scholarly journals Overdiagnosis: An unrecognised and growing worldwide problem in healthcare

2017 ◽  
Vol 56 (3) ◽  
pp. 147-149 ◽  
Author(s):  
John Brodersen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cause Of Death ◽  
High Income ◽  
Pharmaceutical Drugs ◽  
Individual Person ◽  
The World ◽  
Disease Mongering ◽  
Definition Of ◽  
The Individual

Abstract Overdiagnosis is the diagnosis of deviations, abnormalities, risk factors, and pathologies that in themselves would never cause symptoms (this applies only to risk factors and pathology), would never lead to morbidity, and would never be the cause of death. Therefore, treating an overdiagnosed condition (deviation, abnormality, risk factor, pathology) cannot, by definition, improve the patient’s prognosis, and can therefore only be harmful. Overdiagnosis is an extremely harmful and big problem all over the world, and the problem is increasing. This is especially the case in high-income countries, where more sensitive tests, more testing, more screening and earlier diagnosis is in focus, and more of the same will be implemented in the future. Moreover, disease definitions have been and are still being widened, plus thresholds for treating, e.g. risk factors, have been and are still being lowered. Finally, disease mongering is growing, because it is cheaper and faster to invent new “diseases” than new pharmaceutical drugs. From the definition of overdiagnosis it can be reasoned that a patient who has been correctly diagnosed and a person who has been overdiagnosed can have the same kind of pathologies. Therefore, at the level of the individual person or patient it can never be verified whether he or she has in fact been correctly diagnosed or overdiagnosed. Therefore, the complexity, dilemmas and pitfalls in understanding what overdiagnosis really is so succinctly captured by this quote from the Danish philosopher S⊘ren Kirkegaard (1813-55): ‘Life can only be understood backwards; but it must be lived forwards’.

Human Rights, Global Ethics, and the Ordinary Virtues

2017 ◽  
Vol 31 (1) ◽  
pp. 3-16 ◽  
Author(s):  
Michael Ignatieff
Keyword(s):  
Human Rights ◽  
United Nations ◽  
Equal Opportunity ◽  
Universal Declaration ◽  
Global Ethics ◽  
Citizen Action ◽  
Individual Person ◽  
The World ◽  
Universal Human Rights ◽  
The Individual

In a 1958 speech at the United Nations, Eleanor Roosevelt took stock of the progress that human rights had made since the proclamation of the Universal Declaration of Human Rights ten years before. Mrs. Roosevelt had chaired the UN committee that drafted the Universal Declaration and had hoped that, in time, it would become “the international Magna Carta of all men everywhere.” Her answer to the question of how to measure human rights progress has become one of the most frequently quoted remarks of the former First Lady: Where, after all, do universal human rights begin? In small places, close to home—so close and so small that they cannot be seen on any maps of the world. Yet they are the world of the individual person; the neighborhood he lives in; the school or college he attends; the factory, farm, or office where he works. Such are the places where every man, woman, and child seeks equal justice, equal opportunity, equal dignity without discrimination. Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.

scholarly journals The impact of obesity on cardiovascular disease risk factor

2018 ◽  
Vol 10 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Arun Kumar
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Sodium Intake ◽  
Action Plan ◽  
Saturated Fat ◽  
The World

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adultswho were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathwaymay provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity inducedinsulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower bloodpressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction inoverall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

scholarly journals Demographic and Risk Factor Differences between Children with “One-Time” and “Repeat” Visits to the Emergency Department for Asthma

2021 ◽  
Vol 18 (2) ◽  
pp. 486
Author(s):  
Pavani Rangachari ◽  
Jie Chen ◽  
Nishtha Ahuja ◽  
Anjeli Patel ◽  
Renuka Mehta
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Risk Factor ◽  
Childhood Asthma ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Primary Research ◽  
Ed Visits ◽  
The Individual

