Showing papers in "Sage Open Medicine in 2019"
TL;DR: This article illustrates how a framework for a research study design can be used to guide and inform the novice nurse researcher undertaking a study using grounded theory.
Abstract: Background:Grounded theory is a well-known methodology employed in many research studies. Qualitative and quantitative data generation techniques can be used in a grounded theory study. Grounded th...
700 citations
TL;DR: Advances in precision medicine techniques and the development of targeted therapy directed at limiting the excesses of the inflammatory and coagulatory cascades offer potentially viable avenues for future research.
Abstract: There has been a significant evolution in the definition and management of sepsis over the last three decades. This is driven in part due to the advances made in our understanding of its pathophysiology. There is evidence to show that the manifestations of sepsis can no longer be attributed only to the infectious agent and the immune response it engenders, but also to significant alterations in coagulation, immunosuppression, and organ dysfunction. A revolutionary change in the way we manage sepsis has been the adoption of early goal-directed therapy. This involves the early identification of at-risk patients and prompt treatment with antibiotics, hemodynamic optimization, and appropriate supportive care. This has contributed significantly to the overall improved outcomes with sepsis. Investigation into clinically relevant biomarkers of sepsis are ongoing and have yet to yield effective results. Scoring systems such as the sequential organ failure assessment and Acute Physiology and Chronic Health Evaluation help risk-stratify patients with sepsis. Advances in precision medicine techniques and the development of targeted therapy directed at limiting the excesses of the inflammatory and coagulatory cascades offer potentially viable avenues for future research. This review summarizes the progress made in the diagnosis and management of sepsis over the past two decades and examines promising avenues for future research.
214 citations
TL;DR: The definition, pathophysiology, goals of therapy, and treatment agents used in hypertensive disorders of pregnancy are outlined.
Abstract: Hypertensive disorders of pregnancy, an umbrella term that includes preexisting and gestational hypertension, preeclampsia, and eclampsia, complicate up to 10% of pregnancies and represent a significant cause of maternal and perinatal morbidity and mortality. Despite the differences in guidelines, there appears to be consensus that severe hypertension and non-severe hypertension with evidence of end-organ damage need to be controlled; yet the ideal target ranges below 160/110 mmHg remain a source of debate. This review outlines the definition, pathophysiology, goals of therapy, and treatment agents used in hypertensive disorders of pregnancy.
112 citations
TL;DR: These ranked top 10 important research priorities may be used to justify specific research in aortic dissection and to inform healthcare research funding decisions.
Abstract: Objectives:The aim of this study was to establish the top 10 research uncertainties in aortic dissection together with the patient organization Aortic Dissection Association Scandinavia using the J...
91 citations
TL;DR: In asymptomatic women, endometrial polyps may regress spontaneously, in symptomatic women endometrian polyps can be treated safely and efficiently with hysteroscopic excision.
Abstract: Endometrial polyps are overgrowths of endometrial glands that typically protrude into the uterine cavity. Endometrial polyps are benign in nature and affect both reproductive age and postmenopausal women. Although endometrial polyps are relatively common and may be accompanied by abnormally heavy bleeding at menstruation. In asymptomatic women, endometrial polyps may regress spontaneously, in symptomatic women endometrial polyps can be treated safely and efficiently with hysteroscopic excision.
80 citations
TL;DR: Elastic resistance training is able to promote similar strength gains to conventional resistance training, in different population profiles and using diverse protocols, to clarify and quantify the benefits provided by both mode.
Abstract: Given the practicality and low cost of using elastic resistance in training for different populations and its effectiveness in a range of outcomes, a comparison with conventional devices could clar...
58 citations
TL;DR: Six conceptually different multiple imputation methods are described and compared, alongside the commonly used complete case analysis, to explore whether the choice of methodology for handling missing data might impact clinical conclusions drawn from a regression model when data are categorical.
Abstract: Objectives:Missing data is a recurrent issue in many fields of medical research, particularly in questionnaires. The aim of this article is to describe and compare six conceptually different multip...
55 citations
TL;DR: University students, and in particular health science students, represent an appropriate area for health promotion interventions to be established, and study findings showed that health-promoting profiles differed by gender, particularly with respect to physical activity and interpersonal relationships.
Abstract: Objectives:Health promotion is the main strategy for encouraging people to adopt a healthy lifestyle and for preventing non-communicable diseases. Medical students, in particular, are expected to h...
