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Bruun Agger posted an update 10 months, 2 weeks ago
Restrictions in the access to healthcare facilities during COVID-19 pandemic have raised the need for remote monitoring of chronic medical conditions, including multiple sclerosis (MS). In order to enable the continuity of care in these circumstances, many telemedicine applications are currently tested. While physicians’ preferences are commonly investigated, data regarding the patients’ point of view are still lacking. We built a 37 items web-based survey exploring patients’ propensity, awareness, and opinions on telemedicine with the aim to evaluate the sustainability of this approach in MS. Analysing 613 questionnaires out of 1093 that were sent to persons with MS followed at the Multiple Sclerosis Center of Tor Vergata University, Rome, we found that more than half of respondents (54%) were open to having a televisit. Propensity toward telemedicine significantly depended on having a higher income (p = 0.037), living farther from the center (p = 0.038), using computer and tablet (p = 0.010) and using the Internet for other remote activities (p less then 0.001), conversely it was not influenced by any specific disease characteristics (i.e. Zebularine degree of disability). The main advantages and disadvantages of televisit reported by participants were respectively saving time (70%) and impossibility to measure physical parameters (71%). Although the majority of respondents are in favour of televisit, so far this approach is restricted to those displaying better socioeconomic conditions and higher familiarity with technology. Implications of the study are that telemedicine platforms should be better tailored to patients’ demands in order to spread the use of telemedicine, to enhance usability and to increase patients’ adherence.The research tested the psychometrics of the Centers for Disease Control and Prevention’s National HIV Behavioral Surveillance (NHBS) community HIV-related stigma scale. Data was from men who have sex with men (MSM) NHBS cycles conducted 2011-2017 in Miami-Dade, Florida among n = 1455 participants. MSM were cis-gender male, 18+ years old, reported lifetime oral/anal sex with a male, and lived in Miami-Dade County. We assessed reliability using Cronbach’s alpha and McDonald’s omega, determined factors using principal factor analysis, and assessed construct validity using five a priori hypotheses. The scale was unidimensional, had questionable internal reliability (α = 0.68, ω = 0.69), and met four of five a priori hypotheses in the expected direction. Correlations were medium-weak in strength and only one was consistently met. Future iterations of the NHBS survey should consider replacing the 4-item community HIV-related stigma scale with an instrument that has superior internal reliability, measures multiple HIV-related stigma dimensions, and demonstrates stronger evidence of validity.
Body composition, including sarcopenia and fat parameters, has received much attention as a prognostic factor in breast cancer.
A total of 479 breast cancer patients who underwent surgery and received adjuvant chemotherapy were enrolled in this study. Body composition, including the index and density of skeletal muscle, visceral fat, subcutaneous fat, and intermuscular fat calculated by CT scan, was used as a prognostic factor. The endpoints were breast cancer-specific survival (BCSS) and overall survival (OS).
The number of patients with stages I, II, and III was 146 (30.5%), 237 (49.5%), and 96 (20%), respectively. Sarcopenia and muscle density were not significant prognostic factors for BCSS and OS. A high visceral fat index (VFI) was an independent prognostic factor for BCSS (HR, 2.55; 95% CI 1.10-5.95, p = 0.03) and OS (HR 2.55, 95% CI 1.26-5.16, p = 0.01). In addition, high intermuscular fat density (IMFD) was also a significant prognostic factor for BCSS (HR, 2.95; 95% CI 1.34-6.46, p = 0.007) and OS (HR 2.28, 95% CI 1.22-4.26, p = 0.01) in multivariate analysis.
VFI and IMFD were significant prognostic factors for BCSS and OS in breast cancer patients treated with adjuvant chemotherapy.
VFI and IMFD were significant prognostic factors for BCSS and OS in breast cancer patients treated with adjuvant chemotherapy.Parkinson’s disease (PD) is a progressive neurological disorder characterized by motor and non-motor features. Although some progress has been made in conventional PD treatments, these breakthroughs have yet to show high efficacy in treating this neurodegenerative disease. Probiotics are live microorganisms that confer health benefits on the host when administered in adequate amounts. Probiotics have putative anticancer, antioxidative, anti-inflammatory, and neuroprotective effects. Multiple lines of evidence show that probiotics control and improve several motor and non-motor symptoms in patients and experimental animal models of PD. Probiotic supplementation mediates these pharmacological effects by targeting a variety of cellular and molecular processes, i.e., oxidative stress, inflammatory and anti-inflammatory pathways, as well as apoptosis. Herein, we summarize the effects of probiotics on motor and non-motor symptoms as well as various cellular and molecular pathways in PD.
Obesity is often considered mandatory for the diagnosis of Metabolic Syndrome (MS). Data on theprevalence of MS in non-obese patients with Obstructive Sleep Apnea (OSA) is scarce. This study was aimed to determine the prevalence of MS in non-obesepatients with OSA.
All consecutively diagnosed patients with OSA between October 2018 and November 2019 were screened for metabolic syndrome. Patients withOSA and BMI < 25kg/m
(NOOSA) vs BMI > 25kg/m
(obese OSA) were compared. Lean waist NOOSA was defined as BMI < 25kg/m
and WC < 80cm (32 in.) for women or < 90cm (36 in.) for men.
During the study period, 502 patients were diagnosed with OSA. MS was observed in 35% of patients with NOOSA compared to obese patients with OSA(79%). In the NOOSA group, hypertension, impaired fasting glucose, diabetes mellitus and dyslipidemia were observed in 65, 48, 14 and 61% respectively and all ofthese parameters were significantly more common in the obese group (p < 0.001). Parameters of OSA severity (apnea-hypopnea index orAHI, time spent below 90% saturated orT90, and nadir oxygen) were significantly more severe in the obese group withOSA.