Follow-up of Positive Results on #Fecal #Blood Tests: A Systematic Review
http://annals.org/aim/article/2657163/interventions-improve-follow-up-positive-results-fecal-blood-tests-systematic
Fecal immunochemical testing is the most commonly used method for colorectal cancer screening worldwide. However, its effectiveness is frequently undermined by failure to obtain follow-up colonoscopy after positive test results
Eleven studies described patient-level interventions (changes to invitation, provision of results or follow-up appointments, and patient navigators), 5 provider-level interventions (reminders or performance data), and 7 system-level interventions (automated referral, precolonoscopy telephone calls, patient registries, and quality improvement efforts). Moderate evidence supported patient navigators and provider reminders or performance data. Evidence for system-level interventions was low. Seventeen studies reported the proportion of test-positive patients who completed colonoscopy compared with a control population, with absolute differences of −7.4 percentage points (95% CI, −19 to 4.3 percentage points) to 25 percentage points (CI, 14 to 35 percentage points)
Conclusion:
Patient navigators and giving providers reminders or performance data may help improve colonoscopy rates of asymptomatic adults with positive fecal blood test results. Current evidence about useful system-level interventions is scant and insufficient
http://annals.org/aim/article/2657163/interventions-improve-follow-up-positive-results-fecal-blood-tests-systematic
Fecal immunochemical testing is the most commonly used method for colorectal cancer screening worldwide. However, its effectiveness is frequently undermined by failure to obtain follow-up colonoscopy after positive test results
Eleven studies described patient-level interventions (changes to invitation, provision of results or follow-up appointments, and patient navigators), 5 provider-level interventions (reminders or performance data), and 7 system-level interventions (automated referral, precolonoscopy telephone calls, patient registries, and quality improvement efforts). Moderate evidence supported patient navigators and provider reminders or performance data. Evidence for system-level interventions was low. Seventeen studies reported the proportion of test-positive patients who completed colonoscopy compared with a control population, with absolute differences of −7.4 percentage points (95% CI, −19 to 4.3 percentage points) to 25 percentage points (CI, 14 to 35 percentage points)
Conclusion:
Patient navigators and giving providers reminders or performance data may help improve colonoscopy rates of asymptomatic adults with positive fecal blood test results. Current evidence about useful system-level interventions is scant and insufficient
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Society for the Advancement of #Blood Management
Five Things Physicians and Patients Should Question
http://www.choosingwisely.org/societies/society-for-the-advancement-of-blood-management/
Don’t proceed with elective surgery in patients with properly diagnosed and correctable anemia until the anemia has been appropriately treated
Don’t perform laboratory blood testing unless clinically indicated or necessary for diagnosis or management in order to avoid iatrogenic anemia
Don’t transfuse plasma in the absence of active bleeding or significant laboratory evidence of coagulopathy
Avoid transfusion when antifibrinolytic drugs are available to minimize surgical bleeding.
Avoid transfusion, outside of emergencies, when alternative strategies are available as part of informed consent; make discussion of alternatives part of the informed consent process
Society for the Advancement of #Blood Management
Five Things Physicians and Patients Should Question
http://www.choosingwisely.org/societies/society-for-the-advancement-of-blood-management/
Don’t proceed with elective surgery in patients with properly diagnosed and correctable anemia until the anemia has been appropriately treated
Don’t perform laboratory blood testing unless clinically indicated or necessary for diagnosis or management in order to avoid iatrogenic anemia
Don’t transfuse plasma in the absence of active bleeding or significant laboratory evidence of coagulopathy
Avoid transfusion when antifibrinolytic drugs are available to minimize surgical bleeding.
Avoid transfusion, outside of emergencies, when alternative strategies are available as part of informed consent; make discussion of alternatives part of the informed consent process
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#Tranexamic Acid for the Prevention of #Blood Loss after Vaginal Delivery
https://www.nejm.org/doi/full/10.1056/NEJMoa1800942
Of the 4079 women who underwent randomization, 3891 had a vaginal delivery. The primary outcome occurred in 156 of 1921 women (8.1%) in the tranexamic acid group and in 188 of 1918 (9.8%) in the placebo group (relative risk, 0.83; 95% confidence interval CI, 0.68 to 1.01; P=0.07). Women in the tranexamic acid group had a lower rate of provider-assessed clinically significant postpartum hemorrhage than those in the placebo group (7.8% vs. 10.4%; relative risk, 0.74; 95% CI, 0.61 to 0.91; P=0.004; P=0.04 after adjustment for multiple comparisons post hoc) and also received additional uterotonic agents less often (7.2% vs. 9.7%; relative risk, 0.75; 95% CI, 0.61 to 0.92; P=0.006; adjusted P=0.04). Other secondary outcomes did not differ significantly between the two groups. The incidence of thromboembolic events in the 3 months after delivery did not differ significantly between the tranexamic acid group and the placebo group (0.1% and 0.2%, respectively; relative risk, 0.25; 95% CI, 0.03 to 2.24).
