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221. Prostate Cancer

prostate cancer: results from the REDUCE study. Prostate Cancer Prostatic Dis, 2013. 16: 254. 33. James, N.D., et al. Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy. N Engl J Med, 2017. 377: 338. 34. YuPeng, L., et al. Cholesterol Levels in Blood and the Risk of Prostate Cancer: A Meta-analysis of 14 Prospective Studies. Cancer Epidemiol Biomarkers Prev, 2015. 24: 1086. 35. Vidal, A.C., et al. Obesity increases the risk for high-grade prostate cancer: results from

2018 European Association of Urology

222. New Technologies for the Treatment of Peripheral Artery Disease

. A recent Canadian commentary noted that, in addition to educating clinicians to screen their patients for PAD and providing support to high-risk individuals, “a directory of resources available to help treat patients” would be useful. 53 Similarly, Alberta researchers who conducted a 2016 review of rehabilitation therapy for PAD noted the need for a survey of PAD rehabilitation programs across Canada to identify service gaps. 13 References Lovell M, Harris K, Forbes T, Twillman G, Abramson B, Criqui MH (...) is more common in older people (affecting an estimated 20% of those over the age of 65). 44 Risk factors for PAD include diabetes, smoking, high cholesterol, and high blood pressure. 10 Rates of diabetes and smoking are higher in low income communities. 45-47 People with diabetes are at much higher risk for PAD. 48 Diabetic foot ulcers are mainly caused by chronic nerve damage (peripheral neuropathy) and ischemia resulting from peripheral vascular disease. 49,50 About half of those with diabetic foot

2018 CADTH - Issues in Emerging Health Technologies

223. Prescribing patterns of dependence forming medicines

of interest Professor Sir John Strang is Head of Department for the Addictions academic activity of the IoPPN (Institute of Psychiatry, Psychology and Neuroscience), Kings College London, which includes conduct of diverse research studies and provision of educational activity in the Addictions. He is also Academic Lead of the Addictions CAG (Clinical Academic Group), within the KHP AHSC (King’s Health Partners Academic Health Sciences Centre). He also holds an honorary consultant appointment

2017 Public Health Research Consortium

224. Interventions to improve adherence to lipid-lowering medication. (PubMed)

/dL (95% CI 8.51 to 30.51; 3 studies; 333 participants; moderate-quality evidence). Over the long term (more than six months) total cholesterol decreased by a mean of 17.57 mg/dL (95% CI 14.95 to 20.19; 2 studies; 127 participants; high-quality evidence). Included studies did not report usable data for health outcome indications, adverse effects or costs/resource use, so we could not pool these outcomes. We assessed each included study for bias using methods described in the Cochrane Handbook (...) intervention (e.g. electronic reminders, pharmacist-led interventions, healthcare professional education of patients) versus usual care over the short term (six months or less), and were pooled in a meta-analysis. Participants in the intervention group had better adherence than those receiving usual care (odds ratio (OR) 1.93, 95% confidence interval (CI) 1.29 to 2.88; 7 studies; 11,204 participants; moderate-quality evidence). A separate analysis also showed improvements in long-term adherence rates (more

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2016 Cochrane

226. Diabetes Prevention Programs

Improvement IFG Impaired fasting glucose IGT Impaired glucose tolerance NDEP National Diabetes Education Program NDPP National Diabetes Prevention Program NHANES National Health and Nutrition Examination Survey NIH National Institutes of Health OGTT Oral glucose tolerance test P4P Pay for performance PICOTS Population, Intervention, Comparators, Outcomes, Timing, and Settings PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses PSA Public service advertisement QALY Quality-adjusted (...) Key Resources Examples In-person, individual coaching Lowest Highest 1 Humans, facilities DPP Trial In-person, group coaching Medium Medium 8-15 Humans, facilities Weight Watchers for Prediabetes Y Digital, human coaching (virtual interaction) High Medium 1-24 Humans, technology Omada® (Omada Health, Inc.) Virtual Lifestyle Management (VLM™, Canary Health, Inc.) Digital, fully-automated coaching (based on algorithms) Highest Lowest 1+ † Technology Alive-PD™ (Turnaround Health) *Average costs

2017 California Technology Assessment Forum

227. Nurses and pharmacists can prescribe as effectively as doctors

of nurse or pharmacist prescribing compared with doctor prescribing. Most studies were of chronic disease management in primary care settings in high income countries (25 from the US and six from the UK). Independent and supplementary prescribers in the NHS include not only the nurses and pharmacists, as covered in this review, but also other professions such as podiatrists, optometrists, and physiotherapists. At a time of high demand for NHS resources, with shortages of doctors in some specialties (...) for medical prescribing. Blood pressure: People prescribed drugs by nurses or pharmacists had lower systolic blood pressure than those prescribed drugs by doctors (-5.31mmHg, 95% confidence interval [CI] -6.46 to -4.16; in 12 trials, involving 4,229 participants). Cholesterol: People prescribed drugs by nurses or pharmacists had lower low density lipoprotein cholesterol than those prescribed drugs by doctors (-0.21 mmol/L, 95% CI -0.29 to -0.14; in seven trials, involving 1,469 participants). Blood sugar

