scholarly journals Association Between Long-Term Aspirin Use and Frailty in Men: The Physicians’ Health Study

2020 ◽  
Author(s):  
Ariela R Orkaby ◽  
Laiji Yang ◽  
Alyssa B Dufour ◽  
Thomas G Travison ◽  
Howard D Sesso ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Health Study ◽  
Statistical Control ◽  
Logistic Regression Models ◽  
Regular Aspirin ◽  
Anti Inflammatory ◽  
Definition Of ◽  
Reported Data

Abstract Background Chronic inflammation may lead to frailty, however the potential for anti-inflammatory medications such as aspirin to prevent frailty is unknown. We sought to examine the association between long-term aspirin use and prevalent frailty. Methods We included 12 101 men ≥60 years who participated in the Physicians’ Health Study I, a completed aspirin randomized controlled trial (1982–1989). Annual questionnaires collected self-reported data on daily aspirin use, lifestyle, and clinical variables. Average aspirin use was summed into 2 categories: ≤60 days/year and >60 days/year. Frailty was assessed using a 33-item index 11 years after trial completion. A score of ≥0.21 was considered frail. Propensity score inverse probability of treatment weighting was used for statistical control of confounding. Logistic regression models estimated odds of frailty as a function of categories of average aspirin use. Results Mean age was 70.5 years (range 60–101). Following an average of 11 ± 0.6 years of follow-up, aspirin use was reported as ≤60 days/year for 15%; 2413 participants (20%) were frail. Frequency of aspirin use was associated with smoking, alcohol consumption, hypertension, and cardiovascular disease, but negatively associated with bleeding and Coumadin use. The odds ratio (95% confidence intervals) for frailty was 0.85 (0.76–0.96) for average aspirin use >60 days/year versus aspirin use ≤60 days/year. Results were similar using an alternate definition of frailty. Conclusions Long-term regular aspirin use is inversely associated with frailty among older men, even after consideration of multimorbidity and health behaviors. Work is needed to understand the role of medications with anti-inflammatory properties on aging.

Influence of Long-term Non-Aspirin NSAID use on Risk of Frailty in Men ≥60 years: The Physicians’ Health Study

2022 ◽  
Author(s):  
Ariela R Orkaby ◽  
Rachel Ward ◽  
Jiaying Chen ◽  
Akshay Shanbhag ◽  
Howard D Sesso ◽  
...  
Keyword(s):  
Propensity Score ◽  
Frailty Index ◽  
Health Study ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Propensity Score Adjustment

Abstract Background Inflammation is a central pathway leading to frailty but whether commonly used non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) can prevent frailty is unknown. Methods Prospective cohort study of male physicians ≥60 who participated in the Physicians’ Health Study. Annual questionnaires collected data on NSAID use, lifestyle and morbidity. Average annual NSAID use was categorized as 0 days/year, 1-12 days/year, 13-60 days/year, and >60 days/year. Frailty was assessed using a validated 33-item frailty index. Propensity score inverse probability of treatment weighting was used to address confounding by indication and logistic regression models estimated odds ratios (ORs) of prevalent frailty according to non-aspirin NSAID use. Results 12,101 male physicians were included (mean age 70±7 years, mean follow-up 11 years). Reported NSAID use was 0 days/year for 2,234, 1-12 days/year for 5,812, 13-60 days/year for 2,833, and >60 days/year for 1,222 participants. 2,413 participants (20%) were frail. Higher self-reported NSAID use was associated with greater alcohol use, smoking, arthritis, hypertension, and heart disease, while less NSAID use was associated with coumadin use and prior bleeding. After propensity score adjustment, all characteristics were balanced. ORs (95% CIs) of prevalent frailty were 0.90 (0.80-1.02), 1.02 (0.89-1.17), and 1.26 (1.07-1.49) for average NSAID use of 1-12 days/year, 13-60 days/year, and >60 days/year, compared to 0 days/year (p-trend<0.001). Conclusions Long term use of NSAIDs at high frequency is associated with increased risk of frailty among older men. Additional study is needed to understand the role of anti-inflammatory medication in older adults and its implication for overall health.

