Tag: pubmed

BMJ Open. 2023 Jul 10;13(7):e072170. doi: 10.1136/bmjopen-2023-072170.

ABSTRACT

OBJECTIVES: The aim of this study was to explore the current situation of kinesiophobia in patients with coronary heart disease, classify it based on potential profile analysis and explore the relevant factors of kinesiophobia in different categories of patients with coronary heart disease.

DESIGN: Cross-sectional study.

SETTING: Patients with coronary heart disease in China.

PARTICIPANTS: Adult (aged >18 years) patients with coronary heart disease in China; 252 participants in this study answered the questionnaire.

PRIMARY AND SECONDARY OUTCOME MEASURES: The study investigated the scores of Tampa Scale for Kinesiophobia Heart, and collected information on the patient’s age, gender, monthly household income, education level, place of residence, marital status, occupational status, hypertension, diabetes, heart failure and body mass index (BMI).

RESULTS: Kinesiophobia in patients with coronary heart disease can be divided into low fear type (C1), intermediate fear type (C2) and high fear type (C3). Elderly patients were classified as type C3. Women and patients with a normal BMI were classified as type C1; patients with a normal BMI and patients with an overweight BMI were classified as type C2.

CONCLUSION: Kinesiophobia of patients with coronary heart disease can be divided into three categories, and intervention measures are implemented according to their different demographic characteristics to reduce kinesiophobia of patients and promote the participation of patients in exercise rehabilitation.

PMID:37429691 | DOI:10.1136/bmjopen-2023-072170

BMJ Open. 2023 Jul 10;13(7):e073115. doi: 10.1136/bmjopen-2023-073115.

ABSTRACT

INTRODUCTION: Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research.

METHODS AND ANALYSIS: This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Prospective and retrospective observational studies or clinical trials in which prognostic factors associated with the development of IAD are described are eligible. There are no restrictions on study setting, time, language, participant characteristics or geographical regions. Reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports are excluded. MEDLINE, CINAHL, EMBASE and The Cochrane Library will be searched from inception until May 2023. Two independent reviewers will independently evaluate studies. The Quality in Prognostic Studies tool will be used to assess the risk of bias, and the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies-Prognostic Factors checklist will be used for data extraction of the included studies. Separate analyses will be conducted for each identified prognostic factor, with adjusted and unadjusted estimated measures analysed separately. Evidence will be summarised with a meta-analysis when possible, and narratively otherwise. The Q and I² statistics will be calculated in order to quantify heterogeneity. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guidance.

ETHICS AND DISSEMINATION: No ethical approval is needed since all data is already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.

PMID:37429690 | DOI:10.1136/bmjopen-2023-073115

BMJ Open. 2023 Jul 10;13(7):e070518. doi: 10.1136/bmjopen-2022-070518.

ABSTRACT

OBJECTIVES: The objective of this study was to assess the practice of early initiation of breast feeding (EIBF) and its determinant factors among urban-dwelling mothers from Tigray during the COVID-19 pandemic.

DESIGN: A community-based cross-sectional study was conducted from April to June 2021. Data were analysed using StataSE Version 16 software. To identify determinant factors of the dependent variable, multivariate logistic regression analyses was used at a statistical significance of p<0.05. The strength of the association was measured by OR and 95% CI.

SETTING AND PARTICIPANTS: The study was conducted among 633 lactating mothers of infants under the age of 6 months living in Mekelle city, Tigray, Northern Ethiopia from April to June 2021. A three-stage cluster sampling was used to select study participants.

MAIN OUTCOME MEASURE: EIBF or no EIBF.

RESULTS: Three hundred and sixty eight (59.6%) mothers/caregivers practised EIBF. Maternal education (adjusted OR, AOR 2.45, 95 % CI 1.01 to 5.88), parity (AOR 1.20, 95 % CI 1.03 to 2.20), caesarean section delivery (AOR 0.47, 95 % CI 0.32 to 0.69) and breastfeeding information and support postdelivery (AOR 1.59, 95% CI 1.10 to 2.31) were found to be significant determinants of EIBF.

CONCLUSIONS: EIBF is defined as initiation of breastfeeding within 1 hour after delivery. EIBF practice was far from optimal. During the COVID-19 pandemic, maternal education, parity, type of delivery and the provision of up-to-date breastfeeding information and support right after delivery determined the time of breastfeeding initiation.

