Articles Tagged With:
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Brain Atrophy and Type 1 Diabetes
In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.
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Shigella: The New Superbug?
Five percent of Shigella isolates in the United States in 2022 were extensively drug-resistant.
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Which Coronary Artery Calcium Score Signifies the Need for Secondary Prevention?
A large registry study of individuals without known cardiovascular disease but with known coronary artery computed tomography calcium scores showed those with an Agatston score higher than 300 are at risk of experiencing major cardiac events similar to patients with known cardiovascular disease over five years.
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Do We Overdiagnose Breast Cancer in Women 70 Years and Older?
Overdiagnosis of breast cancer from mammography is common in women age 70 years and older and increases with age. The use of mammography in women older than age 70 years does not reduce breast cancer deaths.
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How Many Steps a Day Will Improve Patients’ Longevity?
A systematic review and meta-analysis of studies of the association of step counts and cadence with all-cause mortality and cardiovascular events showed the benefits in these outcomes are statistically significant, at about 2,600 steps/day and peak at about 8,000 steps/day. Also, faster step cadence augments these benefits.
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Subcutaneous Furosemide Infusion Device
A small patient-applied infuser pump for a pH neutral formulation of furosemide has been developed. A comparison of an intravenous (IV) bolus of furosemide to a five-hour infusion with the pump has been completed and shows that the device is well tolerated and provides similar bioavailability as IV furosemide.
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Upgrading Prior Right Ventricular Pacing in Heart Failure
A randomized, controlled, open-label study of upgrading patients with right ventricular pacemaker-induced left ventricular dysfunction and heart failure to cardiac resynchronization pacing plus an implantable cardioverter defibrillator (ICD) has shown reduced heart failure hospitalization and improvements in left ventricular function compared to ICD placement alone.
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Apixaban Dose in Atrial Fibrillation Patients with Chronic Kidney Disease
A large nationwide health systems database study comparing 5 mg apixaban vs. 2.5 mg twice daily in patients with stage 4/5 chronic kidney disease not on dialysis shows that the 5 mg dose increases the risk of bleeding compared to 2.5 mg without any improvement in the risk of stroke, systemic emboli, or death.
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The Natural History of Aortic Stenosis Revisited
A large multi-institution observational study of patients referred for Doppler echocardiography to assess for aortic stenosis has shown that discrepant measurements are not uncommon. When four-year all-cause untreated mortality is considered, the intermediate grades of aortic stenosis behave like the next highest level stenosis, which suggests that we should consider intervening earlier in moderate to severe stenosis.
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Five-Year TAVR vs. SAVR Data Show Encouraging Results, but Do Not Move the Needle for Clinical Decision-Making
The PARTNER 3 trial randomized low-risk patients to transcatheter aortic valve replacement vs. surgical aortic valve replacement. Five-year data show no significant differences in the composite endpoint of death, stroke, or rehospitalization.