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181. BSG and UKPBC primary biliary cholangitis treatment and management guidelines

absorption of fat-soluble vitamins. 111–113 Recurrent UTIs have been associated with PBC in several epide- miological studies. 62 114 It is unclear whether the association is a cause or a consequence of PBC, and thus whether aggressively treating UTIs may have any impact on the natural history of PBC. Recurrent UTIs are, however, a potential cause of impaired QoL in PBC and should be effectively managed for this reason. Despite elevation of cholesterol being a frequent feature in PBC, there is no robust (...) evidence to suggest that ischaemic heart disease or other forms of atherosclerotic disease are seen at increased frequency in the condition. 115–118 This is likely to reflect the fact that cholesterol elevation is typically high-density lipoprotein (HDL) and lipoprotein X. There is no evidence that statin therapy is associated with increased risk of liver injury and these drugs can be used as would be indicated in patients without PBC. 119–121 Of relevance to cardiac risk is the observation from case

2018 British Society of Gastroenterology

182. Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus: A Guidance Statement Update From the American College of Physicians (Full text)

, or no significant cardiovascular disease. ([Grade] C) Less stringent A1C goals (such as <8% [64 mmol/mol]) may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid conditions, or long-standing diabetes in whom the goal is difficult to achieve despite diabetes self-management education, appropriate glucose monitoring, and effective doses of multiple glucose-lowering agents including insulin. ([Grade

2018 American College of Physicians PubMed

183. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

to a facility with an established rupture protocol and suitable endovascular resources. Level of recommendation Good Practice Statement Quality of evidence Ungraded If it is anatomically feasible, we recommend EVAR over open repair for treatment of a ruptured AAA. Level of recommendation 1 (Strong) Quality of evidence C (Low) Choice of anesthetic technique and agent We recommend general endotracheal anesthesia for patients undergoing open aneurysm repair. Level of recommendation 1 (Strong) Quality

2018 Society for Vascular Surgery

184. Well-Woman Visit

Well-Woman Visit Well-Woman Visit - ACOG Menu ▼ Well-Woman Visit Page Navigation ▼ Number 755 (Replaces Committee Opinion Number 534, August 2012) Committee on Gynecologic Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice in collaboration with committee member Catherine Witkop, MD, MPH. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care (...) , and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances

2018 American College of Obstetricians and Gynecologists

185. What national and subnational interventions and policies based on Mediterranean and Nordic diets are recommended or implemented in the WHO European Region, and is there evidence of effectiveness in reducing noncommunicable diseases?

national NCD outcomes? 27 ? 3. Discussion 29 ? 3.1. Strengths and limitations of this review 29 ? 3.2. Diet policy and evidence translation 29 ? 3.3. Monitoring and evaluation 31 ? 3.4. Frameworks to support MD- and ND-based policies, programmes and interventions 32 ? 3.5. Policy implications and options 33 ? 4. Conclusions 37 ? References 38 ? Annex 1. Search strategy 48 ? Annex 2. Resources to guide the implementation of report recommendations 55 ? Annex 3. Glossary 58iv iv ABBREVIATIONS CVD (...) reviewers Cécile Duvelle Former Secretary of the Convention for the Safeguarding of the Intangible Cultural Heritage (2008–2015), United Nations Educational, Scientific and Cultural Organization, Paris, France Pedro Graça Professor, Directorate General of Health/Faculty of Nutrition, University of Porto, Porto, Portugal Satu Männistö Research Manager, National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland Ursula Schwab Professor of Nutrition Therapy

2018 WHO Health Evidence Network

186. Erectile Dysfunction

. Nelson, PhD; Hossein Sadeghi-Nejad, MD; Allen D. Seftel, MD; Alan W. Shindel, MD Copyright © 2018 American Urological Association Education and Research, Inc.® The Panel would like to dedicate this Guideline to the memory of our friend and colleague, Ralph Alterowitz. We will forever be grateful to his contributions and devotion to the field of men’s sexual health. He brought compassion and joy to all of those who were fortunate enough to work with him. 2 American Urological Association (AUA (...) ) Copyright © 2018 American Urological Association Education and Research, Inc.® Guideline Statements: Evaluation and Diagnosis: 1. Men presenting with symptoms of ED should undergo a thorough medical, sexual, and psychosocial history; a physical examination; and selective laboratory testing. (Clinical Principle) 2. For the man with ED, validated questionnaires are recommended to assess the severity of ED, to measure treat- ment effectiveness, and to guide future management. (Expert Opinion) 3. Men should

