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https://www.readbyqxmd.com/read/28806185/graft-quality-verification-in-coronary-artery-bypass-graft-surgery-how-when-and-why
#1
Teresa M Kieser
PURPOSE OF REVIEW: The coronary artery bypass graft (CABG) operation is one of the few remaining operations/interventions on diseased arteries that are not routinely verified during or immediately after the procedure. This review answers the 'how', 'when' and 'why' of intraoperative CABG assessment. RECENT FINDINGS: More recent than new literature on this topic, is the increased interest in quality assurance of CABG. This is most likely due to reports in the last 5 years suggesting CABG superiority to percutaneous coronary intervention (PCI) for improved mid-term and long-term outcomes; for example, for patients with diabetes mellitus (Freedom Trial by Farkouh in 2012), and for patients with SYNTAX score ≥ 33 (SYNTAX Trial by Mohr in 2013)...
August 12, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28803840/development-and-validation-of-risk-equations-for-complications-of-type-2-diabetes-recode-using-individual-participant-data-from-randomised-trials
#2
Sanjay Basu, Jeremy B Sussman, Seth A Berkowitz, Rodney A Hayward, John S Yudkin
BACKGROUND: In view of substantial mis-estimation of risks of diabetes complications using existing equations, we sought to develop updated Risk Equations for Complications Of type 2 Diabetes (RECODe). METHODS: To develop and validate these risk equations, we used data from the Action to Control Cardiovascular Risk in Diabetes study (ACCORD, n=9635; 2001-09) and validated the equations for microvascular events using data from the Diabetes Prevention Program Outcomes Study (DPPOS, n=1018; 1996-2001), and for cardiovascular events using data from the Action for Health in Diabetes (Look AHEAD, n=4760; 2001-12)...
August 10, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28801473/type-2-diabetes-in-the-real-world-the-elusive-nature-of-glycemic-control
#3
Steven V Edelman, William H Polonsky
Despite U.S. Food and Drug Administration (FDA) approval of over 40 new treatment options for type 2 diabetes since 2005, the latest data from the National Health and Nutrition Examination Survey show that the proportion of patients achieving glycated hemoglobin (HbA1c) <7.0% (<53 mmol/mol) remains around 50%, with a negligible decline between the periods 2003-2006 and 2011-2014. The Healthcare Effectiveness Data and Information Set reports even more alarming rates, with only about 40% and 30% of patients achieving HbA1c <7...
August 11, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28798016/bayesian-analysis-a-practical-approach-to-interpret-clinical-trials-and-create-clinical-practice-guidelines
#4
John A Bittl, Yulei He
Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on P values. In this review, we present gradually more complex examples, along with programming code and data sets, to show how Bayesian analysis takes evidence from randomized clinical trials to update what is already known about specific treatments in cardiovascular medicine. In the example of revascularization choices for diabetic patients who have multivessel coronary artery disease, we combine the results of the FREEDOM trial (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) with prior probability distributions to show how strongly we should believe in the new Class I recommendation ("should be done") for a preference of bypass surgery over percutaneous coronary intervention...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28797470/balancing-primary-prevention-and-statin-induced-diabetes-mellitus-prevention
#5
REVIEW
Yogita Rochlani, Ajoe John Kattoor, Naga Venkata Pothineni, Raga Deepak Reddy Palagiri, Francesco Romeo, Jawahar L Mehta
Diabetes mellitus (DM), a modern-day epidemic, is a significant risk factor for cardiovascular disease. It is believed that statins elevate the risk of incident DM. Multiple trials were suggestive of the hyperglycemic effect of long-term statin use. This has prompted the Food and Drug Administration to include the risk of DM in the product label of statins. New-onset DM with statin use is biologically plausible and can be explained based on the multiple pathways in glucose metabolism affected by statins. Most pivotal clinical trials on statins were not powered to adequately assess the risk of incident DM with statin use, and the results from multiple meta-analyses are mixed...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28796008/methicillin-resistant-staphylococcus-aureus-in-cystic-fibrosis-how-should-it-be-managed
#6
Marianne S Muhlebach
PURPOSE OF REVIEW: Methicillin-resistant Staphylococcus aureus (MRSA) remains prevalent in people with cystic fibrosis (CF). As chronic infection with worse pulmonary outcomes develops frequently, the organism is concerning to CF providers and patients. This review describes current epidemiology, our understanding of risk factors for MRSA infection, and relevant aspects of treatment with review of new and ongoing trials. RECENT FINDINGS: Prevalence ranges from a low of 3 to 4% in some European countries to a high of approximately 26% in the United States...
