International journal of clinical practice
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Int. J. Clin. Pract. · Apr 2020
Meta AnalysisDietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta-analysis.
There is no clear summarised report of the association between dietary acid load components including potential renal acid load (PRAL) and net-endogenous acid production (NEAP) with cardiometabolic risk factors. In the current meta-analysis, we aimed to systematically review and summarise the eligible observational studies evaluating the association between PRAL and NEAP with blood pressure and hypertension and markers of glucose haemostasis among adults. ⋯ In the current meta-analysis, we found potent negative effects of high dietary acid load particularly higher PRAL scores cardiometabolic risk factors. Therefore, lower acidogenic food ingredients in the diets are suggested for the prevention of cardiovascular risk factors and diabetes.
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Int. J. Clin. Pract. · Apr 2020
Multicenter StudyDiabetes in day case general and vascular surgery: A multicentre regional audit.
People with Diabetes Mellitus (DM) are at increased risk of postoperative complications if their HbA1C readings are not well controlled. In the UK, there are clear national guidelines requiring all people with DM to have HbA1C blood testing within 6months before undergoing surgery and that these readings should be below 69 mmol/mol if this is safe to achieve. The aim of this study was to determine whether hospitals in the region were compliant with the guidelines. ⋯ A significant proportion of people with diabetes undergoing elective day case procedures in our region do not have HbA1C testing within 6 months of their procedure as recommended by the national guidelines. In patients who do have a high HbA1C, the majority still undergo surgery without adequate control of their DM. Greater awareness amongst healthcare workers and robust pathways are required for this vulnerable group of patients if we are to reduce the risk of developing postoperative complication rates.
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Int. J. Clin. Pract. · Apr 2020
Admission serum phosphate levels and the risk of respiratory failure.
The objective of this study was to evaluate the relationship between admission serum phosphate and in-hospital respiratory failure requiring mechanical ventilation in hospitalised patients. ⋯ Our study revealed the J-shaped association between serum phosphate level at admission and risk of respiratory failure requiring mechanical ventilation in unselected hospitalised patients.
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Int. J. Clin. Pract. · Apr 2020
I beg your pardon?! using conditionals theory to understand doctor-patient communication problems.
Little attention is given to the process and impact of poor communicaton on the doctor-patent relationship. ⋯ A number of recommmednations are made to support GPs to reduce the impact of this problem on the medical consultation.