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KT Evidence Bite: Cardioversion and Thromboembolism - CanadiEM

What is the incidence of and risk factors for thromboembolic events after ED cardioversion of acute atrial fibrillation? Early cardioversion (<12hrs) is  
boringem.org
over 6 years ago
Www.bmj
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India’s urban middle class has high prevalence of cardiometabolic risk factors, finds study

Cardiometabolic risk factors are highly prevalent among India’s urban middle class, indicate the findings of an 11 city, cross sectional survey.1 But a comparatively lower prevalence was seen in cities in eastern India and cities that ranked lower on a social development index.  
feeds.bmj.com
over 6 years ago
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Fetal high-risk factors

Looking for online definition of Fetal high-risk factors in the Medical Dictionary? Fetal high-risk factors explanation free. What is Fetal high-risk factors? Meaning of Fetal high-risk factors medical term. What does Fetal high-risk factors mean?  
medical-dictionary.thefreedictionary.com
over 6 years ago
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Qigong to prevent cardiovascular disease | Cochrane

This review assessed the effectiveness of qigong interventions for reducing cardiovascular events and cardiovascular risk factors among healthy adults and those at high risk of cardiovascular disease.  
cochrane.org
over 6 years ago
Www.bmj
0
11

Half of US cardiovascular deaths are due to modifiable risk factors, study finds

If the five commonest modifiable risk factors for cardiovascular disease—high cholesterol concentrations, diabetes, hypertension, obesity, and smoking—were eliminated in the United States, deaths from cardiovascular disease would be halved, a new study in the Annals of Internal Medicine has found.1 Cardiovascular diseases such as coronary heart disease and stroke are the leading cause of death in the US, accounting for more than 780 000 deaths in 2010.  
feeds.bmj.com
over 6 years ago
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Extra calcium to prevent high blood pressure | Cochrane

Hypertension is a serious health problem that increases the risk of heart and kidney diseases. Several studies have shown that increasing calcium intake lowers blood pressure even in individuals within a normal blood pressure range. Increasing calcium intake also has benefits for pregnancy outcomes, effects which are thought to be mediated also by blood pressure reduction. High blood pressure has been identified as a major risk factor for mortality and even small reductions in blood pressure can decrease the occurrence of coronary artery disease, stroke and death.  
cochrane.org
over 6 years ago
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Novel oral anticoagulants for the treatment of deep vein thrombosis | Cochrane

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in the deep vein of the leg or pelvis. It affects approximately 1 in 1000 people. If it is not treated, the clot can travel in the blood and block the arteries in the lungs. This life-threatening condition is called a pulmonary embolism (PE) and occurs in approximately 3 to 4 per 10,000 people. The chances of getting a DVT can be increased if people have certain risk factors. These include previous clots, prolonged periods of immobility (such as travelling on aeroplanes or bed rest), cancer, exposure to oestrogens (pregnancy, oral contraceptives or hormone replacement therapy), trauma and blood disorders such as thrombophilia (abnormal blood clotting). A DVT is diagnosed through determining the risk factors and performing an ultrasound of the leg veins. If a DVT is confirmed, people are treated with an anticoagulant. This medicine prevents further clots from forming. Until recently, the drugs of choice were heparin, fondaparinux and vitamin K antagonists. However, these drugs can cause side effects and have limitations. Two further classes of novel oral anticoagulants have been developed: these are called direct thrombin inhibitors (DTI) and factor Xa inhibitors. There are particular reasons why oral DTIs and factor Xa inhibitors might now be better medicines to use. They can be given orally, they have a predictable effect, they do not require frequent monitoring or re-dosing and they have few known drug interactions. This review measures the effectiveness and safety of these new drugs with conventional treatment.  
cochrane.org
over 6 years ago
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Psychosocial smoking cessation interventions help patients with heart attacks to quit. | Cochrane

Smoking is a risk factor for heart attacks and stopping smoking is recommended for patients after a heart attack. Psychosocial smoking cessation interventions like counseling can help such patients to stop smoking, if they are provided for over one month. Psychosocial interventions can help such patients to quit within 6 months but studies about the long term effects did not support the beneficial short-term findings. Most trials used a mixture of different intervention strategies, therefore no single strategy showed superior efficacy.  
cochrane.org
over 6 years ago
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Abnormal extra heartbeats may be modifiable risk factor for heart failure, study shows

Having commonly occurring abnormal extra heartbeats known as premature ventricular contractions may be a modifiable risk factor for congestive heart failure, the results of a large US follow-up study have shown.1  
feeds.bmj.com
over 6 years ago
Www.bmj
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Aortic stiffness as a cardiovascular risk predictor

Cardiovascular disease remains the leading cause of death worldwide, despite highly effective preventive treatments. Most current guidelines recommend treatment based on arbitrary thresholds or the risk of a future event. Although the guidelines are effective at identifying those most at risk, in whom to start treatment, many individuals are categorised as moderate-low risk, denied treatment, and go on to have events. This has created considerable interest in refining risk prediction with novel biomarkers, such as C reactive protein and carotid intima-media thickness. Frustratingly, the majority of these add little to risk prediction based on traditional risk factors such as blood pressure, lipids, cigarette smoking, and diabetes.1  
feeds.bmj.com
over 6 years ago
Www.bmj
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Birth weight and later life adherence to unhealthy lifestyles in predicting type 2 diabetes: prospective cohort study

