Unlocking the Power of Influenza Vaccines for Pediatric Population: A Narrative Review.

The flu, often known as influenza, is a dangerous public health hazard for the pediatric population. Immunization is essential for decreasing the burden of the disease and avoiding complications related to influenza. However, the immunogenicity, efficacy, and safety of different influenza vaccines in children warrant careful evaluation. The purpose of this narrative review is to give a summary of the existing literature on the immunogenicity, efficacy, and safety of several vaccinations against influenza viruses in children. The review incorporates evidence from a range of studies focusing on the outcomes of interest. Immunogenicity studies have shown that influenza vaccines induce a robust immune response in children, primarily through neutralizing antibodies' formation. However, variations in vaccine composition influence the duration and magnitude of immune responses. Safety is a crucial consideration in pediatric vaccination. In children, influenza vaccinations have generally shown a high safety profile, with mild and temporary side effects being the most common. Vaccinations against influenza have shown a modest level of efficacy in avoiding hospitalizations linked to influenza, laboratory-confirmed influenza infections, and serious consequences in children. Live attenuated vaccines have shown higher effectiveness against matched strains compared to inactivated vaccines. In conclusion, this narrative review highlights that receiving influenza vaccination in children aged six to 47 months is very important. While different vaccines exhibit varying immunogenicity, safety profiles, and effectiveness, they all contribute to reducing the burden of influenza among children. Future research should focus on optimizing vaccine strategies, improving vaccine coverage, and evaluating long-term protection.

Comparison of the Efficacy of Vaginal Hyaluronic Acid to Estrogen for the Treatment of Vaginal Atrophy in Postmenopausal Women: A Systematic Review.

Topical estrogen is effective for treating postmenopausal vaginal atrophy. However, there is a potential risk of estrogen-related adverse effects. There is a need for finding effective non-hormonal treatment for vaginal atrophy. The topical application of moisturising agents, such as hyaluronic acid (HA), represents a promising non-hormonal treatment for the relief of vaginal atrophy. This study aimed to summarize the evidence regarding the efficacy of topical HA compared to topical estrogen in postmenopausal women with vaginal atrophy. The literature search covered English-published studies from database inception till February 2023. The search included the electronic databases of MEDLINE/PubMed, Cochrane Library, Web of Science, ProQuest, and Scopus, using the terms "Hyaluronic Acid" AND "Postmenopause" AND "Vagina" AND "Atrophy". Due to the diversity in reporting outcomes, meta-analysis was not feasible. A narrative synthesis with a systematic approach was conducted by vote counting of studies that included a direct comparison between topical HA and topical estrogen. Six studies were included. Intra-group comparisons showed that both interventions were significantly effective in alleviating the symptoms of vaginal atrophy and dyspareunia as well as improving vaginal pH and cell maturation index. However, inter-group comparisons in most studies showed that estrogen was superior to HA in relieving vaginal symptoms and improving vaginal pH, dyspareunia, and the cell maturation index. There is no evidence to show the superiority of HA to estrogen in the treatment of postmenopausal vaginal atrophy. However, the therapeutic efficacy of HA seems to be comparable to estrogen and considering its safety, HA can be used as an alternative to estrogen in patients who do not want to use estrogen. The available studies have several limitations, and the reporting of outcomes was considerably heterogeneous.

The usage of different types of food outlets was not significantly associated with body mass index during the third COVID-19 national lockdown in the United Kingdom.

Background: The United Kingdom (UK) implemented several national lockdowns during the coronavirus pandemic during which restaurants were closed and people were advised to stay at home if possible. These restrictions were eased and reapplied multiple times between March 2020 and May 2021. The change in restaurant access and prolonged restriction of activity may have an impact on body weight. Aim: The aim of this study was to examine the impact of multiple lockdowns on body mass index (BMI) change from pre-pandemic till during the third lockdown and on the use of different types of food outlets and their association with BMI change. Materials and Method: Surveys of usage of different types of food outlets were distributed online before the lockdown between 06 January and 12 December 2019 and during the third national lockdown between 29 March and 25 April 2021. The food outlet usage surveys were filled out for seven consecutive days. Self-reported BMI was reported before the pandemic and during the third phase of the lockdown. The total number of individuals who started the study before the pandemic was 681, and 60 participants completed the surveys during the third phase of lockdown. Results: For the 60 participants in both surveys mean BMI was significantly higher during the third lockdown (28.6 ± 5.9 kg.m2) in comparison with the mean BMI before the pandemic 2019 (28.0 ± 5.5 kg.m2) (paired T = 3.09, p < 0.003). There was a significant positive association between BMI change, total number of days spent in lockdown (ß = 0.05, p < 0.01, R 2 = 9.99), and age (ß = 0.06, p < 0.007, R 2 = 11.8). There was no significant association between change in BMI and change in the frequency of using fast food restaurants (FFRs), full-service restaurants (FSRs), and delivery and takeaways. Conclusion: BMI was increased significantly during the lockdown in comparison with prior to the pandemic. Individuals gained more weight the longer they stayed at home during lockdowns, and physical activity was reduced to approximately half. However, the BMI change was not related to the change in use of different types of food outlets. This pattern does not support the widespread belief that visiting restaurants or using delivery and takeaway services has a significant impact on body weight.

