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https://www.readbyqxmd.com/read/29345404/individual-variability-in-response-to-renin-angiotensin-aldosterone-system-inhibition-predicts-cardiovascular-outcome-in-patients-with-type-2-diabetes-a-primary-care-cohort-study
#1
Ellen M Apperloo, Michelle J Pena, Dick de Zeeuw, Petra Denig, Hiddo Jl Heerspink
AIMS: Variability in response to Renin-Angiotensin-Aldosterone System (RAAS) inhibition has been shown in clinical trials but its occurrence and impact in clinical practice are unknown. We assessed variability in systolic blood pressure (SBP) and albuminuria (UACR) responses in patients with type 2 diabetes mellitus initiating RAAS inhibition, and assessed the association of response variability with cardiovascular outcomes. METHODS: We performed an observational cohort study in patients with type 2 diabetes who started RAAS inhibition between 2007 and 2013 (n=1600) were identified from general practices in the Netherlands...
January 18, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29344794/ticagrelor-for-secondary-prevention-of-atherothrombotic-events-after-myocardial-infarction-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#2
REVIEW
Xavier G L V Pouwels, Robert Wolff, Bram L T Ramaekers, Anoukh Van Giessen, Shona Lang, Steve Ryder, Gill Worthy, Steven Duffy, Nigel Armstrong, Jos Kleijnen, Manuela A Joore
The National Institute for Health and Care Excellence (NICE) invited AstraZeneca, the manufacturer of ticagrelor (Brilique®), to submit evidence on the clinical and cost effectiveness of ticagrelor 60 mg twice daily (BID) in combination with low-dose aspirin [acetylsalicylic acid (ASA)] compared with ASA only for secondary prevention of atherothrombotic events in patients with a history of myocardial infarction (MI) and who are at increased risk of atherothrombotic events. Kleijnen Systematic Reviews Ltd (KSR), in collaboration with Maastricht University Medical Centre+, was commissioned as the evidence review group (ERG)...
January 18, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29341850/clinical-inertia-in-a-randomized-trial-of-telemedicine-based-chronic-disease-management-lessons-learned
#3
Anna Beth Barton, Daniel E Okorodudu, Hayden B Bosworth, Matthew J Crowley
BACKGROUND: Treatment nonadherence and clinical inertia perpetuate poor cardiovascular disease (CVD) risk factor control. Telemedicine interventions may counter both treatment nonadherence and clinical inertia. INTRODUCTION: We explored why a telemedicine intervention designed to reduce treatment nonadherence and clinical inertia did not improve CVD risk factor control, despite enhancing treatment adherence versus usual care. METHODS: In this analysis of a randomized trial, we studied recipients of the 12-month telemedicine intervention...
January 17, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29340677/association-of-bariatric-surgery-using-laparoscopic-banding-roux-en-y-gastric-bypass-or-laparoscopic-sleeve-gastrectomy-vs-usual-care-obesity-management-with-all-cause-mortality
#4
Orna Reges, Philip Greenland, Dror Dicker, Morton Leibowitz, Moshe Hoshen, Ilan Gofer, Laura J Rasmussen-Torvik, Ran D Balicer
Importance: Bariatric surgery is an effective and safe approach for weight loss and short-term improvement in metabolic disorders such as diabetes. However, studies have been limited in most settings by lack of a nonsurgical group, losses to follow-up, missing data, and small sample sizes in clinical trials and observational studies. Objective: To assess the association of 3 common types of bariatric surgery compared with nonsurgical treatment with mortality and other clinical outcomes among obese patients...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29338690/multimorbidity-patterns-in-the-elderly-a-prospective-cohort-study-with-cluster-analysis
#5
Marina Guisado-Clavero, Albert Roso-Llorach, Tomàs López-Jimenez, Mariona Pons-Vigués, Quintí Foguet-Boreu, Miguel Angel Muñoz, Concepción Violán
BACKGROUND: Multimorbidity is the coexistence of more than two chronic diseases in the same individual; however, there is no consensus about the best definition. In addition, few studies have described the variability of multimorbidity patterns over time. The aim of this study was to identify multimorbidity patterns and their variability over a 6-year period in patients older than 65 years attended in primary health care. METHODS: A cohort study with yearly cross-sectional analysis of electronic health records from 50 primary health care centres in Barcelona...
January 16, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29337985/increased-risk-of-ischemic-heart-disease-hypertension-and-type-2-diabetes-in-women-with-previous-gestational-diabetes-mellitus-a-target-group-in-general-practice-for-preventive-interventions-a-population-based-cohort-study
#6
Barbara Daly, Konstantinos A Toulis, Neil Thomas, Krishna Gokhale, James Martin, Jonathan Webber, Deepi Keerthy, Kate Jolly, Ponnusamy Saravanan, Krishnarajah Nirantharakumar
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with developing type 2 diabetes, but very few studies have examined its effect on developing cardiovascular disease. METHODS AND FINDINGS: We conducted a retrospective cohort study utilizing a large primary care database in the United Kingdom. From 1 February 1990 to 15 May 2016, 9,118 women diagnosed with GDM were identified and randomly matched with 37,281 control women by age and timing of pregnancy (up to 3 months)...
