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https://www.readbyqxmd.com/read/28449186/the-risk-of-lower-gastrointestinal-bleeding-in-low-dose-aspirin-users
#1
W-C Chen, K-H Lin, Y-T Huang, T-J Tsai, W-C Sun, S-K Chuah, D-C Wu, P-I Hsu
BACKGROUND: Aspirin increases the risk of gastrointestinal bleeding. AIM: To investigate the risk of lower gastrointestinal bleeding (LGIB) in aspirin users. METHODS: Low-dose (75-325 mg daily) aspirin users and controls matched by age, gender and enrollment time in a 1:5 ratio were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. Cox proportional hazard regression models were developed to evaluate the predictors of LGIB with adjustments for age, gender, comorbidities including coronary artery disease, ischaemic stroke, diabetes, hypertension, chronic kidney disease, liver cirrhosis, chronic obstructive pulmonary disease, dyslipidemia, uncomplicated peptic ulcer disease, history of peptic ulcer bleeding, and concomitant use of clopidogrel, ticlopidine, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 inhibitors, steroids, proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), nitrates, alendronate, selective serotonin reuptake inhibitors (SSRIs) and calcium channel blockers...
April 27, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28446537/post-hoc-analyses-of-randomized-clinical-trial-for-the-effect-of-clopidogrel-added-to-aspirin-on-kidney-function
#2
Jesse C Ikeme, Pablo E Pergola, Rebecca Scherzer, Michael G Shlipak, Oscar R Benavente, Carmen A Peralta
BACKGROUND AND OBJECTIVES: Despite the high burden of CKD, few specific therapies are available that can halt disease progression. In animal models, clopidogrel has emerged as a potential therapy to preserve kidney function. The effect of clopidogrel on kidney function in humans has not been established. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Secondary Prevention of Small Subcortical Strokes Study randomized participants with prior lacunar stroke to treatment with aspirin or aspirin plus clopidogrel...
April 26, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28435446/cardiovascular-risk-assessment-in-patients-with-diabetes
#3
REVIEW
Marcello Casaccia Bertoluci, Viviane Zorzanelli Rocha
Although patients with diabetes have 2 to 4 times increased risk of cardiovascular morbidity and mortality than individuals without diabetes, recent studies indicate that a significant part of patients are in a lower cardiovascular risk category. Men younger than 35 years, women younger than 45 years, patients with diabetes duration of less than 10 years without other risk factors have a much lower risk than patients who have traditional cardiovascular risk factors, and subclinical or established coronary artery disease (CAD)...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28421343/antiplatelets-and-anticoagulants-in-vitreoretinal-surgery-with-a-special-emphasis-on-novel-anticoagulants-a-national-survey-and-review
#4
REVIEW
Rupa Patel, Stephen Charles, Assad Jalil
PURPOSE: To survey current practice and opinion regarding the cessation of antiplatelet and anticoagulant agents prior to vitreoretinal surgery, with special emphasis on novel anticoagulants, and to provide an overview of current literature. METHODS: An online survey was sent to 167 members of the British and Eire Association of Vitreoretinal Surgeons (BEAVRS). A literature search and analysis was conducted on studies that reviewed the bleeding risk of antiplatelet and anticoagulant agents...
April 18, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28399868/4-5-4-trihydroxychalcone-8-8-ethene-1-2-diyl-dinaphtalene-1-4-5-triol-and-rutin-from-gynura-segetum-inhibit-phagocytosis-lymphocyte-proliferation-cytokine-release-and-nitric-oxide-production-from-phagocytic-cells
#5
Yuandani, Ibrahim Jantan, Khairana Husain
BACKGROUND: Gynura segetum is used traditionally to treat various ailments related to the immune system, which include cancer, inflammation, rheumatism, diabetes, hypertension, and viral infections but little studies have been carried out to validate their ethnopharmacological aspects. In this study the immunosuppressive effects of G. segetum and its constituents were investigated. METHODS: Isolation of compounds from G. segetum leaves was conducted using vacuum liquid chromatography (VLC) and column chromatography (CC)...
