Adequate Medical Information Research Articles

Healthcare experiences of LGBTQ+ people: non-binary people remain unaffirmed.

Lesbian, gay, bisexual, transgender, queer, and all sexually and gender diverse (LGBTQ+) people experience discrimination across many contexts, including healthcare environments. While some research has shown transgender people and non-binary people often endure higher rates of marginalization than cisgender, sexually diverse people, past data are limited. A sample of LGBTQ+ people (N = 173) in the United States completed an anonymous, online, self-reported survey, which included the Consumer Assessment of Healthcare Providers and Systems and healthcare experience questions. Groups, including people who identified as cisgender, sexually diverse (n = 116), transgender (n = 24), and non-binary (n = 33), were compared using chi-square and multivariate analysis of covariance tests. Compared to cisgender, sexually diverse people, non-binary people were less likely to report feeling comfortable with a physical exam, having good mental health, respected by providers, that providers had adequate medical information, that providers could care for someone going through gender affirmation, and that hospital staff were comfortable interacting with them. Additionally, non-binary people were more likely to report hospital staff misgendering them. These unique LGBTQ+ subgroup differences may be secondary to identity-specific stigma that non-binary people face. More international studies are needed to elucidate these subgroup-specific healthcare experiences across LGBTQ+ identities.

Metabolic syndrome is independently associated with improved overall survival to first-line therapy with immune checkpoint inhibitors in non-small cell lung cancer.

Many co-existing medical conditions may affect the outcome in patients treated with immune checkpoint inhibitors for advanced cancer. There is currently not any information on whether metabolic syndrome (MetS) impacts the clinical outcome in patients treated with immune checkpoint inhibitors (ICIs) for advanced non-small cell line cancer (NSCLC). We carried out a single-center retrospective cohort study to determine the effects of MetS on first-line ICI therapy in patients with NSCLC. One hundred and eighteen consecutive adult patients who received first-line therapy with ICIs and had adequate medical record information for the determination of MetS status and clinical outcomes were included in the study. Twenty-one patients had MetS and 97 did not. There was no significant difference between the two groups in age, gender, smoking history, ECOG performance status, tumor histologic types, pre-therapy use of broad-spectrum antimicrobials, PD-L1 expression, pre-treatment neutrophil:lymphocyte ratio, or proportions of patients who received ICI monotherapy or chemoimmunotherapy. With a median follow-up of 9 months (range 0.5-67), MetS patients enjoyed significantly longer overall survival (HR 0.54, 95% CI: 0.31-0.92) (p = 0.02) but not progression-free survival. The improved outcome was only observed in patients who received ICI monotherapy and not chemoimmunotherapy. MetS predicted for higher probability of survival at 6 months (p = 0.043) and 12 months (p = 0.008). Multivariate analysis indicated that, in addition to the known adverse effects of use of broad-spectrum antimicrobials and the beneficial effects of PD-L1 (Programmed cell death-ligand 1) expression, MetS was independently associated with improved overall survival but not progression-free survival. Our results suggest that MetS is an independent predictor of treatment outcome in patients who received first-line ICI monotherapy for NSCLC.

An Assessment Of The Ethical And Legal Dilemma In The Practice Of Anaesthesiology: The Nigerian Perspective

The practice of medicine intersects with the legal system in two important ways. The ethical code establishes the framework of permissible conduct, through regulation, while the legal system provides patients and other entities recourse when these regulations are breached. Anaesthesia is a branch of Medicine and Anaesthesiologists care for patients at the extremes of health and illness, frequently employing life-sustaining technologies and procedures to restore health. Patients have widely recognised right to reject life-sustaining procedures that may be in conflict with the tradition of physician paternalism and authoritarianism derived from virtue-based ethics. This naturally leads to high expectations among the general public from the Anaesthesiologists. In the past, patients used to subject themselves to surgery after signing a simple willingness form, but in the present scenario, if any catastrophe occurs, it grabs news headlines, negligence is suspected by the general public. There has been a rising trend in medical negligence cases that the services provided by an anaesthesiologist come under the apprehension standard of care, protocols by which anaesthesiologists should abide to avoid legal consequences. This paper examines emerging ethical issues since the establishment of anaesthesia as a branch of medicine. The paper adopts the doctrinal methodology of research by examining primary and secondary sources related to the discourse. The paper further recommends adequate medical information by way of educating patients on their rights before any medical procedure among others.

