Abstract
Objective: Systematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type.
Method: A systematic search of peer-reviewed articles resulted in a pool of 12,933 articles. We included only articles that meet all the selection criteria: (1) peer-reviewed, (2) written in English, and (3) addressed consumer preference for one or more of the e-cigarette attributes including flavor, strength, and type.
Results: 66 articles met the inclusion criteria for this review. Consumers preferred flavored e-cigarettes, and such preference varied with age groups and smoking status. We also found that several flavors were associated with decreased harm perception while tobacco flavor was associated with increased harm perception. In addition, some flavor chemicals and sweeteners used in e-cigarettes could be of toxicological concern. Finally, consumer preference for nicotine strength and types depended on smoking status, e-cigarette use history, and gender.
Conclusion: Adolescents could consider flavor the most important factor trying e-cigarettes and were more likely to initiate vaping through flavored e-cigarettes. Young adults overall preferred sweet, menthol, and cherry flavors, while non-smokers in particular preferred coffee and menthol flavors. Adults in general also preferred sweet flavors (though smokers like tobacco flavor the most) and disliked flavors that elicit bitterness or harshness. In terms of whether flavored e-cigarettes assisted quitting smoking, we found inconclusive evidence. E-cigarette users likely initiated use with a cigarette like product and transitioned to an advanced system with more features. Non-smokers and inexperienced e-cigarettes users tended to prefer no nicotine or low nicotine e-cigarettes while smokers and experienced e-cigarettes users preferred medium and high nicotine e-cigarettes. Weak evidence exists regarding a positive interaction between menthol flavor and nicotine strength.
¿QUÉ TIPO DE ESTUDIO ES? Review Cohorte Casos y controles Ensayo clínico Serie de casos.
Effective messages in vaccine promotion: a randomized trial
Objectives: To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR).
Methods: A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 18 years and older residing in the United States who have children in their household age 17 years or younger (conducted June-July 2011). Parents were randomly assigned to receive 1 of 4 interventions: (1) information explaining the lack of evidence that MMR causes autism from the Centers for Disease Control and Prevention; (2) textual information about the dangers of the diseases prevented by MMR from the Vaccine Information Statement; (3) images of children who have diseases prevented by the MMR vaccine; (4) a dramatic narrative about an infant who almost died of measles from a Centers for Disease Control and Prevention fact sheet; or to a control group.
Results: None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects.
Conclusions: Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.
Keywords: MMR; autism; false; misinformation; misperceptions; myths; vaccines.
¿QUE TIPO DE ESTUDIO ES? Ensayo clínico Cohorte Revisión Casos y controles estudio poblacional.
Recurrencia de la infección gástrica con Helicobacter pylori en
adultos peruanos con distrés postprandial dos años después de
la erradicación exitosa
RESUMEN
* Introducción: Hasta el año 2000, en Perú se habían reportado tasas de recurrencia de H. pylori muy altas que podrían hacer
inefectiva la erradicación de la infección a largo plazo e incrementar la prevalencia de cáncer gástrico y otras patologías asociadas.
* Materiales y métodos: Estudio de cohorte única, prospectivo. Se reclutaron participantes peruanos con distrés postprandial
e infección con H. pylori diagnosticada mediante el análisis histopatológico de biopsias gástricas. Aquellos con erradicación
exitosa después del tratamiento fueron contactados dos años después para determinar la tasa de recurrencia mediante la
prueba del aliento con urea marcada.
* Resultados: De 129 participantes dispépticos infectados con H. pylori elegibles, 101tuvieron erradicación exitosa de la infección y 28 permanecieron infectados post-tratamiento. La tasa de efectividad fue de77,2%. Dos años después, se pudieron contactar a 65 participantes con erradicación exitosa post-tratamiento, 5 de los cuales tuvieron recurrencias positivas y 60 permanecieron libres de la infección. La tasa de recurrencia fue 7,7% dos años posttratamiento (IC 1,5%-13.5%, = 0,05) y la tasa de recurrencia anual fue 3,85% por año-paciente de seguimiento. El 94% de losparticipantes seguidos provenían del nivel socioeconómico bajo de la ciudad, el 95,4% contaba con agua potable domiciliariay el 90,8% consumía agua hervida diariamente.
