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Specialty: Internal Medicine
Source: PLoS Medicine
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Total 24 results found since Jan 2013.

Association of ischemic stroke onset time with presenting severity, acute progression, and long-term outcome: A cohort study
ConclusionsNight-onset strokes, compared with day-onset strokes, are associated with higher presenting neurologic severity, more frequent END, and worse 3-month functional outcome. These findings suggest that circadian time of onset is an important additional variable for inclusion in epidemiologic natural history studies and in treatment trials of neuroprotective and reperfusion agents for acute ischemic stroke.
Source: PLoS Medicine - February 4, 2022 Category: Internal Medicine Authors: Wi-Sun Ryu Source Type: research

Long-term risk of a major cardiovascular event by apoB, apoA-1, and the apoB/apoA-1 ratio —Experience from the Swedish AMORIS cohort: A cohort study
ConclusionsAn imbalance between apoB and apoA-1 resulting in an increased apoB/apoA-1 ratio is strongly associated with the outcome MACE and its sub-components, in both men and women of all ages. An increased apoB/apoA-1 ratio already 2 decades before events calls for early recognition and primary prevention. Simple evidence-based cut values should be considered in future cardiovascular guidelines.
Source: PLoS Medicine - December 1, 2021 Category: Internal Medicine Authors: G öran Walldius Source Type: research

Consumption of coffee and tea and risk of developing stroke, dementia, and poststroke dementia: A cohort study in the UK Biobank
by Yuan Zhang, Hongxi Yang, Shu Li, Wei-dong Li, Yaogang Wang BackgroundPrevious studies have revealed the involvement of coffee and tea in the development of stroke and dementia. However, little is known about the association between the combination of coffee and tea and the risk of stroke, dementia, and poststroke dementia. Therefore, we aimed to investigate the associations of coffee and tea separately and in combination with the risk of developing stroke and dementia. Methods and findingsThis prospective cohort study included 365,682 participants (50 to 74 years old) from the UK Biobank. Participants joined the study f...
Source: PLoS Medicine - November 16, 2021 Category: Internal Medicine Authors: Yuan Zhang Source Type: research

Intrinsic capacity and its associations with incident dependence and mortality in 10/66 Dementia Research Group studies in Latin America, India, and China: A population-based cohort study
ConclusionsIn this study we observed a high prevalence of DICs, particularly in older age groups. Those affected had substantially increased risks of dependence and death. Most needs for care arose in those with DIC yet to become frail. Our findings provide some support for the strategy of optimising intrinsic capacity in pursuit of healthy ageing. Implementation at scale requires community-based screening and assessment, and a stepped-care intervention approach, with redefined roles for community healthcare workers and efforts to engage, train, and support them in these tasks. ICOPE might be usefully integrated into commu...
Source: PLoS Medicine - September 14, 2021 Category: Internal Medicine Authors: Martin J. Prince Source Type: research

Telmisartan use and risk of dementia in type 2 diabetes patients with hypertension: A population-based cohort study
by Chi-Hung Liu, Pi-Shan Sung, Yan-Rong Li, Wen-Kuan Huang, Tay-Wey Lee, Chin-Chang Huang, Tsong-Hai Lee, Tien-Hsing Chen, Yi-Chia Wei BackgroundAngiotensin receptor blockers (ARBs) may have protective effects against dementia occurrence in patients with hypertension (HTN). However, whether telmisartan, an ARB with peroxisome proliferator-activated receptor γ (PPAR-γ)–modulating effects, has additional benefits compared to other ARBs remains unclear. Methods and findingsBetween 1997 and 2013, 2,166,944 type 2 diabetes mellitus (T2DM) patients were identified from the National Health Insurance Research Database of Taiwa...
Source: PLoS Medicine - July 19, 2021 Category: Internal Medicine Authors: Chi-Hung Liu Source Type: research

Evaluation of a package of risk-based pharmaceutical and lifestyle interventions in patients with hypertension and/or diabetes in rural China: A pragmatic cluster randomised controlled trial
by Xiaolin Wei, Zhitong Zhang, Marc K. C. Chong, Joseph P. Hicks, Weiwei Gong, Guanyang Zou, Jieming Zhong, John D. Walley, Ross E. G. Upshur, Min Yu BackgroundPrimary prevention of cardiovascular disease (CVD) requires adequate control of hypertension and diabetes. We designed and implemented pharmaceutical and healthy lifestyle interventions for patients with diabetes and/or hypertension in rural primary care, and assessed their effectiveness at reducing severe CVD events. Methods and findingsWe used a pragmatic, parallel group, 2-arm, controlled, superiority, cluster trial design. We randomised 67 township hospitals in ...
Source: PLoS Medicine - July 1, 2021 Category: Internal Medicine Authors: Xiaolin Wei Source Type: research

