New Perspectives in Food Allergy De Martinis, Massimo; Sirufo, Maria Maddalena; Suppa, Mariano ...
International journal of molecular sciences,
02/2020, Letnik:
21, Številka:
4
Journal Article
Recenzirano
Odprti dostop
The improvement of the knowledge of the pathophysiological mechanisms underlying the tolerance and sensitization to food antigens has recently led to a radical change in the clinical approach to food ...allergies. Epidemiological studies show a global increase in the prevalence of food allergy all over the world and manifestations of food allergy appear increasingly frequent also in elderly subjects. Environmental and nutritional changes have partly changed the epidemiology of allergic reactions to foods and new food allergic syndromes have emerged in recent years. The deepening of the study of the intestinal microbiota has highlighted important mechanisms of immunological adaptation of the mucosal immune system to food antigens, leading to a revolution in the concept of immunological tolerance. As a consequence, new prevention models and innovative therapeutic strategies aimed at a personalized approach to the patient affected by food allergy are emerging. This review focuses on these new perspectives and their practical implications in the management of food allergy, providing an updated view of this complex pathology.
Osteoporosis is a skeletal pathology characterized by compromised bone strength leading to increased risk of fracture, mainly the spine and hip fractures. Osteoporosis affects more than 200 million ...people worldwide and because of the skeletal fractures it causes, represents a major cause of morbidity, disability and mortality in older people. Recently, the new discoveries of osteoimmunology have clarified many of the pathogenetic mechanisms of osteoporosis, helping to identify new immunological targets for its treatment opening the way for new and effective therapies with biological drugs. Currently, there are basically two monoclonal antibodies for osteoporosis therapy: denosumab and romosozumab. Here, we focus on the modern approach to the osteoporosis management and in particular, on current and developing biologic drugs targeted to new immunological checkpoints, in the landscape of osteoimmunology.
Abstract Aim Describe and compare generic and disease‐specific caregiver contribution (CC) to self‐care behaviours in the dimensions of self‐care maintenance, self‐care monitoring and self‐care ...management in multiple chronic conditions (MCCs). Design Multicentre cross‐sectional study. Methods We enrolled caregivers of patients with MCC, from April 2017 to November 2022, if they were (a) 18 years of age or older and (b) identified by the patient as the principal unpaid informal caregiver. The Caregiver Contribution to Self‐Care of Chronic Illness Inventory, Caregiver Contribution to Self‐Care of Heart Failure Index, Caregiver Contribution to Self‐Care of COPD Inventory and Caregiver Contribution to Self‐care of Diabetes Inventory were used to measure generic and disease‐specific contribution to patient self‐care. Descriptive statistics, Student's t ‐tests and Pearson's correlation coefficients were used. Results We found adequate generic CC for self‐care monitoring but inadequate CC in self‐care maintenance and management. All CC to disease‐specific self‐care maintenance, monitoring and management scales' scores were inadequate, except for caregivers of diabetic patients in which we observed an adequate score in the CC to self‐care maintenance and self‐care management scales in those practice insulin therapy. Conclusion Caregivers experience difficulties in performing behaviours of contribution to their patients affected by chronic conditions. Caregivers of patients with MCCs contribute more to self‐care in aspects related to provider prescriptions and less to lifestyle changes. Implications for the Profession and/or Patient Care Healthcare professionals have to know in which behaviours caregivers show gaps and reflect on the reasons for poor CC to self‐care to develop interventions to enhance these behaviours. Impact This study underlines the importance of choosing the most appropriate instrument for measuring CC to self‐care, considering the caregiver's characteristics. Reporting Method We adhered to STROBE guidelines. Patient or Public Contribution Caregivers of patients affected by MCCs were enrolled.
IL-33/IL-31 Axis in Osteoporosis De Martinis, Massimo; Sirufo, Maria Maddalena; Suppa, Mariano ...
