scholarly journals Elevated Plasma Levels of Interleukin-12p40 and Interleukin-16 in Overweight Adolescents

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Michael Lichtenauer ◽  
Marcus Franz ◽  
Michael Fritzenwanger ◽  
Hans-Reiner Figulla ◽  
Norbert Gerdes ◽  
...  
Keyword(s):  
Health Care Systems ◽  
Normal Weight ◽  
Western World ◽  
Obese Patients ◽  
Elevated Plasma ◽  
Childhood Adiposity ◽  
Care Systems ◽  
Overweight Adolescents ◽  
The Individual ◽  
Overweight Subjects

Introduction. Obesity during adolescence is an increasing problem for both the individual and health care systems alike. In Western world countries, childhood adiposity has reached epidemic proportions. It is known that elevated levels of proinflammatory cytokines can be found in the plasma of obese patients. In this study, we sought to determine the relation between IL-12p40, IL-12p70, and Interleukin-16 (IL-16) in overweight adolescents.Materials and Methods. Seventy-nine male Caucasian adolescents aged 13–17 years were included in this study. Thirty-seven of them had a body mass index (BMI) above the 90th age-specific percentile. Il-12p40, IL-12p70, and IL-16 were measured from plasma using Luminex multiplex technology.Results. Both IL-12p40 and IL-16 concentrations were significantly increased in overweight subjects compared to normal weight controls (IL-12p40: 1086.6 pg/mL ± 31.7 pg/mL SEM versus 1228.6 pg/mL ± 43.5 pg/mL SEM; IL-16 494.0 pg/mL ± 29.4 pg/mL SEM versus 686.6 pg/mL ± 52.5 pg/mL SEM,P<0.05andP<0.01, resp.). No differences were found for IL-12p70.Conclusions. Based on these results, we believe that the increased levels of IL-12p40 and IL-16 are associated with an ongoing inflammatory response in obese individuals and could lead to the development of disease conditions related to obesity.

Organizing a diabetes service

2011 ◽  
pp. 2005-2011
Author(s):  
Stephen C. L. Gough
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Health Care Need ◽  
Delivery Of Care ◽  
Strategic Approach ◽  
Effective Manner ◽  
Care Systems ◽  
The Individual ◽  
The Uk

The increasing worldwide incidence and prevalence of diabetes is placing substantial pressures on health care systems and economies. As a consequence individuals involved in the care of people with diabetes are looking at services currently being provided and examining ways in which care can be organized in the most cost-effective manner. Whilst the degree to which diabetes care is delivered differs from country to country, similar fundamental questions are being asked by those involved in the delivery of care, including: What are we currently providing? What do we need to provide? What are we able to provide? Although the answers to these questions are quite different not just between countries but often within specific localities within a country, the ultimate aim is the same: to provide the best possible care to as many people with diabetes as possible. The global diversity of diabetes health care need is enormous and while the solutions will be equally diverse, the approach to the development of a diabetes service will, for many organizations, be similar. The main focus of this chapter is based upon the model or the strategic approach developed in the UK, but many of the individual component parts are present in most health care settings.

scholarly journals Framing the Shades of Sustainability in Health Care: Pitfalls and Perspectives from Western EU Countries

2018 ◽  
Vol 10 (12) ◽  
pp. 4439 ◽  
Author(s):  
Elio Borgonovi ◽  
Paola Adinolfi ◽  
Rocco Palumbo ◽  
Gabriella Piscopo
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Health Care Systems ◽  
Financial Economic ◽  
Point Of View ◽  
Health Care Environment ◽  
Health Gains ◽  
Care Systems ◽  
The One ◽  
The Individual

Sustainability is momentous for the appropriate functioning of health care systems. In fact, health and sustainability are two strictly related values, which could not be separately sought. While studies discussing the contextualization of this issue with respect to the distinguishing attributes of health care systems are rapidly blooming, there is still little agreement about what is ultimately meant by sustainability in the health care arena. On the one hand, attention is primarily focused on the proper use of available financial resources; on the other hand, people engagement and empowerment are gradually arising as a crucial step to enhance the viability of the health care system. This paper tries to identify, from a conceptual point of view inspired by the European integrative movement, the different shades of sustainability in health care and proposes a recipe to strengthen the long-term viability of health care organizations. The balanced mix of financial, economic, political, and social sustainability is compelling to increase the ability of health care organizations to create meaningful value for the population served. However, the focus on a single dimension of sustainability is thought to engender several side effects, which compromise the capability of health care organizations to guarantee health gains at the individual and collective levels. From this standpoint, further conceptual and practical developments are envisioned, paving the way for a full-fledged understanding of sustainability in the health care environment.

