27 research outputs found
Repositioning of the global epicentre of non-optimal cholesterol
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.</p
Repositioning of the global epicentre of non-optimal cholesterol
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol�which is a marker of cardiovascular risk�changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95 credible interval 3.7 million�4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world. © 2020, The Author(s), under exclusive licence to Springer Nature Limited
Non-motor symptoms in akinesia dominant versus other phenotypes in Parkinson's disease (PD): Results from the international PD non-motor symptoms scale study
Objective: Parkinson’s disease (PD) can be separated to three different
motor patterns: Tremor type (TT), Akinetic-Rigid type (ART) and Mixed
type (MT). In this study generated from the international validation study of the recently reported PD non motor symptoms scale (NMSS), we report on the burden of non-motor symptoms and health related quality of life (HrQol, using the Parkinson’s disease Questionnaire-8 items (PDQ-8)) in these different subgroups of PD.
Method: 239 PD patients (137 male, 102 female) were studied; 44
patients (18.4%) have a TT disease, 71 (48.1%) have an ART and
124 (51.88%) a MT. Subjects completed the nine domains, 30 items
NMSS, a grade rating scale (Chaudhuri et al. Mov Disord 2007; DOI:
10.1002/mds.21596). Since the population presented a “non-normal” dis�tribution pattern, non parametric tests were used.
Results: Sex (p 0.257) and distribution among the Hoehn–Yahr stages
(p 0.135) didn’t significantly differ. No significant differences in PDQ�8 score (p 0.124) was found, but there was the trend for ART to have
higher PDQ-8 while NMSS total score was borderline significantly higher in ART patients (p 0.04). However, combining the RT and MT patients (n 168, 70.29%) versus the AR subjects, NMSS score was significantly worse in ART (63.81±38.74 vs 53.44±41.14, p 0.016) and additionally, with worse PDQ-8 scores (33.34±19.04 and 28.34±18.57, p 0.045). There were no differences in age, sex, duration of disease and UPDRS although ART patients were older than non ART subjects at the onset of disease (63.28±12.88 and 59.43±12.36 respectively, p 0.03).
Conclusion: Our data suggest that the burden of non-motor symptoms
complex as a whole is higher in Akinetic type PD patients. This appears
to have a negative impact on health related quality of life
A Cross-sectional study on the knowledge, attitude ,and practices of childhood immunization among mothers of under-five children attending a rural tertiary care center in South India
Background: Immunization is believed to save between 2 and 3 million lives each year. NFHS –4 survey shows that full immunization coverage in Andhra Pradesh is 59.8% in an urban area. The main reasons for inadequate coverage include inadequacy of information, education, and community participation in routine immunization. The study aimed to determine mothers' knowledge, attitude, and practice of childhood immunization.Methods: A cross-sectional study of 300 mothers of under-five children visiting the Pediatrics Out Patient Department during the period between August 2020 to November 2020 was done. The mothers were given a pretested questionnaire consisting of questions related to knowledge, attitude, and immunization practice. This study's data were subjected to standard statistical analysis using the SPSS ver.20 data processing software for windows seven. The p-value was considered significant for all tests if it was less than 0.05 at a confidence level of 95%.Results: The primary resource of information about vaccination was from hospital/ health care workers (58%). Among 300 mothers, 28% of mothers were concerned about adverse reactions. The majority (89%) were utterly immunized, whereas 11% were partially immunized.11% of mothers postponed immunization.86% of mothers had good knowledge about the National immunization schedule. More than half of the studied sample, 162 (54%), were females and 138(46%) were males. The child's gender was not a significant factor in immunization status. There was a statistically significant between the education of the mother and immunization status. In this study, 74% belonged to the lower class and associated with immunization status was statistically significant.Conclusion: We conclude that maternal education, maternal attitude towards immunization, and the source of knowledge about immunization significantly reflected the state of vaccination. The improvement of maternal literacy and dissemination of information about vaccination will increase vaccine coverage in children
RANKL targeted peptides inhibit osteoclastogenesis and attenuate adjuvant induced arthritis by inhibiting NF-κB activation and down regulating inflammatory cytokines
10.1016/j.cbi.2012.12.016Chemico-Biological Interactions2032467-479CBIN
Parkinson's disease staging based of the non-motor symptoms scale
Objective: The Non-Motor Symptoms Scale (NMSS) is a unified
instrument for assessment of non-motor symptoms (NMS) in
Parkinson’s disease (PD). Present study is aimed at exploring a PD
staging based on NMS severity levels determined through NMSS.