A comparative study of unmet information needs of patients with lymphoma and CLL: North America and Europe.

12135 Background: Informed patients are consistently associated with better outcomes and overall patient experiences. However, there are still unknowns about the information needs of patients. This study uses the Lymphoma Coalition (LC) 2020 Global Patient Survey (GPS) on Lymphomas and CLL to describe the differences in the unmet information needs among patients with lymphoma and CLL in North America and Europe. Methods: Globally, 9,179 patients from 90+ countries took part in the LC 2020 GPS. The countries were grouped into regions, and the North American (NA) (n=1543) and European (EU) (n=4343) regions were used for this analysis (Table). The demographics of the regions were examined, and univariate, bivariate and multivariate analyses of questions relating to patients’ information needs, were performed in IBM SPSS v27. Results: When compared, the regions differed significantly in patients’ age distribution, lymphoma subtype, highest educational level completed, and area of residence. The top three areas of unmet information need for patients with lymphoma and CLL in both regions were: diagnosis and what it means, treatment options, and side effects from treatment. Compared to patients in the EU, patients in NA were 27% more likely to need more information about treatment options, 51% more likely to need more information about support for self-care, and 18% less likely to need more information about their diagnosis and what it means. These differences were statistically significant (Table). Patients from NA were 26% more likely to report that they had no informational needs compared to patients from EU (p=0.02) (Table). There was no significant difference between patients in both regions in their need for more information in the following areas: psychological support, support for their families, side effects from treatment and fertility (Table). Conclusions: Regardless of region, patients with lymphoma need more information about certain areas of their care than is currently provided. LC advocates for increased access to appropriate and adequate medical information for patients, and that this information be contextualized to the patient’s needs.[Table: see text]

A cross-sectional study on global disparities in information experiences of patients with lymphoma/CLL.

e18517 Background: Patient-centricity remains a cornerstone in the care of patients with lymphoma and CLL, as informed patients are consistently associated with better outcomes and experiences. This study uses the Lymphoma Coalition (LC) 2020 Global Patient Survey (GPS) on Lymphomas and CLL to describe the global differences in the top choices for medical information among patients with lymphoma, as well as differences in their understanding of this information relating to various aspects of their care. Methods: Globally, 9,179 patients from 89 countries took part in the LC 2020 GPS. The countries were grouped into regions, and the regions with greater than 200 patients were included in the analysis (Table). The demographics of the regions were examined, and descriptive analyses of questions relating to information source preferences, information provision at diagnosis (addressing treatment options; process and stages of care; managing treatment side effects), and corresponding levels of patient understanding were performed in IBM SPSS v27. Results: Doctors were the first choice for medical information for patients in each region (SA-82%, AS- 75%, EU-69%, OC-63%, NA-61%). In EU, NA and SA, websites were the most prevalent second and third choice for information (27% and 28%; 30% and 32%; 35% and 27%, respectively). In AS, patient advocacy organisations were the most prevalent second and third choices for information (32% and 40%, respectively), while in OC, the most prevalent second and third choices were nurses (27%) and patient advocacy groups (32%) respectively. Over a fifth of NA patients were not given information on the process and stages of care and how to manage side effects of treatment (21% and 29%, respectively). About a third of patients from SA (32%) reported not getting information on treatment options. Over half of OC patients reported being given information on and completely understanding the different treatment options (51%), processes and stages of care (53%) and how to manage treatment side-effects (58%). Patients from AS were the most prevalent in reporting across the three categories, that they were given information but did not understand it (10%, 7%, 5%, respectively). Conclusions: Globally, patients with lymphoma use various avenues to source the medical information they need, and they differ in their information experiences. Access to appropriate and adequate medical information remains an essential aspect of a successful patient experience and LC advocates that this information be contextual and accessible to all patients with lymphoma. [Table: see text]

Evaluation of YouTube videos as a patient education source for novel surgical techniques in thyroid surgery.