August 8, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28794656/neuropathic-pain-responds-better-to-increased-doses-of-pregabalin-an-in-depth-analysis-of-flexible-dose-clinical-trials
#7
Michael Serpell, Mark Latymer, Mary Almas, Marie Ortiz, Bruce Parsons, Rita Prieto
BACKGROUND: Pregabalin is an effective treatment option for many patients with neuropathic pain. Higher doses of pregabalin have been shown to be more effective in improving pain outcomes but, in practice, failing to appropriately increase the dose can leave patients under-treated. METHODS: This was a pooled analysis of 6 flexible-dose clinical trials of pregabalin in patients with neuropathic pain (diabetic peripheral neuropathy, peripheral herpetic neuralgia, posttraumatic pain, or postsurgical pain)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28794648/cost-analysis-of-adverse-events-associated-with-non-small-cell-lung-cancer-management-in-france
#8
Christos Chouaid, Delphine Loirat, Emilie Clay, Aurélie Millier, Chloé Godard, Amira Fannan, Laurie Lévy-Bachelot, Eric Angevin
BACKGROUND: Adverse events (AEs) related to medical treatments in non-small cell lung cancer (NSCLC) are frequent and need an appropriate costing in health economic models. Nevertheless, data on costs associated with AEs in NSCLC are scarce, particularly since the development of immunotherapy with specific immune-related AEs. OBJECTIVE: To estimate the costs of grades 3 and 4 AEs related to NSCLC treatments including immunotherapy in France. METHODS: Grades 3 and 4 AEs related to treatment and reported in at least 1% of patients in Phase III clinical trials for erlotinib, ramucirumab plus docetaxel, docetaxel, pemetrexed plus carboplatin plus bevacizumab, platinum-based chemotherapies, nivolumab and pembrolizumab were identified...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28790131/a-team-based-online-game-improves-blood-glucose-control-in-veterans-with-type-2-diabetes-a-randomized-controlled-trial
#9
B Price Kerfoot, David R Gagnon, Graham T McMahon, Jay D Orlander, Katherine E Kurgansky, Paul R Conlin
OBJECTIVE: Rigorous evidence is lacking whether online games can improve patients' longer-term health outcomes. We investigated whether an online team-based game delivering diabetes self-management education (DSME) to patients via e-mail or mobile app can generate longer-term improvements in hemoglobin A1c (HbA1c). RESEARCH DESIGN AND METHODS: Patients (n = 456) on oral diabetes medications with HbA1c ≥58 mmol/mol were randomly assigned between a DSME game (with a civics booklet) and a civics game (with a DSME booklet)...
August 8, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28783802/association-of-neonatal-glycemia-with-neurodevelopmental-outcomes-at-4-5-years
#10
Christopher J D McKinlay, Jane M Alsweiler, Nicola S Anstice, Nataliia Burakevych, Arijit Chakraborty, J Geoffrey Chase, Gregory D Gamble, Deborah L Harris, Robert J Jacobs, Yannan Jiang, Nabin Paudel, Ryan J San Diego, Benjamin Thompson, Trecia A Wouldes, Jane E Harding
Importance: Hypoglycemia is common during neonatal transition and may cause permanent neurological impairment, but optimal intervention thresholds are unknown. Objective: To test the hypothesis that neurodevelopment at 4.5 years is related to the severity and frequency of neonatal hypoglycemia. Design, Setting, and Participants: The Children With Hypoglycemia and Their Later Development (CHYLD) Study is a prospective cohort investigation of moderate to late preterm and term infants born at risk of hypoglycemia...
