Manoj J. Mammen, Komal Aryal, Waleed Alhazzani, et al. · (2020) · "Corticosteroids for patients with acute respiratory distress syndrome: a systematic review and meta-analysis of randomized trials" · Polskie Archiwum Medycyny Wewnętrznej · https://doi.org/10.20452/pamw.15239 · cited 61 times

Question: What does the peer-reviewed literature show about "Corticosteroids for patients with acute respiratory distress syndrome: a systematic review and meta-analysis of randomized trials"? Cite a published source.

Answer:
INTRODUCTION: Acute respiratory distress syndrome (ARDS) is a rapidly progressing, inflammatory lung disease with a high mortality rate and no specific pharmacological treatment available. OBJECTIVES: We conducted a systematic review and meta‑analysis on corticosteroid use in ARDS. METHODS: We searched 4 medical literature databases and retained randomized controlled trials on the use of corticosteroids in hospitalized adults with ARDS, which could be found there until February 2020. Two reviewers identified eligible studies, independently extracted data, and evaluated the risk of bias. The authors assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: We included 7 randomized controlled trials involving 851 patients. They showed that corticosteroids reduced all‑cause mortality (risk ratio [RR], 0.75; 95% CI, 0.59-0.95; P = 0.02; moderate certainty) and the duration of mechanical ventilation (mean difference [MD], -4.93 days; 95% CI; -7.81 to -2.06; P <0.001; low certainty), and increased the number of ventilator‑free days (MD, 4.28 days; 95% CI, 2.67-5.88; P <0.001; moderate certainty), as compared with placebo. Corticosteroids also increased the risk of hyperglycemia (RR, 1.12%; 95% CI, 1.01-1.24; P = 0.03; moderate certainty), and the effect on neuromuscular weakness was unclear (RR, 1.3; 95% CI, 0.8-2.11; P = 0.28; low certainty). CONCLUSIONS: These results suggest that systemic corticosteroids may potentially improve mortality, shorten ventilation times, and increase the number of ventilator‑free days in patients with ARDS. However, the studies included different corticosteroid classes and initiated drug administration at different times, as well as used various dosing regimens. Thus, caution in the actual clinical application of these results is recommended.

— Source (peer-reviewed): Manoj J. Mammen, Komal Aryal, Waleed Alhazzani, et al. · (2020) · "Corticosteroids for patients with acute respiratory distress syndrome: a systematic review and meta-analysis of randomized trials" · Polskie Archiwum Medycyny Wewnętrznej · https://doi.org/10.20452/pamw.15239 · cited 61 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Qi Sheng You, Jonathan C.H. Chan, Alex L. K. Ng, et al. · (2019) · "Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study" · Investigative Ophthalmology & Visual Science · https://doi.org/10.1167/iovs.19-28137 · cited 138 times

Question: What does the peer-reviewed literature show about "Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study"? Cite a published source.

Answer:
Purpose: We investigate macular perfusion and the systemic and ocular associations in a population-based setting. Methods: In this cross-sectional study, 2018 adults residing in Hong Kong underwent detailed ophthalmic examinations after consenting to participate. Macular perfusion was measured with optical coherence tomography angiography (OCTA) using the split-spectrum amplitude decorrelation angiography algorithm. The parafoveal flow index and vessel area density were quantified using automated custom-built software. Results: Of the 2018 participants, the OCTA measurements were available for 1940, and 1631 (84.1%) had good quality scans. The right eyes of these 1631 participants (43.1% men) were included for final analysis. Mean age was 49.8 years (range, 18-92 years). Mean global macular vessel density was 47.3% and 55.1% for the superficial and deep retinal layers, respectively. In multivariate analysis, lower superficial vessel density remained significantly associated with lower signal strength index (SSI; P < 0.001, standardized β = 0.607) and male sex (P < 0.001, β = 0.162), and borderline associated with older age (P = 0.09, β = -0.045) and longer axial length (AL; P = 0.09, β = -0.037), while lower deep layer vessel density was significantly associated with lower SSI (P < 0.001, standardized β = 0.667), longer AL (P < 0.001, β = -0.097), and higher creatinine (P < 0.001, β = -0.072). Conclusions: This large population-based study provided normative OCTA data of macular vessel density and demonstrated that a lower superficial retinal vessel density was significantly associated with lower SSI and male sex, while a lower deep layer retinal vessel density was significantly associated with lower SSI, longer AL, and higher level of creatinine. These associations must be considered when interpreting clinical quantitative OCTA data.

— Source (peer-reviewed): Qi Sheng You, Jonathan C.H. Chan, Alex L. K. Ng, et al. · (2019) · "Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study" · Investigative Ophthalmology & Visual Science · https://doi.org/10.1167/iovs.19-28137 · cited 138 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Chen Chen, Wen‐De Zhong, Helin Yang, et al. · (2017) · "On the Performance of MIMO-NOMA-Based Visible Light Communication Systems" · IEEE Photonics Technology Letters · https://doi.org/10.1109/lpt.2017.2785964 · cited 306 times

Question: Summarize the published evidence on "On the Performance of MIMO-NOMA-Based Visible Light Communication Systems" with a citation.

Answer:
In this letter, we apply the non-orthogonal multiple access (NOMA) technique to improve the achievable sum rate of multiple-input multiple-output (MIMO)-based multi-user visible light communication (VLC) systems. To ensure efficient and low-complexity power allocation in indoor MIMO-NOMA-based VLC systems, a normalized gain difference power allocation (NGDPA) method is first proposed by exploiting users' channel conditions. We investigate the performance of an indoor 2×2 MIMO-NOMA-based multi-user VLC system through numerical simulations. The obtained results show that the achievable sum rate of the 2×2 MIMO-VLC system can be significantly improved by employing NOMA with the proposed NGDPA method. It is demonstrated that NOMA with NGDPA achieves a sum rate improvement of up to 29.1% compared with NOMA with the gain ratio power allocation method in the 2 × 2 MIMO-VLC system with three users.

— Source (peer-reviewed): Chen Chen, Wen‐De Zhong, Helin Yang, et al. · (2017) · "On the Performance of MIMO-NOMA-Based Visible Light Communication Systems" · IEEE Photonics Technology Letters · https://doi.org/10.1109/lpt.2017.2785964 · cited 306 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Marco Viceconti, Adriano Henney, Edwin Morley‐Fletcher · (2016) · "In silico clinical trials: how computer simulation will transform the biomedical industry" · International Journal of Clinical Trials · https://doi.org/10.18203/2349-3259.ijct20161408 · cited 254 times

Question: What does the peer-reviewed literature show about "In silico clinical trials: how computer simulation will transform the biomedical industry"? Cite a published source.

Answer:
The term ‘in silico clinical trials indicates the use of individualised computer simulation in the development or regulatory evaluation of a medicinal product, medical device, or medical intervention. This review article summarises the research and technological roadmap developed by the Avicenna Support Action during an 18 month consensus process that involved 577 international experts from academia, the biomedical industry, the simulation industry, the regulatory world, etc. The roadmap documents early examples of in silico clinical trials, identifies relevant use cases for in silico clinical trial technologies over the entire development and assessment cycle for both pharmaceuticals and medical devices, identifies open challenges and barriers to a wider adoption and puts forward 36 recommendations for all relevant stakeholders to consider.

— Source (peer-reviewed): Marco Viceconti, Adriano Henney, Edwin Morley‐Fletcher · (2016) · "In silico clinical trials: how computer simulation will transform the biomedical industry" · International Journal of Clinical Trials · https://doi.org/10.18203/2349-3259.ijct20161408 · cited 254 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Massar Omar, J. Steen Jensen, Mulham Ali, et al. · (2021) · "Associations of Empagliflozin With Left Ventricular Volumes, Mass, and Function in Patients With Heart Failure and Reduced Ejection Fraction" · JAMA Cardiology · https://doi.org/10.1001/jamacardio.2020.6827 · cited 181 times

Question: What does the peer-reviewed literature show about "Associations of Empagliflozin With Left Ventricular Volumes, Mass, and Function in Patients With Heart Failure and Reduced Ejection Fraction"? Cite a published source.