Patients and physicians are increasingly utilizing online video sharing sites such as YouTube for obtaining and disseminating health-related information in multimedia format; however, due to its free, open-access platform, YouTube videos fall short in providing validated, up-to-date medical information, and may even convey unintended messages to patients who are seeking additional information on surgeries. We evaluated the relevance, reliability, and quality of YouTube videos on novel surgical techniques in thyroid surgery. The top 50 indexed YouTube videos for the queries, "robotic thyroid surgery" and "transoral thyroid surgery", were assessed by two independent reviewers for video quality and reliability for patient understanding. Videos were scored using Global Quality Score (GQS), a scale for video quality, and DISCERN Scoring, a questionnaire for reliability and quality measures of information presented. The mean ± standard deviation (SD) duration of the videos (n=50) was 8.1±3.7 minutes. Total views were 261,440 and the mean ± SD time since upload was 3.6±2.6 years. The median and interquartile range of video power index (VPI) was 1.9 (0.5-3.7), GQS was 3.0 (2.0-4.0), and DISCERN score was 2.8 (2.3-3.2). Most videos were uploaded by physicians (75.8%) and the highest number of videos (63.6%) uploaded were from the United States (US). Videos with higher quality and reliability scores were uploaded by academic professionals, and included videos of physicians who described procedural information, perioperative instructions, and possible postoperative complications (P<0.05). Adequate medical information on the procedure and discussion of complications in YouTube videos were independent predictors of advanced educational quality and reliability. Clinical information on new surgical techniques such as transoral and robotic thyroid surgeries in YouTube videos scored low on quality and reliability as a source of patient education. Physicians should provide supplemental educational material online and offline to aid patient understanding of novel procedures.

Qualitative study of medication review in Flanders, Belgium among community pharmacists and general practitioners.

Objective Examining the implementation barriers and facilitators of this service as provided by Belgian community pharmacists in collaboration with general practitioners. Setting Community pharmacies in Flanders. Method Qualitative study through interviews of pharmacists and general practitioners. Main outcome measure Opinions and experiences of pharmacists and general practitioners about type 3 medication review. Results Sixteen community pharmacists and thirteen general practitioners were interviewed and generally gave a positive assessment of the project. The general practitioners saw the pharmaceutical and pharmacotherapeutic recommendations of the pharmacists as an added value for the patients. The pharmacists indicated that performing an medication review was time-consuming, but that it improved their professional relationship with general practitioners and patients. They reported obstacles in obtaining information: cumbersome access to individual patient data (laboratory values) and difficulties in finding and choosing adequate medical information sources. Moreover, pharmacists indicated that there is a need for adequate reimbursement and additional training to make the implementation sustainable. Conclusion Both pharmacists and general practitioners were enthusiastic about medication reviews. The implementation improved the interprofessional collaboration. However, important barriers remain, such as the considerable investment of time and the difficulty in gathering all the necessary information. The sustainable implementation of type 3 medication review in Belgium requires adequate reimbursement and additional training.

IOT based wearable sensor for diseases prediction and symptom analysis in healthcare sector

Humans with good health condition is some more difficult in today’s life, because of changing food habit and environment. So we need awareness about the health condition to the survival. The health-support systems faces significant challenges like lack of adequate medical information, preventable errors, data threat, misdiagnosis, and delayed transmission. To overcome this problem, here we proposed wearable sensor which is connected to Internet of things (IoT) based big data i.e. data mining analysis in healthcare. Moreover, here we design Generalize approximate Reasoning base Intelligence Control (GARIC) with regression rules to gather the information about the patient from the IoT. Finally, Train the data to the Artificial intelligence (AI) with the use of deep learning mechanism Boltzmann belief network. Subsequently Regularization _ Genome wide association study (GWAS) is used to predict the diseases. Thus, if the people has affected by some diseases they will get warning by SMS, emails. Etc., after that they got some treatments and advisory from the doctors.

Advance care directives: Citizens, patients, doctors, institutions.

Italian Law no. 219/2017 established the advance care directives (“Disposizioni anticipate di trattamento” – DAT), a legal document specifying the person’s wishes in relation to health, drawn up in case of the possible future incapacity to make informed decisions. DAT are an important instrument of empowerment for a person who is not necessarily a “patient” and enable the dialogue between healthcare providers and patient to continue when the latter is no longer able to take part consciously. DAT can only be implemented by guaranteeing the fundamental rights of the person, i.e. by ensuring the “non-complicated” use of this instrument and easy access to the DAT whenever it may be necessary. Furthermore, on the one hand, the requirement of adequate prior medical information has to contend with the fact that the wishes expressed in the document may have been formed outside of the therapeutic relationship; on the other hand, institutions must ensure that DAT are collected and recorded in such a way as to ensure their availability whenever and wherever necessary.Significance for public healthThe impact of such legislation on public health could be significant for various reasons: empowering individuals who are able, precisely, to make decisions “now” to be applied “later”, means fully respecting an individual’s choices irrespective of the reasons: for example, the reasons may be of an entirely personal nature, in some cases driven by the past experience of someone they know, or of a religious nature, with repercussions on the family (such as their children’s health). In this sense, healthcare choices are identified with full acceptance of individual empowerment, which can occur only after the doctor has provided the person/patient with adequate information. Moreover, should the patient refuse treatment, the health resources allocated for their treatment could be re-allocated to another individual who needs them and could benefit in terms of quality and quantity of life.

