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Specialty: Primary Care
Nutrition: Vitamins

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Total 38 results found since Jan 2013.

Effectiveness, safety and costs of stroke prevention in non-valvular auricular fibrillation. Study of cohorts matched by Propensity score.
CONCLUSIONS: Most patients initiated VKA. We found no differences between VKA and dabigatran in the risk of stroke, haemorrhages or mortality. PMID: 31551166 [PubMed - as supplied by publisher]
Source: Atencion Primaria - September 20, 2019 Category: Primary Care Authors: Giner-Soriano M, Casajuana M, Roso-Llorach A, Vedia C, Morros R Tags: Aten Primaria Source Type: research

Cost-effectiveness analysis of apixaban versus acetylsalicylic acid in the prevention of stroke in patients with non-valvular atrial fibrillation in Spain.
CONCLUSIONS: According to this model, when costs and estimated lifetime outcomes achieved with apixaban are compared with those of ASA, apixaban was assessed to be a cost-effective treatment for the prevention of stroke in patients with NVAF in Spain. PMID: 26832316 [PubMed - as supplied by publisher]
Source: Atencion Primaria - January 29, 2016 Category: Primary Care Authors: Escolar-Albaladejo G, Barón-Esquivias G, Zamorano JL, Betegón-Nicolás L, Canal-Fontcuberta C, de Salas-Cansado M, Rubio-Rodríguez D, Rubio-Terrés C Tags: Aten Primaria Source Type: research

Stroke-like lesions in mitochondrial disease may resemble ischemic stroke
J Family Med Prim Care. 2021 Aug;10(8):3151-3153. doi: 10.4103/jfmpc.jfmpc_2314_20. Epub 2021 Aug 27.ABSTRACTThe patient is a 73-y-male who was referred after a fall without losing consciousness or secessus. Clinical exam revealed disorientation, ophthalmoparesis, hemianopia to the left, left hemineglect, hypoacusis, quadruparesis, general wasting, generally reduced tendon reflexes, mild rigor, occasional myoclonic jerks of the right lower limb, and ataxia of the left lower limb. Cerebral magnetic resonance imaging (MRI) showed a stroke-like lesion (SLL), generalized atrophy, white matter lesions, and ponsgliosis. The prev...
Source: Primary Care - October 18, 2021 Category: Primary Care Authors: Josef Finsterer Source Type: research

The change of paradigm in stroke prevention in atrial fibrillation. Challenges and emerging opportunities for the family physician.
Abstract Atrial fibrillation (AF), is the most prevalent sustained arrhythmia in general population, affecting up to 10% in patients of advanced age. AF doubles overall mortality and increases up to 5-6 times the risk of stroke, which have the characteristic of being particularly harmfull. The basis of treatment on AF are the rhythm or rate control and the prevention of thromboembolism. For the latter purpose the treatments that have been most effective are oral acticoagulants. For decades and until just a few years ago, the only oral drugs available for this purpose have been the anti-vitamin K, mainly represente...
Source: Atencion Primaria - April 1, 2013 Category: Primary Care Authors: Castillo Rodríguez JC, Lozano IF Tags: Aten Primaria Source Type: research

Antithrombotic Management of Atrial Fibrillation in the Elderly
This article discusses stroke risk-stratification tools for clinical decision making, reviews pharmacologic options for the prevention of stroke, and highlights several practical considerations to the use of these agents in older adults.
Source: Medical Clinics of North America - February 19, 2015 Category: Primary Care Authors: Karli Edholm, Nathan Ragle, Matthew T. Rondina Source Type: research

New oral anticoagulants for nonvalvular atrial fibrillation in the elderly: Limited applicability in primary care.
CONCLUSION: There is uncertainty about effectiveness and safety of NOACs in unselected elderly patients with AF in primary care. Therefore, the balance between benefit and harm is still unclear. For this reason, routine use of NOACs is not recommended in elderly patients in primary care. PMID: 25495417 [PubMed - in process]
Source: European Journal of General Practice - December 4, 2015 Category: Primary Care Tags: Eur J Gen Pract Source Type: research

