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Cross-sectional population based study examining the impact of children with asthma on US rural families

Health 2013年第2期5卷 351-359页

作者： Laura C. Palombi may nawal lutfiyya Kathryn J. Pederson David R. Simmons Darin J. Steenerson Kenzie G. Hohman Krista Huot Ambulatory Care Residency Program College of Pharmacy University of Minnesota Minneapolis USA Essentia Health Acute Care Pharmacy Residency Duluth USA Essentia Health System Ambulatory Care Pharmacy Services Duluth USA Essentia Institute of Rural Health Duluth USA

Introduction: Approximately 7.1 million US children have asthma. The burden of asthma is disproportionate with ruralUSpopulations experiencing a higher prevalence of the disease. Rural populations experience additional disparities regarding health care access, job availability, and daily living resources. Hence, the family impact of having a child with asthma may be influenced by geographic locale. This impact could be a result of health insurance tied to employment, out of pocket costs, and health care provider availability. Few studies have assessed the impact a child’s asthma has on a family. This study sought to answer the question: What is the impact of children with asthma on US rural families? Methods: Multivariate techniques were performed to examine a single year of data from two connected population-based datasets, the 2007-2008 National Survey of Children’s Health and the 2009-2010 Children with Special Health Care Needs Survey. Children with current asthma defined the study population for both datasets. A logistic regression model was performed for each database. The dependent variable for the first model was child in family currently has asthma, for the second it was rural children with current asthma. Results: The first logistic regression model confirmed that rural children were more likely to have asthma than non-rural children. The second logistic regression model yielded that rural families with a child diagnosed with asthma had greater odds of: not having health insurance, having a parent who stopped working, avoided a job change, or experienced financial problems because of the child’s health. Conclusions: This study demonstrated that rural families experience a disproportionate financial hardship as a result of their child’s asthma. Pharmacist intervention in asthma care in rural areas has the potential to decrease the financial burden for a family while also improving a child’s health.

关键词： Asthma Family Burden Children with Asthma Rural Children with Asthma NSCH Data CSHCNS Data

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Population-based study of health service deficits in US adults with depression: Does chronic disease co-morbidity and/or rural residency make a difference?

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Health 2013年第4期5卷 774-782页

作者： Andrine Lemieux Daniel M. Saman M. nawal lutfiyya Essentia Institute of Rural Health Division of Research Duluth USA

Introduction: Rural residents are at higher risk for a depressive disorder than their non-rural counterparts. Recent research has indicated that co-morbidities are also associated with depression. Health service deficits (HSDs) is an analytic concept that facilitates the examination of how a population uses health services relevant to their condition. A HSD is present when, over the preceding 12 months, an individual has had no health insurance, no specified health care provider, deferred medical care due to cost, or did not have a routine medical exam. Research has shown a high prevalence of HSDs in populations with individual chronic conditions. No study that we know of has examined if there is an association between the constellation of chronic conditions of depression and the co-morbidities of asthma, arthritis, and diabetes, with HSDs. Methods: 2011 Behavioral Risk Factor Surveillance Survey (BRFSS) data were analyzed to identify important dimensions of the epidemiology of depression by ascertaining whether there were differences in the prevalence of health service deficits in rural versus non-rural adults with depression and at least one additional chronic disease (arthritis, asthma, or diabetes). Data analyses entailed both bivariate and multivariate techniques. All analyses were performed on weighted data. Results: Logistic regression analysis performed using the presence of at least one HSD as the dependent variable yielded that for US adults with lifetime depression those who were African American, Hispanic and other/multiracial in comparison to Caucasian had higher odds of having at least one health service deficit. Low socioeconomic status (SES) and middle SES in comparison to high SES were also risk factors for US adults with lifetime depression having at least one HSD. Rural residency in comparison to non-rural residency also emerged as an independent risk factor (for US adults with lifetime depression having at least one HSD. Chronic disease, however,

关键词： Health Service Deficits for Depression and Other Co-Morbidities BRFSS Surveillance Data

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Prevalence of daily or near daily aspirin use by US adults with diabetes: A cross-sectional study using a multi-year national database

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Health 2012年第6期4卷 297-303页

作者： Michael F. Akers M. nawal lutfiyya Maria L. Amaro Michael T. Swanoski Ambulatory Care Residency Program College of Pharmacy University of Minnesota Minneapolis USA Essentia Institute of Rural Essentia Institute of Rural Health Duluth USA Duluth USA