January 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29337445/-news-in-diabetology-2017
#7
François R Jornayvaz
The field of diabetes is constantly evolving, with numerous new molecules reaching the market for the treatment of type 2 diabetes. Paradoxically, this drug jungle is difficult for the primary care physician and can lead to therapeutic inertia. The aim of this article is to discuss new molecules and new cardiovascular outcome studies that lead to changes in guidelines pertinent to the pharmacological treatment of type 2 diabetes.
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29334983/an-individually-tailored-family-centered-intervention-for-pediatric-obesity-in-primary-care-study-protocol-of-a-randomized-type-ii-hybrid-effectiveness-implementation-trial-raising-healthy-children-study
#8
Justin D Smith, Cady Berkel, Neil Jordan, David C Atkins, Shrikanth S Narayanan, Carlos Gallo, Kevin J Grimm, Thomas J Dishion, Anne M Mauricio, Jenna Rudo-Stern, Mariah K Meachum, Emily Winslow, Meg M Bruening
BACKGROUND: Pediatric obesity is a multi-faceted public health concern that can lead to cardiovascular diseases, cancers, and early mortality. Small changes in diet, physical activity, or BMI can significantly reduce the possibility of developing cardiometabolic risk factors. Family-based behavioral interventions are an underutilized, evidence-based approach that have been found to significantly prevent excess weight gain and obesity in children and adolescents. Poor program availability, low participation rates, and non-adherence are noted barriers to positive outcomes...
January 15, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29334810/monitoring-of-metabolic-adverse-effects-associated-with-atypical-antipsychotics-use-in-an-outpatient-psychiatric-clinic
#9
Luis Pereira, Aliaksandr Budovich, Maria Claudio-Saez
BACKGROUND: Atypical antipsychotics are associated with metabolic complications that contribute to a higher risk of cardiovascular disease. Current evidence reveal suboptimal adherence to the complex and variable official recommendations on metabolic monitoring in the corresponding patient population. A study evaluating metabolic monitoring at guideline-recommended intervals may help identify areas for intervention. OBJECTIVE: Describe the frequency of monitoring metabolic adverse effects in patients receiving atypical antipsychotics in an outpatient psychiatric clinic with respect to the specific guideline-recommended intervals...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29333898/the-physical-health-of-individuals-receiving-antipsychotic-medication-a-qualitative-inquiry-on-experiences-and-needs
#10
Angela M Cocoman, Mary Casey
Individuals with a mental illness are reported to have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as cardiovascular disease and Type 2 diabetes. This inquiry sought to identify the physical health beliefs, experiences and needs of individuals with mental health problems in receipt of antipsychotic medication who live in the community. A qualitative inquiry was undertaken using three focus groups in a community mental health service in Ireland with 21 participants with mental health problems who were treated with antipsychotic medication...
January 15, 2018: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/29332153/vasoactive-inotropic-score-as-a-predictor-of-morbidity-and-mortality-in-adults-after-cardiac-surgery-with-cardiopulmonary-bypass
#11
Yumiko Yamazaki, Koji Oba, Yoshiro Matsui, Yuji Morimoto
PURPOSE: The vasoactive-inotropic score (VIS) is a scale showing the amount of vasoactive and inotropic support. Recently, it was suggested that the VIS after cardiac surgery predicts morbidity and mortality in infants. The purpose of this study was to evaluate the VIS at the end of surgery as a predictor of morbidity and mortality in adult cardiac surgery. METHODS: A retrospective cohort study of 129 adult cardiac surgery patients was performed at a university hospital...
January 13, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29331655/what-makes-it-so-difficult-for-nurses-to-coach-patients-in-shared-decision-making-a-process-evaluation
#12
Stephanie Anna Lenzen, Ramon Daniëls, Marloes Amantia van Bokhoven, Trudy van der Weijden, Anna Beurskens
BACKGROUND: Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. OBJECTIVES: To investigate how the approach was implemented and experienced by practice nurses and patients. DESIGN: A process evaluation was conducted using quantitative and qualitative methods...
December 16, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29331282/development-testing-and-implementation-of-a-training-curriculum-for-nonphysician-health-workers-to-reduce-cardiovascular-disease
#13
Maheer Khan, Pablo Lamelas, Hadi Musa, Jared Paty, Tara McCready, Robby Nieuwlaat, Eleonor Ng, Patricio Lopez-Jaramillo, Jose Lopez-Lopez, Khalid Yusoff, Fadhlina A Majid, Kien Keat Ng, Len Garis, Oyere Onuma, Salim Yusuf, Jon-David Schwalm
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide. The need to address CVD is greatest in low- and middle-income countries where there is a shortage of trained health workers in CVD detection, prevention, and control. OBJECTIVES: Based on the growing evidence that many elements of chronic disease management can be shifted to nonphysician health care workers (NPHW), the HOPE-4 (Heart Outcomes Prevention and Evaluation Program) aimed to develop, test, and implement a training curriculum on CVD prevention and control in Colombia, Malaysia, and low-resource settings in Canada...
