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https://www.readbyqxmd.com/read/28808933/cardiovascular-disease-in-clozapine-treated-patients-evidence-mechanisms-and-management
#1
REVIEW
Kathlyn J Ronaldson
Myocarditis occurs in about 3% of those initiated on clozapine but monitoring reduces the risk of serious outcome. Cardiomyopathy may develop after myocarditis, or from prolonged tachycardia. Monitoring using echocardiography is not deemed cost effective. Tachycardia, orthostatic hypotension and reduced heart rate variability are a group of clozapine-related adverse effects associated with autonomic dysfunction and may have serious consequences in the long term. Elevated heart rate and poor heart rate variability can be treated with a β-blocker or a non-dihydropyridine calcium channel blocker, while orthostatic hypotension can be alleviated by increased fluid intake and abdominal binding, but may require pharmacological intervention...
August 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28808091/inter-rater-reliability-and-downstream-financial-implications-of-electrocardiography-screening-in-young-athletes
#2
Harshil Dhutia, Aneil Malhotra, Tee Joo Yeo, Irina Chis Ster, Vincent Gabus, Alexandros Steriotis, Helder Dores, Greg Mellor, Carmen García-Corrales, Bode Ensam, Viknesh Jayalapan, Vivienne Anne Ezzat, Gherardo Finocchiaro, Sabiha Gati, Michael Papadakis, Maria Tome-Esteban, Sanjay Sharma
BACKGROUND: Preparticipation screening for cardiovascular disease in young athletes with electrocardiography is endorsed by the European Society of Cardiology and several major sporting organizations. One of the concerns of the ECG as a screening test in young athletes relates to the potential for variation in interpretation. We investigated the degree of variation in ECG interpretation in athletes and its financial impact among cardiologists of differing experience. METHODS AND RESULTS: Eight cardiologists (4 with experience in screening athletes) each reported 400 ECGs of consecutively screened young athletes according to the 2010 European Society of Cardiology recommendations, Seattle criteria, and refined criteria...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28807713/opioid-drug-use-and-acute-cardiac-events-among-pregnant-women-in-the-united-states
#3
Hamisu M Salihu, Jason L Salemi, Anjali Aggarwal, Beverly F Steele, Ross C Pepper, Mulubrhan F Mogos, Muktar H Aliyu
BACKGROUND: Cardiovascular disease remains a leading cause of pregnancy-associated deaths in the United States (US). The extent to which increasing opioid use among pregnant women contributes to fatal cardiovascular events is unknown. We examine trends in opioid use among pregnant women over the previous decade, and the association between changes in temporal trends in opioid drug use and the incidence of acute cardiac events among mothers. METHODS: In this retrospective analysis of the Healthcare and Cost Utilization Project (HCUP), we utilized a two-stage stratified cluster sampling of all inpatient hospital discharges from non-federal hospitals between 01/01/2002 through 12/31/2014...
August 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28806190/the-challenges-of-proprotein-convertase-subtilisin-kexin-9-inhibitors-for-lipid-guidelines-and-models-of-care
#4
Anthony S Wierzbicki
PURPOSE OF REVIEW: The article reviews the challenges facing cardiovascular disease (CVD) guidelines committees. RECENT FINDINGS: Clinical trials in high-risk populations have shown additional CVD event reduction with ezetimibe and proprotein convertase subtilisin-kexin-9 inhibitors. These trials recruit middle-aged secondary prevention populations, whereas increasingly the population at risk of CVD comprises the elderly in primary prevention. Some major guidelines have moved from a lipid-target to a risk-based approach...
August 12, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28803684/role-of-two-dimensional-speckle-tracking-echocardiography-strain-in-the-assessment-of%C3%A2-right-ventricular-systolic-function-and-comparison-with-conventional-parameters
#5
REVIEW
Luca Longobardo, Valentin Suma, Renuka Jain, Scipione Carerj, Concetta Zito, Dianne L Zwicke, Bijoy K Khandheria
Despite the already well-known role the right side of the heart plays in many diseases, right ventricular (RV) function has only recently been carefully considered. Echocardiography is the first-line diagnostic technique for the assessment of the right ventricle and right atrium, whereas cardiac magnetic resonance is considered the gold standard but is limited by cost and availability. According to the current guidelines, systolic RV function should be assessed by several conventional measurements, but the efficacy of these parameters as diagnostic and prognostic tools has been questioned by many authors...
