Health Science Reports最新文献

Background and Aims

In Japan, about 6000 patients with hemophilia A (PwHA) are separately cared for at ~1000 clinics or hospitals. Interfacility collaboration (IFC) between hemophilia treatment centers and “satellite” medical facilities located closer to patients is necessary to eliminate care disparities. To facilitate IFC, the Japan Hemophilia Network Committee (JHNC) was approved in 2018 by the Japanese Society of Thrombosis and Hemostasis. However, it is unclear whether the JHNC is functioning effectively to provide comprehensive and specialized care to PwHA seen by doctors at non-expert facilities. Therefore, we conducted a retrospective, longitudinal, observational study using the JMDC Claims Database to assess IFC for hemophilia A in Japan. Results are presented in adherence with the “Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)” guidelines.

Methods

PwHA were classified into those who were usually treated at non-expert (N = 82) and expert (N = 97) facilities. Using descriptive statistics, we assessed hemophilia-specific care using records of joint examinations and blood coagulation tests in the JMDC database from April 2013 to March 2023. The JMDC claims database has several limitations, including the number of elderly patients and the total number of health insurance associations providing data.

Results

Among patients who usually attended non-expert facilities, the proportion who received hemophilia-specific tests at expert facilities was persistently low during the observation period (6.9%–16.3% for joint examinations and 15.4%–32.6% for blood coagulation tests). The rate of visits to expert facilities among the non-expert facilities group did not increase during the study period. The proportion of invasive procedures with bleeding risks performed at expert facilities was low (< 20%), and some procedures requiring specialist consultation were performed at non-expert facilities.

Conclusion

These results suggest that IFC for the care of PwHA between non-expert and expert hemophilia care medical facilities could be strengthened in Japan.

Background and Aims

The consumption of ultra-processed foods is linked to an increase in chronic noncommunicable diseases and risk of mortality. Adverse effects on health have a direct impact on quality of life, compromising general well-being. Thus, with this systematic review protocol, we aimed to review the literature on the association of high consumption of ultra-processed foods with quality of life and mental health in adults and quantify it through meta-analysis.

Methods

This protocol is based on PRISMA-P and has been registered on PROSPERO (CRD42024599909). The CINAHL, EMBASE, FSTA, LILACS, Scopus, Ovid, PsycNET, PubMed, and Web of Science databases will be searched. This strategy uses the MeSH terms and their variations. The search was limited to original peer-reviewed articles with no language restrictions. Two reviewers independently read and extracted data. Methodological quality and risk of bias will be assessed using the GRADE, CASP, and Downs and Black methods.

Results

This protocol describes how the results of the systematic review will be organized, detailing the procedures for study selection, inclusion, and data analysis.

Conclusions

It is hoped that it will offer a consolidated and up-to-date view of the impact of ultra-processed foods on the quality of life and mental health.

Trial Registration: PROSPERO: CRD42024599909.

Background and Aims

Type 2 Diabetes Mellitus (T2DM) is a serious public health issue that is considered the leading cause of death. However, it can be controlled and treated with simple interventions, including good dietary practices. This study aims to assess the effect of a diabetes management self-care program on dietary practices among patients with T2DM seeking health services at diabetes and thyroid centers in Lalitpur, Nepal.

Methods

The quasi-experimental study was conducted in three phases. The first phase employed a cross-sectional, quantitative survey to assess the existing status of dietary practices among patients with T2DM. The second phase was the development of the program. Based on Pender's health promotion model, the Diabetes Self-management Program (DSMP) was designed following the P-process of strategic communication. The third phase involves the post-test in the control group, during which quantitative data were collected.

Results

Wilcoxon Signed Rank-test, and there were no statistically significant differences between the intervention and control group in the pretest score of Pender's Health Promotion Model (PHPM) related variables, perceived benefits, perceived barriers, perceived self-efficacy, social support, situational influence, and attitudes towards healthy dietary practice. After 1 month of intervention, the Mann-Whitney U-test was applied to examine the difference between the intervention and control groups, and it found identical significance in perceived barriers, social support, and attitudes with PHPM at p < 0.01.

Conclusion

The DSMP was found to be effective in changing attitudes toward dietary practices and perceived behavioral control over good nutritional practices, which were considered responsible for the increase in good dietary practice intention in the intervention group compared to the control group. Thus, the practices are not only standard but also play a fundamental role in the effective management of diabetes mellitus, complementing pharmacological and lifestyle interventions.

