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Circulation Sep 2019
Review
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
Topics: Advisory Committees; American Heart Association; Cardiology; Cardiovascular Diseases; Humans; Practice Guidelines as Topic; Primary Prevention; Research Report; United States
PubMed: 30879355
DOI: 10.1161/CIR.0000000000000678 -
Clinical Medicine & Research Aug 2020Aspirin has demonstrated a clear benefit in secondary prevention of coronary syndrome, while aspirin's effect in primary prevention is unclear. This report will explore... (Review)
Review
Aspirin has demonstrated a clear benefit in secondary prevention of coronary syndrome, while aspirin's effect in primary prevention is unclear. This report will explore the role of aspirin as primary prevention for various vascular events. It strives to provide a clear guide for clinicians on whether or not to prescribe aspirin for their patients for primary prevention. Current guidelines and recent trials failed to show clear benefit against primary prevention, with risks outweighing benefits in moderate to high risk patients. A thoughtful discussion between patients and their doctors should be conducted before beginning aspirin use. More studies are needed to gain a better understanding of aspirin use in primary prevention.
Topics: Aspirin; Cardiovascular Diseases; Humans; Primary Prevention; Risk Factors
PubMed: 32580960
DOI: 10.3121/cmr.2020.1548 -
Circulation Sep 20191. The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life. 2. A... (Review)
Review
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
1. The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life. 2. A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions. 3. Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. The presence or absence of additional risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning. 4. All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of fats, processed meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss. 5. Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity. 6. For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist. 7. All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit. 8. Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit. 9. Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion. 10. Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.
Topics: Advisory Committees; American Heart Association; Cardiology; Cardiovascular Diseases; Humans; Practice Guidelines as Topic; Primary Prevention; Research Report; Risk Reduction Behavior; United States
PubMed: 30879339
DOI: 10.1161/CIR.0000000000000677 -
Frontiers in Endocrinology 2020Type 1 Diabetes (T1D) is one of the most common chronic autoimmune diseases in children. The disease is characterized by the destruction of beta cells, leading to... (Review)
Review
Type 1 Diabetes (T1D) is one of the most common chronic autoimmune diseases in children. The disease is characterized by the destruction of beta cells, leading to hyperglycemia, and to a lifelong insulin-dependent state. Although several studies in the last decades have added relevant insights, the complex pathogenesis of the disease is not yet completely understood. Recent studies have been focused on several factors, including family history and genetic predisposition (HLA and non-HLA genes) as well as environmental and metabolic biomarkers, with the aim of predicting the development and progression of T1D. Once a child becomes symptomatic, beta cell mass has already reached a critical threshold (usually a residual of 20-30% of normal amounts), thus representing only the very late phase of the disease. In particular, this final stage follows two preceding asymptomatic stages, which have been precisely identified. In view of the long natural history and complex pathogenesis of the disease, many strategies may be proposed for primary, secondary, and tertiary prevention. Strategies of primary prevention aim to prevent the onset of autoimmunity against beta cells in asymptomatic individuals at high risk for T1D. In addition, the availability of novel humoral and metabolic biomarkers that are able to characterize subjects at high risk of progression, have stimulated several studies on secondary and tertiary prevention, aimed to preserve residual beta cell destruction and/or to prolong the remission phase after the onset of T1D. This review focuses on the major current knowledge on prediction and prevention of T1D in children.
Topics: Diabetes Mellitus, Type 1; Disease Progression; Genetic Predisposition to Disease; Humans; Primary Prevention
PubMed: 32670194
DOI: 10.3389/fendo.2020.00248 -
Advances in Skin & Wound Care Mar 2020To review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific... (Review)
Review
GENERAL PURPOSE
To review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline with further discussion of nutrition for pressure injury management in the context of the recommendations.
TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.
LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant should be better able to:1. Distinguish nutrition and malnutrition, especially as they relate to the development and healing of pressure injuries.2. Differentiate the tools and techniques that help clinicians assess nutrition status as well as the causes of pressure injuries in specific populations.3. Identify interventions for improving nutrition status and promoting pressure injury healing.