48 citations
TL;DR: The mechanisms in which metformin may elicit its anti-cancerous effects are provided and its potential role as an adjuvant in the management of breast cancer is discussed.
Abstract: Breast cancer is one of the most common malignancies in females. It is an etiologically complex disease driven by a multitude of cellular pathways. The proliferation and spread of breast cancer is intimately linked to cellular glucose metabolism, given that glucose is an essential cellular metabolic substrate and that insulin signalling has mitogenic effects. Growing interest has focused on anti-diabetic agents in the management of breast cancer. Epidemiologic studies show that metformin reduces cancer incidence and mortality among type 2 diabetic patients. Preclinical in vitro and in vivo research provides intriguing insight into the cellular mechanisms behind the oncostatic effects of metformin. This article aims to provide an overview of the mechanisms in which metformin may elicit its anti-cancerous effects and discuss its potential role as an adjuvant in the management of breast cancer.
43 citations
TL;DR: Sleep disturbances were common in this HIV-positive patient cohort, although largely undiagnosed and untreated, and screening for obstructive sleep apnea, depression, and sleep hygiene habits should be part of routine HIV care.
Abstract: Objective:To evaluate sleep disturbances in a diverse, contemporary HIV-positive patient cohort and to identify demographic, clinical, and immune correlates.Methods:A convenience sample of 176 pati...
35 citations
TL;DR: Winter season had a negative effect on vitamin D levels, therefore, adequate precautions should be taken to increase vitamin D, especially during winter, to maintain the best performance of the athletes.
Abstract: Objective:Nowadays, people tend to spend more time in the closed areas and benefit less from sunlight. In this study, we examined the results of vitamin D measurements of athletes from different di...
TL;DR: Nutritional status of pregnant women as indicated by maternal anthropometry and hemoglobin level was associated with birth weight of the baby, and nutritional status of the pregnant women should be improved to reduce the risk of low birth weight.
Abstract: Back ground:Maternal nutritional status influences the developmental environment of the fetus which consequently affects the birth weight of the newborn. However, the association between maternal n...
TL;DR: The results of this study indicated that 80% methanol extract and solvent fractions of the leaves of V. amygdalina demonstrated promising antimalarial activity and corroborated the folklore use of this plant for the treatment of malaria in ethnomedicine in Ethiopia.
Abstract: Background:Vernonia amygdalina Del. (Asteraceae) is reported to be traditionally used for the treatment of malaria. Based on folkloric repute of this plant in Ethiopian traditional medicine and cru...
TL;DR: Evidence shows that e-cigarettes can have detrimental effects on several cell lines and animal models with their flavourings and nicotine content implicated; this has, however, not translated into major health outcomes after 3.5 years follow-up but has been linked to chronic lung disease and cardiovascular disease.
Abstract: Introduction:E-cigarettes are an alternative to traditional tobacco-based cigarettes. While having considerable societal awareness, conflicting evidence exists to support their claims that they are...
TL;DR: Ankle-brachial index can be used for diagnosis of peripheral arterial disease with some precautions and can also be a prognostic indicator for cardiovascular morbidity and mortality and its prognostic value.
Abstract: Diabetes mellitus is a systemic disease affecting microvascular and macrovascular systems and is considered as the strongest risk factor for peripheral arterial disease. Although the prevalence of the peripheral arterial disease is high among people living with diabetes, its severity is not accurately detected with the prevalent diagnostic methodologies. The ankle-brachial index measurement is a simple, objective, and reliable tool for diagnosis of peripheral arterial disease. However, it is of limited value in the diagnosis of peripheral arterial disease among diabetic patients due to its low sensitivity among diabetic individuals. Diabetes mellitus results in atherosclerosis and calcification of peripheral arterial walls leading to false normal ankle-brachial index values. Therefore, healthcare practitioners should be careful not to misinterpret ankle-brachial index results among diabetic patients. A literature search was conducted using the keywords "ankle-brachial index," "interpretation," "limitations," "diabetic foot," and "peripheral arterial disease" on different medical search engines. The results were manually scanned and then further reviewed to select the articles related to our topic of discussion. This article will review the use of ankle-brachial index measurement among diabetic patients, its limitations and its prognostic value. In Conclusion, Ankle-brachial index can be used for diagnosis of peripheral arterial disease with some precautions (e.g. raising the threshold of diagnosis or using the lowest systolic pressure value measured at the ankle) and can also be a prognostic indicator for cardiovascular morbidity and mortality.
