onset-age (24.3%). Treatment (in particular, cognitive-behavioral psychotherapy) was the most represented theme (with a frequency of 97.76%, recurring in 393 websites). Pro-ana content characterized 147 website pages (with a frequency of 36.57%). Conclusion The quality of Italian language anorexia nervosa-related websites was rather moderate-poor, being generally inconsistent with the principles of the HonCode® certification mark. Therefore, physicians and health authorities should be aware of such findings to provide their patients with proper answers and education.
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Affiliation(s)
- Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,Centro Studi Terapia Della Gestalt (CSTG), Milan, Italy.,UNESCO Chair "Anthropology of Health-Biosphere and Healing System", University of Genoa, Genoa, Italy
| | - Giulia Prasso
- Department of Psychology (DISFOR), University of Genoa, Genoa, Italy.,School of Psychotherapy "Associazione Italiana di Psicoterapia Psicoanalitica dell'Infanzia dell'Adolescenza e della Famiglia" (AIPPI), Milan, Italy
| | - Tania Simona Re
- Centro Studi Terapia Della Gestalt (CSTG), Milan, Italy.,UNESCO Chair "Anthropology of Health-Biosphere and Healing System", University of Genoa, Genoa, Italy
| | | | - Giovanni Del Puente
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
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4127
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The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting ("Ramadan Fasting") on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study. Nutrients 2019; 11:nu11081781. [PMID: 31374976 PMCID: PMC6722961 DOI: 10.3390/nu11081781] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic-relapsing and debilitating disease, which affects the components of the folliculopilosebaceous unit and severely impacts on the perceived health-related quality of life. Among the possible treatments, dietary interventions, such as fasting, have been described to positively impact on HS. However, nothing is known about the effects of circadian, intermittent fasting, such as the Ramadan fasting. A sample of 55 HS patients (24 males (43.6%) and 31 females (56.4%), mean age 39.65 ± 8.39 years, average disease duration 14.31 ± 7.03 years) was recruited in the present study. The “Severity of International Hidradenitis Suppurativa Severity Score System” (IHS4) decreased significantly from 11.00 ± 5.88 (before Ramadan) to 10.15 ± 6.45 (after Ramadan), with a mean difference of −0.85 ± 0.83 (p < 0.0001). At the univariate analyses, the improvement was associated with HS phenotype (with a prominent improvement among those with ectopic type), treatment (with the improvement being higher in patients receiving topical and systemic antibiotics compared to those treated with biologics), the “Autoinflammatory Disease Damage Index” (ADDI), and Hurley scores. At the multivariate regression analysis, only the Hurley score (regression coefficient = 0.70, p = 0.0003) was found to be an independent predictor of change in the IHS4 score after fasting. The improvement in the IHS4 score was not, however, associated with weight loss. In conclusion, the Ramadan fasting proved to be safe and effective in HS patients. Considering the small sample size and the exploratory nature of the present investigation, further studies in the field are warranted, especially longitudinal, prospective and randomized ones.
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4128
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Antonio J, Kenyon M, Horn C, Jiannine L, Carson C, Ellerbroek A, Roberts J, Peacock C, Tartar J. The Effects of an Energy Drink on Psychomotor Vigilance in Trained Individuals. J Funct Morphol Kinesiol 2019; 4:jfmk4030047. [PMID: 33467362 PMCID: PMC7739368 DOI: 10.3390/jfmk4030047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/20/2019] [Accepted: 07/21/2019] [Indexed: 12/27/2022] Open
Abstract
The psychomotor vigilance test (PVT) measures one's behavioral alertness. It is a visual test that involves measuring the speed at which a person reacts to visual stimuli over a fixed time frame (e.g., 5 min). The purpose of this study was to assess the effects of an energy drink on psychomotor vigilance as well as a simple measure of muscular endurance (i.e., push-ups). A total of 20 exercise-trained men (n = 11) and women (n = 9) (mean ± SD: age 32 ± 7 years; height 169 ± 10 cm; weight; 74.5 ± 14.5 kg; percent body fat 20.3 ± 6.2%; years of training 14 ± 9; daily caffeine intake 463 ± 510 mg) volunteered for this randomized, double-blind, placebo-controlled, crossover trial. In a randomized counterbalanced order, they consumed either the energy drink (ED) (product: BANG®, Weston Florida) or a similar tasting placebo drink (PL). In the second visit after a 1-week washout period, they consumed the alternate drink. A full 30 min post-consumption, they performed the following tests in this order: a 5-min psychomotor vigilance test, three sets of push-ups, followed once more by a 5-min psychomotor vigilance test. Reaction time was recorded. For the psychomotor vigilance test, lapses, false starts and efficiency score are also assessed. There were no differences between groups for the number of push-ups that were performed or the number of false starts during the psychomotor vigilance test. However, the ED treatment resulted in a significantly lower (i.e., faster) psychomotor vigilance mean reaction time compared to the PL (p = 0.0220) (ED 473.8 ± 42.0 milliseconds, PL 482.4 ± 54.0 milliseconds). There was a trend for the ED to lower the number of lapses (i.e., reaction time > 500 milliseconds) (p = 0.0608). The acute consumption of a commercially available ED produced a significant improvement in psychomotor vigilance in exercise-trained men and women.
