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Cardiology in Review 2020Cardiovascular disease is the leading cause of death globally, and deaths due to coronary heart disease or stroke account for over half of all cardiovascular deaths in... (Review)
Review
Cardiovascular disease is the leading cause of death globally, and deaths due to coronary heart disease or stroke account for over half of all cardiovascular deaths in the United States. While many important advances have been made in the treatment and secondary prevention of atherosclerotic cardiovascular disease (ASCVD), morbidity and mortality remain high. Aspirin has been commonly used for the primary and secondary prevention of ASCVD for decades and is an easily accessible therapeutic option. While it is a cornerstone of secondary prevention, its role in primary prevention is less clear and professional guidelines have differed in their recommendations. As literature has substantially evolved over the past 40 years, so too has our understanding of aspirin's role in the primary prevention of ASCVD. This article reviews landmark clinical trials of aspirin in primary prevention and highlights key changes in dosing strategies and demographics.
Topics: Aspirin; Atherosclerosis; Cardiovascular Diseases; Diabetes Mellitus; Female; Humans; Male; Primary Prevention
PubMed: 31764014
DOI: 10.1097/CRD.0000000000000297 -
Pediatric Annals Sep 2019Children comprise a special group of international travelers. Immigrant and refugee children, along with children traveling to visit friends and relatives abroad or on... (Review)
Review
Children comprise a special group of international travelers. Immigrant and refugee children, along with children traveling to visit friends and relatives abroad or on leisure trips, require special attention by clinicians to prevent and treat travel-related conditions. [Pediatr Ann. 2019;48(9):e360-e369.].
Topics: Adolescent; Child; Child, Preschool; Emigrants and Immigrants; Global Health; Humans; Infant; Infant, Newborn; Infections; Primary Prevention; Refugees; Travel-Related Illness; Vaccination
PubMed: 31505010
DOI: 10.3928/19382359-20190812-01 -
American Journal of Preventive Medicine Feb 2022Heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke are the 5 leading causes of death in the U.S. The objective of this review is... (Review)
Review
INTRODUCTION
Heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke are the 5 leading causes of death in the U.S. The objective of this review is to examine the economic value of prevention interventions addressing these 5 conditions.
METHODS
Tufts Medical Center Cost-Effectiveness Analysis Registry data were queried from 2010 to 2018 for interventions that addressed any of the 5 conditions in the U.S. Results were stratified by condition, prevention stage, type of intervention, study sponsorship, and study perspective. The analyses were conducted in 2020, and all costs were reported in 2019 dollars.
RESULTS
In total, 549 cost-effectiveness analysis studies examined interventions addressing these 5 conditions in the U.S. Tertiary prevention interventions were assessed in 61.4%, whereas primary prevention was assessed in 8.6% of the studies. Primary prevention studies were predominantly funded by government, whereas industry sources funded more tertiary prevention studies, especially those dealing with pharmaceutical interventions. The median incremental cost-effectiveness ratio for the 5 conditions combined was $68,500 per quality-adjusted life year. Median incremental cost-effectiveness ratios were lowest for primary prevention and highest for tertiary prevention.
DISCUSSION
Primary prevention may be more cost effective than secondary and tertiary prevention interventions; however, research investments in primary prevention interventions, especially by industry, lag in comparison. These findings help to highlight the gaps in the cost-effectiveness analysis literature related to the 5 leading causes of death and identify understudied interventions and prevention stages for each condition.
Topics: Cause of Death; Cost-Benefit Analysis; Humans; Primary Prevention; Quality-Adjusted Life Years; Stroke
PubMed: 34736801
DOI: 10.1016/j.amepre.2021.07.019 -
Current Opinion in Pharmacology Dec 2020There is growing evidence that inflammatory bowel disease has a preclinical phase that precedes disease symptoms, during which immune system activation has already... (Review)
Review
There is growing evidence that inflammatory bowel disease has a preclinical phase that precedes disease symptoms, during which immune system activation has already occurred and inflammatory pathways have been primed, setting the stage for disease to expand and leading up to clinical diagnosis. Gaining insight to this pre-diagnosis period could improve our knowledge about disease pathogenesis and potentially result in the detection of biomarkers that could predict disease development. The ultimate goal of such research is to identify a population at risk for developing IBD, so preventive strategies could be implemented and disease prevention be achieved.