Evaluation of the knowledge level and usage attitudes of the medical students on the medicinal herbs and herbal products: a project of special study module in the first three years of the school of medicine

Background: In this survey, it was aimed to determine the types of medicinal herbs and herbal products, reasons of use and consciousness levels among the medical students in the first three years of the School of Medicine.Methods: A cross-sectional descriptive questionnaire consisting of 50 questions was applied to all the students in the first three years of Dokuz Eylül University School of Medicine between September 1, 2016 and June 1, 2017.Results: The results of 571 participating students were evaluated. Of these students, 301 (52.7%) were females and 270 (47.3%) were males. It was found that 73.4% (n=419) of the students used these products for treatment and mostly consumed linden, sage tea, mint and rosehip. Also, 11.6% of the students had chronic diseases (n=66). It was determined that 69.7% (n=46) of these students having chronic diseases used medicinal herbs and herbal products. Only 12.0% of the students had an opinion about the legal regulations regarding the use of herbs and herbal products in Turkey, while 39.7% of them had no idea, and 48.3% stated that such regulations on this matter were unreasonable. However, 59.7% of the respondents stated that legal regulations were necessary. It was found that the participating students used herbs and herbal products generally for therapeutic purposes without having sufficient knowledge about medicinal herbs; therefore it was necessary to increase their level of consciousness.Conclusions: Medical students neither have adequate medical information about medicinal herbs and herbal products, nor about the regulations on these products. It is crucial to revise the courses in the medical education so that the students would get informed about the regulations as well as potential risks of herbal plants while still in the medical schools.

Pattern of referral to a consultation-liaison psychiatry service in an Egyptian cancer center

Aim/Objective/Background Integration of consultation-liaison(C-L) psychiatry services in palliative care units in oncology departments is very limited in Egypt. A new dedicated C-L psychiatry service was recently established within the premises of the palliative care clinic in Kasr al Ainy Center for Clinical Oncology and Nuclear Medicine (NEMROCK), Cairo, Egypt. The aim of this study was to examine the characteristics, diagnoses and follow up of patients referred to this new service in a year period. Methods The clinical and psychiatric characteristics of all consecutive oncology patients (n=44) referred to this new C-L psychiatric service in a year period were examined. Psychiatric diagnosis was made according to the Diagnostic and Statistical Manual of Psychiatric Disorders, 5th edition (DSM 5). Results A total number of 44 patients (12 males and 32 females) were referred to the C-L clinic during the study period. Half of the patients had breast cancer.The other half was a diverse group involving different sites. In the advanced stage of cancer, males were significantly more represented than the females. As regards psychiatric diagnosis, the most common category was adjustment disorder (22 patients) followed by major depression (11 patients). Six of the patients had non-psychiatric distress, two had a primary psychotic disorder, two had substance related disorder and one had a major cognitive disorder. Causes of suffering in the non-psychiatric distressed group included lack of adequate medical information, physical concerns, existential concerns and family concerns. Most patients received psychotropic medication. Conclusions The scope and severity of psychiatric morbidity and distress detected in the referred oncology patients reflects the need to integrate C-L psychiatric services within psycho-oncological and palliative care clinics.

Post-stroke Recrudescence from Infection: an Immunologic Mechanism?

