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https://www.readbyqxmd.com/read/29777519/combination-glucose-lowering-therapy-plans-in-t2dm-case-based-considerations
#1
REVIEW
Lawrence Blonde, Susana Dipp, Daniel Cadena
Type 2 diabetes mellitus (T2DM) is a complex disease, and while lifestyle interventions remain the cornerstone of therapy, most patients will also require pharmacotherapy. Current diabetes treatment guidelines and algorithms recommend an individualized approach to setting glycemic goals and selecting treatment. Although a single antihyperglycemic agent may be appropriate as the initial T2DM pharmacotherapy, the progressive nature of the disease due to declining pancreatic β-cell function will result in the vast majority of T2DM patients eventually requiring two or more antihyperglycemic agents...
May 18, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29774749/excess-costs-of-non-infectious-comorbidities-among-people-living-with-hiv-estimates-from-denmark-and-sweden
#2
Frida Hjalte, Paul S Calara, Anders Blaxhult, Marie Helleberg, Karoline Wallace, Peter Lindgren
People living with HIV have an increased risk of comorbidities with non-communicable diseases such as cardiovascular disease, chronic kidney disease and osteoporotic fractures, compared to the general population. The burden of these comorbidities is expected to rise as the HIV-infected population ages. This development may require additional health care resources and it is relevant to ascertain the costs associated with these comorbidities. The population attributed risk approach was applied to estimate excess costs associated with the higher rates of comorbidities among HIV patients in Denmark and Sweden compared to their respective general populations...
May 18, 2018: AIDS Care
https://www.readbyqxmd.com/read/29770960/interventions-for-increasing-fruit-and-vegetable-consumption-in-children-aged-five-years-and-under
#3
REVIEW
Rebecca K Hodder, Kate M O'Brien, Fiona G Stacey, Rebecca J Wyse, Tara Clinton-McHarg, Flora Tzelepis, Erica L James, Kate M Bartlem, Nicole K Nathan, Rachel Sutherland, Emma Robson, Sze Lin Yoong, Luke Wolfenden
BACKGROUND: Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Interventions to increase consumption of fruit and vegetables, such as those focused on specific child-feeding strategies and parent nutrition education interventions in early childhood may therefore be an effective strategy in reducing this disease burden. OBJECTIVES: To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29767465/salt-inflammation-il-17-and-hypertension
#4
REVIEW
Ulrich O Wenzel, Marlies Bode, Christian Kurts, Heimo Ehmke
Traditionally, arterial hypertension and subsequent end-organ damage have been attributed to hemodynamic factors, but increasing evidence indicates that inflammation also contributes to the deleterious consequences of this disease. The immune system has evolved to prevent invasion of foreign microorganisms and to promote tissue healing after injury. However, this beneficial activity comes at a cost of collateral damage when the immune system overreacts to internal injury, such as prehypertension. Over the last years important findings have revolutionized hypertension research...
May 16, 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29766560/further-options-for-treating-lipids-in-people-with-diabetes-targeting-ldl-cholesterol-and-beyond
#5
REVIEW
A S Wierzbicki
Diabetes is associated with increased cardiovascular disease (CVD) risk. Previous studies with statins have established that a 1 mmol/l reduction in LDL-cholesterol reduces CVD events by 21% over 5 years in people with diabetes. More recently, trials in people with acute coronary syndromes showed that ezetimibe reduced CVD events by 6% at 5 years and achieved a LDL-cholesterol of 1.6 mmol/l with better results in people with Type 2 diabetes. Several novel lipid-lowering therapies have recently been developed...
