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Results for “individualized prevention”

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PubMed1978

Human infections: economic implications and prevention.

Morbidity and mortality from infectious diseases clearly remain high. Economic assessments should not be based soley on the costs of existing disease but should incorporate costs saved by preventive efforts as well as savings likely to be attained within several years by improved preventive measures. These factors can be used to assess the relative needs for research for specific infections and to compare the economic importance of infections with that of other health problems. Preventive activities for individuals and for larger groups are outlined, and the relation of research to prevention and control of infections is presented.

Botulism↗
PubMed1978

[Analysis of early detection among 7513 preschool children].

The development of cognitive and social abilities of preschool children in Basle is discussed. The importance of education and of detecting developments which do not confirm to standard is stressed in this context. A survey of preventive examinations, carried out during the last five years, in which 7513 kingergarten-children were examined, is given. Only findings confirmed by specialists are stated. Furthermore the measures taken to help preschool children with neurological illness and hearing loss of sensory neural type are discussed. The preventive and the individually curative medical activities have proved sensible and complementary to each other.

Child↗
PubMed1978

[Medicine, health and prevention].

Health problems far exceed the potentialities of medicine as conventionally practised in Switzerland and elsewhere. Only a health policy directed primarily towards prevention will ensure a more harmonious development for all, both individually and collectively. "Passive" preventive medicine (vaccinations, regular check-ups, etc.) has already been shown to be important, and will remain so in the future, but "active" prevention should be employed more generally. In order to motivate the public to assume co-responsibility for its own health, education in human biology and behaviour, customs, risk factors, environment, social conditions and the economic situation of the community should be dispensed at a very early age, as should the elementary measures necessary for maintaining good health. Education on suhc a general scale is only possible by a constant exchange of information and close collaboration between experts in various health-related fields, politicians, laymen, adults and children. Health is not a right as such, but is the result of daily care and a long learning process.

Child↗
PubMed2026

Lifestyle Combination Patterns as Key Modifiable Factors for Type 2 Diabetes Mellitus Risk among Middle-Aged Korean Men.

BACKGRUOUND: The increasing prevalence of type 2 diabetes mellitus (T2DM) worldwide highlights the need to understand risk factors and effective prevention strategies. Although individual lifestyle factors associated with diabetes risk have been identified, research on their collective interactions is limited. This study aimed to identify lifestyle combination patterns in middle-aged Korean men and evaluate their impact on T2DM risk. METHODS: A total of 2,332 middle-aged men without T2DM at baseline (2001-2002) from the Korean Genome and Epidemiology Study (KoGES) cohort were included. T2DM incidence was tracked through the 8th follow-up survey (2017-2018). Lifestyle combination patterns were identified using factor analysis based on sociodemographic, lifestyle, and dietary data. Cox regression was used to assess T2DM incidence across patterns. RESULTS: Four lifestyle combination patterns were identified: 'Healthy Lifestyle,' 'Low Carb & High Protein,' 'High SES & Irregular Lifestyle,' and 'Bad Eating Habits.' The risk of developing T2DM varied across patterns. The 'Healthy Lifestyle' and 'Low Carb & High Protein' patterns showed a slight decrease in risk in T3, but the differences were not significant. The 'High SES & Irregular Lifestyle' pattern was associated with a higher T2DM risk in T3 than in T1 (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.05 to 1.55), but the association was attenuated after adjustment for family history. The 'Bad Eating Habits' pattern showed a 1.21-fold higher risk in T3 (HR, 1.21; 95% CI, 1.01 to 1.47). CONCLUSION: This study underscores the existence of distinct lifestyle combination patterns and their differential implications for T2DM risk. These findings support the need for tailored preventive strategies based on lifestyle patterns.

Humans↗
PubMed2026

International trends in concurrent hysterectomy at risk-reducing surgery in BRCA1/2 pathogenic variant carriers: a mixed-methods study.

