Cost-effectiveness analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at low risk of surgical mortality in Sweden.

Background: Transcatheter aortic valve implantation (TAVI) has shown similar or improved clinical outcomes compared with surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic stenosis at low risk for surgical mortality. This cost-utility analysis compared TAVI with SAPIEN 3 versus SAVR in symptomatic severe aortic stenosis patients at low risk of surgical mortality from the perspective of the Swedish healthcare system.

Methods: A published, two-stage, Markov-based cost-utility model that captured clinical outcomes from the (SWEDEHEART) registry (2018-2020) was adapted from the perspective of the Swedish healthcare system using local general population mortality, utility and costs data.

A Clinicians Guide to Recommending Common Cholesterol-Lowering Dietary Supplements.

The US dietary supplement (DS) market has expanded exponentially since 1994, with an estimated 50,000-80,000 individual products currently available. Many DS claim cholesterol or cardiovascular benefits. Overall, well-designed randomized controlled trials (RCTs) with DS are lacking, while studies with favorable results are commonly performed outside of the USA, resulting in inconsistent findings.

Elevated Lp(a): Guidance for Identifying and Managing Patients.

Lipoprotein(a) (Lp(a)) is a unique low-density lipoprotein-like lipoprotein that is considered an independent and causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis. The Lp(a) molecule also contains apolipoprotein A and apolipoprotein B, which collectively promote atherosclerosis, thrombosis, and inflammation. Lp(a) is highly genetic and minimally responsive to nonpharmacological measures.

Characteristics and Outcomes of Patients Receiving a Second Rescue Valve During Transcatheter Aortic Valve Implantation.

Background: Transcatheter aortic valve implantation (TAVI) has become a safe procedure. However, complications occur, including uncommon complications such as valve malposition, which requires the implantation of an additional rescue valve (rescue-AV). The aim was to study the occurrence and outcomes of rescue-AV in a nationwide registry.

Lipid lowering therapy: implications of recent clinical trials.

Recent lipid lowering therapy trials have provided important insights on certain agents while also continuing to expand our understanding of atherosclerotic cardiovascular disease (ASCVD) risk. Findings from current trials include the impact of statin therapy on ASCVD among populations with HIV, the benefit of lowering low-density lipoprotein cholesterol with bempedoic acid among patients considered statin intolerant, the safety and efficacy of inclisiran over a 4-year period, another failed attempt for fibrates to reduce ASCVD risk, which omega-3 fatty to utilize for lowering cardiovascular events, 'n-of-1' trials evaluating statin intolerance, and how low-dose rosuvastatin compared with commonly utilized supplements for lowering lipid parameters. Such data help inform so clinicians can optimize lipid lowering therapy and improve ASCVD outcomes.

Regional assessment of availability for transcatheter aortic valve implantation in Sweden: a long-term observational study.

Background: Transcatheter aortic valve implantation (TAVI) is an increasingly important treatment option for patients with severe aortic stenosis. Its best implementation is debated, as few centres with high volumes are associated with better outcomes, while centralization might lead to an inferior availability of treatment for patients living far away. The aim of this study was to investigate the implementation of TAVI in Sweden with a focus on regional differences in terms of availability, short-term mortality, and waiting times.

Atherosclerotic Cardiovascular Disease in Women: Providing Protection With Lipid-altering Agents.

Purpose: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in women, yet it remains underdiagnosed, undertreated, and understudied in women compared with men. Although estrogen has provided observational evidence of cardioprotection, randomized controlled trials using hormone replacement therapy have generally produced unfavorable results.

Methods: For this narrative review, a literature search was performed using the key words cardiovascular disease, women, and dyslipidemia in PubMed and Google Scholar with no date limitations.

Developing a Healthy Lifestyle Program for Recent Kidney Transplant Recipients.

Introduction: Many kidney transplant recipients experience weight gain in the first year after transplantation.

Research Question: The objective of this research study was to assess the desires of recent kidney transplant patients about the design features of a healthy lifestyle program to counter unnecessary weight gain.

Design: In this descriptive study, recent recipients at 2 transplant centers were invited to participate in an online survey.

Identifying patient perceptions and attitudes regarding statin-associated diabetes mellitus: a mixed-methods study.

The aims of this study were to explore factors that influence initiation and continuation of statin therapy. Mixed-method design employed with 73 patients completing surveys and 14 patients participating in semi-structured interviews. When lower total cholesterol is achieved, patients' views are favorable while views of statin therapy diminish among those with higher total cholesterol values.

Statin-associated muscle symptoms-A review: Individualizing the approach to optimize care.

The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, also known as "statins" are considered first-line pharmacologic therapy for reducing low-density lipoprotein cholesterol (LDL-C). They have been demonstrated efficacy in a variety of patients populations to reduce atherosclerotic cardiovascular disease (ASCVD) risk. Like any pharmacologic therapy, however, they are not without possible adverse effects that can lead to discontinuation, thus leading to a loss of benefit.

New and emerging lipid-lowering therapy.

Statins remain the drugs of choice in patients at risk of or with atherosclerotic cardiovascular disease (ASCVD). Statins have limitations that drive the development of investigational agents to manage dyslipidemias and/or reduce ASCVD risk. There are a few small-molecule drugs that have the potential to mitigate ASCVD risk either alone or in combination with statins.

Effects of Human Presence and Voice on the Behaviour of Shelter Dogs and Cats: A Preliminary Study.