TL;DR: The risk of drug therapy problem is found to increase with the use of more than three drugs, and this area requires special attention and the cooperation of healthcare professionals to tackle it.
Abstract: Background:Pharmacotherapy is important in reducing morbidity and mortality related to cardiovascular diseases. However, these advantages are limited by drug therapy problems that can impact on a p...
TL;DR: Perceived HIV-related stigma is moderately high among people living with HIV/AIDS, and low education, disclosure concerns, spousal or household abandonment and social exclusion are the significant contributors.
Abstract: Introduction:HIV/AIDS-related stigma remains an essential barrier to the formulated care delivery and improved quality of life of people living with HIV/AIDS in sub-Saharan Africa. Only a few studi...
TL;DR: The age of adolescents, place of residence, having a snack, and mother’s occupation was significantly associated with stunting and thinness, and having at least a one-time snack in addition to the usual diet is strongly recommended.
Abstract: Objective:This study was aimed at assessing socio-demographic and economic factors associated with nutritional status of adolescent school girls in Lay Guyint Woreda, Northwest Ethiopia.Methods:The...
TL;DR: There is inadequate understanding of both sex and gender differences in drug use in older men and women with dementia, and it is important that future work includes sex- or gender-based analysis of drug use.
Abstract: Purpose:To date, research studies in most disciplines have not made sex-based analysis a priority despite increasing evidence of its importance. We now understand that both sex and gender impact me...
TL;DR: If one could create a B. animalis–producing mycosporin-like amino acids via genetic open reading frame engineering it should exert more potent immuno-stimulatory properties and, thereby, become a potent strain-specific microbial based therapy in colorectal cancer prevention.
Abstract: Colorectal cancer is the third most common cancer and the third leading cause of cancer-related death. The pathogensesis of colorectal cancer involves a multi-step and multi-factorial process. Disruption of the gut microbiota has been associated with gastrointestinal diseases such as colorectal cancer. The genus Bifidobacterium is considered an important component of the commensal microbiota and plays important roles in several homeostatic functions: immune, neurohormonal, and metabolic. Bifidobacterium animalis subsp. lactis is a well-documented probiotic within the species Bifidobacterium. Mycosporin-like amino acids are low molecular weight amino acids demonstrated to exert prebiotic effects and to modulate host immunity by regulating the proliferation and differentiation of intestinal epithelial cells, macrophages and lymphocytes, as well as cytokine production.Their modulation of the metabolism of the immune system and transcription factors could exert a beneficial effect on colorectal cancer. B. animalis does not produce mycosporin-like amino acids. If one could create a B. animalis-producing mycosporin-like amino acids via genetic open reading frame engineering it should exert more potent immuno-stimulatory properties and, thereby, become a potent strain-specific microbial based therapy in colorectal cancer prevention.
TL;DR: Significant number of diabetes mellitus patients living in rural areas did not adhere to diabetic self-care activities, and individualized diabetic lifestyle education programs in follow-up clinics should target these population groups to improve self- care.
Abstract: Objectives:Diabetes mellitus is a metabolic disorder of major public health importance due to its prevalence and potential health complication. The success of long-term maintenance therapy of diabe...
TL;DR: A high prevalence of potential DIs among hospitalized cardiac patients in medical wards due to the complexity of pharmacotherapy is demonstrated and close monitoring of hospitalized patients is highly recommended.
Abstract: Background:Concomitant use of several drugs for a patient is often imposing increased risk of drug–drug interactions. Drug–drug interactions are a major cause for concern in patients with cardiovas...
TL;DR: The Brief 2-Way SSS was found to have good psychometric properties in this sample of older adults and provided support for the importance of examining the influence of separable elements of social support on psychological outcomes in older adults.
Abstract: Objectives:This study aimed to explore the relationship between well-being and perceived stress, and the functional dimensions of social support in older adults.Method:Data from 306 older adults we...
TL;DR: Most of the Nepalese women, especially in the rural areas of far-western Nepal, are forced to follow the harmful menstrual practices because of the socio-cultural context surrounding their lives.
