Health Science Reports最新文献

Background and aims: The lack of therapeutic response characterizes treatment-resistant depression despite undergoing at least two adequate monotherapy trials with medications from distinct pharmacologic classes. The inability to attain remission in patients diagnosed with major depressive disorder (MDD) is a significant issue of concern within public health. Therefore, the management of treatment-resistant depression (TRD) poses significant obstacles for both patients and healthcare professionals. Our goal was to investigate the published literature concerning different options for treatment for TRD, including those that do not involve the use of medications.

Methods: We thoroughly searched the literature in the Google Scholar, PubMed, and ScienceDirect databases to find publications relevant to our narrative review and extracted data from appropriate data. For this review, literary works written solely in English were chosen.

Results: Ongoing research is being conducted to explore the treatment options for TRD, including pharmacological and nonpharmacological interventions. Pharmacological interventions include a wide range of therapeutic approaches, including but not limited to investigating innovative medications and strategies such as augmentation, switching, and combination therapies involving established and emerging drugs. Nonpharmacological interventions, including brain stimulation such as theta burst stimulation, deep brain stimulation, electroconvulsive therapy, repetitive transcranial magnetic stimulation, intermittent transcranial magnetic stimulation, and magnetic seizure therapy, as well as psychotherapeutic approaches, are being explored for the management of TRD in both present and future contexts.

Conclusion: Researchers are dedicating significant resources to the aforementioned therapeutic interventions to advance the development of novel and efficacious treatment options for TRD and enhance our comprehension of the underlying disease. This review focused on looking at recent research concerning therapeutic interventions for TRD.

Background and aims: High contact stresses involving the hip have been shown to increase the risk of developing hip osteoarthritis (OA). Although several risk factors have been identified for OA, a holistic approach to predicting contributed factors toward increased hip contact stresses have not been explored. This study was conducted to comprehensively understand the effects of physical activity on high hip contact stress as predisposing factors of OA.

Methods: The protocol of this systematic review was registered in PROSPERO with registration number CRD42022296638 and conducted based on PRISMA guidelines. Full articles that matched our inclusion criteria were selected using PubMed, Web of Science, and Scopus search engines and keywords such as "hip contact stress," "hip contact force," and/or "hip contact pressure." Category of factors, experimental design, results of the study, and evidence from each article were analyzed.

Results: In total 7972 papers were screened, identified, and reviewed. Two independent authors read the collected fulltext of eligible articles resulting in 21 papers that fulfilled the inclusion criteria of this systematic review.

Conclusion: Types of physical activity (n = 21) have correlation with high hip joint contact stress in various manner. Based on the research findings obtained from various inclusion papers, it can be broadly concluded that the more intense the physical activity, such as running and stair climbing, the greater the impact on the increase in hip contact stress values. However, the reviewed studies vary in their methods. This finding suggested that this area is not well investigated and warrants future research.

Background and aims: The goal of this research was to create a minimum data set (MDS) and design a web-based registry for outpatient rehabilitation, focusing on four disciplines: speech therapy, audiology, optometry, and physical therapy. The registry was intended to enhance assessment, guide optimal care, and provide value-based and evidence-based rehabilitation management for patients.

Methods: This cross-sectional study utilized the Delphi technique at Mashhad University of Medical Sciences in northeastern Iran from 2022 to 2023. First, the PubMed, Scopus, Embase, and Web of Science databases were searched in an untimed systematic review. Additional information was gathered from websites and forms related to rehabilitation systems. Coding guidelines were derived from the International Classification of Functioning, Disability, and Health. A questionnaire containing data elements of outpatient rehabilitation was developed based on the systematic reviews. The data items were validated in two stages using the Delphi approach. Subsequently, an MDS and a web-based registry were designed for outpatient rehabilitation.

Results: The study included 25 eligible articles, 6 websites, and 24 forms to establish the rehabilitation MDS. A total of 470 information elements were extracted from the systematic review and rehabilitation registries. Through two rounds of the Delphi technique, 423 data elements were refined. The MDS was categorized into basic information and specialized information. Basic information comprised 12 subcategories of demographic details, socioeconomic information, referral information, service provider information, follow-up information, death information, history, past medical history, environmental factors, treatment measures, rehabilitation measures, and assessment of body systems; specialized information included four subcategories of optometry information, audiology information, physiotherapy information, and speech therapy information. Following the finalization of the MDS, a web-based registry for outpatient rehabilitation was created.

