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Anita Slomski
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October 25, 2016: JAMA: the Journal of the American Medical Association
Joong-Seok Kim, Si-Hoon Lee, Yoon-Sang Oh, Jeong-Wook Park, Jae-Young An, Hyun-Seok Choi, Kwang-Soo Lee
BACKGROUND: Pulse wave velocity is a marker of arterial stiffness and a surrogate marker of vascular damage. Autonomic abnormalities associated with blood pressure are relatively commonly observed in patients with Parkinson's disease (PD). OBJECTIVE: The purpose of this study was to compare arterial stiffness between patients with PD and controls and investigate the associations between cardiovascular autonomic dysfunction and pulse wave velocity in PD. METHODS: One hundred twenty-five PD patients without diabetes mellitus were enrolled into this study, along with 22 age-matched controls...
October 27, 2016: Neuro-degenerative Diseases
Aakash Garg, Deepti Virmani, Sahil Agrawal, Chirag Agarwal, Abhishek Sharma, Giulio Stefanini, John B Kostis
Heart failure with a preserved ejection fraction (HFpEF) is increasingly prevalent and a leading cause of morbidity and mortality worldwide. HFpEF has a complex pathophysiology, with recent evidence suggesting that an interaction of cardiovascular and noncardiovascular comorbidities (e.g. obesity, hypertension, diabetes, coronary artery disease, and chronic kidney disease) induces an inflammatory state that eventually leads to myocardial structural and functional alterations. Current ACCF/AHA guidelines suggest incorporation of biomarkers along with clinical and imaging tools to establish the diagnosis and disease severity in heart failure (HF)...
October 27, 2016: Cardiology
Lauren B Cooper, Xiaojuan Mi, Robert J Mentz, Jennifer B Green, Kevin J Anstrom, Adrian F Hernandez, Lesley H Curtis
BACKGROUND: Several diabetes mellitus (DM) therapies are associated with worse heart failure (HF) outcomes, yet limited data exist characterizing routine DM management based on HF status. HYPOTHESIS: DM medications prescribed for patients with HF will differ in meaningful ways from patients without HF, and co-morbidities will impact the choice of medications prescribed. METHODS: Using Medicare fee-for-service claims data, we identified patients with newly treated DM between 2008 and 2011 and used multivariable logistic regression to assess associations between baseline HF status and DM medication use...
October 26, 2016: Clinical Cardiology
Hiroshi Kaji
Adipose tissue has recently been reevaluated as an endocrine organ, and adipose-tissue-derived endocrine factors are termed adipokines. Plasminogen activator inhibitor-1 (PAI-1) is the primary inhibitor of PAs, which convert plasminogen into plasmin, a critical protease involved in fibrinolysis. PAI-1 induces fibrinogenesis by suppressing intravascular and tissue fibrinolysis. Moreover, PAI-1 exerts various cellular effects independently of fibrinolysis. Although PAI-1 is expressed in various tissues, its expression is regulated by numerous growth factors, cytokines, and hormones in a paracrine and endocrine manner...
September 15, 2016: Comprehensive Physiology
P Abreu, K F Vitzel, I C C R Monteiro, T I Lima, A N Queiroz, J H Leal-Cardoso, S M Hirabara, V M Ceccatto
The aim of this research was to investigate the effects of endurance training on reduction of plasma glucose during high intensity constant and incremental speed tests in Wistar rats. We hypothesized that plasma glucose might be decreased in the exercised group during heavy (more intense) exercise. Twenty-four 10-week-old male Wistar rats were randomly assigned to sedentary and exercised groups. The prescription of endurance exercise training intensity was determined as 60% of the maximum intensity reached at the incremental speed test...
October 24, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Carla Thais Rosada Peruchi, Regina Célia Poli-Frederico, Alexandrina Aparecida Maciel Cardelli, Marina de Lourdes Calvo Fracasso, Carina Gisele Costa Bispo, Rejane Dias Neves-Souza, Jefferson Rosa Cardoso, Sandra Mara Maciel
The aim of this study was to investigate the association between oral health status and central obesity (CO) in Brazilian independent-living elderly. A cross-sectional study was carried out in a sample of 489 elderly, who were participants of the Study on Aging and Longevity, in Londrina, state of Parana. The number of natural teeth and use of prostheses were evaluated according to the World Health Organization criteria. The presence of CO was assessed using measures of waist circumference (WC) and waist-hip ratio (WHR)...
