A study in BMCCardiovascDisord finds that in patients with type 2 diabetes without known prior coronary artery disease, liraglutide treatment is associated with a significant increase in coronary artery fibrous plaque volume during one-year follow-up.
]. In the present observational study, we evaluated changes in coronary artery plaque volumes and composition using serial CCTA in cardiac asymptomatic patients with T2D receiving liraglutide compared to cardiac asymptomatic patients with T2D not receiving liraglutide .This study was a single-center prospective observational study performed from March 2016 to September 2017 at Odense University Hospital Svendborg, Svendborg, Denmark.
Sublingual fast-acting nitrate was administered shortly before the enhanced scan. Images were obtained by a 256-detector system by an electrocardiogram-gated prospective acquisition in the 75% of the R-R interval with additional padding of 45 ms to allow additional reconstruction. An additional phase was acquired in the 40% phase of the R-R interval in patients with heart rates above 65 beats/minute. Furthermore, a repeated scan was acquired if the heart rhythm was irregular.
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Diabetes drugs associated with fewer adverse cardiac events in older veteransGLP1 receptor agonists—a class of diabetes medications—are associated with fewer major adverse cardiovascular events than another type of diabetes drug (DPP4 inhibitors) in older veterans with no prior heart disease. The findings, reported in Annals of Internal Medicine, will aid clinicians in choosing a diabetes drug regimen for older patients.
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Ketogenic diet: A metabolic makeover boosting immunity and battling inflammationKetogenic diet: A metabolic makeover boosting immunity and battling inflammation Ketogenic diet Tcell immunity metabolomics immunometabolism Westerndiet metaflammation ESPENorg
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Timing of intubation and ICU mortality in COVID-19 patients: a retrospective analysis of 4198 critically ill patients during the first and second waves - BMC AnesthesiologyBackground The optimal time to intubate patients with SARS-CoV-2 pneumonia has not been adequately determined. While the use of non-invasive respiratory support before invasive mechanical ventilation might cause patient-self-induced lung injury and worsen the prognosis, non-invasive ventilation (NIV) is frequently used to avoid intubation of patients with acute respiratory failure (ARF). We hypothesized that delayed intubation is associated with a high risk of mortality in COVID-19 patients. Methods This is a secondary analysis of prospectively collected data from adult patients with ARF due to COVID-19 admitted to 73 intensive care units (ICUs) between February 2020 and March 2021. Intubation was classified according to the timing of intubation. To assess the relationship between early versus late intubation and mortality, we excluded patients with ICU length of stay (LOS) | 7 days to avoid the immortal time bias and we did a propensity score and a cox regression analysis. Results We included 4,198 patients [median age, 63 (54‒71) years; 71% male; median SOFA (Sequential Organ Failure Assessment) score, 4 (3‒7); median APACHE (Acute Physiology and Chronic Health Evaluation) score, 13 (10‒18)], and median PaO2/FiO2 (arterial oxygen pressure/ inspired oxygen fraction), 131 (100‒190)]; intubation was considered very early in 2024 (48%) patients, early in 928 (22%), and late in 441 (10%). ICU mortality was 30% and median ICU stay was 14 (7‒28) days. Mortality was higher in the “late group” than in the “early group” (37 vs. 32%, p | 0.05). The implementation of an early intubation approach was found to be an independent protective risk factor for mortality (HR 0.6; 95%CI 0.5‒0.7). Conclusions Early intubation within the first 24 h of ICU admission in patients with COVID-19 pneumonia was found to be an independent protective risk factor of mortality. Trial registration The study was registered at Clinical-Trials.gov (NCT04948242) (01/07/2021).
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North Belfast boy 'in constant agony' awaiting treatment for blocked bowelA young North Belfast boy with complex needs is constantly 'screaming in agony' in hospital as he awaits treatment for a blocked bowel. His mum spoke to Belfast Live.
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Sleep as a vital sign - Sleep Science and PracticeSleep is causally linked to the maintenance of every major physiological body system and disturbed sleep contributes to myriad diseases. The problem is, however, is that patients do not consistently, nor spontaneously, report sleep problems to their clinicians. Compounding the problem, there is no standard-of-care approach to even the most rudimentary of sleep queries. As a result, sleep disturbances remain largely invisible to most clinicians, and consequentially, unaddressed for the patient themselves – thereby exacerbating physical and mental health challenges due to unaddressed sleep problems. In this review, we argue that all patients should be routinely screened with a short, readily available, and validated assessment for sleep disturbances in clinical encounters. If the initial assessment is positive for any subjective sleep-related problems, it should prompt a more thorough investigation for specific sleep disorders. We further describe how a program of short and simple sleep health screening is a viable, efficacious yet currently missing pathway through which clinicians can 1) screen for sleep-related problems, 2) identify patients with sleep disorders, 3) rapidly offer evidence-based treatment, and (if indicated) 4) refer patients with complex presentations to sleep medicine specialists.
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Sutton Hoo: Blue plaque unveiled at home of Basil BrownBasil Brown is commemorated with a blue plaque on the home he lived in for more than 40 years.
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