Background and Aims

Depression, a leading global cause of disease burden, often shows limited response and notable adverse reactions to existing antidepressants. Exploring combination therapies is therefore crucial to enhance therapeutic efficacy and improve safety. Consequently, this study aimed to explore the alterations in blood concentration, therapeutic effect, and safety of San Wei Tan Xiang (SWTX) capsule in combination with paroxetine for the treatment of patients suffering from depression.

Methods

Seventy-six patients fulfilling the diagnostic criteria for depression were enrolled in this randomized controlled trial and randomly divided into a Combination Therapy Group (paroxetine plus SWTX capsule) and a Monotherapy Group (paroxetine alone). Paroxetine blood concentrations and the Treatment Emergent Symptom Scale (TESS) were measured at the second, fourth, and eighth weeks. The 24-item Hamilton Depression Rating Scale (HAMD-24) and the Montgomery Asberg Depression Rating Scale (MADRS) assessed depressive symptoms at baseline and the second, fourth, and eighth weeks.

Results

In the eighth week, the blood paroxetine concentration in the Monotherapy Group was markedly elevated compared to the Combination Therapy Group (p = 0.001). During the fourth and eighth week, the HAMD-24 scores of the Combination Therapy Group were notably lower compared to the Monotherapy Group (p < 0.001). In the second, fourth, and eighth week, the Combination Therapy Group demonstrated a superior HAMD score reduction rate (p < 0.001). By the eighth week, the MADRS scores had dropped significantly lower in the Combination Therapy Group compared to the Monotherapy Group (p < 0.001). And in the eighth week, the Combination Therapy Group had a lower rate of adverse events than the Monotherapy Group, as evaluated by TESS.

Conclusion

Combining SWTX capsule with paroxetine might help maintain paroxetine blood concentration within the optimal range of 20–65 ng/mL, which could potentially lead to better alleviation of depressive symptoms and may reduce adverse reactions compared to paroxetine monotherapy, possibly enhancing overall treatment safety.

Trial Registration: Trial was registered in the China Registry of Clinical Trials (Registration ChiCTR2500110909).

Background and Aims

Variations of accessory renal arteries are different in different population groups, but comprehensive reviews for the ethnically diverse continent of Africa are lacking. Therefore, this review aimed to describe the prevalence of accessory renal arteries in the African population based on specimens from cadaveric, CT angiography, and kidney transplant intraoperative reviews.

Methods

By searching PubMed, Google Scholar, Hinari, and websites (Google, Yahoo), the renal arterial vasculature of 2451 study subjects and 4882 kidneys were retrieved from 17 studies. Anatomical variations of accessory renal arteries were categorized based on prevalence, sex, symmetry, laterality, and termination in the superior pole, hilum, and inferior pole of the kidneys.

Results

Accessory renal arteries were found in 19.7% of study subjects, with 70% of these being males. Additionally, 13.9% of kidneys had accessory renal arteries, with 77.9% of these variations being unilateral. The most common pattern discovered was the presence of single accessory arteries (80.2%). The inferior pole was the predominant point of entry (42%), followed by hilar arteries (39%). Furthermore, a significant difference was observed between the prevalence of left- and right-sided accessory arteries, with a dominance of left-sided arteries (57.1%).

Conclusion

Accessory renal arteries exhibit high prevalence, particularly among males, with the inferior pole as the primary entry point and left-sided dominance. However, the significant heterogeneity and the lack of data from most countries necessitate cautious interpretation. In light of these variations, these findings point out the importance of these reviewed articles as essential references for renal transplantation and other urological procedures.

Background and Aims

Cancer treatment management necessitates comprehensive symptom burden assessment, particularly with therapies like immune checkpoint inhibitors (ICIs), known for unique toxicities. While ICIs show promising outcomes, they also induce immune-related adverse events (irAEs), posing challenges due to their varied onset, duration, and severity. Traditional clinician-reported tools may overlook nuances, hence the importance of Patient-Reported Outcomes (PRO). Symptom clusters, representing interrelated symptoms sharing biological mechanisms, offer a holistic approach to symptom management yet are understudied in ICI therapy.

Methods

A cross-sectional survey at Guang'anmen Hospital, China, from January 2021 to March 2023, enrolled cancer patients undergoing ICI therapy. Validated PRO tools captured symptoms, interference, and quality of life. Descriptive statistics summarized demographics, while exploratory factor analysis identified symptom clusters. Multiple linear regression analyzed factors influencing symptom burden, and Pearson correlation examined relationships.