May 15, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29762084/irritable-bowel-symptoms-use-of-healthcare-costs-sickness-and-disability-pension-benefits-a-long-term-population-based-study
#6
Chalotte H Poulsen, Lene F Eplov, Carsten Hjorthøj, Lene H Hastrup, Marie Eliasen, Thomas M Dantoft, Andreas Schröder, Torben Jørgensen
OBJECTIVES: Irritable bowel syndrome (IBS) is associated with increased healthcare use and work absenteeism. We aimed to investigate long-term use of healthcare services and social benefits across IBS symptom groups. Additionally, we estimated excess healthcare costs. METHODS: A longitudinal population-based study comprising two 5-year follow-up studies: The Danish part of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (Dan-MONICA) 1 (1982-1987) and Inter99 (1999-2004) recruited from the western part of Copenhagen County...
May 1, 2018: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/29750174/factors-affecting-the-length-of-stay-in-the-intensive-care-unit-our-clinical-experience
#7
Mehmet Toptas, Nilay Sengul Samanci, İbrahim Akkoc, Esma Yucetas, Egemen Cebeci, Oznur Sen, Mehmet Mustafa Can, Savas Ozturk
Background and Aim: Long hospital days in intensive care unit (ICU) due to life-threatening diseases are increasing in the world. The primary goal in ICU is to decrease length of stay in order to improve the quality of medical care and reduce cost. The aim of our study is to identify and categorize the factors associated with prolonged stays in ICU. Materials and Method: We retrospectively analyzed 3925 patients. We obtained the patients' demographic, clinical, diagnostic, and physiologic variables; mortality; lengths of stay by examining the intensive care unit database records...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29750172/proanthocyanidins-against-oxidative-stress-from-molecular-mechanisms-to-clinical-applications
#8
REVIEW
Lingyu Yang, Dehai Xian, Xia Xiong, Rui Lai, Jing Song, Jianqiao Zhong
Proanthocyanidins (PCs) are naturally occurring polyphenolic compounds abundant in many vegetables, plant skins (rind/bark), seeds, flowers, fruits, and nuts. Numerous in vitro and in vivo studies have demonstrated myriad effects potentially beneficial to human health, such as antioxidation, anti-inflammation, immunomodulation, DNA repair, and antitumor activity. Accumulation of prooxidants such as reactive oxygen species (ROS) exceeding cellular antioxidant capacity results in oxidative stress (OS), which can damage macromolecules (DNA, lipids, and proteins), organelles (membranes and mitochondria), and whole tissues...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29749101/understanding-patient-adherence-and-concerns-with-statins-and-medication-discussions-with-physicians-action-a-survey-on-the-patient-perspective-of-dialogue-with-healthcare-providers-regarding-statin-therapy
#9
Eliot A Brinton
BACKGROUND: Statin therapy is used first-line for cholesterol lowering and prevention of atherosclerotic cardiovascular disease (CVD), but side effects and the potential for drug-drug interactions may complicate its use. Provider-patient communication is essential for shared decision-making, which, in turn, is recommended by guidelines to reduce or overcome these challenges. Unfortunately, relatively little is known about provider-patient communication surrounding statin use. METHOD: We conducted an online survey of 5,014 patients, U...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29748585/humanizing-miniature-hearts-through-4-flow-cannulation-perfusion-decellularization-and-recellularization
#10
Duong T Nguyen, Matthew O'Hara, Cecilia Graneli, Ryan Hicks, Tasso Miliotis, Ann-Christin Nyström, Sara Hansson, Pia Davidsson, Li-Ming Gan, Maria Chiara Magnone, Magnus Althage, Sepideh Heydarkhan-Hagvall
Despite improvements in pre-clinical drug testing models, predictability of clinical outcomes continues to be inadequate and costly due to poor evidence of drug metabolism. Humanized miniature organs integrating decellularized rodent organs with tissue specific cells are translational models that can provide further physiological understanding and evidence. Here, we evaluated 4-Flow cannulated rat hearts as the fundamental humanized organ model for cardiovascular drug validation. Results show clearance of cellular components in all chambers in 4-Flow hearts with efficient perfusion into both coronary arteries and cardiac veins...
