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Diabetes in long term care

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https://www.readbyqxmd.com/read/27905692/remote-pre-procedural-ischemic-stroke-was-the-strongest-risk-for-stroke-and-death-associated-with-carotid-stenting-a-single-center-experience
#1
Mária Rašiová, Ľubomír Špak, Ľudmila Farkašová, Štefan Pataky, Martin Koščo, Marek Hudák, Matej Moščovič, Norbert Leško
BACKGROUND: The goal of carotid artery stenting (CAS) is to decrease the stroke risk in patients with carotid stenosis. This procedure carries an immediate risk of stroke and death and many patients do not benefit from it, especially asymptomatic patients. Patient selection for carotid procedure who benefit from procedure and who is the procedure hazardous for is important. Remote ischemic stroke is known risk factor for stroke reccurence during surgery. The aim of our study was to determine the periprocedural complication risk (within 30 days after CAS) associated with carotid stenting (stroke, death) between patients with remote pre- procedural ischemic stroke and without it; to analyse periprocedural risk in other specific patient subgroups treated with CAS and to determine the impact of observed variables on all- cause mortality during long-term follow-up...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27903852/topical-honey-in-the-management-of-pediatric-peritoneal-dialysis-exit-sites
#2
Thomas A Forbes, Loren Shaw, Catherine Quinlan
International guidelines in peritoneal dialysis (PD) advocate for regular application of topical mupirocin in chronic PD exit-site care. A strong evidence base links this treatment to reduced rates of exit-site infections and peritonitis. However, emerging reports of increasing mupirocin resistance and gram-negative infections are threatening the long-term viability of topical antibiotic ointments as a prophylactic treatment. Medical grade honey has multiple proven antibacterial and wound healing properties...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27894781/increased-healthcare-utilization-costs-following-initiation-of-insulin-treatment-in-type-2-diabetes-a-long-term-follow-up-in-clinical-practice
#3
Almina Kalkan, Johan Bodegard, Johan Sundström, Bodil Svennblad, Carl Johan Östgren, Peter Nilsson Nilsson, Gunnar Johansson, Mattias Ekman
AIMS: To compare long-term changes in healthcare utilization and costs for type 2 diabetes patients before and after insulin initiation, as well as healthcare costs after insulin versus non-insulin anti-diabetic (NIAD) initiation. METHODS: Patients newly initiated on insulin (n=2823) were identified in primary health care records from 84 Swedish primary care centers, between 1999 to 2009. First, healthcare costs per patient were evaluated for primary care, hospitalizations and secondary outpatient care, before and up to seven years after insulin initiation...
November 25, 2016: Primary Care Diabetes
https://www.readbyqxmd.com/read/27893144/effectiveness-of-shared-medical-appointments-targeting-the-triple-aim-among-patients-with-overweight-obesity-or-diabetes
#4
Kristi H Trickett, Paul M Matiaco, Kathryn Jones, Bernadette Howlett, Kathaleen Briggs Early
BACKGROUND: Obesity and diabetes are epidemic in the United States, with many treatment options having limited long-term efficacy. A possible effective medical management tool is the shared medical appointment (SMA), which offers an efficient and cost-effective approach to behavior change and aligns with the Triple Aim (reduce costs, improve population health, and improve patient care experience) set forth by the Institute for Healthcare Improvement. OBJECTIVES: To assess the effectiveness of SMAs to achieve the Triple Aim and to improve the management of overweight/obesity or diabetes...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27891605/are-two-heads-better-than-one-or-do-too-many-cooks-spoil-the-broth-the-trade-off-between-physician-division-of-labor-and-patient-continuity-of-care-for-older-adults-with-complex-chronic-conditions
#5
Kenton J Johnston, Jason M Hockenberry
OBJECTIVE: To examine the effects of physician division of labor and patient continuity of care (COC) on the care quality and outcomes of older adults with complex chronic conditions. DATA SOURCES/STUDY SETTING: Seven years (2006-2012) of panel data from the Medicare Current Beneficiary Survey (MCBS). STUDY DESIGN: Regression models were used to estimate the effect of the specialty-type of physicians involved in annual patient evaluation and management, as well as patient COC, on simultaneous care processes and following year outcomes...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27891376/smokeless-tobacco-and-stroke-a-clinico-epidemiological-follow-up-study-in-a-tertiary-care-hospital
