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[PMID]:29444073
[Au] Autor:Hall MT; Simms KT; Lew JB; Smith MA; Saville M; Canfell K
[Ad] Endereço:Cancer Research Division, Cancer Council NSW, Sydney, Australia.
[Ti] Título:Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: Example from Australia.
[So] Source:PLoS One;13(2):e0185332, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many countries are transitioning from cytology-based to longer-interval HPV screening. Trials comparing HPV-based screening to cytology report an increase in CIN2/3 detection at the first screen, and longer-term reductions in CIN3+; however, population level year-to-year transitional impacts are poorly understood. We undertook a comprehensive evaluation of switching to longer-interval primary HPV screening in the context of HPV vaccination. We used Australia as an example setting, since Australia will make this transition in December 2017. METHODS: Using a model of HPV vaccination, transmission, natural history and cervical screening, Policy1-Cervix, we simulated the planned transition from recommending cytology every two years for sexually-active women aged 18-20 to 69, to recommending HPV screening every five years for women aged 25-74 years. We estimated rates of CIN2/3, cervical cancer incidence, and mortality for each year from 2005 to 2035, considering ranges for HPV test accuracy and screening compliance in the context of HPV vaccination (current coverage ~82% in females; ~76% in males). FINDINGS: Transient increases are predicted to occur in rates of CIN2/3 detection and invasive cervical cancer in the first two to three years following the screening transition (of 16-24% and 11-14% in respectively, compared to 2017 rates). However, by 2035, CIN2/3 and invasive cervical cancer rates are predicted to fall by 40-44% and 42-51%, respectively, compared to 2017 rates. Cervical cancer mortality rates are predicted to remain unchanged until ~2020, then decline by 34-45% by 2035. Over the period 2018-2035, switching to primary HPV screening in Australia is expected to avert 2,006 cases of invasive cervical cancer and save 587 lives. CONCLUSIONS: Transient increases in detected CIN2/3 and invasive cancer, which may be detectable at the population level, are predicted following a change to primary HPV screening. This is due to improved test sensitivity bringing forward diagnoses, resulting in longer term reductions in both cervical cancer incidence and mortality. Fluctuations in health outcomes due to the transition to a longer screening interval are predicted to occur for 10-15 years, but cervical cancer rates will be significantly reduced thereafter due to the impact of HPV vaccination and HPV screening. In order to maintain confidence in primary HPV screening through the transitional phase, it is important to widely communicate that an initial increase in CIN2/3 and perhaps even invasive cervical cancer is expected after a national transition to primary HPV screening, that this phenomenon is due to increased prevalent disease detection, and that this effect represents a marker of screening success.
[Mh] Termos MeSH primário: Infecções por Papillomavirus/diagnóstico
Vacinas contra Papillomavirus/administração & dosagem
Neoplasias do Colo do Útero/epidemiologia
[Mh] Termos MeSH secundário: Austrália/epidemiologia
Feminino
Seres Humanos
Modelos Biológicos
Infecções por Papillomavirus/prevenção & controle
Cooperação do Paciente
Neoplasias do Colo do Útero/virologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Papillomavirus Vaccines)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185332


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[PMID]:29415037
[Au] Autor:Abbott P; Banerjee T; Aruquipa Yujra AC; Xie B; Piette J
[Ad] Endereço:University of Michigan School of Nursing; Ann Arbor, Michigan, United States of America.
[Ti] Título:Exploring chronic disease in Bolivia: A cross-sectional study in La Paz.
[So] Source:PLoS One;13(2):e0189218, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: This study seeks to develop an understanding that can guide development of programs to improve health and care for individuals with Non-Communicable Diseases (NCDs) in La Paz, Bolivia, where NCDs are prevalent and primary care systems are weak. This exploratory investigation examines the characteristics of chronic disease patients in the region, key health related behaviors, and their perceptions of the care that they receive. The longer-term goal is to lay groundwork for interventional studies based on the principles of the Chronic Care Model (CCM). SUBJECTS AND METHODS: The study is based on two surveys of adults (> 18 years old) administered in 2014 in La Paz, Bolivia. A total of 1165 adult patients participated in the first screening survey. A post-screening second survey, administered only on those who qualified based on Survey 1, collected more detailed information about the subjects' general health and health related personal circumstances, several health behaviors, health literacy, and their perceptions of care received. A final data set of 651 merged records were used for analysis. RESULTS: Characteristic of a low-income country, the majority of participants had low levels of education, income, health literacy and high rates of under/unemployment. Nearly 50% of participants reported 2 or more NCDs. Seventy-four percent (74%) of respondents reported low levels of medication adherence and 26% of the population was found to have an undiagnosed depressive disorder. Overall, the perception of care quality was low (60%), particularly in those under the age of 45. Significant relationships emerged between several sociodemographic characteristics, health behaviors, and perceptions that have major implications for improving NCD care in this population. CONCLUSIONS: These findings illustrate some of the challenges facing low-income countries where reversing the tide of NCDs is of great importance. The prevalence of NCDs coupled with challenging social determinants of health, poor medication adherence, low health literacy, and perceptions of low quality of healthcare highlight several areas of opportunity for intervention.
