scholarly journals The Impact of Ramadan Fasting on the Reduction of PASI Score, in Moderate-To-Severe Psoriatic Patients: A Real-Life Multicenter Study

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 277 ◽  
Author(s):  
Giovanni Damiani ◽  
Abdulla Watad ◽  
Charlie Bridgewood ◽  
Paolo Pigatto ◽  
Alessia Pacifico ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Real Life ◽  
Mtor Inhibitors ◽  
Intermittent Fasting ◽  
Interleukin 17 ◽  
Ramadan Fasting ◽  
Tnf Blockers ◽  
Before And After ◽  
Pasi Score ◽  
The Impact

Fasting during the month of Ramadan consists of alternate abstinence and re-feeding periods (circadian or intermittent fasting). Nothing is currently known on the impact of this kind of fasting on psoriasis. A sample of 108 moderate-to-severe plaque psoriasis patients (aged 42.84 ± 13.61 years, 62 males, 46 females) volunteered to take part in the study. A significant change in the “Psoriasis Area and Severity Index” (PASI) score before and after the Ramadan fasting (mean difference = −0.89 ± 1.21, p < 0.0001) was found. At the multivariate regression, the use of apremilast (p = 0.0009), cyclosporine (p = 0.0003), phototherapy (p = 0.0015), interleukin-17 or IL-17 blockers (p < 0.0001), and tumor necrosis factor or TNF blockers (p = 0.0107) predicted the PASI score before the Ramadan fasting. Disease duration (p = 0.0078), use of apremilast (p = 0.0005), and of mammalian target of rapamycin or mTOR inhibitors (p = 0.0034) resulted in independent predictors of the change in the PASI score before and after the Ramadan fasting. The consumption of cyclosporine (p < 0.0001), phototherapy (p = 0.0015), IL-17 blockers (p < 0.0001), mTOR inhibitors (p = 0.0081), and TNF blockers (p = 0.0017) predicted the PASI score after the Ramadan fasting. These findings reflect the influence of dieting strategy, the biological clock, and circadian rhythm on the treatment of plaque psoriasis.

scholarly journals Changes in the Soundscape of the Public Space Close to a Highway by a Noise Control Intervention

2021 ◽  
Vol 13 (9) ◽  
pp. 5284
Author(s):  
Timothy Van Renterghem ◽  
Francesco Aletta ◽  
Dick Botteldooren
Keyword(s):  
Public Space ◽  
Real Life ◽  
Noise Abatement ◽  
Acoustic Environment ◽  
The Public ◽  
Control Intervention ◽  
Before And After ◽  
Noise Shielding ◽  
Visual Preferences ◽  
The Impact

The deployment of measures to mitigate sound during propagation outdoors is most often a compromise between the acoustic design, practical limitations, and visual preferences regarding the landscape. The current study of a raised berm next to a highway shows a number of common issues like the impact of the limited length of the noise shielding device, initially non-dominant sounds becoming noticeable, local drops in efficiency when the barrier is not fully continuous, and overall limited abatement efficiencies. Detailed assessments of both the objective and subjective effect of the intervention, both before and after the intervention was deployed, using the same methodology, showed that especially the more noise sensitive persons benefit from the noise abatement. Reducing the highest exposure levels did not result anymore in a different perception compared to more noise insensitive persons. People do react to spatial variation in exposure and abatement efficiency. Although level reductions might not be excessive in many real-life complex multi-source situations, they do improve the perception of the acoustic environment in the public space.

scholarly journals Impact Loading During Distracted Running Before and After Auditory Gait Retraining

2018 ◽  
Vol 39 (14) ◽  
pp. 1075-1080 ◽  
Author(s):  
Eric Ching ◽  
Winko An ◽  
Ivan Au ◽  
Janet Zhang ◽  
Zoe Chan ◽  
...  
Keyword(s):  
Visual Feedback ◽  
Impact Loading ◽  
Auditory Feedback ◽  
Loading Rate ◽  
Real Life ◽  
Gait Retraining ◽  
Positive Acceleration ◽  
Before And After ◽  
The Impact ◽  
High Sound

