Nevin Manimala

JMIR Form Res. 2024 Apr 30;8:e48185. doi: 10.2196/48185.

ABSTRACT

BACKGROUND: Obesity is a prevalent and serious chronic condition associated with abnormal or excessive fat buildup that poses significant health risks. The rates of overweight and obesity in adults and children continue to rise, with global rates of children with overweight or obesity aged 5-19 years growing from 4% to 18% between 1975 and 2016. Furthermore, in 2017, nearly 4 million people died due to complications arising from being overweight or obese.

OBJECTIVE: This study aims to investigate the potential impact of the mobile app Heia Meg on promoting healthier lifestyle choices regarding nutrition and physical activity.

METHODS: A prospective longitudinal study was conducted in collaboration with the Norwegian Directorate of Health. Participants were recruited through the Heia Meg app and were asked to complete a questionnaire before and after using the app. A total of 199 responses were included in the first (preintervention) questionnaire, while 99 valid responses were obtained in the second (postintervention) questionnaire.

RESULTS: The majority (159/199, 79.9%) of participants were female, and their age ranged from 18 years to 70 years and older. The results show a reduction in BMI after the digital intervention. However, some variables influence the BMI reduction effect: sex, age, education, and smoking. The group that obtained the most benefit from the intervention consisted of those who were male, aged 30-39 years, highly educated, and nonsmokers. Although positive, some of the findings are slightly above the statistical significance threshold and therefore should be interpreted carefully.

CONCLUSIONS: Our study found weak evidence to support the effectiveness of the Heia Meg app in promoting healthier lifestyle choices. However, limitations and confounding factors suggest that further research in different populations with larger sample sizes is needed to confirm or disprove our findings.

PMID:38687565 | DOI:10.2196/48185

Brain Behav. 2024 Feb;14(2):e3415. doi: 10.1002/brb3.3415.

ABSTRACT

INTRODUCTION: Previous studies have reported a decreased risk of dementia with herpes zoster vaccination. Given this background, this systematic review and meta-analysis aimed to investigate the association between herpes zoster vaccination and the risk of dementia.

METHODS: We searched five databases until November 2023 for case-control, cross-sectional, or cohort studies investigating the association of herpes zoster vaccination and dementia. Odds ratios and 95% confidence intervals (95% CIs) were pooled in the meta-analysis. Meta-regression, subgroup, and sensitivity analysis were also conducted.

RESULTS: We evaluated a total of five studies (one cross-sectional, one case-control, and four cohort studies) that included a total number of 103,615 patients who were vaccinated with herpes zoster vaccine. All the studies were of high quality, ranging from 7 to 9. Due to the high heterogeneity (I² = 100%, p < .00001) observed in our study, a random effect model was used for the analysis. The pooled odds ratio was 0.84 (95% CI: 0.50, 1.43), p (overall effect) = .53), indicating that herpes zoster vaccination reduces the risk of dementia.

CONCLUSION: Herpes zoster vaccination is associated with a reduction of the risk of dementia. More epidemiological studies are needed to confirm the association.

PMID:38687552 | DOI:10.1002/brb3.3415

Rev Med Chil. 2023 May;151(5):610-617. doi: 10.4067/s0034-98872023000500610.

ABSTRACT

OBJECTIVES: To determine the effectiveness of intralesional 5-Fluorouracil (5-FU) in symptomatic relief, astigmatism, and desire for surgery in patients with primary pterygium.

METHODS: The experimental study was carried out between January and March 2020 in the Ophthalmology Unit of the Hospital del Salvador, Chile. Fourteen eyes (14 patients) were selected on the surgical waiting list and exposed to fortnightly intralesional injections of 10 mg of 5-FU. An initial evaluation was performed with OSDI for symptomatic measurement, a photographic camera and slit lamp for clinical appearance, and an auto-refractometer for astigmatism, being re-evaluated 60 days later, adding the question of whether they maintained the desire to undergo surgery. The sample was divided into groups A and B depending on whether they received two or one dose of 5-FU, respectively.

RESULTS: The average age of the participants was 56.8 ± 11.1 years. Group A presented an initial OSDI of 50 ± 23.8, which, after the intervention, decreased to 21 ± 13.5 (p < 0.001). Group B had an initial OSDI of 47 ± 17.3, decreasing to 22 ± 16.2 (p < 0.005)-statistically significant changes. The degree of astigmatism had no changes. Regarding the physical aspect, there was a reduction in the size of the lesion in 2 of the 14 patients, both in group A. Two patients decided not to undergo surgery after the intervention.

CONCLUSIONS: The intralesional injection of 5-FU showed a significant improvement in symptomatic relief without associated complications, generating a therapeutic alternative in patients with primary pterygium without surgical indication.

PMID:38687543 | DOI:10.4067/s0034-98872023000500610

Rev Med Chil. 2023 May;151(5):600-609. doi: 10.4067/s0034-98872023000500600.