Conclusion: This work offers a combined MDS that reflects the priorities and viewpoints of multidisciplinary experts for an outpatient rehabilitation registry that aids in clinical decision-making.

Background and aims: Regular physical activity holds numerous health benefits for older people, yet the majority of older people do not meet the World Health Organization's physical activity recommendations. Brief physical activity screening tools can support healthcare professionals in identifying patients who would benefit from physical activity promotion and counselling. The Rapid Assessment of Physical Activity (RAPA) questionnaire is a validated brief physical activity screening tool designed for clinical practice.

Methods: We conducted a psychometric validation of a new German translation of the RAPA by performing a secondary analysis of survey data from 234 former cardiac rehabilitation patients (mean [SD] age 69 ± 11 years, 23% female) in Austria. For psychometric validation, we used the following survey measures: the new German version of the RAPA, two customized questions about physical activity behavior, one customized question about perceived health self-management, and the German version of the EuroQol health-related quality of life questionnaire. We performed Spearman's correlations to assess the relationship between the German RAPA and the other measures (i.e., physical activity behavior, self-management of health and health-related quality of life).

Results: Aerobic physical activity level according to the RAPA correlated significantly with weekly frequency (Spearman's rho = 0.31, 95% CI [0.18, 0.43], p < .001) and volume of PA (rho = 0.34, 95% CI [0.21, 0.45], p < .001), as well as perceived health self-management and five out of six dimensions of the EuroQol questionnaire.

Conclusion: Our data demonstrate convergent validity and contribute to the psychometric validation of the new German version of the RAPA. These initial findings lend themselves to future dedicated psychometric validation studies of the German RAPA (against gold-standard physical activity questionnaires or direct physical activity measures) to further explore the potential of this tool for use in German-speaking geriatrics healthcare.

Background and aims: This systematic review and meta-analysis evaluate the efficacy of moist versus non-moist dressings for split-thickness skin graft (STSG) donor sites, focusing on time to healing, pain management, and adverse events to guide clinical practice.

Methods: A comprehensive literature search was conducted across databases including Ovid/MEDLINE, Embase, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and Scopus up to November 28, 2023. The study adhered to PRISMA guidelines. Eligible randomized controlled trials (RCTs) were assessed for quality using the Newcastle-Ottawa Scale and Cochrane risk-of-bias tool, with meta-analysis performed using the DerSimonian and Laird random-effects model.

Results: Out of 464 identified studies, 16 RCTs involving 1129 patients were included. Moist dressings such as Tegaderm, Hydrocolloid, Alginate, polyurethane, and hydrofiber showed a faster mean time to healing compared to non-moist dressings like Mepitel and paraffin-impregnated gauze. Hydrocolloid dressings were particularly effective in accelerating wound healing. Additionally, moist dressings were associated with lower pain levels during dressing removal and had comparable rates of adverse events.

Conclusion: The evidence strongly supports the use of moist dressings, particularly Hydrocolloid, for STSG donor site coverage. These dressings promote faster healing and superior pain management. The study highlights the need for further research to address existing limitations and refine recommendations for optimal wound care interventions.

Background and aims: Dengue is a mosquito-borne viral disease that frequently causes seasonal outbreaks in Bangladesh, particularly during the monsoon months from June to September. Recent outbreaks have shown significant shifts in clinical manifestations, including changes in the timeframe and serotype mixing. This study focused on the clinical and hematological profiles of patients during the 2022 outbreak, which was notably severe.

Methods: This quantitative cross-sectional study at Dhaka Medical College and Hospital classified 67 dengue-positive patients as having dengue fever (DF), dengue fever with warning signs (DFWS), and severe dengue (SD). Fisher's exact test, Pearson's chi-squared test, and Wilcoxon rank-sum test were conducted for statistical analysis using the R software (version 4.2), with significance established at p < 0.05.

Results: Predominantly male patients (76%) aged 21-40 (63%) and middle-class patients from Dhaka (57%) formed the majority. Most patients (45%) lacked a regular drainage system. Laboratory tests showed 63% NS1 antigen (nonspecific antigen 1) positivity, and 16% tested positive for both NS1 and IgM (Immunoglobulin M). Symptoms included headache (84%), retroorbital pain (51%), joint pain (75%), myalgia (72%), vomiting (75%), abdominal pain (69%), diarrhea (39%), and shock (48%). Thrombocytopenia was present in 61% of patients, with 79% showing elevated hematocrit (HCT) levels. Pedal edema, pleural effusion, and ascites were observed in DF and DFWS cases, while SD cases exhibited distinct HCT level variations.