Topics: Animals; Biomarkers; Humans; Inflammatory Bowel Diseases; Primary Prevention
PubMed: 33221629
DOI: 10.1016/j.coph.2020.10.001 -
Medicina Clinica Jun 2021
Topics: Crime Victims; Delivery of Health Care; Health Facilities; Health Personnel; Humans; Primary Prevention
PubMed: 33272683
DOI: 10.1016/j.medcli.2020.07.050 -
Revista Espanola de Cardiologia... Mar 2020
Topics: Aged; Aged, 80 and over; Cardiovascular Diseases; Female; Humans; Male; Middle Aged; Primary Prevention; Risk Factors
PubMed: 31831302
DOI: 10.1016/j.rec.2019.09.017 -
European Heart Journal Sep 2023
Topics: Humans; Cardiology; Cardiovascular Diseases; Cardiovascular System; Primary Prevention
PubMed: 37563238
DOI: 10.1093/eurheartj/ehad459 -
Pediatrics Sep 2020An updated synthesis of research on substance abuse prevention programs can promote enhanced uptake of programs with proven effectiveness, particularly when paired with...
CONTEXT
An updated synthesis of research on substance abuse prevention programs can promote enhanced uptake of programs with proven effectiveness, particularly when paired with information relevant to practitioners and policy makers.
OBJECTIVE
To assess the strength of the scientific evidence for psychoactive substance abuse prevention programs for school-aged children and youth.
DATA SOURCES
A systematic review was conducted of studies published up until March 31, 2020.
STUDY SELECTION
Articles on substance abuse prevention programs for school-aged children and youth were independently screened and included if they met eligibility criteria: (1) the program was designed for a general population of children and youth (ie, not designed for particular target groups), (2) the program was delivered to a general population, (3) the program only targeted children and youth, and (4) the study included a control group.
DATA EXTRACTION
Two reviewers independently evaluated study quality and extracted outcome data.
RESULTS
Ninety studies met eligibility criteria, representing 16 programs. Programs evaluated with the largest combined sample sizes were Drug Abuse Resistance Education, Project Adolescent Learning Experiences Resistance Training, Life Skills Training (LST), the Adolescent Alcohol Prevention Trial, and Project Choice.
LIMITATIONS
Given the heterogeneity of outcomes measured in the included studies, it was not possible to conduct a statistical meta-analysis of program effectiveness.
CONCLUSIONS
The most research has been conducted on the LST program. However, as with other programs included in this review, studies of LST effectiveness varied in quality. With this review, we provide an updated summary of evidence for primary prevention program effectiveness.
Topics: Adolescent; Child; Humans; Primary Prevention; Program Evaluation; Substance-Related Disorders
PubMed: 32769198
DOI: 10.1542/peds.2019-2747 -
Clinics in Chest Medicine Mar 2020Tobacco dependence is the most consequential target to reduce the burden of lung cancer worldwide. Quitting after a cancer diagnosis can improve cancer prognosis,... (Review)
Review
Tobacco dependence is the most consequential target to reduce the burden of lung cancer worldwide. Quitting after a cancer diagnosis can improve cancer prognosis, overall health, and quality of life. Several oncology professional organizations have issued guidelines stressing the importance of tobacco treatment for patients with cancer. Providing tobacco treatment in the context of lung cancer screening is another opportunity to further reduce death from lung cancer. In this review, the authors describe the current state of tobacco dependence treatment focusing on new paradigms and approaches and their particular relevance for persons at risk or on treatment for lung cancer.
Topics: Humans; Lung Neoplasms; Primary Prevention; Secondary Prevention; Smoking Cessation
PubMed: 32008628
DOI: 10.1016/j.ccm.2019.10.002 -
Diabetes Research and Clinical Practice Sep 2022Patients with diabetes have a prothrombotic state and a 2 to 4 times higher risk of cardiovascular events than those without diabetes. Aspirin is the cornerstone of... (Review)
Review
Patients with diabetes have a prothrombotic state and a 2 to 4 times higher risk of cardiovascular events than those without diabetes. Aspirin is the cornerstone of treatment in patients withcardiovascular disease, irrespective of diabetes status, being able to confer a 19% relative risk reduction per year in serious vascular events compared with placebo at long-term follow-up (6.7% vs 8.2% per year, p < 0.0001). Data regarding the benefit-risk ratio of aspirin prescribed to patients with diabetes without established cardiovascular disease are less convincing, especially when compared to other preventive strategies. Of note, in primary prevention trials, aspirin allocation yielded a significant 12% proportional reduction in serious vascular events, irrespective of diabetes status, corresponding to a small annual absolute risk reduction (0.06% per year). However, in everyday clinical practice aspirin is still largely prescribed by both diabetologists and cardiologists. In this article, we provide eight questions and answers corroborated by available evidence on the use of aspirin for primary prevention of cardiovascular disease in diabetes.
Topics: Aspirin; Cardiovascular Diseases; Diabetes Mellitus; Humans; Primary Prevention; Risk Assessment
PubMed: 35985427
DOI: 10.1016/j.diabres.2022.110043