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https://www.readbyqxmd.com/read/28214312/update-treatment-of-necrobiosis-lipoidica
#1
REVIEW
Melanie Peckruhn, Jörg Tittelbach, Peter Elsner
Necrobiosis lipoidica (NL) is a rare granulomatous disease of hitherto unclear etiology frequently seen in patients with diabetes. Characterized by its potential for ulcerations, it often presents a serious burden for those affected. There are currently neither German nor European guidelines for the treatment of NL. At the same time, standard treatment with topical or intralesional corticosteroids does not always show satisfactory results. We therefore set out to evaluate whether the various treatment regimens published since 2000 have actually expanded the therapeutic armamentarium in a relevant manner...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28213597/retrospective-examination-of-lipid-lowering-treatment-patterns-in-a-real-world-high-risk-cohort-in-the-uk-in-2014-comparison-with-the-national-institute-for-health-and-care-excellence-nice-2014-lipid-modification-guidelines
#2
Dylan L Steen, Irfan Khan, David Ansell, Robert J Sanchez, Kausik K Ray
BACKGROUND: In 2014, guidelines from the National Institute for Health and Care Excellence (NICE) provided updated recommendations on lipid-modifying therapy (LMT). We assessed clinical practice contemporaneous to release of these guidelines in a UK general practice setting for secondary and high-risk primary-prevention populations, and extrapolated the findings to UK nation level. METHODS: Patients from The Health Improvement Network database with the following criteria were included: lipid profile in 2014 (index date); ≥20 years of age; ≥2 years representation in database prior to index; ≥1 statin indication either for atherosclerotic cardiovascular disease (ASCVD) or the non-ASCVD conditions high-risk diabetes mellitus and/or chronic kidney disease...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28212407/epidemiology-of-low-proteinuric-chronic-kidney-disease-in-renal-clinics
#3
Luca De Nicola, Michele Provenzano, Paolo Chiodini, Silvio Borrelli, Luigi Russo, Antonio Bellasi, Domenico Santoro, Giuseppe Conte, Roberto Minutolo
CKD patients with low-grade proteinuria (LP) are common in nephrology clinics. However, prevalence, characteristics, and the competing risks of ESRD and death as the specific determinants, are still unknown. We analyzed epidemiological features of LP status in a prospective cohort of 2,340 patients with CKD stage III-V referred from ≥6 months in 40 nephrology clinics in Italy. LP status was defined as proteinuria <0.5 g/24h according to current KDIGO guidelines. Patients with higher proteinuria constituted the control group (CON)...
2017: PloS One
https://www.readbyqxmd.com/read/28211604/delays-in-treatment-intensification-with-oral-antidiabetic-drugs-and-risk-of-microvascular-and-macrovascular-events-in-patients-with-poor-glycemic-control-an-individual-patient-simulation-study
#4
Henry J Folse, Jayanti Mukherjee, John J Sheehan, Alexandra J Ward, Ryan L Pelkey, Tuan A Dinh, Lei Qin, Jennifer Kim
AIMS: Despite guideline recommendations, many patients with type 2 diabetes on oral antidiabetic drugs (OADs) whose HbA1c results remain above target do not experience timely treatment intensification. This study uses the Archimedes Model® to estimate the consequences of delays in OAD treatment intensification on glycemic control and long-term outcomes at 5 and 20 years. MATERIALS AND METHODS: Using real world data, we modeled a cohort of hypothetical patients with HbA1c ≥8%, on metformin, with no history of insulin use...
February 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28210870/diabetes-related-burden-and-distress-in-people-with-diabetes-mellitus-at-primary-care-level-in-germany
#5
N Kuniss, T Rechtacek, C Kloos, U A Müller, J Roth, K Burghardt, G Kramer
AIMS: The importance of diabetes-related distress for the treatment of diabetes is emphasised in national and international guidelines recommending routinely screening for psychosocial problems. Data of investigations regarding diabetes-related distress on primary care are rare in Germany though most people with diabetes are treated without insulin therapy at primary care level. METHODS: Three hundred and forty-five people with diabetes mellitus type 2 (DM2, n = 336, 229 without and 107 with insulin therapy) and type 1 (DM1, n = 9) were interviewed with the PAID questionnaire in the period from 1 October 2015 to 31 December 2015 in a general practice...