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Affiliation(s)
- Jose Antonio
- Exercise and Sport Science, NSU Florida, Davie, FL 33328, USA
- Correspondence: ; Tel.: +561-239-1754
| | - Madaline Kenyon
- Exercise and Sport Science, NSU Florida, Davie, FL 33328, USA
| | | | - Lia Jiannine
- Exercise and Sport Science, NSU Florida, Davie, FL 33328, USA
| | | | - Anya Ellerbroek
- Exercise and Sport Science, NSU Florida, Davie, FL 33328, USA
| | - Justin Roberts
- School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge CB5 8DZ, UK
| | - Corey Peacock
- Exercise and Sport Science, NSU Florida, Davie, FL 33328, USA
| | - Jaime Tartar
- Psychology and Neuroscience, NSU Florida, Davie, FL 33328, USA
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4129
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Kedra J, Radstake T, Pandit A, Baraliakos X, Berenbaum F, Finckh A, Fautrel B, Stamm TA, Gomez-Cabrero D, Pristipino C, Choquet R, Servy H, Stones S, Burmester G, Gossec L. Current status of use of big data and artificial intelligence in RMDs: a systematic literature review informing EULAR recommendations. RMD Open 2019; 5:e001004. [PMID: 31413871 PMCID: PMC6668041 DOI: 10.1136/rmdopen-2019-001004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/26/2019] [Accepted: 06/29/2019] [Indexed: 12/27/2022] Open
Abstract
Objective To assess the current use of big data and artificial intelligence (AI) in the field of rheumatic and musculoskeletal diseases (RMDs). Methods A systematic literature review was performed in PubMed MEDLINE in November 2018, with key words referring to big data, AI and RMDs. All original reports published in English were analysed. A mirror literature review was also performed outside of RMDs on the same number of articles. The number of data analysed, data sources and statistical methods used (traditional statistics, AI or both) were collected. The analysis compared findings within and beyond the field of RMDs. Results Of 567 articles relating to RMDs, 55 met the inclusion criteria and were analysed, as well as 55 articles in other medical fields. The mean number of data points was 746 million (range 2000–5 billion) in RMDs, and 9.1 billion (range 100 000–200 billion) outside of RMDs. Data sources were varied: in RMDs, 26 (47%) were clinical, 8 (15%) biological and 16 (29%) radiological. Both traditional and AI methods were used to analyse big data (respectively, 10 (18%) and 45 (82%) in RMDs and 8 (15%) and 47 (85%) out of RMDs). Machine learning represented 97% of AI methods in RMDs and among these methods, the most represented was artificial neural network (20/44 articles in RMDs). Conclusions Big data sources and types are varied within the field of RMDs, and methods used to analyse big data were heterogeneous. These findings will inform a European League Against Rheumatism taskforce on big data in RMDs.
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Affiliation(s)
- Joanna Kedra
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), UMR S 1136, Sorbonne Universite, Paris, France.,Rheumatology Department, Hôpital Universitaire Pitié Salpêtrière, APHP, Paris, France
| | - Timothy Radstake
- Department of Rheumatology, Clinical Immunology and Laboratory for Translational Immunology, University of Utrecht Faculty of Medicine, Utrecht, The Netherlands
| | - Aridaman Pandit
- Department of Rheumatology, Clinical Immunology and Laboratory for Translational Immunology, University of Utrecht Faculty of Medicine, Utrecht, The Netherlands
| | | | - Francis Berenbaum
- Rheumatology Department, Hospital Saint-Antoine, APHP, Paris, Île-de-France, France
| | - Axel Finckh
- Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland
| | - Bruno Fautrel
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), UMR S 1136, Sorbonne Universite, Paris, France.,Rheumatology Department, Hôpital Universitaire Pitié Salpêtrière, APHP, Paris, France
| | - Tanja A Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - David Gomez-Cabrero
- Departamento de Salud-Universidad Pública de Navarra, Translational Bioinformatics Unit, Navarra Biomed, Pamplona, Spain
| | | | | | | | - Simon Stones
- School of Healthcare, University of Leeds, Leeds, West Yorkshire, UK
| | - Gerd Burmester
- Department of Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Berlin, Germany
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), UMR S 1136, Sorbonne Universite, Paris, France.,Rheumatology Department, Hôpital Universitaire Pitié Salpêtrière, APHP, Paris, France
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4130
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Pohanka M. Current Trends in the Biosensors for Biological Warfare Agents Assay. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E2303. [PMID: 31323857 PMCID: PMC6678440 DOI: 10.3390/ma12142303] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 02/07/2023]
Abstract
Biosensors are analytical devices combining a physical sensor with a part of biological origin providing sensitivity and selectivity toward analyte. Biological warfare agents are infectious microorganisms or toxins with the capability to harm or kill humans. They can be produced and spread by a military or misused by a terrorist group. For example, Bacillus anthracis, Francisella tularensis, Brucella sp., Yersinia pestis, staphylococcal enterotoxin B, botulinum toxin and orthopoxviruses are typical biological warfare agents. Biosensors for biological warfare agents serve as simple but reliable analytical tools for the both field and laboratory assay. There are examples of commercially available biosensors, but research and development of new types continue and their application in praxis can be expected in the future. This review summarizes the facts and role of biosensors in the biological warfare agents' assay, and shows current commercially available devices and trends in research of the news. Survey of actual literature is provided.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, CZ-50001 Hradec Kralove, Czech Republic.
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4131
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Ravalli S, Castrogiovanni P, Musumeci G. Exercise as medicine to be prescribed in osteoarthritis. World J Orthop 2019; 10:262-267. [PMID: 31363456 PMCID: PMC6650634 DOI: 10.5312/wjo.v10.i7.262] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/08/2019] [Accepted: 06/28/2019] [Indexed: 02/06/2023] Open
Abstract
Inactivity contributes to chronic diseases, including diabetes, hypertension, cardiovascular disorders, and obesity. Sedentary habits can shorten life expectancy. Exercise has been widely proposed as a valuable approach to prevention. Regular physical activity, as part of one's daily routine, may help to manage pathological conditions. This editorial especially addresses osteoarthritis (OA), a degenerative disease of the articular cartilage, which is one of the most common causes of disability worldwide. Standard treatments for this illness include surgical procedures and pharmacological management; behavioural approaches are also strongly recommended. Physical exercise represents a practical strategy to preserve function, decrease pain and fatigue, and increase muscle strength and flexibility. We suggest that physical activity be considered as an established form of treatment, which means including exercise in standard therapeutic guidelines. A growing number of patients suffer from preventable chronic conditions that impose a heavy social and economic burden on the healthcare system. Preventive exercise training should be prescribed in the same way as pharmaceuticals.
