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[PMID]:29340678
[Au] Autor:Ikramuddin S; Korner J; Lee WJ; Thomas AJ; Connett JE; Bantle JP; Leslie DB; Wang Q; Inabnet WB; Jeffery RW; Chong K; Chuang LM; Jensen MD; Vella A; Ahmed L; Belani K; Billington CJ
[Ad] Endereço:Department of Surgery, University of Minnesota, Minneapolis.
[Ti] Título:Lifestyle Intervention and Medical Management With vs Without Roux-en-Y Gastric Bypass and Control of Hemoglobin A1c, LDL Cholesterol, and Systolic Blood Pressure at 5 Years in the Diabetes Surgery Study.
[So] Source:JAMA;319(3):266-278, 2018 01 16.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The Roux-en-Y gastric bypass is effective in achieving established diabetes treatment targets, but durability is unknown. Objective: To compare durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets. Design, Setting, and Participants: Observational follow-up of a randomized clinical trial at 4 sites in the United States and Taiwan, involving 120 participants who had a hemoglobin A1c (HbA1c) level of 8.0% or higher and a body mass index between 30.0 and 39.9 (enrolled between April 2008 and December 2011) were followed up for 5 years, ending in November 2016. Interventions: Lifestyle-intensive medical management intervention based on the Diabetes Prevention Program and LookAHEAD trials for 2 years, with and without (60 participants each) Roux-en-Y gastric bypass surgery followed by observation to year 5. Main Outcomes and Measures: The American Diabetes Association composite triple end point of hemoglobin A1c less than 7.0%, low-density lipoprotein cholesterol less than 100 mg/dL, and systolic blood pressure less than 130 mm Hg at 5 years. Results: Of 120 participants who were initially randomized (mean age, 49 years [SD, 8 years], 72 women [60%]), 98 (82%) completed 5 years of follow-up. Baseline characteristics were similar between groups: mean (SD) body mass index 34.4 (3.2) for the lifestyle-medical management group and 34.9 (3.0) for the gastric bypass group and had hemoglobin A1c levels of 9.6% (1.2) and 9.6% (1.0), respectively. At 5 years, 13 participants (23%) in the gastric bypass group and 2 (4%) in the lifestyle-intensive medical management group had achieved the composite triple end point (difference, 19%; 95% CI, 4%-34%; P = .01). In the fifth year, 31 patients (55%) in the gastric bypass group vs 8 (14%) in the lifestyle-medical management group achieved an HbA1c level of less than 7.0% (difference, 41%; 95% CI, 19%-63%; P = .002). Gastric bypass had more serious adverse events than did the lifestyle-medical management intervention, 66 events vs 38 events, most frequently gastrointestinal events and surgical complications such as strictures, small bowel obstructions, and leaks. Gastric bypass had more parathyroid hormone elevation but no difference in B12 deficiency. Conclusions and Relevance: In extended follow-up of obese adults with type 2 diabetes randomized to adding gastric bypass compared with lifestyle and intensive medical management alone, there remained a significantly better composite triple end point in the surgical group at 5 years. However, because the effect size diminished over 5 years, further follow-up is needed to understand the durability of the improvement. Trial Registration: clinicaltrials.gov Identifier: NCT00641251.
[Mh] Termos MeSH primário: Derivação Gástrica
Hemoglobina A Glicada/análise
[Mh] Termos MeSH secundário: LDL-Colesterol/sangue
Diabetes Mellitus Tipo 2/sangue
Feminino
Seres Humanos
Hipoglicemiantes
Estilo de Vida
Meia-Idade
Taiwan
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; COMMENT
[Nm] Nome de substância:
0 (Cholesterol, LDL); 0 (Glycated Hemoglobin A); 0 (Hypoglycemic Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180118
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20813


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[PMID]:29505537
[Au] Autor:Chan FK; Hsu CC; Lin HJ; Wang JJ; Su SB; Huang CC; Weng SF
[Ad] Endereço:Department of Emergency Medicine, Kuo General Hospital.
[Ti] Título:Physicians as well as nonphysician health care professionals in Taiwan have higher risk for lumbar herniated intervertebral disc than general population.
