Journal of general internal medicine
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There is a lack of comprehensive view of the association between acute exacerbation of COPD (AECOPD) and the risk of acute cardiovascular events. ⋯ AECOPD was associated with increased 30-day and 1-year incidences of acute cardiovascular event.
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Barriers to healthcare are common in the USA and may result in worse outcomes among hospital survivors of an acute coronary syndrome (ACS). ⋯ Absence of an established usual source of care and inconsistent transportation availability were associated with a higher risk for dying after an ACS. Patients with these barriers to follow-up care may benefit from more intensive follow-up and support.
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Randomized Controlled Trial
A Coaching by Telephone Intervention on Engaging Patients to Address Modifiable Cardiovascular Risk Factors: a Randomized Controlled Trial.
A large proportion of deaths and chronic illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. ⋯ NCT01828567.
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The Chronic Care Model (CCM) has been endorsed by experts to reduce disparities in chronic disease outcomes but benefits may be slow to appear in low-income populations. ⋯ After adopting the CCM for primarily Hispanic patients with DM, SBP control increased significantly despite treatment with fewer HTN drugs. Yet improvement took 3-4 years, suggesting that financial rewards for using the CCM to achieve improved clinical outcomes for low-income, minority patients may be delayed.
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Diarrheal illness is a major reason for hospitalization, but data on consequent acute kidney injury (AKI) are sparse. ⋯ Acute kidney injury is common and consequential among patients hospitalized for diarrheal illness. Persons with CKD and hypertension are the most susceptible, possibly due to diminished renal reserve and exacerbating effects of treatment with diuretics and renin-angiotensin-aldosterone system blockers. Proactive management of these unique pharmacologic and physiologic factors is necessary to prevent AKI in this vulnerable population.