The Role of Calcium in the Prevention of Cardiovascular Disease—A Review of Observational Studies and Randomized Clinical Trials

2013 ◽  
Vol 15 (11) ◽  
Author(s):  
Susanne Rautiainen ◽  
Lu Wang ◽  
JoAnn E. Manson ◽  
Howard D. Sesso
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Trials ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Prevention Of Cardiovascular Disease

scholarly journals Evidence-based approaches to comparing the effectiveness of modern cardiology interventions: trends, bias and prospects

2020 ◽  
Vol 25 (8) ◽  
pp. 4037
Author(s):  
S. R. Gilyarevsky ◽  
Yu. N. Belenkov
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Drug Use ◽  
Propensity Score ◽  
Observational Studies ◽  
Large Scale ◽  
Randomized Clinical Trials ◽  
Evidence Based ◽  
Improved Methods

The article discusses the limitations of the evidence from observational studies. Modern approaches to reducing bias in observational studies are discussed in detail, in particular, propensity score matching, which has become popular in recent years. The main differences between randomized and observational studies are discussed. Arguments against the observational studies and improved methods of analysis to compare the treatments’ effectiveness in clinical practice are presented. The role of observational studies as a source of evidence is discussed. The article points out the validity of performing large-scale prospective observational studies to assess the effects of postmarketing drug use in clinical practice, as well as to obtain data on drug use in patients that differ from those in randomized clinical trials.

scholarly journals Improving Erythropoiesis Stimulating Agent Hyporesponsiveness in Hemodialysis Patients: The Role of Hepcidin and Hemodiafiltration Online

2018 ◽  
Vol 45 (1-3) ◽  
pp. 139-146 ◽  
Author(s):  
Alberto Rosati ◽  
Fiammetta Ravaglia ◽  
Vincenzo Panichi
Keyword(s):  
Clinical Trials ◽  
End Stage Renal Disease ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Hemodialysis Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
Kinetics Of ◽  
Erythropoietin Stimulating Agents

Hyporesponsiveness to erythropoietin stimulating agents (ESAs) is a condition associated with increased mortality. Even after identifying the condition, the causes are difficult to treat and only partially reversible in end-stage renal disease patients. Thus, the role of more recent hemodialysis (HD) techniques in improving such conditions is an emerging issue. However, major randomized clinical trials have not confirmed the results of smaller observational studies in which online hemodiafiltration has shown some efficacy in improving patients’ response to ESAs. In our interpretation, these findings are not in contrast, but they can be explained by a better understanding of the interactions between HD and ESAs on iron mobilization, first of all through the role of hepcidin. The kinetics of hepcidin removal through HD combined with the action of selected ESAs may help the clinician in prescribing the best association between HD treatment and ESAs to overcome hyporesponsiveness.

scholarly journals Selenium and Type 2 Diabetes: Systematic Review

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1924 ◽  
Author(s):  
Lindsay Kohler ◽  
Janet Foote ◽  
Connor Kelley ◽  
Ana Florea ◽  
Colleen Shelly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Positive Association ◽  
Significant Positive Association

Several studies have investigated the potential role of selenium (Se) in the development of type 2 diabetes (T2D) with disparate findings. We conducted a systematic review and meta-analysis to synthesize the evidence of any association between Se and T2D. PubMed, Embase, and Scopus were searched following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Approach (PRISMA). Sixteen studies from 15 papers met inclusion criteria defined for this review. Of the 13 observational studies included, 8 demonstrated a statistically significant positive association between concentrations of Se and odds for T2D, with odds ratios (95% confidence intervals) ranging from 1.52 (1.01–2.28) to 7.64 (3.34–17.46), and a summary odds ratio (OR) (95% confidence interval (CI)) of 2.03 (1.51–2.72). In contrast, among randomized clinical trials (RCTs) of Se, a higher risk of T2D was not observed for those who received Se compared to a placebo (OR = 1.18, 95% CI 0.95–1.47). Taken together, the results for the relationship between Se and T2D differ between observational studies and randomized clinical trials (RCTs). It remains unclear whether these differences are the result of uncontrolled confounding in the observational studies, or whether there is a modest effect of Se on the risk for T2D that may vary by duration of exposure. Further investigations on the effects of Se on glucose metabolism are needed.

Physical activity promotion in primary health care in Slovenia

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Health Promotion ◽  
Health Professionals ◽  
Healthy Lifestyle ◽  
Graduate Nurses ◽  
Primary Health ◽  
The Family ◽  
Prevention Of Cardiovascular Disease

In Slovenia, the role of general practitioners in counselling physical activity for prevention of cardiovascular disease (CVD) is well recognized. The role of general practitioners in advising healthy lifestyle for individuals who are at risk of developing CVD is formally defined in the National Program for Primary Prevention of Cardiovascular Disease, which has been running since 2001. Part of the program is counselling on healthy lifestyle including physical activity, performed in all health centres across the country. First a screening and medical examination is performed. In case of higher risk for CVD (>20%) the physician should give advice on the particular risk factor and direct patients to health-education centres, where they can participate in healthy lifestyle workshops lead by health professionals. Physicians and other health professionals who are involved in the implementation of prevention activities within the program need knowledge and skills that are crucial for successful counselling on healthy lifestyle. The educational program “basic education in health promotion and prevention of chronic non-communicable diseases in primary health care/family medicine” consists of two parts. The first part of the training is open to all health professionals working within the program. The second part is intended for health professionals working in health-education workshops. In the last few years a new family practice model has been introduced and disseminated. Some duties of the family physician, including health promotion and counselling, are being transferred to graduate nurses who become part of the family practice team. This new division of work undoubtedly brings many advantages, both in terms of the work organization, and of high-quality patient care. Nevertheless preventive action cannot be fully passed on to graduate nurses. Careful planning and education are needed to ensure a comprehensive approach in healthy life style counselling.

scholarly journals COVID-19: Role of Nutrition and Supplementation

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 976
Author(s):  
Fiorenzo Moscatelli ◽  
Francesco Sessa ◽  
Anna Valenzano ◽  
Rita Polito ◽  
Vincenzo Monda ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Viral Infections ◽  
Overweight And Obesity ◽  
Shortness Of Breath ◽  
Nutritional Interventions ◽  
The World ◽  
Diet Regimen ◽  
Specific Diet

At the end of 2019, a new coronavirus (COVID-19) appeared on the world scene, which mainly affects the respiratory system, causing pneumonia and multi-organ failure, and, although it starts with common symptoms such as shortness of breath and fever, in about 2–3% of cases it leads to death. Unfortunately, to date, no specific treatments have been found for the cure of this virus and, therefore, it is advisable to implement all possible strategies in order to prevent infection. In this context, it is important to better define the role of all behaviors, in particular nutrition, in order to establish whether these can both prevent infection and improve the outcome of the disease in patients with COVID-19. In the literature, it is widely shown that states of malnutrition, overweight, and obesity negatively affect the immune system, leading to viral infections, and several studies have shown that nutritional interventions can act as immunostimulators, helping to prevent viral infections. Even if several measures, such as the assumption of a specific diet regimen, the use of dietary supplements, and other similar interventions, are promising for the prevention, management, and recovery of COVID-19 patients, it is important to highlight that strong data from randomized clinical trials are needed to support any such assumption. Considering this particular scenario, we present a literature review addressing several important aspects related to diet and SARS-CoV-2 infection, in order to highlight the importance of diet and supplementation in prevention and management of, as well as recovery from COVID-19.

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