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https://www.readbyqxmd.com/read/28920012/comparative-effectiveness-for-glycemic-control-in-older-adults-with-diabetes
#1
Michael Quartuccio, Brian Buta, Rita R Kalyani
PURPOSE OF REVIEW: To review and summarize the current data for comparative effectiveness of glycemic control in older adults. RECENT FINDINGS: In the last several years, professional societies have released guidelines for glycemic control in older adults, generally recommending individualized HbA1c goals. However, recent observational studies demonstrate that many older adults remain aggressively managed and are at increased risk of hypoglycemia. Large randomized trials of older adults with diabetes have failed to show cardiovascular benefit from intensive glycemic control and show only minimal microvascular benefit...
September 2017: Current Geriatrics Reports
https://www.readbyqxmd.com/read/28919117/global-regional-and-national-incidence-prevalence-and-years-lived-with-disability-for-328-diseases-and-injuries-for-195-countries-1990-2016-a-systematic-analysis-for-the-global-burden-of-disease-study-2016
#2
(no author information available yet)
BACKGROUND: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. METHODS: We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences...
September 16, 2017: Lancet
https://www.readbyqxmd.com/read/28918776/-prophylactic-antibiotic-therapy-for-hernia-repair
#3
Siv Fonnes, Barbara Juliane Holzknecht, Magnus Arpi, Jacob Rosenberg
This article aims at outlining and recommending use of prophylactic antibiotic therapy for hernia repair according to literature and newly released guidelines. We do not recommend prophylaxis for elective repair of inguinal and ventral hernias in a low infection risk environment as Denmark except in patients with incisional hernia > 10 cm or presumed increased risk for wound infection, e.g. diabetes or immunosuppression. Antibiotic prophylaxis should always be used in emergent hernia repair. We recommend a prophylactic regimen of second-generation cephalosporin given as a single dose perioperatively...
September 11, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918555/prognostic-factors-for-mortality-in-middle-aged-and-older-hemodialysis-patients-a-5-year-observational-study
#4
Kojiro Nagai, Motokazu Matsuura, Kenji Tsuchida, Hiro-Omi Kanayama, Toshio Doi, Jun Minakuchi
Clinical guidelines for hemodialysis therapy have been described in an evidence-based manner with most evidence from randomized control trials or retrospective studies in which all generations of the hemodialysis patients were enrolled. Therefore, the question still remains whether these guidelines can be applied to increasing older patients. This study is an observational study, including 735 patients who received maintenance hemodialysis in April 2006. At baseline, the participants' age was 62.1 ± 12...
September 16, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28916976/preoperative-risk-factors-for-postoperative-complications-in-endoscopic-pituitary-surgery-a-systematic-review
#5
REVIEW
Daniel J Lobatto, Friso de Vries, Amir H Zamanipoor Najafabadi, Alberto M Pereira, Wilco C Peul, Thea P M Vliet Vlieland, Nienke R Biermasz, Wouter R van Furth
BACKGROUND: The ability to preoperatively predict postoperative complication risks is valuable for individual counseling and (post)operative planning, e.g. to select low-risk patients eligible for short stay surgery or those with higher risks requiring special attention. These risks however, are not well established in pituitary surgery. METHODS: We conducted a systematic review of associations between preoperative characteristics and postoperative complications of endoscopic transsphenoidal surgery according to the PRISMA guidelines...
September 15, 2017: Pituitary
https://www.readbyqxmd.com/read/28916931/physical-exercise-prescription-in-metabolic-chronic-disease
#6
Laura Stefani, Giorgio Galanti
Metabolic syndrome as a consequence of the association to overweight, hypertension, and diabetes is at high risk of coronary events. Regular physical training has been recently promoted to reduce cardiovascular risks factors, by the improved lifestyle and also by the "anti-inflammatory effectiveness." A positive impact has been shown in case of cancer survived patients either with or without comorbidities and especially in those subjects where the inflammatory process is globally represented. The American College of Sports Medicine (ACSM) guidelines and more recently a new Italian model both support the role of "exercise as therapy" at moderate level of energy expenditure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28916152/effects-of-inspiratory-muscle-training-on-cardiovascular-autonomic-control-a-systematic-review
#7
REVIEW
Raphael Martins de Abreu, Patrícia Rehder-Santos, Vinicius Minatel, Gabriela Lopes Dos Santos, Aparecida Maria Catai
PURPOSE: To carry out a systematic review to determine if inspiratory muscle training (IMT) promotes changes in cardiovascular autonomic responses in humans. METHODS: The methodology followed the PRISMA statement for reporting systematic review analysis. MEDLINE, PEDro, SCOPUS and PubMed electronic databases were searched from the inception to March 2017. The quality assessment was performed using a PEDro scale. The articles were included if: (1) primary objective was related to the effects of IMT on the cardiovascular autonomic nervous system, and (2) randomized clinical trials and quasi-experimental studies...