April 11, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28395781/pharmacological-secondary-prevention-in-patients-with-mesenterial-artery-atherosclerosis-and-arterial-embolism
#6
REVIEW
Anders Gottsäter
Visceral arteries such as the coeliac (CA), superior mesenteric (SMA), and the inferior mesenteric artery (IMA) might be affected by atherosclerotic occlusive lesions with or without thrombosis or embolization causing ischaemic symptoms from the gastrointestinal tract. After treatment of an acute event, these patients should be offered both non-pharmacological and pharmacological secondary prevention to reduce risk for future ischaemic arterial manifestations. Patients with mesenteric ischaemia caused by atherosclerosis should be evaluated concerning platelet antiaggregation with low dose aspirin or clopidogrel, and those with cardioembolic disease should be recommended anticoagulant treatment with either warfarin or one of the direct oral anticoagulants (DOAC; apixaban, dabigatran, edoxaban, or rivaroxaban)...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28393040/vitreous-haemorrhage-a-population-based-study-of-the-incidence-and-risk-factors-in-taiwan
#7
Ching-Yu Wang, Wai-Man Cheang, De-Kuang Hwang, Ching-Heng Lin
AIM: To report the epidemiology and incidence of vitreous hemorrhage and to evaluate risk factors for patients with vitreous hemorrhage (VH) in Taiwan. METHODS: A retrospective population-based study. Analyzing a sample of one million subjects from all enrollees of the Taiwan Health Insurance programme. All data were obtained from the Taiwan Health Insurance Research Database, which contained patient sex, date of birth, all records of clinical visits and hospitalizations, and diagnosis codes as included in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28389293/smoking-cessation-counseling-improves-quality-of-care-and-surgical-outcomes-with-financial-gain-for-a-vascular-practice
#8
D A Moses, J H Mehaffey, D V Strider, M C Tracci, J A Kern, G R Upchurch
BACKGROUND: Cigarette smoking is strongly associated with atherosclerotic disease. It is incumbent upon vascular surgeons to provide smoking cessation counseling to their patients. The objective of this study was to determine the association of smoking cessation counseling (SCC) and improvement in quality of care. METHODS: As a quality project using retrospective data, the study received IRB exemption status. A retrospective review of prospectively maintained database from April 2014 through March 2015 of outpatient encounters in a vascular surgery clinic was performed of current smokers...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28370742/evaluation-of-drug-related-problems-in-older-polypharmacy-primary-care-patients
#9
Sandra Vezmar Kovačević, Branislava Miljković, Milica Ćulafić, Milena Kovačević, Bojana Golubović, Marija Jovanović, Katarina Vučićević, Johan J de Gier
AIMS AND OBJECTIVES: Targeting older patients with predictive factors for drug-related problems (DRPs) could make clinical medication reviews more cost-effective. The aim of this study was to identify the number, type, and potential predictive factors for DRPs in older polypharmacy patients. METHODS: Community pharmacists performed clinical medication reviews and documented DRPs, types of interventions, and their implementation in older patients. RESULTS: Three hundred eighty-eight medication reviews were analyzed, 964 DRPs (average 2...
March 29, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28332005/levetiracetam-synergizes-with-gabapentin-pregabalin-duloxetine-and-selected-antioxidants-in-a-mouse-diabetic-painful-neuropathy-model
#10
Radica Stepanović-Petrović, Ana Micov, Maja Tomić, Uroš Pecikoza
RATIONALE: We have reported that levetiracetam, a novel anticonvulsant with analgesic properties, synergizes with ibuprofen/aspirin/paracetamol in a model of diabetic painful neuropathy (DPN). Most guidelines recommend gabapentin, pregabalin, and duloxetine as first- or second-line agents for DPN. OBJECTIVE: We examined the effects of combination treatment of first-/second-line analgesics with levetiracetam in a model of DPN. Additionally, the levetiracetam's combinations with antioxidants, low dose of aspirin, coenzyme Q10, or α-lipoic acid were evaluated...