How health care regionalisation in Italy is widening the North–South gap

2014 ◽  
Vol 9 (3) ◽  
pp. 231-249 ◽  
Author(s):  
Federico Toth
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
The South ◽  
Hospital System ◽  
The North ◽  
Level Of Satisfaction ◽  
Italian National Health Service ◽  
Care Systems ◽  
System 2 ◽  
The Individual

AbstractThe Italian National Health Service began experimenting with a significant regionalisation process during the 1990s. The purpose of this article is to assess the effects that this regionalisation process is having on the rift between the north and the south of the country. Has the gap between the health care systems of the northern and southern regions been increasing or decreasing during the 1999–2009 decade? Three indicators will be utilised to answer this question: (1) the level of satisfaction expressed by the citizens towards the regional hospital system; (2) the mobility of the patients among regions; (3) the health care deficit accumulated by the individual regions. On the basis of these three indicators, there is evidence to conclude that, during the decade under study, the gap between the North and the South, already significant, has increased further.

scholarly journals Colonoscopy and flexible sigmoidoscopy for follow-up of patients with left-sided diverticulitis

2020 ◽  
Vol 102 (9) ◽  
pp. 744-747
Author(s):  
Z Abdulazeez ◽  
N Kukreja ◽  
N Qureshi ◽  
S Lascelles
Keyword(s):  
Computed Tomography ◽  
Diverticular Disease ◽  
Flexible Sigmoidoscopy ◽  
Health Care Systems ◽  
Acute Diverticulitis ◽  
Western World ◽  
Routine Surveillance ◽  
New Findings ◽  
Care Systems

Introduction The prevalence of diverticular disease has been increasing in the western world over the last few decades, causing a growing burden on health care systems. This study compared the uses of flexible sigmoidoscopy with colonoscopy as a follow-up investigation for patients diagnosed with acute left-sided diverticulitis and to evaluate the need for using either procedure. Materials and methods A retrospective study of 327 patients diagnosed with acute diverticulitis was carried out. Of this total, 240 patients with left-sided diverticulitis diagnosed via computed tomography were included. These patients were categorised into two equal groups: the first 120 patients underwent colonoscopy and the second 120 patients underwent flexible sigmoidoscopy. Results All colonoscopes and flexible sigmoidoscopes confirmed the computed tomography diagnosis of sigmoid diverticular disease with no major new findings. All colonoscopes and flexible sigmoidoscopes were reported as having no complications, with nine colonoscopes reported as being difficult compared with only three flexible sigmoidoscopes. All biopsies were reported as no malignancy. Full bowel preparation was required in all colonoscopes, compared with no preparation required for flexible sigmoidoscopes. Conclusions There is no evidence to support the routine use of endoscopic evaluation after an episode of left-sided diverticulitis diagnosed on computed tomography if no worrying radiological findings have been reported. This study supports similar findings from other studies and therefore we disagree with The Royal College of Surgeons of England (Association of Coloproctology of Great Britain and Ireland recommendations) commissioning guide, which advocates routine surveillance of the colon.

Milk, Blood Lipids and Coronary Heart Disease (CHD) - ‘The Myth and the Evidence’

2004 ◽  
Vol 29 ◽  
pp. 199-213
Author(s):  
Anne M. Minihane
Keyword(s):  
Health Care Systems ◽  
Total Mortality ◽  
Cost Effective ◽  
Ageing Population ◽  
Average Life Expectancy ◽  
Working Age ◽  
Care Systems ◽  
Life Threatening ◽  
The Individual ◽  
The Uk

Chronic diet related diseases such as cardiovascular disease (CVD) and cancers account for the vast majority (∼ 65%) of total mortality in the UK (Figure 1). In westernised countries average life expectancy is rapidly increasing with the ratio of people of working age to people over 65 estimated to fall from about to 4:1 to 2.5:1 by the year 2040. These ageing population demographics have placed an almost unbearable strain on the health care systems of these countries. As a result there has been increased focus on the use of diet as a modifiable means of preventing or delaying the onset of disease. This approach in addition to being cost effective would ensure that for the individual who is living longer that they also remain healthier for longer, developing chronic life threatening diseases at an older age.

