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Nutrients Jun 2021A food allergy is a potentially life-threatening disease with a genetic and environmental background. As its prevalence has increased significantly in recent years, the... (Review)
Review
A food allergy is a potentially life-threatening disease with a genetic and environmental background. As its prevalence has increased significantly in recent years, the need for its effective prevention has been emphasized. The role of diet modifications and nutrients in food allergy reduction has been extensively studied. Much less is known about the role of other environmental factors, which can influence the incidence of this disease. Changes in neonates gut microbiome by delivery mode, animal contact, inhalant allergens, oral and then cutaneous allergen exposure, air pollution, smoking, infections and vaccinations can be the potential modifiers of food allergy development. There is some data about their role as the risk or preventive factors, but yet the results are not entirely consistent. In this paper we present the current knowledge about their possible role in primary prevention of food allergies. We discuss the mechanisms of action, difficulties in designing accurate studies about food allergy and the potential biases in interpreting the connection between environmental factors and food allergy prevention. A better understanding of the role of environmental factors in food allergies development may help in implementing practical solutions for food allergy primary prevention in the future.
Topics: Environmental Exposure; Female; Food Hypersensitivity; Humans; Infant; Infant, Newborn; Male; Primary Prevention
PubMed: 34204606
DOI: 10.3390/nu13062025 -
Nature Reviews. Cardiology Oct 2019Polypills can contain multiple pharmaceutical agents targeting the cardiovascular system. The use of polypills in the secondary prevention of cardiovascular disease... (Review)
Review
Polypills can contain multiple pharmaceutical agents targeting the cardiovascular system. The use of polypills in the secondary prevention of cardiovascular disease (CVD) has received broad support; however, the use of polypills in the primary prevention of CVD is more controversial. This controversy stems from an inherent resistance to the medicalization of primary prevention, and the lower CVD event rate in this population means that smaller absolute benefits are derived. Indeed, drug-related adverse effects, such as from aspirin, might even outweigh the benefits. The role of fixed-dose combination (FDC) therapy for blood pressure (BP) lowering in combatting the widespread undertreatment of high BP - the leading modifiable risk factor contributing to the global burden of CVD - has gained momentum. Increasing evidence suggests that FDC pills containing multiple low doses of BP-lowering drugs produce more effective BP lowering than the use of fewer separate BP-lowering drugs at higher doses, without an increase in adverse effects. Trials of FDC pills comprising three half-dose or four quarter-dose BP-lowering drugs have shown substantial efficacy. In this Review, we summarize the current evidence on low-dose BP-lowering FDC pills and the justification for this approach in the context of polypills in the primary prevention of CVD.
Topics: Antihypertensive Agents; Aspirin; Cardiovascular Diseases; Coronary Disease; Drug Combinations; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypertension; Platelet Aggregation Inhibitors; Primary Prevention; Randomized Controlled Trials as Topic; Stroke
PubMed: 31150009
DOI: 10.1038/s41569-019-0209-y -
European Heart Journal Nov 2019
Topics: Cardiovascular Diseases; Exercise; Humans; Primary Prevention; Secondary Prevention
PubMed: 31560038
DOI: 10.1093/eurheartj/ehz697 -
BMJ (Clinical Research Ed.) Mar 2023
Topics: Humans; Magnetic Resonance Imaging; Brain; Primary Prevention; Oxygen; Brain Mapping; Image Processing, Computer-Assisted
PubMed: 36921929
DOI: 10.1136/bmj.p595 -
Global Heart Aug 2020Diet plays a major role in cardiovascular disease (CVD) risk. (Review)
Review
BACKGROUND
Diet plays a major role in cardiovascular disease (CVD) risk.
OBJECTIVES
To determine the effectiveness of a Mediterranean-style diet for the primary and secondary prevention of CVD.
METHODS
We searched for randomised controlled trials (RCTs) of Mediterranean-style diets in healthy adults and those at increased risk of CVD (primary prevention) and with established CVD (secondary prevention).
RESULTS
Thirty RCTs were included, 22 in primary prevention and eight in secondary prevention. Clinical endpoints were reported in two trials where there was moderate quality evidence for a reduction in strokes for primary prevention, and low quality evidence for a reduction in total and CVD mortality in secondary prevention. We found moderate quality evidence of improvement in CVD risk factors for primary prevention and low quality evidence of little or no effect in secondary prevention.
CONCLUSIONS
There is still some uncertainty regarding the effects of a Mediterranean-style diet in CVD prevention.
Topics: Cardiovascular Diseases; Diet, Mediterranean; Humans; Primary Prevention; Secondary Prevention
PubMed: 32923349
DOI: 10.5334/gh.853 -
Indian Heart Journal 2020
Topics: Cardiovascular Diseases; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Primary Prevention
PubMed: 32861373
DOI: 10.1016/j.ihj.2020.07.021 -
Pediatric Annals Sep 2019Children comprise a special group of international travelers. Immigrant and refugee children, along with children traveling to visit friends and relatives abroad or on... (Review)
Review
Children comprise a special group of international travelers. Immigrant and refugee children, along with children traveling to visit friends and relatives abroad or on leisure trips, require special attention by clinicians to prevent and treat travel-related conditions. [Pediatr Ann. 2019;48(9):e360-e369.].
