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361. Systematic review of needs for medical devices for ageing populations

. . . . . . . . . . . . . . . . . . . . .12 2.9 CATEGORIES OF MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 2.10 SUPPLEMENTARY RESOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 3. CARDIOVASCULAR DISEASES . . . . . . . . . . . . . . . . . . . . . . 15 3.1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 3.2 ISCHAEMIC HEART DISEASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Introduction (...) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98 8.2 USE OF SUPPLEMENTARY RESOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .982015 vi Systematic review of needs for medical devices for ageing populations 8.3 OVERALL RESULTS OF INCLUDED MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . .99 8.4 PREVENTIVE DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 8.5 DEVICES ASSOCIATED WITH OLDER PEOPLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 8.6 FUTURE


362. Another ‘breach of trust’ at STAT: patient who praised TV drug ads says pharma PR company asked her to write op-ed

hepatitis C, it’s not about being judgmental,” she replied. “It is treatable and it’s curable. All you have to do is go to your doctor.” She said she also has a message for insurance companies that balk at the high price of Gilead’s drug: “It’s cheaper than a liver transplant.” A Gilead-sponsored journey to patient advocacy: ‘[The drug] I would like to promote now is Harvoni’ Dushane says her journey from retired educator to advocate started with an email from Gilead inviting her to fly out (...) companies including Vertex, Bristol-Myers Squibb, Novarits, Pfizer, and others. Small potatoes, you say? Consider that these are only the traceable payments. He is also on the payroll of Precision Health Economics, a consulting firm which has counted at least 25 different pharmaceutical companies on its roster, . Among these are Gilead, Amgen, Bristol-Myers Squibb, and AbbVie, the leading makers of expensive new cholesterol and hepatitis C drugs. Those types of drugs figure prominently in the argument

2017 HealthNewsReview

363. Using Wearable Fitness Devices to Monitor More Than Just Fitness

happen to be the least likely to be obese or to have high cholesterol—the kinds of health problems that fitness trackers try to address by motivating consumers to be more active or eat healthier. If the appeal of wearables is, well, wearing off—and data from wearables is not helping people meaningfully change their health behaviors—part of the problem may be the narrow set of health-related concerns that personal health wearables tend to emphasize. Manufacturers could help reinvigorate the market (...) are their personal health data as those without such health problems. Education, employment, and neighborhood environment affect individual and community health and well-being more than individual health behaviors alone. One challenge to building a bigger market is that personal health depends less on personal fitness habits than commonly believed. Recent research suggests that —such as education, employment and neighborhood environment—affect individual and community health and well-being more so than

2017 The RAND blog

364. Comparative Benefit of Ezetimibe plus Simvastatin in Individuals with Moderately Reduced eGFR

or Gearoid NSMC Founding Member Get notified of new RFN posts by email Partner A nice repository of landmark articles and reviews in the field of nephrology at . are also included. Partner Endorsed by Follow RFN on Twitter NephJC The Online Nephrology Journal Club The Glomerular Disease Study & Trial Consortium (GlomCon) Endorsed Educational Resource Subscribe to the Concepts in Hypertension Newsletter Blog Archive (78) (2) (5) (6) (4) (7) (5) (15) (26) (8) (76) (6) (6) (4) (9) (5) (5) (5) (6) (8) (7) (7 (...) of requiring renal-replacement therapy, has been uncertain ( , ). More recent work from the found a 21% relative risk reduction per each mmol/L reduction in LDL cholesterol in a broad group of individuals defined as having CKD, but they also found, despite an absolute benefit, the relative benefit of statin therapy appeared to decrease as eGFR declined. Among individuals with CKD, the strongest single-trial supporting cardiovascular risk-lowering benefit for statin therapies was demonstrated with ezetimibe

2017 Renal Fellow Network

365. “Fat but fit”? Studies confuse, while advocates & journalists do little to clarify

to this vitriolic headline in The Telegraph: “ .” Researchers from the University of Birmingham, UK reviewed the records of 3.5 million people (1975-2014) without evidence of cardiovascular disease (at the start of the study) and divided them into people with and without obesity based on body mass index (BMI) measurements. The study found that, compared to people without obesity, individuals with obesity (BMI >30) who were deemed “metabolically healthy” (i.e. normal blood pressure, cholesterol and no type 2 (...) to the authors, the most practical measure available in reviewing such a large data base. But evaluating these preliminary results is not my goal here. My point is this: We are a riding a roller-coaster of conflicting observational studies that can only show association, not causation … that haven’t consistently or reliably defined obesity …. and that typically use surrogate markers (things like blood pressure and cholesterol) to define a concept none of us can agree upon (and probably never will): so-called