#6
Subhransu Sekhar Jena, Shobhitendu Kabi, Baikuntha Nath Panda, B C Kameswari, Payal, Ishwar Chandra Behera, Subrat Kumar Tripathy, Seemanchana Mahanta
INTRODUCTION: Among the modifiable risk factors for stroke, tobacco smoking is well recognized. In some studies the use of Smokeless Tobacco (ST) has also been contributed as a risk factor for ischemic stroke. Use of ST is very common in South-East Asia. The form of ST varies according to the geographical and cultural variation. AIM: To study the various clinical symptoms and radiological findings of stroke due to different types of ST. MATERIALS AND METHODS: This was a prospective hospital based study carried out over a period of 2 years...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27881565/low-dose-aspirin-for-primary-prevention-of-cardiovascular-events-in-patients-with-type-2-diabetes-10-year-follow-up-of-a-randomized-controlled-trial
#7
Yoshihiko Saito, Sadanori Okada, Hisao Ogawa, Hirofumi Soejima, Mio Sakuma, Masafumi Nakayama, Naofumi Doi, Hideaki Jinnouchi, Masako Waki, Izuru Masuda, Takeshi Morimoto
BACKGROUND: -The long-term efficacy and safety of low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes are still inconclusive. METHODS: -The Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial was a randomized, open-label, standard-care controlled trial examining whether low-dose aspirin affected cardiovascular events in 2539 Japanese patients with type 2 diabetes and without pre-existing cardiovascular disease...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27868327/communication-and-patient-participation-influencing-patient-recall-of-treatment-discussions
#8
Claude Richard, Emma Glaser, Marie-Thérèse Lussier
CONTEXT: Patient recall of treatment information is a key variable towards chronic disease (CD) management. It is unclear what communication and patient participation characteristics predict recall. OBJECTIVES: To assess what aspects of doctor-patient communication predict patient recall of medication information. To describe lifestyle treatment recall, in CD primary care patients. DESIGN: Observational study within a RCT. SETTING & PARTICIPANTS: Community-based primary care (PC) practices...
November 21, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/27867883/demographic-details-clinical-features-and-nutritional-characteristics-of-young-adults-with-type-1-diabetes-mellitus-a-south-indian-tertiary-center-experience
#9
Mini Joseph, Asha H Shyamasunder, Riddhi D Gupta, Vijayalakshmi Anand, Nihal Thomas
CONTEXT: Type 1 diabetes mellitus (T1DM) accounts for 5-10% of all diagnosed diabetes and the highest incidence is found in India. AIMS: The main objectives were to study the demographic, clinical, and nutritional characteristics of young adults with T1DM and its effect glycosylated hemoglobin levels. SUBJECTS AND METHODS: This cross-sectional study was conducted among young adults with T1DM (18-45 years of age) in a tertiary hospital in South India...
November 2016: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27857997/a-critical-examination-of-the-use-of-trained-health-coaches-to-decrease-the-metabolic-syndrome-for-participants-of-a-community-based-diabetes-prevention-and-management-program
#10
Brandon Lucke-Wold, Samantha Shawley, John Spencer Ingels, Jonathan Stewart, Ranjita Misra
The epidemic of obesity and diabetes in the United States poses major challenge to the prevention and management of chronic diseases. Furthermore, when this is viewed in other components of the metabolic syndrome (i.e., the burden of high cholesterol and hypertension), the prevalence of the metabolic syndrome continues to rise in the USA continued challenge is how to deal with this epidemic from a medical and public health standpoint. Community Based Participatory Research (CBPR) is a unique approach and offers a novel perspective for answering this challenge...
2016: Journal of Healthcare Communications
https://www.readbyqxmd.com/read/27855101/long-term-cost-effectiveness-of-collaborative-care-vs-usual-care-for-people-with-depression-and-comorbid-diabetes-or-cardiovascular-disease-a-markov-model-informed-by-the-coincide-randomised-controlled-trial
#11
Elizabeth M Camacho, Dionysios Ntais, Peter Coventry, Peter Bower, Karina Lovell, Carolyn Chew-Graham, Clare Baguley, Linda Gask, Chris Dickens, Linda M Davies
OBJECTIVES: To evaluate the long-term cost-effectiveness of collaborative care (vs usual care) for treating depression in patients with diabetes and/or coronary heart disease (CHD). SETTING: 36 primary care general practices in North West England. PARTICIPANTS: 387 participants completed baseline assessment (collaborative care: 191; usual care: 196) and full or partial 4-month follow-up data were captured for 350 (collaborative care: 170; usual care: 180)...
