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Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges

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World Journal of Diabetes 2024年第5期15卷 828-852页

作者： Mahmoud Emad-Eldin Gehan F Balata Eman A Elshorbagy Mona S Hamed Mohamed S Attia Department of Pharmacy Practice Faculty of PharmacyZagazig UniversityZagazig HFQM+872Al-Sharqia GovernorateEgypt Department of Pharmacy Practice Faculty of PharmacyHeliopolis UniversityCairo 44519Egypt Department of Pharmaceutics Faculty of PharmacyZagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt Department of Internal Medicine Faculty of MedicineZagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt Department of Community at Faculty of Medicine Zagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt

Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses.Over the past century,insulin formulations have undergone significant modifications and bioengineering,resulting in a diverse range of available insulin products.These products show distinct pharmacokinetic and pharmacodynamic profiles.Consequently,various insulin regimens have em-erged for the management of type 2 diabetes,including premixed formulations and combinations of basal and bolus insulins.The utilization of different insulin regimens yields disparate clinical outcomes,adverse events,and,notably,patient-reported outcomes(PROs).PROs provide valuable insights from the patient’s perspective,serving as a valuable mine of information for enhancing healthcare and informing clinical decisions.adherence to insulin therapy,a critical patient-reported outcome,significantly affects clinical outcomes and is influenced by multiple factors.This review provides insights into the clinical effectiveness of various insulin preparations,PROs,and factors impacting insulin therapy adherence,with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.

关键词： adherence Diabetes Insulin Patient-reported outcomes Pharmacokinetic Pharmacodynamic

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adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

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International Journal of Clinical Medicine 2024年第3期15卷 145-154页

作者： Maria Maiello Francesca Amati Vincenzo Ezio Santobuono Andrea Igoren Guaricci Cinzia Forleo Marco Matteo Ciccone Pasquale Palmiero Department of Cardiology ASL BR SSN3 Brindisi Italy Cardiovascular Diseases Section Interdisciplinary Department of Medicine (DIM) University of Bari “Aldo Moro” Bari Italy

Background: adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

关键词： adherence Cardiovascular Prevention Postmenopausal Women Hypertensive Metabolic Syndrome

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Effectiveness of Short Message Service Support on adherence to Chemotherapy Treatment among Patients Attending Cancer Treatment Facilities in Kenya

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Open Journal of Nursing 2024年第3期14卷 93-113页

作者： Nebert Kiguhe Mchidi John P. Oyore Gordon Ogweno Department of Specialized Surgery . Kenyatta National Hospital Nairobi Kenya Department of Community Health and Epidemiology School of Public Health Kenyatta University Nairobi Kenya Department of Medical Physiology School of Medicine Kenyatta University Nairobi Kenya

Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ2dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ2dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ2dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ2dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .

关键词： adherence Cancer Symptom Distress Quality of Life Medication Posses-sion Ratio Short Message Service Survivorship

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Polydopamine-coated photoautotrophic bacteria for improving extracellular electron transfer in living photovoltaics

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Nano Research 2024年第2期17卷 866-874页

作者： Melania Reggente Charlotte Roullier Mohammed Mouhib Patricia Brandl Hanxuan Wang Stefano Tacconi Francesco Mura Luciana Dini Rossella Labarile Massimo Trotta Fabian Fischer Ardemis A.Boghossian Institute of Chemical Sciences and Engineering(ISIC) Ecole Polytechnique Fédérale de Lausanne(EPFL)Lausanne 1015Switzerland Department of Biology and Biotechnology Charles Darwin Sapienza University of RomeRome 00185Italy Research Center on Nanotechnology Applied for Engineering of Sapienza(CNIS) University of Rome SapienzaRome 00185Italy CNR-IPCF Consiglio Nazionale delle Ricerche–Istituto per i Processi Chimico Fisici Bari 70126Italy Institute of Life Technologies HES-SO Valais-WallisSion 1950Switzerland Institute for Renewable Energy HES-SO Valais-WallisSion 1950Switzerland