2018 American Urological Association

187. Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association (Full text)

of the world’s population and are one of the fastest-growing ethnic groups in the United States. Although native South Asians share genetic and cultural risk factors with South Asians abroad, South Asians in the United States can differ in socioeconomic status, education, healthcare behaviors, attitudes, and health insurance, which can affect their risk and the treatment and outcomes of atherosclerotic cardiovascular disease (ASCVD). South Asians have higher proportional mortality rates from ASCVD compared (...) disease (ASCVD) risk in South Asians compared with other populations. Cardiovascular disease (CVD) and diabetes mellitus (DM) have also been shown to be more frequent among Fiji Indians. , Although people living in South Asian countries share genetic and cultural risk factors with South Asians living abroad, South Asians residing in the United States can differ in socioeconomic status, education, healthcare behaviors, attitudes, and health insurance, which can affect their risk and the treatment

2018 American Heart Association PubMed

188. Interdisciplinary Models for Research and Clinical Endeavors in Genomic Medicine: A Scientific Statement From the American Heart Association (Full text)

lipid traits; in 1 notable example, they found that loss-of-function variants in APOB were associated with decreased low-density lipoprotein cholesterol levels and triglyceride levels but also increased alanine and aspartate aminotransferase levels, consistent with hepatocyte injury. Notably, patients receiving the APOB -targeting medication mipomersen experience lower low-density lipoprotein cholesterol levels and, in some cases, elevated hepatic transaminases or other liver conditions (...) identified a number of associations, with the most intriguing finding being that methylation of a CpG site near the ABCG1 gene was correlated with decreased expression of the gene, a known regulator of macrophage cholesterol efflux and reverse cholesterol transport; increased triglycerides and decreased high-density lipoprotein cholesterol; and substantially increased risk of coronary artery disease. Transcriptomic analyses of peripheral blood mononuclear cells from patients with and without coronary

2018 American Heart Association PubMed

189. Promoting Risk Identification and Reduction of Cardiovascular Disease in Women Through Collaboration With Obstetricians and Gynecologists: A Presidential Advisory From the American Heart Association and the American College of Obstetricians and Gynecologi (Full text)

, including standardized protocols and enhanced cardiac screening. Shared information can be used to assess risk, initiate interventions, and facilitate significant lifestyle changes. Care can be coordinated to minimize cardiovascular morbidity and mortality and to improve outcomes. By providing a platform for comprehensive well-woman care, primary prevention, and early intervention, providers of women’s health can provide patient education, empowerment, and motivation. Educational Resources Primary care (...) for cardiovascular risk factors. Hypercholesterolemia imparts the highest population-adjusted cardiovascular risk for women at 47%; benefits of statin therapy are similar for women and men. , The new Pooled Cohort Risk Equations, which are gender-specific and should be used for cholesterol management with lifestyle guidelines, are applicable to both genders. Given that 2 of 3 women in the United States are either obese or overweight, we must be cognizant of the adverse associations that increased weight has

2018 American Heart Association PubMed

190. Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association (Full text)

and the diverse perspectives of the experts on the writing group. The 10-member writing group for this statement is diverse in its demographic composition, disciplinary perspectives, and context expertise. It consists of 4 women, includes 2 underrepresented minorities, and comprises clinicians (internal medicine, cardiovascular physicians, and nurses) and clinician scientists engaged in health services research, epidemiology, health education, and behavioral health interventions. The committee is further (...) enhanced by individuals with expertise in social determinants of health (including health literacy) and cardiovascular health disparities affecting racial/ethnic minorities and rural populations and the development and evaluation of community-based interventions and strategies to promote health. Health Literacy: Definitions and Dimensions Measuring Literacy in the United States In 1992, the US Department of Education initiated the first population-based, in-person assessment of adult literacy

2018 American Heart Association PubMed

191. Testosterone Therapy in Men with Hypogonadism (Full text)

instances, educating patients that obesity or opioids may be contributing to hypogonadism could motivate them to lose weight or discontinue narcotic pain medications. Diagnosis of men with suspected hypogonadism 1.1 We recommend diagnosing hypogonadism in men with symptoms and signs of testosterone deficiency and unequivocally and consistently low serum total testosterone and/or free testosterone concentrations (when indicated). (1∣⊕⊕⊕O) Technical remark Testosterone concentrations exhibit significant

2018 The Endocrine Society PubMed

192. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm

sequestrant; BCR-QR = bromocriptine quick release; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CHD = coronary heart disease; CKD = chronic kidney disease; CVD = cardio- vascular disease; DASH = Dietary Approaches to Stop Hypertension; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density lipoprotein cholesterol; IMPROVE-IT = Improved Reduction (...) and education. All patients should strive to attain and main- tain an optimal weight through a primarily plant-based meal plan high in polyunsaturated and monounsaturated fatty acids, with limited intake of saturated fatty acids and avoidance of trans fats. Patients with overweight (body mass index [BMI] 25-29.9 kg/m 2 ) or obesity (BMI =30 kg/ m 2 , see Obesity section) should also restrict their caloric intake with the goal of reducing body weight by at least 5 to 10%. As shown in the Look AHEAD (Action