This retrospective study examines demographic and risk factor differences between children who visited the emergency department (ED) for asthma once (“one-time”) and more than once (“repeat”) over an 18-month period at an academic medical center. The purpose is to contribute to the literature on ED utilization for asthma and provide a foundation for future primary research on self-management effectiveness (SME) of childhood asthma. For the first round of analysis, an 18-month retrospective chart review was conducted on 252 children (0–17 years) who visited the ED for asthma in 2019–2020, to obtain data on demographics, risk factors, and ED visits for each child. Of these, 160 (63%) were “one-time” and 92 (37%) were “repeat” ED patients. Demographic and risk factor differences between “one-time” and “repeat” ED patients were assessed using contingency table and logistic regression analyses. A second round of analysis was conducted on patients in the age-group 8–17 years to match another retrospective asthma study recently completed in the outpatient clinics at the same (study) institution. The first-round analysis indicated that except age, none of the individual demographic or risk factors were statistically significant in predicting of “repeat” ED visits. More unequivocally, the second-round analysis revealed that none of the individual factors examined (including age, race, gender, insurance, and asthma severity, among others) were statistically significant in predicting “repeat” ED visits for childhood asthma. A key implication of the results therefore is that something other than the factors examined is driving “repeat” ED visits in children with asthma. In addition to contributing to the ED utilization literature, the results serve to corroborate findings from the recent outpatient study and bolster the impetus for future primary research on SME of childhood asthma.

Subclinical Hypothyroidism as a Risk Factor for Cardiovascular Disease

2021 ◽  
Vol 15 (9) ◽  
pp. 2748-2752
Author(s):  
Roman Evgenyevich Tokmachev ◽  
Andrey Valerievich Budnevsky ◽  
Andrey Yakovlevich Kravchenko ◽  
Tatiana Alexandrovna Chernik ◽  
Sudakov Oleg Valerievich ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Cardiovascular Diseases ◽  
Cause Of Death ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Epidemiological Studies ◽  
Cardiovascular Disorders ◽  
The World

Nowadays, more than 485 million people in the world suffer from cardiovascular diseases (CVD). According to large epidemiological studies, the group of CVD is the leading cause of death in the world. One of the neurohumoral mechanisms that appears to be a risk factor for CVD is thyroid dysfunction. In this regard, in recent years, more and more attention is paid to the study the influence of subclinical hypothyroidism on the occurrence and development of cardiovascular disorders. MeSH words: cardiovascular diseases, subclinical hypothyroidism

Abstract 242: Prevalence Of Hypertension And Associated Anthropometric Risk Factors In Indigenous Adults Of Guatemala

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
MENFIL A ORELLANA-BARRIOS ◽  
Kenneth Nugent ◽  
Camilo Pena ◽  
Herman Sanchez-Barrios ◽  
Jose R Lopez-Gutierrez
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Protective Factor ◽  
Epidemiological Studies ◽  
Descriptive Statistics ◽  
Developing Regions ◽  
Rural Regions ◽  
The World ◽  
Geographical Clustering ◽  
Crude Prevalence

Background: Hypertension epidemiological studies in developing regions of the world like rural Guatemala are lacking. Methods: A sample size of 1,104 subjects (552 females, all 18 years or older) was obtained through quota and geographical clustering in the entire Department of Sololá, Guatemala. Descriptive statistics and logistic regression were used. Results: Average systolic, diastolic and mean arterial pressures were significantly higher in men compared to women (116.24 vs. 113.80 mmHg, 75.24 mmHg vs. 72.69 mmHg, and 88.91 mmHg vs. 86.39 mmHg, respectively; all with p<0.05). The crude prevalence of HT was 12.5 % with no gender differences. Women had a significantly higher mean BMI than men (26.25 vs. 24.71, p< 0.001). An abnormally high WC was found in 12.7% of men and in 50.7% of women. Significant associations were found between the presence of HT, age ≥ 55 years and an elevated WC. The single most important isolated risk factor for HT was age in women (OR 6.76, CI 95% 3.59-12.72) and WC in men (OR 3.23, CI 95% 1.52-6.87). Increased BMIs (≥ 25 to 30 or ≥30) were not associated with HT in this study. Residing in Sololá's capital was a protective factor in women (OR 0.33, CI 95% 0.13-0.83). Conclusion: Hypertension and associated anthropometric risk factors are present in rural regions of Guatemala. Significant associations are found between gender, age ≥ 55 years, and increased WC but not with an increased BMI in this population.

