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1.
Artigo em Inglês | MEDLINE | ID: mdl-38990977

RESUMO

BACKGROUND: Electronic nicotine delivery systems, often referred to as e-cigarettes, are popular tobacco products frequently advertised as safer alternatives to traditional cigarettes despite preliminary data suggesting a potential negative cardiovascular impact. Cardiorespiratory fitness is a critical cardiovascular health marker that is diminished in individuals who consume traditional tobacco products. Whether the use of e-cigarettes impacts cardiorespiratory fitness is currently unknown. Thus, the purpose of this study was to investigate the impact of regular e-cigarette use on cardiorespiratory fitness in young healthy adults. METHODS: Twenty-six users of e-cigarettes (ECU, 13 males, and 13 females; age: 24±3 yr; e-cigarette usage 4±2 yr.) and sixteen demographically matched non-users (NU, 6 males, and 10 females; age: 23±3 yr.) participated in this study. Cardiorespiratory fitness was measured by peak oxygen consumption (VO2peak) during a cardiopulmonary exercise test. Measurements of chronotropic response, hemodynamic, oxygen extraction and utilization were also evaluated. RESULTS: Our results suggest that regular users of e-cigarettes exhibited significantly lower peak oxygen consumption when compared to non-users, even when controlled by fat-free mass and lean body mass. Hemodynamic changes were not different between both groups during exercise, while lower chronotropic responses and skeletal muscle oxygen utilization were observed in users of e-cigarettes. CONCLUSIONS: Results from the present study demonstrate that young, apparently healthy, regular users of e-cigarettes exhibit significantly reduced cardiorespiratory fitness, lower chronotropic response, and impaired skeletal muscle oxygen utilization during exercise. Overall, our findings contribute to the growing body of evidence that supports adverse effects of regular e-cigarette use on cardiovascular health.

2.
BMC Musculoskelet Disord ; 25(1): 489, 2024 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-38909184

RESUMO

BACKGROUND: The disability and significant economic costs accredited to Low back pain (LBP) are likely to rise which is an essential problem in low and middle-income countries like Pakistan. The associated factors of LBP are age, sex, and race including physical activity, high spinal load, lifting, bending, and twisting occupations. The literature highlighted there is substantial differences in associated factors of LBP within available studies in developing countries. The objective is to investigate the association of demographic factors and lumbar range of motion with disability in patients with chronic low back. METHODS: A baseline data analysis was performed as an analytical cross-sectional study among 150 patients with chronic low back in a randomized controlled trial with a duration from March 2020 and January 2021. After recording demographics, Modified-Modified Schober's test was used to measure lumbar flexion and extension and Oswestry disability index for disability. After the descriptive analysis the continuous variables, age and pain were analyzed with Spearman's correlation. Variables that were significant in bivariate analysis were then fitted in a multivariable linear regression. The Kruskal-Wallis test was used to analyze variations of disability in gender, marital status, work status, education level, and duration of pain. The p-value of 0.05 was significant. RESULTS: The results showed a significant correlation between age and pain in sitting (rh=-0.189, p = 0.021 and rh = 0.788, p < 0.001) with the disability but no significant effects of age and pain in sitting (B=-0.124, p = 0.212 and B = 1.128, p = 0.082) on disability were found. The decrease in lumbar flexion and extension was found to increase disability (B=-6.018 and - 4.032 respectively with p < 0.001). Female gender (x2(1) = 15.477, p = < 0.001) and unmarried marital status (x2(1) = 4.539, p = 0.033) had more disability than male gender and married marital status, respectively. There was a significance between groups of the duration of pain regarding disability (x2 (2) = 70.905, p < 0.001). Age, education level, and work status showed no significance (p > 0.05). CONCLUSIONS: The female gender and unmarried marital status are associated with functional disability. Decreased lumbar range of motion accompanies more disability, while age, education level, and work status do not effect on disability.


