Effect of randomised blood pressure lowering treatment and intensive glucose control on dementia and cognitive decline according to baseline cognitive function and other subpopulations of individuals with type 2 diabetes: Results from the ADVANCE trial.

Background And Aims: Accumulating evidence indicates that reducing high blood pressure (BP) prevents dementia and mild cognitive impairment (MCI). Furthermore, although diabetes is a risk factor for dementia and MCI, there is uncertainty of the effect of intensive glucose control on these endpoints. This study aimed to determine the effects of BP-lowering (vs placebo) and intensive glucose-lowering (vs standard control) treatments according to baseline cognition and other characteristics on dementia and cognitive decline (CD) in people with type 2 diabetes mellitus (T2DM).

CRKL Gene Deletion in Familial Zinner (OSVIRA) and OHVIRA Syndromes.

We present the first description of a family in which 2 siblings show alternative expression of CRKL gene deletion as the phenotypes of Zinner (OSVIRA, obstructed seminal vesicle and ipsilateral renal agenesis) and OHVIRA (obstructed hemivagina with an ipsilateral renal anomaly) syndromes. The male infant with Zinner syndrome and his sister aged 5 years with OHVIRA syndrome both have a paternally inherited 703-kb deletion at chromosome 22q11.21 that includes CRKL.

Risk treatment thresholds for initiating cardiovascular disease pharmacotherapy: Synthesis of international evidence to support guideline recommendations.

Background: A new Australian guideline for cardiovascular disease (CVD) risk assessment and management was published in 2023, including new risk treatment thresholds.

Objective: This article summarises the published peer-reviewed global evidence that informed guideline recommendations on risk treatment thresholds for initiating blood pressure- and lipid-lowering therapy for CVD primary prevention.

Discussion: Evidence from 13 meta-analyses, randomised controlled trials and modelling studies involving more than 515,700 patients showed that preventive pharmacotherapy reduced the number of CVD events at all risk levels.

Intensive Glucose Lowering and Its Effects on Vascular Events and Death According to Age at Diagnosis and Duration of Diabetes: The ADVANCE Trial.

Objective: To compare the vascular effects of pursuing more versus less glucose lowering in patients with younger or older age at diabetes diagnosis, and with shorter or longer diabetes duration.

Research Design And Methods: We studied 11,138 participants from the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial, classified into subgroups defined by age at diabetes diagnosis (≤50, >50-60, and >60 years) and diabetes duration (≤5, >5-10, and >10 years).

Results: Intensive glucose lowering significantly lowered the risk of the primary composite outcome of major macrovascular and microvascular events (hazard ratio 0.

Hypertension in Adults With Diabetes in Southeast Asia: A Systematic Review.

Diabetes is one of the most pressing health issues in the Southeast Asian region, and hypertension has been commonly reported as a comorbidity in adults with diabetes. This systematic review aimed to synthesize evidence on the prevalence and management of hypertension in adults with diabetes in Southeast Asian countries. A literature search was conducted in Ovid MEDLINE and Embase Classic + Embase from database inception until March 15, 2024.

A Proteomics-Based Approach for Prediction of Different Cardiovascular Diseases and Dementia.

Background: Many studies have explored whether individual plasma protein biomarkers improve cardiovascular disease risk prediction. We sought to investigate the use of a plasma proteomics-based approach in predicting different cardiovascular outcomes.

Methods: Among 51 859 UK Biobank participants (mean age, 56.

ASSIGN score and cancer risk in the Scottish Heart Health Extended Cohort (SHHEC) study.

Background: The aim of this work was to determine whether the ASSIGN cardiovascular disease (CVD) score, a 10-year CVD risk score used in primary care in Scotland, could additionally detect cancer risk.

Methods: 18,107 participants were recruited to the Scottish Heart Health Extended Cohort (SHHEC) study between 1982 and 1995. Information on health and lifestyle were collected, along with blood and urine, and participants were followed up via record linkage to 2017.

Haemodiafiltration versus haemodialysis for kidney failure: an individual patient data meta-analysis of randomised controlled trials.

Background: High-dose haemodiafiltration has been shown, in a randomised clinical trial, to result in a 23% lower risk of mortality for patients with kidney failure when compared with conventional high-flux haemodialysis. Nevertheless, whether treatment effects differ across subgroups, whether a dose-response relationship with convection volume exists, and the effects on cause-specific mortality remain unclear. The aim of this individual patient data meta-analysis was to compare the effects of haemodiafiltration and standard haemodialysis on all-cause and cause-specific mortality.

