European Medical Journal (Chelmsford, England)最新文献

{"title":"The Use of Evidence-Based Dietary Interventions for the Management of Obesity","authors":"L Busetto, F Casanueva, J Ard, B Van der Schueren, B Burguera","doi":"10.33590/emj/10302068","DOIUrl":"https://doi.org/10.33590/emj/10302068","url":null,"abstract":"Obesity has become a serious public health issue worldwide, with its prevalence steadily increasing. The potential consequences of this chronic disease, including cardiovascular disease, increased morbidity, and mortality, pose a significant burden on individuals and healthcare systems. Evidence has established that lifestyle and dietary modification are central to achieving effective weight loss. One approach shown to be efficacious in achieving weight loss is the use of a very low calorie ketogenic diet (VLCKD), which includes stages of induced ketosis, followed by a reintroduction to a low calorie diet and maintenance diet. Such regimens have been shown to result in sustained weight loss and, for some people, remission of Type 2 diabetes (T2D). A similar approach, which may also be a component of the VLCKD, is the use of total or partial replacement of meals using nutritionally complete shakes, bars, or soups. These may be combined with other weight loss measures, including bariatric surgery or medications. It is important that such programmes are delivered in a structured, medically-monitored, and supportive environment, such as laid out by Obesity Canada’s ‘5As’ programme. An ‘obesity shared medical appointment’ model is a multidisciplinary approach, whereby a patient with obesity is seen by a number of healthcare specialists, depending on their comorbidities. The patient also has the opportunity to meet with obesity specialists and engage in monthly patient support groups, all of which have been shown to be successful interventions in helping patients lead a healthier lifestyle, and gain more control over their weight. The following proceedings are based on talks given by leading obesity experts, presented at the 30th European Congress on Obesity (ECO 2023), which took place in Dublin, Republic of Ireland, in May 2023.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136363153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity And Specificity of FEF25–75/Forced Vital Capacity for Diagnosing Restrictive Lung Disease","authors":"Mohamad Reza Tarkhorani, Fateme Ziamanesh, Hosein Kazemi Zadeh, Maryam Edalatifard, Besharat Rahimi","doi":"10.33590/emj/10306372","DOIUrl":"https://doi.org/10.33590/emj/10306372","url":null,"abstract":"Introduction and objective: The role of spirometry in the diagnosis of restrictive lung diseases is unclear. This study investigated the sensitivity and specificity of the forced expiratory flow 25–75 (FEF25–75)/forced vital capacity (FVC) parameter in diagnosing restrictive lung disease. Methods: In this study, the records of all restrictive patients who were referred to the pulmonary centre of Imam Khomeini Hospital, Tehran, Iran, from March 2021–March 2022 have been reviewed, and the indexes in the body box and spirometry have been recorded. Results: A total of 527 people were included in the study. Among them, 134 people (25.4%) had restrictive lung disease. The average area under the graph of the FEF25–75/FVC index is 0.648±0.028. It can be said that the area under the graph for the FEF25–75/FVC index is between 0.594–0.703. The FEF25–75/FVC index at values above 79.90 has a sensitivity of 70.9% and a false positive rate (1- specificity) of 53.2%. Conclusions: According to the result of this study, the ratio of FEF25–75/FVC index in spirometry at above 79.90 has a sensitivity of 70.9% and a false positive rate (1- specificity) of 53.2%. Therefore, it can be used as a screening test for restrictive lung diseases.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135817574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interview: Dirk Devroey","authors":"Dirk Devroey","doi":"10.33590/emj/10304915","DOIUrl":"https://doi.org/10.33590/emj/10304915","url":null,"abstract":"","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135114322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infographic: The Backbone of Mobility: Interconnected Musculoskeletal Health","authors":"","doi":"10.33590/emj/10306291.","DOIUrl":"https://doi.org/10.33590/emj/10306291.","url":null,"abstract":"","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"54 33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135859540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Characterisation of the Gastrointestinal Tract Microbiome in Systemic Sclerosis.","authors":"Elizabeth R Volkmann, Anna-Maria Hoffmann-Vold, Yu-Ling Chang, Venu Lagishetty, Philip J Clements, Øyvind Midtvedt, Øyvind Molberg, Jonathan Braun, Jonathan P Jacobs","doi":"10.33590/emj/20-00043","DOIUrl":"10.33590/emj/20-00043","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate changes in microbial composition and the evolution of gastrointestinal tract (GIT) symptoms in systemic sclerosis (SSc).</p><p><strong>Methods: </strong>Adult SSc patients provided stool specimens every 3 months over the course of 1 year. Participants completed the University of California, Los Angeles (UCLA) GIT 2.0 questionnaire to assess GIT symptom severity at each stool collection. The microbiota from these samples were determined by Illumina HiSeq 2500 16S ribosomal RNA sequencing (Illumina, Inc., San Diego, California, USA). Mixed effect models evaluated changes in GIT symptoms and microbial composition over time.