Assuntos
Dor Crônica , Avaliação da Deficiência , Dor Lombar , Vértebras Lombares , Amplitude de Movimento Articular , Humanos , Masculino , Feminino , Dor Lombar/fisiopatologia , Dor Lombar/diagnóstico , Paquistão/epidemiologia , Adulto , Estudos Transversais , Amplitude de Movimento Articular/fisiologia , Pessoa de Meia-Idade , Vértebras Lombares/fisiopatologia , Dor Crônica/fisiopatologia , Dor Crônica/diagnóstico , Dor Crônica/epidemiologia , Fatores Etários , Medição da Dor , Fatores Sexuais , Região Lombossacral/fisiopatologia
4.
Biomol Biomed ; 24(2): 238-255, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-37712883

RESUMO

The range of clinical manifestations associated with the infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encompasses a broad spectrum, ranging from flu-like symptoms to the occurrence of multiple organ failure and death. The severity of the coronavirus disease 2019 (COVID-19) is categorized based on clinical presentation and is divided into three distinct levels of severity identified as non-severe, severe, and critical. Although individuals of all age groups are susceptible to SARS-CoV-2 infection, middle-aged and older adults are more frequently impacted, with the latter being more likely to develop severe illness. Various laboratory characteristics observed in hospitalized COVID-19 patients have been correlated with adverse outcomes. These include elevated levels of D-dimer, liver enzymes, lactate dehydrogenase, C-reactive protein, ferritin, prothrombin time, and troponin, as well as decreased lymphocyte and platelets counts. This review investigated the relationship between baseline clinical characteristics, initial laboratory parameters upon hospital admission, and the severity of illness and mortality rates among COVID-19 patients. Although the COVID-19 pandemic has concluded, understanding the laboratory predictors of virus severity and mortality remains crucial, and examining these predictors can have long-term effects. Such insights can help healthcare systems manage resources more effectively and deliver timely and appropriate care by identifying and targeting high-risk individuals. This knowledge can also help us better prepare for future pandemics. By examining these predictors, we can take steps to protect public health and mitigate the impact of future pandemics.


Assuntos
COVID-19 , Pessoa de Meia-Idade , Humanos , Idoso , Pandemias , SARS-CoV-2 , Proteína C-Reativa , Laboratórios
5.
J Eval Clin Pract ; 30(2): 153-161, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37641432

RESUMO

AIM: Empathic behaviour has a direct link to the positive clinical outcomes. Health professionals, which include dietitians, are increasingly expected to demonstrate the impact of their care on patient outcomes. To date, there is limited research exploring the empathic behaviour of dietetics students. METHODS: This cross-sectional study evaluated the psychometric properties of Jefferson Scale of Empathy-Healthcare Provider Student (JSE-HPS) and empathic behaviour of dietetics students. RESULTS: Undergraduate dietetics students from one private and two public universities in Malaysia participated (n = 455). Item and scale psychometric properties were examined using principal component analysis and differences in mean empathy scores for students were assessed across years of study and types of universities. A 3-factor solution emerged in the results, accounting for 26.76%, 10.75% and 6.3% of the variance. The JSE-HPS demonstrated good internal consistency (α = 0.83). Despite students enroled at public universities scoring higher mean empathy scores than students enroled at the private university, the difference was not significant. The only significant difference was between the empathy level of first and third year students (p = 0.033). CONCLUSION: As empathy underpins patient-centred management in the nutrition care process, it should be well integrated into curriculum delivery so that appropriate levels of empathy can be developed to prepare work-ready healthcare professionals.


Assuntos
Dietética , Estudantes de Medicina , Estudantes de Enfermagem , Humanos , Empatia , Estudos Transversais , Pessoal de Saúde
7.
Am J Pharm Educ ; 87(8): 100003, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37597909

RESUMO

OBJECTIVES: To our knowledge, this systematic review is the first to assess pharmacy-involved interprofessional education (IPE) simulation activities in establishing current methodological effectiveness using Kirkpatrick's Evaluation Model. This is a training evaluative model that assesses educational training activities according to 4 levels: reaction, learning, behavior, and results. FINDINGS: From the 3108 studies retrieved, 14 studies met the inclusion criteria. Thirteen studies achieved levels 1 and 2 of Kirkpatrick's Evaluation Model, and 1 achieved level 3. One study only achieved level 1. Single-group, pre- and posttest studies were the most common study designs (n = 9), and 1 study followed a longitudinal approach. IPE duration ranged from 45 min to 5 days, and most of the studies were conducted in the United States (n = 10). Most studies alluded to an underpinning theory behind IPE simulation design and chose surveys as their mode of data collection. SUMMARY: The most common limitation reported was the uneven representation of professions and a lack of data on the studies' effect in practice. To demonstrate the achievement of outcomes in relation to levels 3 and 4, there is a need for longitudinal studies of IPE simulation activities. Although evaluative studies showed a positive response to IPE simulation at a basic level, there is a lack of effective integration of theory behind IPE design. Future studies need to consider this when setting the infrastructure of IPE design, as well as making efforts to mobilize stakeholders in the workplace to help facilitate transfer of learning.


