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Total 326 results found since Jan 2013.

Lower incidence of recorded cardiovascular outcomes in patients with type 2 diabetes using insulin aspart vs. those on human regular insulin: observational evidence from general practices
ConclusionUse of the rapid‐acting insulin analogue aspart was associated with a reduced incidence of macrovascular outcomes in type 2 diabetes in general practices. It is important to confirm this finding in a randomized controlled trial.
Source: Diabetes, Obesity and Metabolism - November 28, 2012 Category: Endocrinology Authors: W. Rathmann, K. Kostev Tags: ORIGINAL ARTICLE Source Type: research

Characteristics and Future Cardiovascular Risk of Patients With Not‐At‐Goal Hypertension in General Practice in France: The AVANT'AGE Study
Although many studies focus on patients with resistant hypertension, general practitioners (GPs) are more likely to face patients in clinical practice with not‐at‐goal hypertension, whose antihypertensive treatment needs to be modified. However, information regarding such patients is limited. In the present study, 710 GPs in France each included their first 10 not‐at‐goal hypertensive patients, ie, the patients for whom they decided to modify antihypertensive treatment. The study population was composed of 7032 patients (58% men, mean age 62.4±11.5 years). Anthropometric and biologic measurements and clinical dat...
Source: The Journal of Clinical Hypertension - March 7, 2013 Category: Cardiology Authors: Yi Zhang, Hélène Lelong, Sandrine Kretz, Davide Agnoletti, Jean‐Jacques Mourad, Michel E. Safar, Jacques Blacher Tags: Original Paper Source Type: research

Republished: Mainstreaming HIV services for men who have sex with men: the role of general practitioners
Mainstreaming HIV services for men who have sex with men: The role of general practitioners General practitioners (GPs) and other primary care doctors around the world have a strong potential for providing quality HIV prevention, testing and treatment for men who have sex with men, as advocated by the recent WHO guideline.1 As the HIV epidemic becomes more focused on chronic disease care in many parts of the world, a number of primary care issues come to the forefront of clinical HIV service delivery. GPs have advantages in providing HIV services because of their position as trusted, community-based, long-term advocates fo...
Source: Postgraduate Medical Journal - March 12, 2013 Category: Journals (General) Authors: Wong, W. C. W., Kidd, M. R., Tucker, J. D. Tags: Liver disease, Sexual transmitted infections (viral), General practice / family medicine, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Stroke, Hypertension, Communication, Ethics, Legal and forensic medicine Republished editoria Source Type: research

Orlistat reduces weight but its cost-effectiveness remains unclear
This study aimed to evaluate the effectiveness and cost effectiveness of three pharmacological interventions (orlistat, sibutramine and rimonabant) in obese patients in...
Source: Evidence-Based Nursing - March 8, 2013 Category: Nursing Authors: Veerman, L. Tags: Health policy, General practice / family medicine, Drugs: cardiovascular system, Stroke, Obesity (nutrition), Health service research, Health education, Obesity (public health) Primary healthcare Source Type: research

EBN resources page
SIGN Apps for iPhone and Android phonehttp://itunes.com/apps/signguidelines The app for the Apple and Android phones and tablets contains reference guides (QRG) of SIGN guidelines. The app has recently been updated to include our suite of coronary heart disease (CHD) Guidelines:97 Risk estimation and the prevention of cardiovascular disease 96 Management of stable angina 95 Management of chronic heart failure 94 Cardiac arrhythmias in coronary heart disease 93 Acute coronary syndromes (updated February 2013) In addition, navigation of the app has been improved with category listings of guidelines. The content is enhanced w...
Source: Evidence-Based Nursing - June 6, 2013 Category: Nursing Authors: Noble, E. b. H. Tags: Diarrhoea, General practice / family medicine, Immunology (including allergy), Drugs: infectious diseases, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Neurological injury, Pain (neurology), Stroke, Trauma CNS / PNS, Paediatric oncology, Op Source Type: research

