Too much medicine

BACKGROUND: Gestational weight gain (GWG) is an expected component of a healthy pregnancy. Gaining weight within the recommended range helps support the mother's health by providing energy reserves and nutrients to meet the increased metabolic demands during pregnancy. Too much or too little GWG has been associated with adverse health outcomes for the mother and child. OBJECTIVE: The objective of the study was to examine how changes in anthropometric indicators during pregnancy, including fat gain, vary, compare changes among body mass index (BMI) (kg/m2 ) groups, and examine how the changes were associated with adequacy of GWG defined using the 2009 Institute of Medicine guidelines...

Cardiometabolic disorders (CMD) such as hypertension and diabetes are increasingly prevalent in sub-Saharan Africa, placing people living with HIV at risk for cardiovascular disease and threatening the success of HIV care. Spouses are often the primary caregivers for people living with CMD, and understanding patients' and partners' conceptions of CMD could inform care. We conducted semi-structured interviews with 25 couples having a partner living with HIV and either hypertension or diabetes. Couples were recruited from HIV clinics in Malawi and were interviewed on beliefs around symptoms, causation, prevention, and treatment for CMD...

BACKGROUND: Research has shown increased mental health problems and use of prescription drugs among adolescents in recent years and social media use has been linked to poorer mental health. However, trend studies concerning these topics are scarce. The purpose of this study was to analyze gender-specific trends in a) symptoms of depression and loneliness, and b) prescription of antidepressants, hypnotics and sedatives, in relation to the emergence of social media among adolescents in Norway...

No abstract text is available yet for this article.

BACKGROUND: In Sub-Saharan Africa (SSA), the prevalence of hypertension is increasing due to many factors like rapid population growth, globalization, stress, and urbanization. We aimed to characterize the perceptions of cardiovascular disease (CVD) risk among individuals with hypertension living in Nigeria and identify barriers and facilitators to optimal hypertension management. METHODS: This cross-sectional survey study was conducted at a large teaching hospital in Lagos, Nigeria...

"Evidence" is a key term in medicine and health services research, including Health Technology Assessment (HTA). Randomized clinical trials (RCTs) have undoubtedly dominated the scene of generating evidence for a long period of time, becoming the hallmark of evidence-based medicine (EBM). However, due to a number of misunderstandings, the lay audience and some researchers have sometimes placed too much trust in RCTs compared to other methods of investigation. One of the principal misunderstandings is to consider RCTs findings as isolated and self-apparent pieces of information...

BACKGROUND: The learning performance and overall health of students might be impacted by excessive academic stress. While the right amount of stress can help improve learning and performance, too much stress can harm one's mental and physical health as well as academic performance. This research aims to assess the prevalence and use of the beta-blocker propranolol among healthcare students in Saudi Arabia. METHODS: A cross-sectional study was conducted among healthcare students at Umm Al-Qura University in Makkah, Saudi Arabia...

No abstract text is available yet for this article.

Hand gesture classification is of high importance in any sign language recognition (SLR) system, which is expected to assist individuals suffering from hearing and speech impairment. American sign language (ASL) comprises of static and dynamic gestures representing many alphabets, phrases, and words. ASL recognition system allows us to digitize communication and use it effectively within or outside the hearing-deprived community. Developing an ASL recognition system has been a challenge since some of the involved hand gestures closely resemble each other, and thereby it demands high discriminability features to classify these gestures...

Ground -level health care workers provide us a unique perspective of immunization programs. While our official data may be too rosy to be true, a casual / unscheduled /anonymous conversation with such foot- soldiers may bring us face -to- face with reality through another angle If we want our programs to be robust having a wide coverage, Mantra of success lies not only in making good policy while sitting in ivory -towers but also in folding our sleeves up, sweating under the tropical hot Sun, going to hinterlands and initiating a dialogue with those humble low- level workers who sometimes are invisible to us otherwise, not listened to and with whom sometimes promises are not kept...

OBJECTIVES: To investigate self-reported sleep duration, sleep timing, sleep status and influencing factors in the Chinese population. METHODS: This web-based cross-sectional survey was conducted in 2022, covering 31 provinces (91%) in China. 11,000 questionnaires were collected, of which 8970 were valid for analysis. Self-reported sleep habits, problems and quality were investigated. Good or fair sleep ratings, enough duration, regular, with no sleep disturbances and <30 min sleep latency was defined as a composite variable: 'Good sleep'...

