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Specialty: Internal Medicine
Source: PLoS Medicine

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Total 74 results found since Jan 2013.

Mortality attributable to hot and cold ambient temperatures in India: a nationally representative case-crossover study
ConclusionsPublic health interventions to mitigate temperature effects need to focus not only on extremely hot temperatures but also moderately cold temperatures. Future absolute totals of temperature-related deaths are likely to depend on the large absolute numbers of people exposed to both extremely hot and moderately cold temperatures. Similar large-scale and nationally representative studies are required in other low- and middle-income countries to better understand the impact of future temperature changes on cause-specific mortality.
Source: PLoS Medicine - July 24, 2018 Category: Internal Medicine Authors: Sze Hang Fu Source Type: research

Fixed-dose combination antihypertensive medications, adherence, and clinical outcomes: A population-based retrospective cohort study
by Amol A. Verma, Wayne Khuu, Mina Tadrous, Tara Gomes, Muhammad M. Mamdani BackgroundThe majority of people with hypertension require more than one medication to achieve blood pressure control. Many patients are prescribed multipill antihypertensive regimens rather than single-pill fixed-dose combination (FDC) treatment. Although FDC use may improve medication adherence, the impact on patient outcomes is unclear. We compared clinical outcomes and medication adherence with FDC therapy versus multipill combination therapy in a real-world setting using linked clinical and administrative databases. Methods and findingsWe cond...
Source: PLoS Medicine - June 11, 2018 Category: Internal Medicine Authors: Amol A. Verma Source Type: research

Clinical, socioeconomic, and behavioural factors at age 50 years and risk of cardiometabolic multimorbidity and mortality: A cohort study
ConclusionsThe importance of specific midlife factors in disease progression, from disease-free state to single disease, multimorbidity, and death, varies depending on the disease stage. While clinical risk factors at age 50 determine the risk of incident cardiometabolic disease in a disease-free population, midlife socioeconomic and behavioural factors are stronger predictors of progression to multimorbidity and mortality in people with cardiometabolic disease.
Source: PLoS Medicine - May 21, 2018 Category: Internal Medicine Authors: Archana Singh-Manoux Source Type: research

Cerebral white matter disease and functional decline in older adults from the Northern Manhattan Study: A longitudinal cohort study
ConclusionsIn this large population-based study, greater whole brain WMHV was associated with steeper annual decline in functional status over the long term, independently of risk factors, vascular events, and baseline functional status. Subclinical brain ischemic changes may be an independent marker of long-term functional decline.
Source: PLoS Medicine - March 20, 2018 Category: Internal Medicine Authors: Mandip S. Dhamoon Source Type: research

A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study)
ConclusionsThe present study demonstrates that a CDS can increase guideline adherence for anticoagulant therapy in patients with AF. Even though the observed difference was small, this is the first randomized study to our knowledge indicating beneficial effects with a CDS in patients with AF. Trial registrationClinicalTrials.gov NCT02635685
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Lars O. Karlsson Source Type: research

Validation of a genetic risk score for atrial fibrillation: A prospective multicenter cohort study
ConclusionsProspective assessment of a GRS for AF identified participants with elevated risk of AF beyond established clinical criteria. Accordingly, a GRS for AF could be incorporated into overall risk assessment to better identify patients at the highest risk of developing AF, although further testing in larger populations is needed to confirm these findings. Trial registrationClinicalTrials.gov NCT01970969
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Evan D. Muse Source Type: research

Progression of diabetes, heart disease, and stroke multimorbidity in middle-aged women: A 20-year cohort study
ConclusionsStroke was associated with increased risk of progression to diabetes or heart disease. Social inequality, obesity, hypertension, physical inactivity, smoking, or having other chronic conditions were also significantly associated with increased odds of accumulating multimorbidity. Our findings highlight the importance of awareness of the role of diabetes, heart disease, and stroke multimorbidity among middle-aged women for clinicians and health-promotion agencies.
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Xiaolin Xu Source Type: research

The current and potential health benefits of the National Health Service Health Check cardiovascular disease prevention programme in England: A microsimulation study
ConclusionsOur model indicates that the current NHS Health Check programme is contributing to improvements in health and reducing health inequalities. Feasible changes in the organisation of the programme could result in more than a 3-fold increase in health benefits.
Source: PLoS Medicine - March 6, 2018 Category: Internal Medicine Authors: Oliver T. Mytton Source Type: research