Assuntos
Educação em Farmácia , Estudantes de Farmácia , Humanos , Aprendizagem , Simulação por Computador , Coleta de Dados
8.
Nutrition ; 116: 112163, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37562184

RESUMO

OBJECTIVES: Cardiorespiratory fitness (CRF) is influenced by body composition quantity and quality in heart failure with preserved ejection fraction (HFpEF) and obesity. Bioelectrical impedance analysis (BIA) provides a noninvasive quantitative and qualitative body composition assessment. The aim of this study was to determine the role of phase angle (PhA), a BIA-measure of skeletal muscle quality and body cell mass, on CRF in patients with obesity and HFpEF. METHODS: Fifty-nine consecutive outpatients with HFpEF underwent cardiopulmonary exercise testing to measure CRF. Single-frequency segmental BIA was used to measure PhA and body composition quantity. Resting Doppler echocardiography and biomarkers were measured to assess cardiac function and systemic inflammation. RESULTS: Compared with patients with lower PhA, patients with higher PhA (above mean 5.8°) presented a greater absolute peak oxygen consumption (VO2; 1.83 [1.3-2.1] versus 1.39 [1.1-1.6] L/min, P = 0.003), VO2 peak adjusted for body weight (17.5 [12.3-18.1] versus 13.3 [12.7-15.2] mL/kg/min, P = 0.040), and a lower edema index (48.7 [2.9] versus 51.4% [2.7], P < 0.001) and N-terminal pro-B-type natriuretic peptide (NT-proBNP; 64 [50-121] versus 183 [68-343.5] pg/dL, P < 0.001). In the overall sample, PhA was correlated with absolute VO2 peak (r = 0.468, P < 0.001), VO2 peak adjusted for body weight (r = 0.368, P = 0.004), VO2 peak adjusted for fat-free mass (r = 0.315, P = 0.015), edema index (r = -0.508, P < 0.001), and NT-proBNP (r = -0.579, P < 0.001). PhA remained a significant predictor for CRF even after adjustment for potential confounders and HFpEF severity. CONCLUSION: In patients with obesity and HFpEF, a greater PhA is an independent predictor for favorable CRF.


Assuntos
Aptidão Cardiorrespiratória , Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/complicações , Volume Sistólico/fisiologia , Obesidade/complicações , Edema , Músculo Esquelético
9.
Environ Monit Assess ; 195(3): 381, 2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-36757435

RESUMO

Karachi is the largest industrial metropolitan of Pakistan facing an acute water shortage which is leading to an overdraft of groundwater resources in the city. Groundwater is an important freshwater resource for the city as millions of people depend for sustenance. However, over-exploitation of groundwater has led to decreased groundwater levels within the city leading to environmental issues of depleting aquifers, deteriorating groundwater quality, land subsidence, and harm to groundwater-dependent ecosystems. The objective of the study was to assess the potential groundwater accumulation zones by integrating hydrogeological aspects of the city through nine thematic layers using the Geographic Information System (GIS) based multi-criteria decision analysis (MCDA) technique. The potential groundwater accumulation map reveals that 20% of the area has a low potential, 70% has moderate potential, and around 10% of the area in the city is composed of a high potential accumulation zone. The upstream regions of the city have the highest recharge potential because of sandy soil and barren land use, which promote high infiltration rates. The urbanized downstream areas have the lowest recharge potential due to impervious fabric. The findings reveal that the MCDA technique can be used with confidence in data-scarce regions for groundwater resource assessment and management. The recharge potential map can help better manage groundwater resources in the city by helping explore groundwater extraction opportunities and could hint at areas suitable for artificial recharge wells/ponds.