Conclusion: Accurate clinical and laboratory assessments are vital for the treatment and prediction of dengue outcomes in Bangladesh, given the severe manifestations of dengue shock syndrome (DSS). It is characterized by headache, muscle pain, thrombocytopenia, anemia, leukopenia, and potential neurological complications or mortality. Severe cases involve critical plasma leakage, leading to DSS with fluid accumulation, respiratory distress, and potential multiorgan involvement. Enhancing physician awareness regarding dengue case detection and management, along with routine dengue testing, are recommended for early diagnosis and improved patient outcomes.

Background and aims: In Bangladesh, data related to the future risk of dementia and its associated factors are scarce. Furthermore, no dementia risk prediction tool has yet been applied to estimate the risk in any population in Bangladesh. Therefore, our objective was to assess the risk of dementia and its associated factors among patients with coronary artery disease (CAD).

Methods: This cross-sectional study conveniently recruited 280 stable patients with CAD who were admitted for coronary revascularization at a tertiary cardiac hospital situated in Dhaka, Bangladesh. Data were collected face-to-face using a pretested questionnaire adapted from the WHO STEP-wise Approach to Surveillance (STEPS) of Noncommunicable Diseases Risk Factors questionnaire (Version 3.2). The questionnaire included background information (sociodemographic, comorbidity), behavioral and metabolic risk factors, physical and biochemical measurements. The next 20 years' risk of dementia was estimated using the "Cardiovascular Risk Factors, Aging, and Incidence of Dementia" score. The risk score, risk levels, and risk factors were presented descriptively. The associated factors of dementia risk were elucidated using hierarchical multiple regression analysis.

Results: The mean ( ± standard deviation) risk score for dementia was 6.26 ± 2.28. The predicted "at-risk" population was 63.6%. The prevalent risk factors were unhealthy diets (84.3%) presented by inadequate fruit/vegetable consumption (70%) and added salt intake (46.4%). In the final model of hierarchical multiple regression, the risk score showed a significant association with several risk factors: family history of diabetes (p = 0.03), alcohol intake (p = 0.03), current smoking (p = 0.03), estimated glomerular filtration rate (p = 0.001), and diastolic blood pressure (p = 0.02).

Conclusion: A substantial proportion of patients with CAD had a future risk of dementia which demands an urgent risk reduction strategy in Bangladesh. Future longitudinal studies may more precisely justify the current findings.

Background and aims: Population aging is associated with the rising incidence of chronic illness. This presents a significant challenge to healthcare systems, particularly in developing countries, as untreated chronic conditions can lead to years of disability and loss of independence straining health budgets and resources. Promoting healthy aging can be one avenue for mitigating these challenges. This study aims to identify factors influencing health service use among healthy and non-healthy agers, utilizing the Andersen-Newman model that describes predisposing (including demographic characteristics, social structure, and health beliefs), enabling (related to the logistical aspects of obtaining care, such as personal and community resources), and need factors (referring to the individual's perceived and evaluated health status).

Methods: Older adults (n = 545) in Bahir Dar, Ethiopia were surveyed about their health and health-seeking behaviors. Associations between risk factors and health service utilization were examined using Poisson regression with robust standard errors.

Results: A total of 79.3% of older adults utilized health services, with consistent usage between healthy and non-healthy agers. Factors associated with increased health service utilization included severe (RR = 2.20; 95% CI: 1.56-3.09), and moderate (RR = 2.03; 95% CI: 1.44-2.85) disease severity, reporting comorbid conditions (RR = 1.14; 95% CI: 1.06-1.23), having health insurance (RR = 1.14; 95% CI: 1.05-1.23), not reporting loneliness (RR = 1.13; 95% CI: 1.02-1.26), and being financially independent (RR = 1.11; 95% CI: 1.00-1.22). Conversely, residing in rented housing (RR = 0.78; 95% CI: 0.62-0.98) and living greater than 30 min from a healthcare facility (RR = 0.62; 95% CI: 0.54-0.71) decreased health service utilization.

Conclusion: Health service utilization was low compared to developed countries. This could be due to newer and improved health services in developed countries. Improving financial independence, health insurance coverage, access to healthcare facilities, and encouraging peer or family support can enhance healthcare access in Ethiopians.