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Effects of intensive lipid lowering compared with moderate-intensity lipid lowering on coronary atherosclerotic plaque phenotype and major adverse cardiovascular events in adults with low to intermediate 10-year ASCVD risk (ILLUMINATION study): protocol for a multicentre, open-label, blinded-endpoint, randomised controlled trial
Introduction Current guidelines recommend moderate-intensity lipid lowering (low-density lipoprotein cholesterol, LDL-C of <2.6 mmol/L or 30%–49% reduction from the baseline) for patients with intermediate 10-year atherosclerotic cardiovascular disease (ASCVD) risk. The effects of intensive lipid lowering (LDL-C of <1.8 mmol/L) on coronary atherosclerotic plaque phenotype and major adverse cardiovascular events (MACE) in adults with both non-obstructive coronary artery disease (CAD) and low to intermediate 10-year ASCVD risk remain uncertain. Methods and analysis Intensive Lipid-lowering for Plaque and Major A...
Source: BMJ Open - June 5, 2023 Category: General Medicine Authors: Zheng, J., Hou, Z., Yuan, J., Zhao, X., Wang, Y., Li, J., Zhang, W., Dou, K., Lu, B. Tags: Open access, Cardiovascular medicine Source Type: research

Potassium binders for chronic hyperkalaemia in people with chronic kidney disease.
CONCLUSIONS: Evidence supporting clinical decision-making for different potassium binders to treat chronic hyperkalaemia in adults with CKD is of low certainty; no studies were identified in children. Available studies have not been designed to measure treatment effects on clinical outcomes such as cardiac arrhythmias or major GI symptoms. This review suggests the need for a large, adequately powered study of potassium binders versus placebo that assesses clinical outcomes of relevance to patients, clinicians and policy-makers. This data could be used to assess cost-effectiveness, given the lack of definitive studies and t...
Source: Cochrane Database of Systematic Reviews - June 25, 2020 Category: General Medicine Authors: Natale P, Palmer SC, Ruospo M, Saglimbene VM, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly
Conclusions World population is aging and the increase in life expectancy is often unhealthy. In particular, musculoskeletal aging, which leads to sarcopenia and osteoporosis, has several causes such as changes in body composition, inflammation, and hormonal imbalance. Sarcopenia, osteoporosis, and more frequently, sarcopenic obesity are commonly associated with aging and frequently closely linked each other, often leading to the development of a frailty syndrome. Frailty syndrome favors an increased risk of loss function in daily activities, for cardiovascular diseases, cancers, falls, and mortality. As the number of eld...
Source: Frontiers in Endocrinology - April 23, 2019 Category: Endocrinology Source Type: research

Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD).
CONCLUSIONS: In studies of adults with CKD G5D treated with dialysis, sevelamer may lower death (all causes) compared to calcium-based binders and incur less treatment-related hypercalcaemia, while we found no clinically important benefits of any phosphate binder on cardiovascular death, myocardial infarction, stroke, fracture or coronary artery calcification. The effects of binders on patient-important outcomes compared to placebo are uncertain. In patients with CKD G2 to G5, the effects of sevelamer, lanthanum, and iron-based phosphate binders on cardiovascular, vascular calcification, and bone outcomes compared to place...
Source: Cochrane Database of Systematic Reviews - August 22, 2018 Category: General Medicine Authors: Ruospo M, Palmer SC, Natale P, Craig JC, Vecchio M, Elder GJ, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Promoting evidence-based health care in Africa
Charles Shey Wiysonge, Director ofCochane  South Africa, gave an interview to the World Health Organization Bulletin. Here is a re-post , with premission, from their  recent publication.Charles Shey Wiysonge is devoted to encouraging better use of scientific evidence for health policies and programmes in African countries. He is the director of the South African Cochrane Centre, a unit of the South African Medical Research Council, and a professor of epidemiology and biostatistics at the department of Global Health in the Faculty of Medicine and Health Sciences at Stellenbosch University in South Africa. He was Chief Res...
Source: Cochrane News and Events - August 17, 2017 Category: Information Technology Authors: Muriah Umoquit Source Type: news