Objectives To prospectively assess the joint association of birth weight and established lifestyle risk factors in adulthood with incident type 2 diabetes and to quantitatively decompose the attributing effects to birth weight only, to adulthood lifestyle only, and to their interaction.  
feeds.bmj.com
over 6 years ago
Www.bmj
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Low glycaemic index diet fails to reduce cardiovascular risk factors, study shows

Overweight people eating a low glycaemic index diet show no difference in cardiovascular risk factors or insulin sensitivity compared with those consuming a high glycaemic index diet, a randomised trial has shown.  
feeds.bmj.com
over 6 years ago
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Compelling evidence linking sugary drinks with diabetes

Global estimates of diabetes prevalence continue to outpace previous projections, as virtually all regions of the world continue to see a large and growing prevalence.1 Proposals by diabetes prevention experts for how to change these trends have included both structured programmes for adults at high risk for type 2 diabetes (the “high risk approach”) and environmental and food policies to help change risk factors in the whole population (the “population approach”).1 Promising programmes for those at high risk are already underway and need to be expanded,2 but complementary shifts in underlying risk factors in the broader population are also needed. The list of risk factors for type 2 diabetes is long, with dozens of demographic, behavioural, and genetic risk factors now identified.3 Unfortunately the list of simple, consensus based levers to change population risk factors and substantially influence the risk for type 2 diabetes remains short.  
feeds.bmj.com
over 6 years ago
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Standing Better than Sitting for CV Risk Factors

Links seen across markers from glucose and lipids to BMI  
medpagetoday.com
over 6 years ago
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Preventing premature ventricular contractions can prevent heart failure - The Clinical Advisor

Premature ventricular contractions may be a modifiable risk factor for heart failure and death.  
clinicaladvisor.com
over 6 years ago
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Critical Care

A substantial number of patients admitted to the ICU because of an acute illness, complicated surgery, severe trauma, or burn injury will develop a de novo form of muscle weakness during the ICU stay that is referred to as “intensive care unit acquired weakness” (ICUAW). This ICUAW evoked by critical illness can be due to axonal neuropathy, primary myopathy, or both. Underlying pathophysiological mechanisms comprise microvascular, electrical, metabolic, and bioenergetic alterations, interacting in a complex way and culminating in loss of muscle strength and/or muscle atrophy. ICUAW is typically symmetrical and affects predominantly proximal limb muscles and respiratory muscles, whereas facial and ocular muscles are often spared. The main risk factors for ICUAW include high severity of illness upon admission, sepsis, multiple organ failure, prolonged immobilization, and hyperglycemia, and also older patients have a higher risk. The role of corticosteroids and neuromuscular blocking agents remains unclear. ICUAW is diagnosed in awake and cooperative patients by bedside manual testing of muscle strength and the severity is scored by the Medical Research Council sum score. In cases of atypical clinical presentation or evolution, additional electrophysiological testing may be required for differential diagnosis. The cornerstones of prevention are aggressive treatment of sepsis, early mobilization, preventing hyperglycemia with insulin, and avoiding the use parenteral nutrition during the first week of critical illness. Weak patients clearly have worse acute outcomes and consume more healthcare resources. Recovery usually occurs within weeks or months, although it may be incomplete with weakness persisting up to 2 years after ICU discharge. Prognosis appears compromised when the cause of ICUAW involves critical illness polyneuropathy, whereas isolated critical illness myopathy may have a better prognosis. In addition, ICUAW has shown to contribute to the risk of 1-year mortality. Future research should focus on new preventive and/or therapeutic strategies for this detrimental complication of critical illness and on clarifying how ICUAW contributes to poor longer-term prognosis.  
ccforum.com
over 6 years ago
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Concurrent health promotion interventions for preventing cardiovascular disease in low- and middle income countries ("resource-limited settings") | Cochrane

This review examines the effectiveness of health promotion interventions that aim to reduce more than one major cardiovascular risk factor (multiple risk factor intervention) for the primary prevention of cardiovascular disease in low- and middle-income countries (LMICs). Such risk factors are overweight/obesity, high blood pressure, smoking, too much bad cholesterol or low physical activity levels.  
cochrane.org
over 6 years ago
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Food for thought

“During the past month, about how often did you eat hot spicy foods?” Jun Lv and colleagues put that question to over half a million Chinese adults (doi:10.1136/bmj.h3942). In 3.5 million person years of follow-up the risk of death was consistently lower in those who ate spicy food regularly than in those who ate such food less than once a week. The authors acknowledge that residual confounding is possible despite their attempts to adjust for other risk factors. Editorialist Nita Forouhi underscores the need for caution, saying that it is too soon to know whether spicy food directly reduces the risk of death or is simply “a marker of other dietary and lifestyle factors” (doi:10.1136/bmj.h4141).  
feeds.bmj.com
over 6 years ago