October 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27843332/trends-in-medication-use-in-patients-with-type-2-diabetes-mellitus-a-long-term-view-of-real-world-treatment-between-2000-and-2015
#12
Victoria Higgins, James Piercy, Adam Roughley, Gary Milligan, Andrea Leith, James Siddall, Mike Benford
BACKGROUND: Despite the availability of a variety of treatments, many patients with type 2 diabetes mellitus (T2DM) are not achieving glucose control. We analyzed successive waves of the Adelphi Real World Diabetes Disease Specific Programmes (DSPs) to assess treatment patterns reported by primary care physicians (PCPs) and specialists and the effect of treatment on levels of glucose control. METHODS: Data were collected between 2000 and 2015 in the US and EU5 (France, Germany, Italy, Spain, and the UK)...
2016: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/27842539/a-randomized-wait-list-control-trial-to-evaluate-the-impact-of-a-mobile-application-to-improve-self-management-of-individuals-with-type-2-diabetes-a-study-protocol
#13
Laura Desveaux, Payal Agarwal, Jay Shaw, Jennifer M Hensel, Geetha Mukerji, Nike Onabajo, Husayn Marani, Trevor Jamieson, Onil Bhattacharyya, Danielle Martin, Muhammad Mamdani, Lianne Jeffs, Walter P Wodchis, Noah M Ivers, R Sacha Bhatia
BACKGROUND: Management of diabetes through improved glycemic control and risk factor modification can help prevent long-term complications. Much diabetes management is self-management, in which healthcare providers play a supporting role. Well-designed e-Health solutions targeting behavior change can improve a range of measures, including glycemic control, perceived health, and a reduction in hospitalizations. METHODS: The primary objective of this study is to evaluate if a mobile application designed to improve self-management among patients with type 2 diabetes (T2DM) improves glycemic control compared to usual care...
November 15, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27827300/concordance-in-diabetic-foot-ulceration-a-cross-sectional-study-of-agreement-between-wound-swabbing-and-tissue-sampling-in-infected-ulcers
#14
E Andrea Nelson, Alexandra Wright-Hughes, Sarah Brown, Benjamin A Lipsky, Michael Backhouse, Moninder Bhogal, Mwidimi Ndosi, Catherine Reynolds, Gill Sykes, Christopher Dowson, Michael Edmonds, Peter Vowden, Edward B Jude, Tom Dickie, Jane Nixon
BACKGROUND: There is inadequate evidence to advise clinicians on the relative merits of swabbing versus tissue sampling of infected diabetic foot ulcers (DFUs). OBJECTIVES: To determine (1) concordance between culture results from wound swabs and tissue samples from the same ulcer; (2) whether or not differences in bacterial profiles from swabs and tissue samples are clinically relevant; (3) concordance between results from conventional culture versus polymerase chain reaction (PCR); and (4) prognosis for patients with an infected DFU at 12 months' follow-up...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27824941/establishment-and-validation-of-gv-saps-ii-scoring-system-for-non-diabetic-critically-ill-patients
#15
Wen-Yue Liu, Shi-Gang Lin, Gui-Qi Zhu, Sven Van Poucke, Martin Braddock, Zhongheng Zhang, Zhi Mao, Fei-Xia Shen, Ming-Hua Zheng
BACKGROUND AND AIMS: Recently, glucose variability (GV) has been reported as an independent risk factor for mortality in non-diabetic critically ill patients. However, GV is not incorporated in any severity scoring system for critically ill patients currently. The aim of this study was to establish and validate a modified Simplified Acute Physiology Score II scoring system (SAPS II), integrated with GV parameters and named GV-SAPS II, specifically for non-diabetic critically ill patients to predict short-term and long-term mortality...
