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[PMID]:28461283
[Au] Autor:Haskins BL; Davis-Martin R; Abar B; Baumann BM; Harralson T; Boudreaux ED
[Ad] Endereço:University of Massachusetts Medical School, Worcester, MA, United States.
[Ti] Título:Health Evaluation and Referral Assistant: A Randomized Controlled Trial of a Web-Based Screening, Brief Intervention, and Referral to Treatment System to Reduce Risky Alcohol Use Among Emergency Department Patients.
[So] Source:J Med Internet Res;19(5):e119, 2017 May 01.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Computer technologies hold promise for implementing alcohol screening, brief intervention, and referral to treatment (SBIRT). Questions concerning the most effective and appropriate SBIRT model remain. OBJECTIVE: The aim of this study was to evaluate the impact of a computerized SBIRT system called the Health Evaluation and Referral Assistant (HERA) on risky alcohol use treatment initiation. METHODS: Alcohol users (N=319) presenting to an emergency department (ED) were considered for enrollment. Those enrolled (n=212) were randomly assigned to the HERA, to complete a patient-administered assessment using a tablet computer, or a minimal-treatment control, and were followed for 3 months. Analyses compared alcohol treatment provider contact, treatment initiation, treatment completion, and alcohol use across condition using univariate comparisons, generalized estimating equations (GEEs), and post hoc chi-square analyses. RESULTS: HERA participants (n=212; control=115; intervention=97) did not differ between conditions on initial contact with an alcohol treatment provider, treatment initiation, treatment completion, or change in risky alcohol use behavior. Subanalyses indicated that HERA participants, who accepted a faxed referral, were more likely to initiate contact with a treatment provider and initiate treatment for risky alcohol use, but were not more likely to continue engaging in treatment, or to complete treatment and change risky alcohol use behavior over the 3-month period following the ED visit. CONCLUSIONS: The HERA promoted initial contact with an alcohol treatment provider and initiation of treatment for those who accepted the faxed referral, but it did not lead to reduced risky alcohol use behavior. Factors which may have limited the HERA's impact include lack of support for the intervention by clinical staff, the low intensity of the brief and stand-alone design of the intervention, and barriers related to patient follow-through, (eg, a lack of transportation or childcare, fees for services, or schedule conflicts). TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): NCT01153373; https://clinicaltrials.gov/ct2/show/NCT01153373 (Archived by WebCite at http://www.webcitation.org/6pHQEpuIF).
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/prevenção & controle
Consumo de Bebidas Alcoólicas/terapia
Serviço Hospitalar de Emergência
Internet/utilização
Encaminhamento e Consulta
Comportamento de Redução do Risco
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.6812


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[PMID]:28453780
[Au] Autor:Billings LK; Jablonski KA; Warner AS; Cheng YC; McAteer JB; Tipton L; Shuldiner AR; Ehrmann DA; Manning AK; Dabelea D; Franks PW; Kahn SE; Pollin TI; Knowler WC; Altshuler D; Florez JC; Diabetes Prevention Program Research Group
[Ad] Endereço:Diabetes Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114.
[Ti] Título:Variation in Maturity-Onset Diabetes of the Young Genes Influence Response to Interventions for Diabetes Prevention.