“I,” Singular and Universal

2019 ◽  
pp. 1-33
Author(s):  
Béatrice Longuenesse
Keyword(s):  
Singular Term ◽  
First Person ◽  
Individual Person ◽  
The World ◽  
The Individual

In each instance of its use, “I” refers to just one individual: the individual currently saying the sentence or thinking the proposition in which “I” (or, as the case may be, the first-person inflection of the verb) is in use. At the same time, having available the concept and word “I” is understanding that any other person using “I” thereby refers to herself, the thinker or speaker. Moreover, uses of “I” are not necessarily the expression of an egoistic obsession with our individual person. Some of the sentences in which “I” is in use display a striking combination of the singular character of the word and concept “I” and the universality of the claim we make on others, using the singular term and concept “I.” The chapter explores these contrasting features of “I” in relation to our cognitive and agential access to the world.

scholarly journals Duration of Methicillin-ResistantStaphylococcus aureusCarriage, According to Risk Factors for Acquisition

2006 ◽  
Vol 27 (11) ◽  
pp. 1206-1212 ◽  
Author(s):  
Jonas Marschall ◽  
Kathrin Mühlemann
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
University Hospital ◽  
Modifiable Risk Factor ◽  
Lower Probability ◽  
Increased Risk ◽  
Antibiotics Use ◽  
Definition Of

Objective.To examine the duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage and its determinants and the influence of eradication regimens.Design.Retrospective cohort study.Setting.A 1,033-bed tertiary care university hospital in Bern, Switzerland, in which the prevalence of methicillin resistance amongS. aureusisolates is less than 5%.Patients.A total of 116 patients with first-time MRSA detection identified at University Hospital Bern between January 1, 2000, and December 31, 2003, were followed up for a mean duration of 16.2 months.Results.Sixty-eight patients (58.6%) cleared colonization, with a median time to clearance of 7.4 months. Independent determinants for shorter carriage duration were the absence of any modifiable risk factor (receipt of antibiotics, use of an indwelling device, or presence of a skin lesion) (hazard ratio [HR], 0.20 [95% confidence interval {CI}, 0.09-0.42]), absence of immunosuppressive therapy (HR, 0.49 [95% CI, 0.23-1.02]), and hemodialysis (HR, 0.08 [95% CI, 0.01-0.66]) at the time MRSA was first MRSA detected and the administration of decolonization regimen in the absence of a modifiable risk factor (HR, 2.22 [95% CI, 1.36-3.64]). Failure of decolonization treatment was associated with the presence of risk factors at the time of treatment (P= .01). Intermittent screenings that were negative for MRSA were frequent (26% of patients), occurred early after first detection of MRSA (median, 31.5 days), and were associated with a lower probability of clearing colonization (HR, 0.34 [95% CI, 0.17-0.67]) and an increased risk of MRSA infection during follow-up.Conclusions.Risk factors for MRSA acquisition should be carefully assessed in all MRSA carriers and should be included in infection control policies, such as the timing of decolonization treatment, the definition of MRSA clearance, and the decision of when to suspend isolation measures.

Sex difference in types and distribution of risk factors in ischemic and hemorrhagic stroke

2017 ◽  
Vol 13 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Alijan A Ahangar ◽  
Payam Saadat ◽  
Behzad Heidari ◽  
Seyedeh T Taheri ◽  
Shayan Alijanpour
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Sex Difference ◽  
Cause Of Death ◽  
Associated Factors ◽  
Hemorrhagic Stroke ◽  
Age Group

Background Stroke is the second leading cause of death worldwide and is associated with several risk factors with variable risk factor distribution by population. We report the types and frequency of the associated factors of stroke in north Iran. Methods Consecutive patients with stroke were recruited from 2014 to 2015. The two groups of ischemic and hemorrhagic stroke were compared with respect to age, sex, the prevalence, and distribution of the risk factors. Results Among 230 patients (84.3% ischemic stroke) with mean age of 61.2 years, hypertension (73%), diabetes mellitus (53%), cardiovascular disease (51%), and dyslipidemia (47%) were the most frequent risk factors. Hypertension was significantly more prevalent in males compared with females (88% vs. 60%, OR = 4.91, 95% CI: 2.48–9.71). Hypertension, smoking, and opioid consumption were associated with hemorrhagic stroke. Dyslipidemia was significantly higher in ischemic stroke (OR = 2.65, 95% CI: 1.21–5.8). Overall, 84.3% of stroke occurred in patients aged >50 years (92.8% of women vs. 74.5% of the men, OR = 4.43, 95% CI: 1.93–10.16, p = 0.001). Conclusion Stroke was more prevalent in females; hypertension was more prevalent in males. In the age group less than 50 years old, stroke is more prevalent in men.