ABSTRACT
Macro- and micronutrients are required by each organ system in specific amounts to promote the growth, development, maintenance, and repair of body tissues. Specifically, nutrition plays an important role in the prevention and treatment of pressure injuries. The purpose of this manuscript is to review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. Nutrition for pressure injury management is discussed in the context of the recommendations.
Topics: Education, Medical, Continuing; Female; Humans; Internationality; Male; Nutritional Status; Patient Care Team; Practice Guidelines as Topic; Pressure Ulcer; Primary Prevention; Role; Wound Healing
PubMed: 32058438
DOI: 10.1097/01.ASW.0000653144.90739.ad -
Continuum (Minneapolis, Minn.) Apr 2020This article provides an update on the epidemiology and prevention of a first stroke. Risk factor modification plays a large role in stroke prevention. Strategies for... (Review)
Review
PURPOSE OF REVIEW
This article provides an update on the epidemiology and prevention of a first stroke. Risk factor modification plays a large role in stroke prevention. Strategies for early intervention, particularly for hypertension, are critical for reducing stroke morbidity and mortality.
RECENT FINDINGS
Because of the new criteria for hypertension, more people are now classified as hypertensive and can benefit from lifestyle or medical management. Direct oral anticoagulants have made it easier to safely treat patients with atrial fibrillation and are now considered first-line therapy for patients with an additional stroke risk factor.
SUMMARY
Primary prevention of stroke is essential for maintaining brain health throughout the life span. Adherence to a healthy lifestyle and routine screening for stroke risk factors can promote healthy, stroke-free aging.
Topics: Atrial Fibrillation; Humans; Hypertension; Primary Prevention; Risk Reduction Behavior; Stroke
PubMed: 32224751
DOI: 10.1212/CON.0000000000000831 -
Acta Pharmaceutica (Zagreb, Croatia) Dec 2019Taking responsibility for your life, among other factors, means also considering what to eat and which nutrition pattern to follow. Everyone needs to think about what... (Review)
Review
Taking responsibility for your life, among other factors, means also considering what to eat and which nutrition pattern to follow. Everyone needs to think about what they put on the plate and which ingredients should be avoided. Food, as such, will never be a drug or medication, like a painkilling tablet relieving pain in a short amount of time, for example. However, proper nutrition is our ally in the prevention of diseases, maintaining balance in our body and our mind. By following the main principles of a healthy diet, the physiological homeostasis can be managed, as well as faster recovery from disease achieved. This review is aimed at summarizing basic principles of nutrition recommendations and at empowering stakeholders (pharmacists, medical biochemists, physicians) to be able to communicate to their patients and customers healthy and sustainable nutrition choices through the personalized advice.
Topics: Diet, Healthy; Food; Humans; Nutrients; Nutrition Policy; Primary Prevention
PubMed: 31639089
DOI: 10.2478/acph-2019-0051 -
Annals of Allergy, Asthma & Immunology... Jul 2020
Topics: Allergy and Immunology; Humans; Primary Prevention; Vaccines
PubMed: 32564925
DOI: 10.1016/j.anai.2020.03.031 -
Atencion Primaria 2019To assess the effectiveness of the interventions to prevent a pregnancy in adolescence.
OBJECTIVE
To assess the effectiveness of the interventions to prevent a pregnancy in adolescence.
DESIGN
Systematic review.
DATA SOURCES
The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence.
STUDY SELECTION
A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale.
RESULTS
Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P>.05) for any of the results analysed in this review.
CONCLUSION
There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate.
Topics: Adolescent; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Pregnancy; Pregnancy in Adolescence; Primary Prevention; Program Evaluation
PubMed: 29903543
DOI: 10.1016/j.aprim.2018.04.003 -
The American Journal of Medicine Jan 2021
Topics: Aspirin; Humans; Platelet Aggregation Inhibitors; Primary Prevention; Sex Factors
PubMed: 32941847
DOI: 10.1016/j.amjmed.2020.08.014