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https://www.readbyqxmd.com/read/29054482/the-effectiveness-of-an-obstructive-sleep-apnea-screening-and-treatment-program-in-patients-with-type-2-diabetes
#1
Lucas M Donovan, Michael Rueschman, Jia Weng, Nisha Basu, Katherine A Dudley, Jessie P Bakker, Rui Wang, Suzanne M Bertisch, Sanjay R Patel
AIMS: As recommended by current guidelines, we tested the acceptability and impact of screening patients with type 2 diabetes for obstructive sleep apnea (OSA). METHODS: In a large urban primary care practice, we instituted a telephone-based OSA screening program using a validated tool (STOP-BANG) in patients with type 2 diabetes. Patients identified as high risk were referred for diagnostic sleep testing, and those diagnosed with OSA were offered positive airway pressure (PAP) therapy...
October 17, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29053215/the-identification-of-barriers-to-insulin-therapy-and-approaches-for-overcoming-them
#2
REVIEW
D Russell-Jones, F Pouwer, K Khunti
Poor glycaemic control in type 2 diabetes (T2D) is a global problem despite the availability of numerous glucose-lowering therapies and clear guidelines for T2D management. Tackling clinical or therapeutic inertia, where the person with diabetes and/or their healthcare providers do not intensify treatment regimens despite this being appropriate, is key to improving patients' long-term outcomes. This gap between best practice and current level of care is most pronounced when considering insulin regimens, with studies showing that insulin initiation/intensification is frequently and inappropriately delayed for several years...
October 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29051041/retinal-vasculature-and-5-year-metabolic-syndrome-among-women-with-gestational-diabetes-mellitus
#3
Ling-Jun Li, Kok Hian Tan, Izzuddin M Aris, Ryan Eyn Kidd Man, Alfred Tau Liang Gan, Yap Seng Chong, Seang Mei Saw, Peter Gluckman, Tien Yin Wong, Ecosse Lamoureux
BACKGROUND: Women with gestational diabetes mellitus (GDM) are at greater risk of metabolic syndrome (MetS). We studied the association between second-trimester retinal microvasculature and 5-year MetS incidence in women with GDM. METHODS: A total of 142 mothers with GDM were recruited and followed up 5 years after delivery. Retinal photography was performed at 26-28 weeks gestation and metabolic outcomes were assessed at the 5-year postpartum follow-up visit. GDM and MetS were defined based on World Health Organization (WHO) guidelines and Adults Treatment Panel (ATP) III guidelines, respectively...
October 16, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29050979/comparison-of-3-risk-estimators-to-guide-initiation-of-statin-therapy-for-primary-prevention-of-cardiovascular-disease
#4
Sandra Ofori, Sotonye Dodiyi-Manuel, Maclean R Akpa
BACKGROUND: Among high-risk individuals, statins are beneficial for primary prevention of cardiovascular disease (CVD). In Nigeria, currently, there are no CVD prevention guidelines, so the use of CVD risk estimation to guide statin therapy is left to the discretion of the physician. OBJECTIVE: The objective of the study was to compare 3 CVD risk estimation tools in the evaluation of patients presenting to a tertiary hospital in Nigeria. METHODS: Cross-sectional study involving 295 patients with any CVD risk factors but not taking statins...
October 3, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29050900/bone-and-mineral-disorders-in-chronic-kidney-disease-implications-for-cardiovascular-health-and-ageing-in-the-general-population
#5
REVIEW
Adrian Covic, Marc Vervloet, Ziad A Massy, Pablo Ureña Torres, David Goldsmith, Vincent Brandenburg, Sandro Mazzaferro, Pieter Evenepoel, Jordi Bover, Mugurel Apetrii, Mario Cozzolino
The patient with chronic kidney disease (CKD) represents an extreme model for arteriosclerosis, vascular calcification, and bone disorders, all of which are also associated with ageing in the general population. These pathological features are also relevant to other common chronic health disorders such as diabetes, and chronic inflammatory and cardiovascular diseases. Although management and interventions for these major risk factors are now incorporated into most public health guidelines (eg, smoking cessation and control of bodyweight and blood pressure, as well as glucose and cholesterol concentrations), some residual cardiovascular risk is not reduced by implementation of these interventions...