2018 American Association of Clinical Endocrinologists

194. Induced Pluripotent Stem Cells for Cardiovascular Disease Modeling and Precision Medicine: A Scientific Statement From the American Heart Association (Full text)

BMPR2 mutations. These findings suggest that iPSC-endothelial cells can model not only familial pulmonary arterial hypertension caused by BMPR2 mutations but also the effects of genetic modifiers of BMPR2 mutations resulting in an absence of disease. Metabolic Risk Factors for Ischemic Heart Disease Blood concentrations of lipids, namely, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol, are well-established risk factors for ischemic heart disease. A number (...) impaired LDL particle uptake, whereas the familial hypobetalipoproteinemia iPSC-hepatocytes displayed increased LDL particle uptake. Tangier disease, also known as hypoalphalipoproteinemia, is marked by abnormally low blood levels of high-density lipoprotein cholesterol caused by recessive mutations in ABCA1 (ATP-binding cassette subfamily A member 1). ABCA1 is the molecule that effluxes cholesterol from cells such as macrophages onto high-density lipoprotein particles and thus is a key mediator

2018 American Heart Association PubMed

195. Sirens to Scrubs: Acute Coronary Syndromes Part Three – Diagnosis and ED Management

on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. Circulation . 2016;134(10):e123-55. [ ] 9. Ostadal P. Statins as first-line therapy for acute coronary syndrome? Exp Clin Cardiol . 2012;17(4):227-236. [ ] (Visited 606 times, 1 visits today) Paula Sneath Paula is a PGY1 in Emergency Medicine at McMaster University and an Advanced Care Paramedic in Ontario. She has a strong interest in improving access to education and resources for paramedics in Canada (...) ) – by blocking the HMG CoA reductase enzyme, statins decrease cholesterol formation in the liver. In addition, statins have been shown to moderate inflammation, oxidative stress, thrombus formation, and endothelial dysfunction. 9 These are also for life unless adverse effects develop (most commonly, muscle pain). Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) – lower blood pressure and also interfere with the remodeling process described above. Also for life unless

2018 CandiEM

196. Dietary Diversity: Implications for Obesity Prevention in Adult Populations: A Science Advisory From the American Heart Association (Full text)

on Epidemiology and Prevention; Council on Functional Genomics and Translational Biology; and Council on Hypertension August 2016 September 11, 2018 Vol 138, Issue 11 Article Information Metrics Download : 6,700 © 2018 American Heart Association, Inc. PubMed Originally published August 9, 2018 Keywords Subjects Title Title Title Title Circulation AHA Journals Journal Information Subjects Features Resources & Education For Authors & Reviewers National Center 7373 Greenville Ave. Dallas, TX 75231 Customer (...) higher points for adequate daily intake of grains, vegetables, fruit, milk, meat, total fat, saturated fat, cholesterol, and sodium and for greater variety of food items, assessed with simple food count. Higher food-based diet quality scores, such as the HEI, Alternative HEI, and Dietary Approaches to Stop Hypertension, have consistently been associated with lower disease risk. Few previous studies have modified dietary diversity measures to reflect diet quality in addition to, or rather than

2018 American Heart Association PubMed

197. Elagolix for Treating Endometriosis

that provide long-term relief with few side effects is thought to reflect insufficient knowledge of the underlying cause(s) of endometriosis. • Though medical therapies focus on suppressing the production of ovarian hormones, even complete suppression does not eliminate symptoms and cause bothersome side effects. • Risks of long-term use of therapies like GnRH agonists and antagonists include osteoporosis and adverse effects on cholesterol levels. • Moreover, medical therapies have not been shown (...) ? ? Consumption Future consumption unrelated to health ? ? Social services Cost of social services as part of intervention ? ? Legal/Criminal Justice Number of crimes related to intervention ? ? Cost of crimes related to intervention ? ? Education Impact of intervention on educational achievement of population ? ? Housing Cost of home improvements, remediation ? ? Environment Production of toxic waste pollution by intervention ? ? Other Other impacts (if relevant) ? ? Model Parameters Health Care Utilization

2018 California Technology Assessment Forum

199. Sodium and Potassium Intake: Effects on Chronic Disease Outcomes and Risks

medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients. This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted (...) may increase is called the Tolerable Upper Intake Level (UL). The DRIs are for dietary intakes only (i.e., foods and dietary supplements) and are intended to cover the needs of almost all healthy persons. These values serve multiple purposes, including guidance for (a) health professionals for use in dietary counseling and for developing educational materials for consumers and patients, (b) scientists in designing and interpreting research, (c) ES-2 users of national nutrition monitoring, and (d

2018 Effective Health Care Program (AHRQ)

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