disease management

疾病管理
  • 文章类型: Journal Article
    肌肉骨骼(MSK)疾病,影响着全世界数十亿人,对医疗保健系统构成重大挑战,需要有效的管理模式。数字医疗技术(DHT)的快速发展彻底改变了医疗行业。基于DHT的干预措施在管理MSK疾病方面显示出有希望的临床益处。减轻疼痛,改善功能损害。有,然而,没有对这一主题的总体趋势进行文献计量分析。
    我们从WebofScienceCoreCollection(WoSCC)数据库中提取了所有相关出版物,直到2023年4月30日。我们使用CiteSpace进行了文献计量分析和可视化,VOSviewer,R软件出版物的年度趋势,国家/地区分布,资助机构,机构,共同引用的期刊,作者贡献,参考文献,核心期刊,并对关键词和研究热点进行了分析。
    本研究共纳入6810篇论文。出版物从1995年的16篇急剧增加到2022年的1198篇,在过去五年中发表了4067篇文章。总之,53个国家为这一研究领域提供了出版物。美国,联合王国,中国是生产力最高的国家。哈佛大学是贡献最大的机构。关于关键词,研究重点包括人工智能,深度学习,机器学习,远程医疗,康复,和机器人。
    COVID-19大流行进一步加速了对DHT的采用,强调远程护理选项的必要性。分析揭示了DHT对提高医生生产力的积极影响,提高患者护理和生活质量,减少医疗支出,预测结果。DHT不仅是临床领域的研究热点,也是康复多学科交叉领域的研究热点。护理,教育,社会和经济领域。该分析确定了将DHT整合到MSK疼痛管理中的四个有希望的热点,生物力学评估,MSK诊断和预测,以及关节成形术护理中的机器人和远程康复。
    UNASSIGNED: Musculoskeletal (MSK) disorders, affecting billions of people worldwide, pose significant challenges to the healthcare system and require effective management models. The rapid development of digital healthcare technologies (DHTs) has revolutionized the healthcare industry. DHT-based interventions have shown promising clinical benefits in managing MSK disorders, alleviating pain, and improving functional impairment. There is, however, no bibliometric analysis of the overall trends on this topic.
    UNASSIGNED: We extracted all relevant publications from the Web of Science Core Collection (WoSCC) database until April 30, 2023. We performed bibliometric analysis and visualization using CiteSpace, VOSviewer, and R software. Annual trends of publications, countries/regions distributions, funding agencies, institutions, co-cited journals, author contributions, references, core journals, and keywords and research hotspots were analyzed.
    UNASSIGNED: A total of 6810 papers were enrolled in this study. Publications have increased drastically from 16 in 1995 to 1198 in 2022, with 4067 articles published in the last five years. In all, 53 countries contributed with publications to this research area. The United States, the United Kingdom, and China were the most productive countries. Harvard University was the most contributing institution. Regarding keywords, research focuses include artificial intelligence, deep learning, machine learning, telemedicine, rehabilitation, and robotics.
    UNASSIGNED: The COVID-19 pandemic has further accelerated the adoption of DHTs, highlighting the need for remote care options. The analysis reveals the positive impact of DHTs on improving physician productivity, enhancing patient care and quality of life, reducing healthcare expenditures, and predicting outcomes. DHTs are a hot topic of research not only in the clinical field but also in the multidisciplinary intersection of rehabilitation, nursing, education, social and economic fields. The analysis identifies four promising hotspots in the integration of DHTs in MSK pain management, biomechanics assessment, MSK diagnosis and prediction, and robotics and tele-rehabilitation in arthroplasty care.