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Affiliation(s)
- Silvia Ravalli
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95125, Italy
| | - Paola Castrogiovanni
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95125, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95125, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Catania 95123, Italy
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4132
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Dose-response meta-analysis of coffee consumption and risk of colorectal adenoma. Eur J Clin Nutr 2019; 74:297-306. [PMID: 31308476 DOI: 10.1038/s41430-019-0467-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The association between coffee and colorectal adenoma risk remains controversial. We conducted a meta-analysis of cohort and case-control studies to sum up the existing proof about this matter. METHODS We searched Pubmed, Medline, and Embase for studies published before 1 September 2018 on coffee consumption and colorectal adenoma in any language. The different ORs were calculated for cohort and case-control studies in this study, and we use a random-effects model to aggregate the relative risks of individual studies and conduct dose response, heterogeneity, and publication bias. RESULTS A total of 8 studies (6 case-control studies, 2 cohort studies) were identified, including 7090 subjects. In a summary analysis of all studies, high coffee intake (compared the highest with the lowest categories) was associated with a reduced risk of colorectal adenoma (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.55-0.90). The results of subgroup analysis of adenoma location were similar with the pooled analysis, except for rectal adenoma. In the dose-response meta-analysis study, the estimated total odds ratio for increasing coffee consumption by 150 ml per day (about one cup) was 0.91 (95% CI = 0.87-0.95). CONCLUSIONS The meta-analysis demonstrates possible evidence that increased coffee intake is related to a reduced risk of colon adenoma. However, because of latent confusion and different exposure classification, this finding should be carefully considered.
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4133
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Abushady MM, Samy M, Bekhet M, Abdullah A. Effect of Ramadan fasting on renal function in patients with type 2 diabetes. Diabetes Res Clin Pract 2019; 153:176-183. [PMID: 31195024 DOI: 10.1016/j.diabres.2019.05.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/30/2019] [Indexed: 11/21/2022]
Abstract
AIM To evaluate the effect of Ramadan fasting on kidney functions in patients with type 2 DM. METHODS We recruited 90 subjects with type 2 DM intending to fast Ramadan; classified into 30 with albuminuria and renal impairment (group I), 30 with albuminuria and normal kidney functions (group II) and 30 without albuminuria and normal kidney functions (group III). Two weeks before and after Ramadan, fasting plasma glucose, 2 h plasma glucose, hemoglobin A1c, fructosamine, serum creatinine, BUN, eGFR and albumin/ creatinine ratio were measured. RESULTS On comparing data before and after Ramadan, significant reduction in HbA1c was found in all groups. As regards kidney function parameters, no significant difference was found in group I but a significant decline in these parameters was found in groups II and III; serum creatinine, eGFR, urinary albumin/ creatinine ratio (p <0.001). Only Group I showed significant hypoglycemic events and need for dose reduction. CONCLUSION Ramadan fasting improved glycemic control in patients with type 2 DM with no decline in kidney functions in renally impaired group, only a decline in albuminuric and healthy groups within the normal range. Patients should be adviced regarding adequate hydration and dietary modification during Pre-Ramadan health care education.
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Affiliation(s)
- M M Abushady
- Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - M Samy
- Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - M Bekhet
- Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - A Abdullah
- Internal Medicine Department in Specialized Damietta Hospital, Damietta, Egypt
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4134
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de Biase S, Nilo A, Bernardini A, Gigli GL, Valente M, Merlino G. Timing use of novel anti-epileptic drugs: is earlier better? Expert Rev Neurother 2019; 19:945-954. [DOI: 10.1080/14737175.2019.1636649] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Stefano de Biase
- Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Annacarmen Nilo
- Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Andrea Bernardini
- Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
- DMIF, University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
- Department of Medicine, University of Udine Medical School, Udine, Italy
| | - Giovanni Merlino
- Stroke Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
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4135
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Gianfredi V, Moretti M, Lopalco PL. Countering vaccine hesitancy through immunization information systems, a narrative review. Hum Vaccin Immunother 2019; 15:2508-2526. [PMID: 30932725 PMCID: PMC6930057 DOI: 10.1080/21645515.2019.1599675] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/06/2019] [Accepted: 03/15/2019] [Indexed: 01/02/2023] Open
Abstract
Immunization is one of the most important public health interventions to contrast infectious disease; however, many people nowadays refuse vaccination. Vaccine hesitancy (VH) is due to several factors that influence the complex decision-making process. Information technology tools might play an important role in vaccination programs. In particular, immunization information systems (IISs) have the potential to improve performance of vaccination programs and to increase vaccine uptake. This review aimed to present IIS functionalities in order to counter VH. In detail, we analyzed the automatic reminder/recall system, the interoperability of the system, the decision support system, the web page interface and the possibility to record adverse events following immunization. IIS could concretely represent a valid instrument to increase vaccine confidence, especially trust in both health-care workers and decision makers. There are not enough trials aimed to evaluate the efficacy of IIS to counter VH. Further researches might focalize on this aspect.
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Affiliation(s)
- Vincenza Gianfredi
- Post-Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Massimo Moretti
- Department of Pharmaceutical Science, Unit of Public Health, University of Perugia, Perugia, Italy
| | - Pier Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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4136
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Brainina K, Tarasov A, Khamzina E, Kazakov Y, Stozhko N. Disposable Potentiometric Sensory System for Skin Antioxidant Activity Evaluation. SENSORS 2019; 19:s19112586. [PMID: 31174361 PMCID: PMC6603646 DOI: 10.3390/s19112586] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/20/2019] [Accepted: 06/03/2019] [Indexed: 12/26/2022]
Abstract
The skin is a natural barrier between the external and internal environment. Its protective functions and the relationship of its state with the state of health of the organism as a whole are very important. It is known that oxidant stress (OS) is a common indicator of health status. This paper describes a new sensory system for monitoring OS of the skin using antioxidant activity (AOA) as its criteria. The contact hybrid potentiometric method (CHPM) and new electrochemical measuring scheme were used. A new sensory system, including disposable modified screen-printed carbon and silver electrodes covered by membrane impregnated by mediator, was developed. Its informative ability was demonstrated in the evaluation of the impact of fasting, consumption of food and food enriched by vitamins (antioxidants) on skin AOA. This device consisting of a sensory system and potentiometric analyzer can be used in on-site and in situ formats.
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Affiliation(s)
- Khiena Brainina
- Ural State University of Economics, 62/45, 8 Marta/Narodnoi Voli St., 620144 Yekaterinburg, Russia.
