با سلام خدمت کاربران در صورتی که با خطای سیستم پرداخت بانکی مواجه شدید از طریق کارت به کارت (6037997535328901 بانک ملی ناصر خنجری ) مقاله خود را دریافت کنید (تا مشکل رفع گردد).
ردیف | عنوان | نوع |
---|---|---|
1 |
Comorbidity network for chronic disease: A novel approach to understand type 2 diabetes progression
شبکه همبستگی برای بیماری مزمن: روش جدید برای درک پیشرفت نوع 2 دیابت-2018 Background: Chronic diseases management outside expensive hospital settings has become a major target for
governments, funders and healthcare service providers. It is well known that chronic diseases such as Type 2
Diabetes (T2D) do not occur in isolation, and has a shared aetiology common to many other diseases and
disorders. Diabetes Australia reports that it is associated with a myriad of complications, which affect the feet,
eyes, kidneys, and cardiovascular health. For instance, nerve damage in the lower limbs affects around 13% of
Australians with diabetes, diabetic retinopathy occurs in over 15% of Australians with diabetes, and diabetes is
now the leading cause of end-stage kidney disease. Our research focus is therefore to understand the comorbidity
pattern, which in turn can enhance our understanding of the multifactorial risk factors of chronic diseases like
Type 2 Diabetes.
Our research approach is based on utilising valuable indicators present in pre-existing administrative
healthcare data, which are routinely collected but often neglected in health research. One such administrative
healthcare data is the hospital admission and discharge data that carries information about diagnoses, which are
represented in the form of ICD-10 diagnosis codes. Analysis of diagnoses codes and their relationships helps us
construct comorbidity networks which can provide insights that can be used to understand chronic disease
progression pattern and comorbidity network at a population level. This understanding can subsequently enable
healthcare providers to formulate appropriate preventive health policies targeted to address high-risk chronic
conditions.
Methods and findings: The research utilises network theory principles applied to administrative healthcare data.
Given the high rate of prevalence, we selected Type 2 Diabetes as the exemplar chronic disease. We have
developed a research framework to understand and represent the progression of Type 2 diabetes, utilising graph
theory and social network analysis techniques. We propose the concept of a ‘comorbidity network’ that can ef
fectively model chronic disease comorbidities and their transition patterns, thereby representing the chronic
disease progression. We further take the attribution effect of the comorbidities into account while generating the
network; that is, we not only look at the pattern of disease in chronic disease patients, but also compare the
disease pattern with that of non-chronic patients, to understand which comorbidities have a higher influence on
the chronic disease pathway.
The research framework enables us to construct a baseline comorbidity network for each of the two cohorts. It
then compares and merges these two networks into single comorbidity network to discover the comorbidities that
are exclusive to diabetic patients. This framework was applied on administrative data drawn from the Australian
healthcare context. The overall dataset contained approximately 1.4 million admission records from 0.75 million
patients, from which we filtered and sampled the records of 2300 diabetics and 2300 non-diabetic patients. We
found significant difference in the health trajectory of diabetic and non-diabetic cohorts. The diabetic cohort
exhibited more comorbidity prevalence and denser network properties. For example, in the diabetic cohort,
heart and liver-related disorders, cataract etc. were more prevalent. Over time, the prevalence of diseases in the
health trajectory of diabetic cohorts were almost double of the prevalence in the non-diabetic cohort, indicating
entirely different ways of disease progression.
Conclusions: The paper presents a research framework based on network theory to understand chronic disease
progression along with associated comorbidities that manifest over time. The analysis methods provide insights
that can enable healthcare providers to develop targeted preventive health management programs to reduce
hospital admissions and associated hi |
مقاله انگلیسی |
2 |
Renal function, N-terminal Pro-B-Type natriuretic peptide, propeptide big endothelin and patients with heart failure and preserved ejection fraction
عملکرد کلیوی، N ترمینال نرم افزار-B پپتید ناتریورتیک، propeptide اندوتلین بزرگ و بیماران مبتلا به نارسایی قلب و کسر خروجی حفظ-2018 Renal dysfunction may limit the clinical application of NT-proBNP in the diagnosis of heart failure. In general
practice, where echocardiography is not readily available, a biomarker for the diagnosis of a heart failure with
preserved ejection fraction (HFpEF) would be useful. Since cardiac diseases frequently coincide with renal
disease, there is a high need of valid risk stratification methods in patients affected with both. We therefore
examined NT-proBNP and another biomarker, Big-Endothelin-1, as a marker of HFpEF in patients with CKD.
