Hasil untuk "Public aspects of medicine"

A. Aibar-Almazán, Ana Voltes-Martínez, Y. Castellote-Caballero et al.

Osteoporosis has been defined as the silent disease of the 21st century, becoming a public health risk due to its severity, chronicity and progression and affecting mainly postmenopausal women and older adults. Osteoporosis is characterized by an imbalance between bone resorption and bone production. It is diagnosed through different methods such as bone densitometry and dual X-rays. The treatment of this pathology focuses on different aspects. On the one hand, pharmacological treatments are characterized by the use of anti-resorptive drugs, as well as emerging regenerative medicine treatments such as cell therapies and the use of bioactive hydrogels. On the other hand, non-pharmacological treatments are associated with lifestyle habits that should be incorporated, such as physical activity, diet and the cessation of harmful habits such as a high consumption of alcohol or smoking. This review seeks to provide an overview of the theoretical basis in relation to bone biology, the existing methods for diagnosis and the treatments of osteoporosis, including the development of new strategies.

C. Rosen, S. Abrams, J. Aloia et al.

Kaidi Lu, Ming Xie, Wanping Sun et al.

IntroductionThe economic expansion of the Traditional Chinese Medicine (TCM) industry has prompted the Chinese government to introduce a series of policies focused on the registration review and approval of TCM. These policies aim to provide scientific and practical guidance for the innovation, protection, and progress of TCM. Although scholars have conducted detailed studies on the quantitative assessment of Traditional Chinese Medicine Registration Review and Approval Policies(TCMRAPs), Research on the evolution analysis of these policies is still relatively lacking.MethodsThe evolution of TCMRAPs was analyzed using the Latent Dirichlet Allocation (LDA) topic model.ResultsThe results show that the scope of concern of the TCMRAPs in China is vast. TCMRAPs demonstrate their uniqueness at each stage, and over time, they have exhibited a development trend from a basic framework to standardization and refinement.DiscussionThis study provides a reference for the subsequent formulation of TCMRAPs in China. Also, it offers an assessment method and theoretical reference for other countries in formulating their own policies for the drugs.

Alessandra Lucchesi de Menezes Xavier Franco, Zenewton André da Silva Gama, Marianna de Camargo Cancela et al.

Resumo Introdução: Buscar o cuidado integral tornou-se um ideal, pois obtém-se uma visão ampla da satisfação, compreendida como oferta de serviço de qualidade. As avaliações em saúde podem ser realizadas por meio da aplicação de instrumentos, desde que validados para este fim. Método: Trata-se de um estudo qualiquantitativo que elaborou e validou o Instrumento de Avaliação da Qualidade da Atenção ao Câncer Infantojuvenil (IQCANCER-IJ). A primeira versão resulta de revisão da literatura após reunião com experts. Na segunda etapa, cada item foi julgado com escala Likert, pela técnica Delphi, até obtenção da concordância, mensurada pelo Índice de Validade de Conteúdo por Item (IVC-I) e pelo Índice de Validade de Conteúdo (IVC), com valor mínimo de 0,78. Resultados: Foram determinados 4 domínios (95 questões): anterior ao diagnóstico; diagnóstico; tratamento; posterior ao tratamento. Após avaliação por 12 especialistas, foi observado IVC-I inferior ao recomendado em 14 itens, e IVC=0,89. O IVC, baseado nos critérios de avaliação utilizados, foi 0,75, o que implicou a necessidade de ajustes. A 2ª versão com 84 itens foi reavaliada por 10 especialistas (IVC-I>0,78; IVC=0,98) e foi obtido consenso. Conclusão: O instrumento foi validado, e seu score proposto é baseado no percentual de respostas positivas por domínio e globalmente.

Melissa Blum, Donato DeIngeniis, Daniela K. Shill et al.

Introduction: Rising ambient temperatures threaten vulnerable populations such as pregnant women, with urban populations bearing a greater risk due to the urban heat island effect. Here, we assessed the independent effects of trimester-specific warm season exposure during pregnancy and neighborhood heat vulnerability on maternal outcomes, including gestational diabetes, hypertensive disorders of pregnancy, genitourinary infections, and operative delivery. Methods: This retrospective study analyzed 819 participants from the Stress in Pregnancy Study (2009–2014), a longitudinal birth cohort study in New York City. Generalized linear models examined associations between trimester-specific warm season exposure, New York City Heat Vulnerability Index (ranging 1-5), and adverse maternal outcomes, adjusting for demographics, parity, and substance use. Results: First trimester warm season exposure was associated with increased odds of gestational hypertension (adjusted odds ratio [AOR] 4.50, 95%CI 1.17-17.27), preeclampsia (AOR 4.38, 95%CI 1.51-12.75), and genitourinary infection (AOR 2.27, 95%CI 1.14-4.51). Each unit increase in heat vulnerability index was associated with increased odds of preeclampsia (AOR 1.38, 95%CI 1.05-1.81) and genitourinary infection (AOR 1.32, 95%CI 1.11-1.57). Conclusions: Both early pregnancy warm weather exposure and neighborhood vulnerability independently increased the risk of adverse maternal complications. Our findings provide evidence in support of targeted heat mitigation strategies to limit heat exposure in at-risk communities as climate change progresses.

