Hasil untuk "Other systems of medicine"

M. Goddard, Peter C. Smith

Shannon Gwin Mitchell, Jan Gryczynski, Donald C. Worley et al.

Background De-implementing non-effective or even harmful practices in healthcare is sometimes necessary, as has been the case with opioid prescribing in dentistry over the past decade. One approach to practice transformation is to deploy clinical decision support (CDS) tools. This qualitative study examined barriers to CDS use as part of a cluster randomized trial that aimed to decrease opioid prescribing for pain management following tooth extractions across a large dental practice. Method Twenty dental providers who took part in the larger randomized trial were purposively selected to complete a semi-structured qualitative interview. Participants represented a broad range in terms of years of practice, dental specialization, and CDS use patterns. Interviews were conducted via Zoom, audio recorded, transcribed, and analyzed using a content analysis approach in ATLAS.ti following participation in the cluster randomized trial. Results Reasons for not using the CDS fell generally into two broad categories: unintentional (i.e., forgetting to use the CDS) and intentional. Providers who forgot to use the CDS after training and implementation either were not sure where to look for the alert on the screen or did not remember to look for it because its use was never incorporated into their workflow. Reasons for deciding not to use the CDS included feeling that it slowed down their workflow, thinking that the information it provided would not be useful, and not trusting the functionality of the system. Conclusions There were numerous, interdependent human, organizational, and technological factors that influenced the intentionally and unintentionally low CDS use rates observed in the study. Findings highlight issues to be aware of and address in future implementation efforts that utilize CDS. Trial registration Clinicaltrials.gov NCT03584789.

Helena Maria Prado Domingues, Valentina Lima Cartaxo da Silva, Eduarda Menin da Silva et al.

O Papilomavírus Humano é um vírus DNA de fita dupla não envelopado, da família Papillomaviridae, e representa fundamental agente etiológico no desenvolvimento do câncer do colo do útero. A transmissão ocorre principalmente por meio do contato sexual, com infecção das camadas basais do epitélio escamoso via microabrasões. Trata-se de uma infecção comum, acometendo cerca de 80% da população sexualmente ativa exposta ao vírus em algum momento da vida. Diante desse cenário, este estudo tem como objetivo analisar a prevalência e incidência de lesões precursoras significativas de câncer invasor de colo uterino em mulheres jovens fora da faixa etária recomendada para rastreamento, no estado do Paraná. Para isso, foi conduzido um estudo de natureza epidemiológica observacional, de delineamento transversal, utilizando dados do Sistema de Informação do Câncer (2019-2024). Ao todo, foram avaliados 1.817.058 exames citológicos, abrangendo mulheres de diferentes faixas etárias. Os resultados evidenciaram uma progressão na incidência de lesões de alto grau a partir dos 15 anos, com pico entre 30 e 34 anos. Embora a maioria das infecções em jovens seja transitória, 5,92% dos casos abaixo de 25 anos já apresentavam lesões precursoras avançadas. Os achados reforçam a atual recomendação de rastreamento a partir dos 25 anos, mas indicam a necessidade de estratégias personalizadas para subgrupos de maior risco. Assim, a ampliação seletiva do rastreamento pode otimizar a prevenção do câncer cervical e reduzir a morbimortalidade associada. Sendo assim, conclui-se que diante das limitações do rastreamento do câncer de colo uterino baseado apenas na idade, evidencia-se a necessidade de estratégias personalizadas, especialmente para mulheres com fatores de risco. Além disso, o fato de 5,92% das lesões graves ocorrerem antes dos 25 anos reforça a importância de reavaliar os critérios atuais para diagnóstico precoce e prevenção deste tipo de câncer.

