Aim: Although numerous studies of disease management and case management of chronic heart failure (CHF) have been carried out, length of effectiveness after program commencement has not been examined, so we examined a...Aim: Although numerous studies of disease management and case management of chronic heart failure (CHF) have been carried out, length of effectiveness after program commencement has not been examined, so we examined a follow-up study at 36 months after program commencement. Methods: Participants went for follow-up visits to one Japanese clinic which specializes in internal cardiovascular medicine and they were given diagnoses of CHF. 104 outpatients participated in this study and randomized control trial was implemented. An educational program was implemented for 6 months. The data were collected at baseline, 3, 6, 9, 12 months from both intervention and control groups and at 24 and 36 months from the intervention group. Results: There was significant improvement in New York Heart Association (NYHA) in the intervention group between baseline and 36 months. Improvement in weight monitoring and activities or exercise in the intervention group continued up to 36 months. Meanwhile, sodium restricted diets and quitting smoking and/or drinking depended on individual preference and it was difficult to make improvements in these areas. Conclusions: The educational program showed promise in preventing CHF outpatients from deteriorating significantly on a long-term basis as self-monitoring of activity and weight continued significantly and there were no participants with CHF who deteriorated in the intervention group at 36 months after program commencement, although the program aimed only to provide illness and self-management knowledge. On the other hand, future work will need to compare participants in this program to a control group over an extended period of time with consideration for relieving the burden of the control group.展开更多
The prevalence of periodontal disease among pregnant women increases with gestational age. Therefore, oral health education in the early stage of pregnancy should prevent periodontal disease and decrease the risk of a...The prevalence of periodontal disease among pregnant women increases with gestational age. Therefore, oral health education in the early stage of pregnancy should prevent periodontal disease and decrease the risk of an adverse pregnancy outcome such as preterm delivery and low birth weight. However, there has been no study on oral health care intervention for prevention of periodontal disease during pregnancy. The purpose of this study was to examine the efficiency of an oral health education program on periodontal disease among Japanese low-risk pregnant women. A total of 207 pregnant women before 20 weeks of gestation were recruited. The first 131 of them were assigned to the control group and the remaining 76 to the experimental group. The experiment participants received an oral health education program including the toothpick brushing method in their early stage of pregnancy. Improvement of the self-assessment score of periodontal symptoms was used as a binary outcome variable. A logistic regression analysis indicated that the intervention (OR = 3.83) and proficiency of the toothpick brushing method (OR = 24.93) were statistically significant predictors of the outcome in the late stage of pregnancy. The positive outcome appeared after practice of the toothpick method brushing for 20 or more weeks, and was associated with the decrease in the log-transformed proportion of the count of Candida species in salivary microbiota (p = 0.026).展开更多
Diabetes mellitus is a major public health problem globally. It is the cause of serious and sometimes life-threatening complications leading to death. It is one of the most common non communicable diseases and leading...Diabetes mellitus is a major public health problem globally. It is the cause of serious and sometimes life-threatening complications leading to death. It is one of the most common non communicable diseases and leading cause of death in most developed countries including Bangladesh. It is associated with the increased risk of microvascular (nephropathy and retinopathy), macrovascular (cardiovascular diseases, stroke) and other mixed (cataract, pulmonary tuberculosis, foot ulcer etc.) complications. The aim of this study was to determine the risk factors related to diabetes complications and to propose competing risk models for analyzing complications of diabetes mellitus. We study 2887 diabetic patients from the BIRDEM registry record books for the period from 1984 to 1997 who have at least two follow-up visits and who are free from complications at the first visit. The data on variables such as 2-hBG, age, sex, family history of diabetes, area of residence, educational level, BMI, SBP, DBP and treatment status are obtained. Also, the time from the diagnosis of type 2 diabetes mellitus (T2DM) to the occurrence of complications was recorded. We use the competing risk hazard model and examined the potential risk factors for determining the development of such complications. This study reveals that increase in blood pressure is a potential risk factor for CHD and nephropathy in T2DM. We also found that male and illiterate patients are more affected by nephropathy. In our study, we also revealed that female and illiterate patients are also more influenced by cataract.展开更多
Objective: To verify the effectiveness of a “self-foot-care educational program (SFCEP)” for prevention of type 2 diabetes foot disease. Methods: A single-center, randomized and controlled trial was conducted. Fifty...Objective: To verify the effectiveness of a “self-foot-care educational program (SFCEP)” for prevention of type 2 diabetes foot disease. Methods: A single-center, randomized and controlled trial was conducted. Fifty-five patients with type 2 DM, 40 - 75 years of age who were asked to return for a follow-up hospital visit, were allocated to either an SFCEP group (n = 29) or a conventional education program (CEP) group (n = 26). Both of the groups were given foot-care education, monthly for four times in the SFCEP group and in the CEP group one time only by a printed leaflet. The two groups had no statistically significant differences in patient background of the type 2 diabetes history. We evaluated removal rate of skin debris, and the symptoms and conditions of the feet. Results: Between the SFCEP and CEP there were significant differences in removal rate of skin debris (p Conclusion: This study strongly suggests the effectiveness of SFCEP in preventing the occurrence or worsening of diabetic foot diseases.展开更多
