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Self-monitoring patterns after acute coronary syndrome: behavioural markers for secondary prevention.

BACKGROUND: Sustained engagement is essential for remote monitoring (RM) after acute coronary syndrome (ACS), yet self-monitoring behaviour … er ACS, with potential value as behavioural markers for risk stratification and targeted support in secondary prevention.

Equitable lipid optimisation through a data-driven, pharmacist-led secondary prevention pathway.

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in the UK, with raised cholesterol … or Health and Care Excellence recommendations assessed using a pre-post design. RESULTS: Among 204 secondary prevention patients, 65% were from ethnically diverse backgrounds and 71% were male. Mean baseline LDL-C was 3.39 mmol/L and 13% were not actively receiving lipid-lowering therapy. Attendance by IMD quintile was 7.4% (most deprived), 34%, 33%, 13% and 12% (lea …

Пригодны ли глюкагоны-подобно Пептиды-1 для агонистов-рецепторов для вторичной истерии?

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… Particular attention should be paid to stroke mechanisms, timing of treatment initiation, combination with contemporary secondary prevention strategies, and long-term cognitive outcomes after TIA and ischemic stroke. …

Hydrocortisone for Secondary Prevention of Post-Traumatic Stress Disorder: A Case Report.

Post-Traumatic Stress Disorder (PTSD) is prevalent among both the civilian and military populace, causes significant burden to the healthcare system, and diminishes the quality of life of those afflicted by it. Secondary pharmacologic prevention strategies with glucocorticoids have been studied in ICU patients and those who have experienced traumatic events with some effect. This case report follows one Active-Duty Marine who was exposed to a traumatic event during an emergency medical technician shift. Following this event, he was diagnosed with Acute Stress Reaction and treated with a 10-day

Newly identified cerebral microbleeds in patients on anticoagulation for secondary stroke prevention.

Patients with cardioembolic ischemic stroke are commonly prescribed direct oral anticoagulants (DOACs), such as dabigatran (a direct thrombin inhibitor) and factor Xa inhibitors (e.g., apixaban and rivaroxaban), or warfarin to reduce the risk of recurrent stroke. A major concern in anticoagulant therapy is the risk of intracerebral hemorrhage, which is associated with a high mortality rate. Cerebral microbleeds (MBs), small asymptomatic brain hemorrhages detectable by susceptibility-weighted imaging (SWI) on magnetic resonance imaging (MRI), are associated with increased hemorrhagic stroke ris

Acute Coronary Syndromes: State-of-the-Art Diagnosis, Management, and Secondary Prevention.

Background: Acute coronary syndromes (ACSs) remain a leading cause of death and disability. Since the publication of the 2023 ESC ACS guidel … haemic-risk patients, whereas day-0 aspirin-free strategies in unselected ACS are not non-inferior. Secondary prevention: A "strike early and strong" approach to LDL-cholesterol-often with combination therapy in hospital-is emphasized, alongside nuanced roles for SGLT2 inhibitors and GLP-1 receptor agonists. Special populations and implementation: Sex- and age-aware t …

Time Is Bone: Missed Opportunities for Secondary Prevention After a Hip Fracture.

Background/Objectives: Early evaluation and treatment of osteoporosis following a hip fracture is of paramount importance for secondary fracture prevention. Nevertheless, the extent to which osteoporosis management is documented in studies reporting on operatively treated hip fractures in elderly patients is unclear. This study is the first systematic review aiming to investigate and summarize the reporting of osteoporosis management in studies with operatively treated hip fractures in elderly patients. Methods: This systematic review was conducted in compliance with PRISMA guidelines. A compr

Primary and secondary prevention of cervical cancer among Italian AFAB transgender people.

OBJECTIVE: Currently, available data on preventive measures for Human Papillomavirus (HPV) infection and cervical cancer in the transgender assigned female at birth (AFAB) community are extremely limited. Our aim was to analyze adherence to primary and secondary cervical cancer prevention screening programs among transgender AFAB people attending our gender clinic. METHODS: Transgender AFAB people attending our center were recruited. Anamnestic data were collected for each person through completion of a medical history form and medical records. Variables recorded included previous HPV vaccina

World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update.

BACKGROUND: Secondary prevention lifestyle and pharmacological treatment of atherosclerotic cardiovascular disease (ASCVD) reduce a high proportion of recurrent events and mortality. However, significant gaps exist between guideline recommendations and usual clinical practice. OBJECTIVES: Describe the state of the art, the roadblocks, and successful strategies to overcome them in ASCVD secondary prevention management. METHODS: A writing group reviewed guidelines and research papers and received inputs from an international committee composed of cardiovascular prevention and health systems ex…

Recent advances in the prevention of secondary ischemic stroke: A narrative review.

