scholarly journals Update on Cardiovascular Risk and Obesity in Psoriatic Arthritis

2021 ◽  
Vol 8 ◽  
Author(s):  
Julio Ramírez ◽  
Ana Belén Azuaga-Piñango ◽  
Raquel Celis ◽  
Juan D. Cañete

PsA is characterized by a high prevalence of cardiovascular (CV) comorbidities. Recognizing these comorbidities is critical due to their influence on the quality of life and the choice of therapy. Imaging techniques also play an important role in the evaluation of the CV risk in psoriatic disease, improving the prediction of CV events when combined with clinical scores as a predictive tool. Meta-analyses point to a significant reduction in the incidence of CV events associated with the suppression of inflammatory activity when using systemic therapies. Consequently, the mortality rate in PsA patients has fallen in the last 40 years and is now similar to that of the general population, including cardiovascular causes. Obesity is an especially relevant CV comorbidity in patients with psoriatic disease, most of whom are overweight/obese. Body mass index (BMI) is a risk factor for PsA and a causal relationship with psoriasis has been demonstrated by Mendelian randomized studies. The study of fat distribution shows that patients with psoriasis are characterized by visceral fat accumulation, which correlates with CV risk measurements. These findings suggest that approaches to the prevention and treatment of psoriatic disease might come from targeting adiposity levels, in addition to the immune pathways. Weight loss treatment with low energy diets in patients with PsA has been associated with significant improvements in disease activity. Novel strategies using a multimorbidity approach, focused more on patients outcomes, are necessary to better address comorbidities, improve clinical outcomes and the quality of life of patients with psoriatic disease.

2020 ◽  
Vol 31 (2) ◽  
pp. 62-68
Author(s):  
Sara E. Holm ◽  
Alexander Schmidt ◽  
Christoph J. Ploner

Abstract. Some people, although they are perfectly healthy and happy, cannot enjoy music. These individuals have musical anhedonia, a condition which can be congenital or may occur after focal brain damage. To date, only a few cases of acquired musical anhedonia have been reported in the literature with lesions of the temporo-parietal cortex being particularly important. Even less literature exists on congenital musical anhedonia, in which impaired connectivity of temporal brain regions with the Nucleus accumbens is implicated. Nonetheless, there is no precise information on the prevalence, causes or exact localization of both congenital and acquired musical anhedonia. However, the frequent involvement of temporo-parietal brain regions in neurological disorders such as stroke suggest the possibility of a high prevalence of this disorder, which leads to a considerable reduction in the quality of life.


2017 ◽  
Vol 22 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Bastianina Contena ◽  
Stefano Taddei

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Faiza Siddiqui ◽  
Marija Barbateskovic ◽  
Sophie Juul ◽  
Kiran Kumar Katakam ◽  
Klaus Munkholm ◽  
...  

Abstract Background Major depression significantly impairs quality of life, increases the risk of suicide, and poses tremendous economic burden on individuals and societies. Duloxetine, a serotonin norepinephrine reuptake inhibitor, is a widely prescribed antidepressant. The effects of duloxetine have, however, not been sufficiently assessed in earlier systematic reviews and meta-analyses. Methods/design A systematic review will be performed including randomised clinical trials comparing duloxetine with ‘active’ placebo, placebo or no intervention for adults with major depressive disorder. Bias domains will be assessed, an eight-step procedure will be used to assess if the thresholds for clinical significance are crossed. We will conduct meta-analyses. Trial sequential analysis will be conducted to control random errors, and the certainty of the evidence will be assessed using GRADE. To identify relevant trials, we will search Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, PsycINFO, Science Citation Index Expanded, Social Sciences Citation Index, Conference Proceedings Citation Index—Science and Conference Proceedings Citation Index—Social Science & Humanities. We will also search Chinese databases and Google Scholar. We will search all databases from their inception to the present. Two review authors will independently extract data and perform risk of bias assessment. Primary outcomes will be the difference in mean depression scores on Hamilton Depression Rating Scale between the intervention and control groups and serious adverse events. Secondary outcomes will be suicide, suicide-attempts, suicidal ideation, quality of life and non-serious adverse events. Discussion No former systematic review has systematically assessed the beneficial and harmful effects of duloxetine taking into account both the risks of random errors and the risks of systematic errors. Our review will help clinicians weigh the benefits of prescribing duloxetine against its adverse effects and make informed decisions. Systematic review registration PROSPERO 2016 CRD42016053931


BMJ Leader ◽  
2020 ◽  
pp. leader-2019-000199
Author(s):  
Charleen Singh ◽  
Caitlin Loseth ◽  
Noordeen Shoqirat

