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Miyasaka, Yoko,Barnes, Marion E,Petersen, Ronald C,Cha, Stephen S,Bailey, Kent R,Gersh, Bernard J,Casaclang-Verzosa, Grace,Abhayaratna, Walter P,Seward, James B,Iwasaka, Toshiji,Tsang, Teresa S M Academic Press 2007 European Heart Journal Vol. No.
<P>AIMS: To estimate the incidence of dementia after the first atrial fibrillation (AF), and its impact on survival in a community-based cohort. METHODS AND RESULTS: Olmsted County, Minnesota adult residents diagnosed with first AF during 1986-2000 were identified, and followed until 2004. The primary outcome was new detection of dementia. Interim stroke was censored in the analyses. Of 2837 subjects (71 +/- 15 years old) diagnosed with first AF and without any evidence of cognitive dysfunction or stroke at the time of AF onset, 299 were diagnosed with dementia during a median follow-up of 4.6 years [interquartile (IQR) range 1.5-7.9 years], and 1638 died. The Kaplan-Meier cumulative rate of dementia was 2.7% at 1 year and 10.5% at 5 years. After adjustment for age and sex, dementia was strongly related to advancing age [hazard ratio (HR)/10 years, 2.8; 95% confidence interval (CI), 2.5-3.2], but did not vary with sex (P = 0.52). The occurrence of post-AF dementia was associated with significantly increased mortality risk (HR 2.9; 95% CI 2.5-3.3), even after adjustment for multiple comorbidities, and did not vary with age (P = 0.75) or sex (P = 0.33). CONCLUSION: Dementia appeared common following the diagnosis of first AF, and was associated with premature death.</P>
Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision
Broż,ek, Jan L.,Bousquet, Jean,Agache, Ioana,Agarwal, Arnav,Bachert, Claus,Bosnic-Anticevich, Sinthia,Brignardello-Petersen, Romina,Canonica, G. Walter,Casale, Thomas,Chavannes, Niels H.,Correia Elsevier 2017 The journal of allergy and clinical immunology Vol.140 No.4
<P><B>Background</B></P> <P>Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update.</P> <P><B>Objective</B></P> <P>We sought to provide a targeted update of the ARIA guidelines.</P> <P><B>Methods</B></P> <P>The ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patients' values and preferences and resource requirements (up to June 2016). We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence-to-decision frameworks to develop recommendations.</P> <P><B>Results</B></P> <P>The 2016 revision of the ARIA guidelines provides both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H<SUB>1</SUB>-antihistamines, intranasal H<SUB>1</SUB>-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.</P> <P><B>Conclusions</B></P> <P>Appropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.</P>