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  • 文章类型: Journal Article
    背景:糖尿病患者,血管疾病,哮喘经常难以维持其慢性健康状况的稳定,特别是那些在农村地区,生活在贫困中,或种族或种族化的人口。这些群体可能会经历医疗保健方面的不平等,一群人比其他人拥有更少或更低质量的资源。将行为医疗服务纳入初级保健服务有望帮助初级保健团队更好地管理患者病情,但它涉及以多种方式改变诊所提供护理的方式。一些诊所在充分整合行为健康模型方面比其他诊所更成功,如我们团队先前进行的研究所示,确定了四种实施模式:低,结构,部分,和坚强。很少有人知道这种整合的变化可能与慢性病管理有关,以及IBH是否可以成为减少医疗保健不平等的策略。本研究探讨了在医疗保健不平等的背景下,IBH实施变化与慢性病管理之间的潜在关系。
    方法:建立在先前发表的明尼苏达州102个初级保健诊所的潜在类别分析的基础上,我们使用多元回归来建立IBH潜在类别与慢性病管理中医疗保健不平等之间的关系,然后进行结构方程建模,以研究IBH潜在类别如何缓解这些医疗保健不平等。
    结果:与我们的假设相反,并证明了研究问题的复杂性,慢性病管理较好的诊所更可能是低IBH,而不是任何其他整合水平.强大的结构性IBH诊所表现出更好的慢性病管理,因为诊所位置的种族变得更加白化。
    结论:IBH可能会改善护理,尽管这可能不足以解决医疗保健不平等;当存在较少的社会健康决定因素时,IBH似乎会更有效。低IBH的诊所可能没有动力参与这种慢性病管理的实践变化,可能需要提供其他原因。可能需要更大的系统性和政策变革,专门针对医疗保健不平等的机制。
    BACKGROUND: People with diabetes, vascular disease, and asthma often struggle to maintain stability in their chronic health conditions, particularly those in rural areas, living in poverty, or racially or ethnically minoritized populations. These groups can experience inequities in healthcare, where one group of people has fewer or lower-quality resources than others. Integrating behavioral healthcare services into primary care holds promise in helping the primary care team better manage patients\' conditions, but it involves changing the way care is delivered in a clinic in multiple ways. Some clinics are more successful than others in fully integrating behavioral health models as shown by previous research conducted by our team identifying four patterns of implementation: Low, Structural, Partial, and Strong. Little is known about how this variation in integration may be related to chronic disease management and if IBH could be a strategy to reduce healthcare inequities. This study explores potential relationships between IBH implementation variation and chronic disease management in the context of healthcare inequities.
    METHODS: Building on a previously published latent class analysis of 102 primary care clinics in Minnesota, we used multiple regression to establish relationships between IBH latent class and healthcare inequities in chronic disease management, and then structural equation modeling to examine how IBH latent class may moderate those healthcare inequities.
    RESULTS: Contrary to our hypotheses, and demonstrating the complexity of the research question, clinics with better chronic disease management were more likely to be Low IBH rather than any other level of integration. Strong and Structural IBH clinics demonstrated better chronic disease management as race in the clinic\'s location became more White.
    CONCLUSIONS: IBH may result in improved care, though it may not be sufficient to resolve healthcare inequities; it appears that IBH may be more effective when fewer social determinants of health are present. Clinics with Low IBH may not be motivated to engage in this practice change for chronic disease management and may need to be provided other reasons to do so. Larger systemic and policy changes are likely required that specifically target the mechanisms of healthcare inequities.
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  • 文章类型: Journal Article
    糖尿病心肌病(DCM)是2型糖尿病(T2DM)的严重继发性并发症,其被诊断为在糖尿病患者中没有任何先前的心血管病理学情况下发生的心脏病。虽然它仍然缺乏确切的定义,因为它结合了两种病理-T2DM和心力衰竭,更多的证据表明DCM是一种复杂的疾病,应该单独治疗。它是模棱两可的病理表型,使DCM难以诊断和筛查其早期发作的症状或生物标志物。此重新视图提供了对DCM诊断和治疗在实验和临床环境中的新进展的更新。DCM患者的管理本身就提出了挑战,我们的目标是帮助导航和建议临床医生进行DCM的早期筛查和药物治疗。
    Diabetic cardiomyopathy (DCM) is a severe secondary complication of type 2 diabetes mellitus (T2DM) that is diagnosed as a heart disease occurring in the absence of any previous cardiovascular pathology in diabetic patients. Although it is still lacking an exact definition as it combines aspects of both pathologies - T2DM and heart failure, more evidence comes forward that declares DCM as one complex disease that should be treated separately. It is the ambiguous pathological phenotype, symptoms or biomarkers that makes DCM hard to diagnose and screen for its early onset. This re-view provides an updated look on the novel advances in DCM diagnosis and treatment in the experimental and clinical settings. Management of patients with DCM proposes a challenge by itself and we aim to help navigate and advice clinicians with early screening and pharmacotherapy of DCM.