BACKGROUND: BRCA1/2 pathogenic variant carriers are advised to undergo a risk-reducing salpingo-oophorectomy between the ages of 35 and 45 due to their increased risk of tubo-ovarian cancer. A concurrent hysterectomy may be performed at the time of risk-reducing salpingo-oophorectomy. Currently, the international execution of hysterectomy during risk-reducing surgery and the factors guiding related decision-making are unknown. OBJECTIVE: We aimed to evaluate the international execution of concurrent hysterectomy during risk-reducing surgery for tubo-ovarian cancer and factors guiding providers' decision-making about this. STUDY DESIGN: We conducted a mixed-methods study. First, we executed a quantitative analysis with data from the Women choosIng Surgical Prevention (WISP) and TUBectomy with delayed oophorectomy as Alternative for risk-reducing salpingo-oophorectomy in high-risk Women to assess the Safety of Prevention (TUBA-WISP II) study, both prospective preferential trials assessing surgical strategies for tubo-ovarian cancer prevention. Data were collected via electronic case report forms. Concurrent hysterectomy during risk-reducing salpingo-oophorectomy was compared between Europe, North- and South America, and Australia using Kruskal-Wallis tests. We used univariable logistic regression models to estimate the association of personal and prevention-related characteristics with the execution of hysterectomy at risk-reducing salpingo-oophorectomy in women from North- and South America. Subsequently, we conducted focus group interviews with gynecologic providers from 12 countries who provide preventive care for individuals at increased risk of tubo-ovarian cancer to identify indications, barriers, and facilitators for the execution of hysterectomy with risk-reducing salpingo-oophorectomy. RESULTS: In the quantitative analysis, we included 2181 participants, of whom 1647 (75.5%) were from Europe, 498 (22.8%) from North- and South America, and 36 (1.7%) from Australia. Execution of hysterectomy at risk-reducing salpingo-oophorectomy differed substantially between continents, with an execution of 48.8% in North- and South America, 14.2% in Australia, and 2.8% in Europe (P<.001). Execution of concurrent hysterectomy at risk-reducing salpingectomy in women from North- and South America occurred more often in women with a BRCA1 pathogenic variant compared to a BRCA2 pathogenic variant (adjusted odds ratio 0.4 [95% confidence interval, 0.2-0.7]). In the qualitative analysis, we interviewed 23 healthcare providers and identified 31 barriers and 32 facilitators regarding hysterectomy execution during risk-reducing salpingo-oophorectomy. A total of 8 different indications were mentioned, but opinions varied on the validity and weight given to each indication. Providers indicated that important barriers or facilitators for concurrent hysterectomy included a lack of clear guidelines, cultural variation between countries, (lack of) consensus within departments, and different interpretation of the endometrial cancer risk. CONCLUSION: Internationally, there is a large variation in execution of hysterectomy during risk-reducing surgery with frequent utilization in North- and South America, and rare utilization in Europe. This could be explained by the interpretation of indications for hysterectomy by providers, which might be explained by cultural variation, the absence of clear guidelines, and limited scientific evidence.

Humans↗
PubMed2026

Emerging multidimensional biomarker system for cardiovascular-kidney-metabolic syndrome: from multi-omics integration to clinical artificial intelligence.

Cardiovascular-kidney-metabolic (CKM) syndrome is an emerging clinical entity that highlights the complex, bidirectional interplay among cardiovascular disease, chronic kidney disease, and metabolic disorders, representing a substantial and growing global health burden. This conceptualization marks a paradigm shift from viewing these conditions in isolation to understanding them as an interconnected disease continuum. Traditional biomarkers face significant limitations in the early detection, risk stratification, and precise management of CKM, necessitating a transition towards an integrated framework that captures its multisystem nature. This review systematically outlines an emerging multidimensional biomarker system encompassing key pathological axes such as metabolism, immuno-inflammation, oxidative stress, and biological aging, offering refined risk assessment beyond conventional metrics. The development of this system is propelled by revolutionary platforms, including accessible sampling techniques (e.g., dried blood spots), advanced in vitro models (e.g., multi-organ-on-a-chip), and multi-omics technologies. These platforms not only facilitate a deeper dissection of the heterogeneous origins and inter-organ crosstalk in CKM but also accelerate the discovery and validation of novel biomarkers. Concurrently, artificial intelligence serves as a pivotal tool for clinical translation, effectively integrating high-dimensional data to transform complex molecular profiles into actionable clinical insights. By enabling the construction of dynamic risk prediction and decision-support systems, this review charts a pathway toward proactive, individualized, and precise prevention and management of CKM syndrome.

Humans↗
PubMed2026

Protein mediators of chronic kidney disease in Type 2 diabetes: A mendelian randomization study.

