scholarly journals Toward the Development of Personalized Syndrome Discriminant Systems: A Discriminant System for Hypertension with Liver Yang Hyperactivity Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Guang-yao Shang ◽  
Lei Zhang ◽  
Lin Lin ◽  
Hai-qiang Jiang ◽  
Chao Li ◽  
...  
Keyword(s):  
Management Strategies ◽  
Modern Medicine ◽  
Health Concern ◽  
Rotating Platform ◽  
Metabolic Markers ◽  
Rat Models ◽  
Metabolic Characteristics ◽  
Screening Strategies ◽  
Body Surface Temperature ◽  
Successful Replication

Traditional Chinese medicine has shown promising results in treating the symptoms of hypertension, a major global health concern not yet fully managed by modern medicine. It is, therefore, of high priority to clarify the altered pathophysiology of hypertension in individuals with liver Yang hyperactivity syndrome (HLYH) in response to effective treatments to better understand this disorder. The primary aim of this study was to construct a personalized syndrome discriminant system based on data capable of informing management strategies prior to the initiation of antihypertensive therapy or the implementation of screening strategies in at-risk HLYH. Based on the successful replication of HLYH rat models, we extracted the core discriminant factors of the disorder through the integration of physical signs, biochemical indicators, and metabolic markers. Macro and micro information was correlated to construct a syndrome discriminant system. At the macroscopic level, HLYH rat models characterized by elevated blood pressure were found to be associated with significant changes in water intake, pain threshold, retention time on a rotating platform, and body surface temperature. A total of 27 potential biomarkers and 14 metabolic pathways appeared to reflect the primary metabolic characteristics. Through the integration of these data, we successfully constructed a combined macro-micro personalized syndrome discriminant system, which provides a foundation for research regarding the risk loci of HLYH. Our findings also broaden our understanding of the biological pathways involved in HLYH.

scholarly journals The Gender Pain Gap: gender inequalities in pain across 19 European countries

2021 ◽  
pp. 140349482098746
Author(s):  
Kweku Bimpong ◽  
Katie Thomson ◽  
Courtney L. Mcnamara ◽  
Mirza Balaj ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Public Health ◽  
Chronic Pain ◽  
Management Strategies ◽  
European Countries ◽  
Leg Pain ◽  
Health Concern ◽  
Public Health Issue ◽  
Gender Inequalities ◽  
Arm Pain ◽  
Adjusted Rate

Aims: Chronic pain is increasingly considered to be an international public health issue, yet gender differences in chronic pain in Europe are under-examined. This work aimed to examine gender inequalities in pain across Europe. Methods: Data for 27,552 men and women aged 25–74 years in 19 European countries were taken from the social determinants of health module of the European Social Survey (2014). Inequalities in reporting pain were measured by means of adjusted rate differences (ARD) and relative adjusted rate risks (ARR). Results: At the pooled pan-European level, a greater proportion of women (62.3%) reported pain than men (55.5%) (ARD 5.5% (95% confidence intervals (CI) 4.1, 6.9), ARR 1.10 (95% CI 1.08, 1.13)). These inequalities were greatest for back/neck pain (ARD 5.8% (95% CI 4.4, 7.1), ARR 1.15 (95% CI 1.12, 1.19)), but were also significant for hand/arm pain (ARD 4.6% (95% CI 3.5, 5.7), ARR 1.24 (95% CI 1.17, 1.30)) and foot/leg pain (ARD 2.6% (95% CI 1.5, 3.8), ARR 1.12 (95% CI 1.07, 1.18)). There was considerable cross-national variation in gender pain inequalities across European countries. Conclusions: Significant gender pain inequalities exist across Europe whereby women experience more pain than men. The extent of the gender pain gap varies by country. The gender pain gap is a public health concern and should be considered in future prevention and management strategies.

