Sumit R Majumdar

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..The aim of the study was to determine whether heart failure is associated with an increased risk of major osteoporotic fractures that is independent of bone mineral density (BMD)...

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..To test this hypothesis, we examined a prospective population-based cohort predisposed to pneumonia: elderly patients (> or =65 years) who had survived hospitalization for pneumonia...

..The second phase of the randomized trial compared a less intensive intervention, facilitated bone mineral density (BMD) testing, with usual care and the case manager intervention...

..001). Alongside that trial, we conducted an economic analysis...

..Our goal was to determine the association between random admission hyperglycemia and new diagnosis of diabetes after discharge in patients hospitalized with pneumonia...

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..It is uncertain whether this increased risk is related to a deleterious effect of sulfonylurea and insulin or a protective effect of metformin or due to some unmeasured effect related to both choice of therapy and cancer risk...

..To measure 1-year post-hip fracture functional recovery, health-related quality of life (HRQL), and mortality in nursing home residents...

..Our objectives were to determine the utility of chest radiographs for detecting previously unrecognized vertebral fractures; document rates of recognition; and evaluate osteoporosis treatments...

..Most quality improvement efforts for type 2 diabetes have neglected cardiovascular risk factors and are limited by a lack of information about generalizability across settings or persistence of effect over time...

..The purpose of this analysis was to use generic measures of HRQL to describe HRQL deficits associated with varying degrees of severity of type 2 diabetes...

..CONCLUSIONS: Metformin, alone or in combination, in subjects with heart failure and type 2 diabetes was associated with lower morbidity and mortality compared with sulfonylurea monotherapy...

..Recent reports suggest that the health status of individuals residing in rural areas (as much as one third of the Canadian population) may be inferior to those who live in urban areas...

..The case manager educated patients, arranged bone mineral density tests, provided prescriptions, and communicated with primary care physicians. The intervention was compared with usual care in a randomized controlled trial...

..Our aims were to determine the incidence and correlates of new lung cancer and the diagnostic yield of new lung cancer by chest radiography in patients with pneumonia...

..The purpose of this study was to determine the effectiveness of beta-blockers after MI in patients with type 2 diabetes...

..Overall, 36% of the variance in the Health Utilities Index Mark 3 was explained. CONCLUSION: Social and environmental factors are important, but comorbidities have the largest impact on HRQL among people with type 2 diabetes...

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..Future strategies must address a number of dimensions beyond simple education...

..Overall HUI3 scores were significantly predictive of all three categories of health-care resource use. CONCLUSION: Observed differences between groups contribute further evidence of the construct validity of the HUI3 in type 2 diabetes...

..To determine if the risk of developing heart failure (HF) is associated with the use of sulfonylurea or metformin in patients with diabetes...

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..Paper does not change practice, and the creation and mailing out of a practice guideline for the treatment of CAP is only the first necessary step in translating good evidence into everyday clinical practice...

..However, we found significant underuse of aspirin therapy among our study population. Aspirin should be included and better promoted as a factor in high-quality, evidence-based DM management...

..These are patient subgroups that should be targeted as opportunities to improve hypertension management at the population level...

..We hypothesize that lower indirect, out of pocket and productivity costs will offset increased direct health-care costs resulting in lower total costs for bariatric surgery...

..Our objective was to examine wait-listed patients' health status and perceptions regarding the consequences of prolonged wait times using a cross-sectional study design nested within a prospective cohort...

..Programs to improve the quality of cardiovascular risk reduction in these high-risk patients are needed...

..The objective of this study was to evaluate the differential risk of diabetes among people with depression taking antidepressant therapy...

..Although thiazolidinediones precipitate fluid retention in clinical trials, current guidelines advocate their use for patients with diabetes who are felt to be at low risk for heart failure (HF)...

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..Heart failure (HF) is associated with factors that may contribute to accelerated bone loss and subsequent fractures. Whether it leads to an increased fracture risk is unknown...

..Recent reports suggest that the health status of individuals residing in rural areas (as much as one third of the Canadian population) may be inferior to those who live in urban areas...

..We examined the association between premorbid functional status and mortality in patients with severe pneumonia...

..To examine whether hyperglycemia at the time of presentation was associated with outcomes in patients admitted to non-intensive care settings with community-acquired pneumonia (CAP)...

..Despite the availability of proved effective therapies, treatment gaps were present for this cohort of patients...

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..To determine the association between age and mortality in critically ill patients with pneumonia. We hypothesized that increasing age would be independently associated with both short- and long-term mortality...

..CONCLUSION: If the methods used in this intervention are found to improve prescribing practices, similar interventions could be designed for other chronic conditions dealt with in the outpatient setting...

..Therefore, we attempted to conduct a pilot study to evaluate the feasibility of undertaking a large randomized controlled trial with clinical endpoints...

..To review the literature on the association between antidiabetic agents and morbidity and mortality in people with heart failure and diabetes...

..HRQL in people with type 2 diabetes was positively associated with exercise adherence, which was related to a positive PPR. Adherence to diet was also related to a positive PPR, but diet adherence had no association with HRQL...

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..Few studies have been conducted in outpatients with pneumonia, and there is a paucity of data on short and long term morbidity or mortality and associated clinical correlates in this group of patients...

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..43, 95% CI 1.17-1.75). CONCLUSION: Compared with sulfonylurea therapy, metformin therapy appears to be associated with a delay in the onset of secondary failure...

..Whether a lower HbA(1c) level improves outcomes in people with DM and chronic kidney disease (CKD) is unknown...

..For outpatients with pneumonia, guidelines recommend empiric antibiotics and some suggest macrolides are preferred agents. We hypothesized that both guideline-concordant antibiotics and macrolides would be associated with reduced mortality...