NT-proBNP and Big-ET-1 were determined in 439 patients with HFpEF in the Ludwigshafen Risk and
Cardiovascular Health (LURIC) study.
NT-proBNP plasma level has shown an exponential increase with declining GFR, while Big-ET-1 plasma level
increased only in a moderate and linear fashion. In patients without CKD, a NT-proBNP cut-off point at 250 pg/
mL was suitable for the discrimination between HFpEF and patients without HF. When the GFR was less than
60 mL/min/1.73m2, the NT-proBNP cut-off point should be raised to 750 pg/mL. At a cutoff point at 0.85 fmol/
L, Big-ET-1 allowed to distinguish patients with HFpEF from persons without HF, independently of GFR.
In general, NT-proBNP is a good indicator of suspected heart failure. While for NT-proBNP different cut-off
points have to be considered in the diagnosis of HFpEF, a single cut-off point of Big-ET-1 was appropriate in the
diagnosis of HFpEF, regardless of the presence or absence of CKD.
An additional measurement of Big-ET-1 improves the diagnosis of HFpEF in patients with chronic kidney
disease.
Keywords: N-Terminal Pro-B-Type natriuretic peptide ، (NT-proBNP)، Big-Endothelin-1 (Big-ET-1) ، Heart failure with preserved ejection fraction ، (HFpEF) ، Chronic kidney disease (CKD) ، Peptides ، Biomarkers |
مقاله انگلیسی |
3 |
اثر فعالیت فیزیکی بر سلامت قلبی عروقی و اسکلتی-عضلانی: آیا حرکت و جنبش می-تواند به عنوان نوعی دارو تجویز شود؟
سال انتشار: 2017 - تعداد صفحات فایل pdf انگلیسی: 7 - تعداد صفحات فایل doc فارسی: 23 فعالیت فیزیکی یک ابزار درمانی شناخته شده برای انواع شرایط پزشکی است از جمله بیماری های قلبی عروقی مانند بیماری شریان کرونر، سکته مغزی، دیابت نوع 2 و چاقی. علاوه بر این افزایش فعالیت فیزیکی را می توان یک روش درمانی برای بهبود سلامت اسکلتی عضلانی دانست؛ با این حال گزارش های متناقضی در مورد فعالیت فیزیکی وجود دارند که به بیماری دژنراتیو اسکلتی عضلانی به خصوص استئوآرتریت (OA) منجر می شوند. علاوه بر این اگرچه فعالیت فیزیکی مزایای خاص خود را دارد هنوز مشخص نیست چه میزان از فعالیت بدنی بیشترین منفعت را دارد. تمرین های ورزشی بیش از حد و ناکافی ممکن است عواقب نامطلوبی به همراه داشته باشند. این موارد می تواند روی این امر اثر بگذارد که پزشکان در مورد شدت ورزش چه توصیه هایی به بیماران خود می کنند. مطالعات متعددی اثر فعالیت فیزیکی را بر جنبه های مختلف سلامتی بررسی کرده اند. با این حال هنوز مطالعات سیستماتیک کافی وجود ندارند که سلامت اسکلتی عضلانی و قلبی عروقی را به عنوان نتایج ورزش بررسی کنند. بنابراین هدف از این مقاله ی مروری ارزیابی این مسئله است که چگونه فعالیت فیزیکی می تواند روی این جنبه های سلامتی اثر بگذارد. به طور خاص ما اثر سطوح مختلف فعالیت فیزیکی را روی 1)سلامت قلبی عروقی و 2)سلامت اسکلتی عضلانی بررسی کردیم. این مقاله مروری نشان می دهد که فعالیت فیزیکی ممکن است بیماری قلبی عروقی را کاهش دهد و علائم OA را بهبود دهد و بنابراین حرکت و جنبش را می توان نوعی دارو دانست. با این حال از آنجاییکه فعالیت سنگین می تواند به طور بالقوه منجر به افزایش ریسک OA شود، پزشکان باید به بیماران خود اینطور توصیه کنند که فعالیت بیش از حد می تواند اثرات بالقوه ی منفی روی سلامتی آنها داشته باشد و ورزش باید در حد اعتدال انجام شود و پس از آن مطالعات بیشتری صورت گیرد.