[So] Source:Medicine (Baltimore);97(1):e9561, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Physicians in Taiwan have long working hours and are at risk for inappropriate posture when handling patients, which may contribute to lumbar herniated intervertebral disc (L-HIVD). This study was conducted to delineate this issue, which is still unknown. This nationwide population-based cohort study was based on Taiwan National Health Insurance Research Database. We identified 25,428 physicians, 32,316 nonphysician health care professionals (HCPs), and an identical number of age- and sex-matched individuals from the general population. All individuals who had L-HIVD before 2007 were excluded. We compared the L-HIVD risk between physicians and general population, nonphysician HCPs and general population, and physicians and nonphysician HCPs by tracing their medical histories between 2007 and 2011. A comparison among physician specialties was also performed. Physicians and nonphysician HCPs had higher L-HIVD risk than the general population [odds ratio (OR): 1.149; 95% confidence interval (CI): 1.011-1.307 and OR: 1.220; 95% CI: 1.080-1.378, respectively]. Physicians did not have higher L-HIVD risk than nonphysician HCPs [adjusted OR (AOR): 0.912; 95% CI: 0.795-1.046]. Physician specialties of orthopedics and obstetrics and gynecology had a trend of higher L-HIVD risk than other specialties (AOR: 1.538; 95% CI: 0.805-2.939, and AOR: 1.306; 95% CI: 0.967-1.764, respectively). Physicians as well as nonphysician health care professionals in Taiwan have higher L-HIVD risk than the general population, which could be attributed to a probable role of long working hours. This result provides an important reference for the government to promote occupational health in health care professionals; however, further studies are warranted for the underlying mechanisms.
[Mh] Termos MeSH primário: Pessoal Técnico de Saúde/estatística & dados numéricos
Deslocamento do Disco Intervertebral/epidemiologia
Vértebras Lombares
Exposição Ocupacional/efeitos adversos
Médicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Deslocamento do Disco Intervertebral/etiologia
Masculino
Meia-Idade
Risco
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009561


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[PMID]:29394255
[Au] Autor:Hsiao PJ; Lin HC; Chang ST; Hsu JT; Lin WS; Chung CM; Chang JJ; Hung KC; Shih YW; Chen FC; Hu FK; Wu YS; Chang CW; Su SL; Chu CM
[Ad] Endereço:Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
[Ti] Título:Albuminuria and neck circumference are determinate factors of successful accurate estimation of glomerular filtration rate in high cardiovascular risk patients.
[So] Source:PLoS One;13(2):e0185693, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Estimated glomerular filtration rate (eGFR) is used for diagnosis of chronic kidney disease (CKD). The eGFR models based on serum creatinine or cystatin C are used more in clinical practice. Albuminuria and neck circumference are associated with CKD and may have correlations with eGFR. AIM: We explored the correlations and modelling formulates among various indicators such as serum creatinine, cystatin C, albuminuria, and neck circumference for eGFR. DESIGN: Cross-sectional study. METHODS: We reviewed the records of patients with high cardiovascular risk from 2010 to 2011 in Taiwan. 24-hour urine creatinine clearance was used as the standard. We utilized a decision tree to select for variables and adopted a stepwise regression method to generate five models. Model 1 was based on only serum creatinine and was adjusted for age and gender. Model 2 added serum cystatin C, models 3 and 4 added albuminuria and neck circumference, respectively. Model 5 simultaneously added both albuminuria and neck circumference. RESULTS: Total 177 patients were recruited in this study. In model 1, the bias was 2.01 and its precision was 14.04. In model 2, the bias was reduced to 1.86 with a precision of 13.48. The bias of model 3 was 1.49 with a precision of 12.89, and the bias for model 4 was 1.74 with a precision of 12.97. In model 5, the bias could be lower to 1.40 with a precision of 12.53. CONCLUSIONS: In this study, the predicting ability of eGFR was improved after the addition of serum cystatin C compared to serum creatinine alone. The bias was more significantly reduced by the calculation of albuminuria. Furthermore, the model generated by combined albuminuria and neck circumference could provide the best eGFR predictions among these five eGFR models. Neck circumference can be investigated potentially in the further studies.