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  • 文章类型: Journal Article
    DeRitis比率,定义为血清天冬氨酸转氨酶(AST)与丙氨酸转氨酶(ALT)的比值,是一种广泛认可的生化标志物,在诊断和管理各种疾病方面具有重要应用,尤其是肝脏疾病。这篇综合综述综合了当前关于DeRitis比率临床相关性的知识,审视其历史发展,诊断实用程序,以及各种医疗条件下的预后意义,包括肝脏疾病,心血管疾病,和肌肉病理。通过对几十年来的文献的深入分析,这篇综述强调了DeRitis比值不仅在鉴别诊断中的作用,而且作为疾病进展和患者结局的预后指标.该比率能够区分不同类型的肝脏病理,帮助早期疾病检测,并讨论了其在监测治疗反应中的潜在用途。此外,审查涉及方法上的考虑,如混杂因素和口译挑战,影响DeRitis比率的临床效用。鉴于临床诊断的发展和对个性化医疗的推动,审查最后提出了进一步研究的建议。这些包括纵向研究,以探索该比率随时间的变化,跨不同人群的比较研究,和技术集成,以提高诊断准确性和病人护理。这篇综述旨在重申DeRitis比率在现代临床实践中的重要性,并鼓励继续探索其在医疗保健中的潜在应用和益处。
    The De Ritis ratio, defined as the serum aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio, is a widely recognized biochemical marker with significant applications in diagnosing and managing various diseases, particularly liver disorders. This comprehensive review synthesizes current knowledge surrounding the clinical relevance of the De Ritis ratio, examining its historical development, diagnostic utility, and prognostic significance across various medical conditions, including liver diseases, cardiovascular disorders, and muscular pathologies. Through an in-depth analysis of literature spanning several decades, this review highlights the role of the De Ritis ratio not only in differential diagnosis but also as a prognostic indicator for disease progression and patient outcomes. The ratio\'s ability to distinguish between different types of liver pathology, aid in early disease detection, and its potential use in monitoring treatment response are discussed. Additionally, the review addresses the methodological considerations, such as confounding factors and interpretation challenges, that impact the clinical utility of the De Ritis ratio. Given the evolving landscape of clinical diagnostics and the push toward more personalized medicine, the review concludes with recommendations for further research. These include longitudinal studies to explore the ratio\'s changes over time, comparative research across diverse populations, and technological integration to enhance diagnostic accuracy and patient care. This review aims to reaffirm the importance of the De Ritis ratio in modern clinical practice and encourages continued exploration into its potential applications and benefits in healthcare.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    在目前的情况下,基于植物的功能性食品已经获得了更广泛的关注,绿豆含有几种具有良好肠道健康益处和药理重要性的生物活性化合物。绿豆的食用对有益肠道微生物和微生物代谢产物的产生具有积极影响。饲粮绿豆对肠道微生物稳态和肠道相关疾病管理的影响以及可能的作用机制,通过这篇综述已经被强调为膳食绿豆作为功能性食品在肠道相关疾病管理中的有希望的作用铺平了道路,例如绿豆肽不仅可以帮助治疗糖尿病前期,还可以通过靶向肠道微生物区系来延缓衰老过程。此外,扩大我们对饮食如何影响宿主健康和疾病的认识,包括绿豆日粮成分对肠道菌群代谢产物的影响,最终将允许开发定制的饮食和营养素。
    Plant-based functional foods have gained wider attention in current scenario with mung bean harboring several bioactive compounds with promising gut health benefits and pharmacological importance. Consumption of mung bean has a positive impact on beneficial gut microbes and microbial metabolite production. The effects of dietary mung bean on gut microbial homeostasis and the management of gut-related diseases along with the possible mechanism of action, have been highlighted through this review paving a way for a promising role of dietary mung bean as a functional food in the management of gut-related diseases for example mung bean peptides can help not only in treating prediabetes but also delaying the aging process by targeting the intestinal microflora. In addition, expanding our knowledge of how diets affect host health and disease, including the effects of mung bean dietary components on gut microbiota-derived metabolites, will eventually allow for the development of tailored diets and nutrients.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    目的:家庭医生队伍已成为我国开展初级卫生保健的核心载体。本研究旨在测量家庭医生团队过程的网络结构特征对健康绩效的影响。提出了优化家庭医生团队流程以提高绩效的战略建议。