Post-stroke recrudescence (PSR) usually occurs in the setting of infection, hypotension, hyponatremia, insomnia or stress, and benzodiazepine use. Animal studies have suggested an infection-related immunologic mechanism for PSR. This retrospective study was designed to assess whether infection-triggered PSR is related to a prior infection during the index stroke. We identified 95 patients admitted to Massachusetts General Hospital from 2000 to 2015 with post-stroke recrudescence who had adequate medical record information concerning the index stroke. The frequency of infections, as well as other triggers such as hypotension, hyponatremia, insomnia/stress, and benzodiazepine use, was compared between the index stroke and the PSR episode. Independent predictors of infection-related PSR were identified using a logistic regression model. The mean age was 66 ± 17years (53% female); 29 (31%) had infections during the index stroke as compared to 40 (42%) during the PSR episode. The frequency of PSR triggered by infection was higher in patients with infections during the index stroke (65% vs 32%, p = 0.003). The same relationship occurred with benzodiazepine-triggered PSR (41% vs 12%, p = 0.008). The frequencies of other triggers such as hypotension, hyponatremia and insomnia/stress were not significantly different between the index stroke and the PSR episode. In a logistic regression model, infection during the index stroke was an independent predictor of infection-triggered PSR (odds ratio 4.85, 95% C.I. 1.7, 13.7). The association between infection during index stroke and infection-triggered PSR supports the immunologic mechanism postulated in animal models.

DIRECTED ACYCLIC GRAPH-BASED PATIENT EDUCATION SYSTEM FOR CARDIOVASCULAR PATIENTS IN TAIWAN

Background: Cardiovascular disease is the leading global cause of death and the number of patients is expected to grow yearly. Pertinent patient education materials provide adequate medical information to cardiovascular patients to change their behaviors, improve their health status, and reduce medical costs. However, systematic and patient-oriented education materials for cardiovascular disease are currently not available to the public, especially in Chinese. Methods: A directed acyclic graph (DAG) database structure is proposed for storing all created low-demand medical illustrations and video clips. Further, all designed medical media elements are evaluated according to the Patient Education Materials Assessment Tool (PEMAT) to assure the quality of the medical information content. Each media element is automatically annotated by calculating representative keywords; relationships between different media elements are constructed according to keyword associations. Results: A total of 222 video clips and 45 printable medical documents in Chinese were created in the proposed patient education system. This contains fundamental knowledge of diseases, causes of diseases, medical and surgical treatments, and a prognosis of the medical care for the majority of types of cardiovascular disease. It is the first constructive and intelligent patient education system for cardiovascular patients in Taiwan.

Advance Care Planning Finally Gets CMS Support

Advance Care Planning Finally Gets CMS Support

Women's perceptions of the quality of emergency obstetric care in a referral hospital in rural Tanzania.

To assess perceptions of the quality of obstetric care of women who delivered in a rural Tanzanian referral hospital. A descriptive-exploratory qualitative study, using semistructured in-depth interviews and participatory observation. Nineteen recently delivered women and 3 health workers were interviewed. Although most women held positive views about the care they received in hospital, several participants expressed major concerns about negative attitudes of healthcare workers. Lack of medical communication given by care providers constituted a major complaint. A more positive attitude by health workers and the provision of adequate medical information may promote a more positive hospital experience of women in need of obstetric care and enhance attendance.

English

The essence of preparing a biological specimen for microscopic studies is to get adequate and accurate medical information that is a true representation of the specimen, be it for research or diagnostic purposes. An artifact can be defined as unrelated, self-colored artificial feature found in tissue sections. This has been an age long cause of misinterpretation leading to misdiagnosis to microscopists. The processing of specimen for medical information is subject to a procedure that results in a tissue fit for diagnosis and interpretation. The procedures themselves are subject to human and material errors and the result is an artifact that in the least may interfere with adequate diagnosis or at the most render the tissue so distorted as to be undiagnosable. The need to recognize these artifacts and attempt to overcome them is the single biggest challenge in the histopathology Laboratory. This article focused on identifying artifacts and their potential cause so that misinterpretation and difficulty in diagnosis can be overcome, and help microscopist to come into definite diagnosis. Keywords: Artifacts, Histopathologist, Microscopist, Diagnosis

Continuous terbutaline infusion in severe asthma in adults: a retrospective study of long-term efficacy and safety