Long-Term Aspirin Use and Self-Reported Walking Speed in Older Men: The Physicians’ Health Study

2021 ◽  
pp. 1-6
Author(s):  
A.R. Orkaby ◽  
A.B. Dufour ◽  
L. Yang ◽  
H.D. Sesso ◽  
J.M. Gaziano ◽  
...  
Keyword(s):  
Walking Speed ◽  
Multinomial Logistic Regression ◽  
Controlled Trial ◽  
Older Men ◽  
Mobility Limitation ◽  
Health Study ◽  
Logistic Regression Models ◽  
Post Trial ◽  
Propensity Score Adjustment

Background: Mobility limitation is a component of frailty that shares a bidirectional relationship with cardiovascular disease (CVD). Data are limited on the role of established CVD prevention therapies, such as aspirin, for prevention of frailty and mobility limitation. Objectives: Examine the association between long-term aspirin use and walking speed. Design, Setting, Participants: Prospective cohort of 14,315 men who participated in the Physicians’ Health Study I, a completed randomized controlled trial of aspirin (1982-1988), with extended post-trial follow-up. Measurements: Annual questionnaires collected data on aspirin use, lifestyle and other factors. Average annual aspirin use was categorized for each participant: ≤60 days/year and >60 days/year. Mobility was defined according to self-reported walking pace, categorized as: don’t walk regularly (reference), easy/casual <2mph, normal ≥2-2.9mph, or brisk/very brisk ≥3mph. Propensity scoring balanced covariates between aspirin categories. Multinomial logistic regression models estimated odds of being in each self-reported walking category. Results: Mean age was 70±8 years; mean aspirin use 11 years. There were 2,056 (14.3%) participants who reported aspirin use ≤60 days/year. Aspirin use >60 days/year was associated with drinking alcohol, smoking, hypertension, heart disease and stroke, while ≤60 days/year was associated with anticoagulation use and bleeding history. In all, 13% reported not walking regularly, 12% walked <2 mph, 44% walked ≥2-2.9 mph, and 31% walked ≥3 mph. After propensity score adjustment, regular aspirin use was associated with a faster walking speed. Odds ratios (95% confidence intervals) were 1.16 (0.97 to 1.39), 1.24 (1.08 to 1.43), and 1.40 (1.21 to 1.63) for <2 mph, ≥2-2.9 mph and ≥3 mph, respectively, compared to not walking regularly (p-trend<0.001). Conclusions: In this cohort of older men, long-term aspirin use is associated with a greater probability of faster walking speed later in life.

The Role of Knowledge Management (KM) in Aged Care Informatics

Big Data ◽  
2016 ◽  
pp. 1668-1686
Author(s):  
Margee Hume ◽  
Craig Hume ◽  
Paul Johnston ◽  
Jeffrey Soar ◽  
Jon Whitty
Keyword(s):  
Knowledge Management ◽  
Management Practice ◽  
Aged Care ◽  
Social Infrastructure ◽  
Care Giving ◽  
Aged Care Facilities ◽  
Definition Of

Aged care is projected to be the fastest-growing sector within the health and community care industries (Reynolds, 2009). Strengthening the care-giving workforce, compliance, delivery, and technology is not only vital to our social infrastructure and improving the quality of care, but also has the potential to drive long-term economic growth and contribute to the Gross Domestic Product (GDP). This chapter examines the role of Knowledge Management (KM) in aged care organizations to assist in the delivery of aged care. With limited research related to KM in aged care, this chapter advances knowledge and offers a unique view of KM from the perspective of 22 aged care stakeholders. Using in-depth interviewing, this chapter explores the definition of knowledge in aged care facilities, the importance of knowledge planning, capture, and diffusion for accreditation purposes, and offers recommendations for the development of sustainable knowledge management practice and development.

Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury: The role of Helicobacter pylori

1992 ◽  
Vol 102 (6) ◽  
pp. 1899-1905 ◽  
Author(s):  
David S. Loeb ◽  
Nicholas J. Talley ◽  
David A. Ahlquist ◽  
Herschel A. Carpenter ◽  
Alan R. Zinsmeister
Keyword(s):  
Helicobacter Pylori ◽  
Drug Use ◽  
Inflammatory Drug ◽  
Anti Inflammatory

scholarly journals A Translational Perspective of Maternal Immune Activation by SARS-CoV-2 on the Potential Prenatal Origin of Neurodevelopmental Disorders: The Role of the Cholinergic Anti-inflammatory Pathway

2021 ◽  
Vol 12 ◽  
Author(s):  
José Javier Reyes-Lagos ◽  
Eric Alonso Abarca-Castro ◽  
Juan Carlos Echeverría ◽  
Hugo Mendieta-Zerón ◽  
Alejandra Vargas-Caraveo ◽  
...  
Keyword(s):  
Immune Activation ◽  
Neurodevelopmental Disorders ◽  
Inflammatory Pathway ◽  
Maternal Immune Activation ◽  
Increased Risk ◽  
Anti Inflammatory ◽  
Psychophysiological Data

The emergent Coronavirus Disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) could produce a maternal immune activation (MIA) via the inflammatory response during gestation that may impair fetal neurodevelopment and lead to postnatal and adulthood mental illness and behavioral dysfunctions. However, so far, limited evidence exists regarding long-term physiological, immunological, and neurodevelopmental modifications produced by the SARS-CoV-2 in the human maternal-fetal binomial and, particularly, in the offspring. Relevant findings derived from epidemiological and preclinical models show that a MIA is indeed linked to an increased risk of neurodevelopmental disorders in the offspring. We hypothesize that a gestational infection triggered by SARS-CoV-2 increases the risks leading to neurodevelopmental disorders of the newborn, which can affect childhood and the long-term quality of life. In particular, disruption of either the maternal or the fetal cholinergic anti-inflammatory pathway (CAP) could cause or exacerbate the severity of COVID-19 in the maternal-fetal binomial. From a translational perspective, in this paper, we discuss the possible manifestation of a MIA by SARS-CoV-2 and the subsequent neurodevelopmental disorders considering the role of the fetal-maternal cytokine cross-talk and the CAP. Specifically, we highlight the urgent need of preclinical studies as well as multicenter and international databanks of maternal-fetal psychophysiological data obtained pre-, during, and post-infection by SARS-CoV-2 from pregnant women and their offspring.

scholarly journals Effect of Early Initiation of Combination Therapy of Anti-Inflammatory and Anti-Fibrotic Drugs on Post COVID-19 Interstitial Lung Disease: A Case Report

2021 ◽  
Vol 7 (3) ◽  
Keyword(s):  
Case Report ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Oral Prednisone ◽  
Evidence Based ◽  
Limited Evidence ◽  
Anti Inflammatory ◽  
Short Time

The persistence of lung parenchymal changes Post COVID-19 is increasingly recognized as a vital outcome observed on some patients recovering from SARS-CoV2 infection with limited evidence-based management so far. Here we present a 64-year-old male developed extensive interstitial lung changes post SARS-CoV2 infection and was successfully managed with oral prednisone, pirfenidone, and azithromycin maintenance regimen with significant improvement in his clinical and radiographic parameters noted within a relatively short time. The role of a combined therapeutic approach with anti-inflammatory and anti-fibrotic drugs might be provocative action in patients with COVID-19 related interstitial lung disease, especially those at risk for persistent long-term abnormalities and pulmonary fibrosis development.

scholarly journals Varenicline and Bupropion for Long-Term Smoking Cessation (the MATCH Study): Protocol for a Real-World, Pragmatic, Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Laurie Zawertailo ◽  
Tara Mansoursadeghi-Gilan ◽  
Helena Zhang ◽  
Sarwar Hussain ◽  
Bernard Le Foll ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Real World ◽  
Smoking Status ◽  
Controlled Trial ◽  
Health Study ◽  
Open Label ◽  
Randomized Controlled