* Conclusiones: La tasa de recurrencia del H. pylori en algunas poblaciones del Perú es baja y comparable a la de los países desarrollados. En estas poblaciones, la erradicación del H. pylori podría constituir una medida de salud pública para el control de la infección.
* Palabras clave: Recurrencia; Helicobacter pylori; Neoplasias gástricas (fuente: DeCS BIREME)
¿QUÉ TIPO DE ESTUDIO ES? Cohorte Casos y controles Ensayo clínico Serie de casos.
. Tamez-Pérez HE, Bahena-García A, Gómez de Ossio MD, Gutiérrez-Hermosillo H, Tamez-Peña AL. Rosiglitazone as an option for patients with
acromegaly: a case series. J Med Case Reports, Mayo 21, 2011;5(1):200.
Resumen
* Introducción. En el paciente con acromegalia, la cirugía hipofisaria representa el estándar terapéutico. A pesar de someterse a tratamiento quirúrgico, una cantidad significativa de pacientes con acromegalia continúa presentando secreción descontrolada de hormona del crecimiento.Estos pacientes requieren otros tratamientos, como radiación externa, tratamiento farmacológico, o ambos.
* Presentación del caso. Los autores presentan las respuestas clínica y de laboratorio a seis meses de tratamiento con rosiglitazona en cuatro casos. En los cuatro, los pacientes presentaron sobreproducción persistente de hormona del crecimiento, pese a la cirugía previa y otros tratamientos convencionales. El caso 1 corresponde a una mujer caucásica de 57 años; el 2 es un varón hispano de 51 años; el 3, una mujer hispana de 32 años; el 4,un varón hispano de 36 años. En tres de los pacientes, los niveles basal y nadir de la hormona del crecimiento y del factor de crecimiento similar a la insulina 1 estuvieron significativamente disminuidos (p < 0.05 y p < 0.01, respectivamente).
* Conclusión. La rosiglitazona puede ser una opción terapéutica en pacientes seleccionados con acromegalia
¿CUÁL ES SU DISEÑO METODOLÓGICO? Serie de casos Cohorte Ensayo clínico Revisión.
González JG, Elizondo G, Saldívar D, Nanez H, Todd LE, Villarreal JZ.Pituitary gland growth during normal pregnancy: An in Vivo study using magnetic resonance imaging. Am J Med, Ago 1988;85(2):217-20.
* Propósito. Los estudios de autopsia muestran que el embarazo lleva a un agrandamiento fisiológico de la hipófisis. Los autores usaron imágenes de resonancia magnética (MRI) con el fin de corroborar estos datos in vivo.
* Pacientes y métodos. Con base en la edad gestacional, se dividió a 32 pacientes primigrávidas normales en tres grupos: grupo I (n = 10), menos de 12 semanas de gestación; grupo II (n = 11), de 13 a 26 semanas de gestación; grupo III (n = 11), 27 semanas de gestación o más. Las dimensiones y los volúmenes hipofisarios de estos tres grupos fueron comparados con los de 20 mujeres nulíparas sanas (grupo control).
* Resultados. Las mediciones de MRI mostraron un aumento significativo en el volumen hipofisario en los grupos I, II, y también cuando se les comparó con el grupo control (p < 0.001). De manera adicional, se produjo un aumento del volumen hipofisario entre los grupos I y II, y entre los grupos II y III, aunque el primero no alcanzó significancia estadística (p > 0.05). Al final del embarazo, el diámetro vertical de la hipófisis había aumentado 2.6 mm.
¿QUÉ TIPO DE ESTUDIO ES?