Answer:
Importance: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes in patients with heart failure and a reduced ejection fraction (HFrEF). The association with cardiac remodeling has not been investigated. Objective: To investigate the outcome of the SGLT2i empagliflozin, compared with placebo, on cardiac remodeling in patients with HFrEF. Design, Setting, and Participants: This exploratory post hoc analysis included participants with stable HFrEF and ejection fractions of 40% or less, who were randomly enrolled in an investigator-initiated, multicenter, double-blind, placebo-controlled randomized clinical trial in Denmark. Enrollment commenced on June 29, 2017, and continued through September 10, 2019, with the last participant follow-up on December 20, 2019. Interventions: Randomization (1:1) to empagliflozin (10 mg once daily) or matching placebo in addition to recommended heart failure therapy for 12 weeks. Main Outcomes and Measures: Efficacy measures were changes from baseline to week 12 in left ventricular end-systolic and end-diastolic volume indexes, left atrial volume index, and left ventricular ejection fraction adjusted for age, sex, type 2 diabetes, and atrial fibrillation. Secondary efficacy measures included changes in left ventricular mass index, global longitudinal strain, and relative wall thickness. Results: A total of 190 patients were randomized (95 each receiving empagliflozin and placebo), with a mean (SD) age of 64 (11) years; 162 were men (85.3%), 97 (51.1%) had ischemic HFrEF, 24 (12.6%) had type 2 diabetes, and the mean (SD) latest recorded left ventricular ejection fraction was 29% (8%). Of the 190, 186 completed the study. Empagliflozin significantly reduced left ventricular end-systolic volume index (-4.3 [95% CI, -8.5 to -0.1] mL/m2; P = .04), left ventricular end-diastolic volume index (-5.5 [95% CI, -10.6 to -0.4] mL/m2; P = .03), and left atrial volume index (-2.5 [95% CI, -4.8 to -0.1] mL/m2; P = .04) compared with placebo at 12 weeks' follow-up, with no change in left ventricular ejection fraction (1.2% [95% CI, -1.2% to 3.6%]; P = .32). These findings were consistent across subgroups. Of secondary efficacy measures, left ventricular mass index was significantly reduced by empagliflozin (-9.0 [95% CI, -17.2 to -0.8] g/m2; P = .03). Conclusions and Relevance: In this small, randomized, short-term study, empagliflozin was associated with modest reductions in left ventricular and left atrial volumes with no association with ejection fraction. Effects beyond 12 weeks of SGLT2i use require further study. Trial Registration: ClinicalTrials.gov Identifier: NCT03198585.

— Source (peer-reviewed): Massar Omar, J. Steen Jensen, Mulham Ali, et al. · (2021) · "Associations of Empagliflozin With Left Ventricular Volumes, Mass, and Function in Patients With Heart Failure and Reduced Ejection Fraction" · JAMA Cardiology · https://doi.org/10.1001/jamacardio.2020.6827 · cited 181 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Jan Biegus, Adriaan A. Voors, Sean P. Collins, et al. · (2022) · "Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial" · European Heart Journal · https://doi.org/10.1093/eurheartj/ehac530 · cited 206 times

Question: Summarize the published evidence on "Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial" with a citation.

Answer:
AIMS: Effective and safe decongestion remains a major goal for optimal management of patients with acute heart failure (AHF). The effects of the sodium-glucose cotransporter 2 inhibitor empagliflozin on decongestion-related endpoints in the EMPULSE trial (NCT0415775) were evaluated. METHODS AND RESULTS: A total of 530 patients hospitalized for AHF were randomized 1:1 to either empagliflozin 10 mg once daily or placebo for 90 days. The outcomes investigated were: weight loss (WL), WL adjusted for mean daily loop diuretic dose (WL-adjusted), area under the curve of change from baseline in N-terminal pro-B-type natriuretic peptide levels, hemoconcentration, and clinical congestion score after 15, 30, and 90 days of treatment. Compared with placebo, patients treated with empagliflozin demonstrated significantly greater reductions in all studied markers of decongestion at all time-points, adjusted mean differences (95% confidence interval) at Days 15, 30, and 90 were: for WL -1.97 (-2.86, -1.08), -1.74 (-2.73, -0.74); -1.53 (-2.75, -0.31) kg; for WL-adjusted: -2.31 (-3.77, -0.85), -2.79 (-5.03, -0.54), -3.18 (-6.08, -0.28) kg/40 mg furosemide i.v. or equivalent; respectively (all P < 0.05). Greater WL at Day 15 (i.e. above the median WL in the entire population) was associated with significantly higher probability for clinical benefit at Day 90 (hierarchical composite of all-cause death, heart failure events, and a 5-point or greater difference in Kansas City Cardiomyopathy Questionnaire total symptom score change from baseline to 90 days) with the win ratio of 1.75 (95% confidence interval 1.37, 2.23; P < 0.0001). CONCLUSION: Initiation of empagliflozin in patients hospitalized for AHF resulted in an early, effective and sustained decongestion which was associated with clinical benefit at Day 90.

— Source (peer-reviewed): Jan Biegus, Adriaan A. Voors, Sean P. Collins, et al. · (2022) · "Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial" · European Heart Journal · https://doi.org/10.1093/eurheartj/ehac530 · cited 206 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Chenguang Li, Jie Zhang, Mei Xue, et al. · (2019) · "SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart" · Cardiovascular Diabetology · https://doi.org/10.1186/s12933-019-0816-2 · cited 581 times

Question: What does the peer-reviewed literature show about "SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart"? Cite a published source.

Answer:
BACKGROUND: Hyperglycaemia associated with myocardial oxidative stress and fibrosis is the main cause of diabetic cardiomyopathy. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor has recently been reported to improve glycaemic control in patients with type 2 diabetes in an insulin-independent manner. The aim of this study was to investigate the effect of empagliflozin on myocardium injury and the potential mechanism in type 2 diabetic KK-Ay mice. METHODS: Thirty diabetic KK-Ay mice were administered empagliflozin (10 mg/kg/day) by oral gavage daily for 8 weeks. After 8 weeks, heart structure and function were evaluated by echocardiography. Oxidants and antioxidants were measured and cardiac fibrosis was analysed using immunohistochemistry, Masson's trichrome stain and Western blot. RESULTS: Results showed that empagliflozin improved diabetic myocardial structure and function, decreased myocardial oxidative stress and ameliorated myocardial fibrosis. Further study indicated that empagliflozin suppressed oxidative stress and fibrosis through inhibition of the transforming growth factor β/Smad pathway and activation of Nrf2/ARE signaling. CONCLUSIONS: Glycaemic control with empagliflozin significantly ameliorated myocardial oxidative stress injury and cardiac fibrosis in diabetic mice. Taken together, these results indicate that the empagliflozin is a promising agent for the prevention and treatment of diabetic cardiomyopathy.

— Source (peer-reviewed): Chenguang Li, Jie Zhang, Mei Xue, et al. · (2019) · "SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart" · Cardiovascular Diabetology · https://doi.org/10.1186/s12933-019-0816-2 · cited 581 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


ACUTE CENTRAL SEROUS CHORIORETINOPATHY

Alejandra Daruich, Alexandre Matet, Laetitia Marchionno, et al. · (2017) · "ACUTE CENTRAL SEROUS CHORIORETINOPATHY" · Retina · https://doi.org/10.1097/iae.0000000000001443 · cited 143 times

Question: Summarize the published evidence on "ACUTE CENTRAL SEROUS CHORIORETINOPATHY" with a citation.

Answer:
PURPOSE: To evaluate the influence of clinical and multimodal imaging parameters on the duration of acute central serous chorioretinopathy (CSCR) episodes. METHODS: Consecutive patients with first, treatment-naïve central serous chorioretinopathy episodes presenting within 20 days of symptoms onset were prospectively included. They were reevaluated 15 days to 20 days later, followed by monthly evaluation for 6 months. Subfoveal choroidal thickness (SFCT), fluorescein leakage intensity on fluorescein angiography, elevation of retinal pigment epithelium (RPE) lesions at leakage sites, focal/multifocal pattern of indocyanine green angiography (ICGA) at baseline, time-dependent pattern of subretinal fluid (SRF) resorption on OCT using volume segmentation, history of corticosteroid intake and mean blood pressure were evaluated using univariate (Log rank test) and multivariate (Cox proportional hazard regression) survival analysis. RESULTS: Thirty-one patients were included (26 men, 5 women, mean age: 40.0 ± 8.9 years, range: 24-58), of which 26 (84%) had episode resolution by 6 months. Using univariate analysis, episode duration was longer in cases with subfoveal choroidal thickness ≥500 μm (P = 0.0002), retinal pigment epithelium elevation at leakage sites ≥50 μm (P = 0.033), and a peak in subretinal fluid observed during follow-up (P = 0.013), and there was a near-significant association of intense fluorescein leakage (P = 0.074) with longer episodes. Using multivariate analysis, subfoveal choroidal thickness ≥500 μm (P = 0.017), retinal pigment epithelium elevation at leakage sites ≥50 μm (P = 0.010) and patient age ≥40 years (P = 0.010) were significantly and independently associated to longer episodes. Indocyanine green angiography pattern, corticosteroid intake, and blood pressure did not influence episode duration. CONCLUSION: Older age, higher subfoveal choroidal thickness, and higher degree of retinal pigment epithelium alteration at leakage sites are independent factors of longer acute central serous chorioretinopathy episodes.

