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Specialty: Internal Medicine
Source: Evidence-Based Medicine
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Total 12 results found since Jan 2013.
Aspirin reduces cardiovascular events in primary prevention of cardiovascular disease but at a near equivalent risk of increased bleeding
Commentary on: Guirguis-Blake JM, Evans CV, Senger CA, et al.. Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the US Preventive Services Task Force. Ann Intern Med 2016;164:804–13 . Context The use of aspirin in primary prevention of cardiovascular disease (CVD) remains controversial, as randomised controlled trials (RCTs) have produced mixed results. Recently, the United States Preventive Services Task Force (USPSTF) published updated recommendations on the use of aspirin for primary prevention of CVD and colorectal cancer.1 This systematic review and meta-analysis serv...
Source: Evidence-Based Medicine - November 22, 2016 Category: Internal Medicine Authors: Miedema, M. D., Virani, S. S. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease Therapeutics/Prevention Source Type: research
Sugar-sweetened beverage consumption is linked to global adult morbidity and mortality through diabetes mellitus, cardiovascular disease and adiposity-related cancers
Commentary on: Singh GM, Micha R, Khatibzadeh S, et al., Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010. Circulation 2015;132:639–66 . Context Obesity and obesity-related non-communicable diseases are global health burdens associated with all-cause and cause-specific mortality, economic costs and impaired quality of life.1–3 Sugar-sweetened beverage (SSB) consumption has been linked with obesity and has long been thought to contribute to cardiometabolic diseases th...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Ruff, R. R. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Diet, Obesity (nutrition), Dentistry and oral medicine, Diabetes, Health education Aetiology/Harm Source Type: research
Ezetimibe provides incremental reduction in risk for cardiovascular events and need for revascularisation following an acute coronary syndrome
Commentary on: Cannon CP, Blazing MA, Giugliano RP, et al., IMPROVE-IT Investigators. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015;372:2387–97. Context Use of statin therapy to treat dyslipidemia in patients with established coronary artery disease is the standard of care worldwide. Given the negative results of a number of trials that tested the use of adjuvant lipid-lowering therapies against a statin background, there has been great scepticism about whether or not non-statin drugs provide incremental benefit.1–3 Ezetimibe inhibits the absorption of both dietary and bili...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Toth, P. P. Tags: Health policy, Epidemiologic studies, Genetics, Immunology (including allergy), Vaccination / immunisation, Stroke, Diet, Ischaemic heart disease, Health economics, Health service research, Lipid disorders Therapeutics/Prevention Source Type: research
The 'surprise' question may improve the accuracy of GPs in identifying death in patients with advanced stage IV solid-cell cancer
Commentary on: Moroni M, Zocchi D, Bolognesi D, et al.; on behalf of the SUQ-P group. The ‘surprise’ question in advanced cancer patients: a prospective study among general practitioners. Palliat Med 2014;28:,959–64. Context The ‘surprise’ question has been developed in order to improve the ability of clinicians to identify patients who are at risk of dying in the near future. The question, ‘Would I be surprised if this patient died in the next year?’ shifts the focus away from precise identification of dying patients to identifying patients who might be dying.1 This may enable mor...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Rhee, J., Clayton, J. M. Tags: EBM Prognosis, Pancreas and biliary tract, Palliative care, Epidemiologic studies, General practice / family medicine, Stroke, Prostate Source Type: research
Lung cancer CT screening is cost-effective but implementation matters
Commentary on: Black WC, Gareen IF, Soneji SS, et al.; National Lung Screening Trial Research Team. Cost-effectiveness of CT screening in the National Lung Screening Trial. N Engl J Med 2014;37:1793–802. Context The National Lung Screening Trial (NLST) revealed a 20% reduction in lung cancer mortality from three annual low-dose CT screening scans compared with chest radiographs in high-risk individuals.1 Since up to 10 million individuals in the USA may qualify for annual CT screening, policymakers have legitimately questioned whether the benefits of lung cancer screening justify the potential high costs of large-sca...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Goulart, B. Tags: Smoking and tobacco, Health policy, Epidemiologic studies, Stroke, Screening (oncology), Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Health economics, Health service research, Health education, Screening (publi Source Type: research
Fruit and vegetable consumption is associated with reduced all-cause and cardiovascular mortality
Commentary on: Wang X, Ouyang Y, Liu J, et al.. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ 2014;349:g4490 Context Dietary guidelines from around the world recommend the daily consumption of a variety of fruits and vegetables. For example, the ‘5 a day’ public health campaign in the UK encourages people to consume at least five 80 g portions of fruits and vegetables every day. These guidelines are largely based on recommendations from the WHO to consume at least 400&nb...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Crowe, F. L. Tags: Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Diet, Ischaemic heart disease, Health education, Smoking Therapeutics/Prevention Source Type: research
Lung cancer screening with low-dose CT (LDCT) is ready for prime time in the USA
Commentary on: Humphrey LL, Deffebach M, Pappas M, et al.. Screening for lung cancer with low-dose computed tomography: a systematic review to update the US Preventive Services Task Force recommendation. Ann Intern Med 2013;159:411–20. Context The US Preventative Services Task Force (USPSTF) has published their long-awaited, updated systematic review of low-dose CT (LDCT) screening for lung cancer. Last reviewed in 2004, lung cancer screening has been under intense study worldwide for the past decade. The issue of lung cancer screening is important because lung cancer is the leading cause of cancer mortality in the U...