PMID:37429688 | DOI:10.1136/bmjopen-2022-070518

BMJ Open. 2023 Jul 10;13(7):e070999. doi: 10.1136/bmjopen-2022-070999.

ABSTRACT

OBJECTIVES: The objective of this study was to determine the level of home-based optimal newborn care practice and associated factors among mothers in Ethiopia.

DESIGN: A community-based longitudinal panel survey design.

SETTING, PARTICIPANTS AND OUTCOMES: We used data from the Performance Monitoring for Action Ethiopia panel survey (2019-2021). A total of 860 mothers of neonates were included in the analysis. A generalised estimating equation logistic regression model was used to identify factors associated with home-based optimal newborn care practice and to account for the clustering nature of the data by enumeration area. An OR with 95% CI was used to measure the association between exposure and outcome variables.

RESULTS: The level of home-based optimal newborn care practice was 8.7% with 95% uncertainty interval ranging from 6% to 11%. After adjusting the effect of potential confounding factors, area of residence remained statistically significantly associated with mothers’ optimal newborn care practice. The chance of home-based optimal newborn care practice was 69% times lower among mothers from rural areas compared with those in urban areas (adjusted OR=0.31, 95% CI=0.15, 0.61).

CONCLUSION: The findings of this study showed that the level of home-based optimal newborn care practice was very low in Ethiopia. Also, home-based optimal newborn care practice was lower among mothers from rural areas in the nation. Therefore, health planners and healthcare providers, including health extension workers, should give priority attention to mothers from rural areas to improve their optimal newborn care practice by considering their context-specific factors or barriers.

PMID:37429684 | DOI:10.1136/bmjopen-2022-070999

BMJ Open. 2023 Jul 10;13(7):e074510. doi: 10.1136/bmjopen-2023-074510.

ABSTRACT

OBJECTIVE: To assess the quality of available and accessible national Clinical Practice Guidelines (CPGs) in Kenya using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.

METHODS: We searched the websites of the Kenyan Ministry of Health, professional associations and contacted experts in relevant organisations. Our scope was guidelines on maternal, neonatal, nutritional disorders, injuries, communicable and non-communicable diseases in Kenya published in the last 5 years until 30 June 2022. Study selection and data extraction were done by three independent reviewers with disagreements resolved via discussion or with a senior reviewer. We conducted a quality assessment using the online English version of AGREE II tool across six domains. Descriptive statistics were analysed using Stata software V.17. The primary outcome was the methodological quality of the included CPGs assessed by the AGREE II tool score.

RESULTS: We retrieved 95 CPGs and included 24 in the analysis after screening for eligibility. The CPGs scored best in clarity of presentation and least in the rigour of development. In descending order, the appraisal scores (mean and CI) per domain were as follows: Clarity of presentation 82.96% (95% CI 78.35% to 87.57%) with all guidelines scoring above 50%. Scope and purpose 61.75% (95% CI 54.19% to 69.31%) with seven guidelines scoring less than 50%. Stakeholder involvement 45.25% (95% CI 40.01% to 50.49%) with 16 CPGs scoring less than 50%. Applicability domain 19.88% (95% CI 13.32% to 26.43%) with only one CPG scoring above 50%. Editorial independence 6.92% (95% CI 3.47% to 10.37%) with no CPG scoring above 50% and rigour of development 3% (95% CI 0.61% to 5.39%) with no CPG scoring at least 50%.

CONCLUSION: Our findings suggest that the quality of CPGs in Kenya is limited mainly by the rigour of development, editorial independence, applicability and stakeholder involvement. Training initiatives on evidence-based methodology among guideline developers are needed to improve the overall quality of CPGs for better patient care.

PMID:37429677 | DOI:10.1136/bmjopen-2023-074510

BMJ Open. 2023 Jul 10;13(7):e070616. doi: 10.1136/bmjopen-2022-070616.

ABSTRACT

INTRODUCTION: Individuals with anorexia nervosa (AN) harbour distinct gut microbiomes compared with healthy individuals, which are sufficient to induce weight loss and anxiety-like behaviours when transplanted into germ-free mice. We hypothesise that faecal microbiome transfer (FMT) from healthy donors would help restore the gut microbiome of individuals with AN, which in turn, may aid patient recovery.