Assuntos
Sistemas de Informação Geográfica , Água Subterrânea , Humanos , Ecossistema , Monitoramento Ambiental/métodos , Água Subterrânea/análise , Abastecimento de Água
10.
J Ayub Med Coll Abbottabad ; 34(3): 519-523, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36377168

RESUMO

BACKGROUND: Inhibition of nitric oxide synthesis and stimulation of smooth muscle proliferation by increased serum levels of uric acid play an important role in accelerated atherogenesis in the vessels of patients with hyperuricemia. The objective of the study was to determine the frequency of hyperuricemia in patients with acute coronary syndrome and their in-hospital outcomes. METHODS: This cross-sectional study was conducted in the cardiology department of Ayub Teaching Hospital, Abbottabad from 1st September, 2018 to 28th February, 2019. A total of 199 patients diagnosed with acute coronary syndrome (ACS) were enrolled in this study using non-probability consecutive sampling. Diagnosis of ACS was made on history, electrocardiogram (ECG) findings and on the presence of elevated cardiac biomarkers. Serum uric acid was checked within 24 hours of presentation and patients were grouped into hyperuricemic and normouricemic groups according to uric acid levels. Next in-hospital outcomes were compared between the two groups by comparing the presence or absence of complications. The data was collected on a structured proforma and was analyzed statistically by using SPSS version 16. RESULTS: Out of 199 patients, 146 (73.37%) were male and 53 (26.63%) were female. The mean age of the study participants was 57.99 ± 6.07 years with a range of 48-68 years. Hyperuricemia was diagnosed in 50 (25.13%) study participants. Among complications, 15 patients (7.94%) had cardiogenic shock, 27 (13.57%) had heart failure, 10 (5.03%) had cardiac arrhythmias, 16 (8.04%) had conduction defects and hyperuricemia was diagnosed in 50 (25.13%) patients. Cardiogenic shock was more common in patients with hyperuricemia (p < 0.05). CONCLUSIONS: Hyperuricemia is associated with a number of significant adverse outcomes for patients with an acute coronary event. Regular screening / monitoring of serum uric acid level in general population can prevent the direct and indirect morbidity associated with hyperuricemia.


Assuntos
Síndrome Coronariana Aguda , Hiperuricemia , Infarto do Miocárdio , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Hiperuricemia/complicações , Hiperuricemia/epidemiologia , Ácido Úrico , Síndrome Coronariana Aguda/diagnóstico , Estudos Transversais , Choque Cardiogênico/complicações , Angina Instável/complicações , Infarto do Miocárdio/complicações , Prognóstico
11.
BMC Musculoskelet Disord ; 23(1): 567, 2022 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-35698187

RESUMO

BACKGROUND: Non-specific neck pain is the most prevailing musculoskeletal disorder which has a large socioeconomic burden worldwide. It is associated with poor posture and neck strain which may lead to pain and restricted mobility. Physical therapists treat such patients through several means. Post isometric relaxation and Myofascial release therapy are used in clinical practice with little evidence to be firmed appropriately. So, this study was conducted to explore the effect of Post-isometric relaxation in comparison to Myofascial release therapy for patients having non-specific neck pain. METHODOLOGY: Sixty patients were randomly allocated to Post isometric group and the Myofascial group. The treatment period was of 2 weeks. All the patients were evaluated using the Visual analogue scale (VAS), Neck disability index (NDI), Universal Goniometer, and WHO BREF Quality of life-100 in the 1st and 6th sessions. Recorded data was entered on SPSS 21. Data were examined using two-way repeated ANOVA to measure the variance of analysis (group x time). RESULTS: Analysis of the baseline characteristics revealed that both groups were homogenous in terms of age and gender i.e. a total of 60 participants were included in this research study 30 in each group. Out of 60 patients, there were 20(33.3%) males and 40(66.7%) females with a mean age of 32.4(5.0) years. Participants in the Post Isometric group demonstrated significant improvements (p < 0.025) in VAS, NDI, Cervical Extension, left side rotation ranges, and QoL (Social Domain) at the 2-week follow-up compared with those in the Myofascial group. In addition, the Myofascial group indicated significantly better improvement in the mean score of CROM (flexion and right and left side bending). CONCLUSION: The study demonstrated patients with nonspecific neck pain can benefit from the post isometric relaxation with significant improvement in pain, disability, cervical ROM, and Quality of life compared with myofascial release therapy. TRIAL REGISTRATION: Clinical Trial registered on clinicaltrial.gov (NCT number) NCT04638062 , 20/11/2020 (prospectively registered).