[Mh] Termos MeSH primário: Doença Crônica/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Bolívia/epidemiologia
Estudos Transversais
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Cooperação do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189218


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[PMID]:29401500
[Au] Autor:Shields MD; ALQahtani F; Rivey MP; McElnay JC
[Ad] Endereço:Centre for Infection and Immunity. School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
[Ti] Título:Mobile direct observation of therapy (MDOT) - A rapid systematic review and pilot study in children with asthma.
[So] Source:PLoS One;13(2):e0190031, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We describe, for the first time, the use of a mobile device platform for remote direct observation of inhaler use and technique. The research programme commenced with a rapid systematic review of mobile device (or videophone) use for direct observation of therapy (MDOT). Ten studies (mainly pilots) were identified involving patients with tuberculosis, sickle cell disease and Alzheimer's disease. New studies are ongoing (ClinicalTrials.gov website) in TB, stroke, sickle cell disease, HIV and opioid dependence. Having identified no prior use of MDOT in inhaler monitoring, we implemented a feasibility study in 12 healthy volunteer children (2-12 years; 8 females and 4 males) over a period of 14 days, with twice daily video upload of their 'dummy' inhaler use. Two children uploaded 100% of the requested videos, with only one child having an inhaler upload rate of <75%. The quality of uploaded videos was generally good (only 1.7% of unacceptable quality for evaluation). The final aspect of the research was a pilot study using MDOT (6 weeks) in 22 children with difficult to treat asthma. Healthcare professionals evaluated inhaler technique using uploaded videos and provided telephone instruction on improving inhaler use. The main outcomes were assessed at week 12 post initiation of MDOT. By week 5, all children still engaging in MDOT (n = 18) were judged to have effective inhaler technique. Spirometry values did not vary to a significantly significant degree between baseline and 12 weeks (P>0.05), however, mean fraction of exhaled nitric oxide (FeNO) values normalised (mean 38.7 to 19.3ppm) and mean Asthma Control Test values improved (13.1 to mean 17.8). Feedback from participants was positive. Overall the findings open up a new paradigm in device independent (can be used for any type of inhaler device) monitoring, providing a platform for evaluating / improving inhaler use at home.
[Mh] Termos MeSH primário: Antiasmáticos/uso terapêutico
Asma/tratamento farmacológico
Terapia Diretamente Observada
Smartphone
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Nebulizadores e Vaporizadores
Cooperação do Paciente
Projetos Piloto
Ensaios Clínicos Controlados Aleatórios como Assunto
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Asthmatic Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190031


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[PMID]:29400036
[Au] Autor:Sellami M; Mnejja M; Masmoudi M; Charfeddine I; Hammami B; Ghorbel A
[Ti] Título:[Predictive factors for recurrence after surgery of nasal polyposis].
[So] Source:Rev Laryngol Otol Rhinol (Bord);136(4):149-53, 2015.
[Is] ISSN:0035-1334
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Introduction: Endoscopic sinus surgery has become the treatment of choice in the surgical management of patients with nasal polyposis. The aim of our study is to identify the role of some epidemiological, clinical and therapeutic factors in recurrence after surgery of nasal polyposis. Materials and methods: We conducted a retrospective study over a period of 11 years (between 2000 and 2010) including 184 patients operated for nasal polyposis after failure of prolonged medical treatment. We evaluated the impact of epidemiological and clinical factors (age, sex, asthma, Widal disease, allergy and stage of nasal polyposis at the time of surgery) and treatment (surgical technique, observance of postoperative topical steroids ) on postoperative recurrence. Results: Nasal poly­posis recurred in 26.6% of patients after an average period of 23 months. Widal disease, asthma and bad observance of the intranasal steroid therapy were significantly associated with postoperative recurrence in the univariate analysis. In multi­variate analysis the bad observance of the intranasal steroid therapy was the only factor significantly associated with recurren­ce. Conclusion: Postoperative steroids prescribed routi­nely in our practice can effectively prevent recurrence after endonasal surgery and this result was found in both uni­variate and multivariate analysis.
