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https://www.readbyqxmd.com/read/29349199/efficiency-or-equity-simulating-the-impact-of-high-risk-and-population-intervention-strategies-for-the-prevention-of-disease
#1
Jonathan M Platt, Katherine M Keyes, Sandro Galea
Maximizing both efficiency and equity are core considerations for population health. These considerations can result in tension in population health science as we seek to improve overall population health while achieving equitable health distributions within populations. Limited work has explored empirically the consequences of different population health intervention strategies on the burden of disease and on within- and between-group differences in disease. To address this gap, we compared the impact of four simulated interventions using data from the National Health and Nutrition Examination Survey...
December 2017: SSM—Population Health
https://www.readbyqxmd.com/read/29345417/catheter-based-edge-to-edge-mitral-valve-repair-for-pulmonary-pressure-reduction-and-to-postpone-heart-transplantation-in-a-teenaged-patient
#2
Moritz Messner, Florian Hintringer, Silvana Müller, Marc Michael Zaruba, Nikolaos Bonaros, Herwig Antretter, Daniel Basic, Gerhard Pölzl
We report a case of catheter-based edge-to-edge mitral valve repair in a teenage male patient with non-ischaemic cardiomyopathy to improve pulmonary hypertension secondary to severe functional mitral regurgitation (FMR) to defer anticipated heart transplantation. A 19-year-old patient with previous history of fulminant myocarditis followed by markedly left ventricular dysfunction presented with severe mitral regurgitation 3 years after initial recovery. Slightly over time, deterioration of FMR was associated with gradual increase in pulmonary artery pressures despite optimal medical therapy...
January 18, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29345403/improving-patient-adherence-to-secondary-prevention-medications-6-months-after-an-acute-coronary-syndrome-observational-cohort-study
#3
D B Brieger, C Chow, J Gullick, K Hyun, M D'Souza, T Briffa
BACKGROUND: Most patients are recommended secondary prevention pharmacotherapies following an acute coronary syndrome (ACS). AIMS: To identify predictors of adherence at 6 months and strategies to improve adherence to these therapies. Design and methods Patients in the CONCORDANCE registry who were discharged on evidence-based medications were stratified into those receiving ≥75% ('adherent') or <75% ('non-adherent') of indicated medications at 6 months. Baseline characteristics, hospital and post-discharge care were compared between groups...
January 18, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29345199/pulmonary-vascular-dysfunction-secondary-to-pulmonary-arterial-hypertension-insights-gained-through-retrograde-perfusion
#4
Chun Zhou, Edward S Crockett, Lynn Batten, Ivan F McMurtry, Troy Stevens
Here, we tested the hypothesis that severe pulmonary arterial hypertension impairs retrograde perfusion. To test this hypothesis, pulmonary arterial hypertension was induced in Fischer rats using a single injection of Sugen 5416 followed by 3 weeks of exposure to 10% hypoxia and then 2 weeks of normoxia. This Sugen 5416 and hypoxia regimen caused severe pulmonary arterial hypertension, with a Fulton Index of 0.73+0.07, reductions in both the pulmonary arterial acceleration time and pulmonary arterial acceleration to pulmonary arterial ejection times ratio, and extensive medial hypertrophy and occlusive neointimal lesions...
January 18, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29344382/advanced-therapies-for-the-management-of-adults-with-pulmonary-arterial-hypertension-due-to-congenital-heart-disease-a-systematic-review
#5
Daniel L Varela, Mohamed Teleb, Wael El-Mallah
Pulmonary arterial hypertension (PAH) secondary to congenital heart disease (CHD) is the third most common cause of PAH, and it is becoming increasingly common as improvements in the management of CHD have led to increased life expectancy for these patients. The medical management of PAH due to CHD (PAH-CHD) is largely the same as what has been used for the treatment of idiopathic PAH, though the body of literature supporting this management decision is very small. There are currently few studies available which specifically focus on the treatment of PAH-CHD...