Opportunistic screening for atrial fibrillation by clinical pharmacists in UK general practice during the influenza vaccination season: A cross-sectional feasibility study
ConclusionsThis study demonstrates that AF screening performed by GP practice –based pharmacists was feasible, economically viable, and positively endorsed by participants. Furthermore, diagnosis of AF by the clinical pharmacist using anSLECG was more sensitive and more specific than the use of pulse palpation alone. Future research should explore the key barriers preventing the adoption of national screening programmes.
Source: PLoS Medicine - July 16, 2020 Category: Internal Medicine Authors: Vilius Savickas Source Type: research

Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study
This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. Methods and findingsWe harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54 –105 (mean = 72.7) years and without dementia at baseline. Studies had 2–15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mas...
Source: PLoS Medicine - July 22, 2019 Category: Internal Medicine Authors: Darren M. Lipnicki Source Type: research

Lifetime risk and multimorbidity of non-communicable diseases and disease-free life expectancy in the general population: A population-based cohort study
ConclusionsOur study suggests that in this western European community, 9 out of 10 individuals aged 45 years and older develop an NCD during their remaining lifetime. Among those individuals who develop an NCD, at least a third are subsequently diagnosed with multiple NCDs. Absence of 3 common shared risk factors is associated with compression of morbidity of NCDs. These findings underscore the importance of avoidance of these common shared risk factors to reduce the premature morbidity and mortality attributable to NCDs.
Source: PLoS Medicine - February 4, 2019 Category: Internal Medicine Authors: Silvan Licher Source Type: research

Nilvadipine in mild to moderate Alzheimer disease: A randomised controlled trial
This study reports the findings of the first large-scale Phase III investigator-driven clinical trial to slow the rate of cognitive decline in Alzheimer disease with a dihydropyridine (DHP) calcium channel blocker, nilvadipine. Nilvadipine, licensed to treat hypertension, reduces amyloid production, increases regional cerebral blood flow, and has demonstrated anti-inflammatory and anti-tau activity in preclinical studies, properties that could have disease-modifying effects for Alzheimer disease. We aimed to determine if nilvadipine was effective in slowing cognitive decline in subjects with mild to moderate Alzheimer dise...
Source: PLoS Medicine - September 24, 2018 Category: Internal Medicine Authors: Brian Lawlor Source Type: research

Metabolic syndrome and risk of Parkinson disease: A nationwide cohort study
by Ga Eun Nam, Seon Mee Kim, Kyungdo Han, Nan Hee Kim, Hye Soo Chung, Jin Wook Kim, Byoungduck Han, Sung Jung Cho, Ji Hee Yu, Yong Gyu Park, Kyung Mook Choi BackgroundThe association of metabolic syndrome (MetS) with the development of Parkinson disease (PD) is currently unclear. We sought to determine whether MetS and its components are associated with the risk of incident PD using large-scale cohort data for the whole South Korean population. Methods and findingsHealth checkup data of 17,163,560 individuals aged ≥40 years provided by the National Health Insurance Service (NHIS) of South Korea between January 1, 2009, a...
Source: PLoS Medicine - August 21, 2018 Category: Internal Medicine Authors: Ga Eun Nam Source Type: research

Fixed-dose combination antihypertensive medications, adherence, and clinical outcomes: A population-based retrospective cohort study
by Amol A. Verma, Wayne Khuu, Mina Tadrous, Tara Gomes, Muhammad M. Mamdani BackgroundThe majority of people with hypertension require more than one medication to achieve blood pressure control. Many patients are prescribed multipill antihypertensive regimens rather than single-pill fixed-dose combination (FDC) treatment. Although FDC use may improve medication adherence, the impact on patient outcomes is unclear. We compared clinical outcomes and medication adherence with FDC therapy versus multipill combination therapy in a real-world setting using linked clinical and administrative databases. Methods and findingsWe cond...
Source: PLoS Medicine - June 11, 2018 Category: Internal Medicine Authors: Amol A. Verma Source Type: research

Clinical, socioeconomic, and behavioural factors at age 50 years and risk of cardiometabolic multimorbidity and mortality: A cohort study
ConclusionsThe importance of specific midlife factors in disease progression, from disease-free state to single disease, multimorbidity, and death, varies depending on the disease stage. While clinical risk factors at age 50 determine the risk of incident cardiometabolic disease in a disease-free population, midlife socioeconomic and behavioural factors are stronger predictors of progression to multimorbidity and mortality in people with cardiometabolic disease.
Source: PLoS Medicine - May 21, 2018 Category: Internal Medicine Authors: Archana Singh-Manoux Source Type: research

Validation of a genetic risk score for atrial fibrillation: A prospective multicenter cohort study
ConclusionsProspective assessment of a GRS for AF identified participants with elevated risk of AF beyond established clinical criteria. Accordingly, a GRS for AF could be incorporated into overall risk assessment to better identify patients at the highest risk of developing AF, although further testing in larger populations is needed to confirm these findings. Trial registrationClinicalTrials.gov NCT01970969
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Evan D. Muse Source Type: research