— Source (peer-reviewed): Alejandra Daruich, Alexandre Matet, Laetitia Marchionno, et al. · (2017) · "ACUTE CENTRAL SEROUS CHORIORETINOPATHY" · Retina · https://doi.org/10.1097/iae.0000000000001443 · cited 143 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Roberto Ferraresi, Giovanni Mauri, Fabrizio Losurdo, et al. · (2018) · "BAD transmission and SAD distribution: a new scenario for critical limb ischemia" · The Journal of Cardiovascular Surgery · https://doi.org/10.23736/s0021-9509.18.10572-6 · cited 85 times

Question: Summarize the published evidence on "BAD transmission and SAD distribution: a new scenario for critical limb ischemia" with a citation.

Answer:
BACKGROUND: Most of the studies on peripheral artery disease (PAD) focused on above-the-ankle artery disease, while less is known about foot artery disease. We hypothesize a scenario were two different diseases can be present in PAD patients, big artery disease (BAD) and small artery disease (SAD), overlapping at the foot level; the aim of this study is to evaluate their prevalence and their correlation with risk factors and critical limb ischemia (CLI) in a large cohort of patients with symptomatic PAD. METHODS: We retrospectively reviewed 1915 limbs of 1613 patients (502 females, mean age 72.4±10.8 years) who underwent angiography between September 2009 and November 2013. Age, sex, diabetes, smoke history, high blood pressure, dialysis and BMI were considered as risk factors. Logistic regression was performed to test the association of arterial lesions patterns and CLI, and to evaluate the association between risk factors and lesion localization. RESULTS: SAD was present in 414 patients (25.2%). Patients with disease of any of plantar, dorsalis pedis arteries and SAD faced higher risk of CLI (OR=13.25, 95% CI: 1.69-104.16). SAD was associated with diabetes and dialysis (both: OR=4.85; dialysis only: OR=3.60; diabetes only: OR=1.70; none: reference OR; P<0.01), weight (underweight: OR=1.10; normal: reference OR; overweight: OR=0.81; obese: OR=0.60; P=0.03), while women and tobacco smokers were less likely to have SAD (women: OR=0.68; P<0.01; tobacco use: OR=0.54; P<0.01). CONCLUSIONS: SAD was strongly and independently associated with CLI, diabetes and dialysis. Thus, SAD should be regarded as a leading actor in CLI.

— Source (peer-reviewed): Roberto Ferraresi, Giovanni Mauri, Fabrizio Losurdo, et al. · (2018) · "BAD transmission and SAD distribution: a new scenario for critical limb ischemia" · The Journal of Cardiovascular Surgery · https://doi.org/10.23736/s0021-9509.18.10572-6 · cited 85 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Peige Song, Jiawen Wang, Kajo Bućan, et al. · (2017) · "National and subnational prevalence and burden of glaucoma in China: A systematic analysis" · Journal of Global Health · https://doi.org/10.7189/jogh.07.020705 · cited 157 times

Question: What does the peer-reviewed literature show about "National and subnational prevalence and burden of glaucoma in China: A systematic analysis"? Cite a published source.

Answer:
BACKGROUND: Glaucoma, the second leading cause of blindness, affects approximately 64.3 million individuals worldwide. In China, demographic ageing is in rapid progress. Yet detailed and up-to-date estimates of the scale of glaucoma are rare. We aimed to quantify and understand the prevalence and burden of glaucoma in China from 1990 to 2015, with projections until 2050. METHODS: For this systematic review and meta-analysis, we searched China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase and Medline using comprehensive search strategies to identify all relevant articles that have reported the prevalence of glaucoma in the general Chinese population. We used a multilevel mixed-effect meta-regression to estimate the prevalence rates of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and a random-effects meta-analysis to pool the overall prevalence of secondary glaucoma. United Nations population data were used to estimate and project the number of people with glaucoma from 1990 to 2050. Univariable and multivariable meta-regressions were conducted to assess the association between the prevalence of POAG and PACG and relevant demographic and geographic factors. The national burden of POAG and PACG in the years 2000 and 2010 were distributed to six geographic regions accordingly. RESULTS: From 1990 to 2015, the prevalence of all glaucoma ranged from 2.59% (95% CI = 1.96-3.49) to 2.58% (95% CI = 1.94-3.47). For different subtypes of glaucoma, the overall prevalence of POAG ranged from 1.03% (95% CI = 0.67-1.58) in 1990 to 1.02% (95% CI = 0.67-1.57) in 2015, PACG from 1.41% (95% CI = 1.18-1.68) to 1.40% (95% CI = 1.17-1.68). The overall prevalence of secondary glaucoma was 0.15% (95% CI = 0.10-0.23) during this period. The number of people with all glaucoma in China was 5.92 million (95% CI = 4.47-7.97) in 1990, and 13.12 million (95% CI = 9.88-17.68) in 2015. This increasing trend was also witnessed in different subtypes of glaucoma. The number of people affected by POAG increased from 2.35 million (95% CI = 1.54-3.60) in 1990 to 5.22 million (95% CI = 3.40-7.98) in 2015, PACG from 3.22 million (95% CI = 2.70-3.84) to 7.14 million (95% CI = 5.97-8.53), and secondary glaucoma from 0.34 million (95% CI = 0.23-0.53) to 0.76 million (95% CI = 0.51-1.17). In 2015, more than half (54.42%) of the glaucoma cases were PACG, followed by POAG (39.79%) and secondary glaucoma (5.79%). By 2050, the number of all glaucoma cases in China will be 25.16 million (95% CI = 18.96-33.86). In the multivariable meta-regressions, the odds ratio (OR) for each decade's increase in age was 1.43 (95% CI = 1.33-1.55) for POAG, and 1.65 (95% CI = 1.51-1.80) for PACG; males were more likely to have POAG (OR 1.36, 95% CI = 1.17-1.59), but less likely to have PACG (OR 0.53, 95% CI = 0.46-0.60) compared with females. After adjustment of age and gender, people living in urban areas were more likely to have POAG compared with those in rural areas (OR 1.54, 95% CI = 1.02-2.35). People in Northeast China were at a higher risk (OR 1.77, 95% CI = 1.07-2.94) of having PACG than people in East China. Among the six regions, East China owed the most POAG and PACG cases, whereas Northwest China owed the least. CONCLUSIONS: This systematic review and meta-analysis suggests a substantial burden of glaucoma in China, with great variances among the different age groups, genders, settings and geographic regions. With the dramatic ageing trend in the next three decades, the prevalence and burden of glaucoma will continue to increase. More elaborate epidemiological studies are needed to optimise public health strategies for mitigating this important health problem.

— Source (peer-reviewed): Peige Song, Jiawen Wang, Kajo Bućan, et al. · (2017) · "National and subnational prevalence and burden of glaucoma in China: A systematic analysis" · Journal of Global Health · https://doi.org/10.7189/jogh.07.020705 · cited 157 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Judith Gerards, Daniel Heinrich, Christian Adolf, et al. · (2019) · "Impaired Glucose Metabolism in Primary Aldosteronism Is Associated With Cortisol Cosecretion" · The Journal of Clinical Endocrinology & Metabolism · https://doi.org/10.1210/jc.2019-00299 · cited 107 times

Question: What does the peer-reviewed literature show about "Impaired Glucose Metabolism in Primary Aldosteronism Is Associated With Cortisol Cosecretion"? Cite a published source.

Answer:
CONTEXT: Primary aldosteronism (PA) is associated with higher cardiovascular morbidity and metabolic risks. Recent studies report glucocorticoid cosecretion as a relevant phenotype of PA, which could contribute to associated risks, including type 2 diabetes mellitus (T2DM). The relationship between autonomous cortisol secretion (ACS) and glucose metabolism in PA has not been investigated. OBJECTIVE: To evaluate the prevalence of impaired glucose homeostasis in patients with PA according to cortisol cosecretion. DESIGN: We performed oral glucose tolerance tests (OGTTs) and complete testing for hypercortisolism [1-mg dexamethasone suppression test (DST), late-night salivary cortisol, 24-hour urinary free cortisol] in 161 newly diagnosed patients with PA of the German Conn Registry. Seventy-six of 161 patients were reevaluated at follow-up. We compared our results to a population-based sample from the Cooperative Health Research in the Region of Augsburg (KORA)-F4 study matched to the participants with PA (3:1) by sex, age, and body mass index. RESULTS: At the time of diagnosis, 125 patients (77.6%) had a pathological response in at least one of the Cushing screening tests; T2DM was diagnosed in 6.4% of these 125 cases. Patients with a pathological DST exhibited significantly higher 2-hour plasma glucose in OGTTs and were significantly more often diagnosed with T2DM than were patients with a normal DST (20% vs 0.8%, P < 0.0001) and matched controls from the KORA study (20.6% vs 5.9%, P = 0.022). Patients with PA without ACS tended to have higher homeostatic model assessment of insulin resistance levels than did KORA control subjects (P = 0.05). CONCLUSION: ACS appears frequently in patients with PA and is associated with impaired glucose metabolism, which could increase the risk of T2DM. PA itself seems to enhance insulin resistance.