CONCLUSIONS
Among women with vaginal delivery who received prophylactic oxytocin, the use of tranexamic acid did not result in a rate of postpartum hemorrhage of at least 500 ml that was significantly lower than the rate with placebo
#Tranexamic Acid for the Prevention of #Blood Loss after Vaginal Delivery
https://www.nejm.org/doi/full/10.1056/NEJMoa1800942
Of the 4079 women who underwent randomization, 3891 had a vaginal delivery. The primary outcome occurred in 156 of 1921 women (8.1%) in the tranexamic acid group and in 188 of 1918 (9.8%) in the placebo group (relative risk, 0.83; 95% confidence interval CI, 0.68 to 1.01; P=0.07). Women in the tranexamic acid group had a lower rate of provider-assessed clinically significant postpartum hemorrhage than those in the placebo group (7.8% vs. 10.4%; relative risk, 0.74; 95% CI, 0.61 to 0.91; P=0.004; P=0.04 after adjustment for multiple comparisons post hoc) and also received additional uterotonic agents less often (7.2% vs. 9.7%; relative risk, 0.75; 95% CI, 0.61 to 0.92; P=0.006; adjusted P=0.04). Other secondary outcomes did not differ significantly between the two groups. The incidence of thromboembolic events in the 3 months after delivery did not differ significantly between the tranexamic acid group and the placebo group (0.1% and 0.2%, respectively; relative risk, 0.25; 95% CI, 0.03 to 2.24).
CONCLUSIONS
Among women with vaginal delivery who received prophylactic oxytocin, the use of tranexamic acid did not result in a rate of postpartum hemorrhage of at least 500 ml that was significantly lower than the rate with placebo
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Sex differences in faecal occult #blood test screening for #colorectal cancer
https://onlinelibrary.wiley.com/doi/10.1002/bjs.11011
CRC was less common in women than in men (0·34 versus 0·50 per cent; risk ratio (RR) 0·82, 95 per cent c.i. 0·74 to 0·91) and women were less often asymptomatic (16·7 versus 22·0 per cent; RR 0·76, 0·61 to 0·93). Women more often had right‐sided tumours (32·0 versus 21·3 per cent; RR 1·51, 1·26 to 1·80). Among men with left‐sided tumours, those in the screening arm had lower N (RR 1·23, 1·02 to 1·48) and M (RR 1·57, 1·14 to 2·17) categories, as well as a higher overall survival rate than those in the control arm. Furthermore among men with left‐sided tumours, non‐radical resections (26·2 versus 15·7 per cent; RR 1·67, 1·22 to 2·30) and postoperative chemotherapy sessions (61·6 versus 48·2 per cent; RR 1·28, 1·10 to 1·48) were more frequent in the control arm. Similar benefits of screening were not detected in men with right‐sided tumours or in women.
Conclusion
Biennial FOBT screening seems to be effective in terms of improving several different outcomes in men, but not in women. Differences in incidence, symptoms and tumour location may explain the differences in screening efficacy between sexes.
Sex differences in faecal occult #blood test screening for #colorectal cancer
https://onlinelibrary.wiley.com/doi/10.1002/bjs.11011
CRC was less common in women than in men (0·34 versus 0·50 per cent; risk ratio (RR) 0·82, 95 per cent c.i. 0·74 to 0·91) and women were less often asymptomatic (16·7 versus 22·0 per cent; RR 0·76, 0·61 to 0·93). Women more often had right‐sided tumours (32·0 versus 21·3 per cent; RR 1·51, 1·26 to 1·80). Among men with left‐sided tumours, those in the screening arm had lower N (RR 1·23, 1·02 to 1·48) and M (RR 1·57, 1·14 to 2·17) categories, as well as a higher overall survival rate than those in the control arm. Furthermore among men with left‐sided tumours, non‐radical resections (26·2 versus 15·7 per cent; RR 1·67, 1·22 to 2·30) and postoperative chemotherapy sessions (61·6 versus 48·2 per cent; RR 1·28, 1·10 to 1·48) were more frequent in the control arm. Similar benefits of screening were not detected in men with right‐sided tumours or in women.