Patterns and temporal trends of comorbidity among adult patients with incident cardiovascular disease in the UK between 2000 and 2014: A population-based cohort study
ConclusionsThe burden of multimorbidity and comorbidity in patients with incident non-fatal CVD increased between 2000 and 2014. On average, older patients, women, and socioeconomically deprived groups had higher numbers of comorbidities, but the type of comorbidities varied by age and sex. Cardiometabolic conditions contributed substantially to the burden, but 4 out of the 10 top comorbidities were non-cardiometabolic. The current single-disease paradigm in CVD management needs to broaden and incorporate the large and increasing burden of comorbidities.
Source: PLoS Medicine - March 6, 2018 Category: Internal Medicine Authors: Jenny Tran Source Type: research

Postmenopausal hormone therapy and risk of stroke: A pooled analysis of data from population-based cohort studies
by Germ án D. Carrasquilla, Paolo Frumento, Anita Berglund, Christer Borgfeldt, Matteo Bottai, Chiara Chiavenna, Mats Eliasson, Gunnar Engström, Göran Hallmans, Jan-Håkan Jansson, Patrik K. Magnusson, Peter M. Nilsson, Nancy L. Pedersen, Alicja Wolk, Karin Leander BackgroundRecent research indicates a favourable influence of postmenopausal hormone therapy (HT) if initiated early, but not late, on subclinical atherosclerosis. However, the clinical relevance of timing of HT initiation for hard end points such as stroke remains to be determined. Further, no previous research has considered the timing of initiation of HT i...
Source: PLoS Medicine - November 17, 2017 Category: Internal Medicine Authors: Germ án D. Carrasquilla Source Type: research

Under-prescribing of Prevention Drugs and Primary Prevention of Stroke and Transient Ischaemic Attack in UK General Practice: A Retrospective Analysis
ConclusionsIn our study, over half of people eligible for lipid-lowering, anticoagulant, or antihypertensive drugs were not prescribed them prior to first stroke/TIA. We estimate that approximately 12,000 first strokes could potentially be prevented annually in the UK through optimal prescribing of these drugs. Improving prescription of lipid-lowering, anticoagulant, and antihypertensive drugs is important to reduce the incidence and burden of stroke and TIA.
Source: PLoS Medicine - November 14, 2016 Category: Internal Medicine Authors: Grace M. Turner Source Type: research

Circulating Apolipoprotein E Concentration and Cardiovascular Disease Risk: Meta-analysis of Results from Three Studies
We examined the association of circulating ApoE with cardiovascular risk factors in the two population-based studies (ELSA and NPHSII) and the relationship between ApoE concentration and coronary heart disease and stroke in all three studies. Analyses were carried out within study, and, where appropriate, pooled effect estimates were derived using meta-analysis. In the population-based samples, circulating ApoE was associated with systolic blood pressure (correlation coefficient 0.08,p
Source: PLoS Medicine - October 17, 2016 Category: Internal Medicine Authors: Reecha Sofat Source Type: research

Orthostatic Hypotension and the Long-Term Risk of Dementia: A Population-Based Study
ConclusionsIn this population predominantly of European descent, OH was associated with an increase in long-term risk of dementia.
Source: PLoS Medicine - October 10, 2016 Category: Internal Medicine Authors: Frank J. Wolters Source Type: research

Risks and Population Burden of Cardiovascular Diseases Associated with Diabetes in China: A Prospective Study of 0.5 Million Adults
Conclusions Among Chinese adults, diabetes is associated with significantly increased risks of major cardiovascular diseases. The increasing prevalence and younger age of onset of diabetes foreshadow greater diabetes-attributable disease burden in China.
Source: PLoS Medicine - July 4, 2016 Category: Internal Medicine Authors: Fiona Bragg Source Type: research

Investigating the Causal Relationship of C-Reactive Protein with 32 Complex Somatic and Psychiatric Outcomes: A Large-Scale Cross-Consortium Mendelian Randomization Study
by Bram. P. Prins, Ali Abbasi, Anson Wong, Ahmad Vaez, Ilja Nolte, Nora Franceschini, Philip E. Stuart, Javier Guterriez Achury, Vanisha Mistry, Jonathan P. Bradfield, Ana M. Valdes, Jose Bras, Aleksey Shatunov, PAGE Consortium , International Stroke Genetics Consortium , Systemic Sclerosis consortium , Treat OA consortium , DIAGRAM Consortium , CARDIoGRAMplusC4D Consortium , ALS consortium , International Parkinson’s Disease Genomics Consortium , Autism Spectrum Disorder Working Group of the Psychiatric Genomics Consortium , CKDGen consortium , GERAD1 Consortium , International Consortium for Blood Pressure , Schizophre...
Source: PLoS Medicine - June 20, 2016 Category: Internal Medicine Authors: Bram. P. Prins Source Type: research