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Discrimination in Healthcare Settings is Associated with Disability in Older Adults: Health and Retirement Study, 2008–2012
CONCLUSIONS One out of five adults over the age of 50 years experiences discrimination in healthcare settings. One in 17 experience frequent healthcare discrimination, and this is associated with new or worsened disability by 4 years. Future research should focus on the mechanisms by which healthcare discrimination influences disability in older adults to promote better health outcomes for an aging population.
Source: Journal of General Internal Medicine - March 13, 2015 Category: Internal Medicine 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

Type 2 diabetes mellitus screening has no effect on mortality
Commentary on: Selph S, Dana T, Blazina I, et al. Screening for type 2 diabetes mellitus: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2015; 162:765–6. Context Screening for type 2 diabetes mellitus in asymptomatic persons could lead to early identification and treatment, and potentially result in improved outcomes. In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended diabetes screening in asymptomatic adults with sustained blood pressure (BP) greater than 135/80 mm Hg. Unfortunately, the USPSTF found insufficient evidence to assess the balance of benefits...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Yoon, U. Tags: Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Screening (epidemiology), Diabetes, Health education, Screening (public health) Therapeutics/Prevention Source Type: research

Combined oral contraceptives and risk of venous thromboembolism: there is higher risk in new generations compared to second generations, but paradoxically not in norgestimate-containing-pills
This study examines the VTE risk associated with COC use in two large UK databases. Methods...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Plu-Bureau, G. Tags: Smoking and tobacco, Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Contraception, Drugs: obstetrics and gynaecology, Family planning, Alcohol, Health education, Smoking Aetiology/Harm Source Type: research

Mediterranean diet may reduce Alzheimer's risk
This study included 447...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Psaltopoulou, T., Sergentanis, T. N. Tags: Smoking and tobacco, Clinical trials (epidemiology), Dementia, Drugs: CNS (not psychiatric), Stroke, Hypertension, Diet, Memory disorders (psychiatry), Psychiatry of old age, Lipid disorders, Health education, Smoking 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

Current 10-year atherosclerotic cardiovascular disease risk threshold for statin eligibility is cost-effective for primary prevention
Commentary on: Pandya A, Sy S, Cho S, et al. Cost effectiveness of 10-year risk thresholds for initiation of statin therapy for primary prevention of cardiovascular disease. JAMA 2015;314: 142–50 . Context The American College of Cardiology American Heart Association (ACC/AHA) cholesterol guidelines replaced the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) in 2013,1 a change that was accompanied by significant controversy.2 Notable among the criticisms was that the pooled cohort equations (PCE) overestimates risk and coupled with the relatively lenient risk threshold (10-year PCE &g...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Yeboah, J. Tags: Health policy, Epidemiologic studies, Drugs: cardiovascular system, Neuromuscular disease, Stroke, Ischaemic heart disease, Musculoskeletal syndromes, Health economics, Health service research Economic analysis Source Type: research

Excessive Sleep and Lack of Sleep Are Associated With Slips and Falls in the Adult Korean Population: A Population-Based Cross-Sectional Study
This study investigated the associations between sleep duration and falls among Korean adults in a wide range of age groups while adjusting for numerous confounding factors. Data collected from study participants ranging in age from 19 to 109 years old were analyzed from the 2013 Korean Community Health Survey (KCHS). Sleep duration was divided into 5 groups: ≤5, 6, 7, 8, and ≥9 hours per day. The relations between sleep duration and falls (≥1 time or ≥2 times per year) were analyzed using simple and multiple logistic regression analyses with complex sampling. Age, sex, days of vigorous or moderate physical activ...
Source: Medicine - January 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Daytime sleepiness is associated with hyperhomocysteinemia in rural area of China: A cross-sectional study.
CONCLUSIONS: Daytime sleepiness, but not sleep duration abnormity, snoring, apnea and sleep disruption was an independent risk factor for Hhcy. PMID: 27321249 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - June 15, 2016 Category: Internal Medicine Authors: Zhang N, Chen S, Chen Y, Guo X, Sun G, Qian H, Sun Y Tags: Eur J Intern Med Source Type: research