AbstractVisual feedback gait retraining has been reported to successfully reduce impact loading in runners, even when the runners were distracted. However, auditory feedback is more feasible in real life application. Hence, this study compared the peak positive acceleration (PPA), vertical average (VALR) and instantaneous (VILR) loading rate during distracted running before and after a course of auditory feedback gait retraining in 16 runners. The runners were asked to land with softer footfalls with and without auditory feedback. Low or high sound pitch was generated according to the impact of particular footfall, when compared with the preset target. Runners then received a course of auditory gait retraining, and after the gait retraining, runners completed a reassessment. Runners before gait retraining exhibited lower PPA, VALR and VILR with augmented auditory feedback (p<0.049). We found a reduction in PPA, VALR and VILR after gait retraining, regardless of the presence of feedback (p<0.018). However, runners after gait retraining did not demonstrate further reduction in PPA and VALR with auditory feedback (p>0.104). A small effect of auditory feedback on VILR in runners after gait retraining was observed (p=0.032). Real time auditory feedback gait retraining is effective in impact loading reduction, even when the runners were distracted.

scholarly journals Impact of Nutrient Intake on Hydration Biomarkers Following Exercise and Rehydration Using a Clustering-Based Approach

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1276 ◽  
Author(s):  
Colleen X. Muñoz ◽  
Evan C. Johnson ◽  
Laura J. Kunces ◽  
Amy L. McKenzie ◽  
Michael Wininger ◽  
...  
Keyword(s):  
Body Mass ◽  
Nutrient Intake ◽  
Glycemic Load ◽  
Real Life ◽  
Plasma Osmolality ◽  
Urine Specific Gravity ◽  
Body Mass Change ◽  
Urine Color ◽  
Before And After ◽  
The Impact

We investigated the impact of nutrient intake on hydration biomarkers in cyclists before and after a 161 km ride, including one hour after a 650 mL water bolus consumed post-ride. To control for multicollinearity, we chose a clustering-based, machine learning statistical approach. Five hydration biomarkers (urine color, urine specific gravity, plasma osmolality, plasma copeptin, and body mass change) were configured as raw- and percent change. Linear regressions were used to test for associations between hydration markers and eight predictor terms derived from 19 nutrients merged into a reduced-dimensionality dataset through serial k-means clustering. Most predictor groups showed significant association with at least one hydration biomarker: (1) Glycemic Load + Carbohydrates + Sodium, (2) Protein + Fat + Zinc, (3) Magnesium + Calcium, (4) Pinitol, (5) Caffeine, (6) Fiber + Betaine, and (7) Water; potassium + three polyols, and mannitol + sorbitol showed no significant associations with any hydration biomarker. All five hydration biomarkers were associated with at least one nutrient predictor in at least one configuration. We conclude that in a real-life scenario, some nutrients may serve as mediators of body water, and urine-specific hydration biomarkers may be more responsive to nutrient intake than measures derived from plasma or body mass.

scholarly journals Improving physical distancing among healthcare workers in a pediatric intensive care unit

2021 ◽  
pp. 1-21
Author(s):  
Anna C. Sick-Samuels ◽  
Sara Cosgrove ◽  
Clare Rock ◽  
Alejandra Salinas ◽  
Opeyemi Oladapo-Shittu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Healthcare Workers ◽  
Real Life ◽  
Pediatric Intensive Care ◽  
Study Objective ◽  
Before And After ◽  
Small Decline ◽  
The Impact

