Pub Date : 2024-08-23eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_343_23
Behnam Honarvar, Kamran B Lankarani, Hassan Joulaei, Saeed Shahabi, Milad Ahmadi Marzaleh, Yasamin Khosravaninezhad, Fatemeh Shaygani, Yasamin Kaheni, Niloofar R Rad
Background: A decade after the implementation of the Urban Family Physician Program (UFFP) in Fars province, southern Iran, we aimed to reveal people's opinions regarding the strengths and challenges of this program, which help policymakers for evidence-based improvement of this program.
Methods: In this thematic content analysis qualitative study, which was performed in 2023, one adult individual of each family under the coverage of UFPP was selected using a purposeful sampling method. Then, an in-depth and semi-structured phone interview was conducted with each participant. Interviews were continued until the achievement of data saturation. The trustworthiness of data was checked according to Guba and Lincoln criteria. Data analysis was accomplished using MAXQDA software version 10.
Results: A total of 25 participants with a mean age of 41 ± 12 years old were interviewed. Extracted strengths points of UFPP consisted of 390 meaning units, 41 open codes, 16 subcategories, 9 categories, and 3 themes, of which the main themes consisted of proper governance, adequate service provision, and promoting community health. In contrast, the challenges of this program comprised 127 meaning units, 54 open codes, 17 subcategories, 7 categories, and 3 themes, the main themes of which included weak governance, inefficient service provision, and limitation of resources.
Conclusions: After a decade of implementation, people demonstrated contradictory opinions about many aspects of UFPP. Strength points should encourage policymakers to advocate more for this program and extend it to the other provinces of Iran, whereas weak points should be used for its revisions and improvement.
{"title":"Urban Family Physician Program after a Decade of Implementation from the Perspective of People: A Qualitative Study from Iran.","authors":"Behnam Honarvar, Kamran B Lankarani, Hassan Joulaei, Saeed Shahabi, Milad Ahmadi Marzaleh, Yasamin Khosravaninezhad, Fatemeh Shaygani, Yasamin Kaheni, Niloofar R Rad","doi":"10.4103/ijpvm.ijpvm_343_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_343_23","url":null,"abstract":"<p><strong>Background: </strong>A decade after the implementation of the Urban Family Physician Program (UFFP) in Fars province, southern Iran, we aimed to reveal people's opinions regarding the strengths and challenges of this program, which help policymakers for evidence-based improvement of this program.</p><p><strong>Methods: </strong>In this thematic content analysis qualitative study, which was performed in 2023, one adult individual of each family under the coverage of UFPP was selected using a purposeful sampling method. Then, an in-depth and semi-structured phone interview was conducted with each participant. Interviews were continued until the achievement of data saturation. The trustworthiness of data was checked according to Guba and Lincoln criteria. Data analysis was accomplished using MAXQDA software version 10.</p><p><strong>Results: </strong>A total of 25 participants with a mean age of 41 ± 12 years old were interviewed. Extracted strengths points of UFPP consisted of 390 meaning units, 41 open codes, 16 subcategories, 9 categories, and 3 themes, of which the main themes consisted of proper governance, adequate service provision, and promoting community health. In contrast, the challenges of this program comprised 127 meaning units, 54 open codes, 17 subcategories, 7 categories, and 3 themes, the main themes of which included weak governance, inefficient service provision, and limitation of resources.</p><p><strong>Conclusions: </strong>After a decade of implementation, people demonstrated contradictory opinions about many aspects of UFPP. Strength points should encourage policymakers to advocate more for this program and extend it to the other provinces of Iran, whereas weak points should be used for its revisions and improvement.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_360_23
Justin Vianey Mercado Embalsado
{"title":"Positive Mental Health Promotion to Address Suicide Rates: Hope Intervention on Suicide.","authors":"Justin Vianey Mercado Embalsado","doi":"10.4103/ijpvm.ijpvm_360_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_360_23","url":null,"abstract":"","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_344_23
Mohammad-Rafi Bazrafshan, Helia Yarbakhsh
{"title":"The Role of Internet Addiction Recovery Camps in Addressing Digital Dependency.","authors":"Mohammad-Rafi Bazrafshan, Helia Yarbakhsh","doi":"10.4103/ijpvm.ijpvm_344_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_344_23","url":null,"abstract":"","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_351_23
Justin Vianey M Embalsado
{"title":"Adverse Impact of Socioeconomic Status and Economic Issues on Mental Health in the Philippines.","authors":"Justin Vianey M Embalsado","doi":"10.4103/ijpvm.ijpvm_351_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_351_23","url":null,"abstract":"","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Countries possessing robust primary healthcare (PHC) systems typically yield superior health outcomes, reduced inequality, and diminished healthcare expenses for their citizens. Moreover, PHC demonstrates a direct correlation with the efficient utilization of resources. However, the allocation of financial resources dedicated to PHC varies significantly among countries and lacks explicit clarity. Therefore, this paper aims to conduct a review of published literature to ascertain the extent of resource allocation to PHC across diverse nations. In addition, it aims to explore associated factors, challenges, and mechanisms influencing this allocation.