Reading books to shelter animals combining auditory enrichment with human presence is increasingly used although its effects on animal welfare have not yet been investigated. This study compared the behaviour of single-housed shelter dogs and cats during a prerecorded reading condition in the absence or presence of an unfamiliar human (without direct physical contact). Fourteen dogs and twenty-one cats were observed in their enclosure in the two conditions in a counterbalanced order.

Relationship of captive bolt stunning location with basic tissue measurements and exposed cross-sectional brain area in cadaver heads from market pigs.

The objective of this study was to contrast the soft tissue thickness, cranial thickness, total tissue thickness, cross-sectional brain area, and bolt-brain contact from the common frontal application of captive bolt euthanasia with the alternative location behind the ear in cadaver swine heads. Twenty-three cadaver heads from pigs that were approximately 136 kg and 6 mo of age were collected from a regional slaughter establishment following CO stunning and assigned to either the FRONTAL ( = 11) or the CAUDAL TO PINNA ( = 12) application of the captive bolt. The soft tissue thickness was different ( < 0.

The Effect of Domestication and Experience on the Social Interaction of Dogs and Wolves With a Human Companion.

The results of current wolf-dog studies on human-directed behaviors seem to suggest that domestication has acted on dogs' general attitudes and not on specific socio-cognitive skills. A recent hypothesis suggests that domestication may have increased dogs' overall sociability (hypersociability hypothesis). The aim of the present study was to test one aspect of the hypersociability hypothesis, whereby dogs should be more interested in social human contact compared to wolves, and to investigate the relative roles of both domestication and experience on the value that dogs attribute to human social contact.

Comparing patients' prescribed, self-reported, and actual intake of supplemental eicosapentaenoic acid + docosahexaenoic acid.

Background: Dietary fish oil supplements containing the omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are frequently used for cardiovascular benefit. However, several factors may limit the intake of prescribed doses.

Objective: The objective of this study is to compare the prescribed, patient self-reported, and actual intake of supplemental EPA + DHA doses in a lipid-specialty clinic and identify common barriers and influences to therapy.

Preventing infection in shoulder surgery.

Although rare, infection after shoulder surgery can represent a devastating complication. Infection can negatively affect clinical outcomes, and eradication often requires a protracted treatment course. Staphylococcus aureus, Staphylococcus epidermidis, and Cutibacterium acnes are among the most frequently isolated pathogens.

Preoperative Ultrasonography Is Unreliable in Predicting Hamstring Tendon Graft Diameter for ACL Reconstruction.

Background: Hamstring autograft size <8 mm has been shown to be a predictor for failure after anterior cruciate ligament (ACL) reconstruction. The ability to predict graft size preoperatively is helpful in counseling patients about the possible need for graft augmentation.

Purpose: To determine whether preoperative ultrasound (US) measurements of hamstring tendons can predict intraoperative graft diameter during ACL reconstruction.

Proximal Humerus Fracture-Dislocation with Laceration of the Axillary Artery: A Case Report.

Background: Proximal humerus fractures account for approximately 4-6% of all fractures. While the majority of these fractures are treated non-operatively, the amount of fracture displacement, concomitant injuries, and patient factors often result in the need for surgical stabilization. Although concomitant neurovascular injury in the setting of low-energy trauma is rare, injury to the surrounding neurovascular structures have previously been reported.

Variability in Potency Among Commercial Preparations of Berberine.

Berberine is an isoquinoline alkaloid plant extract that is widely available as a dietary supplement in the United States and has demonstrated efficacy in the treatment of type 2 diabetes mellitus and dyslipidemia. Because of its increased use and purported pharmacological properties, potential variations in product quality could pose a barrier to berberine's safety and effectiveness in clinical practice. Thus, this study evaluated the potency of dietary supplements containing berberine available in the U.

Statin-associated muscle symptoms-Managing the highly intolerant.

Musculoskeletal symptoms are the most commonly reported adverse effects associated with statin therapy. Yet, certain data indicate that these symptoms often present in populations with underlying musculoskeletal complaints and are not likely statin related. Switching statins or using lower doses resolves muscle complaints in most patients.

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions.

Shoulder instability is often associated with an impaction fracture of the humeral head, commonly referred to as a "Hill-Sachs lesion." This lesion is present in both anterior and posterior instability. Forty percent to 90% of anterior shoulder dislocations have associated Hill-Sachs lesions, whereas 29% to 86% of posterior shoulder dislocations have reverse Hill-Sachs lesions.

The clinical relevance of omega-3 fatty acids in the management of hypertriglyceridemia.

Hypertriglyceridemia (triglycerides > 150 mg/dL) affects ~25 % of the United States (US) population and is associated with increased cardiovascular risk. Severe hypertriglyceridemia (≥ 500 mg/dL) is also a risk factor for pancreatitis. Three omega-3 fatty acid (OM3FA) prescription formulations are approved in the US for the treatment of adults with severe hypertriglyceridemia: (1) OM3FA ethyl esters (OM3EE), a mixture of OM3FA ethyl esters, primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Lovaza®, Omtryg™, and generics); (2) icosapent ethyl (IPE), EPA ethyl esters (Vascepa®); and (3) omega-3 carboxylic acids (OM3CA), a mixture of OM3FAs in free fatty acid form, primarily EPA, DHA, and docosapentaenoic acid (Epanova®).