Background and Purpose—The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audienc...

/pdf/guidelines-for-the-early-management-of-patients-with-acute-19udbft6e7.pdf

Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

The Structural Transformation of the Public Sphere: An Inquiry into a Category of Bourgeois Society

2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular riskThe Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)

Chronic kidney disease1 (CKD) is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost. The number of individuals with kidney failure treated by dialysis and transplantation exceeded 320 000 in 1998 and is expected to surpass 650 000 by 2010.1,2 There is an even higher prevalence of earlier stages of CKD (Table 1).1,3 Kidney failure requiring treatment with dialysis or transplantation is the most visible outcome of CKD. However, cardiovascular disease (CVD) is also frequently associated with CKD, which is important because individuals with CKD are more likely to die of CVD than to develop kidney failure,4 CVD in CKD is treatable and potentially preventable, and CKD appears to be a risk factor for CVD. In 1998, the National Kidney Foundation (NKF) Task Force on Cardiovascular Disease in Chronic Renal Disease issued a report emphasizing the high risk of CVD in CKD.5 This report showed that there was a high prevalence of CVD in CKD and that mortality due to CVD was 10 to 30 times higher in dialysis patients than in the general population (Figure 1 and Table 2).6–18 The task force recommended that patients with CKD be considered in the “highest risk group” for subsequent CVD events and that treatment recommendations based on CVD risk stratification should take into account the highest-risk status of patients with CKD. 

View this table:

TABLE 1. Stages of CKD 





Figure 1. Cardiovascular mortality defined by death due to arrhythmias, cardiomyopathy, cardiac arrest, myocardial infarction, atherosclerotic heart disease, and pulmonary edema in general population (GP; National Center for Health Statistics [NCHS] multiple cause of mortality data files International Classification of Diseases, 9th Revision [ICD 9] codes 402, 404, 410 to 414, and …

Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention.

Late influenza vaccination is associated with reduced effectiveness.

The association of serum calcium with blood pressure (BP), was examined in a group of 727 male industrial workers aged 20-69 in Israel, who underwent screening for risk factors for cardiovascular disease. Serum calcium was found to be significantly correlated with systolic BP (r = 0.18, p less than 0.001) only among those under the age of 40. This association persisted after adjustment for age and serum albumin levels but was not statistically significant after further adjustment for serum cholesterol. These findings contribute to the evidence implicating calcium as a key factor in the control of blood pressure. However, the fact that adjustment for serum cholesterol levels eliminated the significance of the association between BP and serum calcium suggests that this association may not be direct.

Interrelationships between Blood Pressure, Serum Calcium and Other Biochemical Variables

Deaths following influenza vaccination--background mortality or causal connection?

BACKGROUND Contradictory evidence exists as to the rate of use of healthcare services by Israeli immigrants from the former Soviet Union (fSU). OBJECTIVES The aim of this study was to compare the rates of utilization of healthcare services in veteran Israeli Jews and immigrants a decade and a half after immigration. METHODS The data was obtained from the Israel National Health Interview Survey (INHIS) during 2003-2004, which is based on 6,756 interviews with veteran Israeli Jews and 953 interviews with immigrants from the fSU, of them 835 arrived in Israel during the years 1990-1998, and 118 arrived after 1998. Questions included use of healthcare services, health status and socioeconomic factors. RESULTS The immigrants from the fSU reported similar rates of visiting a family physician and specialist and lower hospitalization rates after adjustment for socioeconomic variables compared to veteran Jews. However, the rate of use of preventive tests such as serum cholesterol tests, mammography and Pap smear tests was lower in immigrants. There was no significant difference in use of healthcare services between recent immigrants and those living in Israel more than 5 years, except for mammography performance. CONCLUSIONS The use of community healthcare services among immigrants is similar to the use among veteran Jews. However, the immigrant population in Israel utilizes preventive services less often than the veteran Jewish population.

Patterns of utilization of healthcare services among immigrants to Israel from the former Soviet Union

In this study we aimed to explore the significance of glycemic control during gestational diabetes mellitus (GDM) pregnancy in predicting recurrence as this is unknown. A retrospective population-based cohort study of women with first diagnosed GDM pregnancy was conducted. A total of 426 women with 4,226 glucose charts were obtained. Daily glucose values were collected from the glucose charts. Non-parametric (LOWESS) regression was used to present the glucose measurements along the gestational weeks. The analyses revealed that the 2-hour postprandial levels among women with GDM recurrence were substantially higher throughout gestation (PR = 1.89 [95% CI: 1.33, 2.73] for every 20 mg/dl increase). In a multivariable log-binomial regression, the mean postprandial glucose was significantly associated with GDM recurrence (p = 0.017) after adjusting for maternal age, family history of diabetes, insulin use, and inter-pregnancy interval (PR = 1.04 [95% CI: 1.01, 1.07]). The study conclusion is that tighter postprandial glycemic control should be considered. Future studies should explore tighter cutoffs of the 2-hour postprandial glucose.

/pdf/postprandial-glycemic-control-during-gestational-diabetes-2mp2ihux32.pdf

Manfred S. Green

Papers

Late influenza vaccination is associated with reduced effectiveness.

Interrelationships between Blood Pressure, Serum Calcium and Other Biochemical Variables

Deaths following influenza vaccination--background mortality or causal connection?

Patterns of utilization of healthcare services among immigrants to Israel from the former Soviet Union

Postprandial glycemic control during gestational diabetes pregnancy predicts the risk of recurrence.