| 1. |
- Al-Ahmad, M, et al.
(författare)
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ARIA 2019 Care Pathways for Allergic Rhinitis in the Kuwait Health Care System
- 2021
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Ingår i: Medical principles and practice : international journal of the Kuwait University, Health Science Centre. - : S. Karger AG. - 1423-0151. ; 30:4, s. 320-330
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Tidskriftsartikel (refereegranskat)abstract
- A worldwide increase in prevalence of allergic diseases has led to adaptations in national and international health care systems. ARIA (Allergic Rhinitis and Its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. In collaboration with international initiatives, ARIA offers updates of real-life integrated care pathways (ICPs) for digitally assisted, integrated, and individualized treatment of allergic rhinitis (AR). This article presents certain aspects of the health care system in Kuwait with reference to the management of AR and the objective of introducing ICPs and adopting the latest ARIA recommendations. Guidelines for ICPs include aspects of patients and health care providers and cover key areas of management of AR. This model of guidelines supports real-life health care better than traditional models. ARIA recommendations will be locally integrated in the health care system with the aim of improving both pharmacotherapy and allergy immunotherapy.
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| 2. |
- Ashrafian, Hutan, et al.
(författare)
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Metabolomics : The Stethoscope for the Twenty-First Century
- 2021
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Ingår i: Medical principles and practice. - : S. Karger. - 1011-7571 .- 1423-0151. ; 30:4, s. 301-310
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Tidskriftsartikel (refereegranskat)abstract
- Metabolomics encompasses the systematic identification and quantification of all metabolic products in the human body. This field could provide clinicians with novel sets of diagnostic biomarkers for disease states in addition to quantifying treatment response to medications at an individualized level. This literature review aims to highlight the technology underpinning metabolic profiling, identify potential applications of metabolomics in clinical practice, and discuss the translational challenges that the field faces. We searched PubMed, MEDLINE, and EMBASE for primary and secondary research articles regarding clinical applications of metabolomics. Metabolic profiling can be performed using mass spectrometry and nuclear magnetic resonance-based techniques using a variety of biological samples. This is carried out in vivo or in vitro following careful sample collection, preparation, and analysis. The potential clinical applications constitute disruptive innovations in their respective specialities, particularly oncology and metabolic medicine. Outstanding issues currently preventing widespread clinical use are scalability of data interpretation, standardization of sample handling practice, and e-infrastructure. Routine utilization of metabolomics at a patient and population level will constitute an integral part of future healthcare provision.
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| 3. |
- Clos, E., et al.
(författare)
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ACTN3's R577X Single Nucleotide Polymorphism Allele Distribution Differs Significantly in Professional Football Players according to Their Field Position
- 2021
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Ingår i: Medical Principles and Practice. - : S. Karger AG. - 1011-7571 .- 1423-0151. ; 30:1, s. 92-97
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Football is characterised by intermittent high-intensity efforts varying according to the field position of a player. We aimed to ascertain whether polymorphisms in the ACTN3 gene are associated with different playing positions in elite professional football players. Subjects and Methods: Genotyping of the ACTN3 gene was conducted in 43 elite professional football players of a single team. Playing position was recorded based on the player's most frequent position. Results: The genotype distribution was not significant between positions (p = 0.057), while the allele distribution differed significantly (p = 0.035). Goalkeepers (p = 0.04, p = 0.03), central defenders (p = 0.03, p = 0.01), and central midfielders (p = 0.01, p = 0.00) had a significantly different allele distribution compared with wide midfielders and forward players. Conclusions: Genetic biomarkers may be important when analysing performance capability in elite professional football. Identifying the genetic characteristics of a player to adapt his playing position may lead to orientation of positions based on physical capabilities and tissue quality in young football players, and also to performance enhancement in those who are already playing in professional teams.
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| 4. |
- Dankl, D, et al.
