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https://www.readbyqxmd.com/read/28918428/modification-of-cardiovascular-pharmacotherapy-in-palliative-care-patients-with-cancer-narrative-review
#1
Tomasz Pasierski
Palliative care cancer patients are treated with many drugs especially at the end of life. Limiting of polypharmacy a decreases the risk of associated adverse effects, medical errors and harmful drug interactions The time lag to benefit of many medications used for cardiovascular diseases or risk factors like hypertension, hypercholesterolemia is frequently longer than palliative care cancer patient's life expectancy. It is ethically appropriate to modify, even to discontinue cardiovascular pharmacotherapy when there is no prospect of benefit...
September 13, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28917688/a-randomized-trial-of-pocket-echocardiography-integrated-mobile-health-device-assessments-in-modern-structural-heart-disease-clinics
#2
Sanjeev P Bhavnani, Srikanth Sola, David Adams, Ashwin Venkateshvaran, P K Dash, Partho P Sengupta
OBJECTIVES: This study sought to determine whether mobile health (mHealth) device assessments used as clinical decision support tools at the point-of-care can reduce the time to treatment and improve long-term outcomes among patients with rheumatic and structural heart diseases (SHD). BACKGROUND: Newly developed smartphone-connected mHealth devices represent promising methods to diagnose common diseases in resource-limited areas; however, the impact of technology-based care on long-term outcomes has not been rigorously evaluated...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28916548/do-comorbidities-play-a-role-in-hand-osteoarthritis-disease-burden-data-from-the-hand-osteoarthritis-in-secondary-care-cohort
#3
Wendy Damman, Rani Liu, Féline P B Kroon, Monique Reijnierse, Tom W J Huizinga, Frits R Rosendaal, Margreet Kloppenburg
OBJECTIVE: Because the association and its clinical relevance between comorbidities and primary hand osteoarthritis (OA) disease burden is unclear, we studied this in patients with hand OA from our Hand OSTeoArthritis in Secondary care (HOSTAS) cohort. METHODS: Cross-sectional data from the HOSTAS study were used, including consecutive patients with primary hand OA. Nineteen comorbidities were assessed: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥ 30 kg/m(2))...
September 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28914276/appropriate-reconciliation-of-cardiovascular-medications-after-elective-surgery-and-postdischarge-acute-hospital-and-ambulatory-visits
#4
Jonathan S Lee, Ralph Gonzales, Eric Vittinghoff, Kitty K Corbett, Kirsten E Fleischmann, Neil Sehgal, Andrew D Auerbach
OBJECTIVE: To describe appropriate discharge reconciliation of cardiovascular medications and assess associations with postdischarge healthcare utilization in surgical patients. DESIGN: Retrospective cohort study from January 2007 to December 2011. SETTING: An academic medical center. PATIENTS: Seven hundred and fifty-two adults undergoing elective noncardiac surgery and taking antiplatelet agents, beta-blockers, renin-angiotensin system inhibitors, or statin lipid-lowering agents before surgery...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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
#5
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/28910237/effects-of-once-weekly-exenatide-on-cardiovascular-outcomes-in-type-2-diabetes
#6
Rury R Holman, M Angelyn Bethel, Robert J Mentz, Vivian P Thompson, Yuliya Lokhnygina, John B Buse, Juliana C Chan, Jasmine Choi, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Steven P Marso, Peter Öhman, Neha J Pagidipati, Neil Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez
Background The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. Methods We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28905004/gastroenteritis-aggressive-versus-slow-treatment-for-rehydration-gastro-a-pilot-rehydration-study-for-severe-dehydration-who-plan-c-versus-slower-rehydration
#7
Kirsty A Houston, Jack G Gibb, Ayub Mpoya, Nchafatso Obonyo, Peter Olupot-Olupot, Margeret Nakuya, Jennifer A Evans, Elizabeth C George, Diana M Gibb, Kathryn Maitland
BACKGROUND: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28902230/chronic-kidney-disease-and-metabolic-syndrome-as-risk-factors-for-cardiovascular-disease-in-a-primary-care-program
#8
Suzana Greffin, Mauro Barros André, Jorge Paulo Strogoff de Matos, Hye Chung Kang, Antonio José Lagoeiro Jorge, Maria Luiza Garcia Rosa, Jocemir Ronaldo Lugon
Introduction: Cardiovascular disease (CVD) is especially prevalent in patients with chronic kidney disease (CKD). Objective: To evaluate the role of CKD and metabolic syndrome (MS), which is a cluster of risk factors for CVD, as predictors of CVD. Methods: Observational, cross-sectional study with a random sample aged 45 or more years extracted from the population assisted by the primary care program in Niterói city in the state of Rio de Janeiro, Brazil...