Methods: This scoping review protocol will adopt the Joanna Briggs Institute's scoping review methodology, which was updated in 2020. It will leverage library studies and refer to reputable databases. The inclusion criteria will include studies conducted between January 2000 and December 2023, focusing on criteria, amounts, mechanisms, and challenges associated with financial resource allocation to PHC globally. In addition, studies must be published in either English and Persian. Studies lacking full-text availability will be excluded from the review. Mendeley software will be utilized to organize and manage the collected studies. The study selection process will be visually depicted using the PRISMA-SCR diagram. Conventional content analysis will be employed to analyze the studies.
Conclusions: Considering the position and role of primary health care in promoting the health of society, by implementing this protocol, the data obtained from the proposed scoping review will enable the managers and officials of the health system to follow the experiences of different countries in the field of scientific and fair allocation of financial resources to PHC, reinforcing Universal Health Coverage (UHC).
{"title":"Allocation of Financial Resources to Primary Healthcare: A Scoping Review Protocol.","authors":"Somayeh Mahdiyan, Reza Rezayatmand, Mostafa Amini-Rarani, Nasrin Shaarbafchizadeh","doi":"10.4103/ijpvm.ijpvm_264_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_264_23","url":null,"abstract":"<p><strong>Background: </strong>Countries possessing robust primary healthcare (PHC) systems typically yield superior health outcomes, reduced inequality, and diminished healthcare expenses for their citizens. Moreover, PHC demonstrates a direct correlation with the efficient utilization of resources. However, the allocation of financial resources dedicated to PHC varies significantly among countries and lacks explicit clarity. Therefore, this paper aims to conduct a review of published literature to ascertain the extent of resource allocation to PHC across diverse nations. In addition, it aims to explore associated factors, challenges, and mechanisms influencing this allocation.</p><p><strong>Methods: </strong>This scoping review protocol will adopt the Joanna Briggs Institute's scoping review methodology, which was updated in 2020. It will leverage library studies and refer to reputable databases. The inclusion criteria will include studies conducted between January 2000 and December 2023, focusing on criteria, amounts, mechanisms, and challenges associated with financial resource allocation to PHC globally. In addition, studies must be published in either English and Persian. Studies lacking full-text availability will be excluded from the review. Mendeley software will be utilized to organize and manage the collected studies. The study selection process will be visually depicted using the PRISMA-SCR diagram. Conventional content analysis will be employed to analyze the studies.</p><p><strong>Conclusions: </strong>Considering the position and role of primary health care in promoting the health of society, by implementing this protocol, the data obtained from the proposed scoping review will enable the managers and officials of the health system to follow the experiences of different countries in the field of scientific and fair allocation of financial resources to PHC, reinforcing Universal Health Coverage (UHC).</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_288_23
Mojtaba Iravani, Reza Khadivi
Background: The second phase of the health sector reform, called the Health Sector Evolution Plan (HSEP), has been implemented in Iran since 2014, aims to improve the equity and quality of health services. In the present study, we aimed to measure the trend of hospitalization and the crude intrahospital mortality rate from 1 year before the HSEP implementation (2013) to 5 years after the HSEP implementation (2018) in public hospitals compared with profit, nonprofit, and charity hospitals, which are affiliated with the Isfahan University of Medical Sciences (MUI).
Methods: In a prospective, cross-sectional study, the data related to the frequency of hospitalized patients and intrahospital mortality during the time of hospitalization were collected through census sampling from 39 public hospitals as the exposed hospitals and 20 profit, nonprofit, and charity hospitals as the control hospitals.
