Adherence to thalidomide in patients with multiple myeloma: A cross-sectional study in a Brazilian metropolis

2021 ◽  
pp. 107815522199352
Author(s):  
Lívia Pena Silveira ◽  
Cristiane A Menezes de Pádua ◽  
Paula Lana de Miranda Drummond ◽  
Jéssica Soares Malta ◽  
Roberta M Marques dos Santos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Metropolitan Region ◽  
Outpatient Clinics ◽  
Southeastern Brazil ◽  
Free Access ◽  
Sectional Study ◽  
Cross Sectional ◽  
Thalidomide Treatment

Purpose The treatment of multiple myeloma (MM) has advanced with the introduction of immunomodulators (IMiDS). Thalidomide is the IMiD available in Brazil with free access to MM patients. Adherence to treatment with IMiDs is essential for a successful therapy. The study proposed to describe adherence to thalidomide treatment in patients diagnosed with MM in onco-hematological outpatient clinics. Methods This is a cross-sectional study with patients over 18 years of age diagnosed with MM undergoing thalidomide treatment. Adherence was measured by the Proportion of Days Covered (PDC), which is an indirect method of measuring adherence that uses database-related medication dispensing information. Patients with PDC ≥90 were classified as adherent. The association between adherence and independent variables was assessed in univariate and multivariate analyses using logistic regression. Results A total of 65 patients with a median age of 62.6 years were identified. The median PDC was 93.7%. The frequency of adherence to thalidomide was 56.9%. Adherence to thalidomide showed a negative association with hospitalization in the last 12 months (OR = 0.202; 95% CI = 0.060–0.687) and with higher schooling (OR =0.161; 95% CI = 0.039–0.667) and a positive association with higher income (OR = 5.115; 95% CI = 1.363–19.190). Conclusion Most patients from onco-hematological outpatient clinics in a metropolitan region of southeastern Brazil showed high adherence to thalidomide, which was independently associated with higher income, hospitalization, and higher schooling. More studies are required to understand better the determinants of adherence to thalidomide in the country.

scholarly journals The Relationships Between Serum DHEA-S and AMH Levels in Infertile Women: A Retrospective Cross-Sectional Study

2021 ◽  
Vol 10 (6) ◽  
pp. 1211
Author(s):  
Li-Te Lin ◽  
Kuan-Hao Tsui
Keyword(s):  
Generalized Linear Models ◽  
Large Scale ◽  
Linear Models ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Dehydroepiandrosterone Sulphate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Infertile Women ◽  
The Relationship

The relationship between serum dehydroepiandrosterone sulphate (DHEA-S) and anti-Mullerian hormone (AMH) levels has not been fully established. Therefore, we performed a large-scale cross-sectional study to investigate the association between serum DHEA-S and AMH levels. The study included a total of 2155 infertile women aged 20 to 46 years who were divided into four quartile groups (Q1 to Q4) based on serum DHEA-S levels. We found that there was a weak positive association between serum DHEA-S and AMH levels in infertile women (r = 0.190, p < 0.001). After adjusting for potential confounders, serum DHEA-S levels positively correlated with serum AMH levels in infertile women (β = 0.103, p < 0.001). Infertile women in the highest DHEA-S quartile category (Q4) showed significantly higher serum AMH levels (p < 0.001) compared with women in the lowest DHEA-S quartile category (Q1). The serum AMH levels significantly increased across increasing DHEA-S quartile categories in infertile women (p = 0.014) using generalized linear models after adjustment for potential confounders. Our data show that serum DHEA-S levels are positively associated with serum AMH levels.

scholarly journals Removable denture is a risk indicator for peri-implantitis and facilitates expansion of specific periodontopathogens: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jasmin Grischke ◽  
Szymon P. Szafrański ◽  
Uthayakumar Muthukumarasamy ◽  
Susanne Haeussler ◽  
Meike Stiesch
Keyword(s):  
Bacterial Species ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Risk Indicators ◽  
Risk Indicator ◽  
Sectional Study ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
Linear Discriminant ◽  
Removable Denture