Thromboembolic and haemorrhagic events in patients with atrial fibrillation: a prospective cohort study in UK primary and secondary care.
CONCLUSION: Anticoagulants are associated with lower risk of thromboembolic and haemorrhagic events among patients with AF than antiplatelets. More research is required on the risk associated with VKAs or NOACs. PMID: 31015222 [PubMed - as supplied by publisher]
Source: The British Journal of General Practice - April 22, 2019 Category: Primary Care Authors: Robson J, Mathur R, Priebe M, Ahmed Z, Ayerbe L Tags: Br J Gen Pract Source Type: research

Anticoagulation: Updated Guidelines for Outpatient Management.
Abstract Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism and preventing stroke in those with nonvalvular atrial fibrillation. Vitamin K antagonists are recommended for patients with mechanical valves and valvular atrial fibrillation. Vitamin K antagonists inhibit the production of vitamin K-related factors and require a minimum of five days overlap with parenteral anticoagulants, ...
Source: American Family Physician - September 30, 2019 Category: Primary Care Authors: Wigle P, Hein B, Bernheisel CR Tags: Am Fam Physician Source Type: research

The VitDISH Study: Vit D Supplementation Does Not Improve ISH in Older Patients
Low vitamin D levels have been associated with stroke and heart failure and studies of supplementation suggest a salutatory effect on hypertension in some patients. Here, more data to consider but no final conclusions.
Source: Consultant Live - October 9, 2013 Category: Primary Care Source Type: news

Pharmacologic Therapies in Anticoagulation
This article reviews the pharmacology of the main anticoagulant classes (vitamin K antagonists, direct oral anticoagulants, and heparins) and their clinical indications based on evidence-based data currently available in the literature.
Source: Medical Clinics of North America - May 26, 2016 Category: Primary Care Authors: Joana Lima Ferreira, Joyce E. Wipf Source Type: research

Patients ’ and physicians’ perceptions and attitudes about oral anticoagulation and atrial fibrillation: a qualitative systematic review
Oral anticoagulant therapy reduces the risk of stroke in patients with atrial fibrillation, but many patients are still not prescribed this therapy. The causes of underuse of vitamin K antagonists oral anticoa...
Source: BMC Family Practice - January 13, 2017 Category: Primary Care Authors: Gemma Mas Dalmau, Elisenda Sant Arderiu, Mar ía Belén Enfedaque Montes, Ivan Solà, Sandra Pequeño Saco and Pablo Alonso Coello Source Type: research

Vitamin B12 Deficiency: Recognition and Management.
Abstract Vitamin B12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. Screening average-risk adults for vitamin B12 deficiency is not recommended. Screening may be warranted in patients with one or more risk factors, such as gastric or small intestine resections, inflammatory bowel disease, use of metformin for more than four months, use of proton pump inhibitors or histamine H2 blockers for more than 12 months, vegans or strict vegetarians, and adults older than 75 years. Initial laboratory assessment should include a complete blood count ...
Source: American Family Physician - September 15, 2017 Category: Primary Care Authors: Langan RC, Goodbred AJ Tags: Am Fam Physician Source Type: research

Variation in anticoagulation for atrial fibrillation between English clinical commissioning groups: an observational study.
CONCLUSION: Anticoagulation for AF has improved substantially in England in association with considerable increases in the eligible population as a result of decreased exception reporting and the use of the CHA2DS2VASc score. There is still substantial room for improvement in most CCGs because, even allowing for exceptions, nine out of 10 CCGs failed to achieve 90% anticoagulation. PMID: 29970397 [PubMed - as supplied by publisher]
Source: The British Journal of General Practice - July 2, 2018 Category: Primary Care Authors: Robson J, Homer K, Ahmed Z, Antoniou S Tags: Br J Gen Pract Source Type: research

Assessment of Knowledge Regarding Risks and Benefits of the Use of Non-Vitamin K Antagonist Oral Anticoagulants
CONCLUSIONS: There is an opportunity to improve NOAC-related knowledge in patients with atrial fibrillation. When developing educational interventions, patient characteristics associated with poor knowledge should be considered. Based on our results, these are patients who are older, more medically complex, are on apixaban, and have been on NOAC therapy for a shorter duration.PMID:36000450 | DOI:10.1177/21501319221118806
Source: Primary Care - August 24, 2022 Category: Primary Care Authors: Jose Raul Valery Ahmad Marar George Pujalte Cynthia Ward Yousif M Abdelmoneim Patrick J Fitzgerald Edson Mwakyanjala Dana M Harris Loren Murray Michael G Heckman Launia J White Fernando Stancampiano Source Type: research