August 28, 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28901219/primary-prevention-of-stroke-and-cardiovascular-disease-in-the-community-prevents-methodology-of-a-health-wellness-coaching-intervention-to-reduce-stroke-and-cardiovascular-disease-risk-a-randomized-clinical-trial
#9
Susan Mahon, Rita Krishnamurthi, Alain Vandal, Emma Witt, Suzanne Barker-Collo, Priya Parmar, Alice Theadom, Alan Barber, Bruce Arroll, Elaine Rush, Hinemoa Elder, Jesse Dyer, Valery Feigin
Rationale Stroke is a major cause of death and disability worldwide, yet 80% of strokes can be prevented through modifications of risk factors and lifestyle and by medication. While management strategies for primary stroke prevention in high cardiovascular disease risk individuals are well established, they are underutilized and existing practice of primary stroke prevention are inadequate. Behavioral interventions are emerging as highly promising strategies to improve cardiovascular disease risk factor management...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28898445/characterizing-adults-with-type-2-diabetes-mellitus-and-intellectual-disability-outcomes-of-a-case-finding-study
#10
L D Bryant, A M Russell, R E A Walwyn, A J Farrin, A Wright-Hughes, E H Graham, D Nagi, A Stansfield, J Birtwistle, S Meer, R A Ajjan, A O House
AIMS: To report the results of a case-finding study conducted during a feasibility trial of a supported self-management intervention for adults with mild to moderate intellectual disability and Type 2 diabetes mellitus, and to characterize the study sample in terms of diabetes control, health, and access to diabetes management services and support. METHODS: We conducted a cross-sectional case-finding study in the UK (March 2013 to June 2015), which recruited participants mainly through primary care settings...
September 12, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28898331/-coverage-of-a-screening-program-and-prevalence-of-diabetic-retinopathy-in-primary-care%C3%A3
#11
Trinidad Covarrubias, Iris Delgado, Daniel Rojas, Marcelo Coria
BACKGROUND: Diabetic retinopathy is the first cause of blindness during working years. AIM: Provide knowledge of screening coverage, prevalence and level of diabetic retinopathy in patients that belong to the Cardiovascular Health Program in primary care. MATERIAL AND METHODS: Analysis of retinographies performed to 9076 diabetic patients aged 61 ± 13 years (61% women) adscribed to a Cardiovascular Health program in primary care centers of South-East Metropolitan Santiago...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28895640/the-application-of-sudoscan-for-screening-diabetic-peripheral-neuropathy-in-chinese-population-screening-dpn-by-sudoscan
#12
Jiewen Jin, Weimin Wang, Tianwei Gu, Wei Chen, Jing Lu, Yan Bi, Dalong Zhu
Purpose Diabetic peripheral neuropathies are the common chronic complications of diabetes, but the diagnosis is insensitive by physical examination in busy outpatients. Here we evaluated the performance of SUDOSCAN in screening diabetic peripheral neuropathies in Chinese type 2 diabetic patients. Methods The study enrolled 180 patients for annually screening. All patients underwent neurological symptoms assessment, clinical examination, nerve conduction studies and cardiovascular autonomic reflex tests. SUDOSCAN was tested and evaluated with electrochemical skin conductance in hands and feet, asymmetry ratio in hands and feet and predicted cardiac neuropathy...
September 11, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28895030/type-2-diabetes-and-cardiovascular-prevention-the-dogmas-disputed
#13
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
In randomized controlled trials (RCTs), more intensive glucose control in patients with type 2 diabetes leads to a modest (9%) reduction in major cardiovascular events (MACE), associated with a 20% reduction of kidney events and 13% reduction of eye events. The FDA issued guidance in 2008 led to the conduct of numerous cardiovascular outcomes (CVOT) trials to assess cardiovascular safety of new antihyperglycemic therapies in patients with type 2 diabetes. The results of these trials show that insulin glargine, three different dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, alogliptin, and sitagliptin) and lixisenatide (a glucagon like peptide-1 receptor agonist) produce no significant difference in CVOT when compared with usual care or placebo...
September 11, 2017: Endocrine
https://www.readbyqxmd.com/read/28892727/a-review-of-simulation-enhanced-team-based-cardiopulmonary-resuscitation-training-for-undergraduate-students
#14
REVIEW
Arif Onan, Nurettin Simsek, Melih Elcin, Sevgi Turan, Bülent Erbil, Kaan Zülfikar Deniz
Cardiopulmonary resuscitation training is an essential element of clinical skill development for healthcare providers. The International Liaison Committee on Resuscitation has described issues related to cardiopulmonary resuscitation and emergency cardiovascular care education. Educational interventions have been initiated to try to address these issues using a team-based approach and simulation technologies that offer a controlled, safe learning environment. The aim of the study is to review and synthesize published studies that address the primary question "What are the features and effectiveness of educational interventions related to simulation-enhanced, team-based cardiopulmonary resuscitation training?" We conducted a systematic review focused on educational interventions pertaining to cardiac arrest and emergencies that addressed this main question...