    方法:于2021年10月至12月在湖北潜江和湖南长沙进行了横断面调查。任务性能,上下文性能,社交网络,并收集了社会人口统计学特征。进行了社会网络分析来计算密度和集中化,然后采用层次线性回归分析探讨了家庭医生团队过程网络结构特征与绩效之间的关系。
    结果:总计,88个家庭医生团队参加了这项调查。家庭医生团队的过渡过程表现出独特的低密度(0.272±0.112),高度集中(0.866±0.197)的网络结构。对于家庭医生团队来说,行动过程的密度对任务绩效有显著的正向影响(B=0.600,P<0.05);行动过程的集中化对任务绩效有正向影响(B=0.604,P<0.01);行动过程的密度对情境绩效有正向影响(B=0.545,P<0.01);人际过程的密度对情境绩效有显著的正向影响(B=0.326,P<0.05)。
    结论:家庭医生团队流程的网络密度和集中化对慢性病管理绩效有积极影响。这项研究的结果有助于增强我们对社交网络的概念理解及其对团队动力学的影响。优化家庭医生队伍流程是加强家庭医生队伍建设,促进家庭医生签约服务质量和效率的有效途径。建议加强对团队流程的管理,加强内部协作机制,优化家庭医生队伍的集中网络结构。
    OBJECTIVE: The family physician team has become the core carrier for delivery primary health care in China. This study aimed to measure the effect of the network structural characteristics of family physician team processes on health performance. Strategic recommendations for optimizing the family physician team processes with a view to improving performance were presented.
    METHODS: A cross-sectional survey was conducted from October to December 2021 in Qianjiang in Hubei Province and Changsha in Hunan Province. Task performance, contextual performance, social networks, and sociodemographic characteristics were collected. Social network analysis was conducted to calculate density and centralization, then hierarchical linear regression analysis was employed to explore the relationship between the network structural characteristics of family physician team processes and performance.
    RESULTS: In total, 88 family physician teams attended in this investigation. The transition processes of family physician team showed a distinctive low density (0.272 ± 0.112), high centralization (0.866 ± 0.197) network structure. For family physician team, the density of action processes significantly and positively affected task performance (B = 0.600, P < 0.05); the centralization of action processes positively affected task performance (B = 0.604, P < 0.01); the density of action processes positively affected contextual performance (B = 0.545, P < 0.01); the density of interpersonal processes significantly and positively affected contextual performance (B = 0.326, P < 0.05).
    CONCLUSIONS: The network density and centralization of family physician team processes have positive effects on chronic disease management performance. The results from this study help to enhance our conceptual understanding of social network and its implications for team-dynamics. Optimizing family physician team processes is an effective way to strengthen the construction of family physician team and promote the quality and efficiency of family physician-contracted service. It is recommended to strengthen the management of team processes, enhance the internal collaboration mechanism, and optimize the centralized network structure of family physician team.