Topics: Adolescent; Child; Child, Preschool; Emigrants and Immigrants; Global Health; Humans; Infant; Infant, Newborn; Infections; Primary Prevention; Refugees; Travel-Related Illness; Vaccination
PubMed: 31505010
DOI: 10.3928/19382359-20190812-01 -
American Journal of Preventive Medicine Feb 2022Heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke are the 5 leading causes of death in the U.S. The objective of this review is... (Review)
Review
INTRODUCTION
Heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke are the 5 leading causes of death in the U.S. The objective of this review is to examine the economic value of prevention interventions addressing these 5 conditions.
METHODS
Tufts Medical Center Cost-Effectiveness Analysis Registry data were queried from 2010 to 2018 for interventions that addressed any of the 5 conditions in the U.S. Results were stratified by condition, prevention stage, type of intervention, study sponsorship, and study perspective. The analyses were conducted in 2020, and all costs were reported in 2019 dollars.
RESULTS
In total, 549 cost-effectiveness analysis studies examined interventions addressing these 5 conditions in the U.S. Tertiary prevention interventions were assessed in 61.4%, whereas primary prevention was assessed in 8.6% of the studies. Primary prevention studies were predominantly funded by government, whereas industry sources funded more tertiary prevention studies, especially those dealing with pharmaceutical interventions. The median incremental cost-effectiveness ratio for the 5 conditions combined was $68,500 per quality-adjusted life year. Median incremental cost-effectiveness ratios were lowest for primary prevention and highest for tertiary prevention.
DISCUSSION
Primary prevention may be more cost effective than secondary and tertiary prevention interventions; however, research investments in primary prevention interventions, especially by industry, lag in comparison. These findings help to highlight the gaps in the cost-effectiveness analysis literature related to the 5 leading causes of death and identify understudied interventions and prevention stages for each condition.
Topics: Cause of Death; Cost-Benefit Analysis; Humans; Primary Prevention; Quality-Adjusted Life Years; Stroke
PubMed: 34736801
DOI: 10.1016/j.amepre.2021.07.019 -
Current Opinion in Pharmacology Dec 2020There is growing evidence that inflammatory bowel disease has a preclinical phase that precedes disease symptoms, during which immune system activation has already... (Review)
Review
There is growing evidence that inflammatory bowel disease has a preclinical phase that precedes disease symptoms, during which immune system activation has already occurred and inflammatory pathways have been primed, setting the stage for disease to expand and leading up to clinical diagnosis. Gaining insight to this pre-diagnosis period could improve our knowledge about disease pathogenesis and potentially result in the detection of biomarkers that could predict disease development. The ultimate goal of such research is to identify a population at risk for developing IBD, so preventive strategies could be implemented and disease prevention be achieved.
Topics: Animals; Biomarkers; Humans; Inflammatory Bowel Diseases; Primary Prevention
PubMed: 33221629
DOI: 10.1016/j.coph.2020.10.001 -
Journal of the National Cancer... Jul 2022In the past 2 decades, the demand for information on health economics research to guide health care decision making has substantially increased. Studies have provided... (Review)
Review
In the past 2 decades, the demand for information on health economics research to guide health care decision making has substantially increased. Studies have provided evidence that eliminating or reducing tobacco use; eating a healthy diet, including fruit and vegetables; being physically active; reducing alcohol consumption; avoiding ultraviolet radiation; and minimizing exposure to environmental and occupational carcinogenic agents should substantially reduce cancer incidence in the population. The benefits of these primary prevention measures in reducing cancer incidence are not instantaneous. Therefore, health economics research has an important role to play in providing credible information to decision makers on the health and economic benefits of primary prevention. This article provides an overview of health economics research related to primary prevention of cancer. We addressed the following questions: 1) What are the gaps and unmet needs for performing health economics research focused on primary prevention of cancer? 2) What are the challenges and opportunities to conducting health economics research to evaluate primary prevention of cancer? and 3) What are the future directions for enhancing health economics research on primary prevention of cancer? Modeling primary prevention of cancer is often difficult given data limitations, long delays before the policy or intervention is effective, possible unintended effects of the policy or intervention, and the necessity of outside expertise to understand key inputs or outputs to the modeling. Despite these challenges, health economics research has an important role to play in providing credible information to decision makers on the health and economic benefits of primary prevention of cancer.
Topics: Economics, Medical; Humans; Neoplasms; Primary Prevention; Tobacco Use; Ultraviolet Rays
PubMed: 35788376
DOI: 10.1093/jncimonographs/lgac014