Tag: nevin manimala

Med J Aust. 2022 Oct 2;217 Suppl 7:S7-S21. doi: 10.5694/mja2.51680.

ABSTRACT

OBJECTIVE: To review recent published trials of nutrition and dietary interventions for people with serious mental illness; to assess their effectiveness in improving metabolic syndrome risk factors.

STUDY DESIGN: Systematic review and meta-analysis of randomised and non-randomised controlled trials of interventions with a nutrition/diet-related component delivered to people with serious mental illness, published 1 January 2010 – 6 September 2021. Primary outcomes were weight, body mass index (BMI), and waist circumference. Secondary outcomes were total serum cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglyceride, and blood glucose levels.

DATA SOURCES: MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL databases. In addition, reference lists of relevant publications were examined for further additional studies.

DATA SYNTHESIS: Twenty-five studies encompassing 26 intervention arms were included in our analysis. Eight studies were at low or some risk of bias, seventeen were deemed to be at high risk. Eight of seventeen intervention arms found statistically significant intervention effects on weight, ten of 24 on BMI, and seven of seventeen on waist circumference. The pooled effects of nutrition interventions on metabolic syndrome risk factors were statistically non-significant. However, we identified small size effects on weight for interventions delivered by dietitians (five studies; 262 intervention, 258 control participants; standardised mean difference [SMD], -0.28; 95% CI, -0.51 to -0.04) and interventions consisting of individual sessions only (three studies; 141 intervention, 134 control participants; SMD, -0.30; 95% CI, -0.54 to -0.06).

CONCLUSIONS: We found only limited evidence for nutrition interventions improving metabolic syndrome risk factors in people with serious mental illness. However, they may be more effective when delivered on an individual basis or by dietitians.

PROSPERO REGISTRATION: CRD42021235979 (prospective).

PMID:36183316 | DOI:10.5694/mja2.51680

Cancer Causes Control. 2022 Oct 2. doi: 10.1007/s10552-022-01636-0. Online ahead of print.

ABSTRACT

PURPOSE: Little is known about cancer survivors’ needs in Alaska. To address this knowledge gap, the Alaska Cancer Partnership conducted a needs assessment survey; our objectives were to identify unmet needs of Alaska’s cancer survivors; identify survivor sub-populations that might benefit from targeted interventions or programming; and develop recommendations for public health and community organizations and healthcare providers for addressing cancer survivors’ unmet needs.

METHODS: Cancer survivors were identified using data from the Alaska Cancer Registry. A random sample of 2,600 individuals was selected to receive the survey, which assessed unmet needs across the following domains: information needs and medical care issues; quality of life; emotional and relationship issues related to cancer diagnoses; and support services. We calculated descriptive statistics for survey responses and assessed demographic predictors of unmet needs using Poisson regression.

RESULTS: We received 335 survey responses, for a response of 13.7%. Only 29.9% of cancer survivors expressed that all their needs were met. The most highly ranked unmet needs were as follows: help to reduce stress in life; to know doctors were coordinating care; and managing concerns about cancer coming back. After adjustment, men, adults younger than 65 at diagnosis, Alaska Native people, survivors still receiving or who had recently received care, and people who had to travel 50+ miles for most of their care had significantly greater unmet needs than their comparison groups.

CONCLUSION: This assessment provided some of the first information regarding the needs of Alaska’s cancer survivors. These results will be used by Alaska Cancer Partnership members across the state to inform healthcare delivery, programs, and public health messaging to support survivors.

PMID:36183311 | DOI:10.1007/s10552-022-01636-0

Eur J Nutr. 2022 Oct 2. doi: 10.1007/s00394-022-03017-4. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effect of an anti-inflammatory compared to a low-calorie diet on the physical and mental health of patients with knee OA.

METHODS: In this randomized parallel clinical trial, participants were selected among overweight and obese women aged 40 years or older with mild to moderate OA. Sixty women with a ratio of 1:1 were randomly assigned to receive either low-calorie or anti-inflammatory accompanied by a low-calorie diet for two months. The dietary intake and weight of participants were measured. Study variables were assessed using the Western Ontario and McMaster Index (WOMAC), visual analog pain scale (VAS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI-I), and the Short Form 36 Health Survey Questionnaire (SF-36) to indicate the quality of life (QoL).