METHODS: We aim to conduct an open-label pilot study in 20 females aged 16-32 years in Auckland, New Zealand who meet the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria for AN and have a body mass index 13-19 kg/m². We will recruit four healthy, lean, female donors, aged 18-32 years, who will undergo extensive clinical screening prior to stool donation. Faecal microbiota will be harvested from donors and double encapsulated in delayed release, acid-resistant capsules. All participants will receive a single course of 20 FMT capsules (five from each donor) which they can choose to take over two or four consecutive days. Stool and blood samples will be collected from participants over a period of 3 months to assess their gut microbiome profile, metabolome, levels of intestinal inflammation and nutritional status. Our primary outcome is a shift in the gut microbiome composition at 3 weeks post-FMT (Bray-Curtis dissimilarity). We will also monitor participants’ body composition (whole-body dual-energy X-ray absorptiometry scans), eating disorder psychopathology, mental health and assess their views on, and tolerability of, treatment. All adverse events will be recorded and reviewed by an independent data monitoring committee.

ETHICS AND DISSEMINATION: Ethics approval was provided by the Central Health and Disability Ethics Committee (Ministry of Health, New Zealand, 21/CEN/212). Results will be published in peer-reviewed journals and presented to both scientific and consumer group audiences.

TRIAL REGISTRATION NUMBER: ACTRN12621001504808.

PMID:37429676 | DOI:10.1136/bmjopen-2022-070616

Zhongguo Zhen Jiu. 2023 Jul 12;43(7):793-9. doi: 10.13703/j.0255-2930.20220602-k0001.

ABSTRACT

OBJECTIVE: To observe the effects of Yizhi Tiaoshen (benefiting mental health and regulating the spirit) acupuncture on learning and memory function, and the expression of phosphorylated tubulin-associated unit (tau) protein in the hippocampus of Alzheimer’s disease (AD) model rats, and explore the effect mechanism of this therapy on AD.

METHODS: A blank group and a sham-operation group were randomly selected from 60 male SD rats, 10 rats in each one. AD models were established in the rest 40 rats by the intraperitoneal injection of D-galactose and okadaic acid in the CA1 region of the bilateral hippocampus. Thirty successfully-replicated model rats were randomly divided into a model group, a western medication group and an acupuncture group, 10 rats in each one. In the acupuncture group, acupuncture was applied to “Baihui” (GV 20), “Sishencong” (EX-HN 1), “Neiguan” (PC 6), “Shenmen” (HT 7), “Xuanzhong” (GB 39) and “Sanyinjiao” (SP 6); and the needles were retained for 10 min. Acupuncture was given once daily. One course of treatment was composed of 6 days, with the interval of 1 day; the completion of treatment included 4 courses. In the western medication group, donepezil hydrochloride solution (0.45 mg/kg) was administrated intragastrically, once daily; it took 7 days to accomplish one course of treatment and a completion of intervention was composed of 4 courses. Morris water maze (MWM) and novel object recognition test (NORT) were used to assess the learning and memory function of the rats. Using HE staining and Nissl staining, the morphological structure of the hippocampus was observed. With Western blot adopted, the protein expression of the tau, phosphorylated tau protein at Ser198 (p-tau Ser198), protein phosphatase 2A (PP2A) and glycogen synthase kinase-3β (GSK-3β) in the hippocampus was detected.

RESULTS: There were no statistical differences in all of the indexes between the sham-operation group and the blank group. Compared with the sham-operation group, in the model group, the MWM escape latency was prolonged (P<0.05), the crossing frequency and the quadrant stay time in original platform were shortened (P<0.05), and the NORT discrimination index (DI) was reduced (P<0.05); the hippocampal cell numbers were declined and the cells arranged irregularly, the hippocampal neuronal structure was abnormal and the numbers of Nissl bodies decreased; the protein expression of p-tau Ser198 and GSK-3βwas increased (P<0.05) and that of PP2A decreased (P<0.05). When compared with the model group, in the western medication group and the acupuncture group, the MWM escape latency was shortened (P<0.05), the crossing frequency and the quadrant stay time in original platform were increased (P<0.05), and DI got higher (P<0.05); the hippocampal cell numbers were elevated and the cells arranged regularly, the damage of hippocampal neuronal structure was attenuated and the numbers of Nissl bodies were increased; the protein expression of p-tau Ser198 and GSK-3β was reduced (P<0.05) and that of PP2A was increased (P<0.05). There were no statistically significant differences in the above indexes between the acupuncture group and the western medication group (P>0.05).

