Open access journal. There is limited research on the economic burden of low back-related leg pain, including sciatica. The aim of this study was to describe healthcare resource utilisation and factors associated with cost and health outcomes in primary care patients consulting with symptoms of low back-related leg pain including sciatica. The study took place in the West Midlands.
In chronic kidney disease (CKD), hypertension is associated with poor outcomes at ages <70 years. At older ages, this association is unclear. We tested 10-year mortality and cardiovascular outcomes by clinical systolic blood pressure (SBP) in older CKD Stages 3 and 4 patients without diabetes or proteinuria.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
Headlines suggesting that a supplement can "slash" your risk of heart disease or stroke are attractive, but the study does not back up the headlines.
This type of study cannot prove that one factor (glucosamine) is the cause of the results they found.
While the researchers tried to take account of other possible causes of the results, they could not account for everything.
Clearly it's good news that more people are surviving stroke and fewer people are dying from it. But the finding that younger people are having more strokes is a concern.
We cannot tell from the study what's behind the improved survival rates for stroke.
But the NHS introduced many changes to stroke care during this period, including specialist stroke units in all hospitals taking stroke patients, better access to brain scans and improved use of medication for acute strokes.
Aspirin is one of the most frequently used drugs worldwide and is generally considered effective for the secondary prevention of cardiovascular disease. By contrast, the role of aspirin in primary prevention of cardiovascular disease is controversial. Early trials evaluating aspirin for primary prevention, done before the turn of the millennium, suggested reductions in myocardial infarction and stroke (although not mortality), and an increased risk of bleeding. In an effort to balance the risks and benefits of aspirin, international guidelines on primary prevention of cardiovascular disease have typically recommended aspirin only when a substantial 10-year risk of cardiovascular events exists. However, in 2018, three large randomised clinical trials of aspirin for the primary prevention of cardiovascular disease showed little or no benefit and have even suggested net harm. In this narrative Review, we reappraise the role of aspirin in primary prevention of cardiovascular disease, contextualising data from historical and contemporary trials.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
The research, published in the European Journal of Preventive Cardiology, showed that CR can benefit somebody who has had a significant heart event regardless of socioeconomic inequalities such as profession, income and the neighbourhood in which they live.
However, the research showed that despite its cost effectiveness, CR uptake is consistently poor, with figures ranging from 10% to 60% globally.
Current guidelines from the American Heart Association/American Stroke Association advocate against the administration of intravenous thrombolysis (IVT) in patients with acute ischaemic stroke (AIS) with a prior ischaemic stroke (IS) within 3 months (Class III: Level of Evidence B).1 This concern is based on a presumed increased risk of symptomatic intracranial haemorrhage (sICH) and mortality2 and therefore led to the respective guideline recommendation. Thus, patients with a history of prior IS have been excluded in the majority of the pivotal randomised controlled clinical trials that have established IVT as a treatment for . To read the full article, log in using your NHS OpenAthens details.
Given the profound impact of language impairment after stroke (aphasia), neuroplasticity research is garnering considerable attention as means for eventually improving aphasia treatments and how they are delivered. Functional and structural neuroimaging studies indicate that aphasia treatments can recruit both residual and new neural mechanisms to improve language function and that neuroimaging modalities may hold promise in predicting treatment outcome. In relatively small clinical trials, both non-invasive brain stimulation and behavioural manipulations targeting activation or suppression of specific cortices can improve aphasia treatment outcomes. Recent language interventions that employ principles consistent with inducing neuroplasticity also are showing improved performance for both trained and novel items and contexts. While knowledge is rapidly accumulating, larger trials emphasising how to select optimal paradigms for individualised aphasia treatment are needed. Finally, a model of how to incorporate the growing knowledge into clinical practice could help to focus future research.. To read the full article, log in using your NHS OpenAthens details.
Open access. The prevalence of asthma and obesity have increased over the last decades. A possible association between these two chronic illnesses has been suggested, since the prevalence of asthmatic symptoms rises with increasing Body Mass Index (BMI). However, asthma is only one of several possible causes of shortness of breath in obese children. The aim of this study is to evaluate the prevalence of overtreatment with asthma medication in a cohort overweight/obese children with respiratory symptoms visiting a pediatric outpatient clinic.
Despite the headlines, we do not know if this medicine would be useful, and most importantly safe, for people with heart failure.
Studies in animals help scientists understand how medicines work. But they do not tell us if the results will translate to humans.
The sheep had a pacemaker implanted, which made their heart beat artificially fast.
This is not automatically the same thing as a human heart that's lost the ability to pump blood because of high blood pressure or a past heart attack.
Open access. Nearly 1% of the population is currently treated with long-term corticosteroid therapy. When corticosteroids are introduced, information concerning potential adverse effects and recommendations for lifestyle changes aimed at preventing such effects is provided to patients. However, studies have shown patients often do not fully comprehend the information provided and have difficulty implementing the recommended dietary and physical activity advice. In this study, we aim to highlight the difficulties encountered by patients in comprehending and implementing recommendations in the context of long-term corticosteroid use. Such information can be used to better optimize care, particularly concerning adherence to the treatment, the diet, and thus improve the quality of life of patients.
Patients will be identified by specialist nurses and clinical pharmacists across the country who are trained to treat a heart condition – called atrial fibrillation – which increases the chance of having a stroke.
Specialist clinicians will identify patients in each surgery who have been diagnosed with atrial fibrillation but are not receiving treatment. Anyone identified as being at risk will be offered a personalised treatment plan developed with their GP.
The new scheme will treat more than 18,000 people, preventing around 700 strokes, saving an estimated 200 lives and stopping long-term health problems among thousands more, including disability.
To evaluate the effectiveness of educational interventions in improving medication adherence among adult patients diagnosed with hypertension, hyperlipidaemia, and/or diabetes.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To explore the role of coping moderators in self‐management of breathlessness crises by people with advanced respiratory disease.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
The study highlights the need for doctors to review the cholesterol response in people who take statins. Notably, those who did not respond were on lower doses, but the study cannot tell us that specific statins or particular doses "do not work" because we do not know enough about why doctors prescribed as they did.
Importantly, the results of this study do not apply to people who have been prescribed statins after a previous heart attack or stroke: they will nearly always be prescribed higher dose statins.
This research sought to explore the pain management beliefs of members of the South Asian community living in the UK. In particular, their understanding of the key components of cognitive behavioural therapy (CBT) informed pain management programmes (PMPs) was explored. You can request a copy of this article by replying to this email. Please be clear which article you are requesting.