[Mh] Termos MeSH primário: Pólipos Nasais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Asma/epidemiologia
Criança
Feminino
Seguimentos
Glucocorticoides/uso terapêutico
Seres Humanos
Masculino
Meia-Idade
Cooperação do Paciente
Cuidados Pós-Operatórios
Recidiva
Estudos Retrospectivos
Tunísia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


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[PMID]:29280370
[Au] Autor:Wozniak A; Krótki M; Anyzewska A; Górnicka M; Wawrzyniak A
[Ad] Endereço:Department of Human Nutrition, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW - WULS), Warsaw, Poland
[Ti] Título:Adherence to nutrition guidelines in patients with cardiovascular diseases (CVD) as a secondary prevention
[So] Source:Rocz Panstw Zakl Hig;68(4):401-407, 2017.
[Is] ISSN:0035-7715
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Background: The appropriate nutrition is an important component of the secondary prevention of cardiovascular diseases (CVD) Objectives: The aim of the study was to investigate if the patients with cardiovascular disease were informed of the role of appropriate nutrition in prevention or received nutrition guidelines and to assess the dietary intake compared to recommendations for patients with cardiovascular disease who received or not nutrition guidelines Material and Methods: The study was conducted among patients with cardiovascular disease (n = 127) of cardiological hospital clinic, aged 62 ± 11. The questionnaire was used to obtain personal and anthropometric details, information if patients had received nutrition guidelines. The method of 3-day food records was used for dietary assessment Results: 20% of subjects had not received nutrition guidelines and almost 40% of subjects did not recognize the nutrition effect on cardiovascular disease development. Compared to the diets of the subjects who had not received nutrition guidelines, the diets of those who had received them were of significantly lower intake of: energy from saturated fatty acids (15%, p = 0.006), cholesterol (21%, p = 0.012) and higher intake (14-26%) of potassium (p = 0,003), sodium (p = 0.013), phosphorus (p = 0.044), magnesium (p = 0.003), iron (p = 0.005), copper (p = 0.001), zinc (p = 0.046). Among the patients who had received nutrition guidelines, percentage of the subjects whose intake of nutrients was consistent with recommendations was higher Conclusions: Not all subjects had received nutrition guidelines. Diets of those who had received them were more balanced, but in neither group nutrition guidelines were complied with
[Mh] Termos MeSH primário: Doenças Cardiovasculares/prevenção & controle
Dieta/psicologia
Comportamento Alimentar/psicologia
Cooperação do Paciente/psicologia
Prevenção Secundária/métodos
[Mh] Termos MeSH secundário: Idoso
Feminino
Guias como Assunto
Seres Humanos
Masculino
Meia-Idade
Avaliação Nutricional
Estado Nutricional
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE


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Moimaz, Suzely Adas Saliba
Texto completo SciELO Brasil
[PMID]:29267676
[Au] Autor:Bordin D; Fadel CB; Santos CBD; Garbin CAS; Moimaz SAS; Saliba NA
[Ad] Endereço:Universidade Estadual Paulista "Júlio de Mesquita Filho" - Unesp, Araçatuba School of Dentistry, Department of Pediatric and Social Dentistry, Araçatuba, SP, Brazil.
[Ti] Título:Determinants of oral self-care in the Brazilian adult population: a national cross-sectional study.
[So] Source:Braz Oral Res;31:e115, 2017 Dec 18.
[Is] ISSN:1807-3107
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:This study aims to investigate variables related to adherence to oral self-care in the Brazilian adult population. It is an exploratory study, using secondary data from a population-based survey on a representative sample of the adult population of the entire Brazilian territory (n=60202). The sample was selected using a multiple stage approach. The oral self-care indicator was defined by grouping the variables: periodicity of dentist appointments, use of dental floss, toothbrush and toothpaste, frequency of brushing and replacement of the toothbrush. The scores obtained from the indicator were categorized into adequate, partially adequate, and inadequate care. Statistical analysis consisted of dimensionality reduction, and oral self-care-related variables were submitted to logistic regression. The variables mostly related to inadequate or partially adequate oral self-care were: illiteracy (OR = 11.20, OR = 4.81), low educational level (OR = 3.50, OR = 1.96), negative oral health self-concept (OR=3.73, OR=1.74), absence of natural teeth (OR = 4.98, OR=2.60), edentulous lower arch (OR = 3.09; _____), number of missing upper teeth (OR=1.14, OR=1.05), absence of health insurance (OR=2.23, OR=2.07), sedentary lifestyle (OR=2.77, OR=1.51), and smoking (OR=2.18, OR=1.40). It was concluded that the individual's level of education is one of the main factors for adherence to adequate oral self-care, followed by level of oral health self-concept and tooth loss. Likewise, lifestyle also bears a significant influence.
