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Complementary Therapies in Medicine May 2021The prevalence of allergic disease has been rapidly increasing in the developed world for over fifty years. The prevention of allergic disease remains one of the most... (Review)
Review
The prevalence of allergic disease has been rapidly increasing in the developed world for over fifty years. The prevention of allergic disease remains one of the most elusive topics in medicine. Integrative medicine emphasizes prevention of disease and utilizes many interventions to help modify long-term outcomes of health. Primary prevention refers to the arrest of manifestations of a disease before they present clinically. Preventing allergy is not simply about preventing sensitization, but also about developing tolerance. This narrative review article will discuss integrative medicine approaches that may help to prevent atopic disease in the pediatric population. It is organized chronologically to aid in counseling patients: 1) prevention during pregnancy and 2) prevention after birth. While research into allergy prevention is in its infancy, Integrative Medicine is well-suited to provide many insights into the prevention and mitigation of atopic disease.
Topics: Child; Female; Food Hypersensitivity; Humans; Integrative Medicine; Pediatrics; Pregnancy; Prevalence; Primary Prevention
PubMed: 33636296
DOI: 10.1016/j.ctim.2021.102695 -
Heart (British Cardiac Society) Jun 2024
Topics: Humans; Cardiovascular Diseases; Primary Prevention; Drug Combinations; Hydroxymethylglutaryl-CoA Reductase Inhibitors
PubMed: 38729637
DOI: 10.1136/heartjnl-2024-323953 -
Atencion Primaria Nov 2020
Topics: Health Promotion; Humans; Primary Prevention
PubMed: 33388110
DOI: 10.1016/j.aprim.2020.09.006 -
The British Journal of General Practice... Dec 2019
Topics: Aspirin; Cardiovascular Diseases; Humans; Primary Prevention; Renal Insufficiency, Chronic; Secondary Prevention; Vascular Diseases
PubMed: 31780468
DOI: 10.3399/bjgp19X706661 -
Family Practice Nov 2019Polypharmacy carries the risk of adverse events, especially in people with multimorbidity.
BACKGROUND
Polypharmacy carries the risk of adverse events, especially in people with multimorbidity.
OBJECTIVE
To investigate the prevalence of polypharmacy in community-dwelling adults, the association of multimorbidity with polypharmacy and the use of medications for primary prevention.
METHODS
Cross-sectional analysis of the follow-up data from the Program of Research on the Evolution of a Cohort Investigating Health System Effects (PRECISE) in Quebec, Canada. Multimorbidity was defined as the presence of three or more chronic diseases and polypharmacy as self-reported concurrent use of five or more medications. Primary prevention was conceptualized as the use of statin or low-dose antiplatelets without a reported diagnostic of cardiovascular disease.
RESULTS
Mean age 56.7 ± 11.6, 62.5% female, 30.3% had multimorbidity, 31.9% had polypharmacy (n = 971). The most common drugs used were statins, renin-angiotensin system inhibitors and psychotropics. Compared to participants without any chronic disease, the adjusted odds ratios (ORs) for having polypharmacy were 2.78 [95% confidence interval (CI): 1.23-6.28] in those with one chronic disease, 8.88 (95% CI: 4.06-19.20) in those with two chronic diseases and 25.31 (95% CI: 11.77-54.41) in those with three or more chronic diseases, P < 0.001. In participants without history of cardiovascular diseases, 16.2% were using antiplatelets and 28.5% were using statins. Multimorbidity was associated with increased likelihood of using antiplatelets (adjusted OR: 2.98, 95% CI: 1.98-4.48, P < 0.001) and statins (adjusted OR: 3.76, 95% CI: 2.63-5.37, P < 0.001) for primary prevention.
CONCLUSION
There was a high prevalence of polypharmacy in community-dwelling adults in Quebec and a strong association with multimorbidity. The use of medications for primary prevention may contribute to polypharmacy and raise questions about safety.
Topics: Aged; Chronic Disease; Cross-Sectional Studies; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Logistic Models; Male; Middle Aged; Multimorbidity; Polypharmacy; Prevalence; Primary Prevention; Quebec; Self Report
PubMed: 31104072
DOI: 10.1093/fampra/cmz023 -
Revisiting evidence of primary prevention of suicide among adult populations: A systematic overview.Journal of Affective Disorders Jan 2022Primary prevention of suicidal behaviors in the general population is required to interrupt the trend of self-inflicted deaths worldwide. We reviewed the evidence of the... (Review)
Review
BACKGROUNDS
Primary prevention of suicidal behaviors in the general population is required to interrupt the trend of self-inflicted deaths worldwide. We reviewed the evidence of the efficacy of primary prevention of suicide among the adult population.
METHODS
This is an overview of systematic reviews. We searched PubMed, EMBASE, Scopus, PsycINFO, and Cochrane databases to identify articles on suicide prevention strategies in non-clinical populations. For the purpose of overview, only systematic reviews were eligible. Primary outcomes: The outcomes of the present study were changes in the number of suicide death or suicide behaviors. Two reviewers assessed the methodological quality and the risk of bias of included studies.