The number of women entering medicine significantly increased over the last decades. Currently, over half of the medical students are women but less than half are applying to surgery and even less go on to surgical specialties. Even fewer women are seen in leadership roles throughout the profession of surgery and surgical residency. Our purpose of the literature review is to identify any themes, which would provide insight to the current phenomenon. We used the Preferred Reporting Items for Systemic Reviews and Meta-Analyses method for a systematic review of the literature over a 20-year period (1998–2018). Five broad themes were identified: education and recruitment, career development, impact of/on life around the globe and surgical subspecialties as areas of barriers for women entering or considering surgery. The systematic review suggests there are opportunities to improve and encourage women entering the profession of surgery as well as the quality of life for surgeons. Creating systems for mentorship across programmes, having policies to support work–life balance and recognising surgical training overlaps with childbearing years are key opportunities for improvement. Improving the current status in surgery will require direction from leadership.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhongyi Chen ◽  
Zhaosheng Ding ◽  
Caixia Chen ◽  
Yangfan Sun ◽  
Yuyu Jiang ◽  
...  

Abstract Background Comprehensive geriatric assessment (CGA) interventions can improve functional ability and reduce mortality in older adults, but the effectiveness of CGA intervention on the quality of life, caregiver burden, and length of hospital stay remains unclear. The study aimed to determine the effectiveness of CGA intervention on the quality of life, length of hospital stay, and caregiver burden in older adults by conducting meta-analyses of randomised controlled trials (RCTs). Methods A literature search in PubMed, Embase, and Cochrane Library was conducted for papers published before February 29, 2020, based on inclusion criteria. Standardised mean difference (SMD) or mean difference (MD) with 95% confidence intervals (CIs) was calculated using the random-effects model. Subgroup analyses, sensitivity analyses, and publication bias analyses were also conducted. Results A total of 28 RCTs were included. Overall, the intervention components common in different CGA intervention models were interdisciplinary assessments and team meetings. Meta-analyses showed that CGA interventions improved the quality of life of older people (SMD = 0.12; 95% CI = 0.03 to 0.21; P = 0.009) compared to usual care, and subgroup analyses showed that CGA interventions improved the quality of life only in participants’ age > 80 years and at follow-up ≤3 months. The change value of quality of life in the CGA intervention group was better than that in the usual care group on six dimensions of the 36-Item Short-Form Health Survey questionnaire (SF-36). Also, compared to usual care, the CGA intervention reduced the caregiver burden (SMD = − 0.56; 95% CI = − 0.97 to − 0.15, P = 0.007), but had no significant effect on the length of hospital stay. Conclusions CGA intervention was effective in improving the quality of life and reducing caregiver burden, but did not affect the length of hospital stay. It is recommended that future studies apply the SF-36 to evaluate the impact of CGA interventions on the quality of life and provide supportive strategies for caregivers as an essential part of the CGA intervention, to find additional benefits of CGA interventions.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sergio Hernández-Jiménez

Objective: To evaluate misconceptions about diabetes in people who attend the first visit at the CAIPaDi program, as well as its association with metabolic and psychological variables at short and long term. Methods and Analysis: The frequency of misconceptions in diabetes was determined through a true/false survey. We compared sociodemographic, metabolic and psychological variables between people with and without misconceptions at baseline, at 3 months and 1 year after a multidisciplinary educational program. Results: 902 participants answered the survey, with an age of 50 ±10 years old, 54.3% were women, with 1 (0-5) years living with type 2 diabetes. At baseline, 53% of the participants had at least 1 misconception, being more frequent in women (p=0.045) and in population with lower educational level (p<0.001). The most common were "emotional stress and fright cause diabetes" (34.4%), "in the control of my diabetes only matters glucose management" (15.2%) and "women with diabetes should not get pregnant" (11.8%). At basal, patients with misconceptions had higher HbA1c (9.0 ± 2.6 vs 8.4 ± 2.4, p <0.001), lower quality of life (DQOL 95.2 ± 26.2 vs 90.2 ± 23.6, p = 0.03), more problematic areas in diabetes (41.2 [21.2-58.4] vs 35 [17.5-52.6], p = 0.01), more depression (42.6% vs 32.9%, p = 0.003) and anxiety (58.6% vs 40.6%, p = 0.001) compared to patients without misconceptions. With the exception of HbA1c (6.6 ± 1 vs 6.4 ± 0.8, p = 0.025 at 1 year), no differences were observed in the annual visits. Conclusion: We found a high prevalence of people with misconceptions in diabetes. This group had worst glycaemic control, higher scores in PAID questionnaire, lower quality of life and more depression and anxiety symptoms. Participants with misconceptions had lower educational level. An educative program an educational assistance program can minimize differences by eradicating misconceptions.


