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1.
Cardiac risk factors: new cholesterol and blood pressure management guidelines.
Anthony, D, George, P, Eaton, CB
FP essentials. 2014;:28-43
Abstract
The 2013 American College of Cardiology/American Heart Association cholesterol guidelines depart from low-density lipoprotein (LDL) treatment targets and recommend treating four specific patient groups with statins. Statins are the only cholesterol-lowering drugs with randomized trial evidence of benefit for preventing atherosclerotic cardiovascular disease (ASCVD). The groups are patients with clinical ASCVD; patients ages 40 to 75 years with diabetes and LDL of 70 to 189 mg/dL but no clinical ASCVD; patients 21 years or older with LDL levels of 190 mg/dL or higher; and patients ages 40 to 75 years with LDL of 70 to 189 mg/dL without clinical ASCVD or diabetes but with 10-year ASCVD risk of 7.5% or higher. Ten-year ASCVD risk may be calculated using the Pooled Cohort Equations. The Eighth Joint National Committee (JNC 8) guidelines for blood pressure management recommend a blood pressure goal of less than 140/90 mm Hg for all adults except those 60 years or older. For the latter group, the JNC 8 recommends a systolic blood pressure goal of less than 150 mm Hg. In another notable change from prior guidelines, the JNC 8 recommends relaxing the systolic blood pressure goal for patients with diabetes and chronic kidney disease to less than 140 mm Hg from less than 130 mm Hg.
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2.
[Effective methods of losing weight in obesity. World experience].
Iuriatin, AA
Meditsina truda i promyshlennaia ekologiia. 2013;(5):46-9
Abstract
The prevalence of obesity among adults in Russia is 18,4-29,8%. It is a significant risk factor for a number of serious diseases. An appropriate diet and aerobic physical activity are effective in overweight management. In studies, Glucerna helped decrease the body weight and waist circumference in obesity and diabetes mellitus.
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3.
Presentation and conservative management of acute calcific tendinopathy: a case study and literature review.
Scibek, JS, Carcia, CR
Journal of sport rehabilitation. 2012;(4):334-42
Abstract
BACKGROUND The efficacy of a variety of noninvasive, conservative management techniques for calcific tendinopathy has been investigated and established for improving pain and function and/or facilitating a decrease in the size or presence of calcium deposits. Surprisingly, few have reported on the use of traditional therapeutic exercise and rehabilitation alone in the management of this condition, given the often spontaneous resorptive nature of calcium deposits. The purpose of this case is to present the results of a conservative approach, including therapeutic exercise, for the management of calcific tendinopathy of the supraspinatus, with an emphasis on patient outcomes. CASE DESCRIPTION The patient was a self-referred 41-y-old man with complaints of acute right-shoulder pain and difficulty sleeping. Imaging studies revealed liquefied calcium deposits in the right supraspinatus. The patient reported constant pain at rest (9/10) and tenderness in the area of the greater tuberosity. He exhibited a decrease in all shoulder motions and had reduced strength. The simple shoulder test (SST) revealed limited function (0/12). Conservative management included superficial modalities and medication for pain and a regimen of scapulothoracic and glenohumeral range-of-motion (ROM) and strengthening exercises. OUTCOMES At discharge, pain levels decreased to 0/10 and SST scores increased to 12/12. ROM was full in all planes, and resisted motion was strong and pain free. The patient was able to engage in endurance activities and continue practicing as a health care provider. DISCUSSION The outcomes with respect to pain, function, and patient satisfaction provide evidence to support the use of conservative therapeutic interventions when managing patients with acute cases of calcific tendinopathy. Successful management of calcific tendinopathy requires attention to outcomes and an understanding of the pathophysiology, prognostic factors, and physical interventions based on the current stage of the calcium deposits and the patient's status in the healing continuum.
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4.
Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: three case reports.
Yeates, EM, Molfenter, SM, Steele, CM
Clinical interventions in aging. 2008;(4):735-47
Abstract
Dysphagia, or difficulty swallowing, often occurs secondary to conditions such as stroke, head injury or progressive disease, many of which increase in frequency with advancing age. Sarcopenia, the gradual loss of muscle bulk and strength, can place older individuals at greater risk for dysphagia. Data are reported for three older participants in a pilot trial of a tongue-pressure training therapy. During the experimental therapy protocol, participants performed isometric strength exercises for the tongue as well as tongue pressure accuracy tasks. Biofeedback was provided using the Iowa Oral Performance Instrument (IOPI), an instrument that measures tongue pressure. Treatment outcome measures show increased isometric tongue strength, improved tongue pressure generation accuracy, improved bolus control on videofluoroscopy, and improved functional dietary intake by mouth. These preliminary results indicate that, for these three adults with dysphagia, tongue-pressure training was beneficial for improving both instrumental and functional aspects of swallowing. The experimental treatment protocol holds promise as a rehabilitative tool for various dysphagia populations.
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5.
Walking talking therapy.
Beauchemin, J, Manns, J
Mental health today (Brighton, England). 2008;:34-5
Abstract
Given the links between mental health, obesity and exercise, could physical activity be incorporated into therapy sessions with young people?
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6.
Exercise and people with serious, persistent mental illness.
McDevitt, J, Wilbur, J
The American journal of nursing. 2006;(4):50-4
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7.
Pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction and postmicturition dribble: three case studies.
Dorey, G, Feneley, RC, Speakman, MJ, Robinson, JP, Paterson, J
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society. 2003;(1):44-51; discussion 51-2
Abstract
Three successful case studies of men receiving treatment for erectile dysfunction and postmicturition dribble are presented to alert nurses to the possible benefits of pelvic floor muscle exercises.
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8.
A team approach to the treatment of AIDS wasting.
Abbaticola, MM
The Journal of the Association of Nurses in AIDS Care : JANAC. 2000;(1):45-56
Abstract
Despite the aggressive use of antiretroviral agents, AIDS wasting (AW) affects many persons infected with HIV. AW is characterized by a disproportionate loss of metabolically active tissue, specifically body cell mass--tissue involved with glucose oxidation, protein synthesis, and immune system function. AW correlates with poor quality of life and clinical outcomes. This condition requires a multidisciplinary team approach for effective management. Optimal maintenance of lean body mass and reversal of AW involves a combination of appropriate antiretroviral use, opportunistic infection prophylaxis, optimal nutrition, exercise, body composition monitoring, anabolic agents including growth hormone (rhGH[m]) and testosterone supplementation, mental health support, economic aid, and legal assistance. The team approach to treatment of AW requires the coordinated activity of nurses, dietitians, physicians, pharmacists, social workers, case managers, reimbursement personnel, caregiver(s), physical therapists, and the patient. This article, based on clinical experience treating AW, explains how the condition is managed using a multidisciplinary team approach.