2018: Open Heart
https://www.readbyqxmd.com/read/29344376/effectiveness-of-pharmacist-s-intervention-in-the-management-of-cardiovascular-diseases
#6
REVIEW
Stefano Omboni, Marina Caserini
The pharmacist may play a relevant role in primary and secondary prevention of cardiovascular diseases, mainly through patient education and counselling, drug safety management, medication review, monitoring and reconciliation, detection and control of specific cardiovascular risk factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes. Systematic reviews of randomised controlled and observational studies have documented an improved control of hypertension, dyslipidaemia or diabetes, smoking cessation and reduced hospitalisation in patients with heart failure, following a pharmacist's intervention...
2018: Open Heart
https://www.readbyqxmd.com/read/29341834/improvement-in-overall-survival-with-carfilzomib-lenalidomide-and-dexamethasone-in-patients-with-relapsed-or-refractory-multiple-myeloma
#7
David S Siegel, Meletios A Dimopoulos, Heinz Ludwig, Thierry Facon, Hartmut Goldschmidt, Andrzej Jakubowiak, Jesus San-Miguel, Mihaela Obreja, Julie Blaedel, A Keith Stewart
Purpose In the ASPIRE study of carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide plus dexamethasone (Rd) in patients with relapsed or refractory multiple myeloma, progression-free survival was significantly improved in the carfilzomib group (hazard ratio, 0.69; two-sided P < .001). This prespecified analysis reports final overall survival (OS) data and updated safety results. Patients and Methods Adults with relapsed multiple myeloma (one to three prior lines of therapy) were eligible and randomly assigned at a one-to-one ratio to receive KRd or Rd in 28-day cycles until withdrawal of consent, disease progression, or occurrence of unacceptable toxicity...
January 17, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29340680/association-of-bariatric-surgery-vs-medical-obesity-treatment-with-long-term-medical-complications-and-obesity-related-comorbidities
#8
Gunn Signe Jakobsen, Milada Cvancarova Småstuen, Rune Sandbu, Njord Nordstrand, Dag Hofsø, Morten Lindberg, Jens Kristoffer Hertel, Jøran Hjelmesæth
Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340676/effect-of-laparoscopic-sleeve-gastrectomy-vs-laparoscopic-roux-en-y-gastric-bypass-on-weight-loss-at-5-years-among-patients-with-morbid-obesity-the-sleevepass-randomized-clinical-trial
#9
Paulina Salminen, Mika Helmiö, Jari Ovaska, Anne Juuti, Marja Leivonen, Pipsa Peromaa-Haavisto, Saija Hurme, Minna Soinio, Pirjo Nuutila, Mikael Victorzon
Importance: Laparoscopic sleeve gastrectomy for treatment of morbid obesity has increased substantially despite the lack of long-term results compared with laparoscopic Roux-en-Y gastric bypass. Objective: To determine whether laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass are equivalent for weight loss at 5 years in patients with morbid obesity. Design, Setting, and Participants: The Sleeve vs Bypass (SLEEVEPASS) multicenter, multisurgeon, open-label, randomized clinical equivalence trial was conducted from March 2008 until June 2010 in Finland...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29339964/cerebral-venous-thrombosis-with-papilloedema-secondary-to-skull-base-plasmacytoma
#10
Peter W MacIntosh, Amy Y Lin, Jin Suh Kim, Fernando D Testai, Heather E Moss
A 60-year-old woman with history of multiple myeloma was in remission after stem cell transplant 6 years prior. She was undergoing work-up for headaches that were thought to be secondary to a right mastoiditis seen on magnetic resonance imaging (MRI). On routine eye exam, papilloedema was noted. A lumbar puncture was performed, with elevated opening pressure with normal constituents. She was an atypical age for idiopathic intracranial hypertension, and her mastoiditis raised concern for secondary cerebral venous sinus thrombosis...