Caustic and Toxic Ingestions

2017 ◽  
Author(s):  
CDR Thomas Q Gallagher ◽  
CDR Robert L Ricca
Keyword(s):  
Surgical Management ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Tracheobronchial Tree ◽  
High Rate ◽  
Health Concern ◽  
Endoscopic Management ◽  
Caustic Ingestion ◽  
Stricture Formation ◽  
Accidental Ingestion

Ingestion of caustic substances remains a potentially fatal public health concern with extensive morbidity and the possibility of long-term sequelae. The management strategies of these complex injuries continue to be extensively studied in the literature. Areas of interest include the most efficacious treatment of caustic esophageal stricture to preserve the native esophagus, use of steroids, and use of esophageal stents. Prevention of accidental ingestion through strategies to limit the availability of caustic substances is a key factor in reducing the incidence of injury, but there continues to be a high rate of accidental ingestion in developing countries with less rigorous manufacturing standards. Initial evaluation includes endoscopic evaluation of the esophagus and tracheobronchial tree. Optimal treatment strategies, including the use of proton pump inhibitors to reduce gastroesophageal reflux, steroid use to prevent stricture formation, and use of stents for management of strictures, continue to be debated. Initial surgical management includes esophagectomy for full-thickness injury with abdominal exploration. Multiple surgical options exist for both restoration of gastrointestinal continuity after esophagectomy and the management of strictures refractory to medical management, including reverse gastric tube, colonic interposition, and gastric advancement. Numerous small studies have evaluated the efficacy of these interventions, but there continues to be a need for larger prospective studies to develop a worldwide consensus opinion on best practices. We provide a review of the recent literature and practice recommendations for the management of injuries due to caustic ingestion. Key words: caustic ingestion, endoscopic management, stricture, surgical management 

Effecting Superior Pain Management Strategies by Combining Technology With Tradition

2019 ◽  
pp. 631-641
Author(s):  
CK Foo
Keyword(s):  
Pain Management ◽  
Management Strategies ◽  
Psychosocial Interventions ◽  
Modern Medicine ◽  
Modern Technology ◽  
Significant Rise ◽  
The Public ◽  
Physical Disorders ◽  
Control Pain ◽  
Traditional Approaches

Today we are witnessing a significant rise in chronic diseases and chronic pain. Modern medicine appears not to be sufficient to relieve symptoms and reduce or eliminate discomfort. The following proffers the need to look at alternate strategies. In particular, it suggests that a solution might lie if we combine modern technology with ancient wisdom and traditional approaches. This chapter serves to highlight strategies for prudent pain management. “Pain is not just from physical disorders but also from combinations of physiological, pathological, emotional, psychological, cognitive, environmental, and social factors. The keys to successful pain control are the mechanisms that initiate and maintain pain.” “Now, the public and health professionals expect to control pain by using preventive and active strategies, including drugs and physical and psychosocial interventions.” (Holdcroft & Power, 2003).

Infertility Management and Pharmacotherapy: What Every Pharmacist Should Know

2020 ◽  
pp. 089719002093096
Author(s):  
Nicole E. Cieri-Hutcherson ◽  
John Brock Harris ◽  
Lamis R. Karaoui ◽  
Lauren Lakdawala ◽  
Nicole M. Lodise ◽  
...  
Keyword(s):  
Financial Burden ◽  
Management Strategies ◽  
The United States ◽  
Health Care Team ◽  
Health Concern ◽  
Management Options ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Pharmacologic Management ◽  
Education Resource

Infertility is a significant public health concern in the United States. As such, utilization of infertility services, including pharmacotherapeutic treatments, is prevalent, and the role of the pharmacist as part of the health care team is essential. Pharmacists can assist patients by providing education on infertility causes, risk factor mitigation, referrals, nonpharmacologic and pharmacologic management options, navigation of the prescription process, and resource availability for the significant financial burden accompanying infertility treatment. In-depth pharmacotherapeutic information may not be readily available to pharmacists dispensing and counseling on these medications, and infertility management regimens are often varied and complicated requiring more in-depth counseling on use and administration. Given the complexity of infertility management, pharmacists are a valuable patient support and education resource. This article provides an in-depth review of infertility management strategies, both nonpharmacologic and pharmacologic.

scholarly journals Evolution of the Insecticide Target Rdl in African Anopheles Is Driven by Interspecific and Interkaryotypic Introgression

2020 ◽  
Vol 37 (10) ◽  
pp. 2900-2917 ◽  
Author(s):  
Xavier Grau-Bové ◽  
Sean Tomlinson ◽  
Andrias O O’Reilly ◽  
Nicholas J Harding ◽  
Alistair Miles ◽  
...  
Keyword(s):  
Large Scale ◽  
Sequence Data ◽  
Management Strategies ◽  
Natural Populations ◽  
Resistance Mechanisms ◽  
Health Concern ◽  
Malaria Vectors ◽  
Resistance Mutations ◽  
Development Of Resistance ◽  
Evolution Of Resistance

