Medicine
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Comparative Study Observational Study
A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation: A crossover design study comparing documentation via iPad with paper-based control.
Medication adherence is crucial for success in the management of patients with chronic conditions. This study analyzes whether a mobile application on a tablet aimed at supporting drug intake and vital sign parameter documentation affects adherence in elderly patients. Patients with coronary heart disease and no prior knowledge of tablet computers were recruited. ⋯ A mobile app for medication adherence increased objectively and subjectively measured adherence in elderly users undergoing rehabilitation. The findings have promising clinical implications: digital tools can assist chronic disease patients achieve adherence to medication and to blood pressure measurement. Although this requires initial offline training, it can reduce complications and clinical overload because of nonadherence.
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Observational Study
FDG PET/CT response in diffuse large B-cell lymphoma: Reader variability and association with clinical outcome.
F-18-fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is essential for monitoring response to treatment in patients with diffuse large B-cell lymphoma (DLBCL) and qualitative interpretation is commonly applied in clinical practice. We aimed to evaluate the interobserver agreements of qualitative PET/CT response in patients with DLBCL and the predictive value of PET/CT results for clinical outcome. PET/CT images were obtained for patients with DLBCL 3 times: at baseline, after 3 cycles of first-line chemotherapy (interim), and after completion of chemotherapy. ⋯ Interim PET/CT result by the more experienced reader using Deauville score was a significant factor for OS (P = 0.019). Moderate-to-substantial interobserver agreement was observed for response assessments according to qualitative PET/CT criteria, and interim PET/CT result could predict OS in patients with DLBCL. Further studies are necessary to further standardize the PET/CT-based response criteria for more consistent interpretation.
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The relationship between homocysteine levels and glaucoma has been questioned in previous studies without conclusive results. In the current study, we assessed the relationship between homocysteine levels and intraocular pressure which is one of the main factors in the development of glaucoma in men and women. A retrospective cross-sectional analysis of a database from a screening center in Israel which assessed 11,850 subjects, within an age range 20 to 80 years. ⋯ Mean homocysteine levels (±SD) in subjects with glaucoma were 11.2 ± 3.5 μmol/L compared to 11.7 ± 5.5 μmol/L in subjects without glaucoma and normal intraocular pressure ≤ 21 mm Hg (P = 0.4, 95% CI 1.2-2.1). The current study displays no clinical correlation between the homocysteine level and the intraocular pressure. Homocysteine may not be used as a predictive parameter to recognize those subjects prone to develop elevated intraocular pressure.
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Observational Study
Increases in perinatal mortality in prefectures contaminated by the Fukushima nuclear power plant accident in Japan: A spatially stratified longitudinal study.
Descriptive observational studies showed upward jumps in secular European perinatal mortality trends after Chernobyl. The question arises whether the Fukushima nuclear power plant accident entailed similar phenomena in Japan. For 47 prefectures representing 15.2 million births from 2001 to 2014, the Japanese government provides monthly statistics on 69,171 cases of perinatal death of the fetus or the newborn after 22 weeks of pregnancy to 7 days after birth. ⋯ Perinatal mortality in areas contaminated with radioactive substances started to increase 10 months after the nuclear accident relative to the prevailing and stable secular downward trend. These results are consistent with findings in Europe after Chernobyl. Since observational studies as the one presented here may suggest but cannot prove causality because of unknown and uncontrolled factors or confounders, intensified research in various scientific disciplines is urgently needed to better qualify and quantify the association of natural and artificial environmental radiation with detrimental genetic health effects at the population level.
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The world will be facing huge population aged 65 and older, accounting for 13% of the total population in the future. Significant disabilities rates reflect an accumulation of health risks. Psychiatry disability is one of the most significant disabilities, because it manifests in cognitive, affective, and behavior disorders that limit one's daily life and restrict their participations. ⋯ Socioeconomic inequities, such as current employment status and marital status, were associated with psychiatry disability in both surveys. These associations remained even after these 2 surveys were combined. The rapidly rising prevalence of psychiatric disorders expected warrants strategies to reduce the burden of these disabilities among females and rural residents.