Infectious Disease
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Hypoglycemia Increases Cardiovascular Risk in Patients With Type 1 and Type 2 Diabetes
This is a retrospective analysis of data from the UK Clinical Practice Research Datalink which includes 265,868 insulin-treated patients age > 30 years diagnosed with diabetes between 2001 and 2007. 3260 were diagnosed with T1DM and 10,422 had T2DM. During a median follow-up of 5 years for type 1 diabetes patients and 4.8 years for those with type 2 diabetes, hypoglycemia was experienced by 573 (18%) and 1463 (14%) of patients, respectively. Compared with patients who did not experience hypoglycemia, the hazard ratio (HR) for CV events among T1DM patients who experienced hypoglycemia was 1.51 (not significant) and 1.61 for those with and without a history of CVD. For T2DM patients, the respective HRs were 1.60 and 1.49. The median time interval between the first hypoglycemia event and the first CV event was 1.5 years for all diabetes patients. Thus, hypoglycemia increases the risk of both CV and all-cause mortality in patients with diabetes.
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Influenza, 2014-2015 — Something Old, Something New, and a Mismatch
By early January, influenza activity had reached epidemic proportions in large parts of the United States, despite prior vaccination.
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Serratia outbreak linked to drug diversion
A former nurse at the University of Wisconsin (UW) Hospital and Clinics in Madison, who allegedly diverted pain medication for personal use, may be linked to a cluster of infections among patients from the units where she worked, UW officials report.
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Trail of Tears: Fired Drug Diverting HCWs Free to Find Another Hospital
A nurse stealing morphine by replacing it with saline in a medication vial may not have realized she was colonized with Serratia marcescens.
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Empagliflozin Tablets (Jardiance ®)
A new sodium glucose co-transporter 2 (SGLT2) has been approved by the FDA. Empagliflozin follows canagliflozin (Invokana) and dapagliflozin (Farxiga)as the third entry in this group. These drugs reduce plasma glucose levels by reducing renal absorption of filtered glucose. Empagliflozin is marketed by Boehringer Ingelheim as Jardiance. -
Good Ol’ Vitamin C: Does It Deserve Another Look for Your Heart?
SYNOPSIS: A meta-analysis and systematic review found vitamin C supplementation improved endothelial function in patients with diabetes, atherosclerosis, and heart failure. -
Stopping Colonoscopy at Age 75 ¡ª Even With a History of Colon Cancer
SYNOPSIS: The incidence of colorectal cancer is much less in people > 75 years of age compared with ages 50-74, even in patients with a personal history of colon cancer or adenomatous polyps. Complication rates for colonoscopy are high in the elderly ¡Ý age 75 and in patients with comorbidities. Surveillance colonoscopy may be stopped in the advanced elderly and in comorbid elderly patients. -
Bring on the Butter and the Eggs
SYNOPSIS: People who were randomized to a low-carbohydrate diet lost more weight than those who were randomized to a low-fat diet over a year. They also had greater improvements in risk factors for cardiovascular disease. -
CLINICAL BRIEFS
The highest morbidity and mortality consequences of influenza occur in senior citizens. The efficacy of standard flu vaccine varies depending on the outcome that is examined -
OnabotulinumtoxinA for Treatment of Chronic Migraines
A pooled analysis of four clinical trials concluded that treatment with onabotulinumtoxinA at doses of 75-260 U administered every 12 weeks for up to five treatment cycles was efficacious, safe, and well tolerated for the prophylaxis of headache in adults with chronic migraine.