[Mh] Termos MeSH primário: Albuminúria/fisiopatologia
Antropometria
Doenças Cardiovasculares/epidemiologia
Taxa de Filtração Glomerular
Pescoço/anatomia & histologia
[Mh] Termos MeSH secundário: Idoso
Doenças Cardiovasculares/diagnóstico
Creatinina/sangue
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
Taiwan
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
AYI8EX34EU (Creatinine)
[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:180203
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185693


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[PMID]:29364952
[Au] Autor:Tseng SH; Lee JY; Chou YL; Sheu ML; Lee YW
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.
[Ti] Título:Association between socioeconomic status and cerebral palsy.
[So] Source:PLoS One;13(1):e0191724, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The present study investigated the annual prevalence of cerebral palsy (CP) among children aged <7 years in Taiwan and the association between socioeconomic status and CP prevalence. METHODS: Data from the Taiwan National Health Insurance Research Database for the 2002-2008 period were used in this population-based study. Severe and total CP were defined according to catastrophic illness certificate and medical claim records, respectively. The annual CP prevalence was calculated as the number of children with CP among all children aged <7 years. RESULTS: From 2002 to 2008, the annual prevalence of total and severe CP ranged from 1.9 to 2.8 and from 1.1 to 1.4 per 1000 children, respectively. Boys were 30% more likely to have CP than girls [adjusted relative risk (RR) and 95% confidence interval (CI) ranged from 1.3 (1.2-1.4) to 1.4 (1.2-1.5)]. Low family income was associated with a higher CP prevalence [adjusted RR (95% CI) ranged from 5.1 (4.2-6.2) to 6.4 (5.4-7.6)]. The prevalence of CP in rural area was higher than that in urban or suburban areas. The mortality rate of severe CP ranged from 12.2-22.7 per 1000 children within the 7 years study period. CONCLUSIONS: The prevalence of CP in Taiwan is similar to that in Western countries. A higher prevalence of CP is associated with male sex, low income, and rural residential location. Our findings provide insights into CP epidemiology among the Chinese population.
[Mh] Termos MeSH primário: Paralisia Cerebral/fisiopatologia
Classe Social
[Mh] Termos MeSH secundário: Paralisia Cerebral/epidemiologia
Criança
Pré-Escolar
Seres Humanos
Prevalência
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[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:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191724


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[PMID]:28742429
[Au] Autor:Lee CF; Tang SM
[Ad] Endereço:a Department of Living Science , National Open University , New Taipei City, Lu Chow District , Taiwan (R.O.C.).
[Ti] Título:Relationship between housework and perceived happiness of middle-aged and older women in Taiwan-The moderating effect of health condition.
[So] Source:Health Care Women Int;38(12):1313-1326, 2017 Dec.
[Is] ISSN:1096-4665
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In this study, we investigated how physical health moderates the effect of housework on the perceived well-being in a sample of middle-aged and older women living with a partner in Taiwan. Two main findings were identified: First, the health status of middle-aged and older women moderates the relationship between their sense of housework fairness and perceived happiness. Second, the health status of their spouse moderates the relationship between their housework performance and perceived happiness.
[Mh] Termos MeSH primário: Felicidade
Nível de Saúde
Serviço de Limpeza
Estresse Psicológico
[Mh] Termos MeSH secundário: Idoso
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Percepção
Cônjuges
Taiwan
[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:N
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1080/07399332.2017.1354863


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[PMID]:29186633
[Au] Autor:Yu YT; Hsieh WS; Hsu CH; Lin YJ; Lin CH; Hsieh S; Lu L; Cherng RJ; Chang YJ; Fan PC; Yao NJ; Chen WJ; Jeng SF
[Ad] Endereço:School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
[Ti] Título:Family-centered Care Improved Neonatal Medical and Neurobehavioral Outcomes in Preterm Infants: Randomized Controlled Trial.
