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Query: UMLS:C0948265 (metabolic syndrome)
 24,271 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Regular physical activity of moderate intensity can bring about major health benefits as well as significant cost savings for the NHS. Evidence suggests that regular exercise can produce up to a 30% reduction in all cause mortality with a 35% lower risk of cardiovascular disease, coronary heart disease and stroke. There is evidence to show that 37% of CHD deaths can be attributed to physical inactivity compared with 19% and 13% for smoking and hypertension respectively. In addition, a 40% reduction in the risk of metabolic syndrome and type 2 diabetes mellitus has been reported with moderate physical activity. Current guidelines from the CMO, for adults aged 19-64 years, recommend: 150 minutes of moderate intensity aerobic exercise per week such as fast walking or cycling plus muscle strengthening activities on two or more days a week, or 75 minutes of vigorous intensity aerobic activity such as running or singles tennis plus the same muscle strengthening regimen, or an equivalent mix of the two. Only 40% of men and 28% of women in England are achieving the recommended levels of exercise/physical activity. One way GPs can increase their patients' physical activity levels could be via an individualised tailored care pathway aiming to motivate individuals to make long-term health changes. Evidence suggests that the risks associated with physical activity at a level to promote health are low and that health benefits outweigh the risks. The 5 As system (Ask, Assess, Advise, Assist and Arrange) which is sometimes used in smoking cessation can be adapted for physical activity. Ask about the patient's current levels of physical activity using the General Practice Physical Activity Questionnaire; Assess their fitness and capabilities; Advise about appropriate exercise and the risks involved; Assist in locating places to get involved, use 'Let's Get Moving' and exercise referral schemes available; Arrange any necessary referrals.
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PMID:Time to encourage patients to take more exercise. 2325 33

Improving physical healthcare to reduce premature mortality in people with SMI (Serious Mental Illness) is a priority for ELFT (East London NHS Foundation Trust) and NHS England. It is well know that people with schizophrenia have a life expectancy which is approximately 20% shorter than that of the general population and a substantial mortality difference exists between people with schizophrenia and the general community.[1-2] Among other risk factors, such as poor diet, physical inactivity, and high rates of smoking, the iatrogenic effects of anti-psychotic medications have been found to increase the risk of metabolic syndrome. This can easily be detected through regular monitoring. Through this project, it was our aim to improve the physical health monitoring of City & Hackney Assertive Outreach Service (AOS) patients with a view to decrease mortality rate, increase life expectancy, increase the quality of life, and reduce harm from medication. This was done using quality improvement methods, including several change ideas, each of which started sequentially over the course of a nine month period from November 2014. Following QI methodology, this utilised cycles of iterative learning using PDSA methods and was supported by the Trust's extensive programme of quality improvement, including training provided by the Institute for Healthcare Improvement. The project involved setting a specific aim which was improving the physical health monitoring of AOS patients to 80% by July 2015 and for our patients to have physical health checks (blood tests, weight, ECG, BP) as a minimum annually. From baseline measurements of between 50-75%, we reached our target of 80% for weight, BP and blood tests monitoring, with 89%, 91%, and 84% achieved respectively by July 2015. Further progress still needs to be made on ECGs, with 77% achieved by July 2015, although the monitoring of ECG nearly doubled from 39% in November 2014 to 77% in July 2015. This project demonstrated that effective leadership, collaborative team work, embedding the project in our daily practice, generating local solutions, and improved communication between primary and secondary care can increase the physical health monitoring of this complex and challenging patient group. The team continues to identify other areas for change that may lead to further improvement in the physical health monitoring of AOS patients while making sure that the improvement is sustained.
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PMID:Improving the Physical Health Monitoring of City & Hackney Assertive Outreach Service Patients. 2749 47

One of the biggest current challenges in managing an ageing cohort living with the HIV is handling dyslipidaemia, diabetes, metabolic syndrome and nonalcoholic fatty liver disease. Combination antiretroviral therapy decrease mortality and morbidity in HIV patients, but lead to increase in insulin resistance, dyslipidaemia, abnormalities of fat distribution and high risk of cardiovascular disease. Therefore, a metabolic clinic was established for individuals living with HIV in the Milton Keynes University Hospital NHS Foundation Trust. The clinic meets considerable demands by service users and hence has the potential to be popular. This review focuses on the importance of the development of a metabolic clinic for the purpose of audit, research, teaching and exchange of knowledge between HIV specialists and the metabolic team in the management of complex cases. Therefore, the metabolic clinic should be an integral part of HIV services especially as the cohort of the 'older' HIV population increases.
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PMID:Metabolic clinic for individuals with HIV/AIDS: a commitment and vision to the future of HIV services. 3164 27