CONCLUSION: Acupuncture therapy of “benefiting mental health and regulating the spirit” could improve the learning and memory function and alleviate neuronal injure of AD model rats. The effect mechanism of this therapy may be related to the down-regulation of GSK-3β and the up-regulation of PP2A in the hippocampus, and then to inducing the inhibition of tau protein phosphorylation.

PMID:37429659 | DOI:10.13703/j.0255-2930.20220602-k0001

Zhongguo Zhen Jiu. 2023 Jul 12;43(7):776-80. doi: 10.13703/j.0255-2930.20220915-k0004.

ABSTRACT

OBJECTIVE: To observe the efficacy and safety of acupuncture combined with auricular point sticking for girls aged 3-8 years with incomplete precocious puberty (IPP).

METHODS: Sixty girls with IPP were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases were eliminated). The girls in the control group were treated with healthy diet and proper exercise for 12 weeks. On the basis of the treatment in the control group, the girls in the observation group were treated with acupuncture combined with auricular point sticking. The acupuncture was applied at Sanyinjiao (SP 6), Guanyuan (CV 4), Guilai (ST 29), etc., the needles were retained for 20 min, acupuncture was given twice a week (once every 3 days). The auricular point sticking was applied at Luanchao (TF₂), Neishengzhiqi (TF₂), Neifenmi (CO₁₈), Yuanzhong (AT_2,3,4i), etc., twice a week. The treatment was given for 12 weeks. Before treatment, after treatment and in follow-up after 12 weeks of treatment completion, the Tanner stage of breast, serum contents of sex hormone (luteinizing hormone [LH], follicle-stimulating hormone [FSH], estradiol [E₂]) were observed. The ovarian volume, the number of follicles with diameter>4 mm, and the uterine volume were measured by abdominal color Doppler ultrasound. In addition, the safety of the observation group was evaluated.

RESULTS: Compared with before treatment, the Tanner stage of breast in the observation group was improved after treatment and in follow-up (P<0.05); after treatment and in follow-up, the Tanner stage of breast in the observation group was better than that in the control group (P<0.05). Compared with before treatment, the serum levels of LH and E₂ in the observation group were increased (P<0.05), and the volume of bilateral ovaries was larger (P<0.05) in follow-up. Compared with before treatment, the serum contents of LH, FSH and E₂ in the control group were increased (P<0.05), the volume of bilateral ovaries was larger (P<0.05), and the number of follicles was increased (P<0.05) after treatment and in follow-up. The serum levels of LH, FSH and E₂ in the observation group were lower than those in the control group (P<0.05), the volume of bilateral ovaries was smaller than that in the control group (P<0.05), and the number of follicles was lower than that in the control group (P<0.05). Compared with before treatment, the uterine volume in the two groups was larger in follow-up (P<0.05). There was no statistically significant difference between the two groups after treatment and in follow-up (P>0.05). During the treatment, 3 cases in the observation group had slight abdominal pain and subcutaneous blood stasis, without serious adverse reactions.

CONCLUSION: Acupuncture combined with auricular point sticking could improve the Tanner stage of breast, reduce the level of sex hormone, slow down the development and maturation of ovary and follicle, and control the degree and speed of sexual development in girls aged 3-8 years with IPP.

PMID:37429657 | DOI:10.13703/j.0255-2930.20220915-k0004

Zhongguo Zhen Jiu. 2023 Jul 12;43(7):771-5. doi: 10.13703/j.0255-2930.20220806-k0001.

ABSTRACT

OBJECTIVE: To observe the effects of auricular thumbtack needle on breast feeding and lactation function in primiparous women with cesarean section, and to explore its mechanism of action from the perspective of lactation-related gene expression.