Conclusion
Biennial FOBT screening seems to be effective in terms of improving several different outcomes in men, but not in women. Differences in incidence, symptoms and tumour location may explain the differences in screening efficacy between sexes.
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#Blood–brain barrier breakdown is an early biomarker of human #cognitive dysfunction
https://www.nature.com/articles/s41591-018-0297-y
Abstract
Vascular contributions to cognitive impairment are increasingly recognized as shown by neuropathological neuroimaging and cerebrospinal fluid biomarker studies. Moreover, small vessel disease of the brain has been estimated to contribute to approximately 50% of all dementias worldwide, including those caused by Alzheimer’s disease (AD)..
Our data show that individuals with early cognitive dysfunction develop brain capillary damage and BBB breakdown in the hippocampus irrespective of Alzheimer’s Aβ and/or tau biomarker changes, suggesting that BBB breakdown is an early biomarker of human cognitive dysfunction independent of Aβ and tau.
#Blood–brain barrier breakdown is an early biomarker of human #cognitive dysfunction
https://www.nature.com/articles/s41591-018-0297-y
Abstract
Vascular contributions to cognitive impairment are increasingly recognized as shown by neuropathological neuroimaging and cerebrospinal fluid biomarker studies. Moreover, small vessel disease of the brain has been estimated to contribute to approximately 50% of all dementias worldwide, including those caused by Alzheimer’s disease (AD)..
Our data show that individuals with early cognitive dysfunction develop brain capillary damage and BBB breakdown in the hippocampus irrespective of Alzheimer’s Aβ and/or tau biomarker changes, suggesting that BBB breakdown is an early biomarker of human cognitive dysfunction independent of Aβ and tau.
Nature
Blood–brain barrier breakdown is an early biomarker of human cognitive dysfunction
Nature Medicine - Neuroimaging and cerebrospinal fluid analyses in humans reveal that loss of blood–brain barrier integrity and brain capillary pericyte damage are early biomarkers of...
Red #blood cell dysfunction: a new player in #cardiovascular disease
https://2medical.news/2020/03/04/red-blood-cell-dysfunction-a-new-player-in-cardiovascular-disease/
The primary role of red blood cells (RBCs) is to transport oxygen to the tissues and carbon dioxide to the lungs. However, emerging evidence suggests an important role of the RBC beyond being just a passive carrier of the respiratory gases. The RBCs are of importance for redox balance and are actively involved in the regulation of vascular tone, especially during hypoxic and ischaemic conditions …
https://2medical.news/2020/03/04/red-blood-cell-dysfunction-a-new-player-in-cardiovascular-disease/
The primary role of red blood cells (RBCs) is to transport oxygen to the tissues and carbon dioxide to the lungs. However, emerging evidence suggests an important role of the RBC beyond being just a passive carrier of the respiratory gases. The RBCs are of importance for redox balance and are actively involved in the regulation of vascular tone, especially during hypoxic and ischaemic conditions …
Relationship between the ABO #Blood Group and the #COVID-19 Susceptibility
https://2medical.news/2020/03/21/relationship-between-the-abo-blood-group-and-the-covid-19-susceptibility/
Detection of ABO blood groups, infection occurrence of SARS-CoV-2, and patient death RESULTS The ABO group in 3694 normal people in Wuhan showed a distribution of 32.16%, 24.90%, 9.10% and 33.84% for A, B, AB and O, respectively, versus the distribution of 37.75%, 26.42%, 10.03% and 25.80% for A, B, AB and O, respectively, in 1775 COVID-19 patients from Wuhan Jinyintan Hospital. The proportion of …
https://2medical.news/2020/03/21/relationship-between-the-abo-blood-group-and-the-covid-19-susceptibility/
Detection of ABO blood groups, infection occurrence of SARS-CoV-2, and patient death RESULTS The ABO group in 3694 normal people in Wuhan showed a distribution of 32.16%, 24.90%, 9.10% and 33.84% for A, B, AB and O, respectively, versus the distribution of 37.75%, 26.42%, 10.03% and 25.80% for A, B, AB and O, respectively, in 1775 COVID-19 patients from Wuhan Jinyintan Hospital. The proportion of …
Effect of convalescent #blood products for patients with severe acute #respiratory infections of #viral etiology: a systematic review and meta-analysis
https://2medical.news/2020/10/03/effect-of-convalescent-blood-products-for-patients-with-severe-acute-respiratory-infections-of-viral-etiology-a-systematic-review-and-meta-analysis/