October 2017: Neuro-ophthalmology
https://www.readbyqxmd.com/read/29338320/effect-of-a-group-medical-clinic-for-veterans-with-diabetes-on-body-mass-index
#11
Adva Eisenberg, Matthew J Crowley, Cynthia Coffman, David Edelman
Objective To assess the impact of a group medical clinic designed for patient with type 2 diabetes mellitus and hypertension on body mass index. Methods Using data from a randomized trial of 239 veterans with type 2 diabetes mellitus, we performed a secondary analysis using analysis of covariance mixed models to explore the effect of a 12-month group medical clinic intervention on change in body mass index vs. usual care. In an exploratory subgroup analysis, we compared change in body mass index between treatment arms stratified by whether patients had >0...
January 1, 2018: Chronic Illness
https://www.readbyqxmd.com/read/29336246/the-role-of-colchicine-in-the-prevention-of-cerebrovascular-ischemia
#12
Georgios Tsivgoulis, Aristeidis H Katsanos, Georgios Giannopoulos, Vasiliki Panagopoulou, Dalius Jatuzis, Robin Lemnens, Spyridon Deftereos, Peter J Kelly
INTRODUCTION: Despite the proven efficacy of anti-thrombotic, lipid-lowering, anti-hypertensive therapies and lifestyle modification changes for secondary ischemic stroke prevention, the risk of recurrent stroke, coronary events and vascular death remains substantial even for patients treated with high rates of established secondary preventive medications. METHODS: In the present review, we summarize available literature data on the association between systemic inflammation and symptomatic atherosclerosis including recurrent cerebral ischemia...
January 15, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29335324/prevalence-of-primary-aldosteronism-in-primary-care-a-cross-sectional-study
#13
Sabine C Käyser, Jaap Deinum, Wim Jc de Grauw, Bianca Wm Schalk, Hans Jhj Bor, Jacques Wm Lenders, Tjard R Schermer, Marion Cj Biermans
BACKGROUND: Primary aldosteronism (PA) is the most frequent cause of secondary hypertension. Reported prevalences of PA vary considerably because of a large heterogeneity in study methodology. AIM: To examine the proportion of patients with PA among patients with newly diagnosed, never treated hypertension. DESIGN AND SETTING: A cross-sectional study set in primary care. METHOD: GPs measured aldosterone and renin in adult patients with newly diagnosed, never treated hypertension...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29332925/pulmonary-artery-pseudoaneurysm-secondary-to-lung-inf-lammation
#14
Shinichirou Ishimoto, Hiroyuki Sakurai, Ryouta Higure, Riken Kawachi, Mie Shimamura
Pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAP) are caused by infections, vasculitis, trauma, pulmonary hypertension, congenital heart disease, and connective tissue disease. Most cases of such aneurysm occur in the trunk or major branches of the pulmonary artery, while the peripheral type is less common. The treatment modalities are medical therapy, surgery, and percutaneous catheter embolization. The mortality rate associated with rupture is approximately 50%. We encountered a case of a 53-year-old man with a pulmonary artery pseudoaneurysm secondary to pneumonia and cavity formation during chemotherapy for acute myeloid leukemia (AML)...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29332108/impact-of-body-mass-index-on-high-blood-pressure-among-obese-children-in-the-western-region-of-saudi-arabia
#15
Abdulmoein E Al-Agha, Areej O Mahjoub
To evaluate the impact of body mass index (BMI) on high blood pressure among obese children and adolescents in western region, Saudi Arabia.  Methods: Cross-sectional data were obtained from 306 (female: 140, male: 166) child, between August 2016 and March 2017. A questioner was filled by health professionals at ambulatory pediatric clinic followed by waist-hip circumference, height, weight, and blood pressure measurement. Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were adjusted to gender, height, and age...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29330837/computer-simulated-modeling-of-healthy-and-diseased-right-ventricular-and-pulmonary-circulation
#16
Jody Chou, Joseph B Rinehart
We have previously developed a simulated cardiovascular physiology model for in-silico testing and validation of novel closed-loop controllers. To date, a detailed model of the right heart and pulmonary circulation was not needed, as previous controllers were not intended for use in patients with cardiac or pulmonary pathology. With new development of controllers for vasopressors, and looking forward, for combined vasopressor-fluid controllers, modeling of right-sided and pulmonary pathology is now relevant to further in-silico validation, so we aimed to expand our existing simulation platform to include these elements...