BACKGROUND: Chronic kidney disease (CKD) occurs in 20-50% of the people living with Type 2 diabetes (T2D) and is the leading cause of kidney failure worldwide. The cause of CKD is not fully understood, and few interventions prevent CKD in individuals living with diabetes. Here, we use large-scale proteomics data to identify circulating proteins that mediate the relationship between T2D and kidney disorders. METHODS AND FINDINGS: First, we used two-sample mendelian randomization (MR) and identified 71 circulating proteins whose levels were altered by genetic predisposition to T2D based on circulating proteomic GWAS from deCODE with 35,559 individuals and T2D GWAS with 80,154 cases. Then, we used cis-genetic variants to proxy the causal effect of some of these T2D-influenced circulating proteins and found that, collectively, five proteins (INHBC, GNPTG, LPO, AGRN, and CTSD) affected three kidney traits (blood urea nitrogen [BUN], estimated glomerular filtration rate [eGFR] and CKD risk) based on GWAS with up to 1,004,040 participants. Notably, we found that higher levels of circulating INHBC protein were estimated to lead to a lower eGFR and higher BUN based on MR analyses. We then replicated this MR analysis with proteomic GWAS from four additional cohorts, namely, UKB-PPP, Fenland, ARIC, and EPIC-Norfolk. We observed a consistent direction of effect across all four proteomic GWAS datasets, supporting the robustness of our results against platform and cohort variation. In observational analyses, increased circulating INHBC levels were associated with increased hazard for kidney disease diagnosis in 37,854 UK Biobank participants. We estimated that circulating INHBC levels mediate 1.3% (95% confidence interval [0.85%, 1.9%]) of the association between T2D and kidney disease diagnosis. There are important limitations in this study. Firstly, although we observed limited evidence for violations to the MR assumptions, some are untestable. Secondly, our study was not based on individuals with diabetic kidney diseases, but rather independent population-based studies assessing diabetes and kidney function separately. Therefore, additional functional analyses in disease specific cohort are needed. CONCLUSIONS: Collectively, these findings suggest that T2D influences the risk of CKD, in part, through increased circulating INHBC levels.

Humans↗
PubMed1979

[Effects of minoxidil on blood pressure and plasma volume in refractory hypertension (author's transl)].

We substituted minoxidil for dihydralazine in the treatment of 10 patients with refractory hypertension. Supine diastolic blood pressure decreased from 114 +/- 15 mmHg ou dihydralazine to 90 +/- 10 mmHg after one week on minoxidil (mean +/- ISD, p less than 0.01), the concomitant therapy being unchanged (sodium depletion and betablockade in all patients, methyl dopa or clonidine in seven). Simultaneously themean plasma volume increased by 395 ml (p less than 0.02) with no correlation to the decrease in blood pressure, and with no change in plasma renin activity and plasma aldosterone. Further expansion of plasma volume was prevented by furosemide, individual dosage requirement ranging from 40 to 500 mg/day, irrespective of the renal function. fter three to six months of ambulatory treatment a satisfactory blood pressure control was maintained. Hirsuties appeared in all our patients, but no subjective side effects was reported.

Adolescent↗
PubMed1978

[Preventive health actions. Various levels of time, of the role of health professions and of individual participation].

At a time when increasing emphasis is placed on promotive and preventive measures in health care, it is important to bear in mind that the ways and means of prevention are diverse and multidisciplinary. The author briefly discusses the levels which are to be considered, in regard to the timing of the intervention (primary, secondary and tertiary prevention), the requisite professional contribution, and the importance of the individual's active participation. Participation is highly desirable, and is in fact indispensable for improvement of the "civilization" health problems we are now facing. It is not always easy, however, to determine its optimal pattern and intensity. It is also necessary to take into account the inteface situations between preventive measures and freedom, at the individual as well as the social level.

Health Occupations↗
PubMed2026

Empagliflozin and functional aerobic capacity in individuals with increased risk of heart failure: The Empire Prevent Cardiac trial.

BACKGROUND: Higher maximal oxygen consumption (VO&#x2082; max) is associated with lower risk of developing heart failure (HF). Empagliflozin improves VO2 max in HF with reduced ejection fraction, but the effect on VO2 max in individuals at risk of HF remain unknown. OBJECTIVE: This study aimed to evaluate the effect of 180 days treatment with empagliflozin compared to placebo on VO2 max, daily physical activity level, and quality of life (QoL) in individuals with overweight or obesity and risk of HF. METHOD: This investigator-initiated, double-blinded, randomized, placebo-controlled, multicenter trial included elderly individuals with body mass index >28 kg/m2 and at least one additional risk factor for HF, including hypertension, ischemic heart disease, stroke, or chronic kidney disease. Individuals with HF or type 2 diabetes mellitus were excluded. The primary endpoint was the mean difference in change of VO2 max. The secondary outcome was objectively measured physical activity level. QoL was an explorative outcome. RESULTS: Among 191 randomized individuals (94 empagliflozin, 97 placebo), 89% had hypertension and 66% ischemic heart disease. At baseline, 69% were male, median age was 68 years, median body mass index 31.9 kg/m&#xb2;, mean left ventricular ejection fraction 65 &#xb1; 9%, and mean VO&#x2082; max 18.1 &#xb1; 4.3 mL/min/kg. Empagliflozin did not change VO2 max with an estimated treatment difference of -0.2 mL/min/kg (97.5% confidence interval -1.2 to 0.8), adjusted P = 1.00. No significant treatment differences were observed for neither daily physical activity nor QoL. CONCLUSIONS: Empagliflozin did not affect VO2 max, physical activity level, or QoL in elderly individuals with overweight or obesity and risk of HF.