Background: Long-term subcutaneous or intravenous infusion of terbutaline has been used to stabilize asthma in patients enduring frequent hospital admissions due to severe asthma despite maximum therapy. However, this treatment is not supported by significant body of evidence. Aim: To study long-term efficacy and safety of using continuous infusions of terbutaline in unstable severe asthma. Methods: The available medical records of all patients received terbutaline infusions at a severe asthma unit between 1982 and 2008 were retrospectively studied. We retrieved data on treatment indication, asthma subtype, patient demographics, pre-treatment terbutaline trial outcome, duration of treatment, effect on lung function, hospital admissions, oral corticosteroids (OCSs) requirement, safety and side effects. Results: Forty-two patients with adequate medical information were studied (31 females, mean age 43.6 years, 88% had type 1 brittle asthma and 12% had other severe asthma). This group of patients had a mean body mass index of 30.8 kg/m2, mean oral prednisolone or equivalent of 26.6 mg and mean predicted FEV1 of 66.8%. The mean treatment duration was 86.7 months (range 7–216). Long-term continuous terbutaline infusion significantly reduced hospital admissions (mean pre-treatment = 6.7 (95% CI 0.96–12.4) per annum, and mean annualized on-treatment admission = 3.3 (95% CI 0.63–6.9, p = 0.045). We observed overall reduction in OCSs use in 59% of patients with available data, but there was no significant change in lung function. Side effects related to terbutaline or the method of its infusion were common and some were serious especially when central venous access device were used. Conclusion: Continuous terbutaline infusion could be a treatment option for severe unstable asthma and may reduce hospital admissions. However, the treatment was associated with significant side effects and its use should be limited to centers possessing necessary expertise.

Changes in decisional conflict and decisional regret in patients with localised prostate cancer

To identify the changes and associated factors in decisional conflict and regret in patients with localised prostate cancer up to six months postprimary treatment. Various treatments of differing qualities can be used for patients with localised prostate cancer; these treatments may cause conflicts in treatment decision-making and post-treatment regret. A quantitative longitudinal study. A total of 48 patients were recruited from a 3700-bed medical centre in northern Taiwan and assessed at pretreatment and one and six months post-treatment. Demographic characteristics, clinical information and results from the psychosocial adjustment to illness scale, decisional conflict scale and decision regret scale were collected. Data were analysed based on the generalised estimating equations models. The overall decisional conflict substantially improved over time. However, the feeling of being less informed was high and did not improve considerably during the study period. Education level, decision preferences and psychosocial adjustment were associated with decisional conflict and influenced decision-making. The feeling of ineffective decision-making and decisional regret was low, post-treatment. Psychosocial adjustment was associated with effective decision-making and decisional regret. In patients with localised prostate cancer, decisional conflict reduced considerably up to six months post-treatment. Moreover, the patients were satisfied with their treatment decision-making and believed that they had made the correct choice up to six months post-treatment. However, patients may have experienced feelings of being less informed pre- and post-treatment, particularly those with lower education levels, a preference for passive roles, or inferior psychosocial adjustment. Consequently, health professionals must provide adequate medical information and psychosocial intervention to help patients in the decision-making process. Nurses and healthcare providers must provide localised prostate cancer patients with adequate information and psychosocial intervention to reduce decisional conflict.

Nutritional supplements for diabetes sold on the internet: business or health promotion?

BackgroundDiabetes is one of the most widespread chronic disease. Although many medications are available for the treatment and prevention of diabetes, many people turn to nutritional supplements (NSs). In these years, the online sales have contributed to the growth of use of nutritional supplement. The aim of the research was to investigate the type of information provided by sales websites on NSs, and analyse the existence of scientific evidence about some of the most common ingredients found in available NSs for diabetes.MethodsA web search was conducted in April 2012 to identify web sites selling NSs in the treatment of diabetes using Google, Yahoo and Bing! and the key word used was “diabetes nutritional supplements”. Website content was evaluated for the quality of information available to consumers and for the presence of a complete list of ingredients in the first NS suggested by the site. Subsequently, in order to analyze the scientific evidence on the efficacy of these supplements a PubMed search was carried out on the ingredients that were shared in at least 3 nutritional supplements.ResultsA total of 10 websites selling NSs were selected. Only half of the websites had a Food and Drug Administration disclaimer and 40% declared clearly that the NS offered was not a substitute for proper medication. A total of 10 NS ingredients were searched for on PubMed. Systematic reviews, meta-analyses or randomized control trials were present for all the ingredients except one. Most of the studies, however, were of poor quality and/or the results were conflicting.ConclusionsEasy internet access to NSs lacking in adequate medical information and strong scientific evidence is a matter of public health concern, mainly considering that a misleading information could lead to an improper prevention both in healthy people and people suffering from diabetes. There is a clear need for more trials to assess the efficacy and safety of these NSs, better quality control of websites, more informed physicians and greater public awareness of these widely used products.

Point/Counterpoint

Point/Counterpoint