Assuntos
Síndromes da Dor Miofascial , Qualidade de Vida , Adulto , Feminino , Humanos , Masculino , Síndromes da Dor Miofascial/terapia , Terapia de Liberação Miofascial , Cervicalgia/diagnóstico , Cervicalgia/terapia , Medição da Dor
12.
Antibiotics (Basel) ; 11(6)2022 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-35740201

RESUMO

Self-medication with antibiotics (SMA) has become considerably common in developing countries, which is a critical factor for driving antibiotic resistance. Individuals involved in SMA generally do not have adequate knowledge regarding the appropriate use, indications and dosage of these drugs. The objective of the present study was to investigate population SMA practices, knowledge and sociodemographic factors associated with SMA in Islamabad, Pakistan. The study adopted a cross-sectional methodology and data collection was performed through an anonymous, structured and pilot-tested questionnaire, which was interview-administered. Inferential statistics and multivariate logistic regression were performed. Out of 480 participants, 55.6% (n = 267) were male with a mean age of 37.1 ± 10.1 years; the total prevalence of SMA was 32.5%. Ciprofloxacin (42.9%) was the most commonly used antibiotic to treat coughs or colds, a runny nose, flu or sore throat, diarrhea or fevers, which were relevant reasons for SMA. Findings from multivariate logistic regression showed that predictors of SMA were: male gender (95% CI: 0.383-1.005), age (95% CI: 0.317-0.953) and highest level of education (95% CI: 0.961-0.649). Despite reasonable access to healthcare facilities, people are still obtaining antibiotics without prescription, bypassing diagnostic and consultative healthcare services. Thus, the government must implement strict healthcare policies to restrict the sale of antibiotics without prescriptions, while at the same time, targeted public awareness campaigns about the proper use of antibiotics are also required.

13.
Essays Biochem ; 66(1): 83-88, 2022 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-35441223

RESUMO

Sound knowledge of the learning process and connectedness of assessment in higher education is imperative. Assessment is essential for both learners and teachers to ensure, and to provide evidence, that learning outcomes/objectives against set competency levels have been achieved for the chosen programme of the study. However, many coming into higher education are often unaware of the rules of the game. In this perspective, we will highlight the reasons why assessment is important, how assessment and feedback affect students' learning process and why the process of assessment can often affect students' mental well-being. We will appraise the different methods of assessment with a specific example (Objective Structured Clinical Examination, OSCE) and highlight why it is important that we adopt a holistic approach towards fostering assessment know-how and student well-being.


Assuntos
Aprendizagem , Estudantes , Retroalimentação , Humanos
14.
Drug Healthc Patient Saf ; 13: 171-181, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34737648

RESUMO

BACKGROUND: Self-medication with antibiotics (SMA) is an important public health issue, which can result in the facilitated development of antibiotic resistance, and may increase the risk of inappropriate utilization of antibiotics. So, the objective of the present study was to estimate the prevalence rate of SMA and to also explore SMA practices among the lay population of Kuala Lumpur (Malaysia). METHODS: The current study was cross-sectional population-based and used a convenient sampling technique. Moreover, Lorenz's formula was used to calculate the sample size and the required sample size was 480. Data were collected through face-to-face interviews with a pre-validated questionnaire and the study was conducted in Kuala Lumpur (Malaysia). Descriptive statistics, cross-tabulation, and logistic regression were executed by using SPSS version 24. RESULTS: Out of 480 participants, 45.8% were polled male and the prevalence of SMA in this study was found to be 15.1%. The majority of participants 23.1% indicated that they practiced antibiotics at least once in the last six months. The commonly self-medicated antibiotics were amoxicillin-clavulanate 20.6%, ampicillin/cloxacillin 14.2%, and levofloxacin 8.3%. Moreover, 64.8% of participants indicated that they bought their antibiotics from pharmacies. Whereas, most of the participants practice antibiotics to save money 19.2% and time 23.1%. Findings from multivariate logistic regressions showed that predictors of SMA were male gender, (95% CI: 0.300-0.877) occupation (95% CI: 0.122-10.797), health insurance (95% CI: 0.025-0.472), and education (95% CI: 0.084-0.800). CONCLUSION: The results of this study indicate that SMA persists among the community and education level has a significant impact on this behavior. Thus, concerning health management authorities should step in with developing legislation to stop this practice, and by implementing such interventions and policies to educate and to raise awareness about the risk of SMA for the future.