کلمات کلیدی: فعالیت فیزیکی | سلامت قلبی عروقی | سلامت اسکلتی عضلانی |
مقاله ترجمه شده |
4 |
Determinants of respiratory and cardiovascular health effects in traffic policemen: A perception-based comparative analysis
عوامل تعیین کننده سلامت تنفسی و قلب و عروقی در پلیس راهنمایی و رانندگی: تجزیه و تحلیل مقایسه ای مبتنی بر درک-2017 This study investigates the determining factors behind the adverse health effects of traffic
policemen in the National Capital Territory (NCT) of Delhi. A comparative analysis be
tween 532 traffic policemen (subject population) and 150 office workers (control group)
was undertaken to study the prevalence of disease. A primary survey was conducted over
a period of 6 months between July 2015 and February 2016 using a questionnaires a
primary tool. A significantly higher (p¼0.005) prevalence rate of respiratory and cardio
vascular diseases was observed among traffic policemen than among the office workers
(control group). Symptoms such as thick sputum, pain in joints and shortness of breath
were prevalent in approximately 59%, 56% and 45% of subjects as compared to approxi
mately 15%, 11% and 6% of the control population. The relative risk (RR) of developing
respiratory and cardiovascular diseases was found to be significantly higher (RR41) for
the traffic policemen than for the office workers. This is the first cross-sectional study to
highlight the plight of traffic policemen in the NCT of Delhi. The influence of factors such
as body mass index (BMI), age, habits (smoking and alcohol consumption) and service
duration on disease prevalence was assessed among traffic policemen using statistical
tests. The service duration was found to be the most important determinant compared
with other influencing factors such as BMI and age, which significantly (p¼0.02) affects
the health of traffic policemen in the present study. A number of potential measures for
improving the health conditions of traffic policemen are also discussed.
Keywords: Traffic policemen vs. office workers | Prevalence rate | Relative Risk | Health survey | Health symptoms due to traffic-related air | pollution |
مقاله انگلیسی |
5 |
Sound the alarm: Health and safety risks associated with alarm response for salaried and retained metropolitan firefighters
صدای زنگ: بهداشت و ایمنی خطرات مرتبط با پاسخ با زنگ هشدار برای حفظ حقوق بگیر و آتش نشان شهری-2016 Responding to an emergency alarm poses a significant risk to firefighters’ health and safety, particularly to cardiovascular health, physical and psychological stress, and fatigue. These risks have been largely cat- egorised for salaried firefighters working ‘on station’. Less is known about the factors that contribute to these risks for the vast number of non-salaried personnel who serve in retained roles, often deploying from home. The present study investigated the alarm response procedure for Australian metropolitan fire fighters, identifying common and divergent sources of risk for salaried and retained staff. There were sig- nificant differences in procedure between the two workgroups and this resulted in differences in risk pro- file between groups. Sleep and fatigue, actual response to the alarm stimulus, work-life balance and trauma emerged as sources of risk experienced differently by salaried and retained firefighters. Key find- ings included reports of fatigue in both groups, but particularly in the case of retained firefighters who manage primary employment as well as their retained position. This also translated into a poor sense of work-life balance. Both groups reported light sleep, insufficient sleep or fragmented sleep as a result of alarm response. In the case of salaried firefighters, this was associated with being woken on station when other appliances are called. There were risks from physical and psychological responses to the alarm stimulus, and reports of sleep inertia when driving soon after waking. The findings of this study highlight the common and divergent risks for these workgroups, and could be used in the ongoing man- agement of firefighters’ health and safety.© 2015 Published by Elsevier Ltd.
Risk | Alarm response | Emergency services | Fatigue | Sleep inertia |
مقاله انگلیسی |