Articles: disease.
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Int. J. Clin. Pract. · Oct 2019
Potential prescribing omissions in patients with cardiovascular disease.
Aims Potential prescribing omissions (PPOs) of medications are a frequent form of inadequate prescription drug practices. The objective of this study was to identify PPOs in a sample of elderly patients with cardiovascular disease. Methods Quasi-experimental study. ⋯ Prescription adjustments were achieved in 35 patients (25.2%). Conclusions Potential prescribing omissions are common in elderly patients with cardiovascular disease. Educational interventions may contribute to a reduced PPO frequency and improve the quality of prescription drug administration.
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Diabetic retinopathy (DR), the primary retinal vascular complication of diabetes mellitus, is a progressive disease and a major cause of impaired vision and blindness, especially among individuals who are of working age. Early detection and treatment of DR can prevent 50% to 70% of its associated blindness. However, fewer than half of all US adults with diabetes adhere to guideline-recommended eye-screening schedules. ⋯ These delays in diagnosis and treatment may result in visual impairment that is permanent and cannot be reversed. Although the direct medical costs of DR are substantial, the indirect costs of visual impairment with respect to loss of productivity, increased nursing home admissions, and decreased quality of life are far more copious. Greater adherence to eye screening guidelines among patients with diabetes is required to facilitate prompt diagnosis and early treatment of DR, and in doing so, reduce the resulting vision loss and economic burden associated with DR.
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Historical Article
An Uneasy Pleasure: Representing the Dangers of Skin-to-skin Contact in Eighteenth-century London 'The William Bynum Prize Essay'.
This article considers the social function of contagious disease as moderator of class relationships in England during the first half of the eighteenth century and takes into account the ways in which the 'communicability' of the plague, great pox (syphilis) and smallpox (variola) was used by authors to crystallise social interaction and tension along class lines. The essay begins by examining the representation of the plague, syphilis and smallpox in the medical tradition, before shifting its attention to the practice of maritime quarantine, as laid out by Richard Mead in his Short Discourse Concerning Pestilential Contagion (1720). ⋯ This article proposes that if we take the time to appreciate the way infectious cutaneous diseases were believed to operate and spread we can recognise the moments in which he not only alludes to disease but invokes it for structural and thematic purposes. In proposing this, I am challenging the dominant interpretation that the problematic realities of eighteenth-century prostitution, especially disease, are subordinated to the narrative's greater interest in erotic pleasure.
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Cochrane Db Syst Rev · Oct 2019
ReviewProstanoids and their analogues for the treatment of pulmonary hypertension in neonates.
Persistent pulmonary hypertension of the newborn (PPHN) is a disease entity that describes a physiology in which there is persistence of increased pulmonary arterial pressure. PPHN is characterised by failure to adapt to a functional postnatal circulation with a fall in pulmonary vascular resistance. PPHN is responsible for impairment in oxygenation and significant neonatal mortality and morbidity. Prostanoids and their analogues may be useful therapeutic interventions due to their pulmonary vasodilatory and immunomodulatory effects. ⋯ Implications for practiceCurrently, no evidence shows the use of prostanoids or their analogues as pulmonary vasodilators and sole therapeutic agents for the treatment of PPHN in neonates (age 28 days or less).Implications for researchThe safety and efficacy of different preparations and doses and routes of administration of prostacyclins and their analogues in neonates must be established. Well-designed, adequately powered, randomized, multi-center trials are needed to address the efficacy and safety of prostanoids and their analogues in the treatment of PPHN. These trials should evaluate long-term neurodevelopmental and pulmonary outcomes, in addition to short-term outcomes.
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Int. J. Clin. Pract. · Oct 2019
Expert consensus on the management of hypertension in the young and middle-aged Chinese population.
Hypertension, defined as blood pressure (BP) ≥140/90 mmHg, is one of the most common, yet reversible, risk factors for cardiovascular disease (CVD). Globally, 9.40 million people died from hypertension in 2010, accounting for 17.8% of total deaths; disability-adjusted life years (DALYs) caused by hypertension were 170 million person-years, or 7.0% of the total global DALYs.1 Data from China showed that hypertension accounted for 24.6% of all deaths, and 12.0% of total DALYs,2 and the direct medical cost of hypertension in China has reached 36.6 billion yuan per year.3.