Zachariassenahmed9297
Electronic cigarettes (e-cigarettes) are being marketed to smokers as a smoking cessation aid. General Practitioners (GPs) have an important role in providing patients with support to encourage them to quit smoking. The emergence and marketing of e-cigarettes as a smoking cessation alternative poses challenges to GPs in advising and supporting smokers to quit.
This systematic review aims to synthesise available evidence on the knowledge, attitudes and perceptions of GPs about e-cigarettes as a smoking cessation aid.
Mixed methods study review including quantitative, qualitative or mixed methods studies of GPs in primary care settings.
MEDLINE, CINAHL, SCOPUS, PsycINFO and EMBASE databases will be searched to identify articles published between 1/1/2003 and 30/6/2021. A Google search will be examined to identify grey literature. Two independent reviewers will screen abstracts for relevance and full-text studies. Articles will be appraised for quality using MMAT and a PRISMA diagram will illustrate the flow of papers and reasons for exclusion. An evidence synthesis method will be employed and guided by the Theory of Planned Behaviour. A descriptive qualitative synthesis of the findings will be reported.
Findings will provide a synthesis of current evidence regarding the knowledge, attitudes and perceptions of e-cigarettes as a smoking cessation aid amongst GPs. This information will be useful to guide future research on the needs of GPs in advising and supporting patients to quit smoking, and develop health policy and guidelines on the role and place of e-cigarettes as a smoking cessation aid.
Findings will provide a synthesis of current evidence regarding the knowledge, attitudes and perceptions of e-cigarettes as a smoking cessation aid amongst GPs. This information will be useful to guide future research on the needs of GPs in advising and supporting patients to quit smoking, and develop health policy and guidelines on the role and place of e-cigarettes as a smoking cessation aid.
To investigate the association between long term residential exposure to road traffic and railway noise and risk of incident dementia.
Nationwide prospective register based cohort study.
Denmark.
1 938 994 adults aged ≥60 years living in Denmark between 1 January 2004 and 31 December 2017.
Incident cases of all cause dementia and dementia subtypes (Alzheimer's disease, vascular dementia, and Parkinson's disease related dementia), identified from national hospital and prescription registries.
The study population included 103 500 participants with incident dementia, and of those, 31 219 received a diagnosis of Alzheimer's disease, 8664 of vascular dementia, and 2192 of Parkinson's disease related dementia. Using Cox regression models, 10 year mean exposure to road traffic and railway noise at the most (L
max) and least (L
min) exposed façades of buildings were associated with a higher risk of all cause dementia. These associations showed a general pattern of higher hazard ratios with higher noiseand dementia subtypes, especially Alzheimer's disease.
Insulin-like growth factor (IGF)2 is a potent mitogen. To elucidate the relationship between IGF2 and risk of tumorigenesis, we analyzed associations between serum levels of IGF2 and incidence of liver cancer in a prospective case-control study nested in the Japan Collaborative Cohort study.
A baseline survey was conducted from 1988 using blood samples from 39,242 subjects. Those who had been diagnosed with liver cancer by 1997 were regarded as cases. For each case, we randomly selected 2 or 3 controls matched for sex, age, and residential area. Conditional logistic regression was used to estimate odds ratios (ORs) for cancer incidence associated with IGF2.
This analysis included 86 cases and 294 controls. Low IGF2 was associated with risk of future liver cancer (P-trend <0.001). After controlling for alcohol intake, body mass index, smoking, hepatitis viral infection, IGF1, and IGF-binding protein-3, participants with low IGF2 displayed a higher risk of liver cancer (P-trend <0.001). Individuals in quintiles 2-5 showed lower risk compared to quintile 1 (OR range, 0.05-0.16). In both sexes and in both non-elderly and elderly groups, subjects in the lowest quintiles showed higher risks of liver cancer. Limiting subjects to those followed for 3 years, low IGF2 was associated with cancer risk (P-trend <0.001).
Our findings suggest that low serum IGF2 level, especially below 460 ng/mL, is related to future risk of liver cancer.
Our findings highlight this important biomarker for further analysis in large prospective cohorts and pooled investigation with other cohorts.
Our findings highlight this important biomarker for further analysis in large prospective cohorts and pooled investigation with other cohorts.
The role of methylation in pancreatic cancer risk remains unclear. We integrated genome and methylome data to identify CpG sites (CpG) with the genetically predicted methylation to be associated with pancreatic cancer risk. We also studied gene expression to understand the identified associations.
Using genetic data and white blood cell methylation data from 1,595 subjects of European descent, we built genetic models to predict DNA methylation levels. After internal and external validation, we applied prediction models with satisfactory performance to the genetic data of 8,280 pancreatic cancer cases and 6,728 controls of European ancestry to investigate the associations of predicted methylation with pancreatic cancer risk. For associated CpGs, we compared their measured levels in pancreatic tumor versus benign tissue.
