Sumit R Majumdar

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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...

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

..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...

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

..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...

..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...

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..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...

..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...

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

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

..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...

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

..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...

..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...

..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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..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...

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

..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...

..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 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...

..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)...

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

..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...

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

..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...

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

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

..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...

..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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..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)...

..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...

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

..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)...

..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)...

..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...

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

..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...

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

..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...

..Our objective is to comprehensively evaluate a collaborative care model for comorbid depression and type 2 diabetes within a Canadian primary care setting...

..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)...

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

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

..Therefore, we systematically reviewed all studies of macrolide use and mortality among patients hospitalized with community-acquired pneumonia (CAP)...

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

..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 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...

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

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

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

..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...

..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...

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..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...

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

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

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..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...

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

..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...

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

..Interrelated with the impact of the trial results themselves and the ensuing media coverage, reduced promotion may have contributed to a substantial decline in hormone therapy prescriptions...

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

..Conversely, more evidence is required to better guide the care of elderly patients with hip fracture during the subacute recovery period and convalescence...

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

..To clarify the evidence for this recommendation, we conducted a meta-analysis of randomized controlled trials that compared different intensities of statin therapy...

..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...

..5%, p = 0.006). INTERPRETATION: Patients without insurance for self-monitoring test strips had poorer glycemic control...

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

..Information on costs of academic detailing could assist with health plan decision making in developing interventions to improve prescribing...

..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...

..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)...

..To test the association of undiagnosed Type 2 diabetes mellitus with education and income level...

..48-0.91). Patient age was not a significant correlate of adherence to guidelines (OR, 1.01; 95% CI, 0.94-1.09). Understanding these observations may lead to strategies to improve guideline adherence and reduce health care disparities...

..Nevertheless, according to current practice guidelines, our patients were underinvestigated. Future guidelines should specifically address the management of patients who use acid suppressing medications on a chronic basis...