International journal of molecular sciences,
02/2020, Letnik:
21, Številka:
4
Journal Article
Recenzirano
Odprti dostop
The study of the immunoskeletal interface has led to the discovery of numerous cytokines involved in the regulation of bone remodeling, providing valuable information on the pathogenesis of ...osteoporosis. The role of inflammatory cytokines of the Th1 and Th17 profile in osteoporosis is well known. Here we focus on two newly discovered Th2 cytokines, IL-31 and IL-33, whose implications in osteoporosis are recently emerging. Clinical and experimental observations suggest an important role of the IL-33/IL-31 axis in osteoporosis. IL-33 induces IL-31 secretion by Th2 cells and inhibits RANKL-dependent osteoclastogenesis, thus counteracting bone loss. IL-31 influences Th1/Th17 osteoclastogenetic inflammation and limits Th2 osteoprotective processes, thus favoring osteoporosis. Better knowledge of the role of IL-31 and IL-33 and their receptor complexes in osteoporosis could provide an interesting perspective for the development of new and more effective therapies, possibly with less side effects.
Aim
This study aimed to identify determinants of physical, mental and emotional nursing workloads.
Background
Workload has a physical, mental and emotional dimension. It influences employees' ...well‐being and quality of care. Nevertheless, studies of specific predictors for each dimension of nurses' workload are scarce.
Methods
We used a cross‐sectional prospective design based on the Job Demand‐Resources theory. We asked nurses to describe workload perceived at the end of every shift over three consecutive weeks. Data were gathered from two academic hospitals, in seven medical–surgical wards. We received 259 responses and tested 2 multivariate regression models.
Results
Physical workload was predicted from all variables tested; mental workload was determined by patient complexity or isolation, adequacy of nurse staffing and skill‐mix, and unscheduled activities; and emotional workload was predicted by all variables except adequacy of staffing and other people's education.
Conclusions
Patient, nurse and workflow aspects influenced nurse's shift workload differently for each specific dimension.
Implications for Nursing Management
Measurement and definition of predictors of workload in the work environment are essential. Recognizing the determinants of specific dimensions of workload facilitates identification of the most appropriate interventions to improve nurses' well‐being in health care settings.
Aims and Objectives
To explore the association between patient and caregiver depression and patient self‐care and caregiver contribution to self‐care in the context of ostomy care.
Background
...Self‐care is essential for ostomy patients and their caregivers. The ostomy self‐care process can be considered a dyadic phenomenon in which the patient and the caregiver interact together and work as a team. The presence of depressive symptoms may limit the patient's ability to perform self‐care and caregivers' abilities to engage in caregiving tasks. Research into the dyadic influence of depression on self‐care behaviours from the perspective of ostomates and their caregivers is still in its infancy.
Design
Secondary analysis of a multicentre, cross‐sectional study. The STROBE checklist was used to report the present study.
Methods
Patient–caregiver dyads were recruited from eight ostomy outpatient clinics from February 2017 to May 2018. Depression was assessed with the nine‐item Patient Health Questionnaire in both patients and caregivers. Patient self‐care was evaluated with the Ostomy Self‐Care Index, and caregiver contribution to self‐care was assessed with the Caregiver Contribution to Ostomy Self‐Care Index. Both instruments measure the dimensions of maintenance, monitoring and management. The actor–partner interdependence model was performed for the dyadic analysis.
Results
In total, 252 patient–caregiver dyads (patients: 69.8% male, mean age 70.05; caregivers: 80.6% female, mean age 58.7) were enrolled. Patient depression was positively associated with caregiver contribution to self‐care maintenance. Caregiver depression was negatively associated with self‐care management.
Relevance to Clinical Practice
These findings add a better understanding of the reciprocal influence of dyadic depression on patient and caregiver contributions to self‐care in ostomy contexts was found. Patient and caregiver depression influence patient self‐care and caregiver contribution to self‐care. Therefore, clinicians should assess and treat depression in both members of the dyad to improve self‐care.
Treatment of gastric cancer Orditura, Michele; Galizia, Gennaro; Sforza, Vincenzo ...