2017 HealthNewsReview

366. Why Nutrition Standards and Policies Should Continue

most people don't have a balanced diet, eat too much, and suffer from diet-related chronic diseases. Rolling back these standards means increasing risks for Americans. Without standards, each individual has to assume the difficult burden of figuring out what is safe and unsafe, healthy and unhealthy. When it comes to food, it is exceedingly difficult for most individuals . This is where public health efforts by the government can educate and give confidence to consumers. Over the past 10 years (...) to include 50 percent whole grains in school lunches could have particularly grave consequences. Whole grains contain fiber, which has multiple health benefits including reducing the risk of heart disease and type 2 diabetes, lowering the risk of several forms of cancer, improving cholesterol and blood pressure, regulating digestion, and increasing satiation, which can reduce overeating. The failure to further lower sodium levels could continue the risk of high blood pressure in the large portion

2017 The RAND blog

367. Vitamin D prevents colds? News stories turn blind eye to limitations of sunshine vitamin study

translate into the generalization that vitamin D augmentation reduces the chances for colds and flu in the general population. And health writers may have missed an easy opportunity to help educate rather than obfuscate findings from another vitamin D study. You might also like Comments (1) Please note , comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts. February 17, 2017 at 12:03 pm (...) This is an excellent blog on the issue of Vitamin D. I would quibble about only one word and that is the word “only”, as in, “The meta-analysis of 25 different studies showed only a 2% overall absolute risk reduction.” For many widely prescribed drugs for prevention, such as cholesterol-lowering drugs, antihypertensives, anti-osteoporosis or anti-diabetic treatments on the absolute benefits are often under 5%, often in the range of “only” 1-3% but when they are reported, very few commentators or critics qualify

2017 HealthNewsReview

368. Federal biomedical science policy under Donald Trump, nearly 100 days in

from the fact that HHS is the department that administers Medicare and Medicaid, but HHS also encompasses such critical agencies as the FDA, NIH, CDC, Agency for Healthcare Research and Quality (AHRQ), and Health Resources and Services Administration (HRSA). Also, the HHS is the department that administers the Affordable Care Act (colloquially called Obamacare) that Republicans promised to "repeal and replace" but failed to do so. Unsurprisingly, President Trump tapped an ultraconservative (...) of Dr. Price's answers during his confirmation hearing testimony suggested that he was open to further weakening the already weak regulation of supplements: On January 18, 2017, then Congressman Tom Price (R, Georgia) testified before the Senate Health, Education, Labor and Pensions Committee. Price was Donald Trump’s pick to serve as Secretary of the Department of Health and Human Services. Not surprisingly, most of the questions—and most of the media’s attention—centered on Price’s views

2017 Respectful Insolence

369. Richard Lehman’s journal review—20 March 2017

the future had become the familiar past. We need longer trials. We need to look at how drugs are priced. We need to look beyond lipid-lowering if we are to reduce cardiovascular disease further. So before you all go to sleep, what were we actually looking at here? You will all, I imagine, have heard of PCSK9 inhibitors and their remarkable ability to lower low density lipid cholesterol by binding to proprotein convertase subtilisin–kexin type 9 in the liver. Three antibodies were developed to achieve (...) ). A mighty coalition of East Coast American institutions decided to address the mountainous issue of whether a professionally delivered intervention plus education aimed at mouse infestation might reduce asthma symptoms among mouse-sensitized children and adolescents with persistent asthma compared with education alone. The mountain groaned for five years. Mice were sacrificed, or fled in terror. , asthma symptoms did not differ between groups. Testing fails to predict preterm birth Spontaneous labour

2017 The BMJ Blog

370. National Evidence Based Guideline on Secondary Prevention of Cardiovascular Disease in Type 2 Diabetes

or in combination with statin) 34 Cholesterol reducing therapies versus control 37 Part D Antithrombotic management 38 Antithrombotic therapy 38 Evidence for antithrombotic therapy 39 Evidence for anticoagulant therapy (incl warfarin) 39 Evidence for specific antiplatelet agents 39 Part E Management – general 50 Part F Future Research 51 Part G Implementation 52 Introduction 52 An approach to implementation 52 Integration of the guideline into daily practice 52 Awareness, education and training 53 Part H (...) Related Australian and Overseas Guidelines and Resources 54 National Vascular Disease Prevention Alliance (Australia) 54 National Stroke Guidelines (Australia) 54 National Evidence-Based Guidelines for Type 2 Diabetes (Australia) 54 National Heart Foundation Guidelines (Australia) 55 National Institute for Clinical Excellence (NICE) - UK 55 Scottish Intercollegiate Guideline Network – (Scotland) 55 ASH_ISH Hypertension guidelines 54 JNC 8 BP guidelines 54 IAS guidelines for lipids 54 2013 ACC AHA