Tehreem Arshad, Muhammad Shahid Rafique, Shazia Bashir et al.

Lahore (Pakistan), being an industrial city, has high emission of aerosols that affects and contaminates the air quality. Therefore, the abatement/inactivation of aerosols is necessary to restrict their infectious activities. In this project, ionic wind isolated from dielectric barrier discharge plasma (DBD plasma) has been utilized to abate the aerosols trapped in the Surgical Mask and KN95 Respirator. To infer the chemical and elemental detection of ambient aerosols, FTIR and LIBS have been employed. “From the results, it is noteworthy that abatement/removal of aerosols has been successfully carried out by the ionic wind irradiation and highlights the potential of DBD plasma technology in removing the aerosols pollution.”

Lawrence A Leiter, David G Kallend, Wolfgang Koenig et al.

Therapeutic Area: ASCVD/CVD Risk Factors Background: Excessive bodyweight, often associated with dyslipidemia, may affect the pharmacology of drugs. Inclisiran, a small interfering RNA targeting PCSK9 hepatic mRNA, is an effective LDL-C lowering agent with twice-yearly subcutaneous dosing (after the initial and 3-month doses). The aim of this analysis was to assess the efficacy and safety of inclisiran in patients with heterozygous familial hypercholesterolemia, atherosclerotic cardiovascular disease (ASCVD) or ASCVD risk equivalent across body mass index (BMI) strata. Methods: In this post hoc analysis from ORION-9 (NCT03397121), ORION-10 (NCT03399370) and ORION-11 (NCT03400800), eligible patients were randomized 1:1 to receive 300 mg inclisiran sodium (equivalent to 284 mg inclisiran) or placebo at baseline, Day 90 and 6-monthly thereafter. Analysis was stratified by baseline BMI: <25, 25–<30, 30–<35 or ≥35 kg/m2. Percentage change in atherogenic lipids from baseline at Day 510 was evaluated. Safety was assessed over 540 days. Results: Baseline demographic and clinical characteristics including atherogenic lipid levels were mostly balanced between treatment arms and across BMI strata (Table). Percentage change in atherogenic lipids from baseline at Day 510 was significantly greater with inclisiran vs placebo within each BMI stratum (Table). Treatment-emergent adverse events (TEAE) and treatment-emergent serious adverse events were generally similar between treatment arms and were reported more frequently with increasing BMI strata (data not shown). Clinically relevant TEAEs at the injection site were reported more frequently with inclisiran vs placebo similarly across strata, but all were mild or moderate. Conclusion: Twice-yearly dosing with inclisiran (after the initial and 3-month doses) provided effective and sustained lipid lowering in patients, irrespective of their baseline BMI, and was generally well tolerated.

Javier Garjón Parra, Lorea Sanz Álvarez

Taddese Alemu Zerfu, Amare Abera Tareke, Sibhatu Biadgilign

Abstract Background Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia’s rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program design and implementation challenges of Ethiopia’s rural HEP based on the lived experiences of health extension workers (HEW) implementing the program at the grassroots level. Methods We employed a longitudinal qualitative exploration linked to a larger cluster-randomized trial (RCT) which was implemented in 282 villages randomly selected from 18 Kebeles of the Gedeo zone, southern Ethiopia. Data were collected using in-depth interviews with key informants, focus group discussion, and passive observation of program implementation. The data were analyzed manually using a thematic framework analysis approach. Themes and sub-themes were generated by condensing, summarizing, and synthesizing data collected in the field in the form of extended notes and field observation checklists. Findings Despite considerable gains in availing basic health services to the rural population, HEP seems to suffer serious design and implementation flaws that demand thoughtful and immediate adjustment. The design constraints span from the number and type of intervention packages to the means of dissemination (vehicle) as well as the target population emphasized. As such, some low-cost high-impact interventions that were strongly desired by the community were overlooked, while others were inappropriately packed. The means of distribution - female health extension workers trained with basic prevention skills, were lacking essential skills. They also had high burnout rates and with little engagement with men, were repeatedly mentioned flaws of the program demanding revitalization. Furthermore, the sheer structure of HEP precluded adult and adolescent men, non-reproductive women, and the elderly. Conclusion Despite significant gains over the last couple of months, Ethiopia’s rural HEP appears to have reached a tipping point that requires a comprehensive revamp of the program package, means of distribution, and target beneficiaries rather than the “usual” tweaks to reap maximum benefits.