Results

Among 213 participants, predominantly male (72%) with lung cancer (75%), most had Stage IV disease (59%). Fatigue (79.8%) and dry mouth (69.5%) were prevalent, with fatigue being the highest incidence of moderate to severe cases. Five symptom clusters were identified: emotion-function, respiratory, autonomic nerve dysfunction, mucosa-related, and skin-related. Poor Eastern Cooperative Oncology Group performance status and time from the first immunotherapy ≤ 3 months correlated with higher symptom burden. Participants reported overall good health-related quality of life, with a median score of 7 (IQR 5–8). The severity of symptom burden correlates with poorer quality of life.

Conclusion

During ICI treatment, cancer patients endure multi-faceted symptoms, forming clusters that may have distinct biological underpinnings. Early recognition and mechanism-driven management of these clusters are crucial for mitigating treatment toxicities and improving patient outcomes. Further research is warranted to deepen our understanding and refine symptom management strategies. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Background and Aims

Ulcerative colitis (UC), a chronic inflammatory bowel disease, causes persistent mucosal inflammation and epithelial dysfunction. Basal progenitor cells (BPCs), critical for intestinal regeneration and mucosal repair, exhibit altered behavior in UC. Despite extensive research into immune dysregulation, the spatial dynamics and functional roles of BPCs in UC remain poorly understood.

Methods

We utilized multi-omics integration, single-cell RNA sequencing (scRNA-seq), spatial transcriptomics (ST), and machine learning (ML) to analyze BPC dynamics in UC. scRNA-seq data from UC and healthy samples were processed to identify the cellular composition, functional gene matrixes, and differentiation trajectories. ST provided spatial expression patterns, and ML models were used to prioritize key genes associated with disease severity. The prognostic potential for colorectal cancer (CRC) was assessed through external survival analysis.

Results

Our analysis revealed significant alterations in BPC differentiation in UC, driven by a FABP1-led functional gene matrix. Key genes, including FABP1, CLCA1, ITLN1, MUC2, and TFF1, exhibited spatially distinct expression patterns in UC samples, with FABP1 downregulated and other genes upregulated in BPCs. External survival analyses identified these genes as important biomarkers for both UC and colorectal cancer.

Conclusion

This study uncovers a previously unrecognized role for BPCs in UC pathogenesis, highlighting their spatial dysfunction and potential as a therapeutic target. The identified FABP1-led matrix offers new insights into epithelial dysregulation in UC and its progression to colorectal cancer, suggesting that restoring BPC function may provide novel treatment avenues.

Background and Aims

Lifestyle and diet influence chronic disease risk through their impact on systemic inflammation. This research evaluated the association among dietary habits, physical activity, and inflammatory biomarkers, specifically glucose and C-reactive protein (CRP).

Methods

This cross-sectional study examined lifestyle, sociodemographic, and nutritional indicators using a structured questionnaire, which was adapted from the WHO STEPwise guideline. A total of 200 participants were included based on their attendance for CRP and glucose assays at two health centers between May and September 2023 in Bangladesh.

Results

Among participants with high fiber intake (> 20 g/day), 22% had normal blood glucose levels and 25.5% showed slightly increased CRP values. In contrast, among those with low fiber intake (< 10 g/day), 28% had pre-diabetes, 23.5% had diabetes, and a moderate 56% exhibited moderately increased CRP levels. Besides, participants with higher saturated fat intake (> 10 g/day) showed moderate CRP elevations in 50%, pre-diabetes in 24%, and diabetes in 19.5%, whereas those with lower intake (< 10 g/day) exhibited smaller CRP elevations in 28.5% and normal blood sugar levels in 27.5% of the group. Participants with a habit of rare or once-weekly physical activity had pre-diabetes in 38.5%, diabetes in 27%, and moderate CRP elevations in 57% of their group. On the contrary, those reporting regular physical activity demonstrated lower CRP levels in 20.5% and normal sugar levels in 34.5% of their group. Intake of fruit, vegetables, red meat, seafood, sugary drinks, high-sugar foods, and smoking showed statistically significant associations with inflammatory biomarkers (p < 0.05); however, water intake did not exhibit a similar association. Glucose and CRP levels were found to be significantly associated with age, dietary factors (fiber, saturated fat, red meat, sugary diet), and lifestyle behaviors (physical activity, smoking), whereas sociodemographic factors (gender and education) showed no statistically significant associations.

Conclusion

The findings highlight associations between diet and physical activity and inflammatory markers, suggesting the necessity for focused public health interventions.