Humans↗
PubMed1977

[Caries prevention by means of local fluoride application].

The topical application of fluoride has developed into an effective health-saving measure for the individual and the collective prevention of caries. A reduction in caries increment of 30 to 40% may be expected. With reference to the mode of action of topically applied fluorides on dental enamel and plaques, methods and preparations are recommended for acceptance in the framework of socialist health protection.

Dental Caries↗
PubMed2026

Preemptive hematopoietic stem cell transplantation in RUNX1 familial platelet disorder: a shared decision-making framework.

RUNX1 familial platelet disorder (RUNX1-FPD) is associated with a 35-50% lifetime risk of hematologic malignancy (HM). Like all germline HM predisposition syndromes, RUNX1-FPD can only be cured with allogeneic hematopoietic stem cell transplantation (HSCT). Current genetic screening techniques allow for early detection of germline predisposition and, consequently, the opportunity for HSCT before overt development of HM (i.e., preemptive HSCT). However, there is as yet no consensus on the use of preemptive HSCT for RUNX1-FPD. Described here is the case of an individual with RUNX1-FPD and a family history of HM who underwent preemptive HSCT. We introduce a shared decision-making framework designed to support individuals with RUNX1-FPD, their families, and their multidisciplinary clinical teams in evaluating whether and when to pursue preemptive HSCT versus continued surveillance. The framework reviews key medical factors that influence the decisions regarding timing of HSCT, including germline and somatic variants, clonal changes over time, familial history of HM, early morphologic or hematologic features, impacts on bleeding-related quality of life, and donor availability. The framework also summarizes the major risks and uncertainties potentially associated with preemptive HSCT while highlighting the associated ethical challenges. Together, the case and framework provide a structured, patient-centered approach for navigating the complex clinical decision of preemptive HSCT. Ongoing collaborative efforts to define cytogenetic and clonal changes preceding malignant transformation in RUNX1-FPD will refine the framework and bolster individualized treatment strategies aimed at preventing HM and improving the quality of life of individuals with RUNX1-FPD.

Humans↗
PubMed1979

Prospective economic evaluation of lead poisoning prevention programs.

This paper illustrates an economic methodology for the prospective evaluation of individual lead poisoning screening and prevention programs. A method is presented for prospectively estimating the prevalence and expected health consequences of lead poisoning in an urban population. The economic costs of these consequences are calculated and cost-benefit analysis is used to complete the evaluation. A case study is developed to illustrate the potential utility of the model as a framework for the prospective evaluation of programs under funding consideration.

Child, Preschool↗
PubMed1976

Prevention of prematurity.

Although only about 8 per cent of pregnancies end prematurely, as much as 75 per cent of perinatal deaths are due to prematurity. Since it is difficult to identify the predisposing factors in individual cases and to prevent the premature onset of labor, it is necessary to try to arrest such labor when it occurs. A theoretical scheme for the mechanism of labor in the human subject is presented. This permits the identification of four possible points of attack: (1) replacement of progesterone to reduce the myometrial sensitivity to oxytocin, (2) administration of beta-mimetic agents to relax the uterus and make it unresponsive to stimuli, (3) administration of ethanol to block oxytocin secretion, and (4) administration of anti-inflammatory drugs to inhibit prostaglandin synthesis. Results obtained with ritodrine, a beta-mimetic agent, and with ethanol are presented as illustration. Ritodrine gave somewhat better results than ethanol, possibly because the treatment was continued after discharge of the patients.

Adrenergic beta-Agonists↗
PubMed1979

Prevention of periodontal disease in the future.

Existing knowledge about periodontal disease is sufficient to permit the interested individual to carry out a preventive program which can result in preventing the major forms of the disease from developing. It is likely that the sooner such a program is started in a person's lifetime, the likelier it is to succeed. With the additional knowledge obtained from current avenues of research, clinical microbiology and immunology will become applicable to the management of selected forms of periodontal disease, both for diagnostic and therapeutic purposes. Some of the information gained may help in fostering the establishment of a desirable microbial flora and in better control of potentially pathogenic strains. The implementation of an effective preventive program for periodontal and other dental diseases will vary on a regional basis depending on political, economic, social and ethical considerations.

Bacteria↗