Implementing the European guidelines for cardiovascular disease prevention in the primary care setting in Cyprus: Lessons learned from a health care services study

<p>Abstract</p> <p>Background</p> <p>Recent guidelines recommend assessment and treatment of the overall risk for cardiovascular disease (CVD) through management of multiple risk factors in patients at high absolute risk. The aim of our study was to assess the level of cardiovascular risk in patients with known risk factors for CVD by applying the SCORE risk function and to study the implications of European guidelines on the use of treatment and goal attainment for blood pressure (BP) and lipids in the primary care of Cyprus.</p> <p>Methods</p> <p>Retrospective chart review of 1101 randomly selected patients with type 2 diabetes mellitus (DM2), or hypertension or hyperlipidemia in four primary care health centres. The SCORE risk function for high-risk regions was used to calculate 10-year risk of cardiovascular fatal event. Most recent values of BP and lipids were used to assess goal attainment to international standards. Most updated medications lists were used to compare proportions of current with recommended antihypertensive and lipid-lowering drug (LLD) users according to European guidelines.</p> <p>Results</p> <p>Implementation of the SCORE risk model labelled overall 39.7% (53.6% of men, 31.3% of women) of the study population as high risk individuals (CVD, DM2 or SCORE ≥5%). The SCORE risk chart was not applicable in 563 patients (51.1%) due to missing data in the patient records, mostly on smoking habits. The LDL-C goal was achieved in 28.6%, 19.5% and 20.9% of patients with established CVD, DM2 (no CVD) and SCORE ≥5%, respectively. BP targets were achieved in 55.4%, 5.6% and 41.9% respectively for the above groups. There was under prescription of antihypertensive drugs, LLD and aspirin for all three high risk groups.</p> <p>Conclusion</p> <p>This study demonstrated suboptimal control and under-treatment of patients with cardiovascular risk factors in the primary care in Cyprus. Improvement of documentation of clinical information in the medical records as well as GPs training for implementation and adherence to clinical practice guidelines are potential areas for further discussion and research.</p

Linear infinite cadmium chains in CaAu4Cd2 and other intermetallics with YbMo2Al4-type structure

International audienceNew YbMo2Al4-type cadmium compounds CaAu4Cd2, SrAu4Cd2, and EuAu4Cd2 were synthesized from the elements in sealed tantalum tubes. The structures of CaAu4Cd2 (I4/mmm, a = 710.7(1), c = 550.2(3) pm, wR2 = 0.026, 168 F 2 values, 10 variables) and EuAu4.80Cd1.20 (a = 716.6(1), c = 545.9(1) pm, wR2 = 0.024, 167 F 2 values, 11 variables) were refined from X-ray single-crystal diffractometry data. The gold and cadmium atoms show different substructures: Au4 squares (279 pm Au-Au in CaAu4Cd2) and cadmium chains (275 pm Cd-Cd in CaAu4Cd2). EuAu4Cd2 forms a solid solution EuAu4+x Cd2−x up to x ≈ 1, where almost every other cadmium atom within the chains is substituted by gold. Chemical bonding analyses on CaAu4Cd2 shows almost complete charge transfer from calcium to the [Au4Cd2] network. Bader charge analysis classifies CaAu4Cd2 as an auride. EuAu4Cd2 shows Curie-Weiss behavior above 25 K with an experimental magnetic moment of 7.86 μB/Eu atom, near to the free ion value of 7.94 μB for Eu2+ and orders ferromagnetically at T C = 16.3(5) K. 151Eu Mössbauer spectra show a single signal at an isomer shift of about −10 mm/s, compatible with divalent europium. At 5 K, and therefore clearly below T C, magnetic hyperfine splitting is observed