Casos y controles Serie de casos Cohortes Ensayo clínico.
González JG, Elizondo G, Saldívar D, Nanez H, Todd LE, Villarreal JZ.Pituitary gland growth during normal pregnancy: An in Vivo study using magnetic resonance imaging. Am J Med, Ago 1988;85(2):217-20.
* Propósito. Los estudios de autopsia muestran que el embarazo lleva a un agrandamiento fisiológico de la hipófisis. Los autores usaron imágenes de resonancia magnética (MRI) con el fin de corroborar estos datos in vivo.
* Pacientes y métodos. Con base en la edad gestacional, se dividió a 32 pacientes primigrávidas normales en tres grupos: grupo I (n = 10), menos de 12 semanas de gestación; grupo II (n = 11), de 13 a 26 semanas de gestación; grupo III (n = 11), 27 semanas de gestación o más. Las dimensiones y los volúmenes hipofisarios de estos tres grupos fueron comparados con los de 20 mujeres nulíparas sanas (grupo control).
* Resultados. Las mediciones de MRI mostraron un aumento significativo en el volumen hipofisario en los grupos I, II, y también cuando se les comparó con el grupo control (p < 0.001). De manera adicional, se produjo un aumento del volumen hipofisario entre los grupos I y II, y entre los grupos II y III, aunque el primero no alcanzó significancia estadística (p > 0.05). Al final del embarazo, el diámetro vertical de la hipófisis había aumentado 2.6 mm.
¿QUÉ SIGNIFICA QUE EL AUMENTO DE VOL. HIPOFISIARIO ENTRE GRUPO NO ALCANZO SIGNIFICANCIA ESTADÍSTICA p >0.05? Hay una posibilidad mayor al 95% de que la relación fue debido al azar Hay una posibilidad mayor al 95% de que la relación no fue debido al azar Hay una posibilidad menor al 5% de que la relación no fue debido al azar Hay una posibilidad menor al 5% de que la relación fue debido al azar.
Background: Asthma is a common condition due to chronic inflammation of the lower respiratory tract. Chronic lower airway inflammation is known to be more common in individuals that also have inflammatory disorders of the upper airway. The scientific understanding of asthma continues to improve and it is important for providers who treat upper or lower airway inflammation to be familiar with asthma's definition and pathophysiology.
Methods: Articles were selected based on literature reviews through PubMed and personal knowledge of the author. The search selection was not standardized.
Results: Asthma is a heterogenic condition that is underdiagnosed and undertreated despite that the skills needed to diagnose it are readily attainable and effective treatments are available. Providers need a working understanding of asthma in order to be proficient at managing their patients with chronic nasal or sinus inflammation. This article provides a primer focusing on the current conception asthma in terms of definition, possible etiologies, inflammatory profile, pathophysiology, subtypes, and overlapping conditions.
Conclusion: Asthma is a chronic inflammatory disorder arising from not fully understood heterogenic gene-environment interactions. It features variable airway obstruction and bronchial hyperresponsiveness. Clinically, asthmatics exhibit recurrent episodes of wheeze, cough, chest tightness, and shortness of breath.
Keywords: asthma; definitions; epigenetics; genetics; pathophysiology; phenotypes.
DOI: 10.1002/alr.21609
¿QUE TIPO DE ESTUDIO ES? Review Cohorte Ensayo clínico Estudio Longitudinal.
Longitudinal school-wide survey data were collected from middle and high school students in Fall 2013 (wave 1) and Spring 2014 (wave 2). Among never e-cigarette users at wave 1 (n = 1720), e-cigarette susceptibility was measured by two items assessing anticipation of experimenting with e-cigarettes in the future and willingness to use an e-cigarette if offered by a best friend. Logistic regression models examined susceptibility as a predictor of e-cigarette initiation and past 30-day use 6 months later at wave 2. Models were clustered by school and controlled for sex, age, race, SES, and other substance use (alcohol, marijuana, and other tobacco).