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  • 文章类型: Journal Article
    背景:端粒是染色体末端的核蛋白复合物,受遗传和环境触发因素的控制。加速的端粒缩短与疾病发病率的增加有因果关系。地中海饮食最近被认为是一种可以预防疾病的饮食。这篇综述旨在确定地中海饮食的每个组成部分对端粒长度动力学的影响。突出了潜在的分子机制。
    方法:搜索PubMed以确定相关研究,以提取数据进行叙述性综述。
    结果:地中海饮食可减轻许多疾病的临床表现。专注于自身免疫性疾病,地中海饮食可以预防炎症,线粒体功能障碍,端粒酶活性异常。此外,每个地中海饮食成分似乎通过端粒长度的维持或延长来减轻衰老,提供对潜在分子机制的见解。多酚,维生素,矿物,脂肪酸似乎在端粒体内平衡中是必不可少的,因为它们抑制炎症反应,DNA损伤,氧化应激,线粒体功能障碍,和细胞死亡并诱导端粒酶活化。
    结论:地中海饮食有利于维持端粒动力学和减轻与年龄有关的疾病。这篇综述全面概述了横截面,观察,以及关于地中海饮食中每种成分对端粒长度和慢性疾病管理的有益影响的随机对照试验。
    BACKGROUND: Telomeres are nucleoprotein complexes at the ends of chromosomes that are under the control of genetic and environmental triggers. Accelerated telomere shortening is causally implicated in the increasing incidence of diseases. The Mediterranean diet has recently been identified as one that confers protection against diseases. This review aimed to identify the effect of each component of the Mediterranean diet on telomere length dynamics, highlighting the underlying molecular mechanisms.
    METHODS: PubMed was searched to identify relevant studies to extract data for conducting a narrative review.
    RESULTS: The Mediterranean diet alleviates clinical manifestations in many diseases. Focusing on autoimmune diseases, the Mediterranean diet can be protective by preventing inflammation, mitochondrial malfunction, and abnormal telomerase activity. Also, each Mediterranean diet constituent seems to attenuate aging through the sustenance or elongation of telomere length, providing insights into the underlying molecular mechanisms. Polyphenols, vitamins, minerals, and fatty acids seem to be essential in telomere homeostasis, since they inhibit inflammatory responses, DNA damage, oxidative stress, mitochondrial malfunction, and cell death and induce telomerase activation.
    CONCLUSIONS: The Mediterranean diet is beneficial for maintaining telomere dynamics and alleviating age-related illnesses. This review provides a comprehensive overview of cross-sectional, observational, and randomized controlled trials regarding the beneficial impact of every constituent in the Mediterranean diet on telomere length and chronic disease management.
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  • 文章类型: Journal Article
    木豆(Cajanuscajan)是半干旱热带地区种植的重要豆类作物之一,在自给自足的农民的经济福祉中发挥着至关重要的作用。印度是木豆的主要生产国,占世界产量的75%以上。无菌花叶病(SMD),由木豆不育花叶病毒(PPSMV)引起,并由叶面螨(Aceriacajani)传播,是印度次大陆木豆种植的主要制约因素,导致高达100%的潜在产量损失。与SMD相关的另一种Emaravirus的最新特征进一步使这种具有挑战性的病毒性疾病的病因复杂化。这次审查的重点是关键领域,包括疾病的现状,传输和主机范围,快速表型技术,以及可用的疾病管理策略。审查的结论是对未来前景的见解,为进一步的研究和管理策略提供概述和方向。
    Pigeonpea (Cajanus cajan) is one of the important grain legume crops cultivated in the semi-arid tropics, playing a crucial role in the economic well-being of subsistence farmers. India is the major producer of pigeonpea, accounting for over 75% of the world\'s production. Sterility mosaic disease (SMD), caused by Pigeonpea sterility mosaic virus (PPSMV) and transmitted by the eriophyid mite (Aceria cajani), is a major constraint to pigeonpea cultivation in the Indian subcontinent, leading to potential yield losses of up to 100%. The recent characterization of another Emaravirus associated with SMD has further complicated the etiology of this challenging viral disease. This review focuses on critical areas, including the current status of the disease, transmission and host-range, rapid phenotyping techniques, as well as available disease management strategies. The review concludes with insights into the future prospects, offering an overview and direction for further research and management strategies.
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