Reducing or Discontinuing Insulin or Sulfonylurea When Initiating a Glucagon-like Peptide-1 Agonist.

Background: Hypoglycemia and weight gain are well-known adverse effects of insulin and sulfonylureas in patients with type 2 diabetes. Glucagon-like peptide-1 (GLP-1) agonist monotherapy has a low incidence of hypoglycemia, but when combined with insulin or sulfonylureas, patients have higher rates of hypoglycemia.

Methods: The primary study outcome was to determine the percentage of patients with dose reductions or discontinuation of insulin or a sulfonylurea at baseline, 3, 6, and 12 months.

Muscle-Related Adverse Events Associated With PCSK9 Inhibitors in a Veteran Population.

Background: Statins and PCSK9 inhibitors (PCSK9i) are used to lower low-density lipoprotein cholesterol and reduce cardiovascular events, yet some patients are unable to tolerate statin therapy due to muscle-related adverse events (AEs). The effect of PCSK9i on muscle-related AEs is not well studied, and available data show inconsistent incidence rates.

Methods: The primary study outcome was to determine the percentage of patients who developed muscle-related PCSK9i AEs.

Addressing Competency in Rheumatology Telehealth Care Delivery.

Objective: Telehealth is an essential facet of care delivery for patients with rheumatic diseases. The Association of American Medical College's (AAMC) telehealth competencies (TCs) define the skills required for delivering general telehealth care across the range of clinician experience. In this study, the American College of Rheumatology's (ACR) TCs working group aimed to adapt the AAMC TCs to rheumatology, outlining the skills acquisition unique to rheumatology with a focus on knowledge, skills, and behaviors expected of recent rheumatology fellowship graduates.

Endoscopic versus Percutaneous Biliary Drainage in Palliation of Advanced Malignant Hilar Obstruction: A Meta-Analysis and Systematic Review.

Background. Palliation in advanced unresectable hilar malignancies can be achieved by endoscopic (EBD) or percutaneous transhepatic biliary drainage (PTBD). It is unclear if one approach is superior to the other in this group of patients.

Urine testing for antipsychotics: a pilot trial for a method to determine detection levels.

Objective: The goal of the present study was to demonstrate that the analytical assay of interest can detect antipsychotics in human urine specimens.

Method: Forty inpatients treated with haloperidol, quetiapine, risperidone, or olanzapine were recruited to participate in a one visit study. During the study visit, demographic and clinical information was collected as well as one urine sample that was forwarded to the Ameritox Laboratory and assayed for the presence of antipsychotic medications and/or metabolites.

A meta-analysis of the relative efficacy and toxicity of single daily dosing versus multiple daily dosing of aminoglycosides.

We performed a meta-analysis of the efficacy and toxicity of single daily dosing (SDD) vs. multiple daily dosing of aminoglycosides and summarized the results of the four previously published meta-analyses on this subject. Our analysis showed that the overall clinical response rate favored SDD therapy (mean difference, +3.