DOI: 10.1093/ntr/ntw393
¿En que parte del articulo, esperarías encontrar lo anterior? Material y métodos Introducción Discusión Resultados.
In total, 8.9% (n = 153) of youth initiated e-cigarettes and 3.7% (n = 63) reported past 30-day use at wave 2. E-cigarette susceptibility was a significant independent predictor of subsequent initiation (OR = 4.27, 95% CI = 3.12-5.85) and past 30-day e-cigarette use (OR = 5.10, 95%CI = 3.38-7.68) 6 months later. Susceptible youth were more likely to be male, older, and have used alcohol, marijuana, or other tobacco products.
DOI: 10.1093/ntr/ntw393
¿En que parte del articulo, esperarías encontrar lo anterior? Resultados Material y métodos Conclusión Discusión.
These findings provide initial support for adapting two susceptibility items to identify adolescents at risk for future e-cigarette use. Identifying strategies that are effective for targeting susceptible youth and preventing future e-cigarette use will be critical areas for future research.
DOI: 10.1093/ntr/ntw393
¿En que parte del articulo, esperarías encontrar lo anterior? Conclusión Introducción Metodología Resultados.
Importance β-Blocker therapy may control heart rate and attenuate the deleterious effects of β-adrenergic receptor stimulation in septic shock. However, β-Blockers are not traditionally used for this condition and may worsen cardiovascular decompensation related through negative inotropic and hypotensive effects.
* Objective To investigate the effect of the short-acting β-blocker esmolol in patients with severe septic shock.
* Design, Setting, and Patients Open-label, randomized phase 2 study, conducted in a university hospital intensive care unit (ICU) between November 2010 and July 2012, involving patients in septic shock with a heart rate of 95/min or higher requiring high-dose norepinephrine to maintain a mean arterial pressure of 65 mm Hg or higher.
* Interventions We randomly assigned 77 patients to receive a continuous infusion of esmolol titrated to maintain heart rate between 80/min and 94/min for their ICU stay and 77 patients to standard treatment.
* Main Outcomes and Measures Our primary outcome was a reduction in heart rate below the predefined threshold of 95/min and to maintain heart rate between 80/min and 94/min by esmolol treatment over a 96-hour period. Secondary outcomes included hemodynamic and organ function measures; norepinephrine dosages at 24, 48, 72, and 96 hours; and adverse events and mortality occurring within 28 days after randomization.
* Results Targeted heart rates were achieved in all patients in the esmolol group compared with those in the control group. The median AUC for heart rate during the first 96 hours was −28/min (IQR, −37 to −21) for the esmolol group vs −6/min (95% CI, −14 to 0) for the control group with a mean reduction of 18/min (P < .001). For stroke volume index, the median AUC for esmolol was 4 mL/m2 (IQR, −1 to 10) vs 1 mL/m2 for the control group (IQR, −3 to 5; P = .02), whereas the left ventricular stroke work index for esmolol was 3 mL/m2 (IQR, 0 to 8) vs 1 mL/m2 for the control group (IQR, −2 to 5; P = .03). For arterial lactatemia, median AUC for esmolol was −0.1 mmol/L (IQR, −0.6 to 0.2) vs 0.1 mmol/L for the control group (IQR, −0.3 for 0.6; P = .007); for norepinephrine, −0.11 μg/kg/min (IQR, −0.46 to 0.02) for the esmolol group vs −0.01 μg/kg/min (IQR, −0.2 to 0.44) for the control group (P = .003). Fluid requirements were reduced in the esmolol group: median AUC was 3975 mL/24 h (IQR, 3663 to 4200) vs 4425 mL/24 h(IQR, 4038 to 4775) for the control group (P < .001). We found no clinically relevant differences between groups in other cardiopulmonary variables nor in rescue therapy requirements. Twenty-eight day mortality was 49.4% in the esmolol group vs 80.5% in the control group (adjusted hazard ratio, 0.39; 95% CI, 0.26 to 0.59; P < .001).
