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https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#1
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28229164/are-cardiovascular-risk-factors-also-associated-with-the-incidence-of-atrial-fibrillation-a-systematic-review-and-field-synopsis-of-23-factors-in-32-population-based-cohorts-of-20-million-participants
#2
Victoria Allan, Shohreh Honarbakhsh, Juan-Pablo Casas, Joshua Wallace, Ross Hunter, Richard Schilling, Pablo Perel, Katherine Morley, Amitava Banerjee, Harry Hemingway
Established primary prevention strategies of cardiovascular diseases are based on understanding of risk factors, but whether the same risk factors are associated with atrial fibrillation (AF) remains unclear. We conducted a systematic review and field synopsis of the associations of 23 cardiovascular risk factors and incident AF, which included 84 reports based on 28 consented and four electronic health record cohorts of 20,420,175 participants and 576,602 AF events. We identified 3-19 reports per risk factor and heterogeneity in AF definition, quality of reporting, and adjustment...
February 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28228902/mri-diagnosis-of-herpes-simplex-encephalitis-in-an-elderly-man-with-nonspecific-symptoms
#3
Benjamin J Croll, Zachary M Dillon, Kevin R Weaver, Marna Rayl Greenberg
A 78-year-old male presented to the Emergency Department complaining of a 1-week onset of increasing fatigue and anorexia. The patient was previously well but had a history of depression, chronic diarrhea, and hypertension. His examination was remarkable for mild fever (100.1°F). He had no acute neurologic deficits. The patient felt better after intravenous fluids and was discharged to follow-up with the primary care provider. With no resolution of symptoms and new memory loss, the patient's primary care doctor ordered an MRI which revealed abnormal signal/patchy enhancement of the left temporal lobe indicative (pathognomonic) of herpes simplex encephalitis...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228887/transarterial-embolization-of-a-hyperfunctioning-aldosteronoma-in-a-patient-with-bilateral-adrenal-nodules
#4
Jason T Salsamendi, Francisco J Gortes, Alejandro R Ayala, Juan D Palacios, Sanjit Tewari, Govindarajan Narayanan
Primary hyperaldosteronism often results in resistant hypertension and hypokalemia, which may lead to cardiovascular and cerebrovascular complications. Although surgery is first line treatment for unilateral functioning aldosteronomas, minimally invasive therapies may be first line for certain patients such as those who cannot tolerate surgery. We present a case of transarterial embolization (TAE) of an aldosteronoma. The patient presented with a cerebrovascular accident, and subsequently developed uncontrolled hypertension, hypokalemia, and a myocardial infarction...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228293/cardiorenal-syndrome-type-4-a-study-of-cardiovascular-diseases-in-chronic-kidney-disease
#5
Suresh H, Arun B S, Venkatesh Moger, Mallikarjuna Swamy
INTRODUCTION: The heart and the kidneys are tightly interlinked with each other. So, primary disorder of one of these organs often results in the secondary dysfunction of other. Such interactions play a vital role in the pathogenesis of a clinical entity called cardio-renal syndrome (CRS). CRS type 4 refers to the development of cardiac failure in the patients with CKD. OBJECTIVES: To study the prevalence of various cardiac diseases in the patients with CKD and risk factors for it...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28225483/homocysteine-and-all-cause-mortality-in-hypertensive-adults-without-pre-existing-cardiovascular-conditions-effect-modification-by-mthfr-c677t-polymorphism
#6
Benjamin Xu, Xiangyi Kong, Richard Xu, Yun Song, Lishun Liu, Ziyi Zhou, Rui Gu, Xiuli Shi, Min Zhao, Xiao Huang, Mingli He, Jia Fu, Yefeng Cai, Ping Li, Xiaoshu Cheng, Changyan Wu, Fang Chen, Yan Zhang, Genfu Tang, Xianhui Qin, Binyan Wang, Hao Xue, Yundai Chen, Ye Tian, Ningling Sun, Yimin Cui, Fan Fan Hou, Jianping Li, Yong Huo