Results: After HSEP implementation, the frequency of hospitalization increased in public hospitals by 50.45% compared with the previous period. Although the crude intrahospital mortality rate increased from 12.61 to 12.93 per 1000 hospitalized patients (an increase of 2.54%) in public hospitals, the raise was not significant (P value = 0.348). The frequency of hospitalization increased in Social Security Organization's (SSO) hospitals as well as charity hospitals. However, the percent of decrease in the intrahospital mortality rates were -42.96%, -34.76%, and -18.47% in the private, charity, and SSO hospitals, respectively, but was not significant (P value > 0.05).
Conclusions: The crude intrahospital mortality rates in public hospitals affiliated with MUI did not change significantly after the implementation of the HSEP.
{"title":"Intrahospital Mortality Rate after the Implementation of the Second Phase of the Health Sector Reform in Comparison with Before that in Iran.","authors":"Mojtaba Iravani, Reza Khadivi","doi":"10.4103/ijpvm.ijpvm_288_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_288_23","url":null,"abstract":"<p><strong>Background: </strong>The second phase of the health sector reform, called the Health Sector Evolution Plan (HSEP), has been implemented in Iran since 2014, aims to improve the equity and quality of health services. In the present study, we aimed to measure the trend of hospitalization and the crude intrahospital mortality rate from 1 year before the HSEP implementation (2013) to 5 years after the HSEP implementation (2018) in public hospitals compared with profit, nonprofit, and charity hospitals, which are affiliated with the Isfahan University of Medical Sciences (MUI).</p><p><strong>Methods: </strong>In a prospective, cross-sectional study, the data related to the frequency of hospitalized patients and intrahospital mortality during the time of hospitalization were collected through census sampling from 39 public hospitals as the <i>exposed</i> hospitals and 20 profit, nonprofit, and charity hospitals as the <i>control</i> hospitals.</p><p><strong>Results: </strong>After HSEP implementation, the frequency of hospitalization increased in public hospitals by 50.45% compared with the previous period. Although the crude intrahospital mortality rate increased from 12.61 to 12.93 per 1000 hospitalized patients (an increase of 2.54%) in public hospitals, the raise was not significant (<i>P</i> value = 0.348). The frequency of hospitalization increased in Social Security Organization's (SSO) hospitals as well as charity hospitals. However, the percent of decrease in the intrahospital mortality rates were -42.96%, -34.76%, and -18.47% in the private, charity, and SSO hospitals, respectively, but was not significant (<i>P</i> value > 0.05).</p><p><strong>Conclusions: </strong>The crude intrahospital mortality rates in public hospitals affiliated with MUI did not change significantly after the implementation of the HSEP.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_346_23
Maryam Rastegar, Eisa Nazar, Mohammad Taghi Shakeri, Vahid Fakoor, Mahshid Nasehi, Saeed Sharafi
Background: Smear-positive pulmonary tuberculosis (SPPTB) is a significant public health concern in Iran. This registry-based study aimed to investigate the incidence rates of SPPTB in Iran from 2018 to 2022.
Methods: The study analyzed SPPTB cases using the Spatial Lag Model to investigate the spatial distribution of SPPTB incidence rates, income inequality, and delayed diagnosis across the provinces of Iran and mapped the results using GIS maps.
Results: The study found that SPPTB is prevalent among older individuals and males. The analysis identified significant spatial variation in the distribution of SPPTB incidence rates, income inequality, and delayed diagnosis across the provinces. The highest incidence rate of SPPTB was found in Sistan and Baluchestan Province and Golestan provinces. The study found a positive association between income inequalities, measured by the Gini index, and SPPTB incidence rates, indicating that provinces with higher income inequality may have higher incidence rates of SPPTB. The negative correlation with delayed diagnosis implies that predominantly, SPPTB cases are identified in the early months.
Conclusions: The study highlights the need to address socioeconomic disparities in health outcomes and implement targeted interventions in areas with higher income inequality to reduce the burden of SPPTB in Iran. Despite decreased SPPTB incidence rates in Iran over the past decade, some regions, such as Sistan and Baluchestan, still have high incidence rates. The Iranian government has implemented policies and programs to reduce income inequality and delayed diagnosis within the country, which can contribute to reducing the burden of SPPTB.