October 16, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29050679/glycaemic-control-of-elderly-patients-with-type-2-diabetes-mellitus-in-spain-2015-and-its-relationship-with-functional-capacity-and-comorbidity-the-escadiane-study
#6
F J Sangrós-González, J Martínez-Candela, L Avila-Lachica, J Díez-Espino, J M Millaruelo-Trillo, J García-Soidán, L Carrillo Fernández, P Ezkurra Loiola
OBJECTIVES: To understand the state of glycaemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity. METHODS: Cross-sectional, observational, multicentre national study on patients with diabetes mellitus aged 65 years or older. The study analysed demographic and anthropometric variables, cardiovascular risk factors, clinical and laboratory data, associated comorbidity and treatments. We analysed the functional capacity using the Barthel index and the comorbidity with Charlson index...
October 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29050566/how-low-to-go-with-glucose-cholesterol-%C3%A2-and-blood-pressure-in-primary%C3%A2-prevention-of-cvd
#7
REVIEW
Kimberly N Hong, Valentin Fuster, Robert S Rosenson, Clive Rosendorff, Deepak L Bhatt
Diabetes, hyperlipidemia, and hypertension are modifiable risk factors that predict cardiovascular disease events. The effect of these risk factors on incident cardiovascular disease increases with progressively higher levels of glucose, low-density lipoprotein cholesterol, and blood pressure. The thresholds for initiating treatment of these modifiable risk factors and the optimal goals of risk factor modification are a focus of primary prevention research. Although an aggressive approach is appealing, adverse events may occur, and potential physiological barriers may exist...
October 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29047326/integrating-chws-as-part-of-the-team-leading-diabetes-group-visits-a-randomized-controlled-feasibility-study
#8
Elizabeth M Vaughan, Craig A Johnston, Victor J Cardenas, Jennette P Moreno, John P Foreyt
Purpose The purpose of the study was to evaluate the feasibility of integrating Community Health Workers (CHWs) as part of the team leading diabetes group visits. Methods This was a randomized controlled study that integrated CHWs as part of the team leading diabetes group visits for low-income Hispanic adults (n = 50). Group visits met for 3 hours each month for a 6-month duration. Main measures included baseline and 6-month clinical outcomes (ie, A1C, lipids), concordance with 8 standard of care guidelines (ie, screens for cervical, breast, and colon cancer) from the US Preventive Task Force and American Diabetes Association, and participant acceptability...
October 1, 2017: Diabetes Educator
https://www.readbyqxmd.com/read/29046698/evaluation-of-in-vitro-and-in-vivo-genotoxicity-of-angelica-acutiloba-in-a-standard-battery-of-assays
#9
Jun-Won Yun, Yun-Soon Kim, Euna Kwon, Seung-Hyun Kim, Ji-Ran You, Hyeon Hoe Kim, Jeong-Hwan Che, Byeong-Cheol Kang
Among three representative species of Angelica found in Asian countries, including Korea, China, and Japan, Angelica acutiloba (AA) has been used as traditional herbal medicine with antitumor, anti-inflammatory, anti-obesity, and anti-diabetes activities. In this study, the potential genotoxicity and mutagenicity of the AA extract were examined in a battery of in vitro and in vivo tests (bacterial reverse mutation assay, in vitro chromosomal aberrations assay, and in vivo micronucleus assay) in accordance with the test guidelines for toxicity testing developed by the Organization for Economic Cooperation and Development...
