The Effects of Online Access to General Practice Medical Records Perceived by Patients: Longitudinal Survey Study.

BACKGROUND: Patient online access to medical records is assumed to facilitate patient empowerment and advance patient-centered health care. However, to date, the actual effects of online access to medical records perceived by patients and other outcomes are insufficiently empirically tested. OBJECTIVE: This study aimed to investigate the effects of online access to medical records on patient empowerment, informed decision-making, and the patient-provider relationship perceived by patients. METHODS: A nationwide, 2-wave, longitudinal survey study was conducted among Dutch adults (N=2402). Linear regression analyses were performed. In model 1, the perceived effects of online access to medical records (measured at T1 [first measurement; July 2021]) on 16 outcomes (measured at T2 [second measurement; January 2022]), which were associated with the use of online access to general practice medical records in previous research, were investigated. Model 2 included sociodemographic factors and patient characteristics as confounders. RESULTS: Users indicated more strongly than nonusers that online access to medical records would increase their participation in health care, improve the relationship with their general practitioner, and support informed decision-making. These results were robust when adjusted for the influence of confounders. Effect sizes were very small, with unstandardized regression coefficients (B) ranging between -0.39 and 0.28. Higher digital and health literacy were associated with higher ratings of almost all effects. CONCLUSIONS: Online access to medical records has the potential to empower patients and foster informed decision-making among patients. The effects in this study were small but might grow over time. Other factors, such as the attitude of general practitioners toward online access to medical records, might moderate these effects. The results indicate that the potential benefits of online access to medical records might be unevenly distributed. We suggest future exploration of the conditions under which online access to medical records can improve health care system functioning and efficiency without increasing health inequality.

Bis-enoxacin inhibits bone resorption and orthodontic tooth movement.

UNLABELLED: Enoxacin inhibits binding between the B-subunit of vacuolar H(+)-ATPase (V-ATPase) and microfilaments, and also between osteoclast formation and bone resorption in vitro. We hypothesized that a bisphosphonate derivative of enoxacin, bis-enoxacin (BE), which was previously studied as a bone-directed antibiotic, might have similar activities. BE shared a number of characteristics with enoxacin: It blocked binding between the recombinant B-subunit and microfilaments and inhibited osteoclastogenesis in cell culture with IC50s of about 10 µM in each case. BE did not alter the relative expression levels of various osteoclast-specific proteins. Even though tartrate-resistant acid phosphatase 5b was expressed, proteolytic activation of the latent pro-enzyme was inhibited. However, unlike enoxacin, BE stimulated caspase-3 activity. BE bound to bone slices and inhibited bone resorption by osteoclasts on BE-coated bone slices in cell culture. BE reduced the amount of orthodontic tooth movement achieved in rats after 28 days. Analysis of these data suggests that BE is a novel anti-resorptive molecule that is active both in vitro and in vivo and may have clinical uses. ABBREVIATIONS: BE, bis-enoxacin; V-ATPase, vacuolar H(+)-ATPase; TRAP, tartrate-resistant acid phosphatase; αMEM D10, minimal essential media, alpha modification with 10% fetal bovine serum; SDS-PAGE, sodium dodecyl sulfate-polyacrylamide gel electrophoresis; RANKL, receptor activator of nuclear factor kappa B-ligand; NFATc1, nuclear factor of activated T-cells; ADAM, a disintegrin and metalloprotease domain; OTM, orthodontic tooth movement.

Investigação do uso de plantas medicinais no tratamento de indivíduos com diabetes melito na cidade de Herval D' Oeste - SC / Research on medicinal plants in treating individuals with diabetes mellitus in the city of Herval D' Oeste, Santa Catarina State, Brazil

O diabetes melito é uma doença crônica caracterizada pela elevação da glicose no sangue (hiperglicemia), sendo considerada um distúrbio do metabolismo dos carboidratos, lipídios e proteínas, devido à ausência de insulina produzida pelo pâncreas e/ou pela diminuição de sua ação. Tal patologia é a sexta causa de internação como diagnóstico primário e contribui em até 50% para outras causas como cardiopatias, acidente vascular cerebral e hipertensão arterial, entre outras. Uma alternativa de tratamento que nos últimos anos vem recebendo aumento de pesquisas e interesse de uso é a fitoterapia, a qual pode ser igualada e somada à terapia convencional. Com isso, o presente estudo teve por objetivo investigar o uso de plantas medicinais no tratamento de indivíduos com diabetes melito na cidade de Herval D'Oeste-SC e também apresentar a importância da ingestão segura de plantas medicinais. Os resultados obtidos mostram que esse consumo de plantas medicinais ocorre de maneira errônea, onde apenas 19% das plantas citadas tiveram comprovação científica na terapêutica do diabetes. Além disso, grande parte dos usuários de plantas medicinais (89,4%) escolhe as espécies vegetais através da cultura familiar. Portanto, há necessidade de mais pesquisas voltadas a essa terapia, assim como, maiores informações para a população e profissionais da saúde em relação à correta utilização das plantas, bem como a forma de preparo e quantidade a ser ingerida.

Diabetes mellitus is a chronic disease characterized by elevated blood glucose (hyperglycemia) and is considered a disturbance in the metabolism of carbohydrates, lipids and proteins, due to lack of insulin produced by the pancreas and / or reduction in its action. This condition is the sixth leading cause of hospitalization as primary diagnosis and contributes up to 50% to other causes such as heart diseases, stroke and hypertension, among others. An alternative treatment, which in recent years had an increase in interest and research, is the herbal medicine, which can be equalled and added to conventional therapy. Therefore, this study aimed to investigate the use of medicinal plants in treating individuals with diabetes mellitus in the city of Herval D' Oeste, Santa Catarina State, Brazil and also present the importance of safe intake of medicinal plants. The obtained results showed that consumption of medicinal plants occurs erroneously, where only 19% of the cited plants had scientific evidence for diabetes therapy. In addition, most users of medicinal plants (89.4%) choose the plant species by family culture. Thus, further research focused on this therapy is needed, as well as further information to the public and health professionals regarding the correct use of plants, preparation and quantity to be ingested.