To determine whether convalescent blood products (CBPs) could offer a survival advantage for patients with severe acute respiratory infections (SARI) of viral etiology.. ..According to observational studies, the cases received CPBs showed a decline of all-cause mortality compared with cases without using (OR 0.36, 95% CI 0.23 to 0.56, P < 0.00001). The all-cause mortality in the randomized controlled trials (RCTs) showed no difference between the interventional …
https://2medical.news/2020/10/03/effect-of-convalescent-blood-products-for-patients-with-severe-acute-respiratory-infections-of-viral-etiology-a-systematic-review-and-meta-analysis/
To determine whether convalescent blood products (CBPs) could offer a survival advantage for patients with severe acute respiratory infections (SARI) of viral etiology.. ..According to observational studies, the cases received CPBs showed a decline of all-cause mortality compared with cases without using (OR 0.36, 95% CI 0.23 to 0.56, P < 0.00001). The all-cause mortality in the randomized controlled trials (RCTs) showed no difference between the interventional …
#Blood type #diets lack supporting evidence: a systematic review
https://2medical.news/2020/12/15/blood-type-diets-lack-supporting-evidence-a-systematic-review/
Background: Diets that are based on the ABO blood group system have been promoted over the past decade and claim to improve health and decrease risk of disease. To our knowledge, the evidence to support the effectiveness of blood type diets has not previously been assessed in the scientific literature. Objective: In this current systematic review, published studies that presented data related to blood type …
https://2medical.news/2020/12/15/blood-type-diets-lack-supporting-evidence-a-systematic-review/
Background: Diets that are based on the ABO blood group system have been promoted over the past decade and claim to improve health and decrease risk of disease. To our knowledge, the evidence to support the effectiveness of blood type diets has not previously been assessed in the scientific literature. Objective: In this current systematic review, published studies that presented data related to blood type …
The #SARS-CoV-2 receptor-binding domain preferentially recognizes #blood group A
https://2medical.news/2021/03/04/the-sars-cov-2-receptor-binding-domain-preferentially-recognizes-blood-group-a/
Key Points The RBD of SARS-CoV-2 shares sequence similarity with an ancient lectin family known to bind blood group antigens. SARS-CoV-2 RBD binds the blood group A expressed on respiratory epithelial cells, directly linking blood group A and SARS-CoV-2. https://bit.ly/3sRfU1l
https://2medical.news/2021/03/04/the-sars-cov-2-receptor-binding-domain-preferentially-recognizes-blood-group-a/
Key Points The RBD of SARS-CoV-2 shares sequence similarity with an ancient lectin family known to bind blood group antigens. SARS-CoV-2 RBD binds the blood group A expressed on respiratory epithelial cells, directly linking blood group A and SARS-CoV-2. https://bit.ly/3sRfU1l
Spatial organization of #protein aggregates on red #blood cells as physical biomarkers of #Alzheimer’s disease pathology
https://2medical.news/2021/09/28/spatial-organization-of-protein-aggregates-on-red-blood-cells-as-physical-biomarkers-of-alzheimers-disease-pathology/
https://2medical.news/2021/09/28/spatial-organization-of-protein-aggregates-on-red-blood-cells-as-physical-biomarkers-of-alzheimers-disease-pathology/
2Medical.News
Spatial organization of #protein aggregates on red #blood cells as physical biomarkers of #Alzheimer’s disease pathology
Quantifying physical differences of protein aggregates implicated in Alzheimer’s disease (AD), in blood, could provide crucial information on disease stages. Here, red blood cells (RBCs) from 50 pa…
Association between #tomato consumption and #blood pressure in an older population at high cardiovascular risk: observational analysis of PREDIMED trial
https://2medical.news/2024/01/17/association-between-tomato-consumption-and-blood-pressure-in-an-older-population-at-high-cardiovascular-risk-observational-analysis-of-predimed-trial/
https://2medical.news/2024/01/17/association-between-tomato-consumption-and-blood-pressure-in-an-older-population-at-high-cardiovascular-risk-observational-analysis-of-predimed-trial/
2Medical.News
Association between #tomato consumption and #blood pressure in an older population at high cardiovascular risk: observational analysis…
Clinical studies have produced conflicting evidence on the effects of the consumption of tomatoes on blood pressure, and there are limited data from epidemiologic studies. This study assesses wheth…