(författare)
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Red Cell Distribution Width Is Independently Associated with Mortality in Sepsis
- 2022
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Ingår i: Medical principles and practice : international journal of the Kuwait University, Health Science Centre. - : S. Karger AG. - 1423-0151. ; 31:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Mortality in sepsis remains high. Studies on small cohorts have shown that red cell distribution width (RDW) is associated with mortality. The aim of this study was to validate these findings in a large multicenter cohort. <b><i>Methods:</i></b> We conducted this retrospective analysis of the multicenter eICU Collaborative Research Database in 16,423 septic patients. We split the cohort in patients with low (≤15%; <i>n</i> = 7,129) and high (>15%; <i>n</i> = 9,294) RDW. Univariable and multivariable multilevel logistic regressions were used to fit regression models for the binary primary outcome of hospital mortality and the secondary outcome intensive care unit (ICU) mortality with hospital unit as random effect. Optimal cutoffs were calculated using the Youden index. <b><i>Results:</i></b> Patients with high RDW were more often older than 65 years (57% vs. 50%; <i>p</i> < 0.001) and had higher Acute Physiology and Chronic Health Evaluation (APACHE) IV scores (69 vs. 60 pts.; <i>p</i> < 0.001). Both hospital (adjusted odds ratios [aOR] 1.18; 95% CI: 1.16–1.20; <i>p</i> < 0.001) and ICU mortality (aOR 1.16; 95% CI: 1.14–1.18; <i>p</i> < 0.001) were associated with RDW as a continuous variable. Patients with high RDW had a higher hospital mortality (20 vs. 9%; aOR 2.63; 95% CI: 2.38–2.90; <i>p</i> < 0.001). This finding persisted after multivariable adjustment (aOR 2.14; 95% CI: 1.93–2.37; <i>p</i> < 0.001) in a multilevel logistic regression analysis. The optimal RDW cutoff for the prediction of hospital mortality was 16%. <b><i>Conclusion:</i></b> We found an association of RDW with mortality in septic patients and propose an optimal cutoff value for risk stratification. In a combined model with lactate, RDW shows equivalent diagnostic performance to Sequential Organ Failure Assessment (SOFA) score and APACHE IV score.
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| 5. |
- Kakavas, G, et al.
(författare)
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Periodization in Anterior Cruciate Ligament Rehabilitation: A Novel Framework
- 2021
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Ingår i: Medical principles and practice : international journal of the Kuwait University, Health Science Centre. - : S. Karger AG. - 1423-0151. ; 30:2, s. 101-108
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Tidskriftsartikel (refereegranskat)abstract
- More than 250,000 anterior cruciate ligament (ACL) injuries occur each year in the USA, and approximately 65% of these injuries undergo reconstructive surgery. Appropriate rehabilitation after ACL reconstruction can yield predictably good outcomes, with return to previous levels of activity and high knee function. At present, periodization is used at all levels of sports training. Whether conceptualized and directed by coaches, or by athletes themselves, competitors structure their training in a cyclic fashion, enabling athletes to best realize their performance goals. In practical application, sport physical therapists use periodization: postoperative “protocols” serve as rudimentary forms of periodization, albeit implemented over shorter time frames than that typically employed in preparation for competition. An ACL injury should not be considered a “simple” musculoskeletal pathology with only local mechanical or motor dysfunctions. Together with the psychological trauma and reduction in physical capacity, there is a cascade of events, including neurological insult to the central nervous system and reduction in afferences to the sensorimotor system. Rehabilitation should consider all these issues, and periodization would allow to better define and to plan aims and objectives to return athletes to their sport. Technological resources including advanced neuroimaging methods, virtual reality for injury risk screening and return to sport assessment, and interactive artificial reality-based neuromuscular training methods offer new approaches and tools to address this important biomedical problem. The cost and availability of many of these technologies will continue to decrease, providing greater availability, scientific rigor, and ultimately, utility for cost-effective and data-driven assessments.
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