RESULTS
From the initial 2,315 records, 32 articles met inclusion criteria. Evidence of reduction of suicide-related outcomes was detected, but of small magnitude. Most multicomponent prevention programs were delivered to specific populations, comprising strategies such as restriction to lethal means, educational programs, and gatekeeper training. Means restriction was the single intervention that showed some evidence of individual efficacy in reducing suicide. There is evidence that poor quality of media reporting is related with increasing suicide and better-quality reports could help suicide prevention. Most of the included SRs were of critically-low methodological quality.
LIMITATIONS
Publication bias, reporting bias, study designs, outcome definition and article overlap across studies are the main concerns.
CONCLUSIONS
Multicomponent programs and means restriction have indicated a reduction of suicide rates, mainly in specific populations. There is insufficient evidence to recommend a widespread implementation of suicide primary prevention in the general population.
Topics: Adult; Humans; Population Groups; Primary Prevention; Suicidal Ideation; Systematic Reviews as Topic; Suicide Prevention
PubMed: 34728288
DOI: 10.1016/j.jad.2021.10.076 -
[Epilepsy in cancer patients: primary prevention and the importance of high-risk patient screening].Revista de Neurologia Dec 2022Epilepsy in cancer patients has a prevalence of 13%, and is especially high in patients with brain tumours, with a higher morbidity and mortality rate compared to... (Review)
Review
INTRODUCTION
Epilepsy in cancer patients has a prevalence of 13%, and is especially high in patients with brain tumours, with a higher morbidity and mortality rate compared to non-tumour-related epilepsy. Its physiopathogenic mechanisms are distinct and include distortion of the cortical architecture and alteration of the glutamate-enhancing tumoural and peritumoural molecular microenvironment. Nevertheless, there is scarce and inconsistent scientific evidence on some fundamental aspects, such as primary post-operative prophylaxis, the ideal pharmacological profile or the withdrawal time of antiseizure drugs after their release.
DEVELOPMENT
Characteristics such as low tumour grade, number/size of cortical lesions, location (frontal, cortical/subcortical or eloquent area), early seizures and molecular alterations, such as IDH1/2 mutation, are factors that favour the occurrence of seizures. Within the treatment, surgery will provide cytoreduction and seizure control by excision of the epileptogenic area, with 75-90% freedom from disabling seizures. Although still a controversial issue, the post-operative use of antiseizure drugs is contraindicated by the main scientific societies due to the scarce evidence and the wide spectrum of side effects. However, they are frequently used in daily clinical practice.
CONCLUSIONS
All this forces us to establish a group of patients at 'high risk' of postoperative seizures, who will need to select the ideal antiseizure drug for primary prevention, with a route of administration that facilitates a rapid action effect and pharmacokinetics that prevents hepatic metabolism and CYP450 induction to achieve a lower number of interactions with chemotherapy, corticosteroids and radiotherapy. Despite this, drug resistance rates of 20-40% and relapse rates of 25-29% have been reported.
Topics: Humans; Early Detection of Cancer; Neoplasm Recurrence, Local; Epilepsy; Seizures; Primary Prevention; Tumor Microenvironment
PubMed: 36440747
DOI: 10.33588/rn.7511.2022200 -
Circulation Jun 2020
Review
Topics: Betacoronavirus; COVID-19; Cardiovascular Diseases; Coronavirus Infections; Healthy Lifestyle; Humans; Pandemics; Pneumonia, Viral; Primary Prevention; SARS-CoV-2; Secondary Prevention
PubMed: 32310675
DOI: 10.1161/CIRCULATIONAHA.120.047194 -
JAMA Cardiology Jan 2023
Topics: Humans; Hyperlipidemias; Atherosclerosis; Lipoprotein(a); Primary Prevention
PubMed: 36383356
DOI: 10.1001/jamacardio.2022.4063 -
Zhonghua Zhong Liu Za Zhi [Chinese... Sep 2022Cancer is a major public health issue that seriously endangers the public health and social development of China. Future initiatives for cancer prevention and control...
Cancer is a major public health issue that seriously endangers the public health and social development of China. Future initiatives for cancer prevention and control should continue to adhere to the principle of prioritizing prevention, and comprehensively implement related prevention activities nationwide. This is critical to reducing cancer burden in Chinese residents, especially in the low- and middle-income populations and those living in areas that are less economically developed. In the past several decades, the international community has significantly reduced the incidence of related cancers through primary prevention measures such as tobacco control, improved occupational hygiene, and vaccination. China has also implemented a series of exploratory primary prevention measures among high-risk groups of cancer in specific areas including Xuanwei, Qidong, and Linxian, and achieved encouraging results. However, due to the low level of systematic awareness of cancer risk factors and the lack of awareness and ability of self-health management in Chinese residents, it is urgent to develop novel research tools and methods to further reveal the causes of cancer, and establish innovative mechanisms and systems of primary prevention of cancer at population and individual levels. Based on current status of the transformation of cancer spectrum and the development of digital intelligence, it would be beneficial to establish a smart digital system for primary cancer prevention service that can cover the entire population, integrating authoritative popular science education on primary prevention of cancer, individualized cancer risk assessment, and personalized health management assistant. This will improve primary cancer prevention among the Chinese general population and can help the sustainable development of cancer prevention and control in China.
Topics: China; Delivery of Health Care; Humans; Neoplasms; Primary Prevention; Risk Factors
PubMed: 36164695
DOI: 10.3760/cma.j.cn112152-20220209-00083