Stroke remains a significant contributor to global morbidity and mortality, with acute ischemic stroke comprising the majority of cases. Secondary stroke, the recurrent stroke, is often more severe and linked to worse functional outcomes and increased mortality. The secondary prevention of ischemic stroke is crucial for reducing the risk of recurrent events. Significant advancements have been made in secondary prevention strategies in recent years. These include the refinement of antithrombotic regimens, the use of direct oral anticoagulants in managing atrial fibrillation, and the implementat…

Implantable cardioverter defibrillator therapy in paediatric patients for primary vs. secondary prevention.

AIMS: The decisions about placing an ICD in a child are more difficult than in an adult due to longer expected lifespan and the complication risk. Young patients gain the most years from ICDs, despite higher risk of device-related complications. The secondary prevention ICD indication is clear, and device is implanted regardless of potential complications. For primary prevention, risk of sudden cardiac death and complications need to be evaluated. We aimed to compare outcomes for primary and secondary prevention ICDs. METHODS AND RESULTS: Retrospective nationwide cohort study including paedia…

Clinical Updates on Antiplatelet Therapy for Secondary Prevention in Acute Ischemic Stroke.

Antiplatelet therapy is the first-line management for noncardioembolic transient ischemic attack (TIA) and acute ischemic stroke (IS). Herei … increases the rate of bleeding complications. Keyword: antiplatelet therapy, acute ischemic stroke, secondary prevention, transient ischemic attack.

Risk factors in cardiovascular patients: Challenges and opportunities to improve secondary prevention.

BACKGROUND: Effective management of major cardiovascular risk factors is of great importance to reduce mortality from cardiovascular disease … aucasus, a region at a very high risk for CVD. AIM: To assess adherence to ESC recommendations for secondary prevention of CVD based on the measurement of both modifiable major risk factors and their therapeutic management in patients with confirmed CHD at different hospitals in Baku (Azerbaijan). METHODS: Six tertiary health care centers participated in the SURF CH …

Secondary Prevention and Rehabilitation for Spontaneous Coronary Artery Dissection: A Systematic Review.

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is a serious, noniatrogenic and nontraumatic cardiac event that predominantly affects women, with a high risk of recurrence. Secondary prevention strategies are not well understood in this population. Therefore, the aim of this systematic review is to determine the current evidence on secondary prevention strategies and their effect on recurrent cardiac events and quality of life (QOL). METHODS: A literature search was conducted on August 21, 2021, of Ovid MEDLINE, Ovid Embase, CINAHL, Cochrane Library (via Wiley), Google Scholar, and …

How can secondary dementia prevention trials of Alzheimer's disease be clinically meaningful?

After clinical trial failures in symptomatic Alzheimer's disease (AD), our field has moved to earlier intervention in cognitively normal individuals with biomarker evidence of AD. This offers potential for dementia prevention, but mainly low and variable rates of progression to AD dementia reduce the usefulness of trials' data in decision making by potential prescribers. With results from several Phase 3 secondary prevention studies anticipated within the next few years and the Food and Drug Administration's recent endorsement of amyloid beta as a surrogate outcome biomarker for AD clinical tr…

A Clinical Update on Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke.

PURPOSE OF REVIEW: Antiplatelet therapy remains the standard of care in secondary stroke prevention for non-cardioembolic ischemic stroke and transient ischemic attack. We aim to examine the use of antiplatelet agents in secondary prevention through highlighting relevant clinical trials and meta-analyses as well as providing commentary regarding our practice. RECENT FINDINGS: In the POINT and CHANCE trials, dual antiplatelet therapy reduced recurrent stroke compared to aspirin monotherapy. Sub-analyses of these trials suggest that genetic polymorphisms could play a role in diminishing the eff…

Non-drug therapies for the secondary prevention of lower limb muscle cramps.

BACKGROUND: Lower limb muscle cramps are common and painful. They can limit exercise participation, and reduce quality of sleep, and quality of life. Many interventions are available for lower limb cramps; some are controversial or could cause harm, and often, people experience no benefit from the interventions used. This is an update of a Cochrane Review first published in 2012. We updated the review to incorporate new evidence. OBJECTIVES: To assess the effects of non-drug, non-invasive therapies for lower limb muscle cramps. SEARCH METHODS: In August 2018 and May 2020, we searched the Coc