World journal of gastroenterology : WJG,
02/2014, Letnik:
20, Številka:
7
Journal Article
Odprti dostop
The authors focused on the current surgical treatment of resectable gastric cancer,and significance of periand post-operative chemo or chemoradiation.Gastric cancer is the 4thmost commonly diagnosed ...cancer and the second leading cause of cancer death worldwide.Surgery remains the only curative therapy,while perioperative and adjuvant chemotherapy,as well as chemoradiation,can improve outcome of resectable gastric cancer with extended lymph node dissection.More than half of radically resected gastric cancer patients relapse locally or with distant metastases,or receive the diagnosis of gastric cancer when tumor is disseminated;therefore,median survival rarely exceeds12 mo,and 5-years survival is less than 10%.Cisplatin and fluoropyrimidine-based chemotherapy,with addition of trastuzumab in human epidermal growth factor receptor 2 positive patients,is the widely used treatment in stageⅣpatients fit for chemotherapy.Recent evidence supports the use of second-line chemotherapy after progression in patients with good performance status
Allergies are rapidly worsening in recent decades, representing the most common immunological diseases. The mechanism of disorders such as asthma, rhinocongiuntivitis, urticaria, atopic dermatitis, ...food and drug allergies, and anaphylaxis still remain unclear and consequently treatments is mostly still symptomatic and aspecific while developments of new therapies are limited. A growing amount of data in the literature shows us how the prevalence of allergic diseases is different in both sexes and its changes over the course of life. Genes, hormones, environmental and immunological factors affect sex disparities associated with the development and control of allergic diseases, while they more rarely are considered and reported regarding their differences related to social, psychological, cultural, economic, and employment aspects. This review describes the available knowledge on the role of sex and gender in allergies in an attempt to improve the indispensable gender perspective whose potential is still underestimated while it represents a significant turning point in research and the clinic. It will offer insights to stimulate exploration of the many aspects still unknown in this relationship that could ameliorate the preventive, diagnostic, and therapeutic strategies in allergic diseases.
Abstract
Introduction
We know that patient and caregiver sex influence patient self‐care and caregiver contribution to self‐care in multiple chronic conditions. However, the role of dyad sex ...combination (e.g., male patient and female caregiver, female patient and male caregiver, male patient and caregiver, and female patient and caregiver) in influencing patient self‐care and caregiver contribution to self‐care remains unexplored. Our aim was to investigate the relationship between patient and caregiver sex combination and patient self‐care and caregiver contribution to self‐care in multiple chronic conditions.
Design
Multicentre cross‐sectional study.
Methods
We enrolled patients with multiple chronic conditions and caregiver dyads in outpatient and community settings from April 2017 to December 2019. We used the Self‐Care of Chronic Illness Inventory and the Caregiver Contribution to Self‐Care of Chronic Illness Inventory that measure, from the patient and caregiver perspective, self‐care maintenance (i.e., behaviors to maintain illness stability), self‐care monitoring (i.e., monitoring of illness signs and symptoms), and self‐care management (i.e., behaviors to manage signs and symptoms). We used multivariate analysis of covariance to evaluate the association between sex and self‐care and caregiver contribution to self‐care.
Results
We recruited 540 patient–caregiver dyads. Male patients cared by female caregivers performed higher self‐care maintenance compared to female patients cared by female caregivers. Female caregivers caring for female patients performed higher caregiver contribution to self‐care monitoring compared to male caregivers caring for female or male patients.
Conclusions
Clinicians should consider the influence of patient and caregiver sex combination on self‐care and caregiver contribution to self‐care in multiple chronic conditions to provide tailored interventions.
Clinical Relevance
Healthcare professionals should consider the patient and caregiver sex combination in the dyad to tailor better interventions aimed at improving patient self‐care and caregiver contribution to self‐care in multiple chronic conditions.
The Nursing Quality of Life Scale (NQOLS) is a 28-item self-report measure evaluating the four dimensions of nurses’ quality of life, namely, the physical, emotional, working, and social dimensions. ...The purpose of this study is to assess the psychometric properties, including validity and reliability, of the NQOLS. The study enrolled 1105 nurses who provided direct assistance to patients. The NQOLS factorial structure was tested using a cross-validation approach via Exploratory Structural Equational Modeling, which confirmed the instrument’s four-dimension structure. Reliability was assessed using omega coefficients, proving excellent for all factors. Cluster analysis identified five distinct groups, each composed of participants sharing a substantial similarity with respect to their profile in the NQOLS. These five identifiable clusters presented significant differences not only in the NQOLS but also in the risk of work-related stress, emotional labor, and burnout. The results show that NQOLS is a simple, reliable, lean tool for measuring nurses’ overall QoL, whose various parts can additionally be used to answer specific research questions.
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