A randomized trial has shown that video-based distance health exercises և weight loss programs with online education support improve pain and function in knee osteoarthritis և overweight or obese people. The intervention, which included a nutritional component, provided modest additional pain relief իայի function benefits և resulted in significant weight loss. The findings have been published Chronicle of Internal Medicine.

Osteoarthritis affects more than 32.5 million adults in the United States and is a major public health problem worldwide. Osteoarthritis of the knee is usually associated with obesity, which exacerbates pain and disability, accelerates the progression of osteoarthritis, and increases the likelihood of requiring expensive knee surgery. Extensive knee osteoarthritis programs are needed to provide the suggested education, exercise, and weight loss interventions.

Researchers from the University of Melbourne recruited 416 people with persistent knee pain to take part in the Better Knee, Better Me test. Patients were randomly assigned to one of two 6-month telemedicine programs, one with dietary intervention and one without dietary intervention compared to the information-only control group.

During the experiment, participants in the intervention groups received support from physiotherapists, nutritionists through Zoom, and a package of educational resources available online. Those included in the exercise plus diet also received dietary supplements to maintain a ketogenic, low-calorie diet.

Over a six-month period, the researchers found that compared with controls, participants in both programs had significant improvements in knee pain, physical function and quality of life that were maintained over the longer term. Compared to the exercise program alone, the combined exercise և diet program led to additional benefits, including greater pain relief, greater physical function improvement, less use of analgesics, and an average weight loss of 22 pounds. With a 6-month program. According to the researchers, these findings suggest that telemedicine programs represent potentially large-scale, affordable ways for people with osteoarthritis of the knee to receive the recommended interventions.

An observational study has shown that gender inequality in the use of dolutegravir-containing antiretroviral therapy (ART) persists despite the World Health Organization’s (WHO) approval of its use in HIV-infected women of reproductive age. The authors of the study say that this inequality greatly limits the health benefits of the population of dolutegravir for a significant number of women living with HIV worldwide. Their findings have been made public Chronicle of Internal Medicine.

In low- and middle-income countries, the transition to dolutegravir was hampered by a preliminary safety signal received in May 2018, suggesting that the effect of dolutegravir during fertilization may be related to neural tube defects in children. Based on additional evidence, the WHO recommended Dolutegravir in July 2019 for all adult adolescents living with HIV.

Researchers from New York City University studied the health data of 134,672 patients aged 16 and over who received HIV care between January 2017 and March 2020 to describe the acceptance of Dolutegravir և gender differences 11 in 11 low- և middle-income countries :

They found that significant differences in the absorption of dolutegravir have been documented to affect women of reproductive age by early 2020. They found that differences in dolutegravir intake among women of childbearing age occurred after a safety signal.

At the end of the study, the cumulative frequency of dolutegravir absorption in women aged 16 to 49 years was 29.4%, compared with 57.7% in men of the same age group. This inequality was greater in countries that started using dolutegravir before the safety signal և initially had very restrictive policies towards countries that used it later.

The researchers note that while this inequality was expected due to access restrictions across the country, the results underscore its magnitude and initial maintenance. WHO review’s policy implications և Program implementation considerations for major AIDS programs և Major initiatives, such as the US PEPFAR program, that seek to ensure that HIV-infected women receive maximum health benefits from HIV treatment from their mode.

Randomized controlled trials have shown that gastric bypass surgery and gastric bypass surgery are highly effective in reducing non-alcoholic fatty liver disease in obese patients with type 2 diabetes. Both procedures resulted in a significant reduction in liver fat 5 weeks after surgery գրեթե almost complete liver fat clearance 1 year after surgery. The effect of bariatric surgery on liver scarring or cirrhosis was unclear. The findings have been published Chronicle of Internal Medicine.

Non-alcoholic fatty liver disease is a serious problem because it causes inflammation of the liver և cirrhosis, which can lead to liver failure or liver cancer. The condition is more common in people with diabetes or obesity. Եւ Moderate weight loss is the first line of treatment. The most common weight loss surgeries are Roux-en-Y gastric bypass և sleeve gastectomy. Gastric bypass surgery is more risky than sleeve surgery, but some low-quality research suggests that gastric bypass may outperform gastric bypass surgery to improve liver fat.

Researchers at the Vestfold Hospital Trust in Tonsberg, Norway, have recruited 109 obese patients with type 2 diabetes who need to undergo weight loss surgery. Experimental patients were randomly assigned to gastric bypass (54 patients) or gastric bypass surgery (55 patients). The researchers followed the patients in the study for 1 year after losing weight, compared the changes in liver fat content, and the number of liver scars between groups.

Researchers have found that both procedures are effective in reducing liver fat. Bariatric surgery had less of an effect on scarring in the short term, but the researchers plan to take participants “back 5 years” to gain additional insights into the relative effectiveness of the two procedures.

Source:

American College of Physicians

Magazine link.

Benel, KL, et al:. (2021) Comparing Video-Based Exercise հեռ Weight Loss Exercise Programs with Online Knee Osteoarthritis Outcome Education. Random test. Chronicle of Internal Medicine. doi.org/10.7326/M21-2388.

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