Older people who report loneliness have increased risk of mortality and functional decline
Commentary on: Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med 2012;172:1078–84. Implications for practice and research National screening recommendations are needed for loneliness. Assessments for loneliness should be a component of primary care for older adults. Interventions focused on the poorly adapted cognitive processes associated with loneliness warrant further study. Context Prevalence rates of loneliness have been reported to be as high as 17% in samples of older adults in the USA.1 Historically, scientists viewed lon...
Source: Evidence-Based Nursing - June 6, 2013 Category: Nursing Authors: Theeke, L. A. Tags: General practice / family medicine, Care of the older person, Drugs: cardiovascular system, Stroke, Hypertension, Screening (public health) Source Type: research

Screening for atrial fibrillation in patients aged 65 years or over attending annual flu vaccination clinics at a single general practice.
CONCLUSIONS: Screening was ineffective. ECG immediately after pulse assessment is essential. Screening was acceptable to patients but required additional resources. Age groups 65-74 and ≥ 85 years were not adequately screened using flu clinics. Novel methods screening older, non-attending patients are required. Practices should introduce annual pulse checks into chronic disease templates and prompts for those aged ≥ 65 years attending surgery. Additional screening should target practices with low AF prevalence or poor rates of opportunistic screening. PMID: 23735694 [PubMed - in process]
Source: Quality in Primary Care - May 1, 2013 Category: Primary Care Authors: Rhys GC, Azhar MF, Foster A Tags: Qual Prim Care Source Type: research

Why acupuncture is giving sceptics the needle
Acupuncture has been prescribed by half of Britain's doctors, but after 3,000 clinical trials its efficacy remains unproven. So is the NHS making a grave error in supporting this ancient treatment?• Are vitamin pills a sham? Q&A with Dr. Paul OffitYou can't get crystal healing on the NHS. The Department of Health doesn't fund faith healing. And most doctors believe magnets are best stuck on fridges, not patients. But ask for a treatment in which an expert examines your tongue, smells your skin and tries to unblock the flow of life force running through your body with needles and the NHS will be happy to oblige.The govern...
Source: Guardian Unlimited Science - July 26, 2013 Category: Science Authors: David Derbyshire Tags: Culture Health Science and scepticism Features NHS Alternative medicine The Observer Source Type: news

General practitioners undertreat women with atrial fibrillation
General practitioners (GPs) undertreat women with atrial fibrillation (AF), according to research presented at ESC Congress 2013 today by Dr Pierre Sabouret from France. The analysis of more than 15,000 patients showed that women were undertreated with antithrombotic medications compared to men regardless of their stroke risk and comorbidities. Dr Sabouret said: "Gender-related differences among outpatients with stable coronary artery disease are well known.1-6 Heart diseases are one of the most important causes of death among women worldwide...
Source: Health News from Medical News Today - September 3, 2013 Category: Consumer Health News Tags: Primary Care / General Practice Source Type: news

Genomic medicine in primary care: barriers and assets
Sequencing the human genome created the tantalising promise of more personalised medicine. Futurists envisage a time when each individual undergoes genome sequencing at birth, stores the data on a chip or in an electronic health record (EHR), and allows healthcare providers to query it throughout one's life. Genomic medicine, the use of one's genotype in medical decision-making, may improve health outcomes, but the clinical translation of this vast body of scientific information is in its infancy. Nonetheless, some patients are eager to use genomic information to shape their healthcare now. Primary care providers (PCPs), h...
Source: Postgraduate Medical Journal - October 15, 2013 Category: Journals (General) Authors: Vassy, J. L., Green, R. C., Lehmann, L. S. Tags: General practice / family medicine, Drugs: cardiovascular system, Stroke, Gynecological cancer, Guidelines Editorials Source Type: research