August 7, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28781064/cardiovascular-mortality-and-morbidity-in-patients-with-type-2-diabetes-following-initiation-of-sodium-glucose-co-transporter-2-inhibitors-versus-other-glucose-lowering-drugs-cvd-real-nordic-a-multinational-observational-analysis
#11
Kåre I Birkeland, Marit E Jørgensen, Bendix Carstensen, Frederik Persson, Hanne L Gulseth, Marcus Thuresson, Peter Fenici, David Nathanson, Thomas Nyström, Jan W Eriksson, Johan Bodegård, Anna Norhammar
BACKGROUND: In patients with type 2 diabetes and a high cardiovascular risk profile, the sodium-glucose co-transporter-2 (SGLT2) inhibitors empagliflozin and canagliflozin have been shown to lower cardiovascular morbidity and mortality. Using real-world data from clinical practice, we aimed to compare cardiovascular mortality and morbidity in new users of SGLT2 inhibitors versus new users of other glucose-lowering drugs, in a population with a broad cardiovascular risk profile. METHODS: CVD-REAL Nordic was an observational analysis of individual patient-level data from the Prescribed Drug Registers, Cause of Death Registers, and National Patient Registers in Denmark, Norway, and Sweden...
August 3, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28776320/cost-effectiveness-of-support-for-people-starting-a-new-medication-for-a-long-term-condition-through-community-pharmacies-an-economic-evaluation-of-the-new-medicine-service-nms-compared-with-normal-practice
#12
Rachel A Elliott, Lukasz Tanajewski, Georgios Gkountouras, Anthony J Avery, Nick Barber, Rajnikant Mehta, Matthew J Boyd, Asam Latif, Antony Chuter, Justin Waring
BACKGROUND: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs. METHODS: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients' non-adherence...
August 3, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28771933/impact-of-clinical-evidence-communications-and-drug-regulation-changes-concerning-rosiglitazone-on-prescribing-patterns-of-antidiabetic-therapies
#13
Yoojin Noh, Dae Ryong Kang, Dae Jung Kim, Kwang Jae Lee, Sukhyang Lee, Sooyoung Shin
PURPOSE: Cardiovascular safety alerts about rosiglitazone resulted in regulatory actions in several countries in 2010, but the Food and Drug Administration eliminated access restrictions in 2013, reflecting new evidence concerning the drug safety. We investigated the effects of safety signals and regulation shifts concerning rosiglitazone on prescribing of antidiabetic drugs (ADs). METHODS: Patient data were extracted from the Korean health insurance claims database for 2007 to 2015...
August 3, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28770327/a-new-perspective-on-metformin-therapy-in-type-1-diabetes
#14
REVIEW
Rachel Livingstone, James G Boyle, John R Petrie
Metformin is quite frequently used off-label in type 1 diabetes to limit insulin dose requirement. Guidelines recommend that it can improve glucose control in those who are overweight and obese but evidence in support of this is limited. Recently-published findings from the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial suggest that metformin therapy in type 1 diabetes can reduce atherosclerosis progression, weight and LDL-cholesterol levels. This provides a new perspective on metformin therapy in type 1 diabetes and suggests a potential role for reducing the long-term risk of cardiovascular disease...
August 2, 2017: Diabetologia
https://www.readbyqxmd.com/read/28770323/understanding-and-preventing-type-1-diabetes-through-the-unique-working-model-of-trialnet
#15
REVIEW
Manuela Battaglia, Mark S Anderson, Jane H Buckner, Susan M Geyer, Peter A Gottlieb, Thomas W H Kay, Åke Lernmark, Sarah Muller, Alberto Pugliese, Bart O Roep, Carla J Greenbaum, Mark Peakman
Type 1 diabetes is an autoimmune disease arising from the destruction of pancreatic insulin-producing beta cells. The disease represents a continuum, progressing sequentially at variable rates through identifiable stages prior to the onset of symptoms, through diagnosis and into the critical periods that follow, culminating in a variable depth of beta cell depletion. The ability to identify the very earliest of these presymptomatic stages has provided a setting in which prevention strategies can be trialled, as well as furnishing an unprecedented opportunity to study disease evolution, including intrinsic and extrinsic initiators and drivers...