[Mh] Termos MeSH primário: Inquéritos de Saúde Bucal/estatística & dados numéricos
Saúde Bucal/estatística & dados numéricos
Cooperação do Paciente/estatística & dados numéricos
Autocuidado/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Brasil
Estudos Transversais
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Masculino
Meia-Idade
Fatores Sexuais
Fatores Socioeconômicos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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Registro de Ensaios Clínicos
Texto completo
[PMID]:28459931
[Au] Autor:Trepanowski JF; Kroeger CM; Barnosky A; Klempel MC; Bhutani S; Hoddy KK; Gabel K; Freels S; Rigdon J; Rood J; Ravussin E; Varady KA
[Ad] Endereço:Department of Kinesiology and Nutrition, University of Illinois at Chicago.
[Ti] Título:Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial.
[So] Source:JAMA Intern Med;177(7):930-938, 2017 Jul 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy. Objective: To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. Design, Setting, and Participants: A single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois. Interventions: Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating "feast days"), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. Main Outcomes and Measures: The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. Results: Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (-6.8% [95% CI, -9.1% to -4.5%] vs -6.8% [95% CI, -9.1% to -4.6%]) and month 12 (-6.0% [95% CI, -8.5% to -3.6%] vs -5.3% [95% CI, -7.6% to -3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL [95% CI, 0.1-12.4 mg/dL]), but not at month 12 (1.0 mg/dL [95% CI, -5.9 to 7.8 mg/dL]), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL [95% CI, 1.9-21.1 mg/dL]) compared with those in the daily calorie restriction group. Conclusions and Relevance: Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction. Trial Registration: clinicaltrials.gov Identifier: NCT00960505.
[Mh] Termos MeSH primário: Restrição Calórica/métodos
Doenças Cardiovasculares/prevenção & controle
Jejum
Obesidade
[Mh] Termos MeSH secundário: Adulto
Glicemia/análise
Glicemia/metabolismo
Doenças Cardiovasculares/metabolismo
Dietoterapia/métodos
Jejum/fisiologia
Jejum/psicologia
Comportamento Alimentar/fisiologia
Feminino
Seres Humanos
Insulina/análise
Insulina/sangue
Masculino
Meia-Idade
Obesidade/diagnóstico
Obesidade/dietoterapia
Obesidade/metabolismo
Obesidade/psicologia
Avaliação de Processos e Resultados (Cuidados de Saúde)
Cooperação do Paciente
Fatores de Risco
Perda de Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Insulin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.0936


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[PMID]:29406630
[Au] Autor:Touch J; Berg JP
[Ti] Título:Parent Perspectives on Appointment Nonattendance: A Descriptive Study.
[So] Source:Pediatr Nurs;42(4):181-8, 2016 Jul-Aug.
[Is] ISSN:0097-9805
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Appointment nonattendance is a phenomenon that has been studied in a variety of settings. Increased nonattendance rates may result in lost productivity, patient and provider dissatisfaction, and difficulty recruiting staff and physicians. In addition, needed care for patients may be delayed. The purpose of this descriptive study was to examine parental perspectives regarding appointment nonattendance in pediatric specialty care clinics in order to better understand the facilitators and barriers to successful appointment attendance. An exploratory, descriptive approach was chosen for this study. Eight parents of children ages five years and younger were interviewed regarding appointment attendance in specialty care clinics, and conventional content analysis was used to identify themes. Findings suggest that multiple factors are associated with nonattendance, including child/family system and provider/healthcare system factors. Reducing wait times for specialty appointments (from time of scheduling to appointment date), coordinating multiple services, and offering convenient appointment times may be beneficial in optimizing appointment attendance.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/estatística & dados numéricos
Agendamento de Consultas
Hospitais Pediátricos/estatística & dados numéricos
Pais/psicologia
Cooperação do Paciente/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29317618
[Au] Autor:Kirtane AR; Abouzid O; Minahan D; Bensel T; Hill AL; Selinger C; Bershteyn A; Craig M; Mo SS; Mazdiyasni H; Cleveland C; Rogner J; Lee YL; Booth L; Javid F; Wu SJ; Grant T; Bellinger AM; Nikolic B; Hayward A; Wood L; Eckhoff PA; Nowak MA; Langer R; Traverso G
[Ad] Endereço:Department of Chemical Engineering and David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
[Ti] Título:Development of an oral once-weekly drug delivery system for HIV antiretroviral therapy.
[So] Source:Nat Commun;9(1):2, 2018 01 09.