Introduction: For persons with diabetes, cardiovascular disease is the major cause of morbidity and mortality that is reflected in a two-to- four times greater risk for both heart disease and stroke when compared to adults without diabetes. Although not without controversy, diabetes and cardiovascular disease (CVD) management guidelines in the US recommend the use of once-daily aspirin. This epidemiological study was undertaken to fill the knowledge gap regarding the prevalence of daily or near daily aspirin use for US age-appropriate adults with diabetes. Methods: Using bivariate and multivariate techniques, a cross-sectional analysis of an amalgamated database using 2005, 2007, and 2009 Behavioral Risk Factor Surveillance Survey data was performed. The dependent variable for this analysis was daily or near daily aspirin use. The population of interest was US adults, men >= 45 - 79 and women >= 55 - 79 years of age. Results: Overall the prevalence of daily or near daily aspirin use by age-appropriate US adults with diabetes was 62.5%;it was 41.0% for similar non-diabetic adults. Logistic regression analysis yielded that age-appropriate adults, of both genders, with diabetes taking daily or near daily aspirin were more likely to be: physically active, male, live in rural locales, not have a health care provider, have deferred medical care because of cost, have an elevated BMI, a smoker, and have hypertension. Conclusion: It was determined that the age-appropriate use of aspirin in the US adult population with diabetes is underutilized. The role of the pharmacist through- out the continuum of care is one way to improve appropriate aspirin use in patients with diabetes.

关键词： Aspirin Use CVD Prevention Diabetes Practice Guidelines

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Care4U: Integrated healthcare systems based on blockchain

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Blockchain(Research and Applications) 2023年第4期4卷 2-13页

作者： Randa Kamal Ezz El-Din Hemdan nawal El-Fishway Department of Computer Science and Engineering Faculty of Electronic EngineeringMenoufia UniversityEgypt

During the COVID-19 crisis, the need to stay at home has increased dramatically. In addition, the number of sickpeople, especially elderly persons, has increased exponentially. In such a scenario, home monitoring of patientscan ensure remote healthcare at home using advanced technologies such as the Internet of Medical Things (IoMT).The IoMT can monitor and transmit sensitive health data;however, it may be vulnerable to various attacks. In thispaper, an efficient healthcare security system is proposed for IoMT applications. In the proposed system, themedical sensors can transmit sensed encrypted health data via a mobile application to the doctor for ***, three consortium blockchains are constructed for load balancing of transactions and reducing transactionlatency. They store the credentials of system entities, doctors' prescriptions and recommendations according to thedata transmitted via mobile applications, and the medical treatment process. Besides, cancelable biometrics areused for providing authentication and increasing the security of the proposed medical system. The investigationalresults show that the proposed system outperforms existing work where the proposed model consumed lessprocessing time by values of 18%, 22%, and 40%, and less energy for processing a 200 KB file by values of 9%,13%, and 17%. Finally, the proposed model consumed less memory usage by values of 7%, 7%, and 18.75%. Fromthese results, it is clear that the proposed system gives a very reliable and secure performance for efficientlysecuring medical applications.

关键词： Healthcare Blockchain Cyber security Internet of things Internet of Medical Things Cancelable biometrics

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State level correlations between high heart attack and stroke symptomology knowledge scores and CVD risk factors and mortality rates

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Health 2013年第10期5卷 1634-1640页

作者： Mary nawal lutfiyya Krista L. Huot Maria L. Amaro Michael F. Akers Michael Swanoski College of Pharmacy Ambulatory Care Residency Program University of Minnesota Minneapolis USA Essentia Health System Ambulatory Care Pharmacy Services Duluth USA Essential Institute of Rural Health Duluth USA

Introduction: In 2008, cardiovascular disease (CVD) accounted for one in three deaths in the United States. Epidemiological analyses suggest that two or more risk factors are the indicator of high risk and/or poor CVD outcomes. Knowledge of heart attack and stroke symptomology has been the focus of much research based on the assumption that accurate identification of an event is critical to reducing time to treatment. There is a paucity of research showing a clear association between knowledge of heart attack and stroke symptomology, risk factors, and mortality rates. In this study, we hypothesized that high stroke and heart attack symptomology knowledge scores would correspond to lower stroke or CVD mortality rankings as well as to a lower prevalence of two or more CVD risk factors. Methods: State was the unit of analysis used to examine data from two different sources and combined into a customized database. The first source was a multiyear Behavioral Risk Factor Surveillance Survey (BRFSS) heart attack and stroke symptom knowledge module database. CVD and stroke mortality data used came from the American Heart Association’s (AHA) 2012 Heart Disease and Stroke Statistics Update. Spearman’s Rho was the test statistic. Results: A moderate negative correlation was found between high heart attack and stroke symptom knowledge scores and the percentage of adults with two or more CVD or stroke risk factors. Likewise, a similar correlation resulted from the two variables, high heart attack and stroke symptoms knowledge score and CVD mortality rank. Conclusions: This study demonstrated a significant relationship between high heart attack and stroke symptom knowledge and lower CVD mortality rates and lower prevalence of two or more CVD risk factors at the state level. Our findings suggest that it is important to continue education efforts regarding heart attack and stroke symptom knowledge. Pharmacists are one group of health care providers who could enhance the needed publ