August 10, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28801393/protocol-for-the-mwellcare-trial-a-multicentre-cluster-randomised-12-month-controlled-trial-to-compare-the-effectiveness-of-mwellcare-an-mhealth-system-for-an-integrated-management-of-patients-with-hypertension-and-diabetes-versus-enhanced-usual-care-in-india
#6
Dilip Jha, Priti Gupta, Vamadevan S Ajay, Devraj Jindal, Pablo Perel, David Prieto-Merino, Pramod Jacob, Jonathan Nyong, Vidya Venugopal, Kavita Singh, Shifalika Goenka, Ambuj Roy, Nikhil Tandon, Vikram Patel, Dorairaj Prabhakaran
INTRODUCTION: Rising burden of cardiovascular disease (CVD) and diabetes is a major challenge to the health system in India. Innovative approaches such as mobile phone technology (mHealth) for electronic decision support in delivering evidence-based and integrated care for hypertension, diabetes and comorbid depression have potential to transform the primary healthcare system. METHODS AND ANALYSIS: mWellcare trial is a multicentre, cluster randomised controlled trial evaluating the clinical and cost-effectiveness of a mHealth system and nurse managed care for people with hypertension and diabetes in rural India...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28799460/economic-and-social-impact-of-increased-cardiac-rehabilitation-uptake-and-cardiac-telerehabilitation-in-belgium-a-cost-benefit-analysis
#7
Ines Frederix, Dominique Vandijck, Niel Hens, Johan De Sutter, Paul Dendale
BACKGROUND: Cardiac rehabilitation for ischaemic heart disease effectively reduces cardiovascular readmission rate and mortality. Current uptake rates however, remain low. This study assesses the social and economic impact of increasing centre-based cardiac rehabilitation uptake and the additional value of cardiac telerehabilitation using cost-benefit analysis (CBA) in Belgium. METHODS: Cost-benefit analysis was conducted to analyse three scenarios: (1) current situation: 20% uptake rate of cardiac rehabilitation; (2) alternative scenario one: 40% uptake rate of cardiac rehabilitation; and (3) alternative scenario two: 20% uptake of cardiac rehabilitation and 20% uptake of both cardiac rehabilitation and telerehabilitation...
August 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28799038/association-of-lead-exposure-with-cardiovascular-risk-factors-and-diseases-in-chinese-adults
#8
Chi Chen, Qin Li, Xiaomin Nie, Bing Han, Yi Chen, Fangzhen Xia, Hualing Zhai, Ningjian Wang, Yingli Lu
We aimed to determine whether lead exposure was associated with cardiovascular diseases (CVD) and risk factors in Chinese adults. Five thousand three hundred and forty-eight subjects were enrolled from 16 sites in China. Blood lead level (BLL) was measured by atomic absorption spectrometry. Cardiovascular diseases included coronary heart disease, stroke, and myocardial infarction. Cardiovascular risk factors included body mass index (BMI), fasting plasma glucose (FPG), lipid profile, and blood pressure. We found that 5...