2019 NIHR Dissemination Centre

228. Simple approaches to weight management of children and adolescents in primary care may not work

Simple approaches to weight management of children and adolescents in primary care may not work Simple approaches to weight management of children and adolescents in primary care may not work Discover Portal Discover Portal Simple approaches to weight management of children and adolescents in primary care may not work Published on 8 November 2016 doi: Brief education and motivational interventions delivered by primary care professionals in several short consultations had only a marginal effect (...) % of children aged two to 15 are obese and a further 14% are overweight. Children who are overweight or obese can experience bullying and low self-esteem which can lead to anxiety and depression and they are also much more likely to be obese as adults. Obesity can also cause high blood pressure, fatty deposits in arteries and raised cholesterol, which increase the risk of long term conditions, such as type 2 diabetes. Obesity can be hard to treat effectively. National and local strategies set out a range

2019 NIHR Dissemination Centre

229. Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting

Translational Sciences, Cincinnati Children’s Hospital Medical Center’s TS Foundation, as well as several advocacy groups (TS Society of the United States, the TS Global Alliance and the Turner Resource Network). The chairs of the consensus working group, Claus H Gravholt and Philippe F Backeljauw, were appointed by the ESE Clinical Committee and PES respectively. Other members of the working and writing group are Niels H Andersen (adult cardiologist), Gerard S Conway (adult endocrinologist), Olaf M Dekkers

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2016 European Society of Human Reproduction and Embryology

230. Exemplar clinical pathways for a stratified approach to cardiovascular disease

, and for stratification of patients along the clinical pathway. ? Building capability through clinical education by embedding the care pathways into specialist and non-specialist training, and developing capacity through additional, focused resources such as trained genetic nurses. ? Raising awareness with both clinicians and patients to facilitate entry onto the right clinical pathway as early as possible, and overcoming clinician and public negative perceptions which may impede patient management. ? Developing (...) should help to achieve this. Embedding FH pathways into clinical education Delegates highlighted the need to integrate FH pathways into clinical training, not only to support an understanding of the pathway but also to propagate a mindset where FH patients are treated as if they already have heart disease, as the high cholesterol from birth places patients at significant risk of coronary artery disease. The low pick up rate on cholesterol levels in primary care needs to be addressed. It was suggested

2016 Academy of Medical Sciences

231. Pharmacist-led Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared to Usual Care

. The ESP CC establishes standard operating procedures for the production of evidence synthesis reports; facilitates a national topic nomination, prioritization, and selection process; manages the research portfolio of each Center; facilitates editorial review processes; ensures methodological consistency and quality of products; produces “rapid response evidence briefs” at the request of VHA senior leadership; collaborates with HSR&D Center for Information Dissemination and Education Resources (CIDER (...) management aims to control symptoms and slow or stop disease progression. Chronic disease management is typically a multi-component intervention that includes medication therapy review, patient medication education, medication monitoring, immunizations, disease self-care and support, and/or prescribing authority. This topic was nominated by Heather Ourth, PharmD, VACO Pharmacy Benefits Management Program Manager, on behalf of the National Clinical Pharmacy Research Group, chartered by the VACO Clinical

2016 Veterans Affairs Evidence-based Synthesis Program Reports

233. The Expressed Genome in Cardiovascular Diseases and Stroke: Refinement, Diagnosis, and Prediction: A Scientific Statement From the American Heart Association

thoroughly described and evaluated elsewhere. Briefly, they involve measures of association, discrimination, calibration, reclassification, and cost-effectiveness. Other important aspects in the evaluation of biomarkers include safety, replication across different populations, needs to re-educate clinicians and the general public, and usefulness for motivating patients. The first requirement of a novel biomarker is that it is robustly associated with the outcome in question, preferably across different (...) -effectiveness analysis. Some existing risk algorithms, for example, the prediction of coronary heart disease in healthy populations, are already quite accurate, and as a result, additional risk markers need to show very large effect sizes to show any improvement in C statistics. It has been argued that it is a waste of time and resources to perform additional studies trying to discover novel biomarkers for risk prediction and that it would be better to focus on applying preventive measures known