文摘Aim: Although numerous studies of disease management and case management of chronic heart failure (CHF) have been carried out, length of effectiveness after program commencement has not been examined, so we examined a follow-up study at 36 months after program commencement. Methods: Participants went for follow-up visits to one Japanese clinic which specializes in internal cardiovascular medicine and they were given diagnoses of CHF. 104 outpatients participated in this study and randomized control trial was implemented. An educational program was implemented for 6 months. The data were collected at baseline, 3, 6, 9, 12 months from both intervention and control groups and at 24 and 36 months from the intervention group. Results: There was significant improvement in New York Heart Association (NYHA) in the intervention group between baseline and 36 months. Improvement in weight monitoring and activities or exercise in the intervention group continued up to 36 months. Meanwhile, sodium restricted diets and quitting smoking and/or drinking depended on individual preference and it was difficult to make improvements in these areas. Conclusions: The educational program showed promise in preventing CHF outpatients from deteriorating significantly on a long-term basis as self-monitoring of activity and weight continued significantly and there were no participants with CHF who deteriorated in the intervention group at 36 months after program commencement, although the program aimed only to provide illness and self-management knowledge. On the other hand, future work will need to compare participants in this program to a control group over an extended period of time with consideration for relieving the burden of the control group.
文摘The prevalence of periodontal disease among pregnant women increases with gestational age. Therefore, oral health education in the early stage of pregnancy should prevent periodontal disease and decrease the risk of an adverse pregnancy outcome such as preterm delivery and low birth weight. However, there has been no study on oral health care intervention for prevention of periodontal disease during pregnancy. The purpose of this study was to examine the efficiency of an oral health education program on periodontal disease among Japanese low-risk pregnant women. A total of 207 pregnant women before 20 weeks of gestation were recruited. The first 131 of them were assigned to the control group and the remaining 76 to the experimental group. The experiment participants received an oral health education program including the toothpick brushing method in their early stage of pregnancy. Improvement of the self-assessment score of periodontal symptoms was used as a binary outcome variable. A logistic regression analysis indicated that the intervention (OR = 3.83) and proficiency of the toothpick brushing method (OR = 24.93) were statistically significant predictors of the outcome in the late stage of pregnancy. The positive outcome appeared after practice of the toothpick method brushing for 20 or more weeks, and was associated with the decrease in the log-transformed proportion of the count of Candida species in salivary microbiota (p = 0.026).
文摘Diabetes mellitus is a major public health problem globally. It is the cause of serious and sometimes life-threatening complications leading to death. It is one of the most common non communicable diseases and leading cause of death in most developed countries including Bangladesh. It is associated with the increased risk of microvascular (nephropathy and retinopathy), macrovascular (cardiovascular diseases, stroke) and other mixed (cataract, pulmonary tuberculosis, foot ulcer etc.) complications. The aim of this study was to determine the risk factors related to diabetes complications and to propose competing risk models for analyzing complications of diabetes mellitus. We study 2887 diabetic patients from the BIRDEM registry record books for the period from 1984 to 1997 who have at least two follow-up visits and who are free from complications at the first visit. The data on variables such as 2-hBG, age, sex, family history of diabetes, area of residence, educational level, BMI, SBP, DBP and treatment status are obtained. Also, the time from the diagnosis of type 2 diabetes mellitus (T2DM) to the occurrence of complications was recorded. We use the competing risk hazard model and examined the potential risk factors for determining the development of such complications. This study reveals that increase in blood pressure is a potential risk factor for CHD and nephropathy in T2DM. We also found that male and illiterate patients are more affected by nephropathy. In our study, we also revealed that female and illiterate patients are also more influenced by cataract.
文摘Objective: To verify the effectiveness of a “self-foot-care educational program (SFCEP)” for prevention of type 2 diabetes foot disease. Methods: A single-center, randomized and controlled trial was conducted. Fifty-five patients with type 2 DM, 40 - 75 years of age who were asked to return for a follow-up hospital visit, were allocated to either an SFCEP group (n = 29) or a conventional education program (CEP) group (n = 26). Both of the groups were given foot-care education, monthly for four times in the SFCEP group and in the CEP group one time only by a printed leaflet. The two groups had no statistically significant differences in patient background of the type 2 diabetes history. We evaluated removal rate of skin debris, and the symptoms and conditions of the feet. Results: Between the SFCEP and CEP there were significant differences in removal rate of skin debris (p Conclusion: This study strongly suggests the effectiveness of SFCEP in preventing the occurrence or worsening of diabetic foot diseases.