关键词： Knowledge of Heart Attack and Stroke Symptomology CVD Risk Factors Stroke Mortality CVD Mortality

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Cross-sectional population based study ascertaining the characteristics of US rural adults with mental health concerns who perceived a stigma regarding mental health issues

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Health 2013年第4期5卷 695-702页

作者： Kathryn J. Pederson M. nawal lutfiyya Laura C. Palombi David R. Simmons Darin J. Steenerson Kenzie G. Hohman Krista L. Huot Essentia Health Acute Care Pharmacy Residency Duluth USA Essentia Health System Ambulatory Care Pharmacy Services Duluth USA Essentia Institute of Rural Health Duluth USA University of Minnesota College of Pharmacy Ambulatory Care Residency Program Minneapolis USA

Introduction: Mental health is an important component of overall health. Mental illness is a leading cause of morbidity and mortality in the US and is associated with chronic diseases such as heart disease, diabetes, and arthritis. In the US, most people with mental health issues or disorders remain untreated. Epidemiological studies have identified rural residents as being at greater risk for health disparities;as a result, rural residents are a vulnerable population in terms of mental health and mental health care. Research has demonstrated that perceived stigma can be a significant barrier to rural residents seeking mental health care. This study examined the research question: What are the characteristics of US rural adults with mental health concerns who perceived stigma? Methods: 2007 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed using bivariate and multivariate techniques to answer the research question. 2007 BRFSS data were used because in that year non-institutionalized US adults in 37 states and territories were queried about their attitudes toward mental illness. BRFSS is a random digit telephone survey that uses a complex multi-stage sampling approach and subsequently a weighting factor is calculated for application to the data in order to ensure that they are representative of the US population based on the most recent census data. Only weighted data were analyzed. Results: Logistic regression analysis revealed that rural adults reporting mental health concerns who perceived stigma regarding mental health were more likely to be unemployed seeking work or not working and not seeking work, military veterans, or to have deferred medical care because of cost. They were also more likely to not have a health care provider and to rarely or never feel supported emotionally. Conclusions: Support systems may render people with mental health issues less vulnerable to perceiving stigma, thus assisting with removing stigma as a barrier to car

关键词： BRFSS Surveillance Data Rural Mental Health Perceived Stigma of Mental Health Issues

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Correlation of Cerebrospinal Fluid Sialic Acid with Various Enzymes in Patients with Meningitis

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Journal of Environmental Science and Engineering(B) 2016年第3期5卷 118-122页

作者： nawal Abdullah Murtadha Department of Basic Science Dentistry College University of Kirkuk Kirkuk lraq

Meningitis is often associated with cerebral compromise which may be responsible for neurological squeal in nearly half of the survivors. Little is known about the mechanisms of Central Nervous System （CNS） involvement in bacterial meningitis. The present study was undertaken to assess the changes in biochemical parameters including glucose, protein, Sialic Acid （SA） and various enzymes like Aspartate Aminotransferase （AST）, Alanine Aminotransferase （ALT）, Creatine Kinase （CK）, Gamma Glutamyltranspeptidase 7 （GGTP） and Lactate Dehydrogenase （LDH） have been determined in the Cerebrospinal Fluid （CSF） of the meningitis patients （n = 26） and compared with control subjects （n = 26）. Total Protein, CK, SA （P 〈 0.02）, AST （P 〈 0.001） and ALT （P 〈 0.0001） of meningitis patients were significantly higher, whereas, glucose （P 〈 0.05） and Gamma Glutamyltranspeptidase （GGT）（P 〈 0.01 and P 〈 0.05, respectively） were significantly lower than those of the controls. This study suggests that loss of integrity of brain-CSF barriers, sialic acid and enzyme profiles may contribute to the severity and neurological complications of meningitis.

关键词： Cerebrospinal fluids meningitis Sialic Acid.

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Adverse Effects of Monosodium Glutamate on Liver and Kidney Functions in Adult Rats and Potential Protective Effect of Vitamins C and E

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Food and Nutrition Sciences 2012年第5期3卷 651-659页

作者： Manal Said Tawfik nawal Al-Badr Department of Food Nutrition King Saud University Riyadh Saudi Arabia Department of Food Science and Technology Faculty of Agriculture-El-Shatby Alexandria University Alexandria Egypt