[So] Source:J Clin Endocrinol Metab;102(8):2678-2689, 2017 Aug 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: Variation in genes that cause maturity-onset diabetes of the young (MODY) has been associated with diabetes incidence and glycemic traits. Objectives: This study aimed to determine whether genetic variation in MODY genes leads to differential responses to insulin-sensitizing interventions. Design and Setting: This was a secondary analysis of a multicenter, randomized clinical trial, the Diabetes Prevention Program (DPP), involving 27 US academic institutions. We genotyped 22 missense and 221 common variants in the MODY-causing genes in the participants in the DPP. Participants and Interventions: The study included 2806 genotyped DPP participants randomized to receive intensive lifestyle intervention (n = 935), metformin (n = 927), or placebo (n = 944). Main Outcome Measures: Association of MODY genetic variants with diabetes incidence at a median of 3 years and measures of 1-year ß-cell function, insulinogenic index, and oral disposition index. Analyses were stratified by treatment group for significant single-nucleotide polymorphism × treatment interaction (Pint < 0.05). Sequence kernel association tests examined the association between an aggregate of rare missense variants and insulinogenic traits. Results: After 1 year, the minor allele of rs3212185 (HNF4A) was associated with improved ß-cell function in the metformin and lifestyle groups but not the placebo group; the minor allele of rs6719578 (NEUROD1) was associated with an increase in insulin secretion in the metformin group but not in the placebo and lifestyle groups. Conclusions: These results provide evidence that genetic variation among MODY genes may influence response to insulin-sensitizing interventions.
[Mh] Termos MeSH primário: Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética
Diabetes Mellitus Tipo 2/genética
Terapia por Exercício
Fator 4 Nuclear de Hepatócito/genética
Programas de Redução de Peso
[Mh] Termos MeSH secundário: Diabetes Mellitus Tipo 2/prevenção & controle
Variação Genética
Glucoquinase/genética
Fator 1-alfa Nuclear de Hepatócito/genética
Fator 1-beta Nuclear de Hepatócito/genética
Proteínas de Homeodomínio/genética
Seres Humanos
Metformina/uso terapêutico
Mutação de Sentido Incorreto
Polimorfismo de Nucleotídeo Único
Comportamento de Redução do Risco
Transativadores/genética
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Basic Helix-Loop-Helix Transcription Factors); 0 (HNF1A protein, human); 0 (HNF1B protein, human); 0 (HNF4A protein, human); 0 (Hepatocyte Nuclear Factor 1-alpha); 0 (Hepatocyte Nuclear Factor 4); 0 (Homeodomain Proteins); 0 (NEUROD1 protein, human); 0 (Trans-Activators); 0 (pancreatic and duodenal homeobox 1 protein); 138674-15-4 (Hepatocyte Nuclear Factor 1-beta); 9100L32L2N (Metformin); EC 2.7.1.2 (Glucokinase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2016-3429


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[PMID]:28468783
[Au] Autor:Ramirez FD; Chen Y; Di Santo P; Simard T; Motazedian P; Hibbert B
[Ad] Endereço:Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
[Ti] Título:Association Between Self-Reported Potentially Modifiable Cardiac Risk Factors and Perceived Need to Improve Physical Health: A Population-Based Study.
[So] Source:J Am Heart Assoc;6(5), 2017 May 03.
[Is] ISSN:2047-9980
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: An individual's perceived need to improve their physical health (PNIPH) is an essential precursor to adopting healthy behaviors. Nine potentially modifiable risk factors (PMRFs) for myocardial infarction collectively account for ≥90% of the population attributable risk. Though widely recognized, their impact on individuals' health perceptions is unclear. METHODS AND RESULTS: Residents from 6 provinces were administered a module on changes to improve health as part of the 2011-2012 Canadian Community Health Survey, yielding relevant data for 8 of the 9 PMRFs sought. The potential effects of PMRFs individually and cumulatively on PNIPH were examined using modified Poisson regression. In total, 45 443 respondents were included, representing 11 006 123 individuals and corresponding to 96.8% of the adult population of the sampled provinces. The sum of PMRFs was positively associated with PNIPH (adjusted prevalence ratio, 1.08; 95% CI, 1.07-1.09 per additional PMRF) with 82.3% of individuals with ≥5 PMRFs reporting this perception. Smoking, obesity, and low physical activity were most strongly associated with PNIPH, whereas hypertension and diabetes mellitus exhibited no association with this outcome after adjusting for potential confounders. Barriers to adopting healthy behaviors were reported by 55.9% of individuals endorsing PNIPH. CONCLUSIONS: The cumulative burden of PMRFs is positively associated with PNIPH; however, individual PMRFs differentially contribute to this perception. Among those at highest cardiac risk, ≈1 in 5 denied PNIPH. A better understanding of factors underlying health perceptions and behaviors is needed to capitalize on cardiovascular preventive efforts.