Interleukin-6, C-Reactive Protein, and Recurrence After Stroke: A Time-Course Analysis of Individual-Participant Data.

Background: Inflammation promotes atherogenesis. Randomized controlled trials of anti-inflammatory therapies for prevention after stroke have not yet demonstrated clear benefit. IL-6 (interleukin-6) and hsCRP (high-sensitivity C-reactive protein) are independently associated with major adverse cardiovascular events poststroke and may guide patient selection in future randomized controlled trials.

Optimal risk thresholds for prescribing statins as primary prevention of cardiovascular disease in Iranian general population: a benefit-harm modelling study.

Purpose: The use of statins for the primary prevention of cardiovascular diseases (CVD) is associated with various beneficial outcomes, alongside certain undesirable effects. This study aims to determine optimal risk thresholds above which statin therapy yields a net benefit, considering both the positive effects and potential adverse effects, as well as their probabilities and patient preferences.

Methods: Quantitative benefit-harm balance modeling was applied to the Iranian general population aged 40 to 75 years with no history of CVD.

Endoscopic balloon dilatation of primary obstructive megaureter: An effective first line management in children.

Aim: This study evaluates outcomes of endoscopic balloon dilatation (EBD) in the management of primary obstructive megaureter (POM) in children.

Methods: Retrospective data between 2013 and 2023 from two tertiary paediatric surgical centres in the UK were reviewed. Pre and post-operative clinical and imaging parameters of children managed with EBD were assessed.

Skull Base Chordoma and Chondrosarcoma: Neuroradiologist's Guide to Diagnosis, Surgical Management, and Proton Beam Therapy.

Skull base chordomas and chondrosarcomas are distinct types of rare, locally aggressive mesenchymal tumors that share key principles of imaging investigation and multidisciplinary care. Maximal safe surgical resection is the treatment choice for each, often via an expanded endoscopic endonasal approach, with or without multilayer skull base repair. Postoperative adjuvant radiation therapy is frequently administered, usually with particle therapy such as proton beam therapy (PBT).

Policies on the collection, analysis, and reporting of sex and gender in Australian health and medical research: a mixed methods study.

Objective: To explore the policies of key organisations in Australian health and medical research on defining, collecting, analysing, and reporting data on sex and gender, and to identify barriers to and facilitators of developing and implementing such policies.

Study Design: Mixed methods study: online planning forum; survey of organisations in Australian health and medical research, and internet search for policies defining, collecting, analysing, and reporting data by sex and gender in health and medical research.

Setting, Participants: Australia, 19 May 2021 (planning forum) to 12 December 2022 (final internet search).

Randomised controlled decentralised feasibility trial of a fixed low-dose combination antihypertensive drug strategy to attenuate cognitive decline in high-risk adults.

Objectives: The Action To promote brain HEalth iN Adults study aimed to determine the feasibility and applicability of recruitment using home blood pressure (BP) monitoring, routine blood biochemistry and videoconference measures of cognition, in adults at high risk of dementia.

Design: A decentralised double-blind, placebo-controlled, randomised feasibility trial with a four-stage screening process.

Setting: Conducted with participants online in the state of New South Wales, Australia.

Using a measurement type-independent metric to compare patterns of determinants between patient-reported versus performance-based physical function in hemodialysis patients.

Purpose: We applied a previously established common T-score metric for patient-reported and performance-based physical function (PF), offering the unique opportunity to directly compare measurement type-specific patterns of associations with potential laboratory-based, psychosocial, sociodemographic, and health-related determinants in hemodialysis patients.

Methods: We analyzed baseline data from the CONVINCE trial (N = 1,360), a multinational randomized controlled trial comparing high-flux hemodialysis with high-dose hemodiafiltration. To explore the associations of potential determinants with performance-based versus patient-reported PF, we conducted multiple linear regression (backward elimination with cross-validation and Lasso regression).

Sex and the Relationship Between Cardiometabolic Risk Factors and Estimated GFR Decline: A Population-Based Cohort Study.

Rationale & Objective: Females have a higher prevalence of chronic kidney disease (CKD) than males but are less likely to be treated with kidney replacement therapy (KRT). We studied the interaction between sex and the association of cardiometabolic risk factors for the decline in kidney function over time.

Study Design: A population-based cohort study.