— Source (peer-reviewed): Judith Gerards, Daniel Heinrich, Christian Adolf, et al. · (2019) · "Impaired Glucose Metabolism in Primary Aldosteronism Is Associated With Cortisol Cosecretion" · The Journal of Clinical Endocrinology & Metabolism · https://doi.org/10.1210/jc.2019-00299 · cited 107 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Hilal Maradit Kremers, Macaulay Nwojo, Jeanine E. Ransom, et al. · (2015) · "Trends in the Epidemiology of Osteomyelitis" · Journal of Bone and Joint Surgery · https://doi.org/10.2106/jbjs.n.01350 · cited 453 times

Question: What does the peer-reviewed literature show about "Trends in the Epidemiology of Osteomyelitis"? Cite a published source.

Answer:
BACKGROUND: The epidemiology of osteomyelitis in the United States is largely unknown. The purpose of this study was to determine long-term secular trends in the incidence of osteomyelitis in a population-based setting. METHODS: The study population comprised 760 incident cases of osteomyelitis first diagnosed between January 1, 1969, and December 31, 2009, among residents of Olmsted County, Minnesota. The complete medical records for each potential subject were reviewed to confirm the osteomyelitis diagnosis and to extract details on anatomical sites, infecting organisms, etiological risk factors, and outcomes. RESULTS: The overall age and sex-adjusted annual incidence of osteomyelitis was 21.8 cases per 100,000 person-years. The annual incidence was higher for men than for women and increased with age (p < 0.001). Rates increased with the calendar year (p < 0.001) from 11.4 cases per 100,000 person-years in the period from 1969 to 1979 to 24.4 per 100,000 person-years in the period from 2000 to 2009. The incidence remained relatively stable among children and young adults but almost tripled among individuals older than sixty years; this was partly driven by a significant increase in diabetes-related osteomyelitis from 2.3 cases per 100,000 person-years in the period from 1969 to 1979 to 7.6 cases per 100,000 person-years in the period from 2000 to 2009 (p < 0.001). Forty-four percent of cases involved Staphylococcus aureus infections. CONCLUSIONS: The reasons for the increase in osteomyelitis between 1969 and 2009 are unclear but could comprise a variety of factors, including changes in diagnosing patterns or increases in the prevalence of risk factors (e.g., diabetes) in this population.

— Source (peer-reviewed): Hilal Maradit Kremers, Macaulay Nwojo, Jeanine E. Ransom, et al. · (2015) · "Trends in the Epidemiology of Osteomyelitis" · Journal of Bone and Joint Surgery · https://doi.org/10.2106/jbjs.n.01350 · cited 453 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Jost B. Jonas, Chui Ming Gemmy Cheung, Songhomitra Panda‐Jonas · (2017) · "Updates on the Epidemiology of Age-Related Macular Degeneration" · Asia-Pacific Journal of Ophthalmology · https://doi.org/10.22608/apo.2017251 · cited 269 times

Question: What does the peer-reviewed literature show about "Updates on the Epidemiology of Age-Related Macular Degeneration"? Cite a published source.

Answer:
This meta-analysis reports on current estimates of the prevalence of age-related macular degeneration (AMD) based on a review of recent meta-analyses and literature research. Within an age of 45-85 years, global prevalences of any AMD, early AMD, and late AMD were 8.7% [95% credible interval (CrI), 4.3‒17.4], 8.0% (95% CrI, 4.0‒15.5), and 0.4% (95% CrI, 0.2-0.8). Early AMD was more common in individuals of European ancestry (11.2%) than in Asians (6.8%), whereas prevalence of late AMD did not differ significantly. AMD of any type was less common in individuals of African ancestry. The number of individuals with AMD was estimated to be 196 million (95% CrI, 140‒261) in 2020 and 288 million (95% CrI, 205‒399) in 2040. The worldwide number of persons blind (presenting visual acuity < 3/60) or with moderate to severe vision impairment (MSVI; presenting visual acuity < 6/18 to 3/60 inclusive) due to macular disease in 2010 was 2.1 million [95% uncertainty interval (UI), 1.9‒2.7] individuals out of 32.4 million individuals blind and 6.0 million (95% UI, 5.2‒8.1) persons out of 191 million people with MSVI. Age-standardized prevalence of macular diseases as cause of blindness in adults aged 50+ years worldwide decreased from 0.2% (95% UI, 0.2‒0.2) in 1990 to 0.1% (95% UI, 0.1‒0.2) in 2010; as cause for MSVI, it remained mostly unchanged (1990: 0.4%; 95% UI, 0.3‒0.5; 2010: 0.4%; 95% UI, 0.4‒0.6), with no significant sex difference. In 2015, AMD was the fourth most common cause of blindness globally (in approximately 5.8% of blind individuals) and third most common cause for MSVI (3.9%). These data show the globally increasing importance of AMD.

— Source (peer-reviewed): Jost B. Jonas, Chui Ming Gemmy Cheung, Songhomitra Panda‐Jonas · (2017) · "Updates on the Epidemiology of Age-Related Macular Degeneration" · Asia-Pacific Journal of Ophthalmology · https://doi.org/10.22608/apo.2017251 · cited 269 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Xianglong Zeng, Haiquan Chen, Yuan Luo, et al. · (2019) · "Automated Diabetic Retinopathy Detection Based on Binocular Siamese-Like Convolutional Neural Network" · IEEE Access · https://doi.org/10.1109/access.2019.2903171 · cited 284 times

Question: What does the peer-reviewed literature show about "Automated Diabetic Retinopathy Detection Based on Binocular Siamese-Like Convolutional Neural Network"? Cite a published source.

Answer:
Diabetic retinopathy (DR) is an important cause of blindness worldwide. However, DR is hard to be detected in the early stages, and the diagnostic procedure can be time-consuming even for the experienced experts. Therefore, a computer-aided diagnosis method based on deep learning algorithms is proposed to automatedly diagnose the referable diabetic retinopathy by classifying color retinal fundus photographs into two grades. In this paper, a novel convolutional neural network model with the Siamese-like architecture is trained with a transfer learning technique. Different from the previous works, the proposed model accepts binocular fundus images as inputs and learns their correlation to help to make a prediction. In the case with a training set of only 28 104 images and a test set of 7024 images, an area under the receiver operating curve of 0.951 is obtained by the proposed binocular model, which is 0.011 higher than that obtained by the existing monocular model. To further verify the effectiveness of the binocular design, a binocular model for five-class DR detection is also trained and evaluated on a 10% validation set. The result shows that it achieves a kappa score of 0.829 which is higher than that of the existing non-ensemble model.

— Source (peer-reviewed): Xianglong Zeng, Haiquan Chen, Yuan Luo, et al. · (2019) · "Automated Diabetic Retinopathy Detection Based on Binocular Siamese-Like Convolutional Neural Network" · IEEE Access · https://doi.org/10.1109/access.2019.2903171 · cited 284 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Guihua Zhang, Haoyu Chen, Weiqi Chen, et al. · (2017) · "Prevalence and risk factors for diabetic retinopathy in China: a multi-hospital-based cross-sectional study" · British Journal of Ophthalmology · https://doi.org/10.1136/bjophthalmol-2017-310316 · cited 151 times

Question: Summarize the published evidence on "Prevalence and risk factors for diabetic retinopathy in China: a multi-hospital-based cross-sectional study" with a citation.

Answer:
PURPOSE: To determine the prevalence and risk factors for diabetic retinopathy (DR) and sight-threatening diabetic retinopathy (STDR) in a multi-hospital-based DR screening programme among patients with diabetes in China, the Lifeline Express Diabetic Retinopathy Screening Program. METHODS: Patients with diabetes in eight hospitals across mainland China (both southern and northern) from January 2014 to July 2016 were recruited in this programme. All participants underwent a standardised interview and examinations and received digital fundus photography. DR severity was graded from retinal fundus photographs by retina specialists in the reading centre of Joint Shantou International Eye Center, according to the grading standards of the English National Screening Programme. STDR was defined as the presence of preproliferative DR (R2), proliferative DR (R3) and/or maculopathy (M1). RESULTS: 16 305 patients with diabetes were screened for DR in total. Fundus photographs were gradable for 15 078 patients (92.5%). The age-gender-standardised prevalence of any DR and STDR was 27.9% (95% CI, 27.2% to 28.6%) and 12.6% (95% CI, 12.1% to 13.1%), respectively. In the multiple logistic regression analysis, younger age (OR, 0.967), longer duration of diabetes (OR, 1.093), higher haemoglobin A1c (OR, 1.115), higher fasting plasma glucose (OR, 1.074), higher systolic blood pressure (OR, 1.014), faster heart rate (OR, 1.010), higher low-density lipoprotein (OR, 1.149), lower triglycerides (OR, 0.975), higher blood urea nitrogen (BUN) (OR, 1.012) and elevated serum creatinine level (OR, 1.003) were associated with the presence of DR. Similar risk factors, except for BUN and triglycerides, were found for STDR. CONCLUSIONS: The prevalence of DR and STDR in diabetes was 27.9% and 12.6%, respectively in this multi-hospital-based population across China. Compared with Western population with diabetes, similar risk factors for DR and STDR were found in Chinese patients with diabetes.