September 2017: Laboratory Animal Research
https://www.readbyqxmd.com/read/29046697/preclinical-safety-assessment-of-angelica-acutiloba-using-a-13-week-repeated-dose-oral-toxicity-study-in-rats
#10
Jun-Won Yun, Euna Kwon, Seung-Hyun Kim, Ji-Ran You, Yun-Soon Kim, In Ae Park, Hyeon Hoe Kim, Jeong-Hwan Che, Byeong-Cheol Kang
Angelica acutiloba (AA), a Japanese species of Danggui, has been used worldwide as a traditional herbal medicine with several bioactivities including anti-diabetic, anti-allergic, anti-inflammatory, anti-tumor, and anti-obesity. However, there is lack of toxicological data available to evaluate potential long-term toxicity and the no-observed-adverse-effect level (NOAEL) of AA extract in accordance with the test guidelines published by the Organization for Economic Cooperation and Development. In the 14-day repeat-dose toxicity study, no adverse effects on mortality, body weight change, clinical signs, and organ weights was found following repeat oral administration to rats for 14 days (125, 250, 500, 1000, and 2000 mg/kg body weight), leading that 2000 mg/kg is the highest recommended dose of AA extract for the 13-week repeat-dose oral toxicity study...
September 2017: Laboratory Animal Research
https://www.readbyqxmd.com/read/29046266/guidelines-and-mhealth-to-improve-quality-of-hypertension-and-type-2-diabetes-care-for-vulnerable-populations-in-lebanon-longitudinal-cohort-study
#11
Shannon Doocy, Kenneth E Paik, Emily Lyles, Hok Hei Tam, Zeina Fahed, Eric Winkler, Kaisa Kontunen, Abdalla Mkanna, Gilbert Burnham
BACKGROUND: Given the protracted nature of the crisis in Syria, the large noncommunicable disease (NCD) caseload of Syrian refugees and host Lebanese, and the high costs of providing NCD care, the implications for Lebanon's health system are vast. OBJECTIVE: The aim of this study was to evaluate the effectiveness of treatment guidelines and a mobile health (mHealth) app on quality of care and health outcomes in primary care settings in Lebanon. METHODS: A longitudinal cohort study was implemented from January 2015 to August 2016 to evaluate the effectiveness of treatment guidelines and an mHealth app on quality of care and health outcomes for Syrian and Lebanese patients in Lebanese primary health care (PHC) facilities...
October 18, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29045299/the-future-of-cesarean-delivery-rates-in-the-united-states
#12
Mark A Clapp, William H Barth
The US cesarean delivery rate remains 30%-32%. Increases in maternal age, obesity, and diabetes put upward pressure on this rate. Alternatives to cesarean delivery, vaginal birth after cesarean (VBAC), and operative vaginal delivery, are underutilized and there are substantial challenges to their resurgence. Practice guidelines offer promise, but demonstrate only minor reductions in cesarean delivery. We estimate that the overall rate in the US will remain 27%-30% for the immediate future. As more states move to recognize the independent practice of midwifery and more payers seek lower cost options for childbirth, we anticipate the overall rate will drop to 20% or 25%, but not for another 15 years or more...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29044298/the-performance-of-crusade-and-acuity-bleeding-risk-scores-in-ticagrelor-treated-acs-patients-who-underwent-pci
#13
Shaozhi Xi, Shanshan Zhou, Xuyun Wang, Jia Liu, Liuan Qin, Jun Liu, Tong Yin, Yundai Chen
The performance of the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) and ACUITY (Acute Catheterization and Urgent Intervention Triage strategy) risk scores for the prediction of major bleeding in ticagrelor-treated acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI) is unknown. The aim of the present study is to validate the performance of both scores in a contemporary Chinese cohort of ACS patients hospitalized for PCI and administrated with ticagrelor...
October 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29042060/australian-general-practitioners-initiate-statin-therapy-primarily-on-the-basis-of-lipid-levels-new-zealand-general-practitioners-use-absolute-risk
#14
REVIEW
Chris Schilling, Josh Knight, Duncan Mortimer, Dennis Petrie, Philip Clarke, John Chalmers, Andrew Kerr, Rod Jackson
OBJECTIVES: To compare the determinants of initial statin prescribing between New Zealand and Australia. New Zealand has a system-wide absolute risk-based approach to primary care cardiovascular disease (CVD) management, while Australia has multiple guidelines. METHOD: Classification and Regression Tree (CART) analysis of two observational studies of primary care CVD management from New Zealand (PREDICT-CVD) and Australia (AusHeart). Over 80% of eligible New Zealanders have been screened for CVD risk...
