International journal of clinical practice
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Int. J. Clin. Pract. · Dec 2016
Perceived weight discrimination and chronic medical conditions in adults with overweight and obesity.
This study investigated whether perceived weight discrimination is associated with increased risk for major chronic medical conditions and whether the associations persist after adjusting for other stressful life events in addition to BMI, physical activity and sociodemographic variables. ⋯ Among overweight/obese adults, perceived weight discrimination is associated with significantly increased risk for obesity-related chronic medical conditions even after adjusting for BMI, physical activity and sociodemographic variables. Accounting for other acute stressful life events may also be important in understanding the health effects of perceived weight discrimination. Such added health risk of overweight/obesity posed by perceived weight discrimination warrants public health and policy interventions against weight discrimination to reduce the socioeconomic burden of obesity.
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Int. J. Clin. Pract. · Nov 2016
ReviewVery low LDL-C levels may safely provide additional clinical cardiovascular benefit: the evidence to date.
Cardiovascular disease (CVD) is the leading cause of death in Europe and increased low-density lipoprotein cholesterol (LDL-C) is a major contributor to CVD risk. Extensive evidence from clinical studies of statins has demonstrated a linear relationship between LDL-C levels and CVD risk. It has been proposed that lower LDL-C levels than those currently recommended may provide additional clinical benefit to patients. ⋯ Genetic and clinical evidence supports the concept that reduction in LDL-C levels below current recommended targets may provide additional clinical benefit to patients without adversely impacting patient safety. Statin add-on therapies, such as ezetimibe and the recently approved proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors alirocumab and evolocumab, allow patients to achieve very low LDL-C levels and are likely to impact on future treatment paradigms.
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Int. J. Clin. Pract. · Nov 2016
Observational StudyNocturia is often inadequately assessed, diagnosed and treated by physicians: results of an observational, real-life practice database containing 8659 European and US-American patients.
The aim of this study was to investigate the quality and timing of the diagnosis and treatment of nocturia in real-life practice in European and US-American patients to obtain better insights into the management of nocturia in different Western healthcare systems. ⋯ Data show that patients with nocturia and LUTS accept their symptoms for a considerable period before they seek help or ultimately receive treatment. They may therefore be enduring significant negative impact on their quality-of-life which could be avoided. Physicians rarely use bladder diaries and primarily use antimuscarinics (women) or α-blockers (men). Improved awareness of nocturia among patients and physicians could improve the management of nocturia.
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Int. J. Clin. Pract. · Nov 2016
Higher levels of apomorphine and rotigotine prescribing reduce overall secondary healthcare costs in Parkinson's disease.
Parkinson's disease (PD) affects around 100,000 people in England. A number of non-oral therapies can improve both the quality of life and reduce patient needs for health and social care. However, these can be relatively expensive at £2000-£10,000 per year per patient. Our aim was to examine how prescribing of these agents relates to secondary care costs. ⋯ Those practices which used more non-oral therapies appear to incur less secondary care costs. A total of 70% of the advanced PD patients are not being given access to non-oral treatment. This is a challenge for all physicians looking after the older patient.