{"title":"Spatial Distribution of Smear-Positive Pulmonary Tuberculosis Incidence Rates in Iran: A Registry-Based Study (2018-2022).","authors":"Maryam Rastegar, Eisa Nazar, Mohammad Taghi Shakeri, Vahid Fakoor, Mahshid Nasehi, Saeed Sharafi","doi":"10.4103/ijpvm.ijpvm_346_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_346_23","url":null,"abstract":"<p><strong>Background: </strong>Smear-positive pulmonary tuberculosis (SPPTB) is a significant public health concern in Iran. This registry-based study aimed to investigate the incidence rates of SPPTB in Iran from 2018 to 2022.</p><p><strong>Methods: </strong>The study analyzed SPPTB cases using the Spatial Lag Model to investigate the spatial distribution of SPPTB incidence rates, income inequality, and delayed diagnosis across the provinces of Iran and mapped the results using GIS maps.</p><p><strong>Results: </strong>The study found that SPPTB is prevalent among older individuals and males. The analysis identified significant spatial variation in the distribution of SPPTB incidence rates, income inequality, and delayed diagnosis across the provinces. The highest incidence rate of SPPTB was found in Sistan and Baluchestan Province and Golestan provinces. The study found a positive association between income inequalities, measured by the Gini index, and SPPTB incidence rates, indicating that provinces with higher income inequality may have higher incidence rates of SPPTB. The negative correlation with delayed diagnosis implies that predominantly, SPPTB cases are identified in the early months.</p><p><strong>Conclusions: </strong>The study highlights the need to address socioeconomic disparities in health outcomes and implement targeted interventions in areas with higher income inequality to reduce the burden of SPPTB in Iran. Despite decreased SPPTB incidence rates in Iran over the past decade, some regions, such as Sistan and Baluchestan, still have high incidence rates. The Iranian government has implemented policies and programs to reduce income inequality and delayed diagnosis within the country, which can contribute to reducing the burden of SPPTB.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_5_23
Mina Gholami, Natalie Coleman-Fuller, Mahsa Salehirad, Sepideh Darbeheshti, Majid Motaghinejad
Diabetes is a chronic endocrine disorder that negatively affects various body systems, including the nervous system. Diabetes can cause or exacerbate various neurological disorders, and diabetes-induced neurodegeneration can involve several mechanisms such as mitochondrial dysfunction, activation of oxidative stress, neuronal inflammation, and cell death. In recent years, the management of diabetes-induced neurodegeneration has relied on several types of drugs, including sodium-glucose cotransporter-2 (SGLT2) inhibitors, also called gliflozins. In addition to exerting powerful effects in reducing blood glucose, gliflozins have strong anti-neuro-inflammatory characteristics that function by inhibiting oxidative stress and cell death in the nervous system in diabetic subjects. This review presents the molecular pathways involved in diabetes-induced neurodegeneration and evaluates the clinical and laboratory studies investigating the neuroprotective effects of gliflozins against diabetes-induced neurodegeneration, with discussion about the contributing roles of diverse molecular pathways, such as mitochondrial dysfunction, oxidative stress, neuro-inflammation, and cell death. Several databases-including Web of Science, Scopus, PubMed, Google Scholar, and various publishers, such as Springer, Wiley, and Elsevier-were searched for keywords regarding the neuroprotective effects of gliflozins against diabetes-triggered neurodegenerative events. Additionally, anti-neuro-inflammatory, anti-oxidative stress, and anti-cell death keywords were applied to evaluate potential neuronal protection mechanisms of gliflozins in diabetes subjects. The search period considered valid peer-reviewed studies published from January 2000 to July 2023. The current body of literature suggests that gliflozins can exert neuroprotective effects against diabetes-induced neurodegenerative events and neuronal dysfunction, and these effects are mediated via activation of mitochondrial function and prevention of cell death processes, oxidative stress, and inflammation in neurons affected by diabetes. Gliflozins can confer neuroprotective properties in diabetes-triggered neurodegeneration, and these effects are mediated by inhibiting oxidative stress, inflammation, and cell death.