[So] Source:Phys Ther;97(12):1158-1168, 2017 Dec 01.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Family-centered care for preterm infants in Western societies has yielded short- to medium-term benefits. However, the intervention effects have rarely been validated in Eastern societies. Objective: The aim of this study was to examine whether a family-centered intervention program (FCIP) could improve the short-term medical and neurobehavioral outcomes in preterm infants with very low birth weight (VLBW; a birth weight of <1,500 g) in Taiwan over the outcomes seen with a usual care program (UCP). Design: This was a multicenter, single-blind, randomized controlled trial study. Setting: Three medical centers in northern and southern Taiwan were the locations for the study. Participants: The participants were 251 VLBW preterm infants without severe perinatal complications. Intervention: The infants were randomly assigned to receive the FCIP or the UCP during hospitalization. Measurements: Infant morbidities, feeding, growth, and neurobehavioral performance were evaluated during the neonatal period. Parental adherence to interventions was measured in the FCIP group. Results: The FCIP promoted earlier full enteral feeding (ß = -1.1 weeks; 95% CI = -1.9 to -0.2 weeks) and hospital discharge (ß = -0.6 week; 95% CI = -1.1 to -0.1 weeks), greater weight gain (ß = 3.3 g/d; 95% CI = 0.1 to 6.6 g/d), and better neurobehavioral performance than the UCP (ß = 1.2 points; 95% CI = 0.2 to 2.3 points). Furthermore, a higher degree of parental motivation in interventions, goal attainment, and comprehensiveness of home activities was significantly associated with greater effects in infants' neurobehavioral performance and weight gain (r = .20-.31; all Ps < .05). Limitations: The findings may not be generalized to preterm infants with severe perinatal diseases and parents with a low level of interest in interventions. Conclusions: Family-centered care facilitated short-term medical and neurobehavioral outcomes in VLBW preterm infants in Taiwan; the effects were likely achieved through parental adherence to interventions. The designated strategies may be considered in a future launch of family-centered care in Taiwan.
[Mh] Termos MeSH primário: Enfermagem Familiar
Doenças do Prematuro/terapia
Terapia Intensiva Neonatal/organização & administração
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Recém-Nascido de muito Baixo Peso
Masculino
Método Simples-Cego
Taiwan
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE
[do] DOI:10.1093/ptj/pzx089


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[PMID]:28450273
[Au] Autor:Rau HH; Wu YS; Chu CM; Wang FC; Hsu MH; Chang CW; Chen KH; Lee YL; Kao S; Chiu YL; Wen HC; Fuad A; Hsu CY; Chiu HW
[Ad] Endereço:Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
[Ti] Título:Importance-Performance Analysis of Personal Health Records in Taiwan: A Web-Based Survey.
[So] Source:J Med Internet Res;19(4):e131, 2017 Apr 27.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Empowering personal health records (PHRs) provides basic human right, awareness, and intention for health promotion. As health care delivery changes toward patient-centered services, PHRs become an indispensable platform for consumers and providers. Recently, the government introduced "My health bank," a Web-based electronic medical records (EMRs) repository for consumers. However, it is not yet a PHR. To date, we do not have a platform that can let patients manage their own PHR. OBJECTIVE: This study creates a vision of a value-added platform for personal health data analysis and manages their health record based on the contents of the "My health bank." This study aimed to examine consumer expectation regarding PHR, using the importance-performance analysis. The purpose of this study was to explore consumer perception regarding this type of a platform: it would try to identify the key success factors and important aspects by using the importance-performance analysis, and give some suggestions for future development based on it. METHODS: This is a cross-sectional study conducted in Taiwan. Web-based invitation to participate in this study was distributed through Facebook. Respondents were asked to watch an introductory movie regarding PHR before filling in the questionnaire. The questionnaire was focused on 2 aspects, including (1) system functions, and (2) system design and security and privacy. The questionnaire would employ 12 and 7 questions respectively. The questionnaire was designed following 5-points Likert scale ranging from 1 ("disagree strongly") to 5 ("Agree strongly"). Afterwards, the questionnaire data was sorted using IBM SPSS Statistics 21 for descriptive statistics and the importance-performance analysis. RESULTS: This research received 350 valid questionnaires. Most respondents were female (219 of 350 participants, 62.6%), 21-30 years old (238 of 350 participants, 68.0%), with a university degree (228 of 350 participants, 65.1%). They were still students (195 out of 350 participants, 56.6%), with a monthly income of less than NT $30,000 (230 of 350 participants, 65.7%), and living in the North Taiwan (236 of 350 participants, 67.4%), with a good self-identified health status (171 of 350 participants, 48.9%). After performing the importance-performance analysis, we found the following: (1) instead of complex functions, people just want to have a platform that can let them integrate and manage their medical visit, health examination, and life behavior records; (2) they do not care whether their PHR is shared with others; and (3) most of the participants think the system security design is not important, but they also do not feel satisfied with the current security design. CONCLUSIONS: Overall, the issues receiving the most user attention were the system functions, circulation, integrity, ease of use, and continuity of the PHRs, data security, and privacy protection.