Vitamin D supplementation for sickle cell disease.
CONCLUSIONS: We included only one low-quality clinical study which had a high risk of bias with regards to incomplete outcome data. Therefore, we consider that the evidence is not of sufficient quality to guide clinical practice. Until further evidence becomes available, clinicians should consider the relevant existing guidelines for vitamin D supplementation (e.g. the Endocrine Society Clinical Practice Guidelines) and dietary reference intakes for calcium and vitamin D (e.g. from the USA Institute of Medicine). Evidence of vitamin D supplementation in sickle cell disease from high quality studies is needed. Well-designed...
Source: Cochrane Database of Systematic Reviews - January 19, 2017 Category: Journals (General) Authors: Soe HH, Abas AB, Than NN, Ni H, Singh J, Said AR, Osunkwo I Tags: Cochrane Database Syst Rev Source Type: research

Drug Therapy of Apparent Treatment-Resistant Hypertension: Focus on Mineralocorticoid Receptor Antagonists
Abstract Apparent treatment-resistant hypertension (aTRH) is defined as blood pressure (BP) >140/90 mmHg despite three different antihypertensive drugs including a diuretic. aTRH is associated with an increased risk of cardiovascular events, including stroke, chronic renal failure, myocardial infarction, congestive heart failure, aortic aneurysm, atrial fibrillation, and sudden death. Preliminary studies of renal nerve ablation as a therapy to control aTRH were encouraging. However, these results were not confirmed by the Symplicity 3 trial. Therefore, attention has refocused on drug therapy. Secondary forms o...
Source: Drugs - March 19, 2015 Category: Drugs & Pharmacology Source Type: research

Title: Beyond Malnutrition: The Role of Sanitation in Stunted Growth
Charles W. Schmidt, MS, an award-winning science writer from Portland, ME, has written for Discover Magazine, Science, and Nature Medicine. Background image: WHO About This Article open Citation: Schmidt CW. 2014. Beyond malnutrition: the role of sanitation in stunted growth. Environ Health Perspect 122:A298–A303; http://dx.doi.org/10.1289/ehp.122-A298 News Topics: Children’s Health, Diet and Nutrition, Gastrointestinal Health, International Environmental Health, Microbial Agents, Musculoskeletal Health, Drinking Water Quality, Sanitation Published: 1 November 2014 PDF Version (2.8 MB) Worldwide, stuntin...
Source: EHP Research - October 31, 2014 Category: Environmental Health Authors: Web Admin Tags: Featured Focus News Children's Health Diet and Nutrition Drinking Water Quality Gastrointestinal Health International Environmental Health Microbial Agents Musculoskeletal Health November 2014 Sanitation Source Type: research

Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis.
CONCLUSION: Vitamin D supplementation might protect against cardiac failure in older people but does not appear to protect against MI or stroke. PMID: 25057156 [PubMed - as supplied by publisher]
Source: The American Journal of Clinical Nutrition - July 23, 2014 Category: Nutrition Authors: Ford JA, MacLennan GS, Avenell A, Bolland M, Grey A, Witham M, for the RECORD Trial Group Tags: Am J Clin Nutr Source Type: research

Quick magnesium treatment fails to improve stroke outcomes, but study has silver lining
In the first study of its kind, a consortium led by UCLA physicians found that giving stroke patients intravenous magnesium within an hour of the onset of symptoms does not improve stroke outcomes.   However, the 8-year trial did find that with the help of paramedics in the field, intravenous medications can frequently be administered to stroke victims within that so-called "golden hour," during which they have the best chance to survive and avoid debilitating, long-term neurological damage.   The latter finding is a "game-changer," said Dr. Jeffrey Saver, director of the UCLA Stroke Center and a professor of ...
Source: UCLA Newsroom: Health Sciences - February 13, 2014 Category: Universities & Medical Training Source Type: news