September 4, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28890062/national-utilization-and-outcomes-of-redo-lower-extremity-bypass-vs-endovascular-intervention-after-previous-failed-bypass-redo-lower-extremity-bypass-superior-to-endovascular-intervention
#15
J Hunter Mehaffey, Alexander Shannon, Robert B Hawkins, Anna Fashandi, Margret C Tracci, Irving L Kron, Gilbert R Upchurch, William P Robinson
BACKGROUND: Redo Lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are options to treat critical limb ischemia after a failed prior lower extremity bypass but the utilization and outcomes of each are poorly described. The purpose of this study was to compare 30-day Major Adverse Limb Events (MALE) and Major Adverse Cardiovascular Events (MACE) after LEB and IEI in patients with a failed prior ipsilateral LEB and determine risk factors for each composite outcome...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28889825/enhancement-of-diuresis-with-metolazone-in-infant-paediatric-cardiac-intensive-care-patients
#16
Russell T Wise, Brady S Moffett, Ayse Akcan-Arikan, Marianne Galati, Natasha Afonso, Paul A Checchia
BACKGROUND: Few data are available regarding the use of metolazone in infants in cardiac intensive care. Researchers need to carry out further evaluation to characterise the effects of this treatment in this population. METHODS: This is a descriptive, retrospective study carried out in patients less than a year old. These infants had received metolazone over a 2-year period in the paediatric cardiac intensive care unit at our institution. The primary goal was to measure the change in urine output from 24 hours before the start of metolazone therapy to 24 hours after...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28887828/opportunities-for-students-to-prescribe-an-evaluation-of-185-consultations-in-the-student-run-cardiovascular-risk-management-programme
#17
Tim Schutte, Katinka Prince, Milan Richir, Erik Donker, Leonie van Gastel, Ferdynand Bastiaans, Henk de Vries, Jelle Tichelaar, Michiel van Agtmael
Involving students in CVRM could offer patients a structured CVRM programme and students a valuable learning opportunity. We describe and evaluate a student-run CVRM programme that was set up to offer primary prevention to patients with known risk factors in a general practitioner's practice. During a consultation, two undergraduate medical students assessed the patients' actual risk and formulated a CVRM plan, which they discussed with the patient after approval by a GP. After the consultations, patients were asked to complete evaluation/feedback questionnaires...
September 9, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28885223/prescription-audit-of-nsaids-and-gastroprotective-strategy-in-elderly-in-primary-care
#18
Khalid Ahmed Jassim Al Khaja, Sindhan Veeramuthu, Husain Ahmed Isa, Reginald Paul Sequeira
BACKGROUND: The use of non-steroidal anti-inflammatory drug (NSAIDs) is deemed a major risk factor for peptic ulcer disease in elderly population that requires concomitant therapy with gastroprotective agents (GPAs). OBJECTIVE: This study evaluated the rational prescribing of NSAIDs and GPAs, and extent of adherence to the guideline recommendations in primary care. METHODS: Nationwide audit of prescriptions issued to elderly patients (≥65 years) with hypertension or diabetic hypertension in primary care...
2017: International Journal of Risk & Safety in Medicine
https://www.readbyqxmd.com/read/28884731/-optimization-of-the-algorithm-for-the-detection-and-the-differential-non-pharmacological-correction-of-the-risk-factors-and-the-preclinical-stages-of-atherosclerosis-at-the-level-of-the-health-resort-based-primary-care
#19
M A Vartazaryan, A T Bykov, A V Chernyshev, L S Khodasevich
This article presents the results of a comparative prospective study of 276 subjects at the age between 40 and 65 years presenting with risk factors (RF) of atherosclerosis and its preclinical stages (APC). All of them were reckoned to be at a moderate risk of developing APC based on the results of evaluation with the use of the SCORE scale which implied the necessity of their differential non-pharmacological treatment during a two-year period with the application of a variety of preventive therapeutic strategies...
2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/28882733/-risk-of-fatal-non-fatal-events-in-patients-with-previous-coronary-heart-disease-acute-myocardial-infarction-and-treatment-with-non-steroidal-anti-inflammatory-drugs
#20
REVIEW
L Muñoz Olmo, J Juan Armas, J J Gomariz García
BACKGROUND: Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk...
September 4, 2017: Semergen
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