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Total 326 results found since Jan 2013.

Self-monitoring and self-titration of antihypertensive medication reduces systolic blood pressure compared with usual care
This study represents a significant advance in hypertension self-management in high-risk patient groups, but the intervention's potential for wide implementation remains unclear. Context Hypertension is a major risk factor for cardiovascular disease, stroke, heart failure and chronic kidney disease.1 Effective treatment reduces risk for these devastating complications, but BP remains insufficiently controlled in up to half of adults.2 Because hypertension generates tremendous morbidity and costs, novel strategies for enhancing BP control are urgently needed. Interventions that enhance...
Source: Evidence-Based Nursing - June 22, 2015 Category: Nursing Authors: Bosworth, H. B., Crowley, M. J. Tags: General practice / family medicine, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Memory disorders (psychiatry) Primary healthcare Source Type: research

Systematic review of rehabilitation programmes initiated within 90 days of a transient ischaemic attack or 'minor' stroke: a protocol
Discussion This review will be of value to clinicians and healthcare professionals working in TIA and stroke services as well as to general practitioners/family physicians who care for these patients in the community and to researchers involved in designing and evaluating rehabilitation interventions. Trial registration number CRD42015016450.
Source: BMJ Open - June 18, 2015 Category: Journals (General) Authors: Heron, N., Kee, F., Donnelly, M., Cupples, M. E. Tags: Open access, Cardiovascular medicine, General practice / Family practice, Neurology, Rehabilitation medicine, Sports and exercise medicine Protocol Source Type: research

GP detection of health risk factors among general practice patients at risk of primary and secondary stroke
Conclusion. Given low sensitivity and specificity of GP detection of risk factors among patients, alternate methods of identification are needed. Research is required to determine strategies to facilitate secondary care of patients with a history of stroke or heart disease by GPs.
Source: Family Practice - May 27, 2015 Category: Primary Care Authors: Grady, A., Carey, M., Oldmeadow, C., Bryant, J., Mazza, D., Sanson-Fisher, R. Tags: Health Service Research Source Type: research

A retrospective cohort study to investigate fatigue, psychological or cognitive impairment after TIA: protocol paper
Introduction Transient ischaemic attack (TIA) is defined by short-lasting, stroke-like symptoms, and is recognised as a medical emergency. Symptoms are assumed to completely resolve, and treatment is focused on secondary stroke/TIA prevention. However, evidence suggests that patients with TIA may experience ongoing residual impairments, which they do not receive therapy for as standard practice. TIA-induced sequelae could impact on patients’ quality of life and ability to return to work or social activities. We aim to investigate whether TIA is associated with subsequent consultation for fatigue, psychological or cog...
Source: BMJ Open - May 3, 2015 Category: Journals (General) Authors: Moran, G. M., Calvert, M., Feltham, M. G., Ryan, R., Marshall, T. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice Protocol Source Type: research

An Unusual Stroke-like Clinical Presentation of Creutzfeldt-Jakob Disease: Acute Vestibular Syndrome
Conclusions: To our knowledge, this is the first report of an initial presentation of Creutzfeldt-Jacob disease closely mimicking vestibular neuritis, expanding the known clinical spectrum of prion disease presentations. Despite the initial absence of neurological signs, the central lesion location was differentiated from a benign peripheral vestibulopathy at the first visit using simple bedside vestibular tests. Familiarity with these tests could help providers prevent initial misdiagnosis of important central disorders in patients presenting vertigo or dizziness.
Source: The Neurologist - April 1, 2015 Category: Neurology Tags: Case Report/Case Series 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

Long-term effect of population screening for diabetes on cardiovascular morbidity, self-rated health, and health behavior.
CONCLUSIONS: Invitation to screening for type 2 diabetes appears to have limited impact on population levels of cardiovascular morbidity, self-rated health status, and health behavior after 7 years. PMID: 25755036 [PubMed - in process]
Source: Annals of Family Medicine - March 1, 2015 Category: Primary Care Authors: Echouffo-Tcheugui JB, Simmons RK, Prevost AT, Williams KM, Kinmonth AL, Wareham NJ, Griffin SJ Tags: Ann Fam Med Source Type: research

Gender differences in stroke prevention in atrial fibrillation in general practice: using the GRASP‐AF audit tool
ConclusionWomen with AF are at higher risk of stroke than men without OAC. The gender‐related differences in risk of stroke disappear if OAC is used. Despite this, women are more likely not to receive OAC.
Source: International Journal of Clinical Practice - March 1, 2015 Category: Internal Medicine Authors: E. Shantsila, A. Wolff, G. Y. H. Lip, D. A. Lane Tags: Original Paper Source Type: research