Antonio Morandi

Background: Digital health can flatten traditional medical knowledge into reductionist codes. Ayurveda locates valid knowledge (Pramāṇa) at the intersection of experience, environment, and awareness – dimensions not exhausted by quantitative computation. Aim and Objective: The aim of the study was to present Structured Distributed Introspection (SDI) as an epistemic framework that operationalizes a perception–reflection–reintegration loop for semantic coherence and to embed it within Collaborative Medicine and Science (CoMS), a translational methodology (Reformulation → Modeling → Localization) that preserves Ayurvedic meaning while enabling computation. Materials and Methods: Conceptual synthesis integrating classical Ayurvedic epistemology with embodied/active-inference theories, anchored to current Ayush/World Health Organization (WHO) standards (ICD-11 TM2, NAMASTE, Ayush Grid). An SDI validation summary is provided from dual-protocol studies across 10 Large Language Models (LLMs; n = 400 responses), quantifying cross-frame consistency. Results: SDI formalizes introspection as structural feedback; within CoMS, it supports (a) semantically faithful, computable Prakṛti/Vikṛti assessment; (b) prodrome-aware saṃprāpti modeling; (c) adaptive learning mirroring introspective practice; and (d) methodical guardrails for Artificial Intelligence (AI) use in Ayurveda. Limitations: SDI’s engineering/architectural phase is a prospective research program; empirical validation beyond LLM self-description requires multicenter studies and clinician-rated endpoints. Conclusion: SDI (epistemic core) within CoMS (translational core) provides a rigorous, concept-first pathway for digitizing Ayurveda that enables interoperability without erasing identity, aligning practice with WHO principles for responsible, culturally grounded AI.

Javier Andreu-Perez, D. Leff, H. Ip et al.

Igor IVANES, Aurelia USTIAN, Constantin IAVORSCHI

Tuberculoza este o boală infecțioasă gravă și răspândită la nivel global, cauzând un număr semnificativ de decese în fiecare an. Aceasta continuă să reprezinte o provocare majoră pentru sistemul de sănătate și necesită eforturi susținute de control și prevenție. Scopul acestei lucrări a fost de a analiza aspectele istorice ale tuberculozei și rezultatele programelor de control la nivel mondial și local. Materialele și metodele utilizate au implicat cercetarea literaturii de specialitate. Principalele concluzii includ evoluția istorică a tuberculozei, impactul descoperirilor și progreselor medicale asupra tratamentului și controlului bolii, precum și necesitatea continuă de a implementa strategii eficiente de prevenție și tratament.

B. Patwardhan, A. Vaidya, M. Chorghade

S. Gando, T. Iba, Y. Eguchi et al.

Deepa S Mandlik Ingawale, A. Namdeo

Abstract Withania somnifera, commonly known as “Ashwagandha” or “Indian ginseng” is an essential therapeutic plant of Indian subcontinent regions. It is regularly used, alone or in combination with other plants for the treatment of various illnesses in Indian Systems of Medicine over the period of 3,000 years. Ashwagandha (W. somnifera) belongs to the genus Withania and family Solanaceae. It comprises a broad spectrum of phytochemicals having wide range of biological effects. W. somnifera has demonstrated various biological actions such as anti-cancer, anti-inflammatory, anti-diabetic, anti-microbial, anti-arthritic, anti-stress/adaptogenic, neuro-protective, cardio-protective, hepato-protective, immunomodulatory properties. Furthermore, W. somnifera has revealed the capability to decrease reactive oxygen species and inflammation, modulation of mitochondrial function, apoptosis regulation and improve endothelial function. Withaferin-A is an important phytoconstituents of W. somnifera belonging to the category of withanolides been used in the traditional system of medicine for the treatment of various disorders. In this review, we have summarized the active phytoconstituents, pharmacologic activities (preclinical and clinical), mechanisms of action, potential beneficial applications, marketed formulations and safety and toxicity profile of W. somnifera. Graphical Abstract

Swathi Iyengar, K. Tay-Teo, S. Vogler et al.