- Ural Federal University named after the first President of Russia B. N. Yeltsin, 28, Mira St., 620078 Yekaterinburg, Russia.
| | - Aleksey Tarasov
- Ural State University of Economics, 62/45, 8 Marta/Narodnoi Voli St., 620144 Yekaterinburg, Russia.
| | - Ekaterina Khamzina
- Ural State University of Economics, 62/45, 8 Marta/Narodnoi Voli St., 620144 Yekaterinburg, Russia.
| | - Yan Kazakov
- Ural State University of Economics, 62/45, 8 Marta/Narodnoi Voli St., 620144 Yekaterinburg, Russia.
| | - Natalia Stozhko
- Ural State University of Economics, 62/45, 8 Marta/Narodnoi Voli St., 620144 Yekaterinburg, Russia.
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4137
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Bendifallah S, Ilenko A, Daraï E. High risk endometrial cancer: Clues towards a revision of the therapeutic paradigm. J Gynecol Obstet Hum Reprod 2019; 48:863-871. [PMID: 31176047 DOI: 10.1016/j.jogoh.2019.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/16/2019] [Accepted: 06/04/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Endometrial cancer (EC) is a major cause of mortality worldwide with nearly 200 000 cases diagnosed annually. The recent ESMO-ESGO-ESTRO guidelines include a new classification defining a heterogeneous high-risk group of recurrence (HR) comprising: (i) endometrioid (type 1) FIGO stage IB grade 3 tumors (type 1/G3ECs), (ii) non-endometrioid tumors (type 2) and (iii) advanced stages whatever the histological type (Colombo et al., 2016). AREAS COVERED The aim of this review is to summarize current evidence for therapeutic approaches in HR-EC according to the updated ESMO-ESGO-ESTRO classification by discussing the following issues: i) HR-EC heterogeneity, (ii) prognostic factors and current classification, and (iii) optimal staging strategies (site and extent) and the role of adjuvant treatment. EXPERT COMMENTARY HR-EC treatment is based on surgery, radiation therapy, brachytherapy, and chemotherapy, either alone or sequentially, in combination with other treatments depending on disease stage, histological grade and risk group. Specific trials are needed to establish the role of systematic pelvic and paraaortic lymphadenectomy, adjuvant therapies and targeted drugs. Although molecular characterization has been reported to customize therapeutic strategies and thereby improve therapeutic outcomes in EC, none of the targeted agents investigated (antiangiogenic and mTOR/PI3K pathway inhibitor agents) have resulted in a change in clinical practice in HR-EC.
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Affiliation(s)
- S Bendifallah
- Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR S 938, Sorbonne université, Paris 6, France
| | - A Ilenko
- Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France.
| | - E Daraï
- Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR S 938, Sorbonne université, Paris 6, France
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4138
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4139
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Chowdhury A, Khan H, Lasker SS, Chowdhury TA. Fasting outcomes in people with diabetes and chronic kidney disease in East London during Ramadan 2018: The East London diabetes in Ramadan survey. Diabetes Res Clin Pract 2019; 152:166-170. [PMID: 31150726 DOI: 10.1016/j.diabres.2019.05.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/09/2019] [Accepted: 05/20/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Fasting in summer months for Muslim people with diabetes during Ramadan is challenging, particularly in temperate climates, where duration of fasting is prolonged. Risk of fasting may be greater in people with diabetes and chronic kidney disease (CKD). We aimed to prospectively monitor the outcomes of patients with diabetes and CKD stage 3 during Ramadan 2018 in East London. METHODS Patients with type 2 diabetes (T2D) and CKD stage 3 attending community diabetes clinics were approached prior to Ramadan 2018 to discuss fasting. Patients were risk categorised according to Diabetes and Ramadan Alliance guidelines. If they chose to fast, Ramadan education was given, and biomedical assessments were undertaken within one week prior to and one week after fasting. Outcomes between patients fasting and non-fasting groups were compared. RESULTS Fasting (n = 68) and non-fasting groups (n = 71) were similar apart from slightly higher insulin use in the non-fasting group. Median days fasted was 21 (range 12-29). There were no significant changes in weight, blood pressure, creatinine, glycated haemoglobin, cholesterol and urinary PCR pre- and post-Ramadan, and no significant differences between the fasting and non-fasting groups. There was no difference in adverse events (acute kidney injury, hypoglycaemia or cardiovascular events) between the fasting and non-fasting groups. CONCLUSIONS No significant differences were seen in clinical or biochemical parameters, or adverse events between fasting and non-fasting patients. Patients with T2D and stable CKD stage 3 may be able to fast safely during Ramadan.
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Affiliation(s)
- Aisha Chowdhury
- Department of Diabetes and Metabolism, Royal London Hospital, London E1 1BB, UK
| | - Halima Khan
- Department of Diabetes and Metabolism, Royal London Hospital, London E1 1BB, UK
| | | | - Tahseen A Chowdhury
- Department of Diabetes and Metabolism, Royal London Hospital, London E1 1BB, UK.
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4140
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Mavragani A, Ochoa G. Google Trends in Infodemiology and Infoveillance: Methodology Framework. JMIR Public Health Surveill 2019; 5:e13439. [PMID: 31144671 PMCID: PMC6660120 DOI: 10.2196/13439] [Citation(s) in RCA: 220] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/17/2019] [Accepted: 03/23/2019] [Indexed: 02/06/2023] Open
Abstract
Internet data are being increasingly integrated into health informatics research and are becoming a useful tool for exploring human behavior. The most popular tool for examining online behavior is Google Trends, an open tool that provides information on trends and the variations of online interest in selected keywords and topics over time. Online search traffic data from Google have been shown to be useful in analyzing human behavior toward health topics and in predicting disease occurrence and outbreaks. Despite the large number of Google Trends studies during the last decade, the literature on the subject lacks a specific methodology framework. This article aims at providing an overview of the tool and data and at presenting the first methodology framework in using Google Trends in infodemiology and infoveillance, including the main factors that need to be taken into account for a strong methodology base. We provide a step-by-step guide for the methodology that needs to be followed when using Google Trends and the essential aspects required for valid results in this line of research. At first, an overview of the tool and the data are presented, followed by an analysis of the key methodological points for ensuring the validity of the results, which include selecting the appropriate keyword(s), region(s), period, and category. Overall, this article presents and analyzes the key points that need to be considered to achieve a strong methodological basis for using Google Trends data, which is crucial for ensuring the value and validity of the results, as the analysis of online queries is extensively integrated in health research in the big data era.