</p><p><strong>Results: </strong>Among 19 patients with SSc (female; 89.5%; median age: 51.3 years), the median disease duration was 7 years and the baseline total GIT 2.0 score was 0.7 (standard deviation: 0.6). The majority of participants (63%) provided at least four stool samples over the course of the 12-month study. Patients with longer disease durations had increased GIT symptoms over the course of the study. There was no difference in the course of GIT symptoms over time between patients with limited versus diffuse cutaneous disease. The relative abundances of specific genera did not change over time within individual subjects. After controlling for age, sex, ethnicity, disease duration, and SSc subtype (i.e., limited versus diffuse), low abundance of <i>Bacteroides</i> was associated with increased GIT symptoms over time.</p><p><strong>Conclusion: </strong>This study is the first to have longitudinally characterised the lower GIT microbiome in SSc patients and demonstrated relative stability of genera abundance over the course of 1 year. The findings provide additional evidence that specific genera are associated with SSc-GIT symptoms and warrant further evaluation in larger SSc studies.</p>","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"7 ","pages":"110-118"},"PeriodicalIF":0.0,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881192/pdf/nihms-1854426.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9157458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Paediatric and Adult Asthma","authors":"Anika Naeem, P. Silveyra","doi":"10.33590/emj/10312930","DOIUrl":"https://doi.org/10.33590/emj/10312930","url":null,"abstract":"Asthma is the most common chronic condition in Western countries. Affecting 1 in 7 children and 1 in 12 adults, asthma is responsible for >350,000 avoidable deaths every year. While most children who develop symptoms of asthma are <5 years of age, the disease is frequently misdiagnosed or not suspected in infants and toddlers. In addition, the prevalence of asthma is different in males and females throughout their lifespan. While boys are more likely to develop asthma than girls, this pattern is reversed after puberty. This indicates that sex-specific factors, such as fluctuations in hormone levels, play a role in the disease’s pathogenesis. In this review, the authors discuss recent advances in diagnostic tools for asthma in both adults and children, as well as the influences of BMI, environmental exposures, socioeconomic factors, and sex hormones in the disease’s pathogenesis. The review will show that both experimental and epidemiological evidence suggest that circulating sex hormone levels are important contributors to asthma symptoms in post-pubertal females, while their role in males and children has not been yet established. In addition, the mechanisms associated with these hormonal influences on airway inflammation and hyper-reactivity have not been yet elucidated. The authors conclude that different factors affect asthma rates and severity in children and adults, and that more research needs to be conducted to identify the specific contributions of sex hormones. These will allow the development of more personalised asthma treatment strategies for men and women at different stages of life.","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"105 1","pages":"27 - 35"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78513362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OCCUPATIONAL ALLERGY.","authors":"Stacey E Anderson, Carrie Long, G Scott Dotson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An estimated 11 million workers in the USA are potentially exposed to agents that can become a cause of allergic diseases such as occupational asthma and allergic contact dermatitis, which can adversely affect health and well-being. Hundreds of chemicals (e.g. metals, epoxy and acrylic resins, rubber additives, and chemical intermediates) and proteins (e.g. natural rubber latex, plant proteins, mould, animal dander) present in virtually every industry have been identified as causes of allergic disease. In general, allergens can be classified as low molecular weight (chemical) allergens and high molecular weight (protein) allergens. These agents are capable of inducing immunological responses that are both immunoglobulin E and non-immunoglobulin E-mediated. Interestingly, the same chemical can induce diverse immune responses in different individuals. As new hazards continue to emerge, it is critical to understand the immunological mechanisms of occupational allergic disease. Specific understanding of these mechanisms has direct implications in hazard identification, hazard communication, and risk assessment. Such efforts will ultimately assist in the development of risk management strategies capable of controlling workplace exposures to allergens to prevent the induction of sensitisation in naïve individuals and inhibit elicitation of allergic responses. The purpose of this short review is to give a brief synopsis of the incidence, agents, mechanisms, and research needs related to occupational allergy.</p>","PeriodicalId":72984,"journal":{"name":"European Medical Journal (Chelmsford, England)","volume":"2 2","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454566/pdf/nihms-1019260.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37321368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}