Optimising stroke prevention in patients with atrial fibrillation.
PMID: 25733417 [PubMed - in process]
Source: The British Journal of General Practice - March 1, 2015 Category: Primary Care Authors: Lane DA, Wolff A, Shantsila E, Lip GY Tags: Br J Gen Pract Source Type: research

A reverse J-shaped association between serum 25-hydroxyvitamin D and cardiovascular disease mortality - the CopD-study.
CONCLUSIONS: In this large observational study low and high levels of 25-hydroxyvitamin D were associated with cardiovascular disease, stroke and acute myocardial mortality in a non-linear, reverse J-shaped manner, with highest risk at lower levels. Whether this was a causal or associational finding cannot be determined from our data. There is a need for randomized clinical trials which include information on the effects of 25-hydroxyvitamin D levels above 100 nmol/L. PMID: 25710567 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Endocrinology and Metabolism - February 24, 2015 Category: Endocrinology Authors: Durup D, Jørgensen HL, Christensen J, Tjønneland A, Olsen A, Halkjær J, Lind B, Heegaard AM, Schwarz P Tags: J Clin Endocrinol Metab Source Type: research

The impact of patients' involvement in cooking on their mortality and morbidity: A 19-year follow-up of patients diagnosed with type 2 diabetes mellitus.
Conclusions. In patients newly diagnosed with T2DM and with a regular intake of warm main meals, infrequent involvement in cooking was associated with an increased risk of diabetes-related death and stroke for women, but not for men. General practitioners should pay special attention to managing diabetes treatment in female patients newly diagnosed with T2DM who report infrequent involvement in cooking. PMID: 25592166 [PubMed - as supplied by publisher]
Source: Primary Care - January 16, 2015 Category: Primary Care Authors: Jandorf S, Siersma V, Køster-Rasmussen R, Olivarius NF, Waldorff FB Tags: Scand J Prim Health Care Source Type: research

Patients' responses to transient ischaemic attack symptoms: a cross-sectional questionnaire study in Australian general practices.
CONCLUSION: Most general practice attendees expressed intentions to seek health care urgently for most symptoms suggestive of TIA, with highest levels of urgency observed in high stroke-risk scenarios. Intentions were not associated with a number of major risk factors for TIA and might be improved by further educational interventions, either targeted or at population level. PMID: 25548313 [PubMed - in process]
Source: The British Journal of General Practice - January 1, 2015 Category: Primary Care Authors: Magin P, Dunbabin J, Goode S, Valderas JM, Levi C, D'Souza M, Marshall M, Barker D, Lasserson D Tags: Br J Gen Pract Source Type: research

Optimising stroke prevention in patients with atrial fibrillation: application of the GRASP-AF audit tool in a UK general practice cohort.
CONCLUSION: Most patients with AF in general practice are at high risk of stroke, but OAC is under-utilised in about 40%. Risk of stroke and death was significantly reduced by OAC, yet antiplatelet monotherapy was inappropriately used in approximately 25% of patients at risk of stroke. Optimal implementation of the CHA2DS2-VASc score in the GRASP-AF tool could help prevent more strokes annually. PMID: 25548312 [PubMed - in process]
Source: The British Journal of General Practice - January 1, 2015 Category: Primary Care Authors: Shantsila E, Wolff A, Lip GY, Lane DA Tags: Br J Gen Pract Source Type: research

Assessment of public awareness on chronic obstructive pulmonary disease in Slovenia
ConclusionsPublic awareness and knowledge about COPD is low and COPD is not considered as relevant public health problem. Strategies to inform and educate Slovenian public about COPD are urgently needed.
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Farkas, J., Lainscak, M. Tags: 1.6 General Practice and Primary Care Source Type: research

Screening for atrial fibrillation in general practice: A national, cross-sectional study of an innovative technology
To test the use of three lead monitoring as a screening tool for atrial fibrillation (AF) in general practice. AF is responsible for up to a quarter of all strokes and is often asymptomatic until a stroke occurs.
Source: International Journal of Cardiology - November 29, 2014 Category: Cardiology Authors: Gerard Bury, Davina Swan, Walter Cullen, David Keane, Helen Tobin, Mairead Egan, David Fitzmaurice, Crea Carberry, Cecily Kelleher Source Type: research