[Mh] Termos MeSH primário: Comportamentos Relacionados com a Saúde
Conhecimentos, Atitudes e Prática em Saúde
Estilo de Vida Saudável
Infarto do Miocárdio/prevenção & controle
Percepção
Comportamento de Redução do Risco
Autorrelato
[Mh] Termos MeSH secundário: Adolescente
Adulto
Canadá/epidemiologia
Comorbidade
Estudos Transversais
Exercício
Feminino
Nível de Saúde
Inquéritos Epidemiológicos
Dieta Saudável
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio/diagnóstico
Infarto do Miocárdio/epidemiologia
Infarto do Miocárdio/psicologia
Valor Preditivo dos Testes
Prevalência
Fatores de Proteção
Medição de Risco
Fatores de Risco
Estilo de Vida Sedentário
Fumar/efeitos adversos
Fumar/epidemiologia
Abandono do Hábito de Fumar
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:29465545
[Au] Autor:Kim HJ; Lee S; Chun KH; Jeon JY; Han SJ; Kim DJ; Kim YS; Woo JT; Nam MS; Baik SH; Ahn KJ; Lee KW
[Ad] Endereço:Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon.
[Ti] Título:Metformin reduces the risk of cancer in patients with type 2 diabetes: An analysis based on the Korean National Diabetes Program Cohort.
[So] Source:Medicine (Baltimore);97(8):e0036, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The epidemiological literature suggests that insulin resistance, hyperinsulinemia, and increased levels of insulin-like growth factors place patients with type 2 diabetes mellitus (T2DM) at greater risk of cancer. The association between cancer incidence and the use of antidiabetic medications in patients with T2DM has been recently examined. There have been conflicting reports regarding an association between metformin and cancer risk. The aim of this study was to investigate the relationship between metformin use and the incidence of cancer in Koreans with T2DM.Data from The Korean National Diabetes Program (KNDP, 2006-2014), a nationwide, large-scale, prospective, multicenter cohort study in Korea, were used to study patients with T2DM. Patients ≥30 years old whose complete medical records were available were included in this study. Patients with a history of any cancer on KNDP registration or those who had been diagnosed with any type of cancer within 1 year of metformin use were excluded. Survival curves with respect to the incidence of cancer were plotted using the Kaplan-Meier method. Hazard ratios and 95% confidence intervals for cancer were estimated in a Cox proportional hazards regression analysis.During a mean 5.8 years of follow-up, 164 of the 1918 study patients (335 metformin nonusers and 1583 metformin users) developed cancer. The incidence per 1000 person-years was 21.8 in metformin nonusers and 13.2 in metformin users. Metformin users had a reduced risk of cancer, even after adjustment for demographic characteristics, metabolic parameters, diabetic complications, and other antidiabetic medications (hazard ratio 0.513, 95% confidence interval 0.318-0.826, P = .0060). Subgroup analysis of metformin users showed a reduced risk of cancer in males, patients < 65 years of age, patients with a T2DM duration < 5 years, nonobese patients, nonsmokers, and good glycemic control group.This large-scale, prospective, multicenter cohort study demonstrated an association between metformin use and reduced cancer risk in patients with T2DM.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/tratamento farmacológico
Hipoglicemiantes/uso terapêutico
Metformina/uso terapêutico
Neoplasias/etiologia
Comportamento de Redução do Risco
[Mh] Termos MeSH secundário: Diabetes Mellitus Tipo 2/complicações
Feminino
Seres Humanos
Incidência
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Neoplasias/epidemiologia
Modelos de Riscos Proporcionais
Estudos Prospectivos
República da Coreia/epidemiologia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 9100L32L2N (Metformin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010036


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[PMID]:27776978
[Au] Autor:Wang Z; Wang G; Xia Q; Shang Z; Yu X; Wang M; Jin X
[Ad] Endereço:Minimally Invasive Urology Center, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
[Ti] Título:Partial nephrectomy vs. radical nephrectomy for renal tumors: A meta-analysis of renal function and cardiovascular outcomes.
