Deprescribing in Older Adults With Type 2 Diabetes: Associations With Patients' Perspectives: The Diabetes and Aging Study.

Background: Little is known about how patients' preferences, expectations, and beliefs (jointly referred to as perspectives) influence deprescribing. We evaluated the association of patients' self-reported perspectives with subsequent deprescribing of diabetes medications in older adults with type 2 diabetes.

Methods: Longitudinal cohort study of 1629 pharmacologically treated adults ages 65-100 years with type 2 diabetes who received care at Kaiser Permanente of Northern California (KPNC) and participated in the Diabetes Preferences and Self-Care survey (2019).

Azelastine Nasal Spray in Non-Hospitalized Subjects with Mild COVID-19 Infection: A Randomized Placebo-Controlled, Parallel-Group, Multicentric, Phase II Clinical Trial.

Nasal spray treatments that inhibit the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry into nose and nasopharynx at early stages can be an appropriate approach to stop or delay the progression of the disease. We performed a prospective, randomized, double-blind, placebo-controlled, parallel-group, multicentric, phase II clinical trial comparing the rate of hospitalization due to COVID-19 infection between azelastine 0.1% nasal spray and placebo nasal spray treatment groups.

Bone Structural Parameters as Measured by 3-Dimensional Dual-Energy X-Ray Absorptiometry Are Superior in Black Women and Demonstrate Unique Associations With Prior Fracture Versus White Women.

Objective: Black patients fracture less often than White patients at any given bone mineral density (BMD). This may be related to superior bone structure; however, bone structure is challenging to measure in clinical practice. Advances in 3-dimensional (3D) modeling have allowed for the measurement of trabecular and cortical parameters from dual-energy x-ray absorptiometry (DXA).

An Update on the Fracture Risk Assessment Tool: What Have We Learned over 15+ years?

The Fracture Risk Assessment Tool (FRAX) was launched in 2008 and uses clinical variables to estimate 10-year fracture risk. FRAX has been incorporated into clinical treatment guidelines and is well validated in specific disease states like chronic kidney disease. However, there are risk factors which are not captured by FRAX such as diabetes and falls.

An electronic health record (EHR)-based risk calculator can predict fractures comparably to FRAX: a proof-of-concept study.

Unlabelled: Information in the electronic health record (EHR), such as diagnoses, vital signs, utilization, medications, and laboratory values, may predict fractures well without the need to verbally ascertain risk factors. In our study, as a proof of concept, we developed and internally validated a fracture risk calculator using only information in the EHR.

Purpose: Fracture risk calculators, such as the Fracture Risk Assessment Tool, or FRAX, typically lie outside the clinician workflow.

Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients with Positive Nodes Using Low-Cost Dual Dye Technique: Identifying Factors Associated with Adequate False Negative Rate Threshold.

Background: In this study, we evaluated the feasibility of the sentinel lymph node (SLN) identification rate (SLN-IR) of fluorescein-guided sentinel lymph node biopsy (SLNB) in combination with methylene blue dye (MBD) and factors which can lead to a false negative rate (FNR) threshold of 10%.

Methods: This was a prospective cross-sectional non-randomized validation study in patients with post-neoadjuvant chemotherapy (NACT) clinically node negative axilla who were node positive prior to start of NACT. Patients underwent validation of SLNB using fluorescein (and blue LED light) and MBD.

Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study.

Background: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these.

Method: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022.

Cinnamon: a nutraceutical supplement for the cardiovascular system.

Common therapies for cardiovascular diseases (CVDs) are associated with wide side effects. Thus, herbal medicines have been regarded due to fewer side effects, availability, cultural beliefs, and being cheap. For thousand years, herbal medicine has been used for bacterial infections, colds, coughs, and CVDs.

Willingness to take less medication for type 2 diabetes among older patients: The Diabetes & Aging Study.

Background: To examine the willingness of older patients to take less diabetes medication (de-intensify) and to identify characteristics associated with willingness to de-intensify treatment.

Methods: Survey conducted in 2019 in an age-stratified, random sample of older (65-100 years) adults with diabetes on glucose-lowering medications in the Kaiser Permanente Northern California Diabetes Registry. We classified survey responses to the question: "I would be willing to take less medication for my diabetes" as willing, neutral, or unwilling to de-intensify.

Severe Hypercalcemia Due to Primary Hyperparathyroidism and Heterozygous Pathogenic Variant of CYP24A1.

Pathogenic variants of CYP24A1 are associated with hypercalcemia due to disruptions in the ability of 24-hydroxylase to break down 1,25-dihydroxyvitamin D (1,25-DHVD). A case involving a heterozygous pathogenic variant of CYP24A1 and primary hyperparathyroidism leading to severe hypercalcemia has not been previously reported. A 23-year-old woman presented with fatigue and was found to be hypercalcemic at 13.

Visceral Adipose Tissue is Negatively Associated With Bone Mineral Density in NHANES 2011-2018.

Context: The relationship of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with bone mineral density (BMD) is not well established.

Objective: To examine the associations of VAT and SAT with total body BMD in a large, nationally representative population with a wide range of adiposity.

