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Total 233 results found since Jan 2013.

Are healthcare costs from obesity associated with body mass index, comorbidity or depression? Cohort study using electronic health records
The objective of this study was to evaluate the association between body mass index (BMI) and healthcare costs in relation to obesity‐related comorbidity and depression. A population‐based cohort study was undertaken in the UK Clinical Practice Research Datalink (CPRD). A stratified random sample was taken of participants registered with general practices in England in 2008 and 2013. Person time was classified by BMI category and morbidity status using first diagnosis of diabetes (T2DM), coronary heart disease (CHD), stroke or malignant neoplasms. Participants were classified annually as depressed or not depressed. Cos...
Source: Clinical Obesity - March 31, 2016 Category: Eating Disorders and Weight Management Authors: C. Rudisill, J. Charlton, H. P. Booth, M. C. Gulliford Tags: Original Article Source Type: research

The use of a portable three-lead ECG monitor to detect atrial fibrillation in general practice.
CONCLUSIONS: The inexpensive portable PEM device recording diagnosed AF with a high sensitivity and specificity. KEY POINTS Simple ECG monitors could be useful to identify atrial fibrillation and thereby lead to a better prevention of stroke. The PEM device was easy to use and 95.7% of the recordings were technically acceptable for detecting atrial fibrillation. The PEM device has a high sensitivity and specificity in detecting atrial fibrillation compared to a standard 12-lead ECG. Further studies should evaluate the clinical usefulness of the PEM device, e.g. to detect intermittent atrial fibrillation. PMID: 2740915...
Source: Primary Care - July 12, 2016 Category: Primary Care Authors: Kristensen AN, Jeyam B, Riahi S, Jensen MB Tags: Scand J Prim Health Care Source Type: research

Ongoing impairments following transient ischaemic attack: retrospective cohort study
ConclusionsTransient ischaemic attack is associated with significantly increased subsequent consultation for fatigue, psychological impairment and cognitive impairment. These findings suggest that impairments exist after initial symptoms of TIA have resolved, which should be considered by clinicians when treating TIA patients.
Source: European Journal of Neurology - July 18, 2016 Category: Neurology Authors: G. M. Turner, M. Calvert, M. G. Feltham, R. Ryan, T. Marshall Tags: Original Article Source Type: research

Risk score developed from routinely collected data by primary healthcare practitioners is useful to rule out dementia in 60-79 year-olds
Commentary on: Walters K, Hardoon S, Petersen I, et al.. Predicting dementia risk in primary care: development and validation of the Dementia Risk Score using routinely collected data. BMC Medicine 2016;14:6 . Context In spite of major repercussions on the life of patients and caregivers, dementia remains a neglected domain in primary care setting. Previous studies have shown that only a third of new dementia cases occurring in the general population were referred to a specialist1 and that too at a severe stage of the disease, 25% of cases were ignored.2 A great proportion of primary care practitioners (PCPs) consider deme...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Dartigues, J. F., Helmer, C. Tags: EBM Diagnosis, Health policy, General practice / family medicine, Drugs: cardiovascular system, Dementia, Drugs: CNS (not psychiatric), Stroke, Memory disorders (psychiatry), Psychiatry of old age, Health service research Source Type: research

Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at ClinicalTrials.gov: a systematic review of registration details
Conclusions Despite widespread multimorbidity, more than three-quarters of ongoing trials assessing interventions for patients with chronic conditions excluded patients with concomitant chronic conditions.
Source: BMJ Open - September 26, 2016 Category: Journals (General) Authors: Buffel du Vaure, C., Dechartres, A., Battin, C., Ravaud, P., Boutron, I. Tags: Open access, Evidence based practice, General practice / Family practice, Research methods Source Type: research

Neurology Health Advocacy Curriculum: Needs Assessment, Curricular Content and Underlying Components.
CONCLUSION: Neurologists' and residents' responses support that NHA curriculum is needed. Four components of NHA were identified that can be used for teaching NHA as well as health advocacy in general practice. PMID: 27846918 [PubMed - as supplied by publisher]
Source: The Canadian Journal of Neurological Sciences - November 15, 2016 Category: Neurology Authors: Abuzinadah AR, Cooke L Tags: Can J Neurol Sci Source Type: research

Comparison of self-perceived cardiovascular disease risk among smokers with Framingham and PROCAM scores: a cross-sectional analysis of baseline data from a randomised controlled trial
Conclusions Among smokers, misperception of their 10-year cardiovascular risk is common, with one-fifth underestimating it. These findings may help physicians target patients with such characteristics to help them change their health behaviour and adherence to risk-reduction therapy. Trial registration number NCT00548665; Post-results.
Source: BMJ Open - January 5, 2017 Category: Journals (General) Authors: Desgraz, B., Collet, T.-H., Rodondi, N., Cornuz, J., Clair, C. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Smoking and tobacco Research Source Type: research