[So] Source:Urol Oncol;34(12):533.e11-533.e19, 2016 12.
[Is] ISSN:1873-2496
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The widespread use of partial nephrectomy (PN) has led to the preservation of functional renal parenchyma. However, the benefits of PN on renal function and cardiovascular outcomes remain controversial. Thus, a meta-analysis was performed to reconcile the conflicting results. MATERIALS AND METHODS: PubMed, Embase, and the Cochrane Library were searched from inception to August 2015, and databases with all relevant comparative studies were included. The Mantel-Haenszel method with random-effects models was used to determine the pooled hazard ratios (HRs) for each outcome. RESULTS: In total, 26 studies were pooled for new-onset chronic kidney disease, and 6 studies were pooled for cardiovascular outcomes. According to the pooled estimates, PN correlated with a 73% risk reduction of new-onset chronic kidney disease in all included patients (HR = 0.27, P<0.0001) and a 65% risk reduction in patients with tumors>4cm (HR = 0.35, P<0.0001) compared with radical nephrectomy. There were no significant differences between groups regarding postsurgery cardiovascular events (HR = 0.86, P = 0.238) and cardiovascular death (HR = 0.79, P = 0.196). Despite inherent selection biases, the pooled estimates were robust in sensitivity and subgroup analyses. CONCLUSIONS: Our findings suggest that PN lowers the postoperative risk of new-onset chronic kidney disease. Nevertheless, the protection of renal function by PN did not reduce the risk of cardiovascular outcomes. However, this result remains controversial, and additional large-scale evaluations are warranted.
[Mh] Termos MeSH primário: Carcinoma de Células Renais/cirurgia
Neoplasias Renais/cirurgia
Rim/fisiopatologia
Nefrectomia/métodos
[Mh] Termos MeSH secundário: Carcinoma de Células Renais/fisiopatologia
Estudos de Casos e Controles
Estudos de Coortes
Seguimentos
Cardiopatias/epidemiologia
Cardiopatias/prevenção & controle
Seres Humanos
Neoplasias Renais/fisiopatologia
Insuficiência Renal Crônica/epidemiologia
Insuficiência Renal Crônica/prevenção & controle
Estudos Retrospectivos
Comportamento de Redução do Risco
Viés de Seleção
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29384876
[Au] Autor:Gilis-Januszewska A; Lindström J; Barengo NC; Tuomilehto J; Schwarz PE; Wójtowicz E; Piwonska-Solska B; Szybinski Z; Windak A; Hubalewska-Dydejczyk A
[Ad] Endereço:Department of Endocrinology, Jagiellonian University, Medical College, Kopernika, Krakow, Poland.
[Ti] Título:Predictors of completing a primary health care diabetes prevention intervention programme in people at high risk of type 2 diabetes: Experiences of the DE-PLAN project.