Introduction New hepatitis C virus (HCV) medicines have markedly improved treatment efficacy and regimen tolerability. However, their high prices have limited access, prompting wide debate about fair and affordable prices. This study systematically compared the price and affordability of sofosbuvir and ledipasvir/sofosbuvir across 30 countries to assess affordability to health systems and patients. Methods and Findings Published 2015 ex-factory prices for a 12-wk course of treatment were provided by the Pharma Price Information (PPI) service of the Austrian public health institute Gesundheit Österreich GmbH or were obtained from national government or drug reimbursement authorities and recent press releases, where necessary. Prices in Organisation for Economic Co-operation and Development (OECD) member countries and select low- and middle-income countries were converted to US dollars using period average exchange rates and were adjusted for purchasing power parity (PPP). We analysed prices compared to national economic performance and estimated market size and the cost of these drugs in terms of countries’ annual total pharmaceutical expenditure (TPE) and in terms of the duration of time an individual would need to work to pay for treatment out of pocket. Patient affordability was calculated using 2014 OECD average annual wages, supplemented with International Labour Organization median wage data where necessary. All data were compiled between 17 July 2015 and 25 January 2016. For the base case analysis, we assumed a 23% rebate/discount on the published price in all countries, except for countries with special pricing arrangements or generic licensing agreements. The median nominal ex-factory price of a 12-wk course of sofosbuvir across 26 OECD countries was US$42,017, ranging from US$37,729 in Japan to US$64,680 in the US. Central and Eastern European countries had higher PPP-adjusted prices than other countries: prices of sofosbuvir in Poland and Turkey (PPP$101,063 and PPP$70,331) and of ledipasvir/sofosbuvir in Poland (PPP$118,754) were at least 1.09 and 1.63 times higher, respectively than in the US (PPP$64,680 and PPP$72,765). Based on PPP-adjusted TPE and without the cost of ribavirin and other treatment costs, treating the entire HCV viraemic population with these regimens at the PPP-adjusted prices with a 23% price reduction would amount to at least one-tenth of current TPE across the countries included in this study, ranging from 10.5% of TPE in the Netherlands to 190.5% of TPE in Poland. In 12 countries, the price of a course of sofosbuvir without other costs was equivalent to 1 y or more of the average annual wage of individuals, ranging from 0.21 y in Egypt to 5.28 y in Turkey. This analysis relies on the accuracy of price information and infection prevalence estimates. It does not include the costs of diagnostic testing, supplementary treatments, treatment for patients with reinfection or cirrhosis, or associated health service costs. Conclusions Current prices of these medicines are variable and unaffordable globally. These prices threaten the sustainability of health systems in many countries and prevent large-scale provision of treatment. Stakeholders should implement a fairer pricing framework to deliver lower prices that take account of affordability. Without lower prices, countries are unlikely to be able to increase investment to minimise the burden of hepatitis C.

Francis Rossetti Pedack , Marciano Eduardo da Rosa, Jaqueline Stall et al.

SARS-COV-2 is transmitted among human beings by saliva droplets that come in direct contact with the oral cavity, nose, and eyes. Since the mouth is one of the anatomical sites primarily contaminated, oral manifestations have also been reported beyond the serious consequences inherent to progressive respiratory failure. This study aimed to identify oral manifestations possibly related to the infection by COVID-19 in hospitalized patients. A prospective study was carried out with patients diagnosed with COVID-19 in the period between March and June 2021, admitted to the Moderate COVID-19 Care Unit of the Hans Dieter Schmidt Regional Hospital, by applying a form and performing a clinical exam of the oral cavity. Out of all patients (n=45), 33.3% reported both olfactory (anosmia) and taste dysfunction (dysgeusia), with an average duration of 5.9 ±3.0 days. Regarding other oral manifestations evaluated, two patients reported dry and burning mouth and one patient reported a change in taste associated with plaque-like changes in the tongue. No patients presented ulcers or other lesions in the oral cavity. Olfactory and taste dysfunction were symptoms recognized of the novel coronavirus disease (COVID-19). However, the association with other oral manifestations is still controversy. Unfortunately, dentistry professionals are still not part of most teams in the hospital environment, mostly because of the lack of prioritization of dental care. Working with a multidisciplinary team may avoid possible systemic complications due to poor dental care.

Manoj K. Pandey, T. S. Sathyanarayana Rao

Xuran Cui, Xibao Liu, Feng Wang et al.

Abstract Huangqin Su (HQS) tablet is mainly composed of baicalein which has been evaluated for its ability to inhibit influenza. The present study aimed to investigate the effect of HQS and oseltamivir phosphate (OS) (single or combination therapy) on influenza-induced acute pneumonia in male and female ICR mice. The regulatory effect of HQS on gut microbiota was also studied by using 16 s rDNA sequencing, and the targets and mechanisms of HQS against influenza were comprehensively analyzed by network pharmacology. Pharmacodynamic results, including lung index and pathological changes, showed that HQS exhibited significant anti-influenza efficacy and could improve the efficacy of low-dose OS (P < 0.05 and P < 0.01, respectively). The results of 16 s rDNA sequencing revealed that HQS modulated the gut microbiota and remarkably enriched the abundance of Lactobacillus. The findings of network pharmacology research suggested that the anti-influenza mechanism of HQS was related to TLRs, MAPK, and other signal transduction pathways. Taken together, this study identified the possibility of the combined use of HQS and OS and demonstrated the role of HQS in modulating the gut microbiota of mice against influenza. Network pharmacology studies also suggested that the anti-influenza effect of HQS was related to TLRs, MAPK, TNF, and other signaling pathways.