Consumption of takeaway and delivery meals is associated with increased BMI and percent fat among UK Biobank participants.

BACKGROUND: Consumption of meals bought from out-of-home sources is a suggested risk factor for obesity, but the supporting evidence is mixed. OBJECTIVES: To investigate the association between consumption of different types of meals and BMI or percent body fat. METHODS: Data were from the UK Biobank in response to a "Type of Meals Eaten" survey, which specified the sources of the meals consumed over the previous 24 h. Because direction of causality is unknown, the data were analyzed with meal choice as the dependent variable first and then BMI as the dependent variable second. RESULTS: The total number of participants was 5197 (2841 women and 2356 men). Participants with higher BMI and percent body fat were more likely to report consuming takeaway and/or delivery meals, with prevalence ORs (95% CIs) of 2.12 (95% CI: 1.40, 3.22; Bonferroni P < 0.0001) for women's adjusted BMI, 1.95 (95% CI: 1.30, 2.93; Bonferroni P < 0.0001) for women's adjusted percent body fat, 1.65 (95% CI: 1.05, 2.59; Bonferroni P < 0.002) for men's adjusted BMI, and 1.41 (95% CI: 0.70, 2.84; Bonferroni P < 0.01) for men's adjusted percent body fat. As BMI and percent body fat increased, both men and women were increasingly less likely to report having consumed a home-cooked and prepared meal during the previous 24 h. Analyzing the data with BMI and percent body fat as the dependent variable showed that both unadjusted and adjusted BMI and percent body fat were higher in individuals reporting consumption of takeaway and delivery foods the previous day and lower in those consuming homecooked meals. The probability of having consumed a meal that was prepared and eaten at a restaurant and/or café was also associated with BMI and percent fat among men but not women. CONCLUSIONS: Homecooked meals were more often consumed by those with low BMI and percent body fat, whereas delivery and takeaway meals were more often eaten by individuals with higher BMI. Consumption of fast-food/café meals was not consistently associated with BMI or percent body fat. The direction of causality in these associations cannot be inferred from this cross-sectional study.

The impact of the novel coronavirus movement restrictions in the United Kingdom on food outlet usage and body mass index.

BACKGROUND: Many countries have implemented various levels of lockdown to mitigate the spread of the global SARS-CoV-2 pandemic. In the United Kingdom, the national lockdown restrictions were implemented between 26 March 2020 and 4 July 2020. These restrictions required all restaurants to close except for takeaway and delivery services. Moreover, individuals were instructed to largely stay in their homes, unless they were identified as essential workers, and to only leave home once per day for exercise. These restrictions might have an impact on energy intake and expenditure, thereby affecting their body weight. AIMS: The aim of this study was to investigate the impact of the movement restrictions in the United Kingdom on food outlet usage and body mass index (BMI). MATERIALS AND METHODS: Food outlet usage surveys were filled out for 7 consecutive days before and during the lockdown. Changes in BMI and food outlet usage before and during the lockdown were measured. A total of 206 participants were included in this study. RESULTS: The mean overall BMI prior to lockdown was 25.8 ± 5.2 kg·m2, and during the lockdown, it was 25.9 ± 5.3 kg·m2 (t= 0.19, p= 0.85). Restaurant usage fell to zero as all establishments were closed. There was a corresponding increase in the use of delivery services to 1.18 ± 0.13 times per week, compared to 0.50 ± 0.05 prior to lockdown (t= 4.44, p< 0.0001). No significant difference in the number of takeaway meals ordered was observed (0.67 ± 0.06 before the lockdown and 0.74 ± 0.12 times per week during the lockdown; t= 0.52, p = 0.60). There was no significant relationship between change in use of fast-food restaurants and full-service restaurants and the change in BMI, either alone or in combination (ß = -0.012, p = 0.62, R 2 = 0.11%). DISCUSSION: Despite the large changes in behavior, there was no overall adverse effect of the lockdown with respect to obesity levels. CONCLUSION: Lockdown in the United Kingdom modified restaurant use but had no effect on obesity levels.

