International journal of clinical practice
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Int. J. Clin. Pract. · Mar 2020
Elevated triglycerides on admission positively correlate with the severity of hypertriglyceridaemic pancreatitis.
Hypertriglycaeridemia has been positively associated with the risk of acute pancreatitis, but whether increased triglyceride (TG) levels are related to the severity of pancreatitis remains unclear. The aim of this study was to assess the relationship between hyperlipidaemia and disease severity of hypertriglycaeridemic pancreatitis. ⋯ Elevated serum TG levels at the time of admission seem to correlate positively with the severity of hypertriglyceridaemia-induced acute pancreatitis.
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Int. J. Clin. Pract. · Mar 2020
Factors that predict recurrent spontaneous bacterial peritonitis in cirrhotic patients.
The recurrence rate of spontaneous bacterial peritonitis (SBP) is increasing in cirrhotic patients. Antibiotic prophylaxis should be prescribed in all cirrhotic patients after the first episode of SBP. However, antibiotics promote the development of antibiotic-resistant bacteria. ⋯ SBP frequently recurs in cirrhotic patients. Serum potassium ≥4 mEq/L, serum albumin ≤2g/dL at SBP diagnosis and platelet count ≤100 000/microliter before discharge were identified as factors that may predict the recurrence of SBP after the first episode.
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Int. J. Clin. Pract. · Mar 2020
Evaluation of provider documentation patterns as a tool to deliver ongoing patient-centred diabetes education and support.
Diabetes mellitus (DM) is one of the most common chronic diseases in the world. As a disease with long-term complications requiring changes in management, DM requires not only education at the time of diagnosis, but ongoing diabetes self-management education and support (DSME/S). In the United States, however, only a small proportion of people with DM receive DSME/S, although evidence supports benefits of ongoing DSME/S. The diabetes education that providers deliver during follow-up visits may be an important source for DSME/S for many people with DM. ⋯ This study focused on the frequency distribution of information providers delivered to the people with DM during follow-up clinic visits based on the AADE7. The results may indicate a lack of patient-centred education when people with DM visit providers for ongoing management. Further studies are needed to identify the underlying reasons why providers have difficulty delivering patient-centred education.
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Int. J. Clin. Pract. · Mar 2020
Acanthosis nigricans in middle-age adults: A highly prevalent and specific clinical sign of insulin resistance.
Insulin resistance (IR) precedes the diagnosis of many metabolic and non-metabolic illnesses, including type 2 diabetes mellitus (T2DM). Acanthosis nigricans (AN) is a clinical sign associated with IR. However, AN prevalence and diagnostic accuracy in middle-age adults before or at the time of prediabetes/diabetes diagnosis remain uncertain. ⋯ In middle-age adults, within the entire spectrum of carbohydrate tolerance, AN is highly prevalent and specific. This finding supports its assessment as a reliable and convenient clinical sign of IR. The understanding of AN behaviour through different carbohydrate tolerance strata, and its different locations, could lead to early detection of individuals at high metabolic risk or help direct a more pathophysiological treatment approach in patients with T2DM.
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Int. J. Clin. Pract. · Mar 2020
Clinical TrialSystolic blood pressure trajectory and cardiovascular outcomes: An analysis using data in the Systolic Blood Pressure Intervention Trial.
Blood pressure changes in response to medication intensification differ over time across individuals, and could affect their cardiovascular outcomes. We aimed to investigate the relationship between systolic blood pressure (SBP) trajectory and cardiovascular outcomes using data from the Systolic Blood Pressure Intervention Trial (SPRINT). ⋯ An SBP treatment target of <120 mm Hg was only associated with a better cardiovascular outcome compared with a treatment target of <140 mm Hg, provided that the target of <120 mm Hg was reached.