January 12, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29329764/-analysis-of-mortality-and-hospital-stay-in-cardiac-surgery-in-mexico-2015-data-from-the-national-cardiology-institute
#17
Alejandra Rodríguez-Hernández, Martha García-Torres, Eduardo Bucio Reta, Francisco Martín Baranda-Tovar
OBJECTIVE: To analyse hospital mortality in patients subjected to cardiac surgery in Mexico during the year 2015, and identify the mortality risks factors, and its correlation with days of hospital stay in the cardiovascular intensive care unit. METHOD: The database of Cardiovascular Intensive Care of the National Institute of Cardiology was examined for this cases and controls study that included only adult patients subjected to cardiac surgery during the year 2015...
January 9, 2018: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29326775/a-systematic-review-on-the-prevalence-of-acute-myocardial-infarction-in-iran
#18
REVIEW
Jaber Mohseni, Toba Kazemi, Mahmood Hosseinzadeh Maleki, Hossein Beydokhti
In Iran, cardiovascular diseases are the most common causes of death. We aimed to perform a systematic review on the prevalence of acute myocardial infarction (AMI) in Iran based on Persian and English papers had been published from 1985 to 2015. Among 267 initially found articles, 142 were excluded; finally, a total number of 40 articles were found relevant which were reduced to 18. Smoking, hypertension, diabetes mellitus, and hypercholesterolemia were the most common risk factors for AMI. Premature MI prevalence was high in men, and smoking was the most common risk factor among young people...
October 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29325773/how-safe-is-metformin-when-initiated-in-early-pregnancy-a-retrospective-5-year-study-of-pregnant-women-with-gestational-diabetes-mellitus-from-india
#19
Vanlalhruaii, Riddhi Dasgupta, Roshna Ramachandran, Jiji E Mathews, Annie Regi, Niranjan Thomas, Vijay Gupta, P Visalakshi, H S Asha, Thomas Paul, Nihal Thomas
BACKGROUND: The initiation of metformin in early pregnancy in Gestational Diabetes mellitus(GDM) remains controversial. The aim of our study was to assess the influence of Metformin on maternal and fetal outcomes when initiated within the first trimester of pregnancy in GDM. METHODS AND MATERIALS: A retrospective analysis of 540 women with diabetes complicating pregnancy (IADPSG criteria) over five years(January 2011 to May 2016)was done. The study population comprised of patients initiated on a)metformin within the first trimester (Group A:n=186),b) metformin after the first trimester(Group B:n=203) and c)insulin at any time during their pregnancy(Group C:n=151)...
January 8, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29324601/potentially-preventable-stillbirth-in-a-diverse-u-s-cohort
#20
Jessica M Page, Vanessa Thorsten, Uma M Reddy, Donald J Dudley, Carol J Rowland Hogue, George R Saade, Halit Pinar, Corette B Parker, Deborah Conway, Barbara J Stoll, Donald Coustan, Radek Bukowski, Michael W Varner, Robert L Goldenberg, Karen Gibbins, Robert M Silver
OBJECTIVE: To estimate the proportion of potentially preventable stillbirths in the United States. METHODS: We conducted a secondary analysis of 512 stillbirths with complete evaluation enrolled in the Stillbirth Collaborative Research Network from 2006 to 2008. The Stillbirth Collaborative Research Network was a multisite, geographically, racially, and ethnically diverse, population-based case-control study of stillbirth in the United States. Cases of stillbirth underwent standard evaluation that included maternal interview, medical record abstraction, biospecimen collection, postmortem examination, placental pathology, and clinically recommended evaluation...
January 9, 2018: Obstetrics and Gynecology
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