Personal responsibility for health: the impact of digitalisation

2019 ◽  
Vol 7 (3) ◽  
pp. 241-258
Author(s):  
Andrea Martani ◽  
Georg Starke
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Personal Responsibility ◽  
Health Care Systems ◽  
Individual Level ◽  
Fine Grained ◽  
Care Systems ◽  
Gerald Dworkin ◽  
The Individual ◽  
The Impact

Fostering the personal responsibility of patients is often considered a potential remedy for the problem of resource allocation in health care systems. In political and ethical debates, systems of rewards and punishments based on personal responsibility have proved very divisive. However, regardless of the controversies it has sparked, the implementation of personal responsibility in concrete policies has always encountered the problem of practical enforceability, i.e.how causally relevant behaviour can be tracked, allowing policies of this kind to be applied in a fine-grained, economically viable and accurate fashion. In this paper, we show how this hurdle can be seemingly overcome with the advent of digitalisation in health and delineate the potential impact of digitalisation on personal responsibility for health. We discuss how digitalisation – by datafying health and making patients transparent – promises to close the loophole of practical enforceability by allowing to trace health-related lifestyle choices of individuals as well as their exposure to avoidable risk factors. Digitalisation in health care thereby reinforces what Gerald Dworkin has called the causal aspect of personal responsibility and strengthens the implicit syllogism that – since exposure to risk factors happens at the individual level – responsibility for health should be ascribed to the individual. We conclude by addressing the limitations of this approach and suggest that there are other ways in which the potential of digitalisation can help with the allocation of resources in health care.

The Canadian Charter of Rights and Freedoms: Implications for Involuntary Admission

1985 ◽  
Vol 4 (1) ◽  
pp. 5-13
Author(s):  
Elaine Newman
Keyword(s):  
Health Care ◽  
Government Intervention ◽  
Health Care Systems ◽  
Involuntary Admission ◽  
Canadian Charter ◽  
Present Practice ◽  
Effective Administration ◽  
Care Systems ◽  
Legal Professions ◽  
The Individual

The paper poses a challenge to the medical and legal professions. Our Charter of Rights and Freedoms defines the standard for government intervention in the lives of the citizens of Canada. It has an immediate and significant impact upon involuntary admissions to psychiatric facilities, in as much as those admissions constitute a deprivation of liberty to the individual. The challenge to our professions is one of reviewing present practice in the field, and of reconciling the need for effective administration of health care systems with the protective standards set by the Charter.

scholarly journals Odor–Taste–Texture Interactions as a Promising Strategy to Tackle Adolescent Overweight

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3653
Author(s):  
Cristina Proserpio ◽  
Elvira Verduci ◽  
Gianvincenzo Zuccotti ◽  
Ella Pagliarini
Keyword(s):  
Caloric Intake ◽  
Normal Weight ◽  
Modal Interactions ◽  
Obesity Epidemic ◽  
Promising Strategy ◽  
Gustatory Function ◽  
Reduce Sugar ◽  
Adolescent Overweight ◽  
Overweight Adolescents ◽  
Overweight Subjects

The adolescence period is characterized by a considerable risk to weight gain due to the high consumption of food rich in sugar. A promising strategy to reduce sugar consumption may lie in exploiting the ability of our senses to interact to each other (cross-modal interactions). The aims were to investigate the cross-modal interactions and gustatory function in normal-weight and overweight adolescents. Fifty adolescents (25 overweight and 25 normal-weight) were involved. Subjects rated liking and attribute intensity in pudding samples obtained by adding vanilla aroma (0.1%; 0.3%), butter aroma (0.05%; 0.1%) or a thickener agent (1%; 1.5%) to a base formulation. The gustatory function was also measured through the “taste strips” methodology. Overweight adolescents were found to have a significantly (p < 0.001) worse ability to correctly identify all tastes. Cross-modal interactions occurred differently according to their body mass index, with a significant increase (p < 0.05) in sensory desirable characteristics (e.g., sweet and creaminess) due to aroma addition, especially in overweight subjects. Furthermore, butter aroma significantly increased hedonic responses only in overweight subjects. Tricking our senses in the way of perceiving sensory attributes could be a promising strategy to develop innovative food formulations with a reduced sugar amount, which will lead to a potential decrease in caloric intake and help to tackle the obesity epidemic.