Abstract The evolution of insecticide resistance mechanisms in natural populations of Anopheles malaria vectors is a major public health concern across Africa. Using genome sequence data, we study the evolution of resistance mutations in the resistance to dieldrin locus (Rdl), a GABA receptor targeted by several insecticides, but most notably by the long-discontinued cyclodiene, dieldrin. The two Rdl resistance mutations (296G and 296S) spread across West and Central African Anopheles via two independent hard selective sweeps that included likely compensatory nearby mutations, and were followed by a rare combination of introgression across species (from A. gambiae and A. arabiensis to A. coluzzii) and across nonconcordant karyotypes of the 2La chromosomal inversion. Rdl resistance evolved in the 1950s as the first known adaptation to a large-scale insecticide-based intervention, but the evolutionary lessons from this system highlight contemporary and future dangers for management strategies designed to combat development of resistance in malaria vectors.

scholarly journals Evolution of the insecticide target Rdl in African Anopheles is driven by interspecific and interkaryotypic introgression

2019 ◽  
Author(s):  
Xavier Grau-Bové ◽  
Sean Tomlinson ◽  
Andrias O. O’Reilly ◽  
Nicholas J. Harding ◽  
Alistair Miles ◽  
...  
Keyword(s):  
Large Scale ◽  
Sequence Data ◽  
Management Strategies ◽  
Natural Populations ◽  
Resistance Mechanisms ◽  
Health Concern ◽  
Malaria Vectors ◽  
Resistance Mutations ◽  
Development Of Resistance ◽  
Evolution Of Resistance

AbstractThe evolution of insecticide resistance mechanisms in natural populations of Anopheles malaria vectors is a major public health concern across Africa. Using genome sequence data, we study the evolution of resistance mutations in the resistance to dieldrin locus (Rdl), a GABA receptor targeted by several insecticides, but most notably by the long-discontinued cyclodiene, dieldrin. The two Rdl resistance mutations (296G and 296S) spread across West and Central African Anopheles via two independent hard selective sweeps that included likely compensatory nearby mutations, and were followed by a rare combination of introgression across species (from A. gambiae and A. arabiensis to A. coluzzii) and across non-concordant karyotypes of the 2La chromosomal inversion. Rdl resistance evolved in the 1950s as the first known adaptation to a large-scale insecticide-based intervention, but the evolutionary lessons from this system highlight contemporary and future dangers for management strategies designed to combat development of resistance in malaria vectors.

scholarly journals 736 Current Management Strategies, Perceptions, and Attitudes of the Paediatricians on Childhood Obesity: An Experience from the Middle East

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H Al-Saadi ◽  
A. Al Kamzari ◽  
H Malallah ◽  
N AlSheala ◽  
J Al-Saadi ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Obesity Prevention ◽  
Management Strategies ◽  
Health Concern ◽  
Dietary Advice ◽  
Related Complication ◽  
Childhood Obesity Prevention ◽  
History Of ◽  
History Of Obesity ◽  
Obesity Prevention And Management

Abstract Background Childhood obesity is a public health concern that in expanding globally. Of those aged between 5-19 years in Oman, 32% were found to be overweight in 2016. Method An electronic survey was distributed to in-training and post residency paediatricians in Oman. Results A total of 69 responses met the inclusion criteria and were analysed. 50% of participants were less than 30 years-old (53.6% female). 70% were in training residency (R1, R2 24.6%, R3, R4 36.2%,) and 30% were post residency. 72% had their training in Oman. About half of participants measure child’s weight and Height, however, only 24.4% document BMI and compare with previous records. 75% regularly obtain family history of obesity and related conditions along with dietary intake. More than half of participants were not confident on discussing weight and related complication with the child, but 62.3 % were confident in discussing it with the parents. 50% were confident in initiating treatment for childhood obesity and providing dietary advice. Attitudes towards exposure to childhood obesity and management varied and overall excellent exposure accounted for less than one third of responses (Medical school 21.7%, Residency 26.1%, 27.5%). In general, only 20.6% believe they are confident in managing childhood obesity and only 29% attended seminar or training on childhood obesity. 93% believe there is a need for a more focused training on childhood obesity prevention and management. Conclusions Great efforts need to be targeted towards strengthening Paediatricians’ confidence in childhood obesity prevention and management via in residency-training and continuous professional development.