Computer vision syndrome —A common cause of unexplained visual symptoms in the modern era
Summary ObjectivesThe aim of this study was to assess the evidence and available literature on the clinical, pathogenetic, prognostic and therapeutic aspects of Computer vision syndrome. MethodsInformation was collected from Medline, Embase & National Library of Medicine over the last 30 years up to March 2016. The bibliographies of relevant articles were searched for additional references. FindingsPatients with Computer vision syndrome present to a variety of different specialists, including General Practitioners, Neurologists, Stroke physicians and Ophthalmologists. While the condition is common, there is a poor awa...
Source: International Journal of Clinical Practice - June 8, 2017 Category: Internal Medicine Authors: Sunil Munshi, Ashley Varghese, Sushma Dhar ‐Munshi Tags: REVIEW ARTICLE Source Type: research

A Point ‐based Prediction Model for Cardiovascular Risk in Orthotopic Liver Transplantation: The CAR‐OLT Score
Conclusion: The point‐based CAR‐OLT risk score can identify patients at risk for CVD complications after OLT surgery (available at: www.carolt.us). This score may be useful for identification of candidates for further risk stratification or other management strategies to improve CVD outcomes after OLT. This article is protected by copyright. All rights reserved.
Source: Hepatology - July 1, 2017 Category: Internal Medicine Authors: Lisa B. VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T. Wilkins, Michael M. Abecassis, Daniela P. Ladner, Anton I. Skaro, Donald M. Lloyd ‐Jones Tags: Liver Failure, Cirrhosis and Portal Hypertension Source Type: research

Novel electronic health record (EHR) education intervention in large healthcare organization improves quality, efficiency, time, and impact on burnout
A novel approach to advanced electronic health record (EHR) skills training was developed in a large healthcare organization to improve high-quality EHR documentation, while reducing stressors linked to physician burnout. The 3-day intensive EHR education intervention covered best practices in EHR documentation and physician well-being. The specialty physician faculty used interactive teaching including demonstration, facilitation, and individual coaching. Laptops were provided for hands-on practice. Mixed-method evaluation included real-time feedback, daily surveys, and post-activity surveys to measure participant learni...
Source: Medicine - September 1, 2018 Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research

Protocol of a clinical trial study involving educational intervention in patients treated with warfarin
Background: Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide. Oral anticoagulation is an effective strategy for primary and secondary prevention of stroke in patients with AF. Warfarin is an oral anticoagulant widely prescribed and, despite its benefits, the achievement of the goals of drug therapy depends on patient involvement, among other factors. Educational interventions can contribute for effectiveness and safety of oral anticoagulation therapy. We sought to describe the protocol of a clinical trial designed to evaluate the effect of a patient-centered educational strategy focused on low-i...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Metabolic syndrome risk in relation to posttraumatic stress disorder among trauma-exposed civilians in Gansu Province, China
This study included 1456 men and 1411 women who were trauma-exposed and underwent routine health examinations in a community epidemiological investigation. The participants completed the posttraumatic stress disorder (PTSD) Check List-Civilian Version (PCL-C) for PTSD and medical examinations to detect metabolic syndrome. Adjustments for age, marriage, exercise, education, cigarette smoking, cancer, stroke, angina, and thyroid disease were performed. The relationship between PTSD and metabolic syndrome and each of its components was analyzed by multiple logistic regression. In women, PTSD was associated with metabolic syn...
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Comparative Effectiveness of Glucose-Lowering Drugs for Type 2 Diabetes: A Systematic Review and Network Meta-analysis.
CONCLUSION: In diabetic patients at low cardiovascular risk, no treatment differs from placebo for vascular outcomes. In patients at increased cardiovascular risk receiving metformin-based background therapy, specific GLP-1 RAs and SGLT-2 inhibitors have a favorable effect on certain cardiovascular outcomes. PRIMARY FUNDING SOURCE: European Foundation for the Study of Diabetes, supported by an unrestricted educational grant from AstraZeneca. (PROSPERO: CRD42019122043). PMID: 32598218 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - June 29, 2020 Category: Internal Medicine Authors: Tsapas A, Avgerinos I, Karagiannis T, Malandris K, Manolopoulos A, Andreadis P, Liakos A, Matthews DR, Bekiari E Tags: Ann Intern Med Source Type: research

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