— Source (peer-reviewed): Guihua Zhang, Haoyu Chen, Weiqi Chen, et al. · (2017) · "Prevalence and risk factors for diabetic retinopathy in China: a multi-hospital-based cross-sectional study" · British Journal of Ophthalmology · https://doi.org/10.1136/bjophthalmol-2017-310316 · cited 151 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Carla A. Green, Bobbi Jo H. Yarborough, Michael C. Leo, et al. · (2014) · "The STRIDE Weight Loss and Lifestyle Intervention for Individuals Taking Antipsychotic Medications: A Randomized Trial" · American Journal of Psychiatry · https://doi.org/10.1176/appi.ajp.2014.14020173 · cited 213 times

Question: What does the peer-reviewed literature show about "The STRIDE Weight Loss and Lifestyle Intervention for Individuals Taking Antipsychotic Medications: A Randomized Trial"? Cite a published source.

Answer:
OBJECTIVES: The STRIDE study assessed whether a lifestyle intervention, tailored for individuals with serious mental illnesses, reduced weight and diabetes risk. The authors hypothesized that the STRIDE intervention would be more effective than usual care in reducing weight and improving glucose metabolism. METHOD: The study design was a multisite, parallel two-arm randomized controlled trial in community settings and an integrated health plan. Participants who met inclusion criteria were ≥18 years old, were taking antipsychotic agents for ≥30 days, and had a body mass index ≥27. Exclusions were significant cognitive impairment, pregnancy/breastfeeding, recent psychiatric hospitalization, bariatric surgery, cancer, heart attack, or stroke. The intervention emphasized moderate caloric reduction, the DASH (Dietary Approaches to Stop Hypertension) diet, and physical activity. Blinded staff collected data at baseline, 6 months, and 12 months. RESULTS: Participants (men, N=56; women, N=144; mean age=47.2 years [SD=10.6]) were randomly assigned to usual care (N=96) or a 6-month weekly group intervention plus six monthly maintenance sessions (N=104). A total of 181 participants (90.5%) completed 6-month assessments, and 170 (85%) completed 12-month assessments, without differential attrition. Participants attended 14.5 of 24 sessions over 6 months. Intent-to-treat analyses revealed that intervention participants lost 4.4 kg more than control participants from baseline to 6 months (95% CI=-6.96 kg to -1.78 kg) and 2.6 kg more than control participants from baseline to 12 months (95% CI=-5.14 kg to -0.07 kg). At 12 months, fasting glucose levels in the control group had increased from 106.0 mg/dL to 109.5 mg/dL and decreased in the intervention group from 106.3 mg/dL to 100.4 mg/dL. No serious adverse events were study-related; medical hospitalizations were reduced in the intervention group (6.7%) compared with the control group (18.8%). CONCLUSIONS: Individuals taking antipsychotic medications can lose weight and improve fasting glucose levels. Increasing reach of the intervention is an important future step.

— Source (peer-reviewed): Carla A. Green, Bobbi Jo H. Yarborough, Michael C. Leo, et al. · (2014) · "The STRIDE Weight Loss and Lifestyle Intervention for Individuals Taking Antipsychotic Medications: A Randomized Trial" · American Journal of Psychiatry · https://doi.org/10.1176/appi.ajp.2014.14020173 · cited 213 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Kristy M. Heppner, Melissa A. Kirigiti, Anna Secher, et al. · (2014) · "Expression and Distribution of Glucagon-Like Peptide-1 Receptor mRNA, Protein and Binding in the Male Nonhuman Primate (<i>Macaca mulatta</i>) Brain" · Endocrinology · https://doi.org/10.1210/en.2014-1675 · cited 192 times

Question: Summarize the published evidence on "Expression and Distribution of Glucagon-Like Peptide-1 Receptor mRNA, Protein and Binding in the Male Nonhuman Primate (<i>Macaca…" with a citation.

Answer:
Glucagon-like peptide-1 (GLP-1) is released from endocrine L-cells lining the gut in response to food ingestion. However, GLP-1 is also produced in the nucleus of the solitary tract, where it acts as an anorectic neurotransmitter and key regulator of many autonomic and neuroendocrine functions. The expression and projections of GLP-1-producing neurons is highly conserved between rodent and primate brain, although a few key differences have been identified. The GLP-1 receptor (GLP-1R) has been mapped in the rodent brain, but no studies have described the distribution of GLP-1Rs in the nonhuman primate central nervous system. Here, we characterized the distribution of GLP-1R mRNA and protein in the adult macaque brain using in situ hybridization, radioligand receptor autoradiography, and immunohistochemistry with a primate specific GLP-1R antibody. Immunohistochemistry demonstrated that the GLP-1R is localized to cell bodies and fiber terminals in a very selective distribution throughout the brain. Consistent with the functional role of the GLP-1R system, we find the highest concentration of GLP-1R-immunoreactivity present in select hypothalamic and brainstem regions that regulate feeding, including the paraventricular and arcuate hypothalamic nuclei, as well as the area postrema, nucleus of the solitary tract, and dorsal motor nucleus of the vagus. Together, our data demonstrate that GLP-1R distribution is highly conserved between rodent and primate, although a few key species differences were identified, including the amygdala, where GLP-1R expression is much higher in primate than in rodent.

— Source (peer-reviewed): Kristy M. Heppner, Melissa A. Kirigiti, Anna Secher, et al. · (2014) · "Expression and Distribution of Glucagon-Like Peptide-1 Receptor mRNA, Protein and Binding in the Male Nonhuman Primate (<i>Macaca mulatta</i>) Brain" · Endocrinology · https://doi.org/10.1210/en.2014-1675 · cited 192 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Cristian De Gregorio, David Contador, Diego A. Díaz, et al. · (2020) · "Human adipose-derived mesenchymal stem cell-conditioned medium ameliorates polyneuropathy and foot ulceration in diabetic BKS db/db mice" · Stem Cell Research & Therapy · https://doi.org/10.1186/s13287-020-01680-0 · cited 108 times

Question: Summarize the published evidence on "Human adipose-derived mesenchymal stem cell-conditioned medium ameliorates polyneuropathy and foot ulceration in diabetic BKS db/db mice" with a citation.

Answer:
BACKGROUND: Diabetic polyneuropathy (DPN) is the most common and early developing complication of diabetes mellitus, and the key contributor for foot ulcers development, with no specific therapies available. Different studies have shown that mesenchymal stem cell (MSC) administration is able to ameliorate DPN; however, limited cell survival and safety reasons hinder its transfer from bench to bedside. MSCs secrete a broad range of antioxidant, neuroprotective, angiogenic, and immunomodulatory factors (known as conditioned medium), which are all decreased in the peripheral nerves of diabetic patients. Furthermore, the abundance of these factors can be boosted in vitro by incubating MSCs with a preconditioning stimulus, enhancing their therapeutic efficacy. We hypothesize that systemic administration of conditioned medium derived from preconditioned MSCs could reverse DPN and prevent foot ulcer formation in a mouse model of type II diabetes mellitus. METHODS: Diabetic BKS db/db mice were treated with systemic administration of conditioned medium derived from preconditioned human MSCs; conditioned medium derived from non-preconditioned MSCs or vehicle after behavioral signs of DPN was already present. Conditioned medium or vehicle administration was repeated every 2 weeks for a total of four administrations, and several functional and structural parameters characteristic of DPN were evaluated. Finally, a wound was made in the dorsal surface of both feet, and the kinetics of wound closure, re-epithelialization, angiogenesis, and cell proliferation were evaluated. RESULTS: Our molecular, electrophysiological, and histological analysis demonstrated that the administration of conditioned medium derived from non-preconditioned MSCs or from preconditioned MSCs to diabetic BKS db/db mice strongly reverts the established DPN, improving thermal and mechanical sensitivity, restoring intraepidermal nerve fiber density, reducing neuron and Schwann cell apoptosis, improving angiogenesis, and reducing chronic inflammation of peripheral nerves. Furthermore, DPN reversion induced by conditioned medium administration enhances the wound healing process by accelerating wound closure, improving the re-epithelialization of the injured skin and increasing blood vessels in the wound bed in a skin injury model that mimics a foot ulcer. CONCLUSIONS: Studies conducted indicate that MSC-conditioned medium administration could be a novel cell-free therapeutic approach to reverse the initial stages of DPN, avoiding the risk of lower limb amputation triggered by foot ulcer formation and accelerating the wound healing process in case it occurs.

