Filtered By:
Specialty: Internal Medicine
Source: Evidence-Based Medicine
This page shows you your search results in order of date. This is page number 2.
Order by Relevance | Date
Total 156 results found since Jan 2013.
Benefits of blood pressure lowering are seen across levels of baseline blood pressure, comorbidity and drug class
Commentary on: Ettehad D, Emdin CA, Kiran A, et al.. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis Lancet 2016;387:957–967 . Context It has been long established that reducing blood pressure with pharmacotherapeutic agents prevents adverse cardiovascular disease events, but questions remain about which patients warrant antihypertensive therapy. Historically, this has been determined by the level of blood pressure alone. However, the evidence suggests that individuals most likely to benefit from blood pressure lowering therapy are those at greatest ab...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Nelson, M. R. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Renal medicine, Drugs: musculoskeletal and joint diseases Therapeutics/Prevention Source Type: research
Transfemoral transcatheter aortic-valve replacement should be preferred over surgery in most intermediate-risk patients
Commentary on: Leon MB, Smith CR, Mack MJ, et al.., PARTNER 2 Investigators. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 2016;374:1609–20 . Context Evidence derived from randomised clinical trials support transcatheter aortic valve replacement (TAVR) as a choice for patients with aortic stenosis with a prohibitive surgical risk and as a valid alternative therapy for those at high-risk of surgical mortality. Owing to increases in operator experience as well as improvements with transcatheter techniques and devices associated with reduction in procedural complications,...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Tamburino, C., Capranzano, P. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research
Erythropoietin corrects anaemia and reduces the risk of blood transfusion in people with chronic kidney disease, but has uncertain effects on other patient-level outcomes
Commentary on: Cody JD, Hodson EM. Recombinant human erythropoietin versus placebo or no treatment for the anaemia of chronic kidney disease in people not requiring dialysis. Cochrane Database Syst Rev 2016;(1):CD003266 Context Anaemia frequency and severity worsen with advancing chronic kidney disease (CKD) and are associated with quality-of-life (QOL) impairment, morbidity and mortality.1 Deficient renal erythropoietin production is a major cause and can be corrected by recombinant human erythropoietin (rhEPO) administration.1 This may improve clinical outcomes, including delaying dialysis. Conversely, rhEPO therapy caus...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Johnson, D. W. Tags: Clinical trials (epidemiology), Epidemiologic studies, Haematology (incl blood transfusion), Stroke, Hypertension, Venous thromboembolism, Renal medicine Therapeutics/Prevention Source Type: research
Physical activity reduces cardiovascular disease risk in older adults
Commentary on: Soares-Miranda L, Siscovick DS, Psaty BM, et al.. Physical activity and risk of coronary heart disease and stroke in older adults: the cardiovascular health study. Circulation 2016;133:147–55 . Context Currently, at least 150 min per week of moderate-to-vigorous physical activity is recommended for adults of all ages to beneficially influence individual and population health and cardiovascular mortality.1 Adhering to current physical activity guidelines has been shown to be associated with a 20% lower mortality risk compared to physically inactive persons.2 A physically active lifestyle is linked ...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Endes, S. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Sports and exercise medicine Aetiology/Harm 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
Restarting oral anticoagulation among patients with atrial fibrillation with gastrointestinal bleeding was associated with lower risk of all-cause mortality and thromboembolism
This study assesses risks of all-cause mortality, thromboembolism, major bleeding and recurrent GIB associated with resuming antithrombotic treatment after GIB among patients with AF. Methods This prospective cohort study included non-valvular patients with AF who experienced GIB while receiving single or combined antithrombotic treatment with an antiplatelet and/or anticoagulant in a Danish cohort from 1996...
Source: Evidence-Based Medicine - July 25, 2016 Category: Internal Medicine Authors: Qureshi, W. T., Nasir, U. Tags: EBM Prognosis, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Stroke, Venous thromboembolism, Pulmonary embolism Source Type: research
Risk of vascular events is lower than expected in patients with transient ischaemic attack or minor stroke treated promptly by stroke specialists
Commentary on: Amarenco P, Lavallée PC, Labreuche J, et al.., TIAregistry.org Investigators. One-year risk of stroke after transient ischemic attack or minor stroke. N Engl J Med 2016;374:1533–42. Context Previous studies estimated the risk of subsequent vascular events in patients with transient ischaemic attack (TIA) or minor stroke at 10–20% within 3 months.1 2 Prevention strategies have been adjusted since. Up-to-date numbers would help to detect a possible temporal trend in risk and to prospectively evaluate risk-scoring tools and specific risk factors in current patient populations. The TIA re...