October 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29040530/the-prevalence-of-type-2-diabetes-is-not-increased-in-normal-weight-women-with-pcos
#15
Rasa Pelanis, Jan Roar Mellembakken, Inger Sundström-Poromaa, Pernille Ravn, Laure Morin-Papunen, Juha S Tapanainen, Terhi Piltonen, Johanna Puurunen, Angelica Lindén Hirschberg, Peter Fedorcsak, Marianne Andersen, Dorte Glintborg
STUDY QUESTION: Is oral glucose tolerance test (OGTT) needed in all women with polycystic ovary syndrome (PCOS)? SUMMARY QNSWER: OGTT is not routinely needed in women with PCOS and BMI < 25 kg/m2. WHAT IS KNOWN ALREADY: PCOS is associated with insulin resistance and increased prevalence of prediabetes and Type 2 diabetes (T2D) which is closely linked to obesity and possibly age, ethnicity and PCOS phenotype. Several guidelines recommend OGTT upon diagnosis of PCOS and during follow-up...
September 29, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29037877/unbreakable-an-analysis-of-the-fragility-of-randomized-trials-that-support-diabetes-treatment-guidelines
#16
B Chase Kruse, B Matt Vassar
AIMS: To analyze the robustness of randomized controlled trials (RCTs) referenced in the American Diabetes Association's Standards of Medical Care in Diabetes-2017 using the Fragility Index (FI) and Fragility Quotient (FQ). METHODS: We performed a systematic survey of all RCTs referenced in the Standards of Medical Care in Diabetes-2017. One investigator screened for trials and then recorded data from them, including sample size per group, event rate per group, and the dichotomous outcome analyzed by trialists...
October 13, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29036278/perceptions-of-risk-and-therapy-among-patients-with-barrett-s-esophagus-a-patient-survey-study
#17
M W Stier, N Lodhia, J Jacobs, D Nozicka, R Kavitt, U Siddiqui, I Waxman, V J Konda
Nondysplastic Barrett's esophagus has a risk of progression to esophageal adenocarcinoma as low as 0.18-0.3% per person per year, and low-grade dysplasia as low as 0.5%. While adherence to guidelines and selection of management options varies, little is known about what modifies patient decision-making. This study aims to evaluate and identify factors that influence patient perceptions of risk and decisions about management. An independently developed and piloted survey was administered to patients at an academic hospital...
September 21, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29033611/stable-ischemic-heart-disease-in-women-current-perspectives
#18
REVIEW
Fatima Samad, Anushree Agarwal, Zainab Samad
Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m(2)), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29032706/quality-and-predictors-of-diabetes-care-among-patients-with-schizophrenia-a-danish-nationwide-study
#19
Mette Jørgensen, Jan Mainz, Fabrizio Carinci, Reimar W Thomsen, Søren Paaske Johnsen
OBJECTIVE: Patients with schizophrenia have a high prevalence of diabetes, but data on diabetes care quality for these patients are limited. This nationwide study compared the quality of diabetes care among individuals with and without schizophrenia and identified predictors of care quality. METHODS: In a population-based cohort study, 83,813 individuals with diabetes seen at hospital outpatient clinics between 2005 and 2013, including 669 with comorbid schizophrenia, were identified from Danish registries...
October 16, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29032696/impact-of-improving-postprandial-glycemic-control-with-intensifying-insulin-therapy-in-type-2-diabetes
#20
Tamer Yacoub
Worldwide, many people with type 2 diabetes are not at recommended glycemic targets and remain at increased risk of microvascular and macrovascular complications. Reaching recommended glycemic targets requires normalizing both fasting and postprandial glucose (PPG). For some patients, this will require addition of a prandial insulin delivered by injection to control PPG excursions. Evidence from epidemiological studies suggests an association between postprandial hyperglycemia and cardiovascular disease, and thus, expert guidelines recommend that treatment for elevated PPG not be delayed...
October 14, 2017: Postgraduate Medicine
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