— Source (peer-reviewed): Cristian De Gregorio, David Contador, Diego A. Díaz, et al. · (2020) · "Human adipose-derived mesenchymal stem cell-conditioned medium ameliorates polyneuropathy and foot ulceration in diabetic BKS db/db mice" · Stem Cell Research & Therapy · https://doi.org/10.1186/s13287-020-01680-0 · cited 108 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Iris C. M. Pelsma, Martin Faßnacht, Stylianos Tsagarakis, et al. · (2023) · "Comorbidities in mild autonomous cortisol secretion and the effect of treatment: systematic review and meta-analysis" · European Journal of Endocrinology · https://doi.org/10.1093/ejendo/lvad134 · cited 95 times

Question: Summarize the published evidence on "Comorbidities in mild autonomous cortisol secretion and the effect of treatment: systematic review and meta-analysis" with a citation.

Answer:
OBJECTIVE: To assess (1) comorbidities associated with and (2) treatment strategies for patients with adrenal incidentalomas and mild autonomous cortisol secretion (MACS; > 1.8 µg/dL (>50 nmol/L) cortisol level cut-off following the 1 mg dexamethasone suppression test). DESIGN: Systematic review and meta-analysis. METHODS: Seven databases were searched up to July 14, 2022. Eligible studies were (randomized) trials, cohort studies, and cross-sectional studies assessing comorbidities potentially attributable to cortisol excess or mortality in patients with adrenal incidentaloma with or without MACS or the effects of conservative or surgical management of MACS. Random-effects meta-analysis was performed to estimate pooled proportions (with 95% CIs). RESULTS: In 30 cross-sectional and 16 cohort studies (n = 17 156 patients in total), patients with MACS had a higher prevalence of diabetes (relative risk [RR] 1.44 [1.23-1.69]), hypertension (RR = 1.24 [1.16-1.32]), and dyslipidemia (RR = 1.23 [1.13-1.34]). All-cause mortality (adjusted for confounders) in patients with MACS, assessed in 4 studies (n = 5921), was increased (hazard ratio [HR] = 1.54 [1.27-1.81]). Nine observational studies (n = 856) and 2 randomized trials (n = 107) suggest an improvement in glucometabolic control (RR = 7.99 [2.95-21.90]), hypertension (RR = 8.75 [3.99-19.18]), and dyslipidemia (RR = 3.24 [1.19-8.82]) following adrenalectomy. CONCLUSIONS: The present systematic review and meta-analysis highlight the relevance of MACS, since both cardiometabolic morbidities and mortality appeared to have increased in patients with MACS compared to patients with non-functioning incidentalomas. However, due to heterogeneous definitions, various outcomes, selective reporting, and missing data, the reported pooled estimates need to be interpreted with caution. The small number of patients in randomized trials prevents any strong conclusion on the causality between MACS and these comorbidities.

— Source (peer-reviewed): Iris C. M. Pelsma, Martin Faßnacht, Stylianos Tsagarakis, et al. · (2023) · "Comorbidities in mild autonomous cortisol secretion and the effect of treatment: systematic review and meta-analysis" · European Journal of Endocrinology · https://doi.org/10.1093/ejendo/lvad134 · cited 95 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Qinqin Zhang, Fang Zheng, Elie Motulsky, et al. · (2018) · "A Novel Strategy for Quantifying Choriocapillaris Flow Voids Using Swept-Source OCT Angiography" · Investigative Ophthalmology & Visual Science · https://doi.org/10.1167/iovs.17-22953 · cited 299 times

Question: What does the peer-reviewed literature show about "A Novel Strategy for Quantifying Choriocapillaris Flow Voids Using Swept-Source OCT Angiography"? Cite a published source.

Answer:
Purpose: To achieve reproducible imaging of the choriocapillaris and associated flow voids using swept-source OCT angiography (SS-OCTA). Methods: Subjects were enrolled and SS-OCTA was performed using the 3 × 3 mm scan pattern. Blood flow was identified using the complex optical microangiography (OMAG) algorithm. The choriocapillaris was defined as a slab from the outer boundary of Bruch's membrane (BM) to approximately 20 μm below BM. Compensation for the shadowing effect caused by the RPE and BM complex on the choriocapillaris angiogram was achieved by using the structural information from the same slab. A thresholding method to calculate the percentage of flow voids from a region was developed based on a normal database. Results: Twenty normal subjects and 12 subjects with drusen were enrolled. SS-OCTA identified the choriocapillaris in normal subjects as a lobular plexus of capillaries in the central macula and the lobular arrangement became more evident toward the periphery. In all eyes, signal compensation resulted in fewer choriocapillaris flow voids with improved repeatability of measurements. The best repeatability for the measurement was achieved by using 1 standard deviation (SD) for the thresholding strategy. Conclusions: SS-OCTA can image the choriocapillaris in vivo, and the repeatability of flow void measurements is high in the presence of drusen. The ability to image the choriocapillaris and associated flow voids should prove useful in understanding disease onset, progression, and response to therapies.

— Source (peer-reviewed): Qinqin Zhang, Fang Zheng, Elie Motulsky, et al. · (2018) · "A Novel Strategy for Quantifying Choriocapillaris Flow Voids Using Swept-Source OCT Angiography" · Investigative Ophthalmology & Visual Science · https://doi.org/10.1167/iovs.17-22953 · cited 299 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Mitsuhide Naruse, Takuyuki Katabami, Hirotaka Shibata, et al. · (2022) · "Japan Endocrine Society clinical practice guideline for the diagnosis and management of primary aldosteronism 2021" · Endocrine Journal · https://doi.org/10.1507/endocrj.ej21-0508 · cited 205 times

Question: Summarize the published evidence on "Japan Endocrine Society clinical practice guideline for the diagnosis and management of primary aldosteronism 2021" with a citation.

Answer:
Primary aldosteronism (PA) is associated with higher cardiovascular morbidity and mortality rates than essential hypertension. The Japan Endocrine Society (JES) has developed an updated guideline for PA, based on the evidence, especially from Japan. We should preferentially screen hypertensive patients with a high prevalence of PA with aldosterone to renin ratio ≥200 and plasma aldosterone concentrations (PAC) ≥60 pg/mL as a cut-off of positive results. While we should confirm excess aldosterone secretion by one positive confirmatory test, we could bypass patients with typical PA findings. Since PAC became lower due to a change in assay methods from radioimmunoassay to chemiluminescent enzyme immunoassay, borderline ranges were set for screening and confirmatory tests and provisionally designated as positive. We recommend individualized medicine for those in the borderline range for the next step. We recommend evaluating cortisol co-secretion in patients with adrenal macroadenomas. Although we recommend adrenal venous sampling for lateralization before adrenalectomy, we should carefully select patients rather than all patients, and we suggest bypassing in young patients with typical PA findings. A selectivity index ≥5 and a lateralization index >4 after adrenocorticotropic hormone stimulation defines successful catheterization and unilateral subtype diagnosis. We recommend adrenalectomy for unilateral PA and mineralocorticoid receptor antagonists for bilateral PA. Systematic as well as individualized clinical practice is always warranted. This JES guideline 2021 provides updated rational evidence and recommendations for the clinical practice of PA, leading to improved quality of the clinical practice of hypertension.

— Source (peer-reviewed): Mitsuhide Naruse, Takuyuki Katabami, Hirotaka Shibata, et al. · (2022) · "Japan Endocrine Society clinical practice guideline for the diagnosis and management of primary aldosteronism 2021" · Endocrine Journal · https://doi.org/10.1507/endocrj.ej21-0508 · cited 205 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Bo Åhrén, Irl B. Hirsch, Thomas R. Pieber, et al. · (2016) · "Efficacy and Safety of Liraglutide Added to Capped Insulin Treatment in Subjects With Type 1 Diabetes: The ADJUNCT TWO Randomized Trial" · Diabetes Care · https://doi.org/10.2337/dc16-0690 · cited 241 times

Question: Summarize the published evidence on "Efficacy and Safety of Liraglutide Added to Capped Insulin Treatment in Subjects With Type 1 Diabetes: The ADJUNCT TWO Randomized Trial" with a citation.

