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Total 326 results found since Jan 2013.
A cluster-randomized controlled trial of a computerized antithrombotic risk assessment tool to optimize stroke prevention in general practice: a study protocol
This study (a prospective, cluster-randomized controlled clinical trial) will be conducted across selected regions in the state of New South Wales, Australia. Fifty GPs will be randomized to either the 'intervention' or 'control' arm, with each GP recruiting 10 patients (aged>=65 with AF); target sample size is 500 patients. GPs in the intervention arm will use CARAT during routine patient consultations to: assess risk factors for stroke, bleeding and medication misadventure; quantify the risk/benefit ratio of antithrombotic treatment, identify the recommended therapy, and decide on the treatment course, for an individual ...
Source: BMC Health Services Research - February 7, 2014 Category: Journals (General) Authors: Beata BajorekParker MaginSarah HilmerInes Krass Source Type: research
Influenza and pneumococcal vaccination and risk of stroke or transient ischaemic attack-Matched case control study.
CONCLUSIONS: Influenza vaccination was associated with a 24% reduction in risk of stroke but not TIA. Pneumococcal vaccination was not associated with reduced risk of stroke or TIA. This has important implications for potential benefits of influenza vaccine.
PMID: 24486370 [PubMed - as supplied by publisher]
Source: Vaccine - January 28, 2014 Category: Allergy & Immunology Authors: Siriwardena AN, Asghar Z, Coupland CA Tags: Vaccine 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
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
Herpes zoster as a risk factor for stroke and TIA: A retrospective cohort study in the UK
Conclusion:
HZ is an independent risk factor for vascular disease in the UK population, particularly for stroke, TIA, and MI in subjects affected before the age of 40 years. In older subjects, better ascertainment of vascular risk factors and earlier intervention may explain the reduction in risk of stroke after the occurrence of HZ.
Source: Neurology - January 20, 2014 Category: Neurology Authors: Breuer, J., Pacou, M., Gauthier, A., Brown, M. M. Tags: Stroke in young adults, Viral infections, All Cerebrovascular disease/Stroke, Cohort studies, Risk factors in epidemiology ARTICLE Source Type: research
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
Adjusting for measurement error in baseline prognostic biomarkers included in a time-to-event analysis: a joint modelling approach
Conclusion:
The joint modelling of longitudinal and survival data is a valid approach to account for measurement error in the analysis of a repeatedly measured biomarker and a time-to-event. User friendly Stata software is provided.
Source: BMC Medical Research Methodology - Latest articles - December 1, 2013 Category: Research Authors: Michael CrowtherPaul LambertKeith Abrams Source Type: research
High salt levels in soluble drugs may raise heart risk
Conclusion
This large case control study suggested that people who had experienced disease of the heart and blood vessels were more likely to have taken sodium-containing medicines than people without cardiovascular disease. Put in other words this can be interpreted that people who took sodium-containing medicines were at a higher risk of experiencing cardiovascular disease than people who took the same medications in formulations free of sodium. The increased risk appeared to be driven mostly by an increased risk of hypertension and to a lesser extent, non-fatal stroke.
The study has some strengths including its large s...
Source: NHS News Feed - November 27, 2013 Category: Consumer Health News Tags: Heart/lungs Medication Medical practice Source Type: news
AUtomated Risk Assessment for Stroke in Atrial Fibrillation (AURAS-AF) - an automated software system to promote anticoagulation and reduce stroke risk: study protocol for a cluster randomised controlled trial
DiscussionAURAS-AF will investigate whether a simple intervention, using electronic primary care records, can improve OAC uptake in a high risk group for stroke. Given previous concerns about safety, especially surrounding inappropriate prescribing, we will also examine whether electronic reminders safely impact care in this clinical area.Trial registration: ISRCTN 55722437
Source: Trials - November 13, 2013 Category: Journals (General) Authors: Tim HoltDavid FitzmauriceTom MarshallMatthew FayNadeem QureshiAndrew DaltonF HobbsDaniel LassersonKaren KearleyJenny HislopJing Jin Source Type: research
Poststroke anxiety is prevalent at the population level, especially among socially deprived and younger age community stroke survivors
ConclusionUsing a conservative HADS‐A cutoff, a high prevalence of definite abnormal anxiety in community stroke survivors is observed. This prevalence increases markedly in younger and more socially deprived stroke survivors.
Source: International Journal of Stroke - November 10, 2013 Category: Neurology Authors: Niall. M. Broomfield, Anne Scoular, Peter Welsh, Matthew Walters, Jonathan J. Evans Tags: Research 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 inter-contact interval: a new measure to define frequent attenders in primary care
Background:
Frequent attenders receive much attention in primary care research. Defining frequent attendance is crucial for an adequate view on this group of demanding patients. We aimed to develop a purely contact-based definition of "frequent attendance" and to apply it to real patients.
Methods:
From electronic records of 123 general practices in Germany, patients' inter-contact intervals (ICI) between two consecutive doctor-patient-contacts were calculated in this retrospective observational study. ICI less than 7 days were labelled "frequent attendance", patients with 60% or more of such intervals "frequent attenders ...
Source: BMC Family Practice - October 23, 2013 Category: Primary Care Authors: Johannes HauswaldtWolfgang HimmelEva Hummers-Pradier Source Type: research
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
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