[So] Source:Medicine (Baltimore);97(5):e9790, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:It has been shown that real-life implementation studies for the prevention of type 2 diabetes (DM2) performed in different settings and populations can be effective. However, not enough information is available on factors influencing the reach of DM2 prevention programmes. This study examines the predictors of completing an intervention programme targeted at people at high risk of DM2 in Krakow, Poland as part of the DE-PLAN project.A total of 262 middle-aged people, everyday patients of 9 general practitioners' (GP) practices, at high risk of DM2 (Finnish Diabetes Risk Score (FINDRISK) >14) agreed to participate in the lifestyle intervention to prevent DM2. Intervention consisted of 11 lifestyle counseling sessions, organized physical activity sessions followed by motivational phone calls and letters. Measurements were performed at baseline and 1 year after the initiation of the intervention.Seventy percent of the study participants enrolled completed the core curriculum (n = 184), 22% were men. When compared to noncompleters, completers had a healthier baseline diabetes risk profile (P <.05). People who completed the intervention were less frequently employed versus noncompleters (P = .037), less often had hypertension (P = .043), and more frequently consumed vegetables and fruit daily (P = .055).In multiple logistic regression model, employment reduced the likelihood of completing the intervention 2 times (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.25-0.81). Higher glucose 2 hours after glucose load and hypertension were the independent factors decreasing the chance to participate in the intervention (OR 0.79, 95% 0.69-0.92 and OR 0.52, 95% CI 0.27-0.99, respectively). Daily consumption of vegetables and fruits increased the likelihood of completing the intervention (OR 1.86, 95% 1.01-3.41).In conclusion, people with healthier behavior and risk profile are more predisposed to complete diabetes prevention interventions. Male, those who work and those with a worse health profile, are less likely to participate and complete interventions. Targeted strategies are needed in real-life diabetes prevention interventions to improve male participation and to reach those who are working as well as people with a higher risk profile.
[Mh] Termos MeSH primário: Aconselhamento
Diabetes Mellitus Tipo 2/prevenção & controle
Comportamentos Relacionados com a Saúde
Estilo de Vida
Atenção Primária à Saúde
[Mh] Termos MeSH secundário: Adulto
Idoso
Exercício
Feminino
Seres Humanos
Masculino
Meia-Idade
Polônia
Comportamento de Redução do Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009790


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[PMID]:27779567
[Au] Autor:Neilson HK; Farris MS; Stone CR; Vaska MM; Brenner DR; Friedenreich CM
[Ad] Endereço:1Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada 2Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada 3Knowledge Resource Service, Alberta Health Services, Calgary, Alberta, Canada 4Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
[Ti] Título:Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis.
[So] Source:Menopause;24(3):322-344, 2017 Mar.
[Is] ISSN:1530-0374
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Physical inactivity increases postmenopausal and possibly premenopausal breast cancer risk, although different biologic mechanisms are proposed. Our primary objective was to estimate breast cancer risk associated with high versus low levels of moderate-vigorous recreational activity, separately for premenopausal and postmenopausal women. METHODS: We conducted a systematic review of literature published to July 2015. Included reports were cohort or case-control studies relating moderate-vigorous recreational physical activity (metabolic equivalent ≥3.0) to breast cancer incidence, exclusively (≥90%) in premenopausal or postmenopausal women. We appraised study quality and performed meta-analyses using random effects modeling. Subgroup meta-analyses were based on tumor subtype, race, body mass index, parity, hormone therapy use, family history of cancer, and statistical adjustment for body fatness. Dose-response relations were examined. RESULTS: Pooled relative risks (RRs, 95% CI) for women with higher versus lower levels of moderate-vigorous recreational activity were RR = 0.80 (0.74-0.87) and RR = 0.79 (0.74-0.84) for premenopausal (43 studies) and postmenopausal (58 studies) breast cancer, respectively, with high heterogeneity. Inverse associations were weaker among postmenopausal cohort studies (RR = 0.90 [0.85-0.95]) and studies that statistically adjusted for nonrecreational (eg, occupational, household) activity (RR = 0.91 [0.77-1.06] premenopausal, RR = 0.96 [0.86-1.08] postmenopausal). Risk estimates with versus without body fatness adjustment did not vary by menopause status, although other subgroup effects were menopause-dependent. Among studies of overweight/obese women, there was an inverse association with postmenopausal but not premenopausal breast cancer (RR = 0.88 [0.82-0.95] and RR = 0.99 [0.98-1.00], respectively). Dose-response curves were generally nonlinear. CONCLUSIONS: Although risk estimates may be similar for premenopausal and postmenopausal breast cancer, subgroup effects may be menopause-dependent.