2015 Clinical Practice Guidelines Portal

371. The National Physical Activity Plan: A Call to Action From the American Heart Association

, , , , , and August 2006 , , , , , , , , , , , , and February 2003 May 26, 2015 Vol 131, Issue 21 Article Information Metrics Download : 643 © 2015 American Heart Association, Inc. PubMed Originally published April 27, 2015 Keywords 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 Service 1-800-AHA-USA-1 1-800-242-8721 ABOUT US OUR SITES TAKE ACTION ONLINE COMMUNITIES (...) activity to prevent a wide variety of disease conditions and to enhance quality of life. Interestingly, there is less of an appreciation of noncardiovascular benefits of lifestyle physical activity and structured exercise, and this is an area of great opportunity for educating the public and healthcare practitioners. Table 1. The Health Benefits of Regular Physical Activity Adults Children and Adolescents Strong evidence Lower risk of Improved cardiorespiratory endurance and muscular fitness Early

2015 American Heart Association

372. Congenital Heart Disease in the Older Adult

estimates, categorized according to severity of lesion as follows: 45% of adults had mild, 37% had moderate, and 14% had severe heart disease. The birth prevalence of specific congenital heart defects varies by ethnicity. Mortality also varies by ethnic group, which raises the possibility of disparities in access to health care and education and in knowledge of care needs within the ACHD population. Importantly, variations in ethnic makeup may limit comparability of data from other countries (...) initially in adulthood. These patients have ventricular inversion and transposed great arteries, which results in normal blood flow with systemic venous return directed to the PA and pulmonary venous return directed to the aorta; however, the ventricular inversion results in a systemic RV. Although its incidence is low (<1% CHD), if diagnosed secondary to symptoms of heart failure, this group may require frequent hospital visits and use increased healthcare resources. Those who present at a younger age

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2015 American Heart Association

373. Social Determinants of Risk and Outcomes for Cardiovascular Disease

are not distributed randomly throughout human society, and neither are resources to prevent illness and its effects. Instead, they cluster at the intersections of social, economic, environmental, and interpersonal forces. Cataloging the Social Determinants of Health Social determinants are highly interrelated and therefore difficult to catalog. Given our focus on CVD in the United States, this statement considers socioeconomic position (SEP; encompassing wealth and income, education, employment/occupational (...) of SEP. Each indicator of SEP emphasizes a particular aspect of social stratification, which may be more or less relevant to different health outcomes and at different stages in the life course. Individual-level indicators of SEP include income, education, and occupation-based indicators, and ideally, they should be considered simultaneously. Others have emphasized that SEP should consider both actual resources and status as determined by prestige or rank-related characteristics

2015 American Heart Association

374. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Words: AHA Scientific Statements ? blood pressure ? coagulopathy ? diagnosis ? intracerebral hemorrhage ? intraventricular hemorrhage ? surgery ? treatment Guidelines for the Management of Spontaneous Intracerebral Hemorrhage A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Endorsed by the American Association of Neurological Surgeons (...) demonstrated to significantly shorten time to computed tomography (CT) scanning in the ED. 11 Two studies have shown that prehospital CT scanning with an appropri- ately equipped ambulance is feasible and may allow for tri- age to an appropriate hospital and initiation of ICH-specific therapy. 12,13 ED Management Every ED should be prepared to treat patients with ICH or have a plan for rapid transfer to a tertiary care center. The crucial resources necessary to manage patients with ICH include neurology

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2015 American Heart Association

375. Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations

/A 0.95 0.80 IASO/IOTF indicates International Association for the Study of Obesity/International Obesity Task Force; IDF, International Diabetes Federation; N/A, not applicable; NCEP, National Cholesterol Education Program; NHLBI, National Heart, Lung, and Blood Institute; and WHO, World Health Organization. Reprinted with permission from Lear et al. Are modified thresholds more accurate for diagnosis of obesity? A large number of studies support the use of lower BMI and WC thresholds for Asian (...) in ethnic and racial minorities. Several studies have documented the poor sensitivity of BMI in Asian populations and the need for lower BMI thresholds. In a study of Japanese Americans, for example, in which elevated cardiovascular risk was defined as the presence of ≥2 risk factors (among them, high-density lipoprotein cholesterol [HDL-C] <40 mg/dL for men or <50 mg/dL for women; triglycerides >150 mg/dL; blood pressure >130/85 mm Hg or taking antihypertensive medication; or fasting plasma glucose

