-
Heart (British Cardiac Society) Mar 2023
Topics: Humans; Hypolipidemic Agents; Lipids; Primary Prevention
PubMed: 36446544
DOI: 10.1136/heartjnl-2022-321972 -
Advances in Skin & Wound Care Sep 2020To explore the changes in the National Pressure Injury Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance Clinical Practice...
GENERAL PURPOSE
To explore the changes in the National Pressure Injury Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance Clinical Practice Guideline for Prevention and Treatment of Pressure Ulcers/Injuries (CPG) nutrition recommendations and strategies for implementation.
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 will:1. Synthesize the current evidence regarding nutrition approaches to medical conditions, including pressure injury prevention and treatment.2. Summarize the changes and recommendations in the 2019 edition of the CPG.
ABSTRACT
Healthy diets provide essential nutrients needed to maintain healthy skin and prevent or manage pressure injuries. The 2019 Clinical Practice Guideline for Prevention and Treatment of Pressure Ulcers/Injuries published by the National Pressure Injury Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance includes specific nutrition recommendations for patients with pressure injuries. The purpose of this CE/CME article is to explore the changes in the nutrition recommendations and strategies for implementation.
Topics: Disease Management; Humans; Nutritional Status; Practice Guidelines as Topic; Pressure Ulcer; Primary Prevention; Soft Tissue Injuries; Wound Healing
PubMed: 32810059
DOI: 10.1097/01.ASW.0000688412.05627.96 -
JACC. Cardiovascular Imaging Jan 2020
Topics: Calcinosis; Cause of Death; Coronary Artery Disease; Humans; Primary Prevention
PubMed: 31918909
DOI: 10.1016/j.jcmg.2019.12.007 -
Revista Espanola de Cardiologia... Jul 2024The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and... (Review)
Review
The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and CORDIOPREV) and 1 primary prevention trial (PREDIMED) that have demonstrated these benefits, there is an unprecedented body of high-quality prospective epidemiological evidence supporting these beneficial effects. The key elements of this traditional pattern are the abundant use of extra-virgin olive oil and high consumption of foods of natural plant-based origin (fruits, vegetables, nuts, and legumes) and fish, along with a reduction in processed meats, red meats, and ultraprocessed products. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence.
Topics: Diet, Mediterranean; Humans; Cardiovascular Diseases; Secondary Prevention; Primary Prevention
PubMed: 38336153
DOI: 10.1016/j.rec.2024.01.006 -
Journal of Cardiovascular Medicine... Sep 2021Despite the well established role of coronary computed tomography angiography (CCTA) as a diagnostic gatekeeper, the yield of subsequent invasive coronary angiographies...
AIMS
Despite the well established role of coronary computed tomography angiography (CCTA) as a diagnostic gatekeeper, the yield of subsequent invasive coronary angiographies (ICA) remains low. We evaluated the adherence of CCTA integration in clinical management and primary prevention therapy.
METHODS
We retrospectively analyzed patients referred for ICA after CCTA without known coronary artery disease (CAD) or structural cardiac pathologies. Based on computed tomography (CT) findings, patients were classified as appropriately or inappropriately referred to ICA, equaling Coronary Artery Disease - Reporting and Data System (CAD-RADS) categories 0-2 (<50% stenosis) and 3-5 (>50% stenosis), respectively. CT exams were compared regarding invasive findings and revascularizations. Integration of CT results into primary prevention measures was analyzed and compared to measures taken after ICA.
RESULTS
Of 1005 patients referred for ICA, 81 (8.1%) had no obstructive CT findings and therefore no ICA indication. ICA inappropriate patients did not differ in symptom characteristics, but had a significantly lower revascularization rate (3.7% vs. 42.1%, P < 0.0001) compared with patients appropriately referred to ICA. In patients with indication for lipid-lowering therapy after the CCTA statin rate was 53.1% and significantly increased after ICA to 76.4% (P < 0.0001). In CCTA, obstructive findings in proximal-only lesions did not increase the revascularization rate (45.6% vs. 42.1%, P = 0.11) but missed nonproximal relevant stenoses (15.0% vs. 2.5%, P < 0.0001) compared with obstructive findings in all segments.
CONCLUSION
The overall rate of inappropriateness was low, but there is relevant statin underutilization in eligible patients due to a lack of CT findings integration. Both ICA referrals and primary preventive therapy could be improved by the implementation of CT results based on CAD-RADS recommendations.