May 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29739326/the-impact-of-nontraditional-lipid-profiles-on-left-ventricular-geometric-abnormalities-in-general-chinese-population
#11
Haoyu Wang, Zhao Li, Xiaofan Guo, Yintao Chen, Ye Chang, Shuang Chen, Yingxian Sun
BACKGROUND: Despite current interest in the unfavorable impact of nontraditional lipid profiles on cardiovascular disease, information regarding its relations to abnormal left ventricular (LV) geometry has not been systemically elucidated. This study sought to understand predictive implication of nontraditional lipid profiles in specific LV geometric patterns in the general population of rural China. METHODS: Analyses were based upon a cross-sectional study of 10,756 participants (mean age 53...
May 8, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29738378/promotion-of-home-based-exercise-training-as-secondary-prevention-of-coronary-heart-disease-a-pilot-web-based-intervention
#12
Anna Torri, Claudia Panzarino, Anna Scaglione, Maddalena Modica, Bruno Bordoni, Raffaella Redaelli, Renata De Maria, Maurizio Ferratini
BACKGROUND: Although cardiac rehabilitation (CR) is cost-effective in improving the health of patients with coronary heart disease (CHD), less than half of eligible CHD patients attend a CR program. Innovative web-based technologies might improve CR delivery and utilization. We assessed the feasibility and impact on functional capacity and secondary prevention targets of a long-term web-monitored exercise-based CR maintenance program. METHODS: Low- to moderate-risk CHD patients were recruited at discharge from inpatient CR after a coronary event or revascularization...
April 30, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29738265/estimation-and-prediction-of-avoidable-health-care-costs-of-cardiovascular-diseases-and-type-2-diabetes-through-adequate-dairy-food-consumption-a-systematic-review-and-micro-simulation-modeling-study
#13
Mehdi Javanbakht, Ahmad Reza Jamshidi, Hamid Reza Baradaran, Zahra Mohammadi, Atefeh Mashayekhi, Farhad Shokraneh, Mohsen Rezai Hamami, Raziyeh Yazdani Bakhsh, Hossien Shabaninejad, Sajad Delavari, Arash Tehrani
BACKGROUND: Recent evidence from prospective cohort studies show a relationship between consumption of dairy foods and cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM). This association highlights the importance of dairy foods consumption in prevention of these diseases and also reduction of associated healthcare costs. The aim of this study was to estimate avoidable healthcare costs of CVD and T2D through adequate dairy foods consumption in Iran. METHODS: This was a multistage modelling study...
May 1, 2018: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29737499/vaccines-targeting-pcsk9-a-promising-alternative-to-passive-immunization-with-monoclonal-antibodies-in-the-management-of-hyperlipidaemia
#14
Stefan Weisshaar, Markus Zeitlinger
Hypercholesterolaemia is frequently observed in patients with cardiovascular diseases (CVD) and is associated with increased mortality. Statin treatment has been the standard of care for reducing low-density lipoprotein cholesterol (LDL-C) to improve cardiovascular outcomes. However, statins have limited effects in some patients and may be discontinued due to adverse effects resulting in LDL-C above target levels. The proprotein convertase subtilisin kexin type 9 (PCSK9) is a pivotal regulator in the LDL-C metabolism by degrading the LDL-C receptor on hepatocytes...
May 8, 2018: Drugs
https://www.readbyqxmd.com/read/29735287/palliative-care-in-heart-failure-review
#15
REVIEW
Katie Wiskar, Mustafa Toma, Barret Rush
Palliative care (PC) is now recommended by all major cardiovascular societies for advanced heart failure (HF). PC is a philosophy of care that uses a holistic approach to address physical, psychosocial, and spiritual needs in patients with a terminal disease process. In HF, PC has been shown to improve symptoms and quality of life, facilitate advanced care planning, decrease hospital readmissions, and decrease hospital-associated healthcare costs. Although PC is still underutilized in HF, uptake is increasing...