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Affiliation(s)
- Amaryllis Mavragani
- Department of Computing Science and Mathematics, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Gabriela Ochoa
- Department of Computing Science and Mathematics, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
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4141
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Sarin HV, Gudelj I, Honkanen J, Ihalainen JK, Vuorela A, Lee JH, Jin Z, Terwilliger JD, Isola V, Ahtiainen JP, Häkkinen K, Jurić J, Lauc G, Kristiansson K, Hulmi JJ, Perola M. Molecular Pathways Mediating Immunosuppression in Response to Prolonged Intensive Physical Training, Low-Energy Availability, and Intensive Weight Loss. Front Immunol 2019; 10:907. [PMID: 31134054 PMCID: PMC6511813 DOI: 10.3389/fimmu.2019.00907] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/09/2019] [Indexed: 01/21/2023] Open
Abstract
Exercise and exercise-induced weight loss have a beneficial effect on overall health, including positive effects on molecular pathways associated with immune function, especially in overweight individuals. The main aim of our study was to assess how energy deprivation (i.e., “semi-starvation”) leading to substantial fat mass loss affects the immune system and immunosuppression in previously normal weight individuals. Thus, to address this hypothesis, we applied a high-throughput systems biology approach to better characterize potential key pathways associated with immune system modulation during intensive weight loss and subsequent weight regain. We examined 42 healthy female physique athletes (age 27.5 ± 4.0 years, body mass index 23.4 ± 1.7 kg/m2) volunteered into either a diet group (n = 25) or a control group (n = 17). For the diet group, the energy intake was reduced and exercise levels were increased to induce loss of fat mass that was subsequently regained during a recovery period. The control group was instructed to maintain their typical lifestyle, exercise levels, and energy intake at a constant level. For quantification of systems biology markers, fasting blood samples were drawn at three time points: baseline (PRE), at the end of the weight loss period (MID 21.1 ± 3.1 weeks after PRE), and at the end of the weight regain period (POST 18.4 ± 2.9 weeks after MID). In contrast to the control group, the diet group showed significant (false discovery rate <0.05) alteration of all measured immune function parameters—white blood cells (WBCs), immunoglobulin G glycome, leukocyte transcriptome, and cytokine profile. Integrative omics suggested effects on multiple levels of immune system as dysregulated hematopoiesis, suppressed immune cell proliferation, attenuated systemic inflammation, and loss of immune cell function by reduced antibody and chemokine secretion was implied after intense weight loss. During the weight regain period, the majority of the measured immune system parameters returned back to the baseline. In summary, this study elucidated a number of molecular pathways presumably explaining immunosuppression in individuals going through prolonged periods of intense training with low-energy availability. Our findings also reinforce the perception that the way in which weight loss is achieved (i.e., dietary restriction, exercise, or both) has a distinct effect on how the immune system is modulated.
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Affiliation(s)
- Heikki V Sarin
- Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ivan Gudelj
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
| | - Jarno Honkanen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Pedia Laboratory, Clinicum, University of Helsinki, Helsinki, Finland
| | - Johanna K Ihalainen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland.,Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden
| | - Arja Vuorela
- Pedia Laboratory, Clinicum, University of Helsinki, Helsinki, Finland
| | - Joseph H Lee
- Sergievsky Center, Taub Institute and Departments of Epidemiology and Neurology, Columbia University, New York, NY, United States
| | - Zhenzhen Jin
- Department of Biostatistics, Columbia University, New York, NY, United States
| | - Joseph D Terwilliger
- Division of Medical Genetics, Departments of Psychiatry, Genetics & Development, Sergievsky Center, New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Ville Isola
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
| | - Juha P Ahtiainen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
| | - Keijo Häkkinen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
| | - Julija Jurić
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
| | - Gordan Lauc
- Genos Glycoscience Research Laboratory, Zagreb, Croatia.,Department of Biochemistry and Molecular Biology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Kati Kristiansson
- Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Juha J Hulmi
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland.,Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Markus Perola
- Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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4142
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Mrad S, Rejeb H, Ben Abdallah J, Graiet H, Ben Khelifa M, Abed A, Ferchichi S, Limem K, Ben Saad H. The Impacts of Ramadan Intermittent Fasting on Oxidant/Antioxidant Stress Biomarkers of Stable Chronic Obstructive Pulmonary Disease Male Patients. Am J Mens Health 2019; 13:1557988319848281. [PMID: 31046536 PMCID: PMC6501488 DOI: 10.1177/1557988319848281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
No prior study has evaluated the impacts of Ramadan intermittent fasting (RIF) on oxidant/antioxidant stress (OS/AOS) biomarkers in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess the impacts of RIF on some OS/AOS biomarkers measured in male patients with stable COPD. Fifteen COPD patients (mean age: 71 ± 6 years) fasting Ramadan in 2017 volunteered to take part in the study. Three sessions (before Ramadan [BR], end Ramadan [ER], after Ramadan [AR]) were selected. Blood samples of OS (homocysteine [μmol/L], thiobarbituric acid reactive substances [TBARS, μmol/L]) and AOS (catalase [U/ml], ceruloplasmin [g/L], superoxide dismutase [SOD, ng/ml], zinc [µmol/L], albumin [g/L]) biomarkers were consistently taken 4.5 to 2.5 hr before the iftar. Findings were analyzed by applying Friedman or Kruskal-Wallis ANOVA. Comparisons of the number of patients with high OS [high homocysteine and/or TBARS] and low AOS (low catalase and/or ceruloplasmin and/or SOD and/or zinc and/or albumin) blood values between the three sessions were performed using the Cochran test. The median ± interquartile of homocysteine (BR: 21.48 [18.98-24.49], ER: 23.15 [21.77-26.45], AR: 24.87 [21.91-37.12]), ceruloplasmin (BR: 0.27 [0.24-0.30], ER: 0.28 [0.26-0.33], AR: 0.28 [0.25-0.32]), SOD (BR: 288.00 [112.00-400.00], ER: 182.00 [152.00-386.00], AR: 234.00 [190.00-420.00]) and the mean ± SD of TBARS (BR: 5.66 ± 1.26, ER: 4.59 ± 0.78, AR: 5.29 ± 1.69), catalase (BR: 120.97 ± 54.62, ER: 106.73 ± 50.92, AR: 137.39 ± 40.88), zinc (BR: 11.85 ± 2.01, ER: 12.47 ± 2.34, AR: 12.21 ± 2.58) and albumin (BR: 39.78 ± 3.19, ER: 40.74 ± 2.26, AR: 40.56 ± 2.38) were not significantly affected by RIF. The number of patients with high OS (BR [ n = 13], ER [ n = 15], AR [ n = 14]) or low AOS (BR [ n = 12], ER [ n = 13], AR [ n = 13]) statuses were not significantly influenced by RIF. In conclusion, RIF did not induce any significant statistical or clinical changes in OS/AOS biomarkers or statuses in COPD patients.