August 10, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28797417/implications-of-coronary-artery-calcium%C3%A2-testing-for-treatment-decisions-among-statin-candidates-according-to%C3%A2-the%C3%A2-acc-aha-cholesterol-management%C3%A2-guidelines-a-cost-effectiveness-analysis
#9
REVIEW
Jonathan C Hong, Ron Blankstein, Leslee J Shaw, William V Padula, Alejandro Arrieta, Jonathan A Fialkow, Roger S Blumenthal, Michael J Blaha, Harlan M Krumholz, Khurram Nasir
This review evaluates the cost-effectiveness of using coronary artery calcium (CAC) to guide long-term statin therapy compared with treating all patients eligible for statins according to 2013 American College of Cardiology/American Heart Association cholesterol management guidelines for atherosclerotic cardiovascular disease. The authors used a microsimulation model to compare costs and effectiveness from a societal perspective over a lifetime horizon. Both strategies resulted in similar costs and quality-adjusted life years (QALYs)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28794833/preoperative-cardiac-evaluation-with-transthoracic-echocardiography-before-non-cardiac-surgery
#10
REVIEW
Chi Young Shim
Transthoracic echocardiography has become increasingly popular in clinical practice. It is used for the functional evaluation of patients with various cardiovascular diseases. Its use has been extended further in routine screening for cardiovascular health and in preoperative risk assessment before non-cardiac surgery because it is non-invasive, easy to perform, reproducible, and cost-effective. When the results of preoperative echocardiography contain abnormalities, the findings must be interpreted to determine clinical relevance...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28780579/a-policy-model-of-cardiovascular-disease-in-moderate-to-advanced-chronic-kidney-disease
#11
Iryna Schlackow, Seamus Kent, William Herrington, Jonathan Emberson, Richard Haynes, Christina Reith, Christoph Wanner, Bengt Fellström, Alastair Gray, Martin J Landray, Colin Baigent, Borislava Mihaylova
OBJECTIVE: To present a long-term policy model of cardiovascular disease (CVD) in moderate-to-advanced chronic kidney disease (CKD). METHODS: A Markov model with transitions between CKD stages (3B, 4, 5, on dialysis, with kidney transplant) and cardiovascular events (major atherosclerotic events, haemorrhagic stroke, vascular death) was developed with individualised CKD and CVD risks estimated using the 5 years' follow-up data of the 9270 patients with moderate-to-severe CKD in the Study of Heart and Renal Protection (SHARP) and multivariate parametric survival analysis...
August 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28777178/sleep-disordered-breathing
#12
Nancy R Foldvary-Schaefer, Tina E Waters
PURPOSE OF REVIEW: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reversible...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28774333/cost-utility-analysis-of-bariatric-surgery-compared-with-conventional-medical-management-in-germany-a-decision-analytic-modeling
#13
Oleg Borisenko, Oliver Mann, Anna Duprée
BACKGROUND: The objective was to evaluate cost-utility of bariatric surgery in Germany for a lifetime and 10-year horizon from a health care payer perspective. METHODS: State-transition Markov model provided absolute and incremental clinical and monetary results. In the model, obese patients could undergo surgery, develop post-surgery complications, experience diabetes type II, cardiovascular diseases or die. German Quality Assurance in Bariatric Surgery Registry and literature sources provided data on clinical effectiveness and safety...
August 3, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28770324/impact-of-metformin-on-cardiovascular-disease-a-meta-analysis-of-randomised-trials-among-people-with-type-2-diabetes
#14
REVIEW
Simon J Griffin, James K Leaver, Greg J Irving
AIMS/HYPOTHESIS: Metformin is the most-prescribed oral medication to lower blood glucose worldwide. Yet previous systematic reviews have raised doubts about its effectiveness in reducing risk of cardiovascular disease, the most costly complication of type 2 diabetes. We aimed to systematically identify and pool randomised trials reporting cardiovascular outcomes in which the effect of metformin was 'isolated' through comparison to diet, lifestyle or placebo. METHODS: We performed an electronic literature search of MEDLINE, EMBASE and the Cochrane Library...