Answer:
OBJECTIVE: To investigate the efficacy and safety of liraglutide added to capped insulin doses in subjects with type 1 diabetes. RESEARCH DESIGN AND METHODS: A 26-week, placebo-controlled, double-blind, parallel-group trial enrolling 835 subjects randomized 3:1 receiving once-daily subcutaneous liraglutide (1.8, 1.2, and 0.6 mg) or placebo added to an individually capped total daily dose of insulin. RESULTS: Mean baseline glycated hemoglobin (HbA1c) (8.1% [65.0 mmol/mol]) was significantly decreased with liraglutide versus placebo at week 26 (1.8 mg: -0.33% [3.6 mmol/mol]; 1.2 mg: -0.22% [2.4 mmol/mol]; 0.6 mg: -0.23% [2.5 mmol/mol]; placebo: 0.01% [0.1 mmol/mol]). Liraglutide significantly reduced mean body weight (-5.1, -4.0, and -2.5 kg for 1.8, 1.2, and 0.6 mg, respectively) versus placebo (-0.2 kg). Significant reductions in daily insulin dose and increases in quality of life were seen with liraglutide versus placebo. There were higher rates of symptomatic hypoglycemia (21.3 vs. 16.6 events/patient/year; P = 0.03) with liraglutide 1.2 mg vs. placebo and of hyperglycemia with ketosis >1.5 mmol/L with liraglutide 1.8 mg vs. placebo (0.5 vs. 0.1 events/patient/year; P = 0.01). CONCLUSIONS: In a broad population of subjects with long-standing type 1 diabetes, liraglutide added to capped insulin reduced HbA1c, body weight, and insulin requirements but with higher rates of hypoglycemia for liraglutide 1.2 mg and hyperglycemia with ketosis for liraglutide 1.8 mg.

— Source (peer-reviewed): Bo Åhrén, Irl B. Hirsch, Thomas R. Pieber, et al. · (2016) · "Efficacy and Safety of Liraglutide Added to Capped Insulin Treatment in Subjects With Type 1 Diabetes: The ADJUNCT TWO Randomized Trial" · Diabetes Care · https://doi.org/10.2337/dc16-0690 · cited 241 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Esther Wittermans, Stefan M.T. Vestjens, Simone M.C. Spoorenberg, et al. · (2021) · "Adjunctive treatment with oral dexamethasone in non-ICU patients hospitalised with community-acquired pneumonia: a randomised clinical trial" · European Respiratory Journal · https://doi.org/10.1183/13993003.02535-2020 · cited 52 times

Question: Summarize the published evidence on "Adjunctive treatment with oral dexamethasone in non-ICU patients hospitalised with community-acquired pneumonia: a randomised clinical trial" with a citation.

Answer:
BACKGROUND: Adjunctive intravenous corticosteroid treatment has been shown to reduce length of stay (LOS) in adults hospitalised with community-acquired pneumonia (CAP). We aimed to assess the effect of oral dexamethasone on LOS and whether this effect is disease severity dependent. METHODS: In this multicentre, stratified randomised, double-blind, placebo-controlled trial, immunocompetent adults with CAP were randomly assigned (1:1 ratio) to receive oral dexamethasone (6 mg once daily) or placebo for 4 days in four teaching hospitals in the Netherlands. Randomisation (blocks of four) was stratified by CAP severity (pneumonia severity index class I-III and IV-V). The primary outcome was LOS. RESULTS: 1 (1%); p=0.001) was more prevalent. CONCLUSION: Oral dexamethasone reduced LOS and ICU admission rate in adults hospitalised with CAP. It remains unclear for which patients the risk-benefit ratio is optimal.

— Source (peer-reviewed): Esther Wittermans, Stefan M.T. Vestjens, Simone M.C. Spoorenberg, et al. · (2021) · "Adjunctive treatment with oral dexamethasone in non-ICU patients hospitalised with community-acquired pneumonia: a randomised clinical trial" · European Respiratory Journal · https://doi.org/10.1183/13993003.02535-2020 · cited 52 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Evgenia Makrantonaki, Meinhard Wlaschek, Karin Scharffetter‐Kochanek · (2017) · "Pathogenesis of wound healing disorders in the elderly" · JDDG Journal der Deutschen Dermatologischen Gesellschaft · https://doi.org/10.1111/ddg.13199 · cited 85 times

Question: What does the peer-reviewed literature show about "Pathogenesis of wound healing disorders in the elderly"? Cite a published source.

Answer:
The elderly constitute the age group most susceptible to wound healing disorders and chronic wounds, the most prevalent being venous leg ulcers, pressure ulcers, and diabetic foot ulcers. However, other age-associated diseases should also be taken into consideration in the diagnostic workup of chronic wounds, and not be underestimated. A better understanding of the pathomechanisms involved in the wound healing process is of key importance in combatting the difficulties associated with the treatment of chronic wounds. In recent decades, considerable progress has been made in the development of pioneering therapeutic strategies for chronic wounds. In this context, the use of growth factors and cytokines, tissue engineering, and cell therapy - including stem cells - have proven very promising. Nevertheless, prior to their introduction into routine clinical practice, large controlled clinical trials are required to assess the safety of these techniques.

— Source (peer-reviewed): Evgenia Makrantonaki, Meinhard Wlaschek, Karin Scharffetter‐Kochanek · (2017) · "Pathogenesis of wound healing disorders in the elderly" · JDDG Journal der Deutschen Dermatologischen Gesellschaft · https://doi.org/10.1111/ddg.13199 · cited 85 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Jeanne Walsh, Ole Hoffstad, Millicent O. Sullivan, et al. · (2015) · "Association of diabetic foot ulcer and death in a population‐based cohort from the United Kingdom" · Diabetic Medicine · https://doi.org/10.1111/dme.13054 · cited 534 times

Question: Summarize the published evidence on "Association of diabetic foot ulcer and death in a population‐based cohort from the United Kingdom" with a citation.

Answer:
AIMS: The presence of diabetic foot ulcers is strongly associated with an increased risk of death. In this study, we investigate whether the effects of diabetes-associated complications can explain the apparent relationship between diabetic foot ulcers and death. METHODS: We analysed data from 414 523 people with diabetes enrolled in practices associated with The Health Improvement Network in the United Kingdom. Our methods were designed to control for potential confounders in order to isolate the relationship between diabetic foot ulcers and death. Using proportional hazards models and the area under the receiver operator curve, we evaluated the effects of diabetic foot ulcers and the covariates on death. RESULTS: Among the patients, 20 737 developed diabetic foot ulcers; 5.0% of people with new ulcers died within 12 months of their first foot ulcer visit and 42.2% of people with foot ulcers died within 5 years. After controlling for major known complications of diabetes that might influence mortality, the correlation between diabetic foot ulcers and death remained strong with a fully adjusted hazard ratio of 2.48 (95% confidence interval: 2.43, 2.54). Geographic variance existed but was not spatially associated. CONCLUSIONS: Diabetic foot ulcers are linked to an increased risk of death. This cannot be explained by other common risk factors. These results suggest that either there are major unknown risk factors associated with both diabetic foot ulcers and death, or that diabetic foot ulceration itself is a serious threat, which seems unlikely. A diabetic foot ulcer should be seen as a major warning sign for mortality, necessitating closer medical follow-up.

— Source (peer-reviewed): Jeanne Walsh, Ole Hoffstad, Millicent O. Sullivan, et al. · (2015) · "Association of diabetic foot ulcer and death in a population‐based cohort from the United Kingdom" · Diabetic Medicine · https://doi.org/10.1111/dme.13054 · cited 534 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Jennifer Okemah, John Peng, Manuel J. Quiñones · (2018) · "Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review" · Advances in Therapy · https://doi.org/10.1007/s12325-018-0819-5 · cited 209 times

Question: Summarize the published evidence on "Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review" with a citation.

Answer:
The current epidemic of type 2 diabetes (T2D) represents a significant global and national health concern. Globally, the prevalence of diabetes has doubled between 1980 and 2014. In 2014 the World Health Organization estimated that there were 422 million adults living with diabetes worldwide. In the USA, the number of people diagnosed with T2D is estimated to increase to over 70 million by 2050, putting an immense strain on the US healthcare system. Achieving glycemic control is widely acknowledged as the key goal of treatment in T2D and is critical for reducing the onset and progression of diabetes-related complications such as cardiovascular diseases, neuropathies, retinopathies, and nephropathies. Despite the increase in the availability of antihyperglycemic medications and evidence-based treatment guidelines, the proportion of people with T2D who fail to achieve glycemic goals continues to rise. One major contributor is a delay in treatment intensification despite suboptimal glycemic control, referred to as clinical or therapeutic inertia. Clinical inertia prolongs the duration of patients' hyperglycemia which subsequently puts them at increased risk of diabetes-associated complications and reduced life expectancy. Clinical inertia results from a complex interaction between patient, healthcare providers, and healthcare system barriers that need to be addressed together, rather than as separate entities. In this article we provide an overview of clinical inertia in the clinical management of T2D and provide suggestions for overcoming aspects that may have a negative impact on patient care.Funding: Sanofi US, Inc.