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2015 American Heart Association

376. Transformative Impact of Proteomics on Cardiovascular Health and Disease

method, aptamers, and N -linked glycan chips ( ). Open-source software that helps users build SRM methods is available to focus on biological questions. There is the potential for development of thousands of SRM assays for human, mouse, and yeast proteins, and many SRMs have been validated and are available via new online resource sites such as the SRM Atlas ( ). MRM has been used in other fields, such as chemistry, for >5 decades but has only in the past few years been widely used in proteomics (...) of PTMs detected. The Human Proteome The Human Proteome Project, a broad-based international effort spearheaded by the Human Proteome Organization, aims to detect all proteins predicted by the Human Genome data, relate them to human health and disease, and provide high-quality reference data and analytical resources available to the community. Very recently, 2 independent groups of investigators published their initial efforts toward obtaining the complete proteome of specific human tissues

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2015 American Heart Association

377. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence

and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. Diabetes mellitus, defined by elevated glycemic markers, is a major risk factor for cardiovascular disease (CVD), which (...) with diabetes mellitus across all age groups from 1988 to 2010. Fewer than half of US adults meet recommended guidelines for diabetes mellitus care, underscoring the magnitude of the public health burden of type 2 diabetes mellitus. Given the changes in the diabetes mellitus landscape over the past 5 years, the purpose of this scientific statement is to summarize key clinical trials pertaining to lifestyle, blood glucose, blood pressure, and cholesterol management for the primary prevention of CVD. We have

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2015 American Heart Association

378. Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease

Cholesterol Education Program, Adult Treatment Panel II, World Health Organization, and International Diabetes Federation. MetS does not have a consensus definition in pediatric populations, although various definitions define risk according to pediatric cut points, most commonly the International Diabetes Federation definition. There is evidence from several studies that the prevalence of MetS among adults with MDD or depressive symptoms is elevated. Similarly, an increased hazard for MetS among people (...) in the Expert Panel indicated that children and adolescents with tier II conditions were to be moved to tier I (high risk) if they had 2 or more of 7 traditional cardiovascular risk factors or comorbidities (obesity, tobacco smoke exposure, hypertension, insulin resistance, dyslipidemia including high levels of low-density lipoprotein cholesterol, high levels of triglycerides, and low levels of high-density lipoproteins). Importantly, in the Expert Panel report, specific cut points and treatment goals were

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2015 American Heart Association

379. The Agenda for Familial Hypercholesterolemia (PubMed)

cardiovascular risk factors Pregnancy Costs and insurance Lifestyle behaviors, self-efficacy around lifestyle change CVD indicates cardiovascular disease; and FH, familial hypercholesterolemia. Table 2. Resources for FH Education for Patients and Families Global genes ( ) International FH Foundation ( ) Australia Australian Heart Foundation ( ) FH Australasian Network ( ) Brazil Hipercol Brasil ( ) Spain Fundación Hipercolesterolemia Familiar ( ) United Kingdom Heart UK–The Cholesterol Charity ( ) British (...) ’ perceptions of risk. provides a list of issues to address in counseling, and provides a list of international resources for FH education. Table 1. Issues to Address With Families Affected by FH Individual and family experiences, including CVD events, response to treatment Genetics and implications of genetic diagnosis Risk perception, including fear of future events Medication side effects, including short-term, midterm, and lifetime treatment needs Medication adherence Assessment and treatment of other

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2015 American Heart Association

380. Task Force 1: Pediatric Cardiology Fellowship Training in General Cardiology

-long self-education beyond the years of formal training. 1 The 2005 training guidelines emphasized the “time” (ie, the number of months or procedures) devoted to a particular “topic.” Since then, competency-based training has become the general framework for medical education and is utilized in this report. Our revised training recommendations describe the pro- gram resources and environment that are required for training pediatric cardiology fellows, together with a competency- based system (...) promulgated by the Accreditation Council of Graduate Medical Education (ACGME), to implement specific goals and objectives for training pediatric cardiology fellows. This system categorizes competencies into 6 core competency domains: Medical Knowledge, Patient Care and Procedural Skills, Systems-Based Practice, Practice-Based Learning and Improvement, Professionalism, and Interpersonal and Communication Skills, along with identification of suggested evaluation tools for each domain. Competencies unique

2015 American Heart Association

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