January 10, 2018: Global Heart
https://www.readbyqxmd.com/read/29330643/antihypertensive-medication-and-dementia-risk-in-older-adult-african-americans-with-hypertension-a-prospective-cohort-study
#14
Michael D Murray, Hugh C Hendrie, Kathleen A Lane, Mengjie Zheng, Roberta Ambuehl, Shanshan Li, Frederick W Unverzagt, Christopher M Callahan, Sujuan Gao
BACKGROUND: African Americans are especially at risk of hypertension and dementia. Antihypertensive medications reduce the risk of cardiovascular events, but may also reduce the risk of dementia. OBJECTIVE: To assess the longitudinal effects of antihypertensive medications and blood pressure on the onset of incident dementia in a cohort of African Americans. DESIGN: Prospective cohort. PARTICIPANTS: 1236 community-dwelling patients from an inner-city public health care system, aged 65 years and older, with a history of hypertension but no history of dementia, and who had at least three primary care visits and a prescription filled for any medication...
January 12, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29330165/survival-in-relation-to-multimorbidity-patterns-in-older-adults-in-primary-care-in-barcelona-spain-2010-2014-a-longitudinal-study-based-on-electronic-health-records
#15
Carolina Ibarra-Castillo, Marina Guisado-Clavero, Concepció Violan-Fors, Mariona Pons-Vigués, Tomàs López-Jiménez, Albert Roso-Llorach
BACKGROUND: Several studies have analysed the characteristics of multimorbidity patterns but none have evaluated the relationship with survival. The purpose of this study was to compare survival across older adults with different chronic multimorbidity patterns (CMPs). METHODS: Prospective longitudinal observational study using electronic health records for 190 108 people aged ≥65 years in Barcelona, Spain (2009-2014). CMPs were identified by cluster analysis...
January 12, 2018: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29329975/risk-of-suicide-and-non-fatal-self-harm-after-bariatric-surgery-results-from-two-matched-cohort-studies
#16
Martin Neovius, Gustaf Bruze, Peter Jacobson, Kajsa Sjöholm, Kari Johansson, Fredrik Granath, Johan Sundström, Ingmar Näslund, Claude Marcus, Johan Ottosson, Markku Peltonen, Lena M S Carlsson
BACKGROUND: Bariatric surgery reduces mortality, but might have adverse effects on mental health. We assessed the risk of suicide and self-harm after bariatric surgery compared with non-surgical obesity treatment. METHODS: Suicide and non-fatal self-harm events retrieved from nationwide Swedish registers were examined in two cohorts. The non-randomised, prospective Swedish Obese Subjects (SOS) study compared bariatric surgery (n=2010; 1369 vertical-banded gastroplasty, 376 gastric banding, and 265 gastric bypass) with usual care (n=2037; recruitment 1987-2001)...
January 9, 2018: Lancet Diabetes & Endocrinology
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/29329763/efficacy-and-safety-of-varenicline-for-smoking-cessation-in-people-living-with-hiv-in-france-anrs-144-inter-activ-a-randomised-controlled-phase-3-clinical-trial
#18
Patrick Mercié, Julie Arsandaux, Christine Katlama, Samuel Ferret, Aurélie Beuscart, Christian Spadone, Claudine Duvivier, Jacques Reynes, Nathalie Wirth, Laetitia Moinot, Antoine Bénard, David Zucman, Xavier Duval, Jean-Michel Molina, Bruno Spire, Catherine Fagard, Geneviève Chêne
BACKGROUND: Tobacco smoking is common in people living with HIV, but high-quality evidence on interventions for smoking cessation is not available in this population. We aimed to assess the efficacy and safety of varenicline with counselling to aid smoking cessation in people living with HIV. METHODS: The ANRS 144 Inter-ACTIV randomised, parallel, double-blind, multicentre, placebo-controlled phase 3 trial was done at 30 clinical hospital sites in France. People living with HIV who had smoked at least ten cigarettes per day for 1 year or longer, were motivated to stop smoking, were not dependent on another psychoactive substance, and had no history of depression or suicide attempt were eligible...
January 9, 2018: Lancet HIV
https://www.readbyqxmd.com/read/29324812/identifying-unmet-clinical-need-in-hypertrophic-cardiomyopathy-using-national-electronic-health-records
#19
Mar Pujades-Rodriguez, Oliver P Guttmann, Arturo Gonzalez-Izquierdo, Bram Duyx, Constantinos O'Mahony, Perry Elliott, Harry Hemingway
INTRODUCTION: To evaluate unmet clinical need in unselected hypertrophic cardiomyopathy (HCM) patients to determine the risk of a wide range of subsequent cardiovascular disease endpoints and safety endpoints relevant for trial design. METHODS: Population based cohort (CALIBER, linked primary care, hospital and mortality records in England, period 1997-2010), all people diagnosed with HCM were identified and matched by age, sex and general practice with ten randomly selected people without HCM...
2018: PloS One
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#20
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
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