ABSTRACT

BACKGROUND: Obesity has been associated with a low-grade proinflammatory state, and it has been related to the development of cancer in general, including hematologic cancer.

AIM: The present work aimed to identify the association of the diagnosis of obesity according to the body mass index (BMI) with prognostic factors of adult patients with Acute Lymphoblastic Leukemia (ALL).

PATIENTS AND METHOD: This observational, retrospective study included hospitalized patients diagnosed with ALL of the B-cell lineages. BMI was estimated based on the weight and height registered on clinical records at the admission of the patients. The relapse risk and bone marrow relapse were determined, and the survival rate was measured. The statistical analysis included the Kaplan-Meier method using the log-Rank test.

RESULTS: This study included 128 clinical records of patients. Weight had no significant association with relapse risk. The frequency of bone marrow relapse was 43.8%. Obesity did not impact overall survival (p = 0.640) or disease-free survival (p = 0.527). The presence of obesity does not behave as a relapse risk variable (p = 0.873). BMI with a 30 kg/m2 cut-off point did not influence relapse risk (OR 1.078).

CONCLUSION: Obesity is not an independent risk factor for the prognosis of adult patients with Acute Lymphoblastic Leukemia B-lineage.

PMID:38687542 | DOI:10.4067/s0034-98872023000500600

Rev Med Chil. 2023 May;151(5):576-582. doi: 10.4067/s0034-98872023000500576.

ABSTRACT

OBJECTIVE: To study the prevalence of adverse drug events (ADE) in hospitalized patients in Chile. As part of our research, we also assessed the validity of the method used to identify the occurrence of an ADE based on the discharge diagnoses of the patient.

DESIGN: The study included 1,7 million patients hospitalized during 2019-2020. We analyzed the following variables for each patient: ICD-10 discharge diagnoses, sociodemographic information, and clinical outcome indicators, i.e., diagnosis-related group (DRG) weight, length of stay, and mortality. To validate the method for the identification of ADEs, first, we generated a random representative sample of patients, stratified by sex and medical specialty, hospitalized in a Chilean public hospital in 2019, and then we compared the outcome of the method with the opinion of a group of clinical experts that reviewed each patient’s discharge summary retrospectively.

RESULTS: The prevalence of ADEs in hospitalized patients in Chile during 2019 and 2020 was 2,7% and 3,1%, respectively. The precision of the method used to identify ADEs was 83,3% or higher (CI 90%).

CONCLUSIONS: This paper uses nationwide data to describe the prevalence of ADEs and their correlation with different factors associated with the patient, the patient’s disease, and the health service. These studies are essential to designing public health policies that effectively address healthcare quality and patient safety.

PMID:38687539 | DOI:10.4067/s0034-98872023000500576

Rev Med Chil. 2023 May;151(5):551-559. doi: 10.4067/s0034-98872023000500551.

ABSTRACT

PURPOSE OF THE STUDY: To know the experience of first-year medical students at Universidad Austral de Chile regarding virtual Problem-Based learning (PBL) tutorials carried out by peer tutors during the second semester of 2021.

METHODS: Quantitative and qualitative research, transversal, descriptive. The non-probabilistic sample consisted of 45 medical students who participated in virtual PBL tutorials with peer tutors. Data collection through an anonymous and voluntary opinion survey comprised two areas: methodology and role of the tutor, considering open questions related to facilitating and hindering aspects. Quantitative data analysis was performed using descriptive statistics with frequency measurements. The qualitative ones with progressive reduction. Study approved by the Scientific Ethics Committee, Valdivia Health Service.

RESULTS: There is a high degree of satisfaction in all three areas. Both in the qualitative and quantitative results, the participants positively value the performance of the peer tutor, highlighting empathy, commitment, trust, facilitation, feedback, and a good learning environment, allowing collaborative learning. Unlike the quantitative, the qualitative is more frequently identified as hindering factors, poor internet connection, excessive curricular load, and lack of knowledge about the methodology by the tutor.

CONCLUSIONS: Although the preparation of peer tutors for PBL tutorials is essential, it is even more critical in virtual mode since they face challenges such as managing virtual platforms and achieving effective communication that allows learning collaboratively.

PMID:38687536 | DOI:10.4067/s0034-98872023000500551

Rev Med Chil. 2023 Apr;151(4):510-517. doi: 10.4067/s0034-98872023000400510.

ABSTRACT

BACKGROUND: Communication skills (CS) are competencies required by health professionals. Clinical simulation with a simulated/standardized patient (SP) is a good resource for teaching this skill. However, it requires trained teachers to guide the process. Not all teachers have this training. HC short evaluation instruments are required to develop a structured observation during the activity, especially those that can be applied by all the participants to guide and understand the process from a broader perspective.

AIM: Validate a short HC assessment questionnaire to evaluate these skills from a 360° analysis, i.e., from the learner, facilitator/teacher, and PS perspective.