BACKGROUND: Previous studies support an association between elevated total homocysteine (tHcy) levels and increased all-cause mortality. However, few prospective studies have examined this association in hypertensive patients, and/or tested any effect modification by the methylene tetrahydrofolate reductase (MTHFR) C677T genotype. METHODS: This was a post hoc analysis of the China Stroke Primary Prevention Trial. Serum tHcy and folate were measured at baseline. Individual MTHFR C677T genotype (CC, CT, and TT) was determined...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28225307/17a-hydroxylase-17-20-lyase-deficiency-clinical-and-molecular-characterization-of-eight-chinese-patients
#7
Chaoming Wu, Shanshan Fan, Yanying Qian, Yingying Zhou, Jian Jin, Zhijuan Dai, Ling Jiang
BACKGROUND: 17α-hydroxylase/17, 20-lyase deficiency (17OHD) is caused by mutations in CYP17A1 gene. OBJECTIVE: To better understand 17OHD, a rare disease, we described the clinical features and analyzed the CYP17A1 gene in eight affected Chinese patients. METHODS: Patients with complete (7/8) or partial (1/8) 17OHD were derived from six families. The diagnosis was established according to their clinical, biochemical, hormonal and radiological characteristics...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28224974/differences-in-outcomes-in-patients-with-stable-coronary-artery-disease-managed-by-cardiologists-versus-non-cardiologists-the-international-prospective-clarify-registry
#8
Zofia Parma, Philippe Gabriel Steg, Nicola Greenlaw, Roberto Ferrari, Ian Ford, Kim Fox, Jean-Claude Tardif, Joao Morais, Marco Alcocer Gamba, Stefan Kääb, Michał Tendera
INTRODUCTION    Clinical outcomes of patients with stable coronary artery disease (SCAD) may differ between those primarily managed by cardiologists versus non-cardiologists.  OBJECTIVES    Our main objective was to analyze the clinical outcomes of outpatients with SCAD in relation to the specialty of the managing physicians.  PATIENTS AND METHODS    We studied 32,468 outpatients with SCAD included in the CLARIFY registry, with up to 4 years follow-up data. Cardiologists provided medical care in 84...
January 20, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28224930/incidence-of-severe-renal-dysfunction-among-individuals-taking-warfarin-and-implications-for-non-vitamin-k-oral-anticoagulants
#9
Christina L Fanola, Deirdre Mooney, Andrew J Cowan, Darae Ko, Emily K Sisson, Lori E Henault, Yorghos Tripodis, Elaine M Hylek
BACKGROUND: The purpose of this study is to assess incidence and risk factors for severe renal dysfunction in patients requiring oral anticoagulation to help guide initial drug choice and provide a rational basis for interval monitoring of renal function for patients prescribed non-vitamin K oral anticoagulants. METHODS: Patients on warfarin for atrial fibrillation or venous thromboembolism were consecutively enrolled from January 2007 to December 2010. Baseline kidney function was assessed, and patients were followed to their first decline of kidney function to creatinine clearance<30 mL/min...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28224720/pyridostigmine-bromide-versus-fludrocortisone-in-the-treatment-of-orthostatic-hypotension-in-parkinson-s-disease-a-randomized-controlled-trial
#10
S R Schreglmann, F Büchele, M Sommerauer, L Epprecht, G Kägi, S Hägele-Link, O Götze, L Zimmerli, D Waldvogel, C R Baumann
BACKGROUND AND PURPOSE: Evidence for effective treatment options for orthostatic hypotension (OH) in Parkinson's disease (PD) is scarce. Elevation of cholinergic tone with pyridostigmine bromide has been reported as a way to improve blood pressure (bp) regulation in neurogenic hypotension without causing supine hypertension. METHODS: This was a double-centre, double-blind, randomized, active-control, crossover, phase II non-inferiority trial of pyridostigmine bromide for OH in PD (clinicaltrials...