March 22, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28329340/baseline-characteristics-of-participants-in-the-aspree-aspirin-in-reducing-events-in-the-elderly-study
#11
John J McNeil, Robyn L Woods, Mark R Nelson, Anne M Murray, Christopher M Reid, Brenda Kirpach, Elsdon Storey, Raj C Shah, Rory S Wolfe, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Jessica E Lockery, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Ruth E Trevaks, Suzanne G Orchard, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Richard H Grimm
Background: There are no primary prevention trials of aspirin with relevant geriatric outcomes in elderly people. ASPirin in Reducing Events in the Elderly (ASPREE) is a placebo-controlled trial of low-dose aspirin that will determine whether 5 years of daily 100-mg enteric-coated aspirin extends disability-free and dementia-free life in a healthy elderly population and whether these benefits outweigh the risks. Methods: Set in primary care, this randomized double-blind placebo-controlled trial has a composite primary endpoint of death, incident dementia or persistent physical disability...
January 20, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28325797/management-of-atherosclerotic-cardiovascular-disease-risk-factors-in-the-older-adult-patient-with-diabetes
#12
Mary T Korytkowski, Daniel E Forman
: Older adults with diabetes are at higher risk for atherosclerotic cardiovascular disease (ASCVD) than younger adults with diabetes and older adults without diabetes. The rationale to implement ASCVD risk-lowering therapies in older adults with diabetes is compelling. Recommendations for lifestyle modification, lipid-lowering therapy, blood pressure management, blood glucose control, and aspirin therapy are often based on studies that show their efficacy in younger populations. However, the risks associated with each of these interventions increase with age, and favorable risk-to-benefit ratios demonstrated in younger adults with diabetes are less certain in older populations...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28319804/are-diabetes-guidelines-truly-evidence-based
#13
REVIEW
Matthew F Bouchonville, Sara Matani, Jason J DuBroff, Robert J DuBroff
The global epidemic of obesity and diabetes underscores the urgency to develop strategies to prevent cardiovascular (CV) disease in this vulnerable population. Clinical guidelines are intended to help the clinician manage these patients, but guidelines are often discordant among professional organizations and not always evidence based. Clinicians must rely upon the best available evidence, and therefore we critically reviewed the evidence behind the American Diabetes Association (ADA) 2016 guidelines on the prevention of CV disease in diabetes...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28300627/serum-uric-acid-is-associated-with-better-executive-function-in-men-but-not-in-women-baseline-assessment-of-the-elsa-brasil-study
#14
Cristina Pellegrino Baena, Claudia Kimie Suemoto, Sandhi Maria Barreto, Paulo Andrade Lotufo, Isabela Benseñor
BACKGROUND: Serum uric acid (SUA) may protect against free radical stress damage and was previously linked to cognitive impairment in older adults, but evidence in middle-aged adults is scarce. PURPOSE: We sought to analyze whether SUA is associated with cognitive performance in apparently healthy middle-aged participants in the ELSA-Brasil cohort study. METHODS: We excluded participants older than age 65, those taking allopurinol, benzbromarone, or medications that could impair cognitive performance, those with previous stroke, and those with incomplete data on cognitive tests or SUA...