Blaise L. Worden, David F. Tolin

Background: Symptoms of ADHD are common in individuals with hoarding disorder (HD). It remains unclear whether these attentional symptoms reflect high co-occurrence rates of ADHD and HD, or whether inattentive symptoms can be conceptualized as intrinsic to the HD syndrome. In addition, inattention (vs. hyperactivity) in particular, appears to be related to HD, but this may be because some inattention criteria (e.g., losing items, disorganization) may be better explained as a result of clutter rather than inattention per se. Method: We explored what specific ADHD symptoms were most likely to be endorsed by individuals with HD, and compared this to a sample of patients with OCD (who have been shown to have some overlapping executive functioning deficits) and a sample of healthy controls. We also examined retrospective ratings of childhood ADHD symptoms to explore whether childhood ADHD symptoms were associated with later HD diagnosis, or whether attentional symptoms in HD onset later in life. Results: Individuals with HD reported higher ADHD symptoms in childhood than did individuals with OCD, and for both clinical groups ADHD symptoms appeared to worsen across the lifespan. Individuals with HD were more likely than were individuals with OCD and healthy controls to endorse inattention subscale items, although the few hyperactive subscale items that were significant appeared to largely reflect verbal impulsivity (e.g., interrupting others, talking too much, “blurting out” responses preemptively). Conclusions: Specific criteria endorsed varied by diagnosis, suggesting that individuals with HD may have a different, specific inattention profile.

Emad Nabil

Darrell J Solet, J. Norvell, G. Rutan et al.

Yen-Wei Chen, J. Moussi, Jeanie L. Drury et al.

S. Giguère

Maruti R. Gudavalli, Gregory D. Cramer, Avinash G. Patwardhan

Objective: The study objective was to quantify the changes in intradiscal pressure (IDP) during the application of a chiropractic procedure known as the Cox flexion-distraction technique. Materials and Methods: Pressure sensors were inserted into lumbar intervertebral discs of eight unembalmed cadavers (five male and three female, age range 43?75 years). Five 4-second cycles of flexion distraction were performed for a 20-sec period. Pressure data were collected while the discs were in an unpressurized state as well as a pressurized state (with water). The pressure data were collected during three separate applications of the flexion-distraction procedure with transducers inserted into the L2-L3, L3-L4, and L4-L5 intervertebral discs. The mean pressure values were documented before, during (in the distracted position), and after the treatment procedure (calculated). Pressure differences were compared using the paired t-test for significance in pressure changes from initial prone position to distracted treatment position. Results: The IDPs significantly decreased in both pressurized and unpressurized discs at all studied disc levels. The average IDP decreases in unpressurized discs were as follows: 5.6?kPa at L2-L3, 20.6?kPa at L3-L4, and 22.0?kPa at L4-L5. The IDP decrease range in pressurized-in-the-initial-prone-position discs were as follows: 17.8?kPa at L2-L3, 35.2?kPa at L3-L4, and 122.0?kPa at L4-L5. Conclusions: IDP was found to decrease during the flexion-distraction procedure, which is consistent with the hypothesis that this procedure may be able to draw a protruded nucleus pulposus back toward the intervertebral disc's center and allow for the nutrients flow into the disc.

Gunpreet Kaur, Parveen Bansal, Ravinder Sharma et al.

Background: Folklore surveys had been a source of development of potential new drugs all over the world. Mumps is a keen extensive disease caused by virus with well-recognized symptoms and complications. In India, a number of herbal drugs have been used as home remedies to cure mumps. This study aimed to create an inventory of the folklore use of medicinal plants in the treatment of mumps in selected states in north India. Methods: A survey was carried out by using a questionnaire on 98 subjects involved in traditional medication in Uttar Pradesh, Himachal Pradesh, Punjab, Uttrakhand, and Union Territories of Chandigarh. Botanical information regarding recognized plants was collected properly and data were further analyzed by using the relative frequency of citation (RFC). Results: As per survey, 23 plant species from 16 families were identified, and the most commonly used plant for treatment of mumps was found to be Glycyrrhiza glabra with RFC value 0.877 followed by Curcuma longa (0.867). It is pertinent to mention that only one clinical study has been done on Mimosa pudica plant with RFC value 0.622 by scientists to support its use in treatment of mumps out of 23 plants reported by traditional healers. Conclusion: This survey expresses the knowledge about medicinal plants used in the treatment of mumps in north India, and it serves as a template for researchers to conduct future research on these plants for mumps treatment.