2017 American Heart Association

234. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease

therapy in patients with coronary artery disease ACC/AHA 2016 20 Perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery ACC/AHA 2014 21 Lifestyle management to reduce cardiovascular risk AHA/ACC 2013 22 Assessment of cardiovascular risk ACC/AHA 2013 23 Blood cholesterol to reduce atherosclerotic cardiovascular risk in adults ACC/AHA 2013 24 PAD (lower extremity, renal, mesenteric, and abdominal aortic) ACC/AHA 2005 9 and 2011 10 Secondary prevention and risk (...) (microangiopathy) Toes, foot, leg Diabetic microangiopathy End-stage renal disease Thromboangiitis obliterans (Buerger’s) Sickle cell anemia Vasculitis (eg, Churg-Strauss, Henoch-Schonlein purpura, leukocytoclastic vasculitis, microscopic polyangiitis, polyarteritis nodosa) Scleroderma Cryoagglutination Embolic (eg, cholesterol emboli, thromboemboli, endocarditis) Thrombotic (eg, antiphospholipid antibody syndrome, Sneddon’s syndrome, warfarin skin necrosis, disseminated intravascular coagulation, livedoid

2017 American Heart Association

235. Dietary Fats and Cardiovascular Disease (PubMed)

not reduce CVD in clinical trials. Replacement of saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of CVD in populations and in clinical trials. Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower (...) . This report discusses the major classes of dietary fatty acids, except for the very-long-chain n-3 fatty acids in fish, which are covered by other AHA reports. The scientific rationale for decreasing saturated fat in the diet has been and remains based on well-established effects of saturated fat to raise low-density lipoprotein (LDL) cholesterol, a leading cause of atherosclerosis ; to cause atherosclerosis in several animal species, especially nonhuman primates ; to clear the atherosclerosis in animals

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2017 American Heart Association

236. Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association

day eating , late day meals , evening eating , evening meals , obesity , body weight , weight loss , cardiovascular risk , coronary heart disease (CHD), cholesterol , plasma lipids , lipid profile , blood pressure , glucose , insulin , and insulin resistance . Articles were excluded if they did not include original data; if they were editorials, letters, comments, or conferences proceedings; or if they did not meet the inclusion criteria described below. References of the retrieved articles were (...) low-density lipoprotein (LDL) cholesterol, low serum high-density lipoprotein (HDL) cholesterol, and elevated blood pressure. , Conversely, among 415 healthy Korean adults, rare breakfast eaters (eating breakfast 1 of 3 days) were less likely to have elevated serum triglycerides (≥150 mg/dL). Notably, in the Korean study, the percent of TEI from carbohydrates was lower and the percent from fat was higher in rare breakfast eaters, which may explain this observation. Skipping breakfast has been

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2017 American Heart Association

237. ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group

existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. Objectives: Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines. Methods: This systematic review was conducted on 4 critical questions, each focusing on the adoption and effectiveness of 4 intervention strategies: (1) reminders, (2) educational outreach visits, (3) audit (...) ordering), clinical effectiveness (eg, blood pressure reduction), or other types of outcomes (eg, cost and utilization and clinician satisfaction). Studies that focused solely on interventions targeting patients, such as those examining patient education or patient reminders, were excluded. The search was limited to English-language resources. 2.3. The Process The ISWG maintained a separation of the collection and compilation of the evidence and the final conclusions. The NHLBI contractor conducted

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2017 American Heart Association

238. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

considerations concerning the role of cholesterol in embryo development and the lack of demonstrated benefit of treating hyperlipidemia during gestation are reasons for not recommending statins during pregnancy. , They remain pregnancy category X drugs in the United States. Fetal Screening During Pregnancy Formal fetal echocardiography at 18 to 22 weeks’ gestation is recommended for all patients with CHD and partners of male patients with CHD ; earlier echocardiographic screening may be recommended

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2017 American Heart Association

239. Potential Impact and Study Considerations of Metabolomics in Cardiovascular Health and Disease: A Scientific Statement From the American Heart Association

that has also been associated with mortality. Given the established importance of lipids (including triacylglycerides and cholesterol-based species) to CVD pathobiology, lipidomic correlates of conventional cholesterol subfractions (eg, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein) have also been the subject of multiple investigations. Studies to date have demonstrated varying degrees of intercorrelation among lipid species, underscoring the potential of lipidomic (...) , proline, and alanine levels, as well as increased concentrations of free fatty acids and products of fatty acid oxidation. More recently, studies of adult twin pairs and age- and sex-matched pairs of unrelated adults have found that more active individuals have better lipoprotein cholesterol profiles and higher levels of polyunsaturated relative to saturated fatty acids. Corroborating the findings from studies of cardiometabolic disease and diabetes mellitus, Kujala et al also found that the BCAA

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2017 American Heart Association

240. Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease

to understand that the AUC should be used to assess an overall pattern of clinical care rather than being the final arbitrator of specific individual cases. The ACC and its collaborators believe that an ongoing review of one’s practice using these criteria will help guide more effective, efficient, and equitable allocation of healthcare resources, and ultimately, better patient outcomes . However, under no circumstances should the AUC be used to adjudicate or determine payment for individual patients

2017 Society for Cardiovascular Angiography and Interventions

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