ecause it can inhibit critical targets p62, YAP, and PD-L1 at the same time.
Region-specific health-related quality of life (HRQoL) scores or utility values are representative and pivotal for economic evaluations as they are influenced by the value judgment of the local population. This study systematically reviewed and pooled EuroQoL-5 Dimension (EQ-5D) utility scores of rheumatoid arthritis (RA) across primary studies from Asia.
Studies reporting EQ-5D utility scores among adult RA patients from Asian countries were systematically searched in PubMed-Medline, Scopus and Embase since inception through February 2020. https://www.selleckchem.com/products/iwp-4.html Selected studies were systematically reviewed and study quality assessment was performed. Meta-analysis was performed using a random-effect model with subgroup and meta-regression analysis to explore heterogeneity.
Among 1391 searched articles, 37 studies with 31983 participants were systematically reviewed and meta-analysis was conducted among 31 studies. The pooled EQ-5D scores and EQ-5D visual analog score were 0.66 (95% CI 0.63-0.69, I
=99.65%) and 61.21 (50.73-71.69, I
=99.56%) respectively with high heterogeneity. For RA patients with no, low, moderate and high disease activity based on Disease Activity Score (DAS)-28, the pooled EQ-5D scores were 0.78 (0.65-0.90), 0.73 (0.65-0.80), 0.53 (0.32- 0.74), and 0.47 (0.32-0.62), respectively. On meta-regression, age of patients (P<.05) was positively associated and use of glucocorticoids (P<.05) was inversely associated with utility values.
Lower EQ-5D scores were associated with severe disease activity, increasing age and female gender among RA patients. The study provides pooled EQ-5D scores for RA patients that are useful inputs for cost-utility studies in Asia.
Lower EQ-5D scores were associated with severe disease activity, increasing age and female gender among RA patients. The study provides pooled EQ-5D scores for RA patients that are useful inputs for cost-utility studies in Asia.
Hospital avoidance services are important for older people who risk deteriorating health and independence when in hospital. However, the evidence base for nurse-led community services is equivocal.
To determine the impact of community nurse-led interventions on the need for hospital use among older adults.
The integrative review method of Whittemore and Knafl was employed and reported in accordance with PRIMSA guidelines. Medline, EMBASE and CINAHL were searched from January 2011 to January 2019. Outcomes were coded and findings reported by outcome domain to provide an integrated, narrative synthesis.
Nine studies were included in the review. Whilst disparities in the evidence base persist, specialist high-intensity, team-based hospital-at-home services were significantly more likely to reduce hospital admissions than standard care. An individual case management services that incorporated self-help education for chronic disease management also reduced hospital admissions. Financial data suggest that whilst high-intensity services are costly, they can lead to significant efficiency savings in the longer-term.
This topic remains an important area for further investment, managerial support and research because of the risks faced by older people when admitted to hospital, for whom health, quality of life and independence are vital considerations.
The provision of high-intensity team-based services and self-help education can optimise health outcomes and reduce the need for hospital use among older adults living in the community.
The provision of high-intensity team-based services and self-help education can optimise health outcomes and reduce the need for hospital use among older adults living in the community.
Posttraumatic olfactory dysfunction is a clinical challenge due to refractory characteristics and limited therapeutic options. Olfactory training has been proved to be effective for olfactory dysfunction with varied etiologies. We pooled existing studies to evaluate the effects of olfactory training in patients with posttraumatic olfactory dysfunction.
A systematic literature review using PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify studies assessing olfactory change in patients with posttraumatic olfactory dysfunction after olfactory training.
Of the initial 812 abstracts reviewed, 13 full-text articles were included. Clinically significant results after olfactory training were defined as an improvement of threshold, discrimination, and identification (TDI) score ≥6 or University of Pennsylvania Smell Identification Test (UPSIT) score ≥4. Six studies were included in the meta-analysis, 36.31% (95% confidence interval [CI], 0.28 to 0.45) of posttraumatic patients would achieve clinically significant results after olfactory training with a mean increase of TDI score of 4.61.
Olfactory training might be a promising modality for the treatment of posttraumatic olfactory dysfunction. More high-quality studies with controls are needed to clarify the effect of olfactory training on total olfactory performance and subcomponents of olfaction.
Olfactory training might be a promising modality for the treatment of posttraumatic olfactory dysfunction. More high-quality studies with controls are needed to clarify the effect of olfactory training on total olfactory performance and subcomponents of olfaction.
Widespread neurocognitive impairment is well-established in individuals at ultra-high risk (UHR) for developing psychoses, but it is unknown whether slowed processing speed may underlie impairment in other neurocognitive domains, as found in schizophrenia. The study delineated domain functioning in a UHR sample and examined if neurocognitive slowing might account for deficits across domains.
The cross-sectional study included 50 UHR individuals with no (n=38) or minimal antipsychotic exposure (n=12; mean lifetime dose of haloperidol equivalent=17.56mg; SD=13.04) and 50 matched healthy controls. Primary analyses compared group performance across neurocognitive domains before and after covarying for processing speed. To examine the specificity of processing speed effects, post hoc analyses examined the impact of the other neurocognitive domains and intelligence as covariates.
UHR individuals exhibited significant impairment across all neurocognitive domains (all ps≤.010), with medium to large effect sizes (Cohen's ds=-0.https://www.selleckchem.com/products/iwp-4.html
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