Living photovoltaics are microbial electrochemical devices that use whole cell–electrode interactions to convert solar energy to electricity.The bottleneck in these technologies is the limited electron transfer between the microbe and the electrode surface.This study focuses on enhancing this transfer by engineering a polydopamine(PDA)coating on the outer membrane of the photosynthetic microbe Synechocystis sp.PCC6803.This coating provides a conductive nanoparticle shell to increase electrode adhesion and improve microbial charge extraction.A combination of scanning electron microscopy(SEM),transmission electron microscopy(TEM),UV–Vis absorption,and Raman spectroscopy measurements were used to characterize the nanoparticle shell under various synthesis conditions.The cell viability and activity were further assessed through oxygen evolution,growth curve,and confocal fluorescence microscopy measurements.The results show sustained cell growth and detectable PDA surface coverage under slightly alkaline conditions(pH 7.5)and at low initial dopamine(DA)concentrations(1 mM).The exoelectrogenicity of the cells prepared under these conditions was also characterized through cyclic voltammetry(CV)and chronoamperometry(CA).The measurements show a three-fold enhancement in the photocurrent at an applied bias of 0.3 V(vs.Ag/AgCl[3 M KCl])compared to non-coated cells.This study thus lays the framework for engineering the next generation of living photovoltaics with improved performances using biosynthetic electrodes.

关键词： biophotovoltaics bioelectronics photosynthetic bacteria cyanobacteria polydopamine adherence

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Mechanistic research:Selenium regulates virulence factors,reducing adhesion ability and inflammatory damage of Helicobacter pylori

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World Journal of Gastroenterology 2024年第1期30卷 91-107页

作者： Chun Qin Gan-Rong Huang Ai-Xing Guan Wen-Ting Zhou Hao Chen Pei-Pei Luo Xian-Ke Luo Yan-Qiang Huang Zan-Song Huang Guangxi Technology Innovation Cooperation Base of Prevention and Control Pathogenic Microbes with Drug Resistance Youjiang Medical University for NationalitiesBaise 533000Guangxi Zhuang Autonomous RegionChina Department of Digestive Diseases Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000Guangxi Zhuang Autonomous RegionChina Key Laboratory of the Prevention and Treatment of Drug Resistant Microbial Infecting Youjiang Medical University for NationalitiesBaise 533000Guangxi Zhuang Autonomous RegionChina Department of Pathology Wannan Medical CollegeWuhu 241002Anhui ProvinceChina Department of Gastroenterology Wujin People’s Hospital affiliated to Jiangsu UniversityChangzhou 213004Jiangsu ProvinceChina Department of Gastroenterology Guangzhou Liwan District People's HospitalGuangzhou 510370Guangdong ProvinceChina

BACKGROUND The pathogenicity of Helicobacter pylori is dependent on factors including the environment and the host.Although selenium is closely related to pathogenicity as an environmental factor,the specific correlation between them remains unclear.AIM To investigate how selenium acts on virulence factors and reduces their toxicity.METHODS H.pylori strains were induced by sodium selenite.The expression of cytotoxin-associated protein A(CagA)and vacuolating cytotoxin gene A(VacA)was determined by quantitative PCR and Western blotting.Transcriptomics was used to analyze CagA,CagM,CagE,Cag1,Cag3,and CagT.C57BL/6A mice were infected with the attenuated strains subjected to sodium selenite induction,and H.pylori colonization,inflammatory reactions,and the cell adhesion ability of H.pylori were assessed.RESULTS CagA and VacA expression was upregulated at first and then downregulated in the H.pylori strains after sodium selenite treatment.Their expression was significantly and steadily downregulated after the 5th cycle(10 d).Transcriptome analysis revealed that sodium selenite altered the levels affect H.pylori virulence factors such as CagA,CagM,CagE,Cag1,Cag3,and CagT.Of these factors,CagM and CagE expression was continuously downregulated and further downregulated after 2 h of induction with sodium selenite.Moreover,CagT expression was upregulated before the 3rd cycle(6 d)and significantly downregulated after the 5th cycle.Cag1 and Cag3 expression was upregulated and downregulated,respectively,but no significant change was observed by the 5th cycle.C57BL/6A mice were infected with the attenuated strains subjected to sodium selenite induction.The extent of H.pylori colonization in the stomach increased;however,sodium selenite also induced a mild inflammatory reaction in the gastric mucosa of H.pylori-infected mice,and the cell adhesion ability of H.pylori was significantly weakened.CONCLUSION These results demonstrate that H.pylori displayed virulence attenuation after the 10th d of sodium selenite treatment.Sodium s

关键词： Helicobacter pylori Sodium selenite Virulence factors adherence Inflammation

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Empowerment in chronic wound care——exploring the scope for patient contribution

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Frontiers of Nursing 2024年第1期11卷 1-16页

作者： Benedikt Hackert Ewa Klara Stürmer Ulrich Weger Department of Psychology and Psychotherapy University of Witten/HerdeckeAlfred-Herrhausen-Straße 5058448 WittenGermany Department for Vascular Medicine University Heart and Vascular Center HamburgUniversity Medical Center Hamburg-EppendorfMartinistreet 5220246 HamburgGermany