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Affiliation(s)
- Sawssan Mrad
- Laboratory of Biochemistry, Farhat Hached Hospital, Sousse, Tunisia
| | - Hadhemi Rejeb
- Pulmonary Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | - Hajer Graiet
- Research Unit of Clinical and Molecular Biology (UR17ES29), University of Monastir, Tunisia
| | | | - Amel Abed
- Laboratory of Biochemistry, Farhat Hached Hospital, Sousse, Tunisia
| | - Salima Ferchichi
- Research Unit of Clinical and Molecular Biology (UR17ES29), University of Monastir, Tunisia
| | - Khelifa Limem
- Laboratory of Biochemistry, Farhat Hached Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Laboratory of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia,Heart Failure (LR12SP09) Research Laboratory, Farhat Hached Hospital, Sousse, Tunisia,Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Tunisia,Helmi Ben Saad, Laboratory of Physiology, Faculty of Medicine of Sousse, Rue Mohamed Karoui, Sousse 4002, Tunisia.
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4143
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Determining Symptomatic Factors of Nomophobia in Peruvian Students from the National University of Engineering. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9091814] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The use of cell phones has increased worldwide in the past few decades, particularly in children and adolescents. Using these electronic devices provides personal benefits. Communicating through cell phones was a very important factor in the socioeconomic progress of developed countries. However, it is beyond doubt that its indiscriminate use can bring up certain psychiatric disorders or cause some disorder in a person, within the phobic group of anxiety disorders called nomophobia; basically associated with anxiety, nervousness, discomfort, and distress when contact with the smartphone is lost, mainly in the youngest users. This research proposal aims to identify symptoms that have not yet been detected by unceasing cell phone use, considering that in Peru there are few studies of human health engineering and the physical mental health. For that reason, we sought to identify the symptomatic factors of nomophobia presented by students at the National University of Engineering and its interference with their academic life. To accomplish this study, we designed a questionnaire according to our reality with the use of focus groups techniques when the test was taken in class. Three symptomatic factors of nomophobia were identified: feelings of anxiety, compulsive smartphone use, and feelings of anxiety and panic. The study included a representative sample of 461 students in different years of study engineering (21% women, 79% men, over 17 years of age). Finally, given the widespread adoption of smartphones and their integration into educational environments, the results of this study can help educators understand students’ inclination to use their smartphones at all times.
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4144
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Damiani G, Pigatto PDM, Marzano AV, Rizzi M, Santus P, Radovanovic D, Loite U, Torelli L, Petrou S, Sarzi-Puttini P, Atzeni F, Adawi M, Bridgewood C, Bragazzi NL, Watad A, Malerba M. Malar rash is a predictor of subclinical airway inflammation in patients with systemic lupus erythematosus: a pilot study. Clin Rheumatol 2019; 38:2541-2546. [PMID: 31020473 DOI: 10.1007/s10067-019-04536-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/19/2019] [Accepted: 03/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a chronic, auto-immune, multi-organ disease that can affect both the skin and the lungs. Malar rash is a common skin manifestation of SLE and is linked to SLE disease activity, whereas lung involvement is a generally negative prognostic factor for these patients. However, a sensitive and non-invasive screening tool for potential lung involvement in SLE patients is still not available. METHODS This study aimed to investigate the relationship between malar rash and airway inflammation in adult SLE patients who were not known to have any lung involvement (clinical or radiologic). The study comprised of the measurement of the concentration of NO in exhaled breath or fraction of exhaled nitric oxide (FeNO) and levels were compared between those with and without malar rash. This tool is considered as a sensitive and non-invasive method that is routinely used in patients with asthma or other respiratory diseases to identify airway inflammation. RESULTS A total of 125 patients (100 females, 25 males) were enrolled during the study period from January 2011 to December 2014. Patients with malar rash (N = 35) had a significant decrease in serum levels of C4 (p < 0.05) compared to patients without malar rash (N = 90). The mean levels of FeNO in overall patients were 36.44 ± 8.87 ppb. A statistically significant difference in FeNO50 values between patients with malar rash (43.46 ± 6.72 ppb) and without (29.43 ± 3.64 ppb) was found (p < 0.001). FeNO50 values were inversely correlated only with serum C4 (p < 0.01). However, no correlation between FeNO50 values and SLE clinical disease activity scores was found. CONCLUSIONS The presence of a malar rash may predict sub-clinical airway inflammation in SLE patients. Further prospective studies are needed to confirm the usefulness of FeNO measurements in monitoring SLE-associated airway inflammation.