Methods: International, multicentre, cross-sectional study. Data on
patients’ sex, age, disease duration, and treatment were collected.
NMSS, Hoehn and Yahr staging (HY), motor examination and motor
complications scales, and the PDQ-8 were applied. NMSS scores
were broken down by quartiles to establish severity levels. Chi squared, Mann-Whitney, and Kruskal-Wallis tests were applied to
compare NMSS severity levels with other variables in the study.
Results: The sample was composed by 750 PD patients (58.5% men;
mean age: 65.98±10.33 years; disease duration: 7.37±5.64 years;
HY median: 2, limits: 1–5). NMSS total score was 56.82±43.62
(range: 0–243, median: 44). NMSS levels were established as
follows: level 0 (no NMS); 1 (slight): 1–7 points; 2 (mild): 8–24;
3 (moderate): 25–44; 4 (severe): 45–80; 5 (very severe): ≥81 points.
No differences were detected in NMS severity level distribution
by gender (p = 0.14) and age (p = 0.09). Disease duration, motor
examination, motor complications, and PDQ-8 scores showed
significant differences by NMSS severity levels (p < 0.0001). There
was also a significant difference between HY and NMS levels
(p < 0.0001).
Conclusions: Severity levels, based on quartiles, can be extracted
from NMSS scores and may be the basis for a staging system based
on NMS. A significant difference was found between HY and NMS
classifications, showing that motor and non-motor manifestations
have a different patter
International study on the psychometric attributes of the non-motor symptoms scale in Parkinson disease.
Contains fulltext :
80119.pdf (publisher's version ) (Open Access)BACKGROUND: Nonmotor symptoms (NMS) have a great impact on patients with Parkinson disease (PD). The Non-Motor Symptoms Scale (NMSS) is an instrument specifically designed for the comprehensive assessment of NMS in patients with PD. NMSS psychometric properties have been tested in this study. METHODS: Data were collected in 12 centers across 10 countries in America, Asia, and Europe. In addition to the NMSS, the following measures were applied: Scales for Outcomes in Parkinson's Disease (SCOPA)-Motor, SCOPA-Psychiatric Complications (SCOPA-PC), SCOPA-Cognition, Hoehn and Yahr Staging (HY), Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), SCOPA-Autonomic, Parkinson's Disease Sleep Scale (PDSS), Parkinson's Disease Questionnaire-39 items (PDQ-39), and EuroQol-5 dimensions (EQ-5D). NMSS acceptability, reliability, validity, and precision were analyzed. RESULTS: Four hundred eleven patients with PD, 61.3% men, were recruited. The mean age was 64.5 +/- 9.9 years, and mean disease duration was 8.1 +/- 5.7 years. The NMSS score was 57.1 +/- 44.0 points. The scale was free of floor or ceiling effects. For domains, the Cronbach alpha coefficient ranged from 0.44 to 0.85. The intraclass correlation coefficient (0.90 for the total score, 0.67-0.91 for domains) and Lin concordance coefficient (0.88) suggested satisfactory reproducibility. The NMSS total score correlated significantly with SCOPA-Autonomic, PDQ-39, and EQ-5D (r(S) = 0.57-0.70). Association was close between NMSS domains and the corresponding SCOPA-Autonomic domains (r(S) = 0.51-0.65) and also with scales measuring related constructs (PDSS, SCOPA-PC) (all p < 0.0001). The NMSS total score was higher for women (p < 0.02) and for increasing disease duration, HY, and CISI-PD severity level (p < 0.001). The SEM was 13.91 for total score and 1.71 to 4.73 for domains. CONCLUSION: The Non-Motor Symptoms Scale is an acceptable, reproducible, valid, and precise assessment instrument for nonmotor symptoms in Parkinson disease