糖尿病是一种慢性内分泌疾病,会对包括神经系统在内的多个身体系统产生负面影响。糖尿病可导致或加重各种神经系统疾病,糖尿病诱发的神经退行性变可能涉及多种机制,如线粒体功能障碍、氧化应激激活、神经元炎症和细胞死亡。近年来,治疗糖尿病诱发的神经退行性变主要依靠几种药物,其中包括钠-葡萄糖共转运体-2(SGLT2)抑制剂,也称为格列酮类。除了在降低血糖方面发挥强大作用外,格列酮类药物还具有很强的抗神经炎症特性,可通过抑制糖尿病患者神经系统中的氧化应激和细胞死亡发挥作用。本综述介绍了糖尿病诱导的神经退行性变所涉及的分子通路,并评估了格列酮嗪类药物对糖尿病诱导的神经退行性变的神经保护作用的临床和实验室研究,讨论了线粒体功能障碍、氧化应激、神经炎症和细胞死亡等不同分子通路的作用。我们在多个数据库(包括 Web of Science、Scopus、PubMed、Google Scholar 以及 Springer、Wiley 和 Elsevier 等多家出版商)中搜索了有关格列酮嗪对糖尿病引发的神经退行性事件的神经保护作用的关键词。此外,还应用了抗神经炎症、抗氧化应激和抗细胞死亡等关键词,以评估格列酮嗪对糖尿病患者神经元的潜在保护机制。检索期间考虑了 2000 年 1 月至 2023 年 7 月期间发表的经同行评审的有效研究。目前的文献表明,格列酮嗪类药物可对糖尿病诱导的神经退行性事件和神经元功能障碍发挥神经保护作用,这些作用是通过激活线粒体功能和防止受糖尿病影响的神经元的细胞死亡过程、氧化应激和炎症介导的。格列酮嗪类药物可对糖尿病引发的神经退行性病变产生神经保护作用,这些作用是通过抑制氧化应激、炎症和细胞死亡来实现的。
{"title":"Neuroprotective Effects of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors (Gliflozins) on Diabetes-Induced Neurodegeneration and Neurotoxicity: A Graphical Review.","authors":"Mina Gholami, Natalie Coleman-Fuller, Mahsa Salehirad, Sepideh Darbeheshti, Majid Motaghinejad","doi":"10.4103/ijpvm.ijpvm_5_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_5_23","url":null,"abstract":"<p><p>Diabetes is a chronic endocrine disorder that negatively affects various body systems, including the nervous system. Diabetes can cause or exacerbate various neurological disorders, and diabetes-induced neurodegeneration can involve several mechanisms such as mitochondrial dysfunction, activation of oxidative stress, neuronal inflammation, and cell death. In recent years, the management of diabetes-induced neurodegeneration has relied on several types of drugs, including sodium-glucose cotransporter-2 <b>(</b>SGLT2) inhibitors, also called gliflozins. In addition to exerting powerful effects in reducing blood glucose, gliflozins have strong anti-neuro-inflammatory characteristics that function by inhibiting oxidative stress and cell death in the nervous system in diabetic subjects. This review presents the molecular pathways involved in diabetes-induced neurodegeneration and evaluates the clinical and laboratory studies investigating the neuroprotective effects of gliflozins against diabetes-induced neurodegeneration, with discussion about the contributing roles of diverse molecular pathways, such as mitochondrial dysfunction, oxidative stress, neuro-inflammation, and cell death. Several databases-including Web of Science, Scopus, PubMed, Google Scholar, and various publishers, such as Springer, Wiley, and Elsevier-were searched for keywords regarding the neuroprotective effects of gliflozins against diabetes-triggered neurodegenerative events. Additionally, anti-neuro-inflammatory, anti-oxidative stress, and anti-cell death keywords were applied to evaluate potential neuronal protection mechanisms of gliflozins in diabetes subjects. The search period considered valid peer-reviewed studies published from January 2000 to July 2023. The current body of literature suggests that gliflozins can exert neuroprotective effects against diabetes-induced neurodegenerative events and neuronal dysfunction, and these effects are mediated via activation of mitochondrial function and prevention of cell death processes, oxidative stress, and inflammation in neurons affected by diabetes. Gliflozins can confer neuroprotective properties in diabetes-triggered neurodegeneration, and these effects are mediated by inhibiting oxidative stress, inflammation, and cell death.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06eCollection Date: 2024-01-01DOI: 10.4103/ijpvm.ijpvm_88_23
Babak Amra, Masoud Mansouri, Forogh Soltaninejad, Awat Feizi, Marta Kaminska
