International journal of clinical practice
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Int. J. Clin. Pract. · Feb 2017
ReviewSuspecting non-cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know.
Non-cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. In the last several decades, its prevalence has increased, making it likely to be encountered in the primary care setting. The aim was to review the clinical presentation and diagnosis of NCFB, with an emphasis on the role of computed tomography (CT). ⋯ Non-cystic fibrosis bronchiectasis should be suspected in the primary care setting in patients with chronic cough, purulent sputum and frequent respiratory infections that tend to resolve slowly or partially. Early diagnosis and determination of the extent and severity of the disease by CT and other tests are critical to establish therapy to improve quality of life and potentially slow progressive decline of lung function in patients with NCFB.
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Int. J. Clin. Pract. · Jan 2017
Review Meta AnalysisAssociation of coffee consumption and chronic kidney disease: A meta-analysis.
The risk of chronic kidney disease (CKD) in individuals who regularly drink coffee is controversial. The aim of this meta-analysis was to evaluate the association between coffee consumption and CKD. ⋯ Our study demonstrates no significant association between coffee consumption and CKD in males. However, future studies are required to assess a potential inverse association between coffee consumption and risk for developing CKD in females.
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Int. J. Clin. Pract. · Jan 2017
Shortened hospital length of stay and lower costs associated with rivaroxaban in patients with pulmonary embolism managed as observation status.
Unlike rivaroxaban, treatment of patients with pulmonary embolism (PE) with warfarin requires parenteral bridging and coagulation monitoring that may prolong length-of-stay (LOS) and increase hospital costs. ⋯ Rivaroxaban was associated with shortened LOS and lowered cost vs parenterally bridged warfarin in PE observation stay patients, without increases in the short-term rate of complications or readmission.
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The high variability in clinical manifestations of Fabry disease can lead to delays between symptom onset and correct diagnosis, and between correct diagnosis and initiation of enzyme replacement therapy. We investigated whether these delays have improved in recent years. ⋯ We found that the delay in diagnosis has not improved substantially whereas the delay in treatment onset has improved in recent years.