METHOD: A brief HC questionnaire was created, subjected to construct and content validity, and thus applied to 40 Kinesiology undergraduate students, facilitator/teacher, and PS during a simulated teleconsultation scenario. We analyzed the result of the communication by descriptive statistics, Lashe, Cronbach, KMO, Bartlett, IVC, Fisher and Cohen tests, and exploratory factorial analysis.

RESULTS: The questionnaire showed content validity for 5 of 6 items. Construct validity with commonalities over 50% for each item. With good reliability (Cronbach’s alpha > 0.79). We found high levels of HC in the students, but the concordance between observers was weak (Cohen’s Kappa < 0.4).

CONCLUSION: The short questionnaire for HC is a valid assessment tool during clinical simulation. Incorporating the views and perceptions of all the simulation participants can improve the understanding of health communication.

PMID:38687527 | DOI:10.4067/s0034-98872023000400510

Rev Med Chil. 2023 Apr;151(4):505-509. doi: 10.4067/s0034-98872023000400505.

ABSTRACT

This article deals with the regulatory violation of issuing sick leave with an evident absence of medical grounds. Two problematic aspects present in the sanctioning practice of the Social Security Regulatory Agency are analyzed: the discrepancy between the wording of the regulation and its application, and the multiplicity of duties that can configure the behavior defined by the law, although they do not constitute fraud against the sick leave system. The context of this study is the bill that seeks to lower the standard for the regulator to impose administrative penalties on offenders who issue unjustified sick leave and aggravate those penalties.

PMID:38687526 | DOI:10.4067/s0034-98872023000400505

Rev Med Chil. 2023 Apr;151(4):453-460. doi: 10.4067/s0034-98872023000400453.

ABSTRACT

INTRODUCTION: Poisonings are a worldwide preventable public health problem that affects the general population.

OBJECTIVE: To epidemiologically characterize BZ and AD poisonings registered in Chile between 2002 and 2019.

METHODS: An observational retrospective study of poisonings registered in the medical outcome report system of the Chilean Ministry of Health was conducted. The World Health Organization International Classification of Disease codes T42.2, T43.0 and T43.2 were included.

RESULTS: 22,807 poisonings associated with BZ or AD were identified, representing 0.08% of all hospitalizations. Poisoning rates distribution were established at regional and national level. There were 9.8% of accidental events, 63.7% of intentional events, and 26.5% of undetermined cases. The highest accidental and intentional poisoning rates were estimated at the ages of 0 to 4 and 15 to 19 years old respectively. Poisoned patients remained hospitalized on average for 3.4 days. 0.3% of cases were related to death of patients.

CONCLUSIONS: Poisoning events were characterized according to the studied variables. National poisoning rates decreased over the years with prevalence of those intentional events linked to women. Efforts should be made in creating poisoning prevention campaigns focused on age-based groups in the general population.

PMID:38687520 | DOI:10.4067/s0034-98872023000400453

Rev Med Chil. 2023 Apr;151(4):435-445. doi: 10.4067/s0034-98872023000400435.

ABSTRACT

BACKGROUND: The increasing use of Mindfulness-based interventions requires standardized construct-based measurement instruments for clinical and research purposes. The Five Facet Mindfulness Questionnaire scale with five factors was developed in the United States and validated in Spain. There are versions of 39, 24 and 15 items (FFMQ-39, FFMQ-24 and FFMQ-15).

OBJECTIVE: To validate the FFMQ-24 and FFMQ-15 scale in Chile.

METHODOLOGY: Six experts performed a linguistic adaptation of the Spanish version of the FFMQ-24. The adapted instrument was applied to a sample of 795 physicians. Internal validity was analyzed by calculating Cronbach’s alpha (α) and confirmatory factor analysis (CFA). Finally, 15 items were retained, and the 5-factor solution was maintained. The FFMQ-15 scale was applied to a sample of 365 medical students and analyzed by calculating (α) and CFA. The external validity of FFMQ-15 was evaluated with the Mental Health Continiuum-14 (MHC-14) scale.

RESULTS: Linguistic changes were made. The CFA of FFMQ-24 obtained a lower-than-expected fit for a 5-factor solution. The (α) value varied between .68 and .86 in all dimensions. The FFMQ-15 had an adequate fit for five factors for physicians (c2 = 216.17, df = 80, p < .01; CFI = .96; TLI = .94; RMSEA = .05 [.04, .06]; SRMR = .04) and students (c2 = 163.61, df = 80, p < .01; CF = .96; TLI = .94; RMSEA = .05 [.04, .07]; SRMR = .05). External validity with MHC-14 was adequate.

CONCLUSION: The FFMQ-15 scale has acceptable internal consistency and adequate internal and external validity in Chile.

PMID:38687518 | DOI:10.4067/s0034-98872023000400435