The Journal of family practice
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Stroke is a significant cause of mortality worldwide, and diabetes is an independent risk factor for ischemic stroke occurrence and recurrence. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) lower the risk of ischemic stroke through beneficial effects on traditional stroke risk factors such as hyperglycemia, hypertension, and dyslipidemia. ⋯ Based on meta-analyses of CV outcomes trials, GLP-1 RAs have a substantial and statistically significant benefit on ischemic stroke risk reduction, whereas SGLT2 inhibitors have a nonsignificant effect. The use of GLP-1 RAs, in addition to non-pharmacologic and pharmacologic management of traditional stroke risk factors, is a key component of complex therapy for ischemic stroke risk reduction.
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Was this a case of the "great masquerader"? Or was it something else?
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The developmental origins of health and disease (DOHaD) hypothesis suggests prenatal nutrition sets the stage for the developing brain, with effects that last into adulthood. Macronutrient and micronutrient requirements increase in pregnancy and deficiencies can influence fetal neurodevelopment and cognition. Foods such as eggs, meat, and seafood contain many of the nutrients needed for healthy neurodevelopment and intake should be encouraged among women of reproductive age. Family practice clinicians play an important role in providing nutrition recommendations surrounding food and prenatal supplements to consume before, during, and after pregnancy.
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At the end of the activity, participants will be able to: Identify the risks of kidney disease and their consequences in patients with type 2 diabetes (T2D). Appropriately screen for the presence of chronic kidney disease (CKD) in patients with T2D. Initiate evidence-based therapy to slow the progression of kidney disease in patients with T2D and CKD. Become familiar with the novel nonsteroidal mineralocorticoid receptor antagonist finerenone and its role in the treatment of patients with T2D and CKD.
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New updates in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report include major changes to initial disease assessment and pharmacologic therapy, highlighting the clinical relevance of exacerbations. The updated GOLD 2023 algorithms offer a shorter path to consideration of triple therapy, including both initial and follow-up treatment. Most mild- or moderate-severity chronic obstructive pulmonary disease (COPD) exacerbations can be successfully managed in outpatient settings; primary care clinicians have many opportunities to identify, diagnose, and treat patients with COPD earlier to reduce lung damage and disease progression. COPD and cardiovascular disease share common mechanisms and risk factors that influence COPD management.