RESULTS: There was no statistically significant difference between the two groups in demographic and baseline variables except for the emotional well-being subscale of QoL. There was significant difference in anti-inflammatory compared to low-calorie diet in terms of weight (MD (95% CI): – 4.02 kg (- 6.77 to – 1.28); p = 0.005), VAS (MD (95% CI): – 0.97 (- 1.53 to – 0.41); p = 0.001), WOMAC-total score (MD (95% CI): – 9.91 (- 15.05 to – 4.78); p < 0.001), WOMAC-pain subscale (MD (95% CI): – 3.30 (- 5.30 to – 1.29); p = 0.002), WOMAC-physical function (MD(95% CI): – 5.48 (- 9.41 to – 1.53); p = 0.007), depression (p = 0.003), anxiety (p = 0.011), QoL-physical functioning (0.041), and QoL-pain (0.010) after the intervention.

CONCLUSION: An anti-inflammatory accompanied by a low-calorie diet resulted in greater weight loss and greater improvement in pain intensity, functional status, depression, anxiety, and some dimension of QoL in overweight and obese women with knee OA compared to the low-calorie diet. Trial registration number and date of registration: IRCT201610220030424N2; 2018-04-23.

PMID:36183308 | DOI:10.1007/s00394-022-03017-4

Acta Neurol Belg. 2022 Oct 2. doi: 10.1007/s13760-022-02097-7. Online ahead of print.

ABSTRACT

OBJECTIVES: Arachnoid granulations (AG) can be located anywhere outside the dural sinuses. Their presence is thought to be associated with idiopathic intracranial hypertension (IIH) and cerebrospinal fluid (CSF) leaks. It was aimed to evaluate the intraosseous AGs located in the middle and anterior cranial fosses in detail with three-dimensional T2-SPACE (Sampling Perfection with Application optimized Contrasts using different flip angle Evolution-Siemens) imaging and to investigate their clinical significance.

MATERIALS AND METHODS: Sixty-five intraosseous AG of 46 patients were included in this retrospective study. The highest diameter, bone indentation degree (in the inner tabula, diploe distance, reaching and exceeding the outer tabula), content (CSF/+parenchyma) of each AG were evaluated by 2 experienced radiologists. In addition, the presence of other MRI findings supporting IIH was examined.

RESULTS: Additional signs of IIH were detected in 25 patients, and they were statistically significantly more common in the middle cranial fossa. Parenchymal herniation (in four patients) was more common in the young population.

CONCLUSIONS: Intraosseous AGs can be evaluated in detail with T2-SPACE imaging. Determining intraosseous AG is very important both as an indicator of IIH and in terms of its content. T2-SPACE imaging is superior to CT and conventional sequences in this regard.

PMID:36183280 | DOI:10.1007/s13760-022-02097-7

J Cancer Educ. 2022 Oct 2. doi: 10.1007/s13187-022-02223-2. Online ahead of print.

ABSTRACT

In Colombia, prostate cancer (PCa) is the most common cancer for incidence and mortality in men, which turns it into a public health problem. For high-risk communities to better understand the usefulness of basic research about PCa, a strategy of social appropriation of knowledge (SAK) in science and cancer was designed and implemented. A pedagogical activity and two tests (a pre-test and a post-test) were applied to middle education students in four schools in three Colombian cities to identify previous knowledge of biology concepts and cancer perceptions. As for biology concepts, there was a statistically significant increase (p < 0.01) in the total results of all questions in the post-test, especially in items related to the structure of DNA, differences between RNA and DNA, and codon. Similarly, better success rates were observed in questions about replication and mutation, and a statistically significant improvement related to the definition of cancer, cancer prevention, and its association with culture or ethnicity (p < 0.01). The results of the open question show what students learned about or were interested in the most, as evidence of the exchange of knowledge in those cities and the social appropriation of knowledge about PCa in Colombia. These findings show that this type of intervention, in diverse social contexts, is essential to improve understanding and perceptions that link school and scientific knowledge to a real problem, such as health and, in this case, cancer.

PMID:36183277 | DOI:10.1007/s13187-022-02223-2

Arch Orthop Trauma Surg. 2022 Oct 2. doi: 10.1007/s00402-022-04620-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Posterolateral approach has been advocated for the treatment of ankle fractures involving the posterior malleolus and satisfactory results were demonstrated in several studies. The Bartonicek classification based on 3-dimensional CT scanning was commonly used for treatment recommendation of posterior malleolar fracture (PMF). The aim of this retrospective study was to evaluate the clinical effect of the posterolateral approach for the treatment of PMF and present outcomes of patients with different types of Bartonicek classification.