Frequency of Restaurant, Delivery and Takeaway Usage Is Not Related to BMI among Adults in Scotland.

BACKGROUND: The frequency of visits to restaurants has been suggested to contribute to the pandemic of obesity. However, few studies have examined how individual use of these restaurants is related to Body Mass Index (BMI). AIM: To investigate the association between the usage of different types of food outlets and BMI among adults in Scotland. METHOD: The study was cross-sectional. Participants completed an online survey for seven consecutive days where all food purchased at food outlets was reported each day. We explored the relationship between BMI and usage of these food outlets. RESULTS: The total number of participants that completed the survey was 681. The BMI of both males and females was not related to frequency of use of Full-Service Restaurants (FSRs), Fast-Food Restaurants (FFRs), delivery or takeaways, when assessed individually or combined (TFOs = total food outlets). CONCLUSION: These cross-sectional data do not support the widespread belief that consumption of food out of the home at fast-food and full-service restaurants, combined with that derived from deliveries and takeaways, is a major driver of obesity in Scotland.

Associations of Food Outlet Densities with Obesity Measures Identify Fish and Chip Shops as a Uniquely Important Problem.

Increases in the number of food outlets have been proposed as a key factor driving obesity. This study aimed to investigate the association between the densities of food establishments serving meals (excluding supermarkets and grocery stores), with body mass index (BMI), waist to hip ratio (WHR) and percentage of body fat among middle-aged adults in the UK. BMIs, WHR, %fat and socioeconomic factors were obtained from 456,079 individuals from the UK Biobank and averaged across 923 postcode districts (PD). The number of Fast-Food Restaurants (FFRs), Full-Service Restaurants (FSRs), delivery shops, takeaways, fish and chip shops, pubs and cafes were also obtained for each PD. We adjusted the obesity measures for deprivation level, education, employment, ethnicity, household size, household income and age. After adjustment, the density of fish and chip shops (per 1000 population) was positively associated with BMI and %fat for both sexes (males: BMI converted (exponentiated coefficient) ß = 0.5, R2 = 4.14%, p < 0.0001; %fat converted ß = 0.8, R2 = 3.32%, p < 0.0001; females: BMI converted ß = 0.9, R2 = 5.31%, p < 0.0001; %fat converted ß= 1.4 R2 = 4.65%, p < 0.0001). The densities of FFRs and delivery shops (per 1000 population) were not related to the adjusted obesity measures among males and females, except BMI in males where FFRs were significantly negatively associated. The densities (per 1000 population) of FSRs, pubs, cafes and total food outlets were all significantly inversely related to the obesity measures for both sexes. The number of fish and chip shops per 1000 individuals was significantly positively associated with obesity in middle-aged adults in the UK. A negative association between the other types of food outlet densities and the measures of obesity suggests access to such establishments is not a major driver of obesity. This is potentially because the food supplied at such establishments is not significantly less healthy than what is eaten elsewhere including at home (and may even be better). Paying attention only to fast food and/or full-service restaurants in intervention policy will likely not be effective. Policy intervention should potentially focus on the numbers of fish and chip shops and the deep-fried food served in such restaurants.

Physicians' Perspective on Diabetes Mellitus Management within the Context of Personalized Medicine Era in Tabuk Governorate, Saudi Arabia.

BACKGROUND: Minimizing the number of therapy failures and decreasing the diabetic complications can be achieved by the application of personalising diabetes therapy, based on patient`s genetics, however, currently, personalised Medicine (PM) in diabetes mellitus management is not extensively applied. AIM: To assess the knowledge, attitudes, and willingness of physicians in practising of PM in diabetes management. METHODS: A cross-sectional analytical study was implemented among 126 physicians from six different governmental hospitals and 12 primary care centres selected by the stratified random sampling technique in the Tabuk region of Saudi Arabia. A structured self-administered questionnaire was utilised for data collection. A simple scoring system (scale of 5 points) was utilised to assess knowledge and willingness. Likert scale was applied to evaluate the attitudes towards practising PM in DM management by the fixed choice response formats. RESULTS: The majority of the participants (97.62%) claimed not receiving any PM and/or genomic medicine training. Most of them (82.54%) expressed unsatisfactory knowledge concerning personalised DM, whereas the medium level of attitudes was reported among 57.14% of them and a good level of willingness had been observed among 76.98% of the physicians. CONCLUSION: Emphasizing on essential personalised DM management knowledge aspects should be given a considerable priority. Fortunately, positive attitudes and goodwill of physicians towards PM are encouraging and should be supported by policymakers.