February 16, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28209453/-detection-and-classification-of-chronic-kidney-disease-in-primary-care-and-importance-of-albuminuria
#6
P J Labrador, S González-Sanchidrián, S Polanco, E Davin, J M Fuentes, J R Gómez-Martino
INTRODUCTION: Chronic kidney disease (CKD) is a public health problem, and Primary Care (PC) plays a key role in its detection and classification based on estimated glomerular filtration rate (eGFR), as well as the level of albuminuria for its proper management. The aim of this study was to analyse the prevalence and classification of CKD in patients attended in PC. MATERIAL AND METHODS: An analysis was made of CKD prevalence and classification according to the Kidney Disease-Improving Global Outcomes guidelines in PC patients...
February 13, 2017: Semergen
https://www.readbyqxmd.com/read/28208907/current-practice-of-hypertension-in-india-focus-on-blood-pressure-goals
#7
Jagdish S Hiremath, Vijay M Katekhaye, Vijay S Chamle, Rishi M Jain, Amit I Bhargava
INTRODUCTION: Recommended Blood Pressure (BP) goals in elderly and those with co-morbid conditions like Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) vary in different Hypertension (HTN) management guidelines. AIM: To understand currently followed BP goals and practices among the physicians involved in management of HTN in India. MATERIALS AND METHODS: A cross-sectional, observational survey was conducted at 66(th) annual conference of Cardiological Society of India (CSICON-2014, Hyderabad)...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208043/the-australasian-diabetes-data-network-first-national-audit-of-children-and-adolescents-with-type-1-diabetes
#8
Helen Phelan, Helen Clapin, Loren Bruns, Fergus J Cameron, Andrew M Cotterill, Jennifer J Couper, Elizabeth A Davis, Kim C Donaghue, Craig A Jefferies, Bruce R King, Richard O Sinnott, Elaine B Tham, Jerry K Wales, Timothy W Jones, Maria E Craig
OBJECTIVES: To assess glycaemic control, anthropometry and insulin regimens in a national sample of Australian children and adolescents with type 1 diabetes. DESIGN: Cross-sectional analysis of de-identified, prospectively collected data from the Australasian Diabetes Data Network (ADDN) registry. SETTING: Five paediatric diabetes centres in New South Wales, Queensland, South Australia, Victoria and Western Australia. PARTICIPANTS: Children and adolescents (aged 18 years or under) with type 1 diabetes of at least 12 months' duration for whom data were added to the ADDN registry during 2015...
February 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28207612/a-systematic-review-and-meta-analysis-of-executive-function-performance-in-type-1-diabetes-mellitus
#9
Melanie M Broadley, Melanie J White, Brooke Andrew
OBJECTIVE: To examine the current evidence for executive function (EF) performance differences between groups with Type 1 diabetes mellitus (T1DM) and non-diabetic control groups during adolescence and early adulthood, and to explore the relationships between EF and diabetes-related risk factors. METHODS: A systematic review of the literature examining EF performance in groups with T1DM was conducted according to the PRISMA guidelines. Electronic database searches for published and unpublished literature yielded a final set of 26 articles after application of inclusion and exclusion criteria...
February 16, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28203385/appraising-the-methodological-quality-of-the-clinical-practice-guideline-for-diabetes-mellitus-using-the-agree-ii-instrument-a-methodological-evaluation
#10
Mahmoud Radwan, Ali Akbari Sari, Arash Rashidian, Amirhossein Takian, Sanaa Abou-Dagga, Aymen Elsous
OBJECTIVES: To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. DESIGN: Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. SETTING: Palestinian Primary Healthcare Centres. PARTICIPANTS: Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II...
