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International Journal of Clinical Practice

Elamin M Elamin, Catherine S Wilson, Chakrapol Sriaroon, Bianca Crudup, Sophia Pothen, Younghee C Kang, Kevin T White, William M Anderson
PURPOSE: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease associated with high morbidity and mortality. We evaluated the ability of pulmonary function tests to predict disease progression by ALS clinical phenotypes, and the timing of the introduction of non-invasive positive pressure ventilation (NIPPV). MATERIALS AND METHODS: A cohort study was performed in all adult patients who fulfilled El Escorial criteria at a tertiary-care academic medical centre for veterans in the USA from 1 January 2010 to 31 December 2014...
September 19, 2018: International Journal of Clinical Practice
Magdalena Emilia Grzybowska, Dariusz Wydra
AIMS: To compare quality of life (QoL) in women with urinary incontinence (UI) using continence pads during the day versus all day and night; to identify risk factors for a 24-hour pad use; to calculate quality-adjusted life years (QALY). METHODS: A cross-sectional study in 331 women with lower urinary tract symptoms referred to urogynaecologic examination was conducted. Main outcome measures were the scores of King's Health Questionnaire (KHQ), clinical data, and KHQ-derived utility values...
September 19, 2018: International Journal of Clinical Practice
David W Donnelly, Therese Kearney, Eilis McCaughan, Amy Downing, David Weller, Adam W Glaser, Anna Gavin
BACKGROUND: Erectile dysfunction is common among older men; however, diagnosis and treatment compared to reported prevalence is low. We aim to identify the degree to which older men are offered treatment for the condition and determine the level of unmet need within Northern Ireland (NI). METHODOLOGY: Analysis of data collected using a cross-sectional survey was conducted for men aged ≥60 years with data weighted to the NI population by age and deprivation. Respondents answered questions on sociodemographic factors, health-related characteristics, ability to function sexually, level of sexual interest and activity, and any treatment offered to improve erections in the last 3 years...
September 17, 2018: International Journal of Clinical Practice
Ángel Herráiz-Adillo, Olga Piñar-Serrano, Julián Ángel Mariana-Herráiz, Vicente Martínez-Vizcaíno, Diana Patricia Pozuelo-Carrascosa, Blanca Notario-Pacheco
INTRODUCTION: Peripheral arterial disease (PAD) is an underdiagnosed prevalent disease which implies high cardiovascular risk. Professionals usually depend on physical examination to screen for PAD. OBJECTIVE: To assess the diagnostic accuracy of physical examination to screen for PAD in a rural Primary Care population and to evaluate the nurse-physician level of agreement in pedal pulse palpation. METHODS: Diagnostic accuracy study in which two experienced professionals (physician-nurse) prospectively performed pedal pulse palpation (grading as absent, reduced, normal, or bounding), femoral bruit auscultation and calf circumference (index tests) comparing with Doppler ABI (reference test, positive cut-off: 0...
September 17, 2018: International Journal of Clinical Practice
Flemming Skjøth, Henrik Vadmann, Søren Pihlkjaer Hjortshøj, Sam Riahi, Gregory Y H Lip, Torben Bjerregaard Larsen
AIMS: The aim of this study was to study the risk of death and development of arrhythmia and/or subsequently heart failure after an atrial flutter ablation procedure compared with an atrial fibrillation (AF) ablation procedure. METHODS: This observational study is based on data from Danish nationwide health databases. Patients with a first-time ablation procedure for either atrial flutter or AF in the period 2000-2016 were included. Rates of renewed arrhythmia, heart failure or death were compared and reported as adjusted hazard ratios (HR)...
September 17, 2018: International Journal of Clinical Practice
Rahel Mahmud, Adam Gray, Adam Nabeebaccus, Martin Brunel Whyte
AIMS: Prolonged QT interval on electrocardiogram (ECG) increases the risk of ventricular arrhythmia. Patients admitted to acute medical units (AMU) may be at risk of QT prolongation from multiple, recognised risk factors. Few data exist regarding incidence or outcomes of QT prolongation in acute general medical admissions. The aims were to determine the incidence of Bazett's-corrected QT (QTc) prolongation upon admission to AMU; the relationship between QTc and inpatient mortality, length of stay and readmission; proportion with prolonged QTc subsequently administered QT interval-prolonging drugs...