[Mh] Termos MeSH primário: Neoplasias da Mama/etiologia
Exercício/fisiologia
Menopausa
Recreação/fisiologia
Comportamento de Redução do Risco
[Mh] Termos MeSH secundário: Adulto
Neoplasias da Mama/prevenção & controle
Estudos de Casos e Controles
Estudos de Coortes
Feminino
Seres Humanos
Meia-Idade
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1097/GME.0000000000000745


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[PMID]:27773937
[Au] Autor:Ryder JR; Kaizer A; Rudser KD; Gross A; Kelly AS; Fox CK
[Ad] Endereço:Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
[Ti] Título:Effect of phentermine on weight reduction in a pediatric weight management clinic.
[So] Source:Int J Obes (Lond);41(1):90-93, 2017 Jan.
[Is] ISSN:1476-5497
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Phentermine is the most widely prescribed obesity medication in adults, yet studies of its use in the pediatric population are limited. We conducted a retrospective chart review of adolescents with obesity treated in a pediatric weight management clinic to examine the weight loss effectiveness of phentermine added to standard of care (SOC) lifestyle modification therapy versus SOC alone. All patients receiving phentermine plus SOC (n=25) were matched with a comparison group receiving only SOC (n=274). Differences at 1, 3 and 6 months were evaluated using generalized estimated equations adjusting for age, sex and baseline body mass index (BMI) and robust variance standard error estimates for confidence intervals and P-values. Phentermine use was associated with a greater percent change in BMI at 1 month (-1.6%; 95% confidence interval (CI): -2.6, -0.6%; P=0.001), 3 months (-2.9%; 95% CI: -4.5, -1.4%; P<0.001) and 6 months (-4.1%; 95% CI: -7.1, -1.0%; P=0.009) compared with SOC alone, with no differences in systolic or diastolic blood pressure between groups. Heart rate was higher at all time-points in the phentermine plus SOC compared with SOC-only group. These data suggest that short-term use of phentermine added to SOC may enhance weight loss in adolescents with obesity in the clinical setting.
[Mh] Termos MeSH primário: Fármacos Antiobesidade/uso terapêutico
Obesidade Pediátrica/prevenção & controle
Fentermina/uso terapêutico
Perda de Peso
[Mh] Termos MeSH secundário: Adolescente
Terapia Comportamental
Dieta Redutora
Feminino
Seres Humanos
Masculino
Minnesota/epidemiologia
Obesidade Pediátrica/terapia
Estudos Retrospectivos
Comportamento de Redução do Risco
Resultado do Tratamento
Perda de Peso/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Obesity Agents); C045TQL4WP (Phentermine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1038/ijo.2016.185


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[PMID]:27776677
[Au] Autor:Jarlais DC; Arasteh K; Feelemyer J; McKnight C; Barnes DM; Tross S; Perlman DC; Campbell AN; Cooper HL; Hagan H
[Ad] Endereço:Icahn School of Medicine at Mount Sinai, New York, NY, United States. Electronic address: ddesjarlais@chpnet.org.
[Ti] Título:From Long-Term Injecting to Long-Term Non-Injecting Heroin and Cocaine Use: The Persistence of Changed Drug Habits.
[So] Source:J Subst Abuse Treat;71:48-53, 2016 12.