June 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28274053/dentists-knowledge-attitude-and-practice-in-treating-patients-taking-oral-antithrombotic-medications-a-survey
#15
Ravindran Chinnaswami, Ritvi K Bagadia, Anusha Mohan, Eswar Kandaswamy, Deepak Chandrasekaran
INTRODUCTION: India lists high on patients suffering from diabetes, hypertension, stroke and myocardial infarction. Hence, a large proportion of the population is on long term Oral Antithrombotic Medications (OAM). Though several guidelines exist on dental management of these patients, previous surveys have shown variation among the dentists. AIM: The purpose of this study was to assess the knowledge, attitude and practice of dentists in Chennai, India, towards dental management of patients taking OAM using a questionnaire survey...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28255102/randomized-angiographic-and-intravascular-ultrasound-comparison-of-dual-antiplatelet-therapy-vs-triple-antiplatelet-therapy-to-reduce-neointimal-tissue-proliferation-in-diabetic-patients
#16
Maria Fernanda Zuliani Mauro, J Armando Mangione, J Ribamar Costa, Ricardo Costa, Luiz Alberto Piva E Mattos, Rodolfo Staico, Fausto Feres, Dimytri Siqueira, Amanda Sousa, Alexandre Abizaid
BACKGROUND: Previous studies have suggested a benefit of cilostazol in addition to standard dual-antiplatelet therapy (DAPT), reducing in-stent late luminal loss and restenosis after percutaneous coronary intervention (PCI) with bare-metal and drug-eluting stent (DES) implantation. However, there is a paucity of intravascular ultrasound (IVUS) assessment of neointimal tissue hyperplasia (NIH) after triple-antiplatelet therapy (TAPT), especially in diabetic patients treated with DES. METHODS: This prospective, placebo-controlled trial was conducted in diabetic patients randomized (1:1) to receive either standard DAPT (aspirin and clopidogrel) vs TAPT with cilostazol for a minimum of 12 months after PCI with Endeavor zotarolimus-eluting stent (E-ZES)...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28238190/effects-of-6%C3%A2-months-of-resveratrol-versus-placebo-on-pentraxin-3-in-patients-with-type-2-diabetes-mellitus-a-double-blind-randomized-controlled-trial
#17
S Bo, V Ponzo, A Evangelista, G Ciccone, I Goitre, F Saba, M Procopio, M Cassader, R Gambino
AIMS: The anti-inflammatory effects of the polyphenol resveratrol in patients with type 2 diabetes mellitus (T2DM) are controversial. Its role on pentraxin 3 (PTX3) concentrations, a human acute phase protein, has never been evaluated. Our aim was to determine whether a two-dosage resveratrol supplementation (500 and 40 mg/day) has an impact on PTX3 values in T2DM patients from a double-blind randomized placebo-controlled trial. Variations in total antioxidant status (TAS) were evaluated too...
May 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28188508/potentially-inappropriate-prescribing-and-associated-factors-in-elderly-patients-at-hospital-discharge-in-brazil-a-cross-sectional-study
#18
Ana Luiza Pereira Moreira Mori, Renata Cunha Carvalho, Patricia Melo Aguiar, Maria Goretti Farias de Lima, Magali da Silva Pacheco Nobre Rossi, José Fernando Salvador Carrillo, Egídio Lima Dórea, Sílvia Storpirtis
Background The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria is used to identify instances of potentially inappropriate prescribing in a patient's medication regimen. Objective To determine the prevalence and predictors of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients at hospital discharge. Setting A university hospital medical clinic in Brazil. Method Discharge prescriptions were examined using the STOPP/START criteria...
February 10, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28154100/stroke-caused-by-atherosclerosis-of-the-major-intracranial-arteries
#19
Chirantan Banerjee, Marc I Chimowitz
Our goal in this review is to discuss the pathophysiology, diagnosis, and treatment of stroke caused by atherosclerosis of the major intracranial arteries. References for the review were identified by searching PubMed for related studies published from 1955 to June 2016 using search terms intracranial stenosis and intracranial atherosclerosis. Reference sections of published randomized clinical trials and previously published reviews were searched for additional references. Intracranial atherosclerotic disease is a highly prevalent cause of stroke that is associated with a high risk of recurrent stroke...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28138903/the-treatment-of-giant-cell-arteritis
#20
REVIEW
Imran Jivraj, Madhura Tamhankar
Giant cell arteritis (GCA) is a systemic inflammatory vasculitis affecting medium and large vessels with potentially sight and life-threatening complications. Early diagnosis and prompt treatment are imperative in order to prevent vision loss and progression of the disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers which are elevated in the majority of patients and support the diagnosis of GCA among patients who present with typical symptoms. GCA is confirmed with superficial temporal artery biopsy which demonstrates characteristic pathological findings...
January 2017: Current Treatment Options in Neurology
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