October 24, 2016: Brazilian Oral Research
Sara de Souza Silva, Juliana Vaz de Melo Mambrini, Maria Aparecida Turci, James Macinko, Maria Fernanda Lima-Costa
This study compared the use of health services and medication, screening test coverage, characteristics of primary care, and health behaviors in 370 diabetics 45 years or older according to sources of care: private health policyholders regardless of place of residence; residents in areas covered by the Family Health Strategy; and individuals covered by a "traditional" Primary Care Unit. The study used data from the 2nd Adult Health Survey in Belo Horizonte Metropolitan Region (2010), Minas Gerais State, Brazil...
October 20, 2016: Cadernos de Saúde Pública
Viviane Peixoto Dos Santos Pennafort, Maria Veraci Oliveira Queiroz, Lucila Castanheira Nascimento, Maria Vilani Cavalcante Guedes
Objective: to understand the influence of network and social support in the care of a child with type 1 diabetes. Method: qualitative study, with assumptions of ethnonursing, conducted in a reference service specialized in the treatment of diabetes, in 2014, in the city of Fortaleza, state of Ceará, Brazil. Twenty-six members of the family and their respective school children participated in the study. The process of collection and analysis followed the observation-participation-reflection model...
September 2016: Revista Brasileira de Enfermagem
Tsai-Ling Liu, A Sidney Barritt Iv, Morris Weinberger, John E Paul, Bruce Fried, Justin G Trogdon
BACKGROUND: Increasingly, patients with multiple chronic conditions are being managed in patient-centered medical homes (PCMH) that coordinate primary and specialty care. However, little is known about the types of providers treating complex patients with diabetes and compensated cirrhosis. OBJECTIVE: We examined the mix of physician specialties who see patients dually-diagnosed with diabetes and compensated cirrhosis. DESIGN: Retrospective cross-sectional study using 2000-2013 MarketScan® Commercial Claims and Encounters and Medicare Supplemental Databases...
2016: PloS One
Satyanarayana Swamy Cheekatla, Deepak Tripathi, Sambasivan Venkatasubramanian, Pavan Kumar Nathella, Padmaja Paidipally, Munenori Ishibashi, Elwyn Welch, Amy R Tvinnereim, Mitsuo Ikebe, Vijaya Lakshmi Valluri, Subash Babu, Hardy Kornfeld, Ramakrishna Vankayalapati
In this study, we developed a mouse model of type 2 diabetes mellitus (T2DM) using streptozotocin and nicotinamide and identified factors that increase susceptibility of T2DM mice to infection by Mycobacterium tuberculosis (Mtb). All Mtb-infected T2DM mice and 40% of uninfected T2DM mice died within 10 months, whereas all control mice survived. In Mtb-infected mice, T2DM increased the bacterial burden and pro- and anti-inflammatory cytokine and chemokine production in the lungs relative to those in uninfected T2DM mice and infected control mice...
October 2016: PLoS Pathogens
Ines Rama, Ines Llaudó, Pere Fontova, Gema Cerezo, Carlos Soto, Casimiro Javierre, Miguel Hueso, Nuria Montero, Alberto Martínez-Castelao, Juan Torras, Josep M Grinyó, Josep M Cruzado, Nuria Lloberas
BACKGROUND: Patients undergoing conventional hemodialysis (C-HD) present a greater immuno-inflammatory state probably related to uremia, sympathetic nervous system (SNS) activation and /or membrane bioincompatibility, which could improve with a technique-switching to online hemodiafiltration (OL-HD). The antigen-independent pathway activation of this modified immunologic state turns dendritic cells (DC) into an accurate cell model to study these patients. The aim of this study is to further evaluate the immune-inflammatory state of patients in C-HD assessed by DC maturation...
2016: PloS One
Patrizia Belfiore, Davide Di Palma, Francesca Gallé, Valeria Di Onofrio, Alessandro Scaletti, Giorgio Liguori
Type II diabetes has a high prevalence rate worldwide, especially in industrialized countries. By requiring increasing health expenditures and resources, the disease and its complications generate a considerable economic burden. Since many years several institutions promote awareness and information programs regarding the most effective strategies to prevent and control diabetes. By reducing the severity of the disease and its complications, Adapted Exercise therapy (AE) represents an ideal instrument to remodulate the Therapeutic Healthcare Management Protocol (THMP) of patients with type II diabetes and may be defined as a new health technology...