Monosodium glutamate (MSG) was administrated to rats at doses of 0.6 and 1.6 mg/g body weight for 14 days. Body weight and relative liver and kidney weight of rats were significantly increased. On regard to liver functions, the activities of alanine aminotransferase (ALT) and γ glutamyle transferase (GGT) significantly increased in the serum, on MSG administration, meanwhile, serum total protein, albumin and serum total bilirubin significantly decreased. MSG had adverse effects on kidney functions as serum urea and serum creatinine were significantly increased. Vitamin C (0.3 mg/g body weight) and vitamin E (0.2 mg/g body weight) co-adminstrated with MSG, significantly restored the body weight and relative liver and kidney weights to control levels. In the presence of vitamin C and vitamin E the activities of ALT and GGT in the serum were also significantly reduced to become comparable with control trail. Consequently, serum total protein, albumin and serum total bilirubin were significantly increased in the serum, while serum urea and serum creatinine were significantly decreased after administration of each vitamin. The results showed that MSG at doses of 0.6 and 1.6 mg/g of body weight may cause an adverse effect on the hepatic and renal functions which might be due to oxidative stress induced by MSG on the liver and renal tissue. Supplementation of vitamin C and vitamin E was capable of ameliorating MSG-induced oxidative stress on hepatic and renal functions.

关键词： Monosodium Glutamate Hepatic Stress Renal Stress Alanine Aminotransferase γ Glutamyle Transferase Creatinine Total Bilirubin

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Role of Complement Regulatory Proteins (CD55, CD59, and CD35) on Red Blood Cells of <i>β</i>-Thalassaemia Patients

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Open Journal of Blood Diseases 2021年第4期11卷 89-104页

作者： Hend Hanafy Mahmoud nawal Mahrous Nasef Dalia Mahmoud Eldewi Rasha Kamel Fathy Galal Clinical Pathology Department Faculty of Medicine for Girls Al-Azhar University Cairo Egypt Internal Medicine Department Faculty of Medicine Ain Shams University Cairo Egypt

Background: β-thalassaemia (β-Thal) is an inherited chronic haemolytic anaemia resulting from absent or low level of synthesis of β-globin chains of haemoglobin A in erythropoietic cells. The complement system is an important part of innate immune response that may be implicated in red blood cell (RBC) lysis. Mammalian cells are provided with surface bound complement regulatory proteins (MCRPs) that regulate the activation of complement cascade, thus protecting them from uncontrolled complement-mediated lysis. Objective is to evaluate the role of complement regulatory proteins (CD55, CD59, and CD35) on red blood cells, and to explain the pathogenesis of anaemia in β-thalassemia major. Methods: This case-control study enrolled 74 β thalassemia major patients who were compared with 40 age and sex matched controls. We performed expression of CD55, CD59, and CD35 on RBCs using flow cytometry. Results: CD55 levels of β-thalassemia major patients (79.78% ± 18.54%) were significantly decreased compared to healthy controls (99.45% ± 0.59%)

关键词： CD55 CD59 CD35 β-Thalassemia Major

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A Giant Spindle Cell Lipoma of the Parotid-Masseter Lodge (A Case Report)

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International Journal of Otolaryngology and Head & Neck Surgery 2021年第4期10卷 251-257页

作者： Siham Mehdaoui Alaoui Adbellatif Oudidi nawal Hammas Imane Fadlallah Mohammed Noureddine El Alami El Amine Faculty of Medicine and Pharmacy Sidi Mohammed Ben Abdellah University Fez Morocco Department of Otorhinolaryngology Head and Neck Surgery Hassan II Hospital Fez Morocco Department of Pathology Hassan II Hospital Fez Morocco

Background: The spindle cell lipoma is a rare benign tumor that originated from subcutaneous adipose tissue. It is a slow growing lesion and may become voluminous causing the patient an aesthetic disfigure. The diagnosis is made by the histological examination combined with immunohistochemical analysis. Radiological features present a variety of description because of the proportions difference of spindle cell lipoma components, but imaging is useful to determine the mass extents. The treatment of this kind of benign tumors is surgery which must be completed without need for other therapy. Aim: This case report highlights the exceptional location of spindle cell lipoma in the soft tissues of the parotid-masseter lodge, which may raise differential diagnosis problems with a primary parotid gland tumor. Case Presentation: A 58-year-old man, with no medical history, was presenting a swelling of the parotid region, growing progressively for 6 years, without other associated sign. The patient benefited from a careful physical examination. A computed tomography and magnetic resonance imaging were carried out. Clinical and radiological findings were suggesting a benign tumor occupying the left parotid-masseter lodge. The patient went through a surgical excision of the tumor. Histological and immunohistochemical features revealed a classic shape of spindle cell lipoma. After one year of follow-up, we notice a good recovery without local recurrence. Conclusion: Surgeons and pathologists have to keep in mind the possible development of spindle cell lipoma in any subcutaneous site even if unusual one.

关键词： Spindle Cell Lipoma Parotid-Masseter Lodge Surgery Histology

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