Multi-armed bandits are very simple and powerful methods to determine actions to maximize a reward in a limited number of trials. An early phase in dose-finding clinical trials needs to identify the maximum tolerated dose among multiple doses by repeating the dose-assignment. We consider applying the superior selection performance of multi-armed bandits to dose-finding clinical designs. Among the multi-armed bandits, we first consider the use of Thompson sampling which determines actions based on random samples from a posterior distribution...

Background and Objectives: Impulse Control Disorders (ICDs) including pathological gambling, hypersexuality, compulsive eating, compulsive buying, and other related behaviors are well-known distinct non-motor symptoms in Parkinson's Disease (PD). Some large-scale studies present a prevalence of at least 10%, however, there are other reports providing much higher rates. The majority of the conducted studies investigating ICDs focus mainly on pharmacological factors, however, from a psychological perspective, there is yet enough room for investigation...

Quality in biomedical research is a much-discussed topic among experts, research institutes, and funding organizations. Quality issues are frequently reported in the scientific and general press (e.g., stability of study results after test retake - "replication crisis"). Quality management systems are a globally accepted and established tool to guide and manage quality and to address quality problems. However, the notion of quality management is often met with resistance among researchers: low resources, too much regulation, restriction of research, and unnecessary bureaucracy are counter-arguments...

BACKGROUND: Although neonatal Staphylococcus aureus pneumonia is common and usually curable, it can also be refractory and life-threatening. Herein, we report a case of severe neonatal community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) necrotizing pneumonia with bilateral recurrent pyopneumothorax, respiratory failure, heart failure, and cardiac arrest. We hope our report will add to the understanding of this disease. CASE SUMMARY: An 18-d-old boy presented with cough for five days, fever for three days, and dyspnea for two days...

A considerable amount of spending in health care is deemed wasteful. Overdiagnosis, i.e. the labelling of a person with a diagnosis that lacks net benefit, is an entity within the overarching concept of »too much medicine«. Overdiagnosis includes overdetection and overdefinition. Disease mongering is a type of overdefinition with economic drivers. Overtesting and overtreatment are other aspects of »too much medicine«, but are not overdiagnosis per se. Medical research tends to focus on benefits of diagnostics and therapy, whereas overdiagnosis and other harms receive less attention, leading to overestimation of benefits...

Occlusion of the left coronary circumflex artery (LCX) during surgical procedures of the mitral valve is an infrequent but potentially life-threatening complication (1-3). Due to its close anatomical relationship to the posterior mitral valve annulus, there is a relevant risk of causing a stenosis or an occlusion of the left circumflex artery, especially by surgical annular sutures. The perioperative clinical course is heterogeneous, ranging from-initially-asymptomatic or solely electrocardiographic abnormalities to cardiogenic shock...

BACKGROUND: Good sleep is correlated with health. Primary insomnia is a common reason for consulting a primary care physician. It is usually treated with drugs despite clear evidence for the efficacy of behavioral therapy. METHODS: We conducted a selective search of PubMed for German- and English-language reviews of the past decade that deal with the function and regulation of sleep in healthy individuals and/or the mechanism of action of currently used drugs and behavioral therapy...

WHAT IS THIS SUMMARY ABOUT?: This summary describes a study of a new pill for treating chronic heart failure called empagliflozin (brand name Jardiance® ). The study is called EMPEROR-Preserved and was published in the New England Journal of Medicine . Chronic heart failure is a condition where the heart does not pump blood around the body properly. Heart failure causes symptoms such as shortness of breath, tiredness and build-up of too much water in the body (fluid retention). These symptoms often need hospital treatment and increase the risk of early death...

WHAT IS THIS SUMMARY ABOUT?: This is a summary of the article describing the EMPEROR-Reduced study of empagliflozin, which was published in the New England Journal of Medicine . Empagliflozin (brand name Jardiance® ) is a new drug therapy for the treatment of chronic heart failure. Chronic heart failure is a long-term condition where the heart cannot pump enough blood around the body, leading to symptoms such as shortness of breath, fatigue and build-up of too much water in the body (fluid retention)...