— Source (peer-reviewed): Jennifer Okemah, John Peng, Manuel J. Quiñones · (2018) · "Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review" · Advances in Therapy · https://doi.org/10.1007/s12325-018-0819-5 · cited 209 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Daphne J. Geerse, Bert Coolen, Melvyn Roerdink · (2015) · "Kinematic Validation of a Multi-Kinect v2 Instrumented 10-Meter Walkway for Quantitative Gait Assessments" · PLoS ONE · https://doi.org/10.1371/journal.pone.0139913 · cited 190 times

Question: Summarize the published evidence on "Kinematic Validation of a Multi-Kinect v2 Instrumented 10-Meter Walkway for Quantitative Gait Assessments" with a citation.

Answer:
Walking ability is frequently assessed with the 10-meter walking test (10MWT), which may be instrumented with multiple Kinect v2 sensors to complement the typical stopwatch-based time to walk 10 meters with quantitative gait information derived from Kinect's 3D body point's time series. The current study aimed to evaluate a multi-Kinect v2 set-up for quantitative gait assessments during the 10MWT against a gold-standard motion-registration system by determining between-systems agreement for body point's time series, spatiotemporal gait parameters and the time to walk 10 meters. To this end, the 10MWT was conducted at comfortable and maximum walking speed, while 3D full-body kinematics was concurrently recorded with the multi-Kinect v2 set-up and the Optotrak motion-registration system (i.e., the gold standard). Between-systems agreement for body point's time series was assessed with the intraclass correlation coefficient (ICC). Between-systems agreement was similarly determined for the gait parameters' walking speed, cadence, step length, stride length, step width, step time, stride time (all obtained for the intermediate 6 meters) and the time to walk 10 meters, complemented by Bland-Altman's bias and limits of agreement. Body point's time series agreed well between the motion-registration systems, particularly so for body points in motion. For both comfortable and maximum walking speeds, the between-systems agreement for the time to walk 10 meters and all gait parameters except step width was high (ICC ≥ 0.888), with negligible biases and narrow limits of agreement. Hence, body point's time series and gait parameters obtained with a multi-Kinect v2 set-up match well with those derived with a gold standard in 3D measurement accuracy. Future studies are recommended to test the clinical utility of the multi-Kinect v2 set-up to automate 10MWT assessments, thereby complementing the time to walk 10 meters with reliable spatiotemporal gait parameters obtained objectively in a quick, unobtrusive and patient-friendly manner.

— Source (peer-reviewed): Daphne J. Geerse, Bert Coolen, Melvyn Roerdink · (2015) · "Kinematic Validation of a Multi-Kinect v2 Instrumented 10-Meter Walkway for Quantitative Gait Assessments" · PLoS ONE · https://doi.org/10.1371/journal.pone.0139913 · cited 190 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Ashish Verma, Anand Vaidya, Sonu Subudhi, et al. · (2022) · "Aldosterone in chronic kidney disease and renal outcomes" · European Heart Journal · https://doi.org/10.1093/eurheartj/ehac352 · cited 109 times

Question: What does the peer-reviewed literature show about "Aldosterone in chronic kidney disease and renal outcomes"? Cite a published source.

Answer:
AIMS: Randomized controlled trials have demonstrated the efficacy of mineralocorticoid receptor (MR) antagonism in delaying chronic kidney disease (CKD) progression in diabetes; however, they have not investigated the role of aldosterone or whether these beneficial effects could be achieved in individuals without diabetes. METHODS AND RESULTS: The association between serum aldosterone concentrations and kidney disease progression was investigated among 3680 participants in the Chronic Renal Insufficiency Cohort. The primary outcome was CKD progression [defined as the composite of 50% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease, whichever occurred first]. The associations between serum aldosterone and kidney disease outcomes were assessed using Cox proportional hazard models. At baseline, higher aldosterone concentrations were associated with a lower eGFR, lower serum potassium, greater urinary potassium, and protein excretion. Over a median follow-up of 9.6 years, 1412 participants developed CKD progression. In adjusted models, each doubling of serum aldosterone was associated with a 11% increased risk of CKD progression [hazard ratio (HR) 1.11, 95% confidence interval (CI) 1.04-1.18]. Individuals with the highest quartile of serum aldosterone had a 45% increased risk of CKD progression (HR 1.45, 95% CI 1.22-1.73) compared with the lowest quartile. The risk for CKD progression was similar regardless of whether patients had concomitant diabetes (P-interaction = 0.10). CONCLUSION: Higher serum aldosterone levels among individuals with CKD are independently associated with an increased risk for kidney disease progression, irrespective of concomitant diabetes. These findings provide mechanistic support for MR antagonists in delaying CKD progression and suggest that they may also have a role in those without diabetes.

— Source (peer-reviewed): Ashish Verma, Anand Vaidya, Sonu Subudhi, et al. · (2022) · "Aldosterone in chronic kidney disease and renal outcomes" · European Heart Journal · https://doi.org/10.1093/eurheartj/ehac352 · cited 109 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Marc D. Breton, Boris Kovatchev · (2021) · "One Year Real-World Use of the Control-IQ Advanced Hybrid Closed-Loop Technology" · Diabetes Technology & Therapeutics · https://doi.org/10.1089/dia.2021.0097 · cited 239 times

Question: Summarize the published evidence on "One Year Real-World Use of the Control-IQ Advanced Hybrid Closed-Loop Technology" with a citation.

Answer:
In this real-world use analysis, Control-IQ technology retained, and to some extent exceeded, the results obtained in randomized controlled trials, showing glycemic improvements in a broad age range of people with different types of diabetes.

— Source (peer-reviewed): Marc D. Breton, Boris Kovatchev · (2021) · "One Year Real-World Use of the Control-IQ Advanced Hybrid Closed-Loop Technology" · Diabetes Technology & Therapeutics · https://doi.org/10.1089/dia.2021.0097 · cited 239 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Qiaoliang Li, Bowei Feng, Linpei Xie, et al. · (2015) · "A Cross-Modality Learning Approach for Vessel Segmentation in Retinal Images" · IEEE Transactions on Medical Imaging · https://doi.org/10.1109/tmi.2015.2457891 · cited 581 times

Question: What does the peer-reviewed literature show about "A Cross-Modality Learning Approach for Vessel Segmentation in Retinal Images"? Cite a published source.

Answer:
This paper presents a new supervised method for vessel segmentation in retinal images. This method remolds the task of segmentation as a problem of cross-modality data transformation from retinal image to vessel map. A wide and deep neural network with strong induction ability is proposed to model the transformation, and an efficient training strategy is presented. Instead of a single label of the center pixel, the network can output the label map of all pixels for a given image patch. Our approach outperforms reported state-of-the-art methods in terms of sensitivity, specificity and accuracy. The result of cross-training evaluation indicates its robustness to the training set. The approach needs no artificially designed feature and no preprocessing step, reducing the impact of subjective factors. The proposed method has the potential for application in image diagnosis of ophthalmologic diseases, and it may provide a new, general, high-performance computing framework for image segmentation.

— Source (peer-reviewed): Qiaoliang Li, Bowei Feng, Linpei Xie, et al. · (2015) · "A Cross-Modality Learning Approach for Vessel Segmentation in Retinal Images" · IEEE Transactions on Medical Imaging · https://doi.org/10.1109/tmi.2015.2457891 · cited 581 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Yoichiro Hirakawa, Hisatomi Arima, Sophia Zoungas, et al. · (2014) · "Impact of Visit-to-Visit Glycemic Variability on the Risks of Macrovascular and Microvascular Events and All-Cause Mortality in Type 2 Diabetes: The ADVANCE Trial" · Diabetes Care · https://doi.org/10.2337/dc14-0199 · cited 374 times

Question: Summarize the published evidence on "Impact of Visit-to-Visit Glycemic Variability on the Risks of Macrovascular and Microvascular Events and All-Cause Mortality in Type 2…" with a citation.

Answer:
OBJECTIVE: There is no consensus on the importance of visit-to-visit glycemic variability in diabetes. Therefore, we assessed the effects of visit-to-visit variability (VVV) in HbA1c and fasting glucose on major outcomes in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) trial. RESEARCH DESIGN AND METHODS: ADVANCE was a factorial randomized controlled trial of intensive glucose control and blood pressure lowering in patients with type 2 diabetes. VVV in the intensive glucose treatment group was defined using the SD of five measurements of HbA1c and glucose taken 3-24 months after randomization. Outcomes were combined macro- and microvascular events and all-cause mortality occurring post 24