Concussion in Youth Sport: Developmental Aspects

2019 ◽  
Vol 8 (3) ◽  
pp. 220-228 ◽  
Author(s):  
Tracey Covassin ◽  
Kyle M. Petit ◽  
Morgan Anderson
Keyword(s):  
At Risk ◽  
Management Strategies ◽  
Clinical Signs ◽  
Return To Play ◽  
Health Concern ◽  
Future Research ◽  
Youth Athletes ◽  
Mood Changes ◽  
Wide Range ◽  
Education And Awareness

Sport-related concussion (SRC) is a growing health concern, particularly in younger, at-risk athletic populations. These injuries commonly present with a wide range of clinical signs (i.e., poor coordination, behavioral, mood changes) and symptoms (i.e., headache, dizziness, difficulty concentrating), along with neurocognitive and vestibular/ocular impairments. This review of SRCs in youth athletes focuses on individuals 5–18 years of age and includes an overview of concussion (i.e., definition, signs/symptoms, epidemiology), as well as concussion education and awareness. This is followed by a review of SRC assessment and management strategies, along with common recovery, return-to-play, and treatment approaches. Finally, suggestions are made for future research and recommendations pertaining to SRC in youth athletes.

scholarly journals Siderophore–Antibiotic Conjugate Design: New Drugs for Bad Bugs?

Molecules ◽  
2019 ◽  
Vol 24 (18) ◽  
pp. 3314 ◽  
Author(s):  
Negash ◽  
Norris ◽  
Hodgkinson
Keyword(s):  
Molecular Design ◽  
Modern Medicine ◽  
New Drugs ◽  
Phase Iii ◽  
Health Concern ◽  
Phase Iii Clinical Trials ◽  
Antibiotic Drug ◽  
New Antibiotics ◽  
General Guide ◽  
New Strategies

Antibiotic resistance is a global health concern and a current threat to modern medicine and society. New strategies for antibiotic drug design and delivery offer a glimmer of hope in a currently limited pipeline of new antibiotics. One strategy involves conjugating iron-chelating microbial siderophores to an antibiotic or antimicrobial agent to enhance uptake and antibacterial potency. Cefiderocol (S-649266) is a promising cephalosporin–catechol conjugate currently in phase III clinical trials that utilizes iron-mediated active transport and demonstrates enhanced potency against multi-drug resistant (MDR) Gram-negative pathogens. Such molecules demonstrate that siderophore–antibiotic conjugates could be important future medicines to add to our antibiotic arsenal. This review is written in the context of the chemical design of siderophore–antibiotic conjugates focusing on the differing siderophore, linker, and antibiotic components that make up conjugates. We selected chemically distinct siderophore–antibiotic conjugates as exemplary conjugates, rather than multiple analogues, to highlight findings to date. The review should offer a general guide to the uninitiated in the molecular design of siderophore–antibiotic conjugates.

scholarly journals Diagnosis and management of benign prostatic hyperplasia in primary care

2013 ◽  
Vol 3 (3-S2) ◽  
pp. 92 ◽  
Author(s):  
Simon Tanguay ◽  
Murray Awde ◽  
Gerald Brock ◽  
Richard Casey ◽  
Joseph Kozak ◽  
...  
Keyword(s):  
Primary Care ◽  
Benign Prostatic Hyperplasia ◽  
Primary Care Physicians ◽  
Management Strategies ◽  
Prostatic Hyperplasia ◽  
Health Concern ◽  
Treatment Needs ◽  
Diagnosis And Management ◽  
Aging Men ◽  
American Urological Association

Benign prostatic hyperplasia (BPH), and its clinical manifestation as lower urinarytract symptoms (LUTS), is a major health concern for aging men. There havebeen significant advances in the diagnosis and treatment of BPH in recentyears. There has been a renewed interest in medical therapies and less invasivesurgical techniques. As a consequence, the treatment needs of men withmild to moderate LUTS without evidence of prostate cancer can now be accomplishedin a primary care setting. There are differences in the way urologistsand primary care physicians approach the evaluation and management of LUTSdue to BPH, which is not reflected in Canadian Urological Association (CUA)and American Urological Association (AUA) guidelines. A “shared care” approachinvolving urologists and primary care physicians represents a reasonable andviable model for the care of men suffering from LUTS. The essence of the modelcentres around educating and communicating effectively with the patient onBPH. This article provides primary care physicians with an overview of the diagnosticand management strategies outlined in recent CUA and AUA guidelinesso that they may be better positioned to effectively deal with this patient population.It is now apparent that we must move away from the urologist as thefirst-line physician, and allow primary care physicians to accept a new role inthe diagnosis and management of BPH.

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