[Is] ISSN:1873-6483
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Transitioning from injecting to non-injecting routes of drug administration can provide important individual and community health benefits. We assessed characteristics of persons who had ceased injecting while continuing to use heroin and/or cocaine in New York City. METHODS: We recruited subjects entering Mount Sinai Beth Israel detoxification and methadone maintenance programs between 2011 and 2015. Demographic information, drug use histories, sexual behaviors, and "reverse transitions" from injecting to non-injecting drug use were assessed in structured face-to-face interviews. There were 303 "former injectors," operationally defined as persons who had injected at some time in their lives, but had not injected in at least the previous 6 months. Serum samples were collected for HIV and HCV testing. RESULTS: Former injectors were 81% male, 19% female, 17% White, 43% African-American, and 38% Latino/a, with a mean age of 50 (SD=9.2), and were currently using heroin and/or cocaine. They had injected drugs for a mean of 14 (SD=12.2) years before ceasing injection, and a mean of 13 (SD=12) years had elapsed since their last injection. HIV prevalence among the sample was 13% and HCV prevalence was 66%. The former injectors reported a wide variety of reasons for ceasing injecting. Half of the group appeared to have reached a point where relapse back to injecting was no longer problematic: they had not injected for three or more years, were not deliberately using specific techniques to avoid relapse to injecting, and were not worried about relapsing to injecting. CONCLUSIONS: Former injectors report very-long term behavior change toward reduced individual and societal harm while continuing to use heroin and cocaine. The behavior change appears to be self-sustaining, with full replacement of an injecting route of drug administration by a non-injecting route of administration. Additional research on the process of long-term cessation of injecting should be conducted within a "combined prevention and care" approach to HIV and HCV infection among persons who use drugs.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Cocaína/epidemiologia
Dependência de Heroína/epidemiologia
Comportamento de Redução do Risco
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Cidade de Nova Iorque/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29381992
[Au] Autor:Lin H; Zhang L; Zheng R; Zheng Y
[Ad] Endereço:Department of Cardiology.
[Ti] Título:The prevalence, metabolic risk and effects of lifestyle intervention for metabolically healthy obesity: a systematic review and meta-analysis: A PRISMA-compliant article.
[So] Source:Medicine (Baltimore);96(47):e8838, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We conducted a systematic review and meta-analysis to firstly obtain a reliable estimation of the prevalence of metabolically healthy obese (MHO) individuals in obesity, then assessed the risk of developing metabolic abnormalities (MA) among MHO individuals. At last, we evaluated the effects of traditional lifestyle interventions on metabolic level for MHO subjects. METHODS: A systematic review and meta-analysis (PRISMA) guideline were conducted, and original studies were searched up to December 31, 2016. The prevalence of MHO in obesity from each study was pooled using random effects models. The relative risks (RRs) were pooled to determine the risk of developing MA for MHO compared with metabolically healthy normal-weight (MHNW) subjects. For the meta-analysis of intervention studies, the mean difference and standardized mean differences were both estimated for each metabolic parameter within each study, and then pooled using a random-effects model. RESULTS: Overall, 40 population-based studies reported the prevalence of MHO in obesity, 12 cohort studies and 7 intervention studies were included in the meta-analysis. About 35.0% obese individuals were metabolically healthy in the obese subjects. There were dramatic differences in the prevalence among different areas. However, 0.49 (95% confidence intervals [CI]: 0.38 to 0.60) of the MHO individuals would develop one or more MA within 10 years. Compared with MHNW subjects, the MHO subjects presented higher risk of incident MA (pooled RR = 1.80, 95%CI: 1.53-2.11). Following intervention, there was certain and significant improvement of metabolic state for metabolically abnormal obesity (MAO) subjects. Only diastolic blood pressure had reduced for MHO individuals after intervention. CONCLUSIONS: Almost one-third of the obese individuals are in metabolic health. However, they are still at higher risk of advancing to unhealthy state. Therefore, it is still needed to advise MHO individuals to maintain or adopt a healthy lifestyle, so as to counterbalance the adverse effects of obesity.
[Mh] Termos MeSH primário: Doenças Metabólicas/etiologia
Manejo da Obesidade/métodos
Obesidade Metabolicamente Benigna/epidemiologia
Obesidade Metabolicamente Benigna/terapia
Comportamento de Redução do Risco
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Estilo de Vida
Masculino
Meia-Idade
Obesidade Metabolicamente Benigna/complicações
Prevalência
Medição de Risco
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008838



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