International journal of clinical practice
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Int. J. Clin. Pract. · Mar 2021
Impact of Incorporating Echocardiographic Screening into a Clinical Prediction Model to Optimize Utilization of Echocardiography in Primary Care.
Access to public subspecialty healthcare is limited in underserved areas of Brazil, including echocardiography (echo). Long waiting lines and lack of a prioritisation system lead to diagnostic lag and may contribute to poor outcomes. We developed a prioritisation tool for use in primary care, aimed at improving resource utilisation, by predicting those at highest risk of having an abnormal echo, and thus in highest need of referral. ⋯ The addition of screening echo to clinical variables significantly improves the performance of a score to predict major HD.
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Int. J. Clin. Pract. · Mar 2021
Adherence to antihypertensive medication after referral to secondary health care: a prospective cohort study.
Nonadherence (NAd) to antihypertensive medication is associated with lack of blood pressure control and worsened long-term outcomes. Increased access to a programme for high-risk cardiovascular patients has the potential to reduce NAd and improve clinical outcomes. We evaluated implementation NAd prevalence and risk factors among severely hypertensive patients after 12-month-long access to secondary healthcare centres. ⋯ Greater access to health services is associated with a reduction in NAd to antihypertensive medication and better blood pressure control. NAd was correlated with modifiable variables such as treatment complexity and, for the first time, team satisfaction, suggesting that implementation of similar programmes may limit NAd in similar patient groups.
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Int. J. Clin. Pract. · Mar 2021
Temporal Trends and Outcomes in Utilization of Transcatheter and Surgical Aortic Valve Therapies in Aortic Valve Stenosis Patients with Heart Failure.
Heart failure (HF) is a common comorbidity in patients undergoing surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). We sought to access the temporal trends and outcomes of TAVR or SAVR in HF patients. ⋯ For patients with severe aortic valve stenosis and heart failure who undergo aortic valve intervention, TAVR is associated with less odds of in-hospital mortality compared with SAVR.
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Int. J. Clin. Pract. · Mar 2021
Meta AnalysisEffects of resveratrol supplementation on liver enzymes: A systematic review and meta-analysis of randomized controlled trials.
The available evidence regarding the possible effects of resveratrol on liver function is inconsistent. Therefore, the present meta-analysis was performed to investigate the overall effects of resveratrol supplementation on liver enzymes in adults. ⋯ Overall, in our study, resveratrol does not affect liver enzyme levels significantly, but subgroup analysis indicates that these results may be influenced by resveratrol dose, duration of the study and population status, so future high-quality studies are necessary to get definitive results.
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Int. J. Clin. Pract. · Mar 2021
Review Meta AnalysisImpact of Ramadan-focused diabetes education on hypoglycemia risk and metabolic control for patients with type 2 diabetes mellitus: A systematic review.
Ramadan fasting is regarded as a form of worship amongst Muslims. However, patients with a high risk of diabetic complications are advised to avoid fasting, as the practice is associated with significant impacts on several health factors for type 2 diabetic patients, including glycaemic control. Thus, a lack of focused education before Ramadan may result in negative health outcomes. ⋯ Ramadan-focused diabetes education had a significant impact on hypoglycemia and glycaemic control, with no significant effect on body weight, blood lipids or blood pressure.