METHODS: One hundred cases of primiparous women with cesarean section were randomly divided into an observation group (50 cases, 3 cases dropped off) and a control group (50 cases, 2 cases were eliminated). The patients in the control group were treated with routine obstetric care. Based on the treatment of the control group, the patients in the observation group were treated with auricular thumbtack needle at Neifenmi (CO₁₈), Xiong (AH₁₀), Xiongzhui (AH₁₁), Shenmen (TF₄), and Jiaogan (AH_6a), etc., with one side of auricular point selected, only once for a total of 3 d. The lactation initiation time, lactation adequacy rate at postpartum 72 h, exclusive breastfeeding rate at postpartum 42 d, and breastfeeding score after treatment were compared between the two groups. Real-time quantitative PCR and Western blot method were used to detect the mRNA and protein expression levels of TDP-43, Btn1A1 and XDH.

RESULTS: After treatment, the lactation initiation time in the observation group was earlier than that in the control group (P<0.01), and breastfeeding score in the observation group was higher than that in the control group (P<0.01). The lactation adequacy rate at postpartum 72 h was 63.8% (30/47) in the observation group, which was higher than 41.7% (20/48) in the control group (P<0.05). The exclusive breastfeeding rate at postpartum 42 d was 72.3% (34/47) in the observation group, which was higher than 47.9% (23/48) in the control group (P<0.05). The mRNA and protein expression levels of TDP-43 and Btn1A1 in breast milk in the observation group were higher than those in the control group (P<0.01), while there was no statistically significant difference in mRNA and protein expression of XDH in breast milk between the two groups (P>0.05).

CONCLUSION: The auricular thumbtack needle in addition to routine care could promote lactation initiation, improve lactation adequacy rate and exclusive breastfeeding rate in primiparous women with cesarean section, and the action mechanism may be related to up-regulation of TDP-43 and Btn1A1 expression.

PMID:37429656 | DOI:10.13703/j.0255-2930.20220806-k0001

Zhongguo Zhen Jiu. 2023 Jul 12;43(7):751-5. doi: 10.13703/j.0255-2930.20220919-k0002.

ABSTRACT

OBJECTIVE: To observe the effects of transcutaneous acupoint stimulation (TEAS) on sleep quality and inflammatory factor in frail elderly patients undergoing laparoscopic colorectal cancer surgery.

METHODS: A total of 100 frail elderly patients undergoing elective laparoscopic colorectal cancer surgery were randomly divided into an observation group and a control group, 50 cases in each one. Patients in the observation group received TEAS, 30 min before surgery until the end of surgery, at 18:00 on the day of surgery and on the 1st, 2nd and 3rd day after surgery (30 min each time). TEAS was delivered at bilateral Neiguan (PC 6), Shenmen (HT 7) and Hegu (LI 4). The disperse-dense wave of 2 Hz/100 Hz was selected, and the maximal stimulation intensity depended on patient’s tolerance. The operation procedure in the control group was same as the observation group, but without electric stimulation exerted. The 1st day before surgery and on the 1st, 3rd and 7th day after surgery, the scores of Pittsburgh sleep quality index (PSQI) and Athens insomnia scale (AIS), as well as the serum levels of C reactive protein (CRP) and interleukin-6 (IL-6) were observed in the patients of two groups. At 24 h, 48 h and 72 h after surgery, the score of pain visual analogue scale (VAS) was recorded in the two groups, as well as the pressing times of analgesic pump and the usage of flurbiprofen axetil during analgesic stage. The occurrence of post operative adverse reactions was observed in the patients of two groups.

RESULTS: On the 1st and 3rd day after surgery, except the usage of hypnotic drug scores, the scores of each item and the total scores of PSQI, as well as AIS scores were all increased in the two groups compared with those of 1 day before surgery (P<0.05); and the scores in the observation group were lower than those in the control group (P<0.05). On the 7th day after surgery, the scores of each item and the total scores of PSQI, and AIS scores were not different statistically in comparison between the two groups (P>0.05). On the 1st, 3rd and 7th day after surgery, serum levels of CRP and IL-6 were all increased in the patients of two groups when compared with those of 1 day before surgery (P<0.05), serum levels CRP and IL-6 in the patients of the observation group were lower than those of the control group (P<0.05). The VAS scores of 24 h, 48 h and 72 h after surgery, the pressing times of analgesic pump, the frequency and dosage of the remedies were not different statistically between the two groups (P>0.05).

CONCLUSION: TEAS can effectively improve sleep quality and reduce inflammatory reaction in frail elderly patients undergoing laparoscopic colorectal cancer surgery.

PMID:37429652 | DOI:10.13703/j.0255-2930.20220919-k0002