July 2016: Igiene e Sanità Pubblica
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used for prevention of stroke secondary to nonvalvular atrial fibrillation (NVAF). Increased use of NOACs is partially a result of simplified regimens compared with warfarin, which has been associated with poor adherence and persistence to therapy. Few studies have assessed adherence to NOACs, especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To evaluate adherence to NOACs in a cohort of newly diagnosed NVAF patients who are commercially insured...
November 2016: Journal of Managed Care & Specialty Pharmacy
Corey A Lester, Kevin A Look, Michelle A Chui
BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) adopted the proportion of days covered (PDC) calculation for use in their Five-Star Quality Rating System for Medicare Advantage and Prescription Drug Plans. This calculation uses the prescription adjudication date (i.e., date the prescription is billed to the benefits manager by a pharmacy) as a proxy for medication adherence. Adherence programs, such as automatic refill programs, have become commonplace in community pharmacy and have been identified by industry leaders as interfering with the ability to accurately measure adherence using PDC...
November 2016: Journal of Managed Care & Specialty Pharmacy
Samuel Stolpe, Michel A Kroes, Neil Webb, Tami Wisniewski
BACKGROUND: Diabetes care is associated with a considerable burden to the health care system in the United States, and measuring the quality of health care is an important development goal of the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. Diabetes is a priority disease within the National Quality Strategy and should therefore remain a focus in the measurement of health care quality. Despite the importance of measuring quality in diabetes care management, no quality measure is currently associated with adherence to insulin treatment, and measuring adherence to insulin is known to be complicated...
November 2016: Journal of Managed Care & Specialty Pharmacy
Alex Peaslee, Marleen Wickizer, Julie Olson, Robert Topp
BACKGROUND: Value-based insurance design (VBID) waives or reduces prescription copayments in order to decrease member cost barriers to refilling medications. Medication therapy management (MTM) is a member clinical intervention designed to reinforce members' knowledge of their medications, which addresses barriers to medication adherence. Both methods have been shown to increase adherence in members, particularly when used in combination. To date, studies of such combined programs have often been completed within integrated health systems but have rarely included control populations...
November 2016: Journal of Managed Care & Specialty Pharmacy
Wendy S Bibeau, Haoda Fu, April D Taylor, Anita Y M Kwan
BACKGROUND: Medication adherence is pivotal for the successful treatment of diabetes. However, medication adherence remains a major concern, as nonadherence is associated with poor health outcomes. Studies have indicated that increasing patients' share of medication costs significantly reduces adherence. Little is known about a potential out-of-pocket (OOP) cost threshold where substantial reduction in adherence may occur. OBJECTIVE: To examine the impact of diabetes OOP pharmacy costs on antihyperglycemic medication adherence and identify the potential threshold at which significant reduction in adherence may occur among patients with type 2 diabetes mellitus (T2DM)...
November 2016: Journal of Managed Care & Specialty Pharmacy
JaeJin An
BACKGROUND: Current evidence suggests that patient-centered medical homes (PCMHs) potentially increase overall quality of disease management, including preventive care. However, there are mixed findings regarding quality of diabetes care, and little evidence exists with respect to the effect of PCMHs on medication adherence in patients with diabetes. OBJECTIVE: To investigate associations between PCMHs and process measures of diabetes care, as well as adherence to oral hypoglycemic agents (OHAs) in patients with diabetes in a nationally representative U...
November 2016: Journal of Managed Care & Specialty Pharmacy
Shivani K Mhatre, Omar Serna, Shubhada Sansgiry, Marc L Fleming, E James Essien, Sujit S Sansgiry
BACKGROUND: Low adherence to oral antidiabetic drugs (OADs) in the Medicare population can greatly reduce Centers for Medicare & Medicaid Services (CMS) star ratings for managed care organizations (MCOs). OBJECTIVE: To develop and validate a risk assessment tool (Prescription Medication Adherence Prediction Tool for Diabetes Medications [RxAPT-D]) to predict nonadherence to OADs using Medicare claims data. METHODS: In this retrospective observational study, claims data for members enrolled in a Medicare Advantage Prescription Drug (MA-PD) program in Houston, Texas, were used...
November 2016: Journal of Managed Care & Specialty Pharmacy
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