Statin prescribing for people with severe mental illnesses: a staggered cohort study of 'real-world impacts
Conclusions We found that statin prescribing to people with SMI in UK primary care was effective for lipid modification but not CVD events. The latter finding may reflect insufficient power to detect a smaller effect size than that observed in randomised controlled trials of statins in people without SMI.
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Blackburn, R., Osborn, D., Walters, K., Falcaro, M., Nazareth, I., Petersen, I. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Mental health Research Source Type: research

The role of contraindications in prescribing anticoagulants to patients with atrial fibrillation: a cross-sectional analysis of primary care data in the UK.
CONCLUSION: The presence or absence of recorded contraindications has little influence on the decision to prescribe anticoagulants for the prevention of stroke in patients with AF. The study analysis suggests that, nationally, 38 000 patients with AF with contraindications are treated with anticoagulants. This has implications for patient safety. PMID: 28630059 [PubMed - as supplied by publisher]
Source: The British Journal of General Practice - June 19, 2017 Category: Primary Care Authors: Adderley N, Ryan R, Marshall T Tags: Br J Gen Pract Source Type: research

Effects of obesity on metabolic and cardiovascular outcomes following insulin initiation in patients with type 2 diabetes
Conclusion Among patients with T2D insulin initiators, obesity adversely influences HbA1c up to 12 months, but not beyond 24 months and is associated with a decrease in BMI compared to non-obese groups. Morbidly obese patients initiating insulin have 30% increased risk of composite CV events after 5 years.
Source: Obesity Research and Clinical Practice - September 21, 2017 Category: Eating Disorders & Weight Management Source Type: research

Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults
Conclusions/interpretationA population-based stepwise screening programme for type 2 diabetes and cardiovascular risk factors among all middle-aged adults in Denmark was not associated with a reduction in rate of mortality or cardiovascular events between 2001 and 2012.
Source: Diabetologia - September 27, 2017 Category: Endocrinology Source Type: research

Effect of adding GLP-1RA on mortality, cardiovascular events and metabolic outcomes among insulin-treated patients with Type 2 Diabetes: A Large Retrospective UK Cohort Study
Conclusion Based on a large UK cohort in routine clinical practice, adding a GLP-1RA to insulin therapy is associated with a reduction in risk of composite CV events and all-cause mortality, but non-significant higher risk of hospitalisation for heart failure in overweight patients with Type 2 diabetes.
Source: American Heart Journal - October 10, 2017 Category: Cardiology Source Type: research

Males with prolactinoma are at increased risk of incident cardiovascular disease
ConclusionsIn contrast to females, men with prolactinoma have increased risk for incident CVD; the aetiology of this gender‐specific finding remains to be elucidatedThis article is protected by copyright. All rights reserved.
Source: Clinical Endocrinology - October 16, 2017 Category: Endocrinology Authors: Konstantinos A. Toulis, Tim Robbins, Narendra Reddy, Balachandran Kumarendran, Krishna Gokhale, Haren Wijesinghe, Kar Keung Cheng, Niki Karavitaki, John Wass, Krishnarajah Nirantharakumar Tags: Original Article Source Type: research

Predictive values of referrals for transient ischaemic attack from first-contact health care: a systematic review.
CONCLUSION: This study highlights the variation in prevalence of true vascular events in patients referred to TIA clinics. For patients without a cerebrovascular diagnosis, the high prevalence of conditions that also require specialist investigations and management are an additional burden on a care pathway that is primarily designed to prevent recurrent stroke. Service commissioners need to assess whether the existing outpatient provision is optimal for people with pathologies other than cerebrovascular disease. PMID: 29158247 [PubMed - as supplied by publisher]
Source: The British Journal of General Practice - November 20, 2017 Category: Primary Care Authors: Kandiyali R, Lasserson DS, Whiting P, Richards A, Mant J Tags: Br J Gen Pract Source Type: research

Low annual frequency of HbA1c testing in people with Type 2 diabetes in primary care practices in Germany
ConclusionsOnly three out of four individuals with Type 2 diabetes underwent at least two HbA1c tests in Germany in 2016, which means that 25% of individuals underwent fewer tests than required by German guidelinesThis article is protected by copyright. All rights reserved.
Source: Diabetic Medicine - November 25, 2017 Category: Endocrinology Authors: K. Kostev, L. Jacob, W. Rathmann Tags: Research Article Source Type: research