Abstract Background The prevalence of peri-implantitis ranges between 7 and 38.4% depending on risk indicators such as smoking, diabetes mellitus, lack of periodontal maintenance program, and history or presence of periodontitis. Currently, the possible effect of the type of superstructure on peri-implant health is unclear. This cross-sectional study aims to investigate the influence of the superstructure on the prevalence of peri-implant mucositis, peri-implantitis and peri-implant dysbiosis. Methods During a 32-month recruitment period dental implants were assessed to diagnose healthy peri-implant tissues, mucositis or peri-implantitis. The study included 1097 implants in 196 patients. Out of all peri-implantitis cases 20 randomly chosen submucosal biofilms from implants with fixed denture (FD) originating from 13 patients and 11 biofilms from implants with removable dentures (RD) originating from 3 patients were studied for microbiome analysis. Composition of transcriptionally active biofilms was revealed by RNAseq. Metatranscriptomic profiles were created for thirty-one peri-implant biofilms suffering from peri-implantitis and microbiome changes associated with superstructure types were identified. Results 16.41% of the implants were diagnosed with peri-implantitis, 25.00% of implants with RD and 12.68% of implants with FD, respectively. Multivariate analysis showed a significant positive association on patient (p =  < 0.001) and implant level (p = 0.03) between the prevalence of peri-implantitis and RD. Eight bacterial species were associated either with FD or RD by linear discriminant analysis effect size method. However, significant intergroup confounders (e.g. smoking) were present. Conclusions Within the limitations of the present work, RDs appear to be a risk indicator for peri-implantitis and seem to facilitate expansion of specific periodontopathogens. Potential ecological and pathological consequences of shift in microbiome from RDs towards higher activity of Fusobacterium nucleatum subspecies animalis and Prevotella intermedia require further investigation.

scholarly journals Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043997
Author(s):  
Charilaos Lygidakis ◽  
Jean Paul Uwizihiwe ◽  
Michela Bia ◽  
Francois Uwinkindi ◽  
Per Kallestrup ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Cross Sectional Study ◽  
Diabetes Control ◽  
Outpatient Clinics ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Social Burden

ObjectivesTo report on the disease-related quality of life of patients living with diabetes mellitus in Rwanda and identify its predictors.DesignCross-sectional study, part of the baseline assessment of a cluster-randomised controlled trial.SettingOutpatient clinics for non-communicable diseases of nine hospitals across Rwanda.ParticipantsBetween January and August 2019, 206 patients were recruited as part of the clinical trial. Eligible participants were those aged 21–80 years and with a diagnosis of diabetes mellitus for at least 6 months. Illiterate patients, those with severe hearing or visual impairments, those with severe mental health conditions, terminally ill, and those pregnant or in the postpartum period were excludedPrimary and secondary outcome measuresDisease-specific quality of life was measured with the Kinyarwanda version of the Diabetes-39 (D-39) questionnaire. A glycated haemoglobin (HbA1c) test was performed on all patients. Sociodemographic and clinical data were collected, including medical history, disease-related complications and comorbidities.ResultsThe worst affected dimensions of the D-39 were ‘anxiety and worry’ (mean=51.63, SD=25.51), ‘sexual functioning’ (mean=44.58, SD=37.02), and ‘energy and mobility’ (mean=42.71, SD=20.69). Duration of the disease and HbA1c values were not correlated with any of the D-39 dimensions. A moderating effect was identified between use of insulin and achieving a target HbA1c of 7% in the ‘diabetes control’ scale. The most frequent comorbidity was hypertension (49.0% of participants), which had a greater negative effect on the ‘diabetes control’ and ‘social burden’ scales in women. Higher education was a predictor of less impact on the ‘social burden’ and ‘energy and mobility’ scales.ConclusionsSeveral variables were identified as predictors for the five dimensions of quality of life that were studied, providing opportunities for tailored preventive programmes. Further prospective studies are needed to determine causal relationships.Trial registration numberNCT03376607.

scholarly journals Regular access and adherence to medications of the specialized component of pharmaceutical services

2017 ◽  
Vol 51 ◽  
pp. 109
Author(s):  
Janaína Soder Fritzen ◽  
Fabiane Raquel Motter ◽  
Vera Maria Vieira Paniz
Keyword(s):  
Cross Sectional Study ◽  
Pharmaceutical Services ◽  
Free Access ◽  
Rio Grande Do Sul ◽  
Sectional Study ◽  
Cross Sectional ◽  
Robust Variance ◽  
Free Data ◽  
Drug Policies ◽  
Continuous Use