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Affiliation(s)
- Giovanni Damiani
- Department of Transplant and Medico-Surgical Physiopathology, University of Milan Dermatology Unit, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy. .,Young Dermatologists Italian Network (YDIN), Centro Studi GISED, Bergamo, Italy.
| | - Paolo Daniele Maria Pigatto
- Clinical Dermatology, IRCCS Galeazzi Orthopedic Institute, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Angelo Valerio Marzano
- Department of Transplant and Medico-Surgical Physiopathology, University of Milan Dermatology Unit, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy
| | - Maurizio Rizzi
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan Pulmonary Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan Pulmonary Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Dejan Radovanovic
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan Pulmonary Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Ulvi Loite
- Department of Dermatology, University of Tartu, Tartu, Latvia
| | - Lucio Torelli
- Department of Mathematics and Geoscience, University of Trieste, Trieste, Italy
| | - Stephen Petrou
- St. George's University School of Medicine, St. George's, West Indie, Grenada
| | | | - Fabiola Atzeni
- Rheumatology Unit, Department of Internal and Experimental Medicine, University of Messina, Messina, Italy
| | - Mohammad Adawi
- Padeh and Ziv Hospitals, Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
| | - Charlie Bridgewood
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, England
| | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Abdulla Watad
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, England.,Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Chapel Allerton Hospital, Leeds, LS7 4SA, UK
| | - Mario Malerba
- Department of Internal Medicine, University of Brescia, Brescia, Italy
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4145
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Eriksson E, Wejåker M, Danhard A, Nilsson A, Kristofferzon ML. Living with a spouse with chronic illness - the challenge of balancing demands and resources. BMC Public Health 2019; 19:422. [PMID: 31014309 PMCID: PMC6480606 DOI: 10.1186/s12889-019-6800-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The number of partners providing informal care for their chronically ill spouse is rising, and they describe their daily life as demanding. The aim of this paper was to describe the partners' experiences of living with a person with chronic illness and how they manage everyday life. METHODS A descriptive design with a qualitative approach was used. A purposive sample of 16 Swedish partners with a chronically ill spouse were interviewed. The interviews were recorded, transcribed, and analyzed using qualitative content analysis. RESULTS Four main themes were identified: 'Managing challenges in daily life,' 'Seeking support and use own capabilities to manage life,' 'Appreciating the good parts of life' and 'Adapting to constant changes and an uncertain future'. Their experiences of support from formal care providers varied; they expressed the need for more assistance from the health care sector. CONCLUSIONS The partners experienced many challenges in everyday life when providing informal care for their chronically ill spouse. This affected both their physical and psychological health, as they had limited time for themselves. The partners seemed to receive more support from their informal network than from formal care providers. In handling daily life, the partners balanced demands and resources to identify possibilities to move forward and find meaning in life. This is congruent with theories by Antonovsky, and Folkman and Lazarus that describes meaningfulness and how to handle challenges in everyday life.
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Affiliation(s)
- Elisabet Eriksson
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Maria Wejåker
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Anna Danhard
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Annika Nilsson
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Marja-Leena Kristofferzon
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
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4146
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Dini G, Bragazzi NL, Montecucco A, Toletone A, Debarbieri N, Durando P. Big Data in occupational medicine: the convergence of -omics sciences, participatory research and e-health. LA MEDICINA DEL LAVORO 2019; 110:102-114. [PMID: 30990472 PMCID: PMC7809972 DOI: 10.23749/mdl.v110i2.7765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 03/06/2019] [Indexed: 01/28/2023]
Abstract
Background: New occupational hazards and risks are emerging in our progressively globalized society, in which ageing, migration, wild urbanization and rapid economic growth have led to unprecedented biological, chemical and physical exposures, linked to novel technologies, products and duty cycles. A focus shift from worker health to worker/citizen and community health is crucial. One of the major revolutions of the last decades is the computerization and digitization of the work process, the so-called “work 4.0”, and of the workplace. Objectives: To explore the roles and implications of Big Data in the new occupational medicine settings. Methods: Comprehensive literature search. Results: Big Data are characterized by volume, variety, veracity, velocity, and value. They come both from wet-lab techniques (“molecular Big Data”) and computational infrastructures, including databases, sensors and smart devices (“computational Big Data” and “digital Big Data”). Conclusions: In the light of novel hazards and thanks to new analytical approaches, molecular and digital underpinnings become extremely important in occupational medicine. Computational and digital tools can enable us to uncover new relationships between exposures and work-related diseases; to monitor the public reaction to novel risk factors associated to occupational diseases; to identify exposure-related changes in disease natural history; and to evaluate preventive workplace practices and legislative measures adopted for workplace health and safety.
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4147
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Dagar A, Falcone T. Pins and PNES: Systematic content analysis of Pinterest for information on psychogenic nonepileptic seizures (PNES). Epilepsy Behav 2019; 93:129-132. [PMID: 30765306 DOI: 10.1016/j.yebeh.2019.01.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 11/27/2022]
Abstract
Pinterest is a visual search based, the fourth largest social networking site in the U.S. with 81% of its users being women. Because of Pinterest's popularity and the high incidence of psychogenic nonepileptic seizures (PNES) among women, the aim of our current study was to perform a thorough content analysis of information available about PNES on Pinterest. The systematic search of Pinterest using various PNES related keywords revealed 57 unique pins. This was followed by content analysis by two independent reviewers. Most (87.7%) pins included in the final analysis reported at least one factor indicative of PNES. Most common were the consistent association of PNES with emotional triggers (61.4%), history of current or remote abuse (57.9%), and seizure's unresponsiveness to antiepileptic drugs (38.6%). Semiology of PNES was reported in 77.2% pins and two-thirds (66.6%) mentioned diagnostic procedures. Psychogenic nonepileptic seizure treatment and prognosis were reported in 68.4% and 56.1% pins, respectively. Around one-third of pins were from academic resources. More than 80% of pins targeted lay people with the primary aim of education and awareness and used a neutral or positive tone. To our knowledge, even though most pins have scientifically sound information, this widely popular web-based resource seems to be underutilized by academia, healthcare workers, and stakeholders for the dissemination of awareness about PNES.