METHOD: We retrospectively reviewed the clinical outcomes of 72 patients with ankle fractures involving posterior malleolus (PM) from January 2016 to December 2018. Posterior malleolus fractures (PMFs) were all directly reduced and fixed by a posterolateral approach using lag screws and/or buttress plates. AOFAS score and VAS pain score were used as the primary functional outcome measures. The radiographic evaluation included the quality of the reduction and Kellgren-Lawrence (KL) osteoarthritis classification. According to the CT-based Bartonicek classification, all patients were classified into three groups: 42 type II, 18 type III and 12 type IV. Bartonicek type II patients were further divided into subtype IIa 19 cases, subtype IIb 16 cases and subtype IIc 7 cases. The radiological and functional outcomes were analyzed among different types and subtypes of Bartonicek classification.

RESULTS: Sixty-eight patients (94.5%) achieved good or excellent reduction of PMF after surgery. The mean AOFAS score was 81.35 ± 6.15 at 6 months and 90.56 ± 4.98 at the final follow-up, respectively. The VAS score was 6.62 ± 1.03 one week after surgery, and 1.20 ± 0.92 at the final follow-up. Radiological evaluation at the final follow-up showed that primary bone union was achieved in all patients and 65 patients (88.9%) got no (KL grade 0) or just doubtable (KL grade 1) post-traumatic osteoarthritis. AOFAS scores decreased significantly with the severity of Bartonicek classification at 6 month (p < 0.001) and final follow-up (p < 0.05), while there was no statistical difference of VAS pain score among different types of Bartonicek classification. Reduction quality and the presence of osteoarthritis was not correlated to Bartonicek classification either. Besides, AOFAS scores at the final follow-up were statistically different among three subtypes of Bartonicek type II fractures (p < 0.05), and Bartonicek subtype IIa fractures had the highest AOFAS scores as 93 ± 4.99. Presence and severity of osteoarthritis was lower in patients with subtype IIa PMF compared to other subtype groups, this finding was statistically significant (p < 0.05).

CONCLUSION: The posterolateral approach could achieve good clinical outcomes in the treatment of posterior malleolus fracture. Patients with a Bartonicek type II fracture had a better functional outcome measured by the AOFAS score compared to other types. Bartonicek type IIa fractures got a higher AOFAS score and a lower incidence of osteoarthritis at the final follow-up than the other two subtypes. Classification of PMFs according to the Bartonicek classification was reliable.

PMID:36183274 | DOI:10.1007/s00402-022-04620-0

Farm Hosp. 2022 Aug 18;46(5):282-289.

ABSTRACT

OBJECTIVE: To determine the factors associated with virologic failure n HIV patients on antiretroviral treatment treated in a Colombian health institution.

METHOD: This was a cross-sectional observational retrospective analytical study of HIV patients receiving antiretroviral treatment between 2007‑2020. Sociodemographic, pharmacological and clinical variables were collected, including viral load, adherence, and the medication possession ratio. For statistical analysis, crude and adjusted odds ratios and confidence intervals were obtained.

RESULTS: In a population of 5,406 patients, the proportion of virologic failure was 16.7%. Moreover, in the adjusted model, an association was found between virologic failure and time on treatment greater than one year, medication possession ratio under 80%, failure to claim medications from the pharmacy due to dose omission or discontinuation, adherence under 85%, CD4 count under 500, total cholesterol levels above 201 mg/dL, high density lipoproteins under 39 mg/dL and presence of mycosis.

CONCLUSIONS: In our cohort of HIV patients, short treatment periods, CD4 counts under 200, a low medication possession ratio, failure to timely claim medications from the pharmacy due to omission or discontinuation, and a lower degree of adherence were factors related to virologic failure.

PMID:36183228

Trop Med Int Health. 2022 Oct 2. doi: 10.1111/tmi.13824. Online ahead of print.

ABSTRACT

INTRODUCTION: Tuberculosis (TB) patients on the National Tuberculosis Elimination Program (NTEP) treatment protocol receive daily doses without health professional-supervised drug intake as during the previous directly observed treatment short-course (DOTS) regimen. We aimed to measure the level of adherence to anti-tubercular treatment (ATT) and the reasons for non-adherence among drug-sensitive TB patients on a daily-dose regimen in South India.

METHODS: A cross-sectional study was conducted among TB patients who received ATT as part of the standard treatment protocol in NTEP. Patients were interviewed to capture their understanding of TB, adherence, and the reason for non-adherence to ATT using validated instruments. Urine drug metabolite testing was performed using the High-Performance Liquid Chromatography (HPLC) technique to confirm adherence.