February 21, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29731659/meta-analysis-of-the-association-of-the-haptoglobin-genotype-with-cardiovascular-outcomes-and-the-pharmacogenomic-interactions-with-vitamin-e-supplementation
#16
Rabea Asleh, Alexandros Briasoulis, Elliot M Berinstein, Joshua B Wiener, Mohan Palla, Sudhir S Kushwaha, Andrew P Levy
Objectives: The objectives of the study were to compile and summarize the data from all of the clinical trials designed to examine the association between haptoglobin (Hp) genotype and incidence of cardiovascular (CV) events in patients with diabetes mellitus (DM) and to assess the impact of vitamin E treatment on CV outcomes according to the Hp genotype. Background: The Hp genotype could serve as a predictive biomarker to DM patients who may benefit from vitamin E therapy...
2018: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/29731350/the-cost-effectiveness-of-pcsk9-inhibitors-the-australian-healthcare-perspective
#17
Radya Kumar, Andrew Tonkin, Danny Liew, Ella Zomer
BACKGROUND: For patients in whom statins are not tolerated or effective as monotherapy, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) represent a new class of lipid lowering therapies that may reduce low-density lipoprotein cholesterol (LDL-C) levels by up to 50% and lower cardiovascular events. While an important treatment option, the cost-effectiveness of PCSK9i in Australia remains unknown. This study aimed to determine the cost-effectiveness of PCSK9i compared to placebo in the prevention of atherosclerotic cardiovascular disease (CVD)...
April 26, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29730785/may-the-force-be-with-you-why-resistance-training-is-essential-for-subjects-with-type-2-diabetes-mellitus-without-complications
#18
REVIEW
Roberto Codella, Marta Ialacqua, Ileana Terruzzi, Livio Luzi
Physical activity, together with diet and pharmacological therapy, represents one of the three cornerstones in type 2 diabetes mellitus treatment and care. The therapeutic appeal of regular physical activity stems from: (i) its non-pharmacological nature; (ii) its beneficial effects on the metabolic risk factors associated with diabetes complications; (iii) its low costs. Evidence accumulated in the last years suggests that aerobic training-endurance training-constitutes a safe modality of intervention, achievable, and effective in diabetes treatment, whenever it is not limited by comorbidities...
May 5, 2018: Endocrine
https://www.readbyqxmd.com/read/29730551/inpatient-care-expenditure-of-the-elderly-with-chronic-diseases-who-use-public-health-insurance-disparity-in-their-last-year-of-life
#19
Worawan Chandoevwit, Phasith Phatchana
The Thai elderly are eligible for the Civil Servant Medical Benefit Scheme (CS) or Universal Coverage Scheme (UCS) depending on their pre-retirement or their children work status. This study aimed to investigate the disparity in inpatient care expenditures in the last year of life among Thai elderly individuals who used the two public health insurance schemes. Using death registration and inpatient administrative data from 2007 to 2011, our subpopulation group included the elderly with four chronic disease groups: diabetes mellitus, hypertension and cardiovascular disease, heart disease, and cancer...
April 28, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29724635/mandatory-criteria-for-cardiac-rehabilitation-programs-2018-guidelines-from-the-portuguese-society-of-cardiology
#20
Ana Abreu, Miguel Mendes, Hélder Dores, Conceição Silveira, Paulo Fontes, Madalena Teixeira, Helena Santa Clara, João Morais
Cardiac rehabilitation (CR) is a multidisciplinary process for patients recovering after an acute cardiac event or with chronic cardiovascular disease that reduces mortality and morbidity and improves quality of life. It is considered a cost-effective intervention and is expressly indicated in the guidelines of the major medical societies. In Portugal, only 8% of patients discharged from hospital after myocardial infarction are included in CR programs. In Europe overall, the percentage admitted to CR programs is 30%, while in the USA it is 20-30%...
April 30, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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