Objective:In this study,we investigated the concept of empowerment in chronic wound care and propose to facilitate patient control by making use of degrees of freedom(DOF):that is,shaping of everyday wound care tasks initiated by patients and based on their wishes,mostly in terms of patients executing treatment steps,requesting or directing health care professionals to under take changes,or modifications of internal states.Methods:As a first step,we conducted a systematic literature search,followed by an inductive form of qualitative content analysis,which resulted in the identification of 5 dimensions as main elements of empowerment:education and shared decision making,adherence to self-care behaviors,responsibility and control,general call for empowerment,and DOF.However,the latter are noticeably absent in the literature.To investigate patients'freedom in shaping the wound care process,we conducted a second literature search.Results:A number of possibilities for patients to influence the wound care process could be identified,but experimental or clinical evidence about their effects is missing,their variety is limited,and they are only inadequately described.Conclusions:However,DOF should be an indispensable aspect of genuine empowerment,since they allow patients to occupy the role of the agent in the treatment process and give rise to the subjective experience of feeling empowered.Thus,in the third part,we develop a research proposal on how to investigate and include DOF in the clinical practice of wound care.Finally,limitations about implementations are discussed(e.g.,patients being reluctant to overcome their passive role,resulting in frustration for health care professionals).

关键词： adherence chronic wounds control degrees of freedom empowerment shared decision making

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adherence to dietary prescriptions in patients with acute food protein-induced enterocolitis syndrome

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Pediatric Investigation 2022年第3期6卷 207-210页

作者： Stefano Miceli Sopo Dario Sinatti Giorgio Sodero Mariannita Gelsomino Francesco Mastellone Department of Life Sciences and Public Health Pediatric Allergy UnitPediatrics SectionPoliclinico Gemelli Universitary Foundation IRCCSCatholic University of Sacre HearthRomeItaly Department of Life Sciences and Public Health Post-Graduate School of PediatricsPoliclinico Gemelli Universitary Founda tion IRCCSCatholic University of Sacre HearthRomeItaly

Food protein-induced enterocolitis syndrome(FPIES)is a non-Immunoglobulin(non-IgE)-mediated food allergy.The elimination diet is the only therapy,the culprit food will be reintroduced if tolerance is acquired.However,it is possible that patients do not follow the recommendations given by the healthcare professional.We investigated if our advice to avoid the trigger food in patients with active FPIES and to reintroduce it in the diet in patients who achieved tolerance had been implemented.We interviewed by telephone the parents of children who were diagnosed with acute FPIES.About 23.2%of our patients disregarded our dietary recommendations:6/42(14.3%)of patients who passed a tolerance oral food challenge(OFC)did not eat the trigger food,4/22(18.2%)of patients who failed OFC ate the trigger food,and 9/18(50.0%)of patients who did not perform a tolerance OFC ate the trigger food.We have analyzed some possible influencing factors and no difference was found to be statistically significant.Our results are in line with those reported for IgE-mediated food allergies.As has already been proposed by others,we suggest reassessing food consumption in all patients after a food challenge.

关键词： adherence Dietary management Follow up Food protein-induced enterocolitis syndrome

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Renin-angiotensin system inhibitors prescriptions in Chinese hospitalized chronic kidney disease patients

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World Journal of Clinical Cases 2024年第17期12卷 3061-3075页

作者： Chun Zhang Zhi-Yu Duan Sa-Sa Nie Zhou Zhang Xin-Ru Guo Chao-Yang Zhang Jing Dong Guang-Yan Cai Department of Nephrology The First Medical CentreChinese PLA General HospitalBeijing 100853China School of Medicine Nankai UniversityTianjin 300071China National Engineering Laboratory for Medical Big Data Application Technology Chinese PLA General HospitalBeijing 100853China