OBJECTIVE: To investigate the prevalence of the adherence to the medications of the Specialized Component of Pharmaceutical Services and its association with regular access in users of these medications in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil. METHODS: This is a cross-sectional study with adults aged 20 years and over, who are users of medications of the Specialized Component of Pharmaceutical Services. Sampling was carried out consecutively for users who accessed the service of the Specialized Component of Pharmaceutical Services during the period from December 2014 to March 2015. Adherence was measured by the Brief Medication Questionnaire, and adherents were defined as those who did not present barriers to adherence in the three domains. Regular access was defined as getting all edications in the last three months, regardless of how it was obtained (paying or for free). Data analysis was performed using Poisson regression with robust variance. RESULTS: We nterviewed 414 subjects, being them mostly women (60.9%), with mean age of 55 years (SD = 13), and using a single medication of the Specialized Component of Pharmaceutical Services (68.1%). The prevalence of adherence to the medications used in the last seven days was 28.3% and the prevalence of free regular access was 46.1%, and 25.7% did not have access to all treatment. After adjusting for the number of medications in the Specialized Component of Pharmaceutical Services and the number of medications of continuous use, users who had free regular access in the last three months were 60% more likely to show adherence. For individuals with paid regular access, no association was found between access and adherence. CONCLUSIONS: The regularity in the free access to the medications of the Specialized Component of Pharmaceutical Services has an impact on the behavior of users, contributing to their commitment to treatment and self-care. The Specialized Component of Pharmaceutical Services needs programming in order to avoid irregular access, which suggests a significant limitation of the drug policies in Brazil.

scholarly journals Caesarean birth rates in public and privately funded hospitals: a cross-sectional study

2017 ◽  
Vol 51 ◽  
pp. 101 ◽  
Author(s):  
Bruna Dias Alonso ◽  
Flora Maria Barbosa da Silva ◽  
Maria do Rosário Dias de Oliveira Latorre ◽  
Carmen Simone Grilo Diniz ◽  
Debra Bick
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Cross Sectional Study ◽  
University Education ◽  
Southeastern Brazil ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Care Funding

OBJECTIVE: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.

Exploring the relationship of human–nature interaction and mindfulness: a cross-sectional study

2021 ◽  
Author(s):  
Pooja Sahni ◽  
Jyoti Kumar
Keyword(s):  
Mental Health Problems ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
Nature Relatedness ◽  
Relationship Of ◽  
The Relationship ◽  
Nature Experience

History is replete with examples where humans have sought refuge in nature for psychological restoration. In this cross-sectional study we explore the relationship of nature experience and mindfulness. Nature experience is assessed through “nature in the neighbourhood”, “frequency of visit” to nature-rich spaces, as well as one's inherent connection with nature described as “nature relatedness”. The study sample consisted of 334 Indian adults. The findings from this study show that frequency of visit to nature-rich spaces has a significant positive association with mindfulness. The hierarchical regression analysis suggests an interaction effect of “nature relatedness” in the association of the presence of nature rich spaces in the neighbourhood, frequency of visit as well as mindfulness. Interestingly, when childhood experiences were explored they had a significant association with “nature relatedness” and mindfulness. The evidence from this research suggests that nature experience may find its application as one of the mindfulness techniques prescribed for self-management of mental health problems.

scholarly journals Demographic and epidemiological aspects of mortality from penile cancer

2014 ◽  
Vol 27 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Ricarlly Soares da Silva ◽  
Ana Carla Martins da Silva ◽  
Suelayne Gonçalves do Nascimento ◽  
Conceição Maria de Oliveira ◽  
Cristine Vieira do Bonfim
Keyword(s):  
Penile Cancer ◽  
Demographic Data ◽  
Public Information ◽  
Mortality Rates ◽  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Metropolitan Region ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean

OBJECTIVE: Describing the demographic and epidemiological aspects of mortality from cancer of the penis.METHODS: A cross-sectional study consisting of 183 deaths registered in a public information system on mortality that had penile cancer as the primary cause of mortality. It was used descriptive statistics and the mortality rate was calculated.RESULTS: The mean coefficient of mortality was 0.45/100,000 that is an increase of 19.04%. The demographic data revealed a higher prevalence in men aged 60 years or older (50.8%), brown (54.1%), married (47.6%), retired (24%) and residents of the metropolitan region (44.8%).CONCLUSION: The demographic and epidemiological aspects revealed increase of mortality rates from cancer in the penis.

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