September 7, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28915969/hyperglycemia-in-acute-ischemic-stroke-is-it-time-to-re-evaluate-our-understanding
#8
Rwoof Reshi, Chris Streib, Mustapha Ezzeddine, Michelle Biros, Benjamin Miller, Kamakshi Lakshminarayan, David Anderson, Agnieszka Ardelt
Among 700,000 new and recurrent ischemic stroke patients per year, forty percent are hyperglycemic on admission. In-vitro, hyperglycemia is toxic to neurons. Acute ischemic stroke patients who are hyperglycemic on admission experience higher morbidity and mortality. Results of multiple trials have provided no evidence supporting benefit in achieving normoglycemia. On the contrary, there is some evidence that tight glycemic control in acute brain injury is associated with poor outcome. Current consensus derived guidelines from the American Heart Association/American Stroke Association recommend an upper limit of blood glucose of 140-180mg/dl, as there is no evidence to support strict control...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915960/pleiotropic-effects-of-metformin-to-rescue-statin-induced-muscle-injury-and-insulin-resistance-a-proposed-mechanism-and-potential-clinical-implications
#9
Nicholas W Carris, Srinivas M Tipparaju, David J Magness, Kalyan C Chapalamadugu, Ronald R Magness
The 2013 American Heart Association Blood Cholesterol Guidelines increased the number of patients recommended for statin therapy in the United States to 56million. Two common statin side effects are muscle pain, referred to as "statin-associated muscle symptoms", and increased risk for new onset type-2-diabetes mellitus. Up to 25% of statin users report muscle symptoms resulting in many patients being switched to lower dose or lower potency statins, or refusing statins altogether. The most likely signaling mechanisms for statin-associated muscle symptoms overlaps with the proposed mechanism of statin-induced insulin resistance...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915908/advances-in-paediatrics-in-2016-current-practices-and-challenges-in-allergy-autoimmune-diseases-cardiology-endocrinology-gastroenterology-infectious-diseases-neonatology-nephrology-neurology-nutrition-pulmonology
#10
REVIEW
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Silvia Montella, Sergio Bernasconi
This review reports main progresses in various pediatric issues published in Italian Journal of Pediatrics and in international journals in 2016. New insights in clinical features or complications of several disorders may be useful for our better understanding. They comprise severe asthma, changing features of lupus erythematosus from birth to adolescence, celiac disease, functional gastrointestinal disorders, Moebius syndrome, recurrent pneumonia. Risk factors for congenital heart defects, Kawasaki disease have been widely investigated...
September 16, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28915897/development-of-a-complex-intervention-to-promote-appropriate-prescribing-and-medication-intensification-in-poorly-controlled-type-2-diabetes-mellitus-in-irish-general-practice
#11
Mark E Murphy, Molly Byrne, Atieh Zarabzadeh, Derek Corrigan, Tom Fahey, Susan M Smith
BACKGROUND: Poorly controlled type 2 diabetes mellitus (T2DM) can be seen as failure to meet recommended targets for management of key risk factors including glycaemic control, blood pressure and lipids. Poor control of risk factors is associated with significant morbidity, mortality and healthcare costs. Failure to intensify medications for patients with poor control of T2DM when indicated is called clinical inertia and is one contributory factor to poor control of T2DM. We aimed to develop a theory and evidence-based complex intervention to improve appropriate prescribing and medication intensification in poorly controlled T2DM in Irish general practice...
September 16, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28915818/the-impact-of-cardiovascular-co-morbidities-and-duration-of-diabetes-on-the-association-between-microvascular-function-and-glycaemic-control
#12
F Casanova, D D Adingupu, F Adams, K M Gooding, H C Looker, K Aizawa, F Dove, S Elyas, J J F Belch, P E Gates, R C Littleford, M Gilchrist, H M Colhoun, A C Shore, F Khan, W D Strain
BACKGROUND: Good glycaemic control in type 2 diabetes (T2DM) protects the microcirculation. Current guidelines suggest glycaemic targets be relaxed in advanced diabetes. We explored whether disease duration or pre-existing macrovascular complications attenuated the association between hyperglycaemia and microvascular function. METHODS: 743 participants with T2DM (n = 222), cardiovascular disease (CVD = 183), both (n = 177) or neither (controls = 161) from two centres in the UK, underwent standard clinical measures and endothelial dependent (ACh) and independent (SNP) microvascular function assessment using laser Doppler imaging...