scholarly journals Peripheral Blood Mononuclear Cells Oxidative Stress and Plasma Inflammatory Biomarkers in Adults with Normal Weight, Overweight and Obesity

Antioxidants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 813
Author(s):  
Margalida Monserrat-Mesquida ◽  
Magdalena Quetglas-Llabrés ◽  
Cristina Bouzas ◽  
Xavier Capó ◽  
David Mateos ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Mononuclear Cells ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Inflammatory Biomarkers ◽  
Obese Patients ◽  
Peripheral Blood Mononuclear ◽  
Protein Levels ◽  
Blood Mononuclear Cells ◽  
Overweight Subjects

Background: Obesity is an important pathology in public health worldwide. Obese patients are characterized by higher cardiovascular risk and a pro-inflammatory profile. Objective: To assess the oxidative stress in peripheral blood mononuclear cells (PBMCs) and inflammatory biomarkers in plasma in adults with normal weight, overweight and obesity. Methods: One hundred and fifty adults (55-80-years-old; 60% women) from the Balearic Islands, Spain, were recruited and classified according to body mass index (BMI). Anthropometric measurements were carried out, fasting blood samples were collected and plasma and PBMCs were obtained. Biochemical parameters, hemogram, antioxidant enzyme activities and protein levels, reactive oxygen species production (ROS), malondialdehyde (MDA), and cytokine (tumour necrosis factor, TNFα, and interleukin 6, IL-6) levels were measured. Results: Glycaemia, triglyceridemia, abdominal obesity, and waist-to-height ratio (WHtR) were higher, and HDL-cholesterol was lower in obese patients. MDA and TNFα plasma levels were higher in the obese compared to normal-weight group, while the levels of IL-6 were higher in both obese and overweight subjects with respect to normal-weight peers. The activities of all antioxidant enzymes in PBMCs as well as the production ROS progressively increased with BMI. The protein levels of catalase in PBMCs were higher in obese and glutathione reductase in obese and overweight subjects compared to normal-weight peers. No other differences were observed. Conclusion: The current results show that overweight and obesity are related to an increase in pro-oxidant and proinflammatory status in plasma and PBMCs. The studied biomarkers may be useful for monitoring the progression/reversal of obesity.

scholarly journals Impact of obesity on survival in COVID-19 ARDS patients receiving ECMO: results from an ambispective observational cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Florence Daviet ◽  
Philippe Guilloux ◽  
Sami Hraiech ◽  
David Tonon ◽  
Lionel Velly ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Health Care Systems ◽  
Survival Rates ◽  
Multivariate Logistic Regression Analysis ◽  
University Hospital ◽  
Obese Patients ◽  
Arterial Ph ◽  
Younger Age ◽  
Care Systems ◽  
Observational Cohort

Abstract Background Since March 2020, health care systems were importantly affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, with some patients presenting severe acute respiratory distress syndrome (ARDS), requiring extra-corporeal membrane oxygenation (ECMO). We designed an ambispective observational cohort study including all consecutive adult patients admitted to 5 different ICUs from a university hospital. The main objective was to identify the risk factors of severe COVID-19 ARDS patients supported by ECMO associated with 90-day survival. Results Between March 1st and November 30th 2020, 76 patients with severe COVID-19 ARDS were supported by ECMO. Median (interquartile range IQR) duration of mechanical ventilation (MV) prior to ECMO was of 6 (3–10) days. At ECMO initiation, patients had a median PaO2:FiO2 of 71 mmHg (IQR 62–81), median PaCO2 of 58 mmHg (IQR 51–66) and a median arterial pH of 7.33 (IQR 7.25–7.38). Forty-five patients (59%) were weaned from ECMO. Twenty-eight day, 60-day and 90-day survival rates were, respectively, 92, 62 and 51%. In multivariate logistic regression analysis, with 2 models, one with the RESP score and one with the PRESERVE score, we found that higher BMI was associated with higher 90-day survival [odds ratio (OR): 0.775 (0.644–0.934), p = 0.007) and 0.631 (0.462–0.862), respectively]. Younger age was also associated with 90-day survival in both models [OR: 1.1354 (1.004–1.285), p = 0.044 and 1.187 (1.035–1.362), p = 0.014 respectively]. Obese patients were ventilated with higher PEEP than non-obese patients and presented slightly higher respiratory system compliance. Conclusion In this ambispective observational cohort of COVID-19 severe ARDS supported by ECMO, obesity was an independent factor associated with improved survival at 90-day.

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