Methods: We analyzed 10 641 subjects aged 20 to 59 years in National Health and Nutrition Examination Survey 2011-2018 who had undergone total body BMD and had VAT and SAT measured by dual-energy X-ray absorptiometry.

Use of Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitor Remogliflozin and Possibility of Acute Kidney Injury in Type-2 Diabetes.

The major trials, e.g., EMPA-REG OUTCOME, CANVAS, and CREDENCE, showed the renal and cardiovascular benefit of sodium-glucose transport protein 2 (SGLT2) inhibitors.

Cetuximab Concurrent with Radiotherapy in Unresectable, Locally Advanced Squamous Cell Carcinoma of Head and Neck: Real-World Evidence from a Tertiary Care Hospital.

Cetuximab (EGFR-targeted IgG1 monoclonal antibody) has shown to improve the treatment outcomes in head and neck cancer. The evidence on the beneficial outcomes of cetuximab with radiotherapy (RT) in unresectable patients of locally advanced squamous cell carcinoma of head and neck (LA-SCCHN) is limited in real-life practice. The present study evaluated the treatment outcomes of cetuximab concurrent with RT in Indian patients with unresectable LA-SCCHN.

A Prospective Randomised Comparative Study Between Weekly Cisplatin Versus Three Weekly Cisplatin with Radiotherapy in Unresectable Locally Advanced Head and Neck Cancer.

To compare the efficacy, compliance and the complications of weekly cisplatin 40 mg/m2 against the three weekly cisplatin 100 mg/m2 with EBRT(external beam radiotherapy) in unresectable locally advanced head and neck squamous cell carcinoma(LAHNSCC) Study design was Prospective randomized and comparative.85 Patients with histologically proven stage III-IVA LAHNSCC presenting from December 2017 to May 2019 were assigned to concurrent three weekly cisplatin 100 mg/m2 (arm 1) and weekly cisplatin 40 mg/m2 (arm 2) with EBRT. There were 41 patients were in arm 1 and 44 patients in arm 2.

Integration of Consolidation Chemotherapy After Concurrent Chemoradiation in the Treatment of Locally Advanced Uterine Cervical Cancer.

Background: Despite the current standard of concurrent chemoradiation (CCRT), around 30-40% are still dying from locally advanced cervical cancer. Increasing the radiation dose further was not a feasible option, but addition of chemotherapy further was tried due to the different toxicity profiles of it. So, the use of consolidation chemotherapy beyond CCRT has been studied.

Fat Mass Has Negative Effects on Bone, Especially in Men: A Cross-sectional Analysis of NHANES 2011-2018.

Context: The effect of high levels of obesity on bone health are not clear.

Objective: We aimed to examine the associations of body composition and bone mineral density (BMD) in a large, nationally representative population with a wide range of body mass index.

Methods: We analyzed 10 814 subjects aged 20-59 from NHANES 2011-2018 who had total body BMD and body composition data.

BMDs Derived From Total Body DXA are Strongly Correlated With Dedicated Hip and Spine BMD and are Associated With Prior Fractures in NHANES.

Dedicated dual energy X-ray absorptiometry (DXA) bone mineral density (BMD) of the hip and spine are strongly associated with fractures, but it is not clear whether total body (TB) DXA measures correlate with dedicated DXA or relate to fractures. Using National Health and Nutrition Examination Survey (NHANES) data from years 2013-2014 and 2017-2018, we assessed Pearson correlations between dedicated and TB DXA measures. Associations with fractures were examined using self-reported prior fractures or fractures found on vertebral fracture assessment (VFA) using logistic regression models while controlling for age, gender, race/ethnicity, and body mass index.

Diagnosing Gestational Diabetes by a Single-Test Procedure Is a Propitious Step Towards Containing the Epidemic of Diabetes.

In recent years, diabetes has evolved into a non-communicable disease pandemic with data showing that one out of ten adults in the world have diabetes. Among various factors that contribute to this rising trend in diabetes, one factor that is of paramount importance is gestational diabetes mellitus (GDM). Maternal hyperglycemia sets off a vicious cycle that affects not only the mother and her child but also the generations to come.

Negotiating Gestational Diabetes Mellitus in India: A National Approach.

The worldwide epidemic of diabetes mellitus and hyperglycemia in pregnancy (HIP) presents many challenges, some of which are country-specific. To address these specific problems, parochial resolutions are essential. In India, the government, by working in tandem with (a) national groups such as the Diabetes in Pregnancy Study Group of India, and (b) global organizations such as the International Diabetes Federation, has empowered the medical and paramedical staff throughout the country to manage HIP.

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

Background: There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates.

Increased concentration of serum gamma-glutamyl transferase in ischemic stroke patients.

Background: Stroke is responsible for the largest proportion of neurological disorders causing a significant morbidity. Gamma-glutamyl transferase (GGT) enzyme has an active involvement in atherosclerosis through its role in oxidative and inflammatory mechanisms. Recent evidence suggests that serum GGT is related to the risk and prognosis of cerebrovascular diseases.