scholarly journals The Relationship Between Biomechanical Indicators of the Snatch Technique and Female Weightlifters' Levels

2015 ◽  
Vol 21 (4) ◽  
pp. 218-222 ◽  
Author(s):  
Paulina Szyszka ◽  
Andrzej Mastalerz
Keyword(s):  
Horizontal Displacement ◽  
Biomechanical Analysis ◽  
Maximum Speed ◽  
World Championship ◽  
Margin Of Error ◽  
The World ◽  
The Difference ◽  
Definition Of ◽  
The Individual ◽  
The Relationship

Abstract Introduction. The snatch technique is a discipline in Olympic weightlifting. The lifter has to raise the barbell from the platform directly above their head in one movement. While reviewing the literature on biomechanical analysis of the techniques of weightlifting, one can find positions on the analysis of parameters, such as barbell track, horizontal displacement, and angular positions of the joints in the individual phases of the lifter's movement. Many texts concern female and male lifters taking part in World or European Championships. The parameters of the best competitors are outlined - mostly those who finish in the top five places in competition. Mostly these are parameters regarding male lifters, and less frequently those of female lifters. In the literature review, an overlooked aspect is that of the definition of the diversity of indicators as regards the snatch technique practiced by female lifters depending on score. Material and methods. In the research, registered snatch attempts during the World Championship were used. Videos were used by judges to establish a maximum weight limit for female lifters. The attempts were registered by two cameras and were later digitally processed by the APAS 2000 system. Barbell parameters, maximum speed, average of the bar, and the parameters of the lifter-bar collocation (horizontal displacement of barbell weights and height elevation) were assessed. Results. The analysed attempts show the margin of error for measurement of the average speed of the barbell as 0.03 m/s. The difference in maximum speed of analysed attempts is 15%. The height of clearance of the first-placed female lifter's barbell was 12.7 cm, 30 cm for the last-placed. Conclusions. The sporting level of weightlifting by female lifters influences the analysed biomechanical indicators of the snatch. Those indicators, which are similar in the case of both the World Championship winner and the female lifter who came last, may be described as the average speeds of the barbell. The high sporting level of female lifters performing heavy lifting is characterized by the clearance of the barbell.

scholarly journals COVID-19 and Diabetes Among Comorbidities: A Systematic Review

2020 ◽  
Vol 2 (2) ◽  
pp. 50-60
Author(s):  
Perihan Gurbuz ◽  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Chronic Disease ◽  
Cardiovascular Diseases ◽  
Disease Severity ◽  
Respiratory Diseases ◽  
Smoking Status ◽  
The World ◽  
Novel Coronavirus

The world has been facing a novel coronavirus, COVID-19 pandemic since the beginning of 2020. Until the end of May, 5.9 million confirmed cases and 350.000 deaths have been reported. Diabetes, as a prevalent chronic disease is known to be a risk factor for infection onset and disease severity. In this study, a systematic review has been planned to determine the relation between COVID-19 and diabetes among other comorbidities. For this aim, 564 researches have been determined about the topic and 48 of them have been evaluated in the review. The researches have been done with 91.172 COVID-19 patients, and diabetes ratio among the researches differ from 3.3% to 40%. Besides, age, hypertension, cardiovascular diseases, smoking status, and respiratory diseases have been evaluated in the review as common comorbidities. As a result of the study, diabetes and hypertension have been determined to be important risk factors in COVID-19 onset and severity. However, further detailed multidisciplinary researches about COVID-19, diabetes and comorbidities will be valuable in the COVID-19 pandemic process and future aspects.

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