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Affiliation(s)
- Anjali Dagar
- Department of Psychiatry, Cleveland Clinic, United States of America.
| | - Tatiana Falcone
- Department of Psychiatry, Cleveland Clinic, United States of America
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4148
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Li T, Huang B, Li D, Zhu Y, Ding L, Shu C. Development and validation of a specific and sensitive LC-MS/MS method for determination of eslicarbazepine in human plasma and its clinical pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1112:61-66. [PMID: 30856604 DOI: 10.1016/j.jchromb.2019.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/14/2019] [Accepted: 02/25/2019] [Indexed: 11/18/2022]
Abstract
In this work, we developed and validated the specific, sensitive and simple LC-MS/MS method for quantification of eslicarbazepine in human plasma. The analyte samples were prepared through a simple one-step protein precipitation method by acetonitrile. The chromatographic separation was operated on an economical Hanbon ODS-2 C18 column (150 mm × 2.1 mm, 10 μm) with isocratic elution using 10 mM ammonium acetate containing 0.01% formic acid and acetonitrile (72:28, v/v) as the mobile phase at the flow rate of 0.5 mL/min. The mass quantification was carried on the multiple reaction monitoring (MRM) of the transitions of m/z 255.1 → 194.1 for eslicarbazepine and m/z 446.1 → 321.1 for glipizide (the internal standard), respectively. The established method was validated with acceptable specificity, linearity, accuracy, precision, extraction recovery, matrix effect and stability in accordance with FDA regulations. At last, the validated method was successfully applied to determination of eslicarbazepine in human plasma obtained from clinical study.
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Affiliation(s)
- Tengfei Li
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing 210009, PR China; Department of Pharmaceutical Analysis, School of Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, PR China
| | - Bin Huang
- The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai 519100, P. R. China
| | - Duo Li
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing 210009, PR China; Department of Pharmaceutical Analysis, School of Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, PR China
| | - Yantong Zhu
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing 210009, PR China; Department of Pharmaceutical Analysis, School of Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, PR China
| | - Li Ding
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing 210009, PR China; Department of Pharmaceutical Analysis, School of Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, PR China
| | - Chang Shu
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing 210009, PR China; Department of Pharmaceutical Analysis, School of Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, PR China.
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4149
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Ubaida-Mohien C, Gonzalez-Freire M, Lyashkov A, Moaddel R, Chia CW, Simonsick EM, Sen R, Ferrucci L. Physical Activity Associated Proteomics of Skeletal Muscle: Being Physically Active in Daily Life May Protect Skeletal Muscle From Aging. Front Physiol 2019; 10:312. [PMID: 30971946 PMCID: PMC6443906 DOI: 10.3389/fphys.2019.00312] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/07/2019] [Indexed: 01/18/2023] Open
Abstract
Muscle strength declines with aging and increasing physical activity is the only intervention known to attenuate this decline. In order to adequately investigate both preventive and therapeutic interventions against sarcopenia, a better understanding of the biological changes that are induced by physical activity in skeletal muscle is required. To determine the effect of physical activity on the skeletal muscle proteome, we utilized liquid-chromatography mass spectrometry to obtain quantitative proteomics data on human skeletal muscle biopsies from 60 well-characterized healthy individuals (20-87 years) who reported heterogeneous levels of physical activity (not active, active, moderately active, and highly active). Over 4,000 proteins were quantified, and higher self-reported physical activity was associated with substantial overrepresentation of proteins associated with mitochondria, TCA cycle, structural and contractile muscle, and genome maintenance. Conversely, proteins related to the spliceosome, transcription regulation, immune function, and apoptosis, DNA damage, and senescence were underrepresented with higher self-reported activity. These differences in observed protein expression were related to different levels of physical activity in daily life and not intense competitive exercise. In most instances, differences in protein levels were directly opposite to those reported in the literature observed with aging. These data suggest that being physically active in daily life has strong and biologically detectable beneficial effects on muscle.
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Affiliation(s)
- Ceereena Ubaida-Mohien
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
| | - Marta Gonzalez-Freire
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
| | - Alexey Lyashkov
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
| | - Ruin Moaddel
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
| | - Chee W Chia
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
| | - Ranjan Sen
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging - National Institutes of Health, Baltimore, MD, United States
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4150
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Efficacy of antiepileptic drugs in the adjunctive treatment of refractory partial-onset seizures: Meta-analysis of pivotal trials. Epilepsy Res 2019; 143:120-129. [PMID: 29784458 DOI: 10.1016/j.eplepsyres.2017.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/14/2017] [Accepted: 10/03/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE In the absence of randomized clinical trials (RCTs) assessing the relative efficacy of antiepileptic drugs (AEDs), meta-analyses are useful resources for informing treatment choices. This meta-analysis assesses the relative efficacy and tolerability of AEDs for adjunctive treatment of refractory partial onset seizures (POS). METHODS A systematic literature review was conducted to identify pivotal AED trials serving as the basis for US Food and Drug Administration (FDA) approval. INCLUSION CRITERIA 1) double-blind, placebo-controlled, parallel-group design, with 8- to 14-week maintenance period; 2) enrolled patients ≥16years with refractory POS, including complex partial seizures; 3) study was conducted between 1993 and 2013; and; 4) patients received FDA-approved dosage. Outcomes analyzed: 1) 50% responder rate (≥50% reduction from baseline in seizure frequency); 2) seizure freedom (proportion of seizure-free patients); and 3) discontinuation due to adverse events (AEs). DerSimonian and Laird random-effects model was used to derive odds ratios (OR) and 95% confidence intervals (CI). RESULTS A total of 29 publications for 11 AEDs (eslicarbazepine, ezogabine, gabapentin, lacosamide, levetiracetam, perampanel, pregabalin, tiagabine, topiramate, vigabatrin, and zonisamide) were included in the meta-analysis. Tiagabine 56mg/day (OR 8.82, 95% CI: 2.77-28.11), pregabalin 600mg/day (OR 8.08, 95% CI: 5.45-11.98), and vigabatrin 3000mg/day (OR 6.23, 95% CI: 1.46-26.20) had the highest OR versus placebo of 50% response. The odds of seizure freedom were ≥7 times greater than placebo for levetiracetam 3000mg/day (OR 11.00, 95% CI: 2.08-58.06), vigabatrin 3000mg/day (OR 7.41, 95% CI: 1.31-41.84), and ezogabine 1200mg/day (OR 7.09, 95% CI: 0.36-58.06). Patients were more likely to discontinue any AED (except low-dose pregabalin) than placebo. CONCLUSION In this meta-analysis of >9000 patients, those treated with AEDs were more likely than placebo to achieve seizure response or freedom. Patients receiving pregabalin, tiagabine, and vigabatrin had the highest odds of ≥50% reduction in seizures, and patients receiving ezogabine, levetiracetam, and vigabatrin had the highest odds of seizure freedom.
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