September 15, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28914815/a-systematic-review-family-support-integrated-with-diabetes-self-management-among-uncontrolled-type-ii-diabetes-mellitus-patients
#13
REVIEW
Rian Adi Pamungkas, Kanittha Chamroonsawasdi, Paranee Vatanasomboon
The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control...
September 15, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28913755/management-and-clinical-outcome-of-stable-coronary-artery-disease-in-austria-results-from-5%C3%A2-years-of-the-clarify-registry
#14
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
September 14, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#15
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28912201/race-and-socioeconomic-differences-associated-with-changes-in-statin-eligibility-under-the-2013-american-college-of-cardiology-american-heart-association-cholesterol-guidelines
#16
Amol A Verma, Marcia P Jimenez, S V Subramanian, Allan D Sniderman, Fahad Razak
BACKGROUND: The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines expanded eligibility criteria for statins. We examined race and socioeconomic differences associated with these changes. METHODS AND RESULTS: This was an observational study of adults between 40 and 75 years of age using data from the National Health and Nutrition Examination Surveys between 2005 and 2012. Change in eligibility for statins was assessed based on the third adult treatment panel criteria and the 2013 ACC/AHA guidelines...
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28911306/management-of-blood-pressure-and-heart-rate-in-patients-with-diabetes-mellitus
#17
Ioanna Gouni-Berthold, Ruth Hanssen, Lisa Ravarani, Heiner K Berthold
BACKGROUND: In patients with diabetes mellitus (DM) there is a clear association between blood pressure (BP) levels and macrovascular and microvascular complications. However, the BP targets that need to be achieved for optimal outcomes remain controversial. METHODS: The purpose of this narrative review is to discuss BP targets and management in patients with DM. The subject of elevated heart rate, which has been associated with mortality in many populations, and which is observed in some patients with DM will also be addressed...
June 8, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28905658/decision-support-for-diabetes-in-scotland-implementation-and-evaluation-of-a-clinical-decision-support-system
#18
Nicholas Conway, Karen A Adamson, Scott G Cunningham, Alistair Emslie Smith, Peter Nyberg, Blair H Smith, Ann Wales, Deborah J Wake
BACKGROUND: Automated clinical decision support systems (CDSS) are associated with improvements in health care delivery to those with long-term conditions, including diabetes. A CDSS was introduced to two Scottish regions (combined diabetes population ~30 000) via a national diabetes electronic health record. This study aims to describe users' reactions to the CDSS and to quantify impact on clinical processes and outcomes over two improvement cycles: December 2013 to February 2014 and August 2014 to November 2014...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28905359/guideline-recommended-medications-and-physical-function-in-older-adults-with-multiple-chronic-conditions
#19
Gail McAvay, Heather G Allore, Andrew B Cohen, Danijela Gnjidic, Terrence E Murphy, Mary E Tinetti
BACKGROUND/OBJECTIVES: The benefit or harm of a single medication recommended for one specific condition can be difficult to determine in individuals with multiple chronic conditions and polypharmacy. There is limited information on the associations between guideline-recommended medications and physical function in older adults with multiple chronic conditions. The objective of this study was to estimate the beneficial or harmful associations between guideline-recommended medications and decline in physical function in older adults with multiple chronic conditions...
September 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28904714/-the-overweight-the-obesity-and-the-glycemic-control-among-diabetics-of-the-provincial-reference-center-of-diabetes-crd-kenitra-morocco
#20
Zeghari Lotfi, Youssef Aboussaleh, Rachid Sbaibi, Imane Achouri, Rachid Benguedour
INTRODUCTION: Diabetes is a disorder of assimilation, use and storage of sugars provided in the diet. Its management is based on follow-up of overweight and obese patients and on regular glycemic control. This study aimed to analyze overweight, obesity and glycemic control in 2227 patients with different types of diabetes (type 1, 2 and gestational) presenting to the Provincial referral center of diabetes (RCD) in Kenitra, Morocco. METHODS: We conducted a study over the period January-December 2015...
2017: Pan African Medical Journal
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