February 2017: JRSM Open
https://www.readbyqxmd.com/read/28199464/identification-of-patients-with-stable-chest-pain-deriving-minimal-value-from-noninvasive-testing-the-promise-minimal-risk-tool-a-secondary-analysis-of-a-randomized-clinical-trial
#11
Christopher B Fordyce, Pamela S Douglas, Rhonda S Roberts, Udo Hoffmann, Hussein R Al-Khalidi, Manesh R Patel, Christopher B Granger, John Kostis, Daniel B Mark, Kerry L Lee, James E Udelson
Importance: Guidelines recommend noninvasive testing for patients with stable chest pain, although many subsequently have normal test results and no adverse clinical events. Objective: To describe a risk tool developed to use only pretest clinical data to identify patients with chest pain with normal coronary arteries and no clinical events during follow-up (minimal-risk cohort). Design, Setting, and Participants: This secondary analysis of a randomized, pragmatic comparative effectiveness trial (Prospective Multicenter Imaging Study for Evaluation of Chest Pain [PROMISE]) includes stable, symptomatic outpatients without known coronary artery disease referred for noninvasive testing at 193 sites in North America...
February 15, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28199038/the-duration-of-intrapartum-maternal-hyperglycaemia-predicts-neonatal-hypoglycaemia-in-women-with-pre-existing-diabetes
#12
T Joshi, C Oldmeadow, J Attia, K Wynne
AIM: There is a high incidence of neonatal hypoglycaemia in neonates born to mothers with pre-existing diabetes. This often necessitates admission to the neonatal intensive care. Guidelines suggest maintaining intrapartum blood glucose levels (BGLs) of 4-7 mmol/l in women with diabetes to reduce the risk of neonatal hypoglycaemia. This study assessed whether intrapartum BGLs in women with pre-gestational Type 1 and 2 diabetes were predictive of neonatal hypoglycaemia. METHODS: A retrospective analysis of 261 births delivered at a tertiary hospital in Australia from 2009 to 2014...
February 15, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28198939/compliance-with-the-prescription-of-antihypertensive-medications-and-blood-pressure-control-in-primary-care
#13
Mayra Faria Novello, Maria Luiza Garcia Rosa, Ranier Tagarro Ferreira, Icaro Gusmão Nunes, Antonio José Lagoeiro Jorge, Dayse Mary da Silva Correia, Wolney de Andrade Martins, Evandro Tinoco Mesquita
Background: Hypertension is the most prevalent risk factor for cardiovascular disease, and its proper control can prevent the high morbidity and mortality associated with this disease. Objective: To assess the degree of compliance of antihypertensive prescriptions with the VI Brazilian Guidelines on Hypertension and the blood pressure control rate in primary care. Methods: Cross-sectional study conducted between August 2011 and November 2012, including 332 adults ≥ 45 years registered in the Family Doctor Program in Niteroi and selected randomly...
February 13, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28198732/intensive-blood-pressure-lowering-in-chronic-kidney-disease-the-time-has-come
#14
Marcel Ruzicka, Swapnil Hiremath
PURPOSE OF REVIEW: Release of the findings from the Systolic Blood Pressure Intervention Trial has resulted in a renewed examination of intensive blood pressure (BP) lowering. Only a few national hypertension guidelines (Canada and Australia) have changed recommendations, but considerable heterogeneity still exists with respect to the patient population to whom intensive BP lowering may apply. RECENT FINDINGS: There is fairly robust evidence that lower BP targets in nondiabetic chronic kidney disease (CKD) results in a decrease in heart failure and mortality...
February 13, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28193516/metabolic-and-bariatric-surgery-for-obesity
#15
Josep Vidal, Ricard Corcelles, Amanda Jiménez, Lílliam Flores, Antonio M Lacy
Metabolic and bariatric surgery (MBS) leads to weight loss in obese individuals and reduces comorbidities such as type 2 diabetes. MBS is superior to medical therapy in reducing hyperglycemia in persons with type 2 diabetes, and has been associated with reduced mortality and incidences of cardiovascular events and cancer in obese individuals. New guidelines have been proposed for the use of MBS in persons with type 2 diabetes. We review the use of MBS as a treatment for obesity and obesity-related conditions and, based on recent evidence, propose health care systems make the appropriate changes to increase accessibility for eligible patients...
