Internal medicine journal
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Internal medicine journal · Apr 2015
Review Meta AnalysisAssociation between vitamin B12 deficiency and long-term use of acid-lowering agents: a systematic review and meta-analysis.
Vitamin B12 (cobalamin) deficiency can result in irreversible structural brain changes if not treated appropriately. Long-term use of acid-lowering agents (ALA) has been linked to vitamin B12 deficiency, but results are inconsistent. ⋯ Chronic use of ALA is a risk factor for developing vitamin B12 deficiency. Judicious prescribing of ALA and regular monitoring of vitamin B12 in patients who are inevitably on long-term ALA therapy are recommended.
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Internal medicine journal · Apr 2014
Review Meta AnalysisCardiovascular disease in human immunodeficiency virus.
With widespread access to high-quality medical care as in Australia, human immunodeficiency virus (HIV) is now considered a chronic, treatable condition, with a good life expectancy. The use of combined highly active antiretroviral therapy has enabled effective suppression of the virus, but has also been associated with increased cardiac morbidity and mortality. ⋯ Therefore, a contemporary management strategy for patients with HIV must include active prevention and treatment of cardiovascular risk. This review will outline the complex interplay between HIV infection, antiretroviral drug regimens and accelerated cardiovascular disease, with a particular focus on screening, prevention and treatment options in a contemporary Australian HIV population.
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Internal medicine journal · Nov 2013
Meta AnalysisPopulation attributable risks for modifiable lifestyle factors and breast cancer in New Zealand women.
Breast cancer is the most commonly diagnosed invasive cancer in New Zealand women and modifiable lifestyle risk factors may contribute to this. ⋯ The most important primary preventive strategies to reduce the risk of breast cancer in New Zealand are lifestyle changes to reduce obesity, promoting regular physical activity (which may in turn reduce the prevalence of obesity), reducing HRT use and avoiding high alcohol intake. Strategies that encourage regular physical activity and reduce obesity could also have other benefits, such as reduced risks of cardiovascular disease and diabetes.
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Internal medicine journal · Jul 2012
Review Meta AnalysisArterial stiffness as a cause of cognitive decline and dementia: a systematic review and meta-analysis.
Although arterial stiffness has recently been confirmed as a predictor of cardiovascular disease, the association between arterial stiffness and cognitive decline is less clear. ⋯ Aortic stiffness was found to predict cognitive decline in both qualitative review and quantitative analysis.
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Internal medicine journal · May 2012
Meta AnalysisDiabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies.
This study examined the association of diabetes with the onset of dementia (including Alzheimer's disease (AD), vascular dementia (VD) and any dementia) and mild cognitive impairment (MCI) by using a quantitative meta-analysis of longitudinal studies. EMBASE and MEDLINE were searched for articles published up to December 2010. All studies that examined the relationship between diabetes and the onset of dementia or MCI were included. ⋯ All subjects were without dementia or MCI at baseline. The quantitative meta-analysis showed that subjects with diabetes had higher risk for AD (relative risk (RR):1.46, 95% confidence interval (CI): 1.20-1.77), VD (RR: 2.48, 95% CI: 2.08-2.96), any dementia (RR: 1.51, 95% CI: 1.31-1.74) and MCI (RR: 1.21, 95% CI: 1.02-1.45) than those without. The quantitative meta-analysis showed that diabetes was a risk factor for incident dementia (including AD, VD and any dementia) and MCI.