September 17, 2018: International Journal of Clinical Practice
Adrian H Heald, Mark Livingston, Anthony Fryer, Gabriela Cortes, Simon G Anderson, Roger Gadsby, Ian Laing, Mark Lunt, Robert J Young, Mike Stedman
AIMS/HYPOTHESIS: Our aim was to quantify the impact of Blood Glucose Monitoring Strips variability (BGMSV) at GP practice level on the variability of reported glycated haemoglobin (HbA1cV) levels. METHODS: Overall GP Practice BGMSV and HbA1cV were calculated from the quantity of main types of BGMS being prescribed combined with the published accuracy, as % results within ±% bands from reference value for the selected strip type. The regression coefficient between the BGMSV and HbA1cV was calculated...
August 31, 2018: International Journal of Clinical Practice
Hai Deng, Alena Shantsila, Yumei Xue, Tatjana S Potpara, Ying Bai, Xianzhang Zhan, Xianhong Fang, Hongtao Liao, Wei Wei, Shulin Wu, Gregory Y H Lip
INTRODUCTION: Several clinical scoring systems have been derived to predict the arrhythmia outcome of catheter ablation (CA) for atrial fibrillation (AF) but which is better is not clear. Simple clinical risk scores (that any clinician can use in the everyday clinic) can help assess the likelihood of recurrence of AF following CA and the simple MB-LATER score has recently been described. We compare the predictive ability of seven existing clinical scoring systems (HATCH, CHADS2 , CHA2 DS2 -VASc, BASE-AF2 , APPLE, CAAP-AF, and MB-LATER) in a Chinese cohort of AF patients undergoing CA...
August 24, 2018: International Journal of Clinical Practice
Shivani Gaitonde, Rena D Malik, Alana L Christie, Philippe E Zimmern
PURPOSE: Few medical treatment options exist for detrusor underactivity or urinary retention in women. Bethanechol, a cholinergic agonist, may improve detrusor contractility in these conditions; however, its clinical efficacy is limited. We sought to examine the patterns of Bethanechol use by physicians in an ambulatory care setting using a national database to determine if it is still prescribed for patients with bladder dysfunction. MATERIALS AND METHODS: The National Ambulatory Medical Care Survey (NAMCS) database was queried for a sample of patient visits to office-based physicians from 2003-2013...
August 15, 2018: International Journal of Clinical Practice
Faisal Jamshaid, Saied Froghi, Pierpaolo Di Cocco, Frank Jmf Dor
BACKGROUND AND OBJECTIVES: Acute rejection is a significant complication detrimental to kidney transplant function. Current accepted means of diagnosis is percutaneous renal biopsy, a costly and invasive procedure. There is an urgent need to detect and validate non-invasive biomarkers capable of replacing the biopsy. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Comprehensive literature searches of Medline, EMBASE and Cochrane Central Register of Controlled Trials databases were performed...
July 16, 2018: International Journal of Clinical Practice
Katarina Petrakova, Jiri Vyskocil, Peter Grell, Ondrej Majek, Renata Soumarova, Jiri Novak, Petr Burkon, Zdenek Kral, Tomas Kazda, Rostislav Vyzula
BACKGROUND AND PURPOSE: Appropriate surveillance guidelines for patients after successful treatment of Hodgkin's lymphoma (HL) are needed to reduce mortality of iatrogenic secondary cancers (SC). This large single institutional retrospective study analyses the risk of SC in HL patients treated outside of clinical trials over past decades. MATERIAL AND METHODS: Consecutive series of HL patients were analysed with median follow-up 12 years. Standardised incidence ratio (SIR) and absolute excess risk (AER) were calculated for site-specific risk of SC...