BACKGROUND Varenicline and bupropion are efficacious, prescription-only pharmacotherapies for smoking cessation; however, their real-world impact is limited by prescriber knowledge, affordability, and accessibility. OBJECTIVE The primary objective of the MATCH (Medication Aids for Tobacco Cessation Health) study was to evaluate the real-world, long-term effectiveness of mailed bupropion and varenicline in a sample of interested smokers with the utilization of Web-based recruitment and follow-up. In addition, the study aims to investigate the genotypic and phenotypic predictors of cessation. METHODS This is a two-group, parallel block, randomized (1:1) open-label clinical trial. This study will be conducted online with the baseline enrollment through the study’s website and follow-up by emails. In addition, medication prescriptions will be filled by the study contract pharmacy and couriered to participants. Individuals who smoke ≥10 cigarettes per day and intend to quit within the next 30 days will be recruited through Public Health Units and Tobacco Control Area Networks throughout Ontario by word-of-mouth and the internet. Eligible participants will receive an email with a prescription for 12-week assigned medication and a letter to take to their physician. The recruitment and randomization will continue until 500 participants per arm have received medication. All participants will receive weekly motivational emails during the treatment phase. The primary outcome measure is the smoking status after 6 months, biochemically confirmed by mailed-in salivary cotinine. Follow-ups will be conducted through emails after 4, 8, 12, 26, and 52 weeks of starting the treatment to assess the smoking prevalence and continuous smoking abstinence. In addition, mailed-in saliva samples will be used for genetic and nicotine metabolism analyses. Furthermore, personality characteristics will be assessed using the Big Five Aspect Scales. RESULTS The project was funded in 2014 and enrollment was completed in January 2017. Data analysis is currently underway. CONCLUSIONS To the best of our knowledge, this is the first randomized controlled trial to mass distribute prescription medications for smoking cessation. We expect this method to be logistically feasible and cost effective with quit outcomes that are comparable to published clinical trials. CLINICALTRIAL ClinicalTrials.gov NCT02146911; https://clinicaltrials.gov/ct2/show/NCT02146911 (Archived by WebCite at http://www.webcitation.org/72CZ6AvXZ) REGISTERED REPORT IDENTIFIER RR1-10.2196/10826

scholarly journals Why does a subsidiary need a strategy?

2021 ◽  
Vol 83 (2) ◽  
pp. 285-290
Author(s):  
T. V. Lutchenko ◽  
A. I. Khorev ◽  
I. A. Khorev ◽  
V. V. Grigorieva
Keyword(s):  
Competitive Advantages ◽  
Market Penetration ◽  
Sustainable Competitive Advantage ◽  
Accurate Definition ◽  
Market Niche ◽  
Marketing Service ◽  
Definition Of ◽  
Integrated Structures

A feature of the formation of Russian integrated structures is that they were formed by state structures - shareholders - without taking into account the opinion of those enterprises that entered them. However, the enterprises included in these structures would like to benefit from such integration. The basis for the effective operation of an enterprise in the long term is a sustainable competitive advantage, which it can obtain either through low costs or through product differentiation. Since the majority of subsidiaries do not have developed strategies, it becomes necessary to develop such strategies. Additional competitive advantages due to the implementation of focused strategies of the enterprise included in the integrated structures can be obtained only through the establishment of relationships between themselves, as well as enterprises and the parent company. The maximum competitive advantages will be gained by those enterprises as part of integrated structures that will be able to discover and profitably use relationships with other enterprises of this structure, but operating in related areas of activity. The role of the marketing service is also important in the formation of a focused strategy. The necessary market conditions for the implementation of focused strategies are the most accurate definition of consumer needs, the size and prospects of the market segment, a low number of competitors and sufficient resources to serve the segment. The main risks are determined by overflowing the market niche, reducing the differences between the needs of the segment and the entire market, changing prices in the segment towards the general market, penetration into the segment of competitors.

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