Source: Evidence-Based Medicine - July 25, 2016 Category: Internal Medicine Authors: Nolte, C. H. Tags: EBM Prognosis, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease Source Type: research
Drug-eluting stents and drug-eluting balloons are the best strategies to treat coronary in-stent restenosis
Commentary on: Giacoppo D, Gargiulo G, Aruta P, et al.. Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 randomised trials and 4880 patients. BMJ 2015;351:h5392. Context Drug-eluting stents (DES) drastically improved the efficacy of percutaneous coronary intervention by reducing the risk of in-stent restenosis (ISR) and subsequent need of target lesion revascularisation (TLR). However, despite the advances in DES technology, the incidence of ISR is still significant and considering that more than five million DES are implanted each year worldwide...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Giustino, G., Mehran, R. Tags: Clinical trials (epidemiology), Immunology (including allergy), Stroke, Interventional cardiology, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research
Revascularisation plus supervised exercise is superior to supervised exercise alone for the treatment of intermittent claudication
This study was a multicentre (10 sites), parallel-design randomised controlled trial of supervised exercise plus endovascular revascularisation versus supervised exercise alone for IC.4 Patients with IC and one or more stenotic lesions at the aortoiliac and/or femoropopliteal level amenable to endovascular therapy were eligible. Supervised exercise was provided 2–3 times per week for 30–45 min per session for 3 months and then continued...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Vemulapalli, S. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Radiology, Clinical diagnostic tests Therapeutics/Prevention Source Type: research
New reversal agent for factor Xa inhibitors shows promise
Commentary on: Siegal DM, Curnette JT, Connolly SJ, et al.. Andexanet alfa for the reversal of Factor Xa inhibitor activity. N Engl J Med 2015;373:2413–24. Context Direct oral anticoagulants (DOACs) have emerged as alternatives to vitamin K-antagonists (eg, warfarin) for the long-term management of stroke prevention for non-valvular atrial fibrillation or venous thromboembolic disease. Favourable side-effect profiles and absence of therapeutic monitoring are important benefits of these newer agents. Warfarin is readily reversed with fresh frozen plasma (FFP) or prothrombin complex concentrates.1 The first reversal ag...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Ghadimi, K., Welsby, I. J. Tags: Clinical trials (epidemiology), Immunology (including allergy), Drugs: cardiovascular system, Stroke, Venous thromboembolism, Unwanted effects / adverse reactions Therapeutics/Prevention Source Type: research
High-sensitivity troponin predicts coronary disease outcomes in type 2 diabetes but yields no benefit in selecting patients for revascularisation
Commentary on: Everett BM, Brooks MM, Vlachos HE, et al.., BARI 2D Study Group. Troponin and cardiac events in stable ischemic heart disease and diabetes. N Engl J Med 2015;373:610–20. Context High-sensitivity troponin (hs-TnT) assays have been developed for early recognition of patients with acute coronary syndrome (ACS). Additionally, hs-TnT has been shown to be a feasible tool for assessing risk among patients with heart failure. Even though efforts have been made to improve prognosis among patients with coronary artery disease (CAD) with high-risk features, most adverse events occur in patients without these feat...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Junttila, J. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Radiology, Clinical diagnostic tests, Diabetes Therapeutics/Prevention Source Type: research
In hypertensive patients with elevated risk of cardiovascular disease, targeting systolic blood pressure to less than 120 mm Hg significantly reduces the rate of fatal and non-fatal cardiovascular events as well as death from any cause
Commentary on: Wright JT, Williamson JD, Whelton PK, et al.., SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015;373:2103–16. Context Hypertension is among the most significant modifiable risk factor for cardiovascular disease, yet there is considerable debate on the optimal blood pressure (BP) goal. Observational studies1 and the ACCORD trial2 suggest a target organ heterogeneity in that with lower systolic BP goals (<120 mm Hg) the risk of cerebrovascular events are reduced, but not coronary events. As such, systolic BP goals of <130, <...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Owlia, M., Bangalore, S. Tags: Geriatric medicine, Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Renal medicine Therapeutics/Prevention Source Type: research
Insomnia is associated with risk of future cardiovascular events irrespective of comorbidities
Commentary on: Hsu CY, Chen YT, Chen MH, et al.. The association between insomnia and increased future cardiovascular events: a nationwide population-based study. Psychosom Med 2015;77:743–51. Context Increasing evidence suggests a relatively strong association between insomnia and risk of future cardiovascular events. However, the exact nature of this association is poorly understood and causality remains uncertain due to methodological limitations in prior literature. An important methodological shortcoming was the inadequate consideration of comorbidities in several previous studies. Insomnia symptoms clearly over...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Janszky, I. Tags: EBM Prognosis, Geriatric medicine, Health policy, Epidemiologic studies, Drugs: cardiovascular system, Epilepsy and seizures, Sleep disorders (neurology), Stroke, Ischaemic heart disease, Drugs misuse (including addiction), Sleep disorders, Sleep disorder Source Type: research
Preoperative treatment with {beta}-blockers is associated with elevated postoperative mortality and cardiac morbidity in patients with uncomplicated hypertension undergoing non-cardiac surgery
Commentary on: Jørgensen ME, Hlatky MA, Køber L, et al.. β-Blocker-associated risks in patients with uncomplicated hypertension undergoing noncardiac surgery. JAMA Intern Med 2015;175:1923–31. Context The role of β-blockers in preventing cardiovascular complications of non-cardiac surgery is controversial. Early enthusiasm was dampened by accumulating trial data and concerns about the scientific validity of several trials. When studies with uncertain validity are excluded, meta-analyses of randomised trials show that perioperative β-blockers (started within 1 day before surgery) prev...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Wijeysundera, D. N. Tags: Liver disease, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Chemotherapy, Ischaemic heart disease Aetiology/Harm Source Type: research
Aerobic exercise training reduces bronchial hyper-responsiveness and serum pro-inflammatory cytokines in patients with asthma
Commentary on: Franca-Pinto A, Mendes FAR, de Carvalho-Pinto RM, et al.. Aerobic training decreases bronchial hyper-responsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial. Thorax 2015;70:732–9. Context Exercise is a well-known trigger for asthma symptoms. In patients with asthma, strenuous physical activity increases the risk of an asthma attack, with a ‘U’-shaped curve showing that moderate exercise training carries a lower risk of asthma compared to high-intensity exercise training. Lack of physical activity appears to be independently associat...
Source: Evidence-Based Medicine - March 21, 2016 Category: Internal Medicine Authors: del Giacco, S. R., Garcia-Larsen, V. Tags: Clinical trials (epidemiology), Immunology (including allergy), Drugs: CNS (not psychiatric), Stroke, Asthma Therapeutics/Prevention Source Type: research