RESULTS: A total of 488 patients were recruited for the study. 64.8% of patients had “good knowledge” about TB and ATT. According to the subjective report, 63.7% of patients were adherent, but urine drug metabolite testing revealed 53.4% adherence. A statistically significant difference (p<0.05) exists between subjective and objective adherence measures. Patient-reported reasons for non-adherence were side effects of ATT (18.6%), loss of daily wages (15.0%), and forgetfulness (10.0%), among others.

CONCLUSIONS: Nearly half of the patients were non-adherent to the daily dosing regimen. Adherence as reported by the patients is unreliable, and urine testing could be used in routine care to assess adherence. This article is protected by copyright. All rights reserved.

PMID:36183194 | DOI:10.1111/tmi.13824

Farm Hosp. 2022 May 19;46(4):203-207.

ABSTRACT

OBJECTIVE: Given poor medication adherence in severe asthma is difficult to evaluate in daily practice, using at least two methods concurrently is recommended. We aimed to determine the prevalence of nonadherence to inhalers using the Test of Adherence to Inhalers questionnaire and the medication possession ratio obtained from the pharmacy refill data in patients with severe asthma treated with anti-interleukin-5 biologics and to evaluate their concordance.

METHOD: This was a cross-sectional retrospective observational study of 53 patients with severe asthma recruited from the severe asthma unit of a tertiary hospital in Madrid from June to December 2020. We registered demographic data, comorbidities and concomitant therapy for sthma. Nonadherence was defined as pharmacy refill data &lt; 80% and/or Test of Adherence to Inhalers questionnaire results &lt; 50. Concordance was assessed by determining the Cohen’s kappa statistic. Results: The median age was 61 years (interquartile range 51.8-67.0), and 33 (61%) were women. According to the pharmacy refill data lack of adherence to the primary inhaler was 58.5%. However, when using the Test of Adherence to Inhalers questionnaire, it was 22.6%. Combining both methods, 17% of patients were considered to have nonadherence to inhalers. Likewise, when identifying nonadherence by either of these methods, it reached a prevalence of 64.2%. The pharmacy refill data and Test of Adherence to Inhalers questionnaire agreed in 53.1% and disagreed in 46.9% of patients (k = 0.137; 95% confidence interval -0.057 to 0.331; p = 0.318).

CONCLUSIONS: We observed a higher prevalence of non-adherence to inhalers in patients with severe asthma treated with anti-interleukin-5 biologics. The agreement between the Test of Adherence to Inhalers questionnaire and the pharmacy refill data is lower when evaluating nonadherence in patients with severe asthma treated with anti-interleukin-5 biologics. The pharmacy refill data detect a higher proportion of nonadherence compared with the Test of Adherence to Inhalers questionnaire.

PMID:36183217

Pediatr Pulmonol. 2022 Oct 2. doi: 10.1002/ppul.26170. Online ahead of print.

ABSTRACT

BACKGROUND: Peripheral airway impairment (PAI) has been shown to have a close association to risk of uncontrolled asthma in children. However, clear methods have not been established for the clinician to select IOS reference equations best suited for their population. Our study aimed to develop a practical external validation analytic approach for the clinician to determine which of the available reference equations best predicts uncontrolled asthma for their patients.

METHODS: This is a post-hoc analyses of data collected at baseline in a RCT that occurred from March 2016-March 2018. The study population consisted of 227 children, ages 4 to 18 years, with moderate to severe asthma. Discrimination and calibration predictive performance of available and suitable IOS equations were assessed by using uncontrolled asthma as the criterion outcome. Discrimination statistics of accuracy, sensitivity, and specificity served as the primary performance indicators. Rank scores were determined by the number of acceptable limit thresholds met for these measures (>=60%, >=50%, and >=60%, respectively) across IOS metrics (R5, R5-R20, AX, and X5) resulting in a total possible score of 12.

RESULTS: External validity assessment determined the rank order of best to worst equations as being Gochicoa-Rangel (rank score=10)>Nowowiejska (rank score=9)>Assumapcao (rank score=6)>Amra (rank score=2). Gochicoa-Rangel reference equations provided the best option for universal application with accuracy of 73.1%, 72.2%, 76.7%, and 66.2% for R5, R5-R20, AX, and X5, respectively.

CONCLUSIONS: External validation, particularly discrimination in asthmatic children, offers the clinician a practical approach to selecting the most suitable predictive equations for their patients. This article is protected by copyright. All rights reserved.

PMID:36183193 | DOI:10.1002/ppul.26170