August 2, 2017: Diabetologia
https://www.readbyqxmd.com/read/28770322/metformin-for-diabetes-prevention-insights-gained-from-the-diabetes-prevention-program-diabetes-prevention-program-outcomes-study
#15
REVIEW
Vanita R Aroda, William C Knowler, Jill P Crandall, Leigh Perreault, Sharon L Edelstein, Susan L Jeffries, Mark E Molitch, Xavier Pi-Sunyer, Christine Darwin, Brandy M Heckman-Stoddard, Marinella Temprosa, Steven E Kahn, David M Nathan
The largest and longest clinical trial of metformin for the prevention of diabetes is the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS). In this review, we summarise data from the DPP/DPPOS, focusing on metformin for diabetes prevention, as well as its long-term glycaemic and cardiometabolic effects and safety in people at high-risk of developing diabetes. The DPP (1996-2001) was a RCT of 3234 adults who, at baseline, were at high-risk of developing diabetes. Participants were assigned to masked placebo (n = 1082) or metformin (n = 1073) 850 mg twice daily, or intensive lifestyle intervention (n = 1079)...
August 2, 2017: Diabetologia
https://www.readbyqxmd.com/read/28770321/metformin-clinical-use-in-type-2-diabetes
#16
REVIEW
Elizabeth Sanchez-Rangel, Silvio E Inzucchi
Metformin is one of the most popular oral glucose-lowering medications, widely considered to be the optimal initial therapy for patients with type 2 diabetes mellitus. Interestingly, there still remains controversy regarding the drug's precise mechanism of action, which is thought to involve a reduction in hepatic glucose production. It is now recommended as first-line treatment in various guidelines, including that of the EASD and ADA. Its favoured status lies in its efficacy, low cost, weight neutrality and good safety profile...
August 2, 2017: Diabetologia
https://www.readbyqxmd.com/read/28768610/behavior-change-techniques-in-physical-activity-ehealth-interventions-for-people-with-cardiovascular-disease-systematic-review
#17
Orlaith Mairead Duff, Deirdre Mj Walsh, Bróna A Furlong, Noel E O'Connor, Kieran A Moran, Catherine B Woods
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of premature death and disability in Europe, accounting for 4 million deaths per year and costing the European Union economy almost €196 billion annually. There is strong evidence to suggest that exercise-based secondary rehabilitation programs can decrease the mortality risk and improve health among patients with CVD. Theory-informed use of behavior change techniques (BCTs) is important in the design of cardiac rehabilitation programs aimed at changing cardiovascular risk factors...
August 2, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28768301/representativeness-of-medicare-participants-in-the-jackson-heart-study-for-african-american-medicare-beneficiaries
#18
Kishan S Parikh, Melissa A Greiner, Wei Wang, Yuan-I Min, Adolfo Correa, Benjamin F Banahan, Lesley H Curtis, Adrian F Hernandez, Emily C O'Brien, Robert J Mentz
BACKGROUND: The Jackson Heart Study (JHS) assesses cardiovascular disease risk factors among African Americans in Jackson, Mississippi. Whether characteristics of JHS participants differ from those of a broader African American population are unknown. METHODS: In a retrospective observational analysis, we compared characteristics and outcomes of JHS participants 65 years old and older and enrolled in Medicare (n = 1,105) to regional (n = 57,489) and national (n = 95,494) cohorts of African American Medicare beneficiaries...
September 2017: Epidemiology
https://www.readbyqxmd.com/read/28767918/economic-analysis-of-costs-with-enteral-and-parenteral-nutritional-therapy-according-to-disease-and-outcome
#19
Adriano Hyeda, Élide Sbardellotto Mariano da Costa
Objective: To conduct an economic analysis of enteral and parenteral diet costs according to the type of disease and outcome (survivors versus deaths). Methods: It is a cross-sectional, observational, retrospective study with a qualitative and quantitative design, based on analysis of hospital accounts from a healthcare insurance provider in the Southern region of Brazil. Results: We analyzed 301 hospital accounts of individuals who used enteral and parenteral diets...
April 2017: Einstein
https://www.readbyqxmd.com/read/28767722/cost-effectiveness-analysis-of-population-based-tobacco-control-strategies-in-the-prevention-of-cardiovascular-diseases-in-tanzania
#20
Frida Ngalesoni, George Ruhago, Mary Mayige, Tiago Cravo Oliveira, Bjarne Robberstad, Ole Frithjof Norheim, Hideki Higashi
BACKGROUND: Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. AIMS: We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania...
2017: PloS One
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