BACKGROUND Many guidelines have recommended renin-angiotensin system inhibitors(RASI)as the first-line treatment for patients with chronic kidney disease(CKD).We studied RASI prescription trends from 2010 to 2019,and analyzed the characteristics associated with RASI prescription in Chinese hospitalized CKD patients.AIM To study the prescription of renin angiotensin system inhibitors in hospitalized patients with CKD in China.METHODS It was retrospectively,cross-sectional reviewed RASI prescriptions in hospitalized CKD patients in China from 2010 to 2019.RASI prescribing trends were analyzed from 2010 to 2019,and bivariate and multivariate logistic regression analyses were conducted to identify characteristics associated with RASI prescription.RESULTS A total of 35090 CKD patients were included,with 10043(28.6%)RASI prescriptions.Among these patients,18919(53.9%)met the criteria for RASI treatments based on the 2012 kidney disease:Improving global outcomes guidelines.Of these,7246(38.3%)patients received RASI prescriptions.RASI prescriptions showed an initial rapid increase from 2011 to 2012,reached its peak around 2015 and 2016,and then exhibited a subsequent slight decreasing trend.Both bivariate and multivariate analyses showed that several characteristics,including the male gender,age less than 60-year-old,nephrology department admission,lower CKD stage,history of hypertension or diabetes,proteinuria,glomerulonephritis as the CKD etiology,and non-acute kidney injury were associated with RASI prescriptions.CONCLUSION The frequency of RASI prescriptions showed an initial increase but a slight decreasing trend in more recent years.CKD patients with certain characteristics such as elderly age,advanced disease stage,surgery department admission,or acute kidney injury were less likely to receive RASI prescriptions.In the application of RASI in hospitalized CKD patients is insufficient.The actual clinical practice needs to be improved.The development of related research is helpful to guide the correct choice of clini

关键词： Chronic kidney disease Renin-angiotensin system inhibitors Prescriptions adherence

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Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

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Journal of Biosciences and Medicines 2024年第3期12卷 316-327页

作者： Sahar Moawia Balla Elnour Tayseer Abdelmotalib Ahmed Taha Haiam Abdalla Wadatalla Ziryab Zainelabdin Mohamed Elmahdi Marwah Isam Abdulmajeed Mohammedahmed Rowa Abdelmonem Sidig Hamadto Nahla Yousif Osman Mohammed Saeed Omnia Mubarak Saad Abdallah Sulafa Abdelbagi Mustafa Ahmed Hanady Abdelhameed Ahmed Mohamed Sarah Khalil Fathi Khalil Family Medicine Health Gates Primary Care Riyadh SAU Family Medicine Dhaman Health Assurance Hospitals Company Kuwait KWT Family Medicine First Health Cluster Riyadh SAU Emergency Department Sheikh Khalifa Medical City Abudahbi ARE Family Medicine University of Medical Sciences and Technology Khartoum SDN Family Medicine Sudan Medical Specialization Board-Sudan Khartoum SDN Family Medicine Ultra Care Home Care Company Riyadh SAU Medicine Department Health Gates Primary Care Riyadh SAU Family Medicine Mouwasat Hospital Madinah SAU

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical r

关键词： Sudan adherence Intervention Education Self-Management Diabetes

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Exclusive breastfeeding greater than 50%, success of education in a university hospital in Bogotá: Case-control study

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World Journal of Clinical Pediatrics 2024年第1期13卷 23-30页

作者： Marcela Murillo Galvis Sofia Ortegon Ochoa Clara Eugenia Plata García Maria Paula Valderrama Junca Dayanna Alejandra Inga Ceballos Daniel Mauricio Mora Gómez Claudia M Granados Martin Rondón Department of Pediatrics Hospital Universitario San IgnacioBogotá110111Colombia Department of Clinical Epidemiology and Biostatistics Pontifica Universidad JaverianaBogotá110111Colombia

BACKGROUND Maintenance rates of exclusive breastfeeding(EBF)worldwide are low,thus,one of the objectives of the summary of policies on breastfeeding(BF)in world nutrition goals for 2025 are that at least 50%of infants under six months of age receive EBF that year.The Objective of this study is to document the rates of EBF in children born in San Ignacio University Hospital(HUSI)and identify factors associated with maintenance.AIM To document the percentages of EBF in those that were born at HUSI and identify factors associated to their maintenance.METHODS This is a study of cases and controls in an analytic,retrospective cohort that took children born alive between January 2016 and January 2019 at HUSI located in the city of Bogotá,Colombia.RESULTS Receiving information about BF at HUSI was able to maintain EBF up until 4 mo(OR=1.65;95%CI:1.02-2.66).The presence of gynecologic and obstetric comorbidities(OR=0.32;95%CI:0.12-0.83),having mastitis(OR=0.56;95%CI:0.33-0.94),and receiving information from mass media(OR=0.52;95%CI:0.31-0.84)are factors associated with not maintaining EBF.CONCLUSION Receiving education at a Women-and Child-Friendly Institution was the only significant factor to achieve EBF until 4 mo,with a frequency greater than the one reported in the country,which matches multiple studies where counseling and individualized support on BF achieve this purpose.Knowledge about BF and early detection of obstetric/gynecologic complications must be strengthened among the healthcare staff in charge of mothers during post-partum.Additionally,strategies must be promoted to continue BF such as creating milk banks with the objective of increasing BF rates even when mothers return to work.

关键词： Breastfeeding Women-and Child-Friendly Institutional Strategy Strategies adherence Education

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