[Is] ISSN:2041-1723
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The efficacy of antiretroviral therapy is significantly compromised by medication non-adherence. Long-acting enteral systems that can ease the burden of daily adherence have not yet been developed. Here we describe an oral dosage form composed of distinct drug-polymer matrices which achieved week-long systemic drug levels of the antiretrovirals dolutegravir, rilpivirine and cabotegravir in a pig. Simulations of viral dynamics and patient adherence patterns indicate that such systems would significantly reduce therapeutic failures and epidemiological modelling suggests that using such an intervention prophylactically could avert hundreds of thousands of new HIV cases. In sum, weekly administration of long-acting antiretrovirals via a novel oral dosage form is a promising intervention to help control the HIV epidemic worldwide.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Sistemas de Liberação de Medicamentos/métodos
Compostos Heterocíclicos com 3 Anéis/administração & dosagem
Piridonas/administração & dosagem
Rilpivirina/administração & dosagem
[Mh] Termos MeSH secundário: Administração Oral
Animais
Fármacos Anti-HIV/farmacocinética
Fármacos Anti-HIV/uso terapêutico
Avaliação Pré-Clínica de Medicamentos
Compostos Heterocíclicos com 3 Anéis/farmacocinética
Compostos Heterocíclicos com 3 Anéis/uso terapêutico
Seres Humanos
Modelos Teóricos
Cooperação do Paciente
Estudo de Prova de Conceito
Piridonas/farmacocinética
Piridonas/uso terapêutico
Rilpivirina/farmacocinética
Rilpivirina/uso terapêutico
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-HIV Agents); 0 (GSK1265744); 0 (Heterocyclic Compounds, 3-Ring); 0 (Pyridones); DKO1W9H7M1 (dolutegravir); FI96A8X663 (Rilpivirine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1038/s41467-017-02294-6


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Texto completo
[PMID]:28449699
[Au] Autor:Munteanu SE; Landorf KB; McClelland JA; Roddy E; Cicuttini FM; Shiell A; Auhl M; Allan JJ; Buldt AK; Menz HB
[Ad] Endereço:Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, 3086, Australia. s.munteanu@latrobe.edu.au.
[Ti] Título:Shoe-stiffening inserts for first metatarsophalangeal joint osteoarthritis (the SIMPLE trial): study protocol for a randomised controlled trial.
[So] Source:Trials;18(1):198, 2017 Apr 27.
[Is] ISSN:1745-6215
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This article describes the design of a parallel-group, participant- and assessor-blinded randomised controlled trial comparing the effectiveness of shoe-stiffening inserts versus sham shoe insert(s) for reducing pain associated with first metatarsophalangeal joint (MTPJ) osteoarthritis (OA). METHODS: Ninety participants with first MTPJ OA will be randomised to receive full-length shoe-stiffening insert(s) (Carbon Fibre Spring Plate, Paris Orthotics, Vancouver, BC, Canada) plus rehabilitation therapy or sham shoe insert(s) plus rehabilitation therapy. Outcome measures will be obtained at baseline, 4, 12, 24 and 52 weeks; the primary endpoint for assessing effectiveness being 12 weeks. The primary outcome measure will be the foot pain domain of the Foot Health Status Questionnaire (FHSQ). Secondary outcome measures will include the function domain of the FHSQ, severity of first MTPJ pain (using a 100-mm Visual Analogue Scale), global change in symptoms (using a 15-point Likert scale), health status (using the Short-Form-12® Version 2.0 and EuroQol (EQ-5D-5L™) questionnaires), use of rescue medication and co-interventions, self-reported adverse events and physical activity levels (using the Incidental and Planned Activity Questionnaire). Data will be analysed using the intention-to-treat principle. Economic analysis (cost-effectiveness and cost-utility) will also be performed. In addition, the kinematic effects of the interventions will be examined at 1 week using a three-dimensional motion analysis system and multisegment foot model. DISCUSSION: This study will determine whether shoe-stiffening inserts are a cost-effective intervention for relieving pain associated with first MTPJ OA. The biomechanical analysis will provide useful insights into the mechanism of action of the shoe-stiffening inserts. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, identifier: ACTRN12616000552482 . Registered on 28 April 2016.
[Mh] Termos MeSH primário: Protocolos Clínicos
Órtoses do Pé
Articulação Metatarsofalângica/fisiopatologia
Osteoartrite/terapia
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Análise Custo-Benefício
Seres Humanos
Osteoartrite/reabilitação
Avaliação de Resultados (Cuidados de Saúde)
Cooperação do Paciente
Sapatos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13063-017-1936-1



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