2021 ◽  
Vol 39 (10) ◽  
Author(s):  
Nurashikin Saaludin ◽  
Amna Saad ◽  
Cordelia Mason ◽  
Norsaadah Zakaria

Anthropometric data is widely used in various applications such as manufacturing, healthcare, forensics, and medical treatments. In addition, the data can be applied to design ergonomic tools, equipment, clothing, and footwear to ensure that the products, facilities, and services fit the users. This paper aims to analyze the existing literature on the importance of anthropometric data on the Malaysian population's productivity and quality of life and look into any further research that needs improvement. Guided by the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), through Scopus and Web of Science databases, 15 related studies were identified. The review managed to extract six applications of anthropometric data and its seven perceived benefits. Data applications were classified into furniture, clothing and footwear, car seat, fitting and fixture, forensic investigation, and safety products. The benefits were grouped into easy to use, fit, well-being, welfare, safety, work efficiency, and identity verification by using thematic analysis. The review also highlighted the methodological issues related to the number of samples, locations coverage for a survey and the financial support in conducting research. Finally, several recommendations were drawn, including the importance of anthropometric database development at the end of this paper for reference by future scholars.


2018 ◽  
Vol 21 ◽  
pp. S88
Author(s):  
K. Dooley ◽  
M. Drew ◽  
A. Schultz ◽  
S. Snodgrass ◽  
T. Pizzari ◽  
...  

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S5) ◽  
pp. 20-23 ◽  
Author(s):  
Gary W. Small

AbstractThe prevalence of Alzheimer's disease (AD) and dementia continues to rise. However, a significant number of patients are undiagnosed or untreated. Given the complexities of detecting cognitive impairment and the early signs of AD, this review discusses how advances in brain imaging can help assist in improving overall management. Imaging techniques and surrogate markers may provide unique opportunities to diagnose accurately AD in presymptomatic stages with practical consequences for patients, caregivers, and physicians. The possible outcomes for using imaging and surrogate markers as adjuncts to clinical examination and as screening tools for AD, as well as tangible and intangible advantages to early diagnosis and treatment, will be discussed. The specific value of using advanced serial imaging in patients with a genetic disposition to AD will be evaluated. If neurons can be protected from neurodegenerative damage in early stages, this may preserve patient cognition, function, and quality of life, and may confer considerable societal healthcare benefits.


2020 ◽  
Vol 92 (4) ◽  
pp. 9-16
Author(s):  
E. M. Elfimova ◽  
O. O. Mikhailova ◽  
N. T. Khachatryan ◽  
A. Yu. Litvin ◽  
I. E. Сhazova

Relevance. Obstructive sleep apnea syndrome (OSAS) is an important medical and social problem due to its high prevalence and impact on quality of life. The relationship between OSAS and cardiovascular pathology has been proven by many studies, which confirms the necessity for early diagnosis of OSAS and its treatment for the prevention of fatal and non-fatal events.Aim: to study epidemiological and clinical profile of the patients referred by a cardiologist to a specialized sleep laboratory to verify the diagnosis of OSAS.Materials and methods. Object of study 527 patients aged 56.912.5 years who were hospitalized to the Myasnikov Clinical Cardiology Research Institute from 20162018 and had OSAS risk factors. Initially, complaints, medical history, anthropometric data were collected. As a screening survey, questionnaires were conducted using questionnaire scales. Verification of the diagnosis of OSAS and determination of the severity was carried out by cardiorespiratory or respiratory monitoring. Subsequently, 4 groups were formed depending on the presence and severity of OSAS.Results. The prevalence of OSAS among patients in a cardiology hospital referred to a verification study was 88.6%. A comparative analysis of the groups revealed a progressive increase in the values of anthropometric indicators with increasing severity of OSAS. No differences were found between the groups by gender and daytime sleepiness on the Karolinska Sleepiness Scale. The average score on the Epworth sleepiness scale was statistically significantly lower only in the group of patients without OSAS when compared with the group with a severe degree of OSAS, and is comparable with the scores in the groups of mild and moderate degrees of OSAS. In a multivariate model of logistic regression, independent predictors of OSAS were identified as: age over 45 years, indications of loud intermittent snoring, frequent nightly urination, overweight or obesity. According to the results of assessing the incidence of various cardiovascular diseases in patients referred to the sleep laboratory, no significant differences were detected. At the same time, a significant difference was found in the frequency of obesity in patients with severe OSAS compared with other groups, as well as the frequency of type 2 diabetes mellitus or impaired glucose tolerance when compared with groups without OSAS, and with mild OSAS. In one-factor logistic regression models, it was found that the likelihood of having a severe degree of OSAS increases with increasing both comorbidity and age.Conclusions. High prevalence of OSAS in patients of a cardiological hospital, referred to a sleep laboratory for verification study, was confirmed. Considering the data that early diagnosis and treatment of OSAS can affect the course of both nosologies, the quality of life and prognosis of these patients, it is advisable to routinely screen and verify the diagnosis of OSAS in patients with cardiovascular diseases.


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