[Mh] Termos MeSH primário: Registros Eletrônicos de Saúde/organização & administração
Registros Eletrônicos de Saúde/normas
Internet
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Adulto
Segurança Computacional
Estudos Transversais
Registros Eletrônicos de Saúde/utilização
Feminino
Nível de Saúde
Seres Humanos
Renda
Masculino
Satisfação do Paciente
Privacidade
Reprodutibilidade dos Testes
Taiwan
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.7065


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[PMID]:28468786
[Au] Autor:Chang WT; Chang CL; Ho CH; Hong CS; Wang JJ; Chen ZC
[Ad] Endereço:Department of Cardiology, Chi Mei Medical Center, Tainan, Taiwan.
[Ti] Título:Long-Term Effects of Unprovoked Venous Thromboembolism on Mortality and Major Cardiovascular Events.
[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: Patients with unprovoked venous thromboembolism (VTE) are at an increased risk of mortality, but whether their cardiovascular risks also increase remains to be determined. We aimed to investigate the factors associated with overall mortality and major adverse cardiovascular events in patients with unprovoked VTE. METHODS AND RESULTS: We identified 2154 patients newly diagnosed with unprovoked VTE from Taiwan's National Health Insurance Database between 2000 and 2013, excluding those with reversible etiologies, underlying cancer, or autoimmune diseases. These patients with VTE were compared with an age-, sex-, and cardiovascular risk-matched cohort of 4308 controls. The risk of mortality and major adverse cardiovascular events in patients with VTE was 2.23 (CI, 1.93-2.57; <0.0001) and 1.86 (CI, 1.65-2.09; <0.0001) times, respectively, higher than that of the conditions in controls. These events mostly occurred during the first year after the diagnosis of unprovoked VTE. Among patients with VTE, advanced age, male sex, and comorbid diabetes mellitus indicated a higher incidence of mortality and major adverse cardiovascular events. Conversely, comorbid hyperlipidemia attenuated these risks. CONCLUSIONS: This nation-wide cohort study revealed that patients with unprovoked VTE, particularly older males with diabetes mellitus, had an elevated risk of both mortality and cardiovascular events. Risk of mortality and major adverse cardiovascular events were highest within the first year after diagnosis and persisted during the 10 years of follow-up.
[Mh] Termos MeSH primário: Tromboembolia Venosa/mortalidade
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Comorbidade
Bases de Dados Factuais
Diabetes Mellitus/diagnóstico
Diabetes Mellitus/mortalidade
Feminino
Seres Humanos
Hiperlipidemias/diagnóstico
Hiperlipidemias/mortalidade
Incidência
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Prognóstico
Modelos de Riscos Proporcionais
Fatores de Proteção
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Fatores Sexuais
Taiwan/epidemiologia
Fatores de Tempo
Tromboembolia Venosa/diagnóstico
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]:28455326
[Au] Autor:Lu CY; Huang HC; Chang HH; Yang TH; Chang CJ; Chang SW; Chen PC
[Ad] Endereço:From the Department of Sport and Health Management, Da-Yeh University, Changhua, Taiwan (C.-Y.L.); Department of Chinese Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei, Taiwan (C.-Y.L.); School of Post-Baccalaureate Chinese Medicine (H.-H.C.) and Department of Public Health (P
[Ti] Título:Acupuncture Therapy and Incidence of Depression After Stroke.
[So] Source:Stroke;48(6):1682-1684, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: We investigated whether use of acupuncture within a 3-month poststroke period after hospital discharge is associated with reduced risk of depression. METHODS: This cohort study included 16 046 patients aged ≥18 years with an initial hospitalization for stroke during 2000 and 2012 in the claims database of a universal health insurance program. Patients who had received acupuncture therapies within 3 months of discharge were defined as acupuncture users (n=1714). All patients were followed up for incidence of depression until the end of 2013. We assessed the association between use of acupuncture and incidence of depression using Cox proportional hazards models in all subjects and in propensity score-matched samples consisting of 1714 pairs of users and nonusers. RESULTS: During the follow-up period, the incidence of depression per 1000 person-years was 11.1 and 9.7 in users and nonusers, respectively. Neither multivariable-adjusted Cox models (hazard ratio, 1.04; 95% confidence interval, 0.84-1.29) nor the propensity score-matching model (hazard ratio, 1.06; 95% confidence interval, 0.79-1.42) revealed an association between use of acupuncture and incidence of depression. CONCLUSIONS: In patients admitted to hospital for stroke, acupuncture therapy within 3 months after discharge was not associated with subsequent incidence of depression.