..The potential role of respiratory viruses in the natural history of community-acquired pneumonia (CAP) in adults has not been well described since the advent of nucleic amplification tests (NATs)...

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..This study was done to evaluate the quality of the evidence (based on consideration of its internal validity, clinical relevance, and applicability) underlying therapy recommendations in evidence-based clinical practice guidelines...

..We determined whether PPV was associated with reduced mortality or additional hospitalization for vaccine-preventable infections in patients previously hospitalized for community-acquired pneumonia (CAP)...

..INTERPRETATION: Using a large, population-based administrative cohort, we found little evidence that type 2 diabetes increases the risk of depression once comorbid diseases and the burden of diabetes complications were accounted for...

..The same relation was not observed with metformin. This implies that the manner in which blood glucose concentration is lowered may be as important as achieving recommended glucose targets...

..Thiazolidinediones, especially pioglitazone, may increase the risk. We conducted a systematic review and meta-analysis to evaluate the risk of bladder cancer among adults with type 2 diabetes taking thiazolidinediones...

..It is vigorously debated whether pneumococcal polysaccharide vaccination (PPV) reduces risk of acute coronary syndrome (ACS) events in patients with community-acquired pneumonia (CAP)...

..Despite the high risk for future fractures and the availability of effective treatments, fewer than 10% to 20% of patients who sustain a fragility fracture are tested or treated for osteoporosis...

..Our objectives were to: 1 document VCF prevalence in COPD patients; and 2 determine the independent correlates of VCF...

..To evaluate the effect of adding pharmacists to primary care teams on the management of hypertension and other cardiovascular risk factors in patients with type 2 diabetes...

..96, 95% CI=1.36-2.83). We conclude that routine measurement of serum albumin provides valuable prognostic information for treating this frail population...

..To evaluate the prevalence of cardiovascular risk factors (CV-RF) and disease (CV-D) in people with schizophrenia...

..To evaluate the relation between adherence to drug therapy, including placebo, and mortality...

..The effect of consultations generated at SPCs on the adequacy of the management of these risk factors for stroke has not been well described, and few studies have long-term follow-up...

..Future interventions should incorporate the finding that osteoporosis-specific visits and abnormal QUS results were strongly associated with getting a BMD testing and should give greater attention to men...

..The relationship between spontaneous admission hypoglycemia and mortality in patients hospitalized with community-acquired pneumonia is unclear...

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..We evaluated whether evidence summaries, which were either unsigned or signed by local opinion leaders, improved the quality of secondary prevention care delivered by primary care physicians of patients with coronary artery disease...

..CONCLUSIONS: A diabetes outreach service has the potential to improve the quality of diabetes care for rural patients. Future studies need to involve longer timelines and larger sample sizes...

..We determined the incidence of stroke in people newly treated for type 2 diabetes...

..To analyze trends in health care costs in the decade after identification of diabetes, contrasting type 1 and 2 diabetes...

..Our objectives were to describe the prevalence and predictors of the most common osteoporotic fracture, vertebral compression fractures (VCF), in patients with HF...

..Only then can patients and their physicians be confident that the putative benefits of such drugs outweigh their risks and costs...

..Eight (4%) of 193 patients had hMPV RNA present, all detected during influenza season. hMPV is an important cause of pneumonia in adults...

..The absence of radiographic findings should not supercede clinical judgment and empiric treatments in these patients...

..However, the utility of measuring the AAI to predict postoperative cardiac complications in patients undergoing noncardiac surgery is unknown...

..We tested this hypothesis using a population-based cohort of hospitalized patients with CAP...

..We evaluated the impact of a CRRC on lipid levels and assessed the long-term effect of a CRRC in maintaining improved lipid levels following discharge...

..44-0.90]; P = 0.012). CONCLUSIONS: The use of ACE inhibitors was associated with a significant reduction in all-cause and cardiovascular-related mortality in a broad spectrum of patients with type 2 diabetes and no cardiovascular disease...

..For example, local audit and feedback of outcomes data to persuade physicians of the benefits of CAP pathways will need to be instituted...

..To systematically review the evidence for the prevention of type 2 diabetes by pharmacological therapies...

..0; p = 0.007). Thus, preoperative factors can identify those patients referred to pulmonologists or internists who are at increased risk for pulmonary complications after nonthoracic surgery...

..We conclude that mild cognitive impairment might contribute to falls risk beyond conventional risk factors in older people with and without PD...

..We tested the short-term (primary outcome) and long-term (secondary outcome) effect of a patient decision aid on the appropriateness of antithrombotic therapy among patients with NVAF...

..outline which of the strategies for translating evidence into clinical care have been shown to be ineffective, which strategies have been shown to be effective and to describe some untested approaches that hold promise...

..We designed this study to determine whether this association reflects a beneficial effect of metformin or a harmful effect of other agents...

..If our intervention improves the provision of secondary prevention therapies in these patients, the clinical (and financial) implications will be enormous...

..Our objectives are to: (1) undertake a randomized trial testing this hypothesis, and (2) conduct a meta-analysis of our findings with 2 earlier studies...

..AEs are unintended injuries or complications resulting in death, disability or prolonged hospital stay that arise from health care management. We estimated the incidence of AEs among patients in Canadian acute care hospitals...

..Stroke is a major cause of morbidity and mortality, and the application of evidence for stroke prevention varies considerably...

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..Interventions to improve the detection and treatment of osteoporosis in high-risk patients need to be developed...

..The aim of this study was to examine the relationship between use of metformin and sulfonylurea and mortality in new users of these agents...