February 22, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28223722/to-screen-or-not-to-screen-celiac-antibodies-in-liver-diseases
#11
REVIEW
Janaína Luz Narciso-Schiavon, Leonardo Lucca Schiavon
Celiac disease (CD) is a systemic immune-mediated disorder triggered by dietary gluten in genetically predisposed individuals. The typical symptoms are anemia, diarrhea, fatigue, weight loss, and abdominal pain. CD has been reported in patients with primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis, aminotransferase elevations, nonalcoholic fatty liver disease, hepatitis B, hepatitis C, portal hypertension and liver cirrhosis. We evaluate recommendations for active screening for CD in patients with liver diseases, and the effect of a gluten-free diet in these different settings...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28223208/characterizing-the-poagome-a-bioinformatics-driven-approach-to-primary-open-angle-glaucoma
#12
REVIEW
Ian D Danford, Lana D Verkuil, Daniel J Choi, David W Collins, Harini V Gudiseva, Katherine E Uyhazi, Marisa K Lau, Levi N Kanu, Gregory R Grant, Venkata R M Chavali, Joan M O'Brien
Primary open-angle glaucoma (POAG) is a genetically, physiologically, and phenotypically complex neurodegenerative disorder. This study addressed the expanding collection of genes associated with POAG, referred to as the "POAGome." We used bioinformatics tools to perform an extensive, systematic literature search and compiled 522 genes with confirmed associations with POAG and its related phenotypes (normal tension glaucoma, ocular hypertension, juvenile open-angle glaucoma, and primary congenital glaucoma)...
February 18, 2017: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/28223154/idiopathic-and-systemic-sclerosis-associated-pulmonary-arterial-hypertension-a-comparison-of-demographic-haemodynamic-and-magnetic-resonance-imaging-characteristics-and-outcomes
#13
Sheila Ramjug, Nehal Hussain, Judith Hurdman, Catherine Billings, Athanasios Charampopoulos, Charlie A Elliot, David G Kiely, Ian Sabroe, Smitha Rajaram, Andrew J Swift, Robin Condliffe
BACKGROUND: Previous studies have identified survival in systemic sclerosis (SSc)-associated pulmonary arterial hypertension (SSc-PAH) to be worse than in idiopathic pulmonary arterial hypertension (IPAH). We investigated differences between these conditions by comparing demographic, haemodynamic and radiological characteristics and outcomes in a large cohort of incident patients. METHODS: 651 patients diagnosed with IPAH or SSc-associated pre-capillary pulmonary hypertension were included...
February 18, 2017: Chest
https://www.readbyqxmd.com/read/28223086/long-term-10-year-outcomes-after-laparoscopic-roux-en-y-gastric-bypass
#14
Shanu N Kothari, Andrew J Borgert, Kara J Kallies, Matthew T Baker, Brandon T Grover
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the "gold standard" for weight loss surgery. Long-term data are limited, and reporting methods for LRYGB outcomes vary in the literature. In addition, follow-up compliance within bariatric centers is poor due to insurance and access to care issues, making long-term follow-up evaluation difficult. OBJECTIVE: Evaluate long-term LRYGB outcomes using standard outcome reporting definitions. SETTING: Integrated multispecialty health system...