ACE inhibitor use may be linked to kidney failure
Conclusion ACE inhibitors and ARAs are recognised as a potential risk factor for AKI in some patients. This particular study has tried to estimate the possible size of the problem, but its findings should be viewed with some caution. As the authors point out: some of the conditions these drugs are prescribed for are themselves a risk factor for AKI changes in hospital coding and better recognition of AKI could explain the rise in admissions an ageing population leads to both increased prescribing of these drugs and an increased risk for AKI increased use of these drugs may be a marker for increased use of other...
Source: NHS News Feed - November 7, 2013 Category: Consumer Health News Tags: Medication Heart/lungs Source Type: news

The UK prevalence of hereditary haemorrhagic telangiectasia and its association with sex, socioeconomic status and region of residence: a population-based study
Conclusions HHT prevalence is more common in the UK population than previously demonstrated, though this updated figure is still likely to be an underestimate. HHT appears to be significantly under-diagnosed in men, which is likely to reflect their lower rates of consultation with primary care services. There is under-diagnosis in patients from lower socioeconomic groups and a marked variation in the prevalence of diagnosis between different geographical regions across the UK that requires further investigation.
Source: Thorax - January 15, 2014 Category: Respiratory Medicine Authors: Donaldson, J. W., McKeever, T. M., Hall, I. P., Hubbard, R. B., Fogarty, A. W. Tags: Epidemiologic studies, General practice / family medicine, Clinical genetics, Ear, nose and throat/otolaryngology Orphan lung disease Source Type: research

Limited impact of omega-3 fatty acids in patients with multiple cardiovascular risk factors
Commentary on: Roncaglioni MC, Tombesi M, et al.. Risk and Prevention Study Collaborative Group. n-3 fatty acids in patients with multiple cardiovascular risk factors. N Engl J Med 2013;368:1800–8 Context Ecological, case–control and prospective studies consistently demonstrate reduced cardiovascular morbidity and mortality associated with higher intake of fish and their constituent omega-3 fatty acids and with higher omega-3 fatty acid status.1 This effect has been ascribed to improvement of the cardiovascular risk profile resulting in disease prevention.1 Trials in patients following myocardial infarction (MI...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Calder, P. Tags: Clinical trials (epidemiology), Epidemiologic studies, General practice / family medicine, Immunology (including allergy), Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Arrhythmias Therapeutics Source Type: research

Warfarin therapy for atrial fibrillation in general practice - is bleeding risk underestimated?
Abstract BACKGROUND Atrial fibrillation causes a five-fold increase in the risk of thromboembolic stroke. Warfarin therapy reduces the risk by 64 %, but increases the risk of serious bleeding. We aimed to investigate the quality of warfarin therapy in a general practice and determine which patients would be likely to benefit from the treatment.MATERIAL AND METHOD We carried out retrospective registration of patients with atrial fibrillation, and calculated the risk of thromboembolism (CHA2DS2-VASc score) and of bleeding (HAS-BLED score) for each patient. Two alternative methods were used for calculating the absol...
Source: Tidsskrift for den Norske Laegeforening - January 28, 2014 Category: Journals (General) Authors: Bratland B, Hornnes MB Tags: Tidsskr Nor Laegeforen Source Type: research

Clinical prediction rules in practice: review of clinical guidelines and survey of GPs.
CONCLUSION: GPs use CPRs to guide management but also to comply with local policy requirements. Future research could focus on which clinical areas clinicians would most benefit from CPRs and promoting the use of robust, externally validated CPRs. PMID: 24686888 [PubMed - in process]
Source: The British Journal of General Practice - April 1, 2014 Category: Primary Care Authors: Plüddemann A, Wallace E, Bankhead C, Keogh C, Van der Windt D, Lasserson D, Galvin R, Moschetti I, Kearley K, O'Brien K, Sanders S, Mallett S, Malanda U, Thompson M, Fahey T, Stevens R Tags: Br J Gen Pract Source Type: research