2016: PloS One
https://www.readbyqxmd.com/read/27823611/bariatric-surgery-pathophysiology-and-outcomes
#16
REVIEW
Sidra Azim, Sangeeta R Kashyap
Diabetes mellitus and obesity are closely interrelated and pose a major burden on health care in terms of morbidity and mortality. Weight loss has favorable metabolic benefits for glycemic control and improvement of metabolic syndrome. Bariatric surgery (BS) is the most effective treatment for weight loss with durable results as compared to lifestyle modification. BS procedures have been associated with significant reduction in abdominal obesity, metabolic syndrome components, and glycemic control requiring fewer medications...
December 2016: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/27821132/-why-screen-if-we-cannot-follow-up-and-manage-challenges-for-gestational-diabetes-screening-and-management-in-low-and-lower-middle-income-countries-results-of-a-cross-sectional-survey
#17
Bettina Utz, Vincent De Brouwere
BACKGROUND: The prevalence of gestational diabetes (GDM) in low and lower middle income countries (LLMIC) is increasing. Despite its associated short and long term complications for mothers and their newborns, there is a lack of knowledge about how to detect and manage GDM. The objective of our study was to identify the challenges that first line healthcare providers in LLMIC face in screening and management of GDM. METHODS: We conducted a cross-sectional survey of key informants from 40 low and lower-middle income countries in Africa, South-Asia and Latin-America by sending out questionnaires to 182 gynecologists, endocrinologists and medical doctors...
November 8, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27817838/noncontraceptive-use-of-oral-combined-hormonal-contraceptives-in-polycystic-ovary-syndrome-risks-versus-benefits
#18
REVIEW
Anuja Dokras
The use of steroid sex hormones for noncontraceptive benefits has been endorsed by several medical societies. In women with polycystic ovary syndrome (PCOS), hormonal contraceptives are first-line therapy for concurrent treatment of menstrual irregularity, acne, and hirsutism. The association of PCOS with obesity, diabetes, and dyslipidemia frequently brings up the debate regarding risks versus benefits of hormonal contraceptives in this population. In women with PCOS, the lack of large-scale studies evaluating the risks with varying doses of ethinyl estradiol, types of progestins, and presence of confounding factors such as obesity, smoking, and other cardiometabolic comorbidities is a significant limitation in these deliberations...
November 3, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27810642/topical-administration-of-cryopreserved-living-micronized-amnion-accelerates-wound-healing-in-diabetic-mice-by-modulating-local-microenvironment
#19
Yongjun Zheng, Shizhao Ji, Haibin Wu, Song Tian, Yunqing Zhang, Li Wang, He Fang, Pengfei Luo, Xingtong Wang, Xiaoyan Hu, Shichu Xiao, Zhaofan Xia
Approximately 25% of diabetic patients suffer from diabetic lower-extremity ulcer throughout their lives and 7%-20% of patients will eventually need an amputation despite standard care treatment. The development of new therapies to treat diabetic wounds is urgent. In this study, we used cryopreserved living micronized amnion (300-600 μm) to treat wounds in diabetic mice. Post-thaw micronized amnion retained high cell viability, as well as intact cell morphology and membrane structure. When transplanted onto the wounds of db/db mice, the cryopreserved living micronized amnion greatly promoted wound healing in diabetic mice mainly by secreting growth, inflammation, and chemotaxis-related factors that regulated macrophage migration and phenotype switch, recruited CD34(+) progenitor cells, and increased neovascularization...
October 21, 2016: Biomaterials
https://www.readbyqxmd.com/read/27789111/the-relationship-between-diabetes-care-quality-and-diabetes-related-hospitalizations-and-the-modifying-role-of-comorbidity
#20
Yelena Petrosyan, Yu Qing Bai, Anna J Koné Pefoyo, Andrea Gruneir, Kednapa Thavorn, Colleen J Maxwell, Susan E Bronskill, Walter P Wodchis
OBJECTIVES: To evaluate the impact of comorbidity on diabetes care quality and diabetes-related hospitalizations and to examine whether associations between the likelihood of diabetes-related hospitalizations and compliance with diabetes testing are modified by type of comorbidity. METHODS: A population-based cohort study of 861 354 adults with diabetes was conducted in Ontario, Canada. The diabetes cohort was categorized into 4 groups defined by their comorbidity statuses: no comorbidity, diabetes-concordant only, diabetes-discordant only, and both concordant and discordant...
October 24, 2016: Canadian Journal of Diabetes
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