Topics: Austria; Computed Tomography Angiography; Coronary Angiography; Coronary Artery Disease; Female; Health Services Needs and Demand; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Medical Overuse; Middle Aged; Practice Patterns, Physicians'; Primary Prevention; Referral and Consultation
PubMed: 34714258
DOI: 10.2459/JCM.0000000000001191 -
Internal and Emergency Medicine Nov 2019Aspirin, in 2017, has celebrated its 120th birthday. The efficacy and safety of low-dose aspirin in secondary prevention of cardiovascular disease is well supported by... (Review)
Review
Aspirin, in 2017, has celebrated its 120th birthday. The efficacy and safety of low-dose aspirin in secondary prevention of cardiovascular disease is well supported by many studies, instead in primary prevention it remains controversial, especially in the aftermath of the publication in 2018 of three novel primary prevention randomized clinical trials, showing that the benefit of low-dose aspirin, although additive to that of statin, is counterbalanced by an excess of (mainly gastrointestinal) bleeding events. The signal for a net benefit seems to be even more controversial in the elderly starting aspirin after the age of 70 years. While international guidelines have promptly downgraded their recommendations to more conservative indications, the practicing clinician is called to make the effort to individualize the treatment, after careful evaluation of the haemorrhagic risk vis-a-vis the risk to develop, in the mid-term and long-term follow-up, major cardiovascular events or cancer. This is a particularly complex task, given the different immediate and long-term impact of diverse outcomes on health, the dynamic nature over time of the benefit/risk balance, prompting periodic re-assessments of its indication, and the interindividual variability in aspirin response. The chemopreventive properties of aspirin, anticipated by a large body of epidemiological and mechanistic evidence, are awaiting their final confirmation by the long-term follow-up of the latest trials specifically designed to assess this endpoint, with the expectation to subvert the delicate benefit/risk balance of aspirin in primary prevention. This review is intended to provide an interpretation of past and current evidence to guide clinical decision making on the contemporary patient.
Topics: Aspirin; Cardiovascular Diseases; Clinical Competence; Humans; Platelet Aggregation Inhibitors; Primary Prevention; Risk Factors
PubMed: 31542891
DOI: 10.1007/s11739-019-02191-4 -
Australasian Psychiatry : Bulletin of... Feb 2020We reviewed the literature for preventive programs against illicit drug use that specifically target adults aged 18-25 (i.e. emerging adults). (Review)
Review
OBJECTIVES
We reviewed the literature for preventive programs against illicit drug use that specifically target adults aged 18-25 (i.e. emerging adults).
METHODS
Narrative review of preventive programs that have a high strength of recommendation according to the US Preventive Services Task Force (USPSTF) grading system.
RESULTS
Prevention programs that met the criteria are school and college based, family-based, community based, peer-led, workplace-based, and technology-based interventions. They target the known modifiable risk factors associated with illicit drug use among adolescents and young adults.
CONCLUSION
The preventive programs we reviewed are utilizing evidence-based strategies for the prevention of illicit drug use. Further research is needed to formulate new and effective preventive strategies for the reduction of illicit drug use by emerging adults.
Topics: Adolescent; Adult; Female; Humans; Male; Primary Prevention; Secondary Prevention; Substance-Related Disorders; Young Adult
PubMed: 31526182
DOI: 10.1177/1039856219875048 -
Journal of Behavioral Medicine Aug 2019Intentional and unintentional firearm injury is the second leading cause of death for youth, underscoring the need for effective primary prevention approaches that focus... (Review)
Review
Intentional and unintentional firearm injury is the second leading cause of death for youth, underscoring the need for effective primary prevention approaches that focus on increasing safe storage by caregivers and decreasing handling/carriage among youth. This article describes the state of the science for prevention of firearm injuries among children and adolescents. We applied PRISMA guidelines to present results from a scoping review using PubMed, Scopus, CINAHL, and CJ Abstracts for original research articles published between January 1, 1985 and March 1, 2018 in the U.S. focusing on primary screening or interventions for primary prevention of pediatric firearm injuries. In total, 46 articles met inclusion criteria: safe storage (23), screening (2), firearm handling/carriage/use (21). Across school, healthcare, and community settings, few evidenced-based programs exist, and data on firearm safety technologies are lacking. Programs have generally not employed rigorous designs, and/or assessed behavioral (e.g., carriage) or injury-related firearm outcomes. Evidenced-based prevention programs are needed to mitigate firearm morbidity and mortality among youth.
Topics: Adolescent; Child; Female; Firearms; Humans; Male; Mass Screening; Primary Prevention; Risk Assessment; Safety; Schools; Wounds, Gunshot
PubMed: 31367940
DOI: 10.1007/s10865-019-00043-2 -
The Lancet. Diabetes & Endocrinology Oct 2019
Topics: Atherosclerosis; Diabetes Mellitus, Type 2; Endocrinology; Guidelines as Topic; Humans; Metabolic Syndrome; Primary Prevention
PubMed: 31501042
DOI: 10.1016/S2213-8587(19)30292-X -
Postgraduate Medicine Nov 2020
Topics: Acute Kidney Injury; Ambulatory Care; Fluid Therapy; Humans; Kidney Function Tests; Monitoring, Physiologic; Primary Prevention; Risk Factors
PubMed: 32657222
DOI: 10.1080/00325481.2020.1795484