15.
Curr Probl Cardiol ; 46(10): 100842, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33994028

RESUMO

PURPOSE OF REVIEW: Although the respiratory system is the main target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is evident from recent data that other systems, especially cardiovascular and hematological, are also significantly affected. In fact, in severe form, COVID-19 causes a systemic illness with widespread inflammation and cytokine flood, resulting in severe cardiovascular injury. Therefore, we reviewed cardiac injury biomarkers' role in various cardiovascular complications of COVID 19 in recent studies. RECENT FINDINGS: Cardiac injury biomarkers were elevated in most of the complicated cases of COVID-19, and their elevation is directly proportional to the worst outcome. Evaluation of cardiac biomarkers with markers of other organ damage gives a more reliable tool for case fatalities and future outcome. SUMMARY: Significant association of cardiac biomarkers in COVID-19 cases helps disease management and prognosis, especially in severely ill patients.


Assuntos
COVID-19 , Doenças Cardiovasculares , Biomarcadores , Humanos , Prognóstico , SARS-CoV-2
16.
Int J Clin Pract ; 75(3): e13714, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32949074

RESUMO

BACKGROUND: Older individuals are seemingly having more medical conditions, which predispose them to a greater risk of polypharmacy. Potentially inappropriate medications (PIMs), including those having anticholinergic and sedative properties, are common in their prescriptions, often associated with functional decline and negative health outcomes. Thus, this study reports proportions of inappropriate drugs and drug burden exposures and its correlation with patient-reported outcomes (PROs) among cognitively intact older adults admitted to a ward or visiting the outpatient clinic at a tertiary care hospital in Malaysia. METHODS: This cross-sectional study included data from 344 older (173 inpatients and 171 outpatients) patients, aged 60 years and above, through validated questionnaires. Medication appropriateness was assessed via Medication Appropriateness Index (MAI) tool, whereas Beers and Screening Tool of Older Person's Potentially Inappropriate Prescribing (STOPP) criteria were used to evaluate PIMs and potentially inappropriate prescribing (PIP), respectively. The Drug Burden Index (DBI) and polypharmacy, as well as PROs, included Groningen Frailty Indicator (GFI), Katz Index of Independence in Activities of Daily Living (Katz ADL) and Older People's Quality of Life (OPQOL) were also evaluated. RESULTS: Overall, inpatients received significantly higher medications (6.90 ± 2.70 vs 4.49 ± 3.20) than outpatients. A significantly higher proportion of inpatients received at least one PIM (65% vs 57%) or PIP (57.4% vs 17.0%) and higher mean MAI score (1.76 ± 1.08 and 1.10 ± 0.34) and DBI score (2.67 ± 1.28 vs 1.49 ± 1.17) than outpatients. Inpatients had significantly higher total OPQOL (118.53 vs 79.95) and GFI score (5.44 vs 3.78) than outpatients. We only found significant correlations between GFI and DBI and total OPQOL and the number of PIMs. CONCLUSIONS: Proportions of PIMs and DBI exposure were significantly higher in an inpatient setting. No significant correlations between exposures to inappropriate medications or drug burden and PROs were observed.


Assuntos
Pacientes Internados , Lista de Medicamentos Potencialmente Inapropriados , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Humanos , Prescrição Inadequada , Malásia , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Qualidade de Vida , Centros de Atenção Terciária
17.
Antibiotics (Basel) ; 9(9)2020 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-32932630

RESUMO

The current scoping review is an attempt to explore the key reasons, determinants, patterns and prevalence related to self-medication with antibiotics (SMA) among the lay public. An online search was conducted using Google Scholar, Science Direct, ProQuest and PubMed. A two-phase mapping approach was used. In the first phase, studies were screened. In the second phase, the data were extracted from selected studies followed by the assessment of data quality. A total of 24 studies were included; 20 were cross-sectional, 3 were qualitative and one was observational. The most common indications were flu, cough, common colds, sore throat, diarrhea, toothache and fever. The most common determinants reported were past good experience and suggestions from friends or relatives. The use of SMA was observed to be more frequent in younger aged individuals belonging to low- or middle-income groups. The prevalence rate was reported to be high among the South Asian lay public and may be a major contributor to antibiotic resistance. In conclusion, this scoping review identifies a need for education campaigns and mass media campaigns to strengthen lay public awareness about the side effects and risks associated with SMA. In addition to this, there is a need to implement strict policies by government agencies to restrict over the counter availability of antibiotics.