Abstract Background: Healthcare workers (HCWs) not adhering to physical distancing recommendations is a risk factor for acquisition of severe acute respiratory coronavirus virus 2 (SARS-CoV-2). The study objective was to assess the impact of interventions to improve HCW physical distancing on actual distance between HCWs in a real-life setting. Methods: HCWs voluntarily wore proximity beacons to measure the number and intensity of physical distancing interactions between each other in a pediatric intensive care unit. We compared interactions before and after implementing a bundle of interventions including changes to the layout of workstations, cognitive aids, and individual feedback from wearable proximity beacons. Results: Overall, we recorded 10,788 interactions within 6 feet (∼2 m) and lasting >5 seconds. The number of HCWs wearing beacons fluctuated daily and increased over the study period. On average, 13 beacons were worn daily (32% of possible staff; range, 2–32 per day). We recorded 3,218 interactions before the interventions and 7,570 interactions after the interventions began. Using regression analysis accounting for the maximum number of potential interactions if all staff had worn beacons on a given day, there was a 1% decline in the number of interactions per possible interactions in the postintervention period (incident rate ratio, 0.99; 95% confidence interval, 0.98–1.00; P = .02) with fewer interactions occurring at nursing stations, in workrooms and during morning rounds. Conclusions: Using quantitative data from wearable proximity beacons, we found an overall small decline in interactions within 6 feet between HCWs in a busy intensive care unit after a multifaceted bundle of interventions was implemented to improve physical distancing.

scholarly journals P1855ONLINE PATIENT/CAREGIVER EDUCATION ON HYPERKALEMIA CAN IMPROVE KNOWLEDGE AND COMPETENCE AS WELL AS PROMPT REAL LIFE CHANGES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Amy Larkin ◽  
Don Blatherwick
Keyword(s):  
Heart Failure ◽  
Online Education ◽  
Real Life ◽  
Outcomes Analysis ◽  
High Potassium ◽  
Caregiver Education ◽  
Knowledge Question ◽  
Before And After ◽  
Strict Diet ◽  
The Impact

Abstract Background and Aims Managing hyperkalemia with a strict diet is limiting and difficult for patients. We sought to measure the impact of online education for patients/caregivers on knowledge and confidence as well as prompting change in daily life. Method The patient/caregiver education was designed as 2 online, interactive activities. Both were comprised of text and integrated visuals; the second also included a patient commentary video. Demographic questions were asked prior to starting the education. A knowledge question was asked both before and after the activity to assess learning gains, as well as intent to change and confidence questions at the end. Absolute improvements were calculated for pre/post questions. The activities launched in April and May of 2019, and data collected through October 2019. Results To date, 98,462 learners have participated in the patient/caregiver activity. Activity 1: High Potassium: Causes and reasons to Treat Participants: 60,060 Completers of all questions (included in outcomes analysis): 7,262 Demographics: 59% female; 49% white, non-Hispanic; 66% over the age of 54; 16% have hyperkalemia, 75% were interested in learning more about the condition Knowledge changes: 13% improvement in understanding what causes hyperkalemia (46% pre to 59% post) Intent-to-act: 66% plan to talk to an HCP about next steps for treating hyperkalemia Confidence changes: 82% reported increased confidence understanding why it’s important to treat hyperkalemia Activity 2: It’s Complicated: How to Manage High Potassium and Heart Failure Participants: 38,402 Completers of all questions (included in outcomes analysis): 3,816 Demographics: 60% female; 63% white, non-Hispanic; 69% over the age of 54; 58% were interested in learning more about the condition and 25% have this condition Knowledge changes: 13% improvement in recognizing how potassium levels effect the heart (76% pre to 89% post) Intent-to-act: 64% plan to talk to their healthcare provider about a plan to manage my hyperkalemia Confidence changes: 82% reported increased confidence understanding how important is it to manage my heart failure and hyperkalemia Conclusion The metrics and outcomes gathered in this assessment are a strong indicator that these patient/caregiver-focused online educational activities improved knowledge and confidence, and prompted intent to act by patients/caregivers related to hyperkalemia.

scholarly journals Removal of Procalcitonin and Selected Cytokines during Continuous Veno-Venous Hemodialysis Using High Cutoff Hemofilters in Patients with Sepsis and Acute Kidney Injury