[Mh] Termos MeSH primário: Terapia por Acupuntura/estatística & dados numéricos
Depressão/epidemiologia
Acidente Vascular Cerebral/epidemiologia
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Hospitalização/estatística & dados numéricos
Seres Humanos
Incidência
Masculino
Meia-Idade
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.016959


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[PMID]:29386192
[Au] Autor:Tu H; Wen CP; Tsai SP; Chow WH; Wen C; Ye Y; Zhao H; Tsai MK; Huang M; Dinney CP; Tsao CK; Wu X
[Ad] Endereço:Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
[Ti] Título:Cancer risk associated with chronic diseases and disease markers: prospective cohort study.
[So] Source:BMJ;360:k134, 2018 01 31.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To assess the independent and joint associations of major chronic diseases and disease markers with cancer risk and to explore the benefit of physical activity in reducing the cancer risk associated with chronic diseases and disease markers. DESIGN: Prospective cohort study. SETTING: Standard medical screening program in Taiwan. PARTICIPANTS: 405 878 participants, for whom cardiovascular disease markers (blood pressure, total cholesterol, and heart rate), diabetes, chronic kidney disease markers (proteinuria and glomerular filtration rate), pulmonary disease, and gouty arthritis marker (uric acid) were measured or diagnosed according to standard methods, were followed for an average of 8.7 years. MAIN OUTCOME MEASURES: Cancer incidence and cancer mortality. RESULTS: A statistically significantly increased risk of incident cancer was observed for the eight diseases and markers individually (except blood pressure and pulmonary disease), with adjusted hazard ratios ranging from 1.07 to 1.44. All eight diseases and markers were statistically significantly associated with risk of cancer death, with adjusted hazard ratios ranging from 1.12 to 1.70. Chronic disease risk scores summarizing the eight diseases and markers were positively associated with cancer risk in a dose-response manner, with the highest scores associated with a 2.21-fold (95% confidence interval 1.77-fold to 2.75-fold) and 4.00-fold (2.84-fold to 5.63-fold) higher cancer incidence and cancer mortality, respectively. High chronic disease risk scores were associated with substantial years of life lost, and the highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. The population attributable fractions of cancer incidence or cancer mortality from the eight chronic diseases and markers together were comparable to those from five major lifestyle factors combined (cancer incidence: 20.5% 24.8%; cancer mortality: 38.9% 39.7%). Among physically active (versus inactive) participants, the increased cancer risk associated with chronic diseases and markers was attenuated by 48% for cancer incidence and 27% for cancer mortality. CONCLUSIONS: Chronic disease is an overlooked risk factor for cancer, as important as five major lifestyle factors combined. In this study, chronic diseases contributed to more than one fifth of the risk for incident cancer and more than one third of the risk for cancer death. Physical activity is associated with a nearly 40% reduction in the cancer risk associated with chronic diseases.
[Mh] Termos MeSH primário: Biomarcadores/sangue
Doença Crônica/epidemiologia
Neoplasias/complicações
[Mh] Termos MeSH secundário: Adulto
Artrite Gotosa/epidemiologia
Artrite Gotosa/metabolismo
Doenças Cardiovasculares/complicações
Doenças Cardiovasculares/epidemiologia
Doença Crônica/mortalidade
Complicações do Diabetes
Diabetes Mellitus/epidemiologia
Detecção Precoce de Câncer/métodos
Exercício/fisiologia
Feminino
Seres Humanos
Incidência
Estilo de Vida
Pneumopatias/epidemiologia
Pneumopatias/metabolismo
Pneumopatias/fisiopatologia
Masculino
Meia-Idade
Neoplasias/epidemiologia
Neoplasias/mortalidade
Avaliação de Resultados (Cuidados de Saúde)
Estudos Prospectivos
Insuficiência Renal Crônica/complicações
Insuficiência Renal Crônica/epidemiologia
Fatores de Risco
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k134



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