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0001, .001, .022, and .018, respectively while the multivariate analysis showed a strong correlation between EFT and weight and creatinine with a
-value of <.0001 and .033 respectively.
LSG can have a favourable impact on metabolic syndrome aspects, namely EFT, as it can decrease it considerably.
LSG can have a favourable impact on metabolic syndrome aspects, namely EFT, as it can decrease it considerably.
CeQur Simplicity™ (CeQur, Marlborough, MA) is a 3-day insulin delivery patch designed to meet mealtime insulin requirements. A recently reported 48-week, randomized, multicenter, interventional trial compared efficacy, safety and self-reported outcomes in 278 adults with type 2 diabetes (T2D) on basal insulin therapy who initiated and managed mealtime insulin therapy with a patch pump versus insulin pen. We assessed changes in key glycemic metrics among a subset of patients who wore a continuous glucose monitoring (CGM) device.
Study participants (patch,
= 49; pen,
= 48) wore a CGM device in masked setting during the baseline period and prior to week 24. Glycemic control was assessed using international consensus guidelines for percentage of Time In Range (%TIR >70% at 70-180 mg/dL), Time Below Range (%TBR <4% at <70 mg/dL; <1% at <54 mg/dL), and Time Above Range (%TAR <25% at >180 mg/dL; <5% at >250 mg/dL).
Both the patch and pen groups achieved recommended targets in %TIR (74.1% ± 18.7%, 75.2 ± 16.1%, respectively) and marked reductions in %TAR >180 mg/dL (21.1% ± 19.9%, 19.7% ± 17.5%, respectively) but with increased %TBR <70 mg/dL (4.7% ± 5.2%, 5.1 ± 5.8, respectively), all
< .0001. No significant between-group differences in glycemic improvements or adverse events were observed.
CGM confirmed that the patch or pen can be used to safely initiate and optimize basal-bolus therapy using a simple insulin adjustment algorithm with SMBG. Preference data suggest that use of the patch vs pen may enhance treatment adherence.
CGM confirmed that the patch or pen can be used to safely initiate and optimize basal-bolus therapy using a simple insulin adjustment algorithm with SMBG. Preference data suggest that use of the patch vs pen may enhance treatment adherence.
Fenestrated endovascular aneurysm repair (FEVAR) is a well-established endovascular treatment option for pararenal abdominal aortic aneurysms in which balloon-expandable covered stents (BECS) are used to bridge the fenestration to the target vessels. This study presents midterm clinical outcomes and patency rates of the Advanta V12 BECS used as a bridging stent.
All patients treated with FEVAR with at least 1 Advanta V12 BECS were included from 2 large-volume vascular centers between January 2012 and December 2015. Primary endpoints were freedom from all-cause reintervention, and freedom from BECS-associated complications and reintervention. BECS-associated complications included significant stenosis, occlusion, type 3 endoleak, or stent fracture. Secondary endpoints included all-cause mortality in-hospital and during follow-up.
This retrospective study included 194 FEVAR patients with a mean age of 72.2±8.0 years. A total of 457 visceral arteries were stented with an Advanta V12 BECS. Median (interquarn and reintervention rates at 3 years. A substantial number of FEVAR patients required a reintervention, but most were not BECS related.
The Advanta V12 BECS used as bridging stent in FEVAR showed low complication and reintervention rates at 3 years. A substantial number of FEVAR patients required a reintervention, but most were not BECS related.
Pancreaticoduodenal artery aneurysms (PDAAs) are rare and have a high propensity for rupture. Historically, management of PDAAs included surgical reconstruction but has evolved with advances in endovascular therapy. We report our experience with management of PDAAs during the last 30 years.
We retrospectively reviewed our prospectively maintained registry between January 1, 1992- March 30, 2020.
We identified 8 patients with PDAAs 4 with associated celiac artery occlusive disease and 4 without identifiable etiologies. Four patients were treated with surgical resection of the PDAAs 2 intact aneurysms underwent concomitant revascularization (superior mesenteric artery-to-hepatic artery Dacron bypass; supra celiac aorta-to-hepatic artery Dacron bypass) and 2 (1 intact, 1 rupture) underwent ligation alone. Four patients were treated with coil embolization of the PDAA 2 with concomitant stent-graft exclusion of the aneurysm (1 non-rupture, 1 rupture) and 2 without adjunctive measures (intact). There were no deaths nor any significant procedure-related morbidity.
Our large single-center experience shows that PDAAs can be successfully treated by open or endovascular intervention with selective revascularization.
Our large single-center experience shows that PDAAs can be successfully treated by open or endovascular intervention with selective revascularization.There is an urgent need for new clinical models to improve access to child mental health care. Pediatricians are tasked to care for youth with mild to moderate mental health problems, but require additional training. This article describes an outpatient child psychiatry consultation clinic (CPC) designed to empower pediatricians to care for youth with depression, anxiety, and attention deficit/hyperactivity disorder. Over a 2-year period, 40 primary care physicians (PCPs) referred 159 patients to the CPC. The most common primary diagnoses of patients seen for consultation were generalized anxiety disorder (35%), major depressive disorder (24%), and attention deficit/hyperactivity disorder (20%). Most patients (89%) had at least 2 psychiatric diagnoses. Nearly four fifths (79%) of these patients successfully returned to their PCP for ongoing care. PCPs reported that the CPC enhanced their skills and improved access to mental health care. Similar models are needed to facilitate early intervention for the millions of youth with mental health problems.
In middle-income countries, malnutrition concentrates in marginalized populations with a lack of effective preventive strategies.
Identify risk factors for undernutrition in a peri-urban Ecuadorian community of children aged 12 to 59 months.
Data from a cross-sectional survey in 2011 of children 1 to 5 years were analyzed including demographic data, medical history and examination, food frequency questionnaire (FFQ), anthropometric measurements, and blood for complete blood count, C-reactive protein, vitamin A, iron, and zinc levels. Dietary Diversity Score (DDS) was calculated from FFQ. Bivariate and multivariate analysis assessed effects on primary outcome of undernutrition by DDS, vitamin deficiencies, and demographic and nutritional data.
N = 67, 52.2% undernourished 49.3% stunted, 25.4% underweight, and 3% wasted; 74.6% (n = 50) were anemic and 95.1% (n = 39) had low serum zinc. find more Dietary Diversity Score was universally low (mean 4.91 ± 1.36, max 12). Undernutrition was associated with lower vitamin A levels (20 306, IQR 16605.
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