August 2, 2017: Diabetologia
https://www.readbyqxmd.com/read/28765644/lipid-levels-and-new-onset-diabetes-in-a-hypertensive-population-the-china-stroke-primary-prevention-trial
#16
Leliang Li, Ping Li, Juan Yang, Xiao Huang, Huihui Bao, Chunyan Zhang, Yun Song, Min Zhao, Meng Ji, Yi Wang, Geng Qian, Genfu Tang, Shanqun Jiang, Qiang Dong, Yan Zhang, Jianping Li, Xiping Xu, Binyan Wang, Yong Huo, Xiaoshu Cheng
This study aimed to provide insights into the relationship between lipid levels and new-onset diabetes (NOD) in 14,864 Chinese hypertensive patients without diabetes (6056 men and 8808 women) aged 45-75 years from the China Stroke Primary Prevention Trial (CSPPT, led by Nanfang Hospital, Guangzhou, China). NOD (defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L at the end of study or self-reported physician diagnosis of diabetes or self-reported use of hypoglycemic agents during follow-up) was analyzed using multivariate analysis...
August 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28765411/heart-failure-what-s-new-and-what-s-changed
#17
Paul D Callan, Andrew L Clark
Physicians responsible for the care of patients with heart failure due to left ventricular systolic dysfunction have access to a broad range of evidence-based treatments that prolong life and reduce symptoms. In spite of the significant progress made over the last four decades, there is an ongoing need for novel therapies to treat a condition that is associated with stubbornly high morbidity and mortality. In this article, we discuss the findings of SERVE-HF, a randomised controlled trial of adaptive servo-ventilation in patients with left ventricular systolic dysfunction, as well as EMPA-REG, a study of the effects of a novel diabetic agent that may be of greater interest to heart failure specialists than diabetologists...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28763548/effect-of-oral-methylprednisolone-on-clinical-outcomes-in-patients-with-iga-nephropathy-the-testing-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Jicheng Lv, Hong Zhang, Muh Geot Wong, Meg J Jardine, Michelle Hladunewich, Vivek Jha, Helen Monaghan, Minghui Zhao, Sean Barbour, Heather Reich, Daniel Cattran, Richard Glassock, Adeera Levin, David Wheeler, Mark Woodward, Laurent Billot, Tak Mao Chan, Zhi-Hong Liu, David W Johnson, Alan Cass, John Feehally, Jürgen Floege, Giuseppe Remuzzi, Yangfeng Wu, Rajiv Agarwal, Hai-Yan Wang, Vlado Perkovic
Importance: Guidelines recommend corticosteroids in patients with IgA nephropathy and persistent proteinuria, but the effects remain uncertain. Objective: To evaluate the efficacy and safety of corticosteroids in patients with IgA nephropathy at risk of progression. Design, Setting, and Participants: The Therapeutic Evaluation of Steroids in IgA Nephropathy Global (TESTING) study was a multicenter, double-blind, randomized clinical trial designed to recruit 750 participants with IgA nephropathy (proteinuria greater than 1 g/d and estimated glomerular filtration rate [eGFR] of 20 to 120 mL/min/1...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28762143/pharmaceutical-interventions-for-diabetes-prevention-in-patients-at-risk
#19
REVIEW
Sudesna Chatterjee, Melanie Davies, Kamlesh Khunti
With the rising incidence and prevalence rates of type 2 diabetes globally, it is imperative that diabetes prevention strategies are implemented to stem the flow of new cases. Successful interventions include both lifestyle modification and pharmaceutical agents, and large, multicentre, randomised, controlled studies in different populations have identified the benefits of both. However, translating positive trial outcomes to the real world is particularly challenging, as lifestyle interventions require regular reinforcement from healthcare professionals to be maintained...
July 31, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28760727/randomized-trial-comparing-the-electronic-composite-psychosocial-screener-youthchat-with-a-clinician-interview-assessment-for-young-people-a-study-protocol
#20
Hiran Thabrew, Arden Corter, Felicity Goodyear-Smith, Mary Goldfinch
BACKGROUND: Psychosocial problems such as depression, anxiety, and substance abuse are common and burdensome in young people, particularly those with long-term physical conditions such as asthma and diabetes. In New Zealand, "screening" for such problems is undertaken routinely only with Year 9 students in low-decile schools and opportunistically in pediatric settings using a nonvalidated and time-consuming clinician-administered Home, Education/employment, Eating, Activity, Drugs, Sexuality, Suicide/depression, Safety (HEEADSSS) interview...
July 31, 2017: JMIR Research Protocols
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