February 10, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28193194/the-objective-physical-activity-and-cardiovascular-disease-health-in-older-women-opach-study
#16
Andrea Z LaCroix, Eileen Rillamas-Sun, David Buchner, Kelly R Evenson, Chongzhi Di, I-Min Lee, Steve Marshall, Michael J LaMonte, Julie Hunt, Lesley Fels Tinker, Marcia Stefanick, Cora E Lewis, John Bellettiere, Amy H Herring
BACKGROUND: Limited evidence exists to inform physical activity (PA) and sedentary behavior guidelines for older people, especially women. Rigorous evidence on the amounts, intensities, and movement patterns associated with better health in later life is needed. METHODS/DESIGN: The Objective PA and Cardiovascular Health (OPACH) Study is an ancillary study to the Women's Health Initiative (WHI) Program that examines associations of accelerometer-assessed PA and sedentary behavior with cardiovascular and fall events...
February 14, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28187724/case-management-of-patients-with-type-2-diabetes-mellitus-a-cross-sectional-survey-in-chongqing-china
#17
Miao He, Jiaqi Gao, Weiwei Liu, Xiaojun Tang, Shenglan Tang, Qian Long
BACKGROUND: Type 2 diabetes mellitus has been identified as one of the priority diseases and included in the essential public health service package in China. This study investigated the frequency of follow-up visits and contents of care for case management of patients with Type 2 diabetes in Chongqing located in the western China, in terms of the regional practice guideline; and analyzed factors associated with the use of care. METHODS: A cross-sectional survey was conducted with patients diagnosed with Type 2 diabetes in two areas in Chongqing...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28187718/an-education-programme-influencing-health-professionals-to-recommend-exercise-to-their-type-2-diabetes-patients-understanding-the-processes-a-case-study-from-oxfordshire-uk
#18
Anne Matthews, Natasha Jones, Alastair Thomas, Perdy van den Berg, Charlie Foster
BACKGROUND: Increasing levels of physical activity decreases the risk of premature mortality associated with chronic diseases e.g., coronary heart disease, type 2 diabetes, stroke. Despite this, most adults in England do not meet physical activity guidelines. Physical activity advice and signposting offered to at-risk patients by primary care providers is recommended. However, exercise medicine education is sparse, leading to poor practitioner knowledge of the risk reduction evidence and strategies to implement effective patient behaviour change...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28187470/-indications-for-retinal-laser-therapy-revisited
#19
P Enders, F Schaub, S Fauser
Background Laser therapy is an important treatment option in retinal diseases, especially in cases of vascular involvement. Most approaches are based on coagulation of retinal structures. As there is increasing use of agents targetting vascular endothelial growth factor in the treatment of macular diseases, indications for the use of laser treatment need to be reviewed carefully, especially with respect to their significance in first line therapy. This article explains recent strategies and treatment protocols...
February 10, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28186933/use-of-the-diabetes-medication-choice-decision-aid-in-patients-with-type-2-diabetes-in-greece-a-cluster-randomised-trial
#20
Thomas Karagiannis, Aris Liakos, Megan E Branda, Eleni Athanasiadou, Maria Mainou, Panagiota Boura, Dimitrios G Goulis, Annie LeBlanc, Victor M Montori, Apostolos Tsapas
OBJECTIVE: To assess the efficacy of the Diabetes Medication Choice Decision Aid among patients with type 2 diabetes in Greece. DESIGN: Open-label cluster randomised controlled trial. SETTING: Primary and secondary care practices across Greece. PARTICIPANTS: 5 sites allocated to the decision aid (n=101 patients) and 4 sites to control (n=103 patients). INTERVENTION: Clinicians and patients in the intervention arm used a decision aid, based on outcomes that both consider important when choosing among antihyperglycaemic medications...
November 14, 2016: BMJ Open
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