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N. N. Ladhani S. R. Majumdar J. A. Johnson R. T. Tsuyuki R. Z. Lewanczuk R. Spooner S. H. Simpson 《Diabetic medicine》2012,29(11):1433-1439
Aim To determine the impact of adding pharmacists to primary care teams on predicted 10‐year risk of cardiovascular events in patients with Type 2 diabetes without established cardiovascular disease. Methods This was a pre‐specified secondary analysis of randomized trial data. The main study found that, compared with usual care, addition of a pharmacist resulted in improvements in blood pressure, dyslipidaemia, and hyperglycaemia for primary care patients with Type 2 diabetes. In this sub‐study, predicted 10‐year risk of cardiovascular events at baseline and 1 year were calculated for patients free of cardiovascular disease at enrolment. The primary outcome was change in UK Prospective Diabetes Study (UKPDS) risk score; change in Framingham risk score was a secondary outcome. Results Baseline characteristics were similar between the 102 intervention patients and 93 control subjects: 59% women, median (interquartile range) age 57 (50–64) years, diabetes duration 3 (1–6.5) years, systolic blood pressure 128 (120–140) mmHg, total cholesterol 4.34 (3.75–5.04) mmol/l and HbA1c 54 mmol/mol (48–64 mmol/mol) [7.1% (6.5–8.0%)]. Median baseline UKPDS risk score was 10.2% (6.0–16.7%) for intervention patients and 9.5% (5.8–15.1%) for control subjects (P = 0.80). One‐year post‐randomization, the median absolute reduction in UKPDS risk score was 1.0% greater for intervention patients compared with control subjects (P = 0.032). Similar changes were seen with the Framingham risk score (median reduction 1.2% greater for intervention patients compared with control subjects, P = 0.048). The two risk scores were highly correlated (rho = 0.83; P < 0.001). Conclusion Adding pharmacists to primary care teams for 1 year significantly reduced the predicted 10‐year risk of cardiovascular events for patients with Type 2 diabetes without established cardiovascular disease. 相似文献
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Ladhani S Dosekun E Patel V Shingadia D 《The Pediatric infectious disease journal》2002,21(11):1090-1092
Hypermalarial splenomegaly syndrome (HMS) usually occurs in adults living in malaria-endemic areas. A 7-year-old girl presented with a 7-week history of gradual distention of the abdomen and low grade fever, 8 months after traveling to Ghana, and was subsequently diagnosed with HMS. Presentation at such a young age after very brief exposure to a malaria-endemic area has not been described previously. 相似文献
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