December 22, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28220472/renal-denervation-for-resistant-hypertension
#15
REVIEW
Giuseppe Coppolino, Anna Pisano, Laura Rivoli, Davide Bolignano
BACKGROUND: Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28220020/randomized-phase-ii-study-of-ramucirumab-or-icrucumab-in-combination-with-capecitabine-in-patients-with-previously-treated-locally-advanced-or-metastatic-breast-cancer
#16
Linda T Vahdat, Rachel Layman, Denise A Yardley, William Gradishar, Mohamad A Salkeni, Anil Abraham Joy, Agustin A Garcia, Patrick Ward, James Khatcheressian, Joseph Sparano, Gladys Rodriguez, Shande Tang, Ling Gao, Rita P Dalal, John Kauh, Kathy Miller
BACKGROUND: Icrucumab (ICR) and ramucirumab (RAM) bind vascular endothelial growth factor (VEGF) receptors 1 and 2 (VEGFR-1 and -2), respectively. This open-label, randomized phase II study evaluated their efficacy and safety in combination with capecitabine (CAP) in patients with previously treated unresectable, locally advanced or metastatic breast cancer. METHODS: Patients were randomly assigned (1:1:1) to receive CAP (1,000 mg/m(2) orally twice daily, days 1-14) alone or in combination with RAM (10 mg/kg intravenously [IV], days 1 and 8) (RAM + CAP) or ICR (12 mg/kg IV, days 1 and 8) (ICR + CAP) every 21 days...
February 20, 2017: Oncologist
https://www.readbyqxmd.com/read/28218404/topical-medication-instillation-techniques-for-glaucoma
#17
REVIEW
Li Xu, Xuemei Wang, Meijing Wu
BACKGROUND: Glaucoma is a leading cause of irreversible blindness worldwide and the second most common cause of blindness after cataracts. The primary treatment for glaucoma aims to lower intraocular pressure (IOP) with the use of topical medicines. Topical medication instillation techniques, such as eyelid closure and nasolacrimal occlusion when instilling drops, have been proposed as potential methods to increase ocular absorption and decrease systemic absorption of the drops. OBJECTIVES: To investigate the effectiveness of topical medication instillation techniques compared with usual care or another method of instillation of topical medication in the management of glaucoma or ocular hypertension...
February 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28217594/effectiveness-of-yoga-program-in-the-management-of-diabetes-using-community-health-workers-in-the-urban-slums-of-bangalore-city-a-non-randomized-controlled-trial
#18
Hemavathi Dasappa, Farah Naaz Fathima, Rugmani Prabhakar
TRIAL DESIGN: Nonrandomized controlled trial. METHODS: Nonrandomized controlled trial. This was an interventional study that was conducted in 4 slums of Bengaluru. Of the 256 diabetes participants, only 109 people agreed to participate in the program. Of 109 people, 52 people agreed to participate in the intervention (agreed to learn and practice Yoga) while the remaining 57 people were assigned to nonintervention group. Randomization and blinding could not be done...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217585/blood-pressure-bp-control-and-perceived-family-support-in-patients-with-essential-hypertension-seen-at-a-primary-care-clinic-in-western-nigeria
#19
Oluwaseun S Ojo, Sunday O Malomo, Peter T Sogunle
CONTEXT: Nonadherence to therapeutic plans has been reported among hypertensive patients. Researchers have also shown that adherence to therapeutic plans improves if motivation in the form of social support is provided. There is a dearth of local studies that explore the influence of family support on treatment outcomes of hypertensive patients. AIMS: The aim of the study was to determine the relationship between BP control and perceived family support in patients with essential hypertension seen at a primary care setting in Western Nigeria...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28216704/attenuation-of-haemodynamic-responses-to-laryngoscopy-and-endotracheal-intubation-with-intravenous-dexmedetomidine-a-comparison-between-two-doses
#20
Bon Sebastian, Anand T Talikoti, Dinesh Krishnamurthy
BACKGROUND AND AIMS: Laryngoscopic manipulation and endotracheal intubation are noxious stimuli capable of producing tachycardia, arrhythmias and hypertension. The aim of this study was to arrive at an optimal dose of dexmedetomidine by comparing two doses with placebo to attenuate stress response during laryngoscopy and endotracheal intubation. METHODS: It was a randomised, prospective, double-blind placebo-controlled study. After Institutional Ethical Committee clearance, ninety patients of American Society of Anesthesiologists Physical Status 1 were enrolled in the study and divided into three equal groups...
January 2017: Indian Journal of Anaesthesia
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