Source: Evidence-Based Medicine - July 18, 2014 Category: Internal Medicine Authors: Wilson, D. O. Tags: Smoking and tobacco, Health policy, Clinical trials (epidemiology), Epidemiologic studies, Immunology (including allergy), Stroke, Screening (oncology), Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Health econom Source Type: research
Conservative management for low-risk prostate cancer improves quality-adjusted life expectancy at lower cost compared with initial treatment
Commentary on: Hayes JH, Ollendorf DA, Pearson SD, et al.. Observation versus initial treatment for men with localized, low-risk prostate cancer: a cost-effectiveness analysis. Ann Intern Med 2013;158:853–60. Context What is the best treatment for localised prostate cancer? This simple question, for a common disease now affecting about one in six North American men, does not have a clear answer. This is not a ‘normal’ situation in medicine. For most common diseases, including most primary cancers, there is usually a consensus as to the best therapeutic approach. Not so for localised prostate cancer. Surge...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Klotz, L. Tags: Epidemiologic studies, Stroke, Screening (oncology), Radiology, Surgical diagnostic tests, Clinical diagnostic tests, Prostate Economic analysis Source Type: research
Modest cancer prevention benefit with long-term multivitamin supplementation: Physicians' Health Study II results warrant cautious interpretation
Commentary on Gaziano JM, Sesso HD, Christen WG, et al.. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomised controlled trial. JAMA 2012;308:1871–80. Context Various vitamins and minerals have been shown to inhibit carcinogenesis or reduce cancer risk in preclinical experiments and observational studies. Such work has given rise to several chemoprevention trials of isolated nutrients, many of which (eg, Alpha-Tocopherol and Beta-Carotene (ATBC) Trial, Carotene and Retinol Efficacy Trial (CARET) and Selenium and Vitamin E Cancer Prevention Trial (SELECT)) have produced d...
Source: Evidence-Based Medicine - November 21, 2013 Category: Internal Medicine Authors: Demark-Wahnefried, W. Tags: Liver disease, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Diet, Prevention, Complementary medicine, Dermatology, Prostate Therapeutics Source Type: research
Lung cancer screening with low-dose CT: benefits and potential risks
Commentary on: Bach PB, Mirkin JN, Oliver TK, et al.. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA 2012;307:2418–29. Context Lung cancer is the leading cause of cancer death worldwide.1 The majority of patients present with advanced disease and the current 5-year survival is only 15%.2 Previous research showed no mortality benefit to screening with chest radiography and sputum cytology. The recent results of the National Lung Screening Trial (NLST) are the first to show a significant reduction in lung cancer mortality with the use of low-dose CT (LDCT) in high risk individuals. The po...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Tanner, N. T., Silvestri, G. A. Tags: Smoking and tobacco, Clinical trials (epidemiology), Epidemiologic studies, Stroke, Screening (oncology), Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Guidelines, Health education, Screening (public health), Smo Source Type: research
Opposite impacts of dietary versus supplemental calcium on cardiovascular health
Commentary on: Li K, Kaaks R, Linseisen J, et al.. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European prospective investigation into cancer and nutrition study (EPIC-Heidelberg). Heart 2012;98:920–5. Context Calcium supplementation is widely used to maintain bone health. Growing data suggests that calcium supplementation, but not dietary calcium intake, may harm cardiovascular (CV) health.1 2 There is no randomised controlled trial (RCT) that addressed CV events as primary endpoints...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Guessous, I., Bochud, M. Tags: EBM Prognosis, Clinical trials (epidemiology), Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Diet, Ischaemic heart disease Source Type: research
Aspirin prophylaxis in people without prior cardiovascular disease does not lead to reductions in cardiovascular death or cancer mortality
Commentary on: Seshasai SR, Wijesuriya S, Sivakumaran R, et al.. Effect of aspirin on vascular and nonvascular outcomes: meta-analysis of randomized controlled trials. Arch Intern Med 2012;172:209–16. Context Prophylactic antiplatelet therapy with aspirin reduces the risk of non-fatal myocardial infarction (MI), non-fatal stroke and vascular death in patients with known cardiovascular disease (CVD) and is of net benefit. The absolute reduction in recurrent events significantly exceeds the increase in major bleeding.1 However, the role of aspirin in primary prevention of CVD is not clear. According to the Antithrombot...
Source: Evidence-Based Medicine - March 19, 2013 Category: Internal Medicine Authors: Farooq, M. U., Gorelick, P. B. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Prevention, Ischaemic heart disease Online articles Source Type: research