We identified 45 CpGs at nine loci showing an association with pancreatic cancer risk, including 15 CpGs showing an association independent from identified risk variants. We observed significant correlations between predicted methylation of 16 of the 45 CpGs and predicted expression of eight adjacent genes, of which six genes showed associations with pancreatic cancer risk. Of the 45 CpGs, we were able to compare measured methylation of 16 in pancreatic tumor versus benign pancreatic tissue. Of them, six showed differentiated methylation.
We identified methylation biomarker candidates associated with pancreatic cancer using genetic instruments and added additional insights into the role of methylation in regulating gene expression in pancreatic cancer development.
A comprehensive study using genetic instruments identifies 45 CpG sites at nine genomic loci for pancreatic cancer risk.
A comprehensive study using genetic instruments identifies 45 CpG sites at nine genomic loci for pancreatic cancer risk.
It remains open whether gastric precancerous lesions are associated with an elevated risk of pancreatic cancer. Our aim was to investigate the association between gastric mucosal status and pancreatic cancer risk.
Patients with gastric biopsies (normal, minor changes, superficial gastritis, and atrophic gastritis/intestinal metaplasia/dysplasia [AG/IM/Dys]) from the Swedish histopathology registers during 1979-2011 were included. Cross linkages with several nationwide registries allowed complete follow-up and identification of pancreatic cancer cases until 2014. Standardized incidence ratios (SIRs) and hazard ratios were estimated.
During 3,438,248 person-years of follow-up with 318,653 participants, 3,540 cases of pancreatic cancer were identified. The same pattern of excess risk of pancreatic cancer compared to the general population was observed across all groups a peak of 12- to 21-fold excess risk in the first year after biopsy (e.g., normal SIR=17.4, 95% CI 15.7-19.3; AG/IM/Dys SIR=11.5, 95% CI 9.9-13.4) which dropped dramatically during the second and third year, followed by 20%-30% increased risk after the third year (e.g., normal SIR=1.2, 95% CI 1.1-1.4; AG/IM/Dys SIR=1.3, 95% CI 1.1-1.5). However, no significant excess risk was observed with the normal gastric mucosa as reference.
This unique large pathological cohort study did not find evidence that abnormal gastric mucosal status is causally associated with a long-term pancreatic cancer risk. However, a highly increased short-term risk was observed for people undergoing gastroscopy with biopsy sampling compared with the general population.
Further studies for a long-term risk of pancreatic cancer in patients with gastric biopsies are needed, with further adjustments.
Further studies for a long-term risk of pancreatic cancer in patients with gastric biopsies are needed, with further adjustments.
The ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals.
Prospective, multicentre, mixed-methods cohort study in seven Chilean ICUs.
450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation >48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment-blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, dishe study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020-78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings.
NCT04979897.
NCT04979897.
Predictive algorithms to inform risk management decisions are needed for patients with COVID-19, although the traditional risk scores have not been adequately assessed in Asian patients. NSC-2260804 We aimed to evaluate the performance of a COVID-19-specific prediction model, the 4C (Coronavirus Clinical Characterisation Consortium) Mortality Score, along with other conventional critical care risk models in Japanese nationwide registry data.
Retrospective cohort study.
Hospitalised patients with COVID-19 and cardiovascular disease or coronary risk factors from January to May 2020 in 49 hospitals in Japan.
Two different types of outcomes, in-hospital mortality and a composite outcome, defined as the need for invasive mechanical ventilation and mortality.
The risk scores for 693 patients were tested by predicting in-hospital mortality for all patients and composite endpoint among those not intubated at baseline (n=659). The number of events was 108 (15.6%) for mortality and 178 (27.0%) for composite endpoints. Afatients and allocation of medical resources.
UMIN000040598.
The 4C Mortality Score performed well in an independent external COVID-19 cohort and may enable appropriate disposition of patients and allocation of medical resources.Trial registration number UMIN000040598.
Multimorbidity refers to the presence of two or more chronic non-communicable diseases (NCDs) in a given individual. It is associated with premature mortality, lower quality of life (QoL) and greater use of healthcare resources. The burden of multimorbidity could be huge in the low and middle-income countries (LMICs), including Ethiopia. However, there is limited evidence on the magnitude of multimorbidity, associated risk factors and its effect on QoL and functionality. In addition, the evidence base on the way health systems are organised to manage patients with multimorbidity is sparse. The knowledge gleaned from this study could have a timely and significant impact on the prevention, management and survival of patients with NCD multimorbidity in Ethiopia and in LMICs at large.
This study has three phases (1) a cross-sectional quantitative study to determine the magnitude of NCD multimorbidity and its effect on QoL and functionality, (2) a qualitative study to explore organisation of care for patients with multimorbidity, and (3) a longitudinal quantitative study to investigate disease progression and patient outcomes over time.
