Taha Taher

..Patients with renal insufficiency are less likely to be prescribed efficacious therapies, but have better outcomes if they receive these medications...

..The Alberta Cardiac Access (ACA) initiative was implemented in the spring of 2008 to increase access to specialized heart failure (HF) clinics after hospital discharge...

..The prevalence and prognostic import of renal dysfunction in HF if the CKD-EPI equation is used rather than the MDRD is uncertain...

..It is unclear whether angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) are beneficial in individuals with, or at increased risk for, atherosclerotic vascular disease who are normotensive...

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

..The primary analysis will be intention-to-treat. Planned recruitment will be complete by June 2011 and results available by December 2011. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00978354...

..abstract:..

..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...

..Even with optimal pharmacotherapy, symptomatic heart failure is associated with substantial morbidity and mortality...

..The aim of this study was to determine whether multidisciplinary strategies improve outcomes for heart failure (HF) patients...

..The purpose of this study was to examine whether prescribing practices for elderly individuals with diabetes and hypertension changed over the past decade...

..In addition, the impact of this decision aid on patient knowledge, decisional conflict, well-being, and adherence will be assessed after 3 months, 6 months, and 12 months...

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

..7, p < 0.001), and duration of anesthesia (OR 3.3 for operations lasting at least 2.5 hours, p = 0.008). Thus, several perioperative factors predict an increased risk for pulmonary complications after elective nonthoracic surgery...

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..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...

..To determine what proportion of patients with heart failure are eligible for cardiac resynchronization therapy (CRT)...

..In the present article, the key features of the Canadian Hypertension Education Program methodology are reviewed, with attention to those factors thought to be critical to the successful translation of recommendations into practice...

..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)...

..The cause of the "treatment-risk paradox" reported for patients with coronary disease is unknown; however, determining the factors that contribute to this paradox is essential to properly design quality improvement interventions...

..Atrial-synchronized biventricular pacemakers (cardiac resynchronization therapy [CRT]) received US Food and Drug Administration (FDA) approval for use in selected patients with LV systolic dysfunction in 2001...

..Guidelines recommend that patients with heart failure receive beta-blockers in doses used in the trials that have proven their efficacy. Although the adverse effects of beta-blockade are dose-related, it is unclear whether the benefits are...

..The prevalence, prognostic import, and impact of renal insufficiency on the benefits of ACE inhibitors and beta-blockers in community-dwelling patients with heart failure are uncertain...

..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...

..This study was done to examine the trends in the prevalence of hypertension and in control rates in Canada between 1992 and 2009...

..To determine whether multidisciplinary disease management programmes for patients with coronary heart disease improve processes of care and reduce morbidity and mortality...

..To provide updated, evidence-based recommendations for the therapy of hypertension in adults...

..quot; The key points of these guidelines are compared and the shortcomings that may impede their ability to influence practice are discussed. The main implications for future guideline developers are outlined...

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..The validity of a review depends on its methodologic quality...

..This study was designed to determine the safety of combination therapy with these two drugs in clinical practice...

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

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

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..To determine the adequacy of perioperative glycemic control in diabetic patients undergoing coronary artery bypass grafting (CABG) and to explore the association between glycemic control and in-hospital morbidity/mortality...

..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...

..Although specialty care has been shown to improve short-term outcomes in patients hospitalised with acute medical conditions, its effect on patients with chronic conditions treated in the ambulatory care setting is less clear...

..To provide updated, evidence-based recommendations for the diagnosis and assessment of high blood pressure in adults...

..To determine the adequacy of hypertension management in institutionalized elderly patients...

..There is a need for a randomized trial comparing different doses of beta-blockers in heart failure...

..Further research into the mechanisms of anemia in CHF and randomized controlled trials to test whether correction of anemia improves prognosis in CHF are needed...

..Only recommendations achieving at least 70% consensus are reported here. These guidelines will continue to be updated annually...

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..We sought to determine the research priorities for perioperative medicine using a cross sectional survey of Canadian and American general internists...

..An economic analysis of the trial now demonstrates that the intervention tested "dominates" usual care: over a lifetime horizon, it reduces fracture, increases quality-adjusted life years, and saves the healthcare system money...

..All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually...

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..This study was designed to examine whether discharge use of beta-blockers was associated with outcomes after hospitalization in patients who had undergone nontransplant cardiac surgery...

..Although guidelines now recommend polytherapy to achieve blood pressure targets, little is know about which antihypertensive drugs are combined in clinical practice...

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

..Thus, the development and validation of a risk stratification scheme to identify those patients most likely to benefit from ICDs for primary prophylaxis should be a research priority...

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..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...

..We were interested in evaluating how general internists assess, define, communicate, and attempt to modify perioperative cardiac risk...

..Data on mortality are inconclusive. Further studies are needed to establish the incremental benefits of the different elements of these programs...

..To review the factors contributing to treatment resistance in hypertensive patients and assess the evidence from therapeutic trials in these patients...

..Methods to improve timely and appropriate access to specialists and to improve collaborative care structures are needed...

..Thus, although the complication rate was higher, the benefits of spironolactone seen in RALES extended to participants not in a trial who were treated with similar doses and followed closely in a clinic specializing in heart failure...

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

..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)...

..Finally, correction of resting arterial hypoxemia with oxygen therapy for more than 15 h/d prolongs survival of COPD patients for those with a resting PaO2 lower than 55 to 60 mm Hg...

..The Canadian Hypertension Education Program educational model for improving health care could be adopted by other countries with well-developed professional and scientific societies...

..002). CONCLUSIONS: Prompt fibrinolytic treatment improved the likelihood of aborted MI. The subgroup with complete 60-min ST-segment resolution had the best clinical outcomes...

..Whether this relationship exists for patients at high risk of developing diabetes should be examined in a randomized trial...

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..To quantify the cost-savings that could be realized by switching patients from two separate agents, ACE inhibitor/ARB and thiazide diuretic, to a fixed dose combination product...

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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...

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..More data are needed before statins can be recommended in those with isolated heart failure...

..Our objective was to determine whether this counterintuitive relationship extends to health-related quality of life (HRQOL) outcomes...

..We hypothesized that the inclusion of HRQL in routine clinical care would improve patient-clinician communication, affect clinical management, and improve patients' HRQL...

..The drivers of these disparities are not clear. Greater understanding is needed for clinicians, researchers and policy makers to determine the most effective and sustainable strategies...

..The purpose of this study was to examine the long-term incidence of heart failure (HF) in elderly patients with myocardial infarction (MI)...

..Only those recommendations achieving high levels of consensus are reported here. These guidelines will continue to be updated annually...

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..In our cohort of elderly patients with multiple comorbidities, beta-blockers were well tolerated...

..To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with high blood pressure...

..All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually...

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

..The aim of this study was to determine the effect of exercise training and type of exercise (aerobic vs. strength vs. combined training) on left ventricular (LV) remodeling in heart failure (HF)...

..The methodological criteria outlined in this article for judging the validity of active-control equivalence trials are not specific to antihypertensive trials and may be applied to trials that test a wide variety of interventions...

..Prescribed treatment did not differ across socioeconomic gradients...

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..Although diabetes mellitus is associated with increased risks of death and cardiovascular events in Framingham subjects, much of this excess risk is attributable to coexistent hypertension...

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..In 1999, the Canadian Hypertension Education Program (CHEP) was launched to develop and implement evidence-based hypertension guidelines...

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..0001). Our data provide evidence that the physician management of hypertension in elderly Canadians became more aggressive between 1994 and 2002...

..Socioeconomic status did not influence use of thiazides, but age, sex, and comorbidities did...

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