2018 ◽  
Vol 46 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Grzegorz Kade ◽  
Sławomir Literacki ◽  
Agnieszka Rzeszotarska ◽  
Stanisław Niemczyk ◽  
Arkadiusz Lubas
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Interleukin 12 ◽  
Interleukin 17 ◽  
Reactive Protein ◽  
Before And After ◽  
Factor Α ◽  
The Impact ◽  
Necrosis Factor

Introduction: The purpose of this study was to evaluate the impact of continuous veno-venous hemodialysis (CVVHD) using high cutoff (HCO) hemofilters on the removal of procalcitonin (PCT), and other inflammatory markers in the treatment of patients during septic shock with acute kidney injury (AKI). Materials and Methods: Thirty-six patients with septic shock and AKI were included in the study. Before and after the 24-h HCO-CVVHD, PCT, native C-reactive protein (CRP) and cytokines (interleukin-1β, interleukin-6, interleukin-12, interleukin-17, tumor necrosis factor-α) in serum and effluent were assessed. Results: After the HCO-CVVHD serum concentrations of PCT, CRP and selected cytokines were significantly lower. The decrease in PCT was bigger than in CRP (p = 0.007). The change in PCT concentration was significantly influenced by PCT and IL-17 clearances (R2 = 0.525; p < 0.001). Conclusion: In contrast to the native CRP, monitoring of PCT during HCO-CVVHD is less useful because it reflects the clearance of this marker and anti-inflammatory effectiveness of the method.

scholarly journals Impact of Ramadan Intermittent Fasting on the Heart Rate Variability and Cardiovascular Parameters of Patients with Controlled Hypertension

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Sabah Hammoud ◽  
Iman Saad ◽  
Rita Karam ◽  
Fayez Abou Jaoude ◽  
Bart J. F. van den Bemt ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Blood Glucose ◽  
Intermittent Fasting ◽  
Ramadan Fasting ◽  
Hypertensive Patients ◽  
Cardiac Stress ◽  
Lipid Panel ◽  
The Impact

Background. Conflicting results are reported on the effect of Ramadan fasting on the cardiovascular health of patients with hypertension, a highly prevalent cardiovascular disease risk factor. This research aimed to evaluate the impact of fasting on cardiac health and heart rate variability (as a measure of cardiac stress) of hypertensive patients. Methods. Patients with controlled hypertension were followed in a prospective cohort during and after Ramadan. Lipid panel and blood glucose were measured at the end of each phase. Blood pressure and heart rate variability were monitored in the morning, afternoon, and evening of each follow-up day. Results. The study included 58 subjects (mean age: 54 ± 11.5 years, 52% male). Fasting did not affect body composition, lipid panel parameters, and blood pressure of hypertensive subjects; males only presented lower body weight and hip circumference during Ramadan. Blood glucose was significantly higher during Ramadan. Fasting significantly increased HRV during the afternoon period. Conclusions. Ramadan intermittent fasting reduces cardiac stress among hypertensive patients controlled by and adherent to hypertensive medication, without affecting their hypertensive state.

scholarly journals Fasting and Its Impact on Skin Anatomy, Physiology, and Physiopathology: A Comprehensive Review of the Literature

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 249 ◽  
Author(s):  
Nicola Bragazzi ◽  
Maha Sellami ◽  
Iman Salem ◽  
Rosalynn Conic ◽  
Mark Kimak ◽  
...  
Keyword(s):  
Caloric Restriction ◽  
Skin Diseases ◽  
Middle Eastern ◽  
Radical Change ◽  
The Body ◽  
Intermittent Fasting ◽  
Comprehensive Overview ◽  
Economic Implications ◽  
Ramadan Fasting ◽  
The Impact

Skin serves as the first protective line and barrier of the body. Like many other organs, skin can be affected by several disorders in response to external factors such as pathogens, ultraviolet light, and pollution, as well as endogenous alterations related to aging and/or oxidative stress disturbance. Researchers have reported new insights into how skin cells are altered in response to caloric restriction diets in mammals. One of the most well-known caloric restriction diets is the Ramadan intermittent fasting, which is a radical change in the diet plan of practitioners for the period of one lunar month. Ramadan fasting represents the fourth of the five pillars of the Islamic creed. Even though infirm individuals are waived to take part in this religious duty, patients with various health problems, including those with different skin disorders, might choose to share this event with peers and family members. No standardized protocols or guidelines exist, however, to advise their physicians on the proper management of their patients’ condition during fasting. With an increasing Muslim population living in Western countries, this topic has started to draw substantial attention, not only of Middle-Eastern physicians, but also of clinicians in the West. For this purpose, we carried out a comprehensive overview on the topic. Our main findings are that: (1) there is a strong need for evidence-based suggestions and guidance. Literature on the impact of the Ramadan fasting, as well as of other kinds of fasting, on skin diseases is scarce and of poor quality, as well as the information available from the Internet; (2) patients willing to fast should be advised about the importance of taking proper treatments or consider alternative options including administration of trans-dermal/topical drugs, as they are permitted during daylight hours. Further, non-compliance has important, clinical and economic implications for an effective patient management.

Ixekizumab—An Effective and Safe Treatment for Moderate-to-Severe Plaque Psoriasis in Patients Previously Treated With Other IL-17 Inhibitors: Results From IXORA-P

2019 ◽  
Vol 4 (4) ◽  
pp. 180-185 ◽  
Author(s):  
Kim Papp ◽  
Andrew Blauvelt ◽  
John Sullivan ◽  
Yayoi Tada ◽  
Paula Polzer ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Therapeutic Option ◽  
Previous Treatment ◽  
Severity Index ◽  
Interleukin 17 ◽  
Severe Plaque Psoriasis ◽  
Previously Treated ◽  
Double Blinded ◽  
The Impact ◽  
Blinded Trial

Background: The impact of treatment with interleukin 17 (IL-17) inhibitors on the efficacy of subsequent IL-17 inhibitor therapy is unknown. Objective: To evaluate the impact of previous treatment with IL-17 inhibitors on the 52-week efficacy of ixekizumab in patients with moderate-to-severe psoriasis. Methods: In a phase 3, randomized, double-blinded trial (IXORA-P; NCT02513550), patients with moderate-to-severe plaque psoriasis were randomized (2:1:1) to ixekizumab 80 mg every 2 weeks (IXE Q2W, n = 611), every 4 weeks (IXE Q4W, n = 310), or IXE Q4W/IXE Q2W dose adjustment (per predefined criteria; n = 306). Psoriasis Area and Severity Index 75%, 90%, and 100% response rates (PASI 75, PASI 90, and PASI 100) were assessed. Results: Overall, 288 (23.5%) of 1227 patients were IL-17 inhibitor experienced (brodalumab, 22.6%; secukinumab, 1.1%). The PASI 75, 90, and 100 at week 52 were similar between IL-17 inhibitor-naive and IL-17 inhibitor-experienced patients. The PASI 75 at week 52 for IL-17 inhibitor-naive and -experienced patients was 85% and 89% (IXE Q2W), 79% and 81% (IXE Q4W), and 83% and 85% (IXE Q4W/IXE Q2W), respectively. The PASI 90 at week 52 for IL-17 inhibitor-naive and -experienced patients was 79% and 82% (IXE Q2W), 65% and 67% (IXE Q4W), and 73% and 75% (IXE Q4W/IXE Q2W), respectively. The PASI 100 at week 52 for IL-17 inhibitor-naive and -experienced patients was 60% and 59% (IXE Q2W), 44% and 42% (IXE Q4W), and 49% and 52% (IXE Q4W/IXE Q2W), respectively. Safety findings were generally similar between IL-17 inhibitor-naive and -experienced patients. Conclusion: Ixekizumab was demonstrated to be an effective and safe therapeutic option for patients previously treated with other IL-17 inhibitors.

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