* Conclusions and Relevance For patients in septic shock, open-label use of esmolol vs standard care was associated with reductions in heart rates to achieve target levels, without increased adverse events. The observed improvement in mortality and other secondary clinical outcomes warrants further investigation.
doi:10.1001/jama.2013.278477
¿QUÉ TIPO DE ESTUDIO ES? Ensayo clínico Cohorte Casos y controles Revisión.
Methods: 60 patients with CML-CP combined with vPh from January 2010 to May 2017 in the First Affiliated Hospital of Kunming Medical University were chosen as CML-CP-vPh group, and 107 patients with CML-CP combined with typical Ph chromosome at the same time were chosen as control group. The patients in two groups were treated with imatinib; The curative efficacy, karyotype and FISH signal type were compared between 2 groups, and the factors influencing long-term survival of patients were analyzed by Cox risk model.
DOI: 10.19746/j.cnki.issn.1009-2137.2020.04.013
¿QUE TIPO DE DISEÑO DE ESTUDIO ES?
Casos y controles Review Ensayo clínico Cohorte.
(A) There are few reports of the appearance of pulmonary arterial hypertension following arterial switch surgery in the neonatal period to correct transposition of the great arteries. We assessed the frequency and clinical pattern of this complication in our series of patients.
(B) Our database was reviewed to select patients with transposition of the great arteries corrected by neonatal arterial switch at our hospital and who developed pulmonary hypertension over time.
(C) We identified 2 (1.3%) patients with transposition of the great arteries successfully repaired in the first week of life who later experienced pulmonary arterial hypertension. The first patient was a 7-year-old girl diagnosed with severe pulmonary hypertension at age 8 months who did not respond to medical treatment and required lung transplantation. The anatomic pathology findings were consistent with severe pulmonary arterial hypertension. The second patient was a 24-month-old boy diagnosed with severe pulmonary hypertension at age 13 months who did not respond to medical therapy.
(D) Pulmonary hypertension is a rare but very severe complication that should be investigated in all patients with transposition of the great arteries who have undergone neonatal arterial switch, in order to start early aggressive therapy for affected patients, given the poor therapeutic response and poor prognosis involved.
(E) Arterial switch; Hipertensión arterial pulmonar; Pulmonary arterial hypertension; Switch arterial; Transposición de grandes arterias; Transposition of the great arteries.
DOI: 10.1016/j.rec.2016.03.006
¿Cual letra corresponde a la conclusión? D A B C.
(A) There are few reports of the appearance of pulmonary arterial hypertension following arterial switch surgery in the neonatal period to correct transposition of the great arteries. We assessed the frequency and clinical pattern of this complication in our series of patients.
(B) Our database was reviewed to select patients with transposition of the great arteries corrected by neonatal arterial switch at our hospital and who developed pulmonary hypertension over time.
(C) We identified 2 (1.3%) patients with transposition of the great arteries successfully repaired in the first week of life who later experienced pulmonary arterial hypertension. The first patient was a 7-year-old girl diagnosed with severe pulmonary hypertension at age 8 months who did not respond to medical treatment and required lung transplantation. The anatomic pathology findings were consistent with severe pulmonary arterial hypertension. The second patient was a 24-month-old boy diagnosed with severe pulmonary hypertension at age 13 months who did not respond to medical therapy.
(D) Pulmonary hypertension is a rare but very severe complication that should be investigated in all patients with transposition of the great arteries who have undergone neonatal arterial switch, in order to start early aggressive therapy for affected patients, given the poor therapeutic response and poor prognosis involved.
(E) Arterial switch; Hipertensión arterial pulmonar; Pulmonary arterial hypertension; Switch arterial; Transposición de grandes arterias; Transposition of the great arteries.
DOI: 10.1016/j.rec.2016.03.006
¿Cual letra corresponde a los resultados? C A B D.
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