The prevalence of obstructive sleep apnea syndrome (OSA) increases in women during pregnancy and negatively affects maternal and fetal outcomes. The updated systematic review and meta-analysis aimed to evaluate the validity of the Berlin, STOP-Bang, and Epworth sleepiness scale (ESS) questionnaires in detecting OSA in pregnant women. PubMed, Embase, and Web of Science were searched systematically up to March 2022. After eligible studies inclusion, two independent reviewers extracted demographic and clinical data. Bivariate random effects models were used to estimate the pooled accuracy measures including sensitivity and specificity, positive (PPV) and negative predictive values (NPVs), diagnostic odds ratio (DOR), and receiver operating characteristic curve (ROC) curve. We included 8 studies including 710 pregnant women with suspected OSA. The performance values of Berlin, STOP-Bang, and ESS questionnaires were as follows: the pooled sensitivity were 61% (95% confidence interval (CI): 40%-80%), 59% (95% CI: 49%-69%), and 29%, (95% CI: 10%-60%); pooled specificity were 61% (95% CI: 42%-78%), 80% (95% CI: 55%-93%), and 80% (95% CI: 50%-94%); pooled PPVs were 60% (95% CI: 0.49-0.72), 73% (95% CI: 61%-85%), and 59% (95% CI: 31%-87%); pooled NPVs were 60% (95% CI: 0.49-0.71), 65% (95% CI: 54%-76%), and 53% (95% CI: 41%-64%); and pooled DORs were 3 (95% CI: 1-5), 6 (95% CI: 2-19), and 2 (95% CI: 1-3), respectively. It seems that the Berlin, STOP-Bang, and ESS questionnaires had poor to moderate sensitivity and specificity in pregnancy, with the ESS showing the worst characteristics. Further studies are required to evaluate the performance of alternative screening methods for OSA in pregnancy.
{"title":"Screening Tools for Obstructive Sleep Apnea in Pregnant Women: An Extended and Updated Systematic Review and Meta-analysis.","authors":"Babak Amra, Masoud Mansouri, Forogh Soltaninejad, Awat Feizi, Marta Kaminska","doi":"10.4103/ijpvm.ijpvm_88_23","DOIUrl":"https://doi.org/10.4103/ijpvm.ijpvm_88_23","url":null,"abstract":"<p><p>The prevalence of obstructive sleep apnea syndrome (OSA) increases in women during pregnancy and negatively affects maternal and fetal outcomes. The updated systematic review and meta-analysis aimed to evaluate the validity of the Berlin, STOP-Bang, and Epworth sleepiness scale (ESS) questionnaires in detecting OSA in pregnant women. PubMed, Embase, and Web of Science were searched systematically up to March 2022. After eligible studies inclusion, two independent reviewers extracted demographic and clinical data. Bivariate random effects models were used to estimate the pooled accuracy measures including sensitivity and specificity, positive (PPV) and negative predictive values (NPVs), diagnostic odds ratio (DOR), and receiver operating characteristic curve (ROC) curve. We included 8 studies including 710 pregnant women with suspected OSA. The performance values of Berlin, STOP-Bang, and ESS questionnaires were as follows: the pooled sensitivity were 61% (95% confidence interval (CI): 40%-80%), 59% (95% CI: 49%-69%), and 29%, (95% CI: 10%-60%); pooled specificity were 61% (95% CI: 42%-78%), 80% (95% CI: 55%-93%), and 80% (95% CI: 50%-94%); pooled PPVs were 60% (95% CI: 0.49-0.72), 73% (95% CI: 61%-85%), and 59% (95% CI: 31%-87%); pooled NPVs were 60% (95% CI: 0.49-0.71), 65% (95% CI: 54%-76%), and 53% (95% CI: 41%-64%); and pooled DORs were 3 (95% CI: 1-5), 6 (95% CI: 2-19), and 2 (95% CI: 1-3), respectively. It seems that the Berlin, STOP-Bang, and ESS questionnaires had poor to moderate sensitivity and specificity in pregnancy, with the ESS showing the worst characteristics. Further studies are required to evaluate the performance of alternative screening methods for OSA in pregnancy.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}