19.
Curr Probl Cardiol ; 45(9): 100648, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32703535

RESUMO

The exceptional outbreak of COVID-19 pandemic has let the scientific community to work closely and quickly learnt things in a very short period of time. This has let us recognize that thromboembolic complications are responsible for morbidity and mortality among the COVID-19 infected patients. Available data have suggested a possible multifactorial basis of these complications, and while efforts are being made to treat this infection, preventive measures with the use of systemic anticoagulation were quickly adopted to deal with this issue. Despite obvious benefits as appeared with the use of systemic anticoagulation, most of the emerged data were retrospective, hence raise questions on the possible interplay of the confounders as well as long-term benefits and safety of systemic anticoagulation.


Assuntos
Anticoagulantes/uso terapêutico , Transtornos da Coagulação Sanguínea/sangue , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Tromboembolia/sangue , Betacoronavirus , Transtornos da Coagulação Sanguínea/tratamento farmacológico , Transtornos da Coagulação Sanguínea/etiologia , COVID-19 , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/tratamento farmacológico , Coagulação Intravascular Disseminada/etiologia , Células Endoteliais , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Heparina/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , SARS-CoV-2 , Tromboembolia/tratamento farmacológico , Tromboembolia/etiologia , Receptores Toll-Like/metabolismo , Fator de von Willebrand/metabolismo , Tratamento Farmacológico da COVID-19
20.
JMIR Res Protoc ; 9(6): e16676, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32459639

RESUMO

BACKGROUND: Hypertensive disorders, including preeclampsia, complicate 10% of all pregnancies, causing maternal and fetal morbidity and mortality. In Bangladesh, 24% of all maternal deaths are directly attributed to hypertensive disorders. Conventional antenatal care practices often delay or miss detecting hypertensive disorders in pregnancy, which may allow some women to become vulnerable to the adverse consequences of the hypertensive disorders. Regular self-monitoring of blood pressure and weight gain may improve maternal and fetal outcomes among pregnant women at risk of developing hypertensive disorders during pregnancy through early diagnosis, prompt referral, and timely clinical management; however, to undertake a randomized controlled trial of an intervention to reduce adverse consequences of hypertensive disorders in pregnancy, its feasibility must first be determined. OBJECTIVE: The objectives of this study are to evaluate the accuracy of a wearable blood pressure monitoring device (Health Gauge) in order to test the design and methods of a future definitive randomized controlled trial, and to examine the feasibility, acceptability, and fidelity of an intervention focusing on regular monitoring of weight gain and self-monitoring of blood pressure for pregnant women at risk of developing hypertensive disorders and their associated complications. METHODS: The study is located in Matlab, Bangladesh will be conducted in two phases. First, a wearable blood pressure device (Health Gauge) will be validated in accordance with the European Society of Hypertension International Protocol (revision 2010). Second, a prospective, two-arm, parallel, and nonblinded randomized controlled external pilot trial will be conducted. In the pilot trial, 70 eligible participants will be individually randomized to the intervention arm, in which pregnant women will self-monitor their blood pressure daily using a wearable device (Health Gauge) and be evaluated monthly by trained health workers for weight gain from 20 weeks of gestation until delivery, or the control arm, in which pregnant women will be assessed for weight gain every two months from 20 weeks of gestation until delivery (1:1 intervention to control allocation ratio using a permuted block randomization method with concealment). All women will receive standard antenatal care. RESULTS: A validation study of the wearable blood pressure device has successfully been conducted among the general adult population in Matlab, Bangladesh. As of September 2019, the pilot trial has completed enrollment of women who are pregnant (N=70; intervention: n=35; control: n=35) and follow-up of the participants is ongoing. Data analysis is expected to be completed by June 2020, and results are expected to be submitted for publication in August 2020. CONCLUSIONS: The findings of this study will help us to design a comprehensive, full-scale randomized controlled trial to test the efficacy of regular self-monitoring of blood pressure and weight gain during pregnancy, a simple and inexpensive intervention to help to achieve optimal maternal and fetal outcomes in pregnant women at risk of developing hypertensive disorders and their associated complications during pregnancy. TRIAL REGISTRATION: ClinicalTrials.gov NCT03858595; https://clinicaltrials.gov/ct2/show/NCT03858595. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/16676.

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