July 16, 2018: International Journal of Clinical Practice
Magnolia Cardona, John Kellett, Ebony Lewis, Mikkel Brabrand, Danielle Ní Chróinín
Predicting risk of death based on personalised and objective clinical indicators is an improvement over intuition and clinical judgement. Risk assessment can benefit clinicians by improving prognostic certainty, and truth disclosure helps patients and families by preventing futile management. Some argue that consent should be obtained before a patient is given an estimate of their prognosis as disclosure of bad news can overburden patients. In this article, we argue that it is unethical not to use existing person-specific information to guide diagnosis and shared decision making on management in partnership with well-informed patients...
July 16, 2018: International Journal of Clinical Practice
Chien-Chia Chuang, Erru Yang, Kelly H Zou, Anna Araiza, Alan Wang, Xuemei Luo
AIMS: To assess the prevalence of overactive bladder (OAB) among medically complex vulnerable elderly (MCVE) patients in the United States and to compare health status measures, functional status, healthcare events, use of healthcare services and costs between MCVE patients with and without OAB. METHODS: Using the 2001-2010 Medicare Current Beneficiary Surveys, we defined the MCVE as those respondents who were ≥65 years old with scores ≥3 on the Vulnerable Elders Survey-13...
July 16, 2018: International Journal of Clinical Practice
Walid Bouaziz, Elise Schmitt, Thomas Vogel, François Lefebvre, Pierre-Marie Leprêtre, Georges Kaltenbach, Bernard Geny, Pierre-Olivier Lang
BACKGROUND: Interval aerobic training programme with active recovery bouts (IATP-R) has shown to improve tolerance to IATP among seniors. However, data concerning its benefits for seniors' health are still limited. PURPOSE: The purpose of this study was to examine the effects of IATP-R on seniors' health status. METHODS: Sedentary volunteers (n = 60, aged ≥70 years) were randomly assigned to either IATP-R or maintained sedentary lifestyle for 9...
July 2, 2018: International Journal of Clinical Practice
Alessandro P Delitala, Marta Manzocco, Federico G Sinibaldi, Giuseppe Fanciulli
No abstract text is available yet for this article.
October 2018: International Journal of Clinical Practice
Adrian Heald, Mike Stedman, Sanam Farman, Sue Bailey, Roger Gadsby
No abstract text is available yet for this article.
October 2018: International Journal of Clinical Practice
Ana López-de-Andrés, María D Esteban-Vasallo, Javier de Miguel-Díez, Valentín Hernández-Barrera, José M de Miguel-Yanes, Manuel Méndez-Bailón, Rodrigo Jiménez-García
AIM: To examine incidence and in-hospital outcomes of Clostridium difficile infection (CDI) among patients with type 2 diabetes (T2DM); compare clinical variables among T2DM patients with matched non-T2DM patients hospitalised with CDI and identify factors associated with in-hospital mortality (IHM) among T2DM patients. METHODS: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001-2015. We included patients that had CDI as primary or secondary diagnosis in their discharge report...
October 2018: International Journal of Clinical Practice
Michael Nauck, Atsushi Araki, Uwe Hehnke, Arian Plat, Douglas Clark, Kamlesh Khunti
AIMS: To investigate the risk of hypoglycaemia in people aged ≥65 years with type 2 diabetes mellitus (T2DM) treated with linagliptin, in the largest pooled analysis performed to date. MATERIALS AND METHODS: One thousand four hundred and eighty-nine patients aged ≥65 years with T2DM were pooled from 11 randomised, double-blind, parallel group, placebo-controlled trials evaluating linagliptin 5 mg alone, or in addition to various background therapies. The primary safety endpoint was the incidence of investigator-defined hypoglycaemia...
October 2018: International Journal of Clinical Practice
William Schaffner, Paul van Buynder, Shelly McNeil, Albert D M E Osterhaus
Adults over the age of 60-65 years suffer disproportionally from seasonal influenza, experiencing high rates of complications, exacerbation of underlying medical comorbidities, and excess mortality. Thus, older adults are an important priority for influenza immunisation campaigns. Unfortunately, older adults generally display lower immune responses to standard influenza vaccines because of immunosenescence, with resulting suboptimal vaccine effectiveness. Thus, the development of improved vaccines that heighten immune responses and improve effectiveness is an important medical need...
October 2018: International Journal of Clinical Practice
Leslie Citrome
No abstract text is available yet for this article.
October 2018: International Journal of Clinical Practice
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