International journal of clinical practice
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Int. J. Clin. Pract. · Jan 2016
ReviewPredictive factors and clinical biomarkers for treatment in patients with chronic pain caused by osteoarthritis with a central sensitisation component.
The aim of this non-systematic review was to provide a practical guide for clinicians on the evidence for central sensitisation in chronic osteoarthritis (OA) pain and how this pain mechanism can be addressed in terms of clinical diagnosis, investigation and treatment. ⋯ Clinicians should be aware of central sensitisation in patients with chronic OA pain, especially in patients presenting with severe pain with unusual features.
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Int. J. Clin. Pract. · Jan 2016
ReviewLung cancer screening: a systematic review of clinical practice guidelines.
Lung cancer screening using low-dose computed tomography presents an exciting development for high-risk individuals. Several expert bodies and governments have recently issued and updated their clinical practice guidelines (CPGs) for lung cancer screening. We evaluate the CPGs and compare and contrast the recommendations between them. ⋯ The qualities of the selected CPGs vary and there is potential to improve the qualities among and between each. Specifically, more evidence is needed to support the recommendations such as a larger cohort of high-risk participants, and further analysis of the lung cancer screening interval, the benefit vs. harm of lung cancer screening, the timing and rigour of follow-up and availability of effective treatments.
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Int. J. Clin. Pract. · Dec 2015
Older type 2 diabetic patients are more likely to achieve glycaemic and cardiovascular risk factors targets than younger patients: analysis of a primary care database.
Older subjects with type 2 diabetes mellitus (T2DM) have differential characteristics compared with middle-aged or younger populations, and require tailored management of the disease. ⋯ Control of glycaemia and cardiovascular risk factors was better among older T2DM patients. There is a need for prospective studies to quantify the weight of risk factors in each complication to adapt the therapeutic and care approaches in elderly people.
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Int. J. Clin. Pract. · Dec 2015
The impact of opioid-induced constipation among chronic pain patients with sufficient laxative use.
The impact of sufficient laxative use on opioid-induced constipation (OIC) is not known. ⋯ These findings demonstrate constipation persists despite sufficient laxative use with little improvement in symptoms, HRQL or activity impairment. This ongoing burden emphasises the need to identify more efficacious constipation therapies for this chronic pain patient population.
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Int. J. Clin. Pract. · Dec 2015
Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States.
To assess the prevalence, patient-physician communication, treatment and health outcomes associated with urinary incontinence (UI) among the medically complex vulnerable elderly (MCVE) in the United States (US). ⋯ Urinary incontinence prevalence in the USA increased among MCVE from 2006 to 2012, although treatment of UI remained low. UI problems, particularly big UI problems, adversely impact health outcomes. Efforts to better identify and manage UI among the MCVE are needed.