Abstract: Objective:Unhealthy menstrual practices and the contexts surrounding them should be explored and clearly understood; this information could be useful while developing and implementing interventions...
TL;DR: Light is shed on the importance of relational factors and psychosocial vulnerabilities in pain clinical practice and an attachment-informed approach to pain will help health professionals to offer adequate support during procedures and to increase effectiveness of interventions.
Abstract: Pain experience is a negative complex phenomenon influenced by several mechanisms. Attachment processes may affect the way in which individuals experience and signal pain. Hence, in the last two decades, the role of attachment quality has drawn attention in pain research and practice. However, previous reviews on this topic focused on adulthood and/or specific types or pain. We conducted a narrative review examining the association between attachment and different pain conditions from infancy to adolescence. Two independent researchers searched scientific databases for relevant papers. A total of 17 articles were included. Results highlight the following: (a) children and adolescents with chronic idiopathic pain showed low rates of attachment security compared to control groups; (b) pain conditions are consistently associated with elevated rates of at-risk pattern of attachment and information processing; and (c) the presence of unresolved trauma or loss is higher in children and adolescent who experienced pain compared to healthy controls. Despite the significance of these empirical evidences, the impact of caregiving environment and interpersonal context on pain experience in infancy and preschool age is poorly investigated compared to adulthood. Research on pain and attachment needs to be extended since the majority of the studies are limited to specific pain conditions. Future research should investigate the role of anxious attachment on procedural pain and transition from acute to chronic pain, testing new conceptual models. These findings shed light on the importance of relational factors and psychosocial vulnerabilities in pain clinical practice. An attachment-informed approach to pain will help health professionals to offer adequate support during procedures and to increase effectiveness of interventions. A developmental perspective is needed to integrate familial and relational contribution into a multimodal assessment and treatment of pain. Longitudinal studies are recommended.
TL;DR: A brief practical guide to episode-based cost analysis and some examples of episode grouper products is provided for an audience of health services researchers and managers in public health settings who perform or commission cost-of-illness studies with the US healthcare claims fee-for-service data but lack familiarity with episode groupers.
Abstract: Despite the prominence of episode groupers for analysis and reimbursement in US payer settings, peer-reviewed articles using episode groupers for cost-of-illness analysis that informs public health research and decision-making are uncommon. This article provides a brief practical guide to episode-based cost analysis and offers some examples of episode grouper products. It is intended for an audience of health services researchers and managers in public health settings who perform or commission cost-of-illness studies with the US healthcare claims fee-for-service data but lack familiarity with episode groupers.
TL;DR: There is suboptimal use of pulmonary function test in a primary care setting for diagnosis of chronic obstructive pulmonary disease and substantial errors in diagnosis.
Abstract: Objectives:Over 380 million people in the world live with chronic obstructive pulmonary disease, and it is the third leading cause of death in the United States. Despite updated guidelines, there m...
TL;DR: Present review was dedicated to discuss potential usage of cardioneuroablation in patients with vagally mediated functional atrioventricular block.
Abstract: An increase in parasympathetic tone may be the main cause of some transient or permanent atrioventricular block cases. Some of these patients, defined as vagally mediated functional atrioventricular block, may be severely symptomatic and refractory to conventional therapies and may necessitate cardiac pacing. Cardioneuroablation is a relatively new strategy for management of patients with excessive vagal activation based on radiofrequency catheter ablation of main ganglionated plexi around the heart. Present review was dedicated to discuss potential usage of cardioneuroablation in patients with vagally mediated functional atrioventricular block.
TL;DR: The role of the innate immune system in rheumatoid arthritis and systemic lupus erythematosus pathophysiology is not only important in early stages but is essential to maintain the immune response and to allow disease progression.
Abstract: Rheumatoid arthritis and systemic lupus erythematosus are two highly prevalent autoimmune diseases that generate disability and low quality of life. The innate immune system, a long-forgotten issue...
TL;DR: High levels of leisure-time physical activity and low levels of sedentary behavior were both inversely associated with the cardiometabolic variables analyzed; however, the two variables when evaluated in conjunction appear to produce more consistent associations, particularly when sedentarybehavior is evaluated according to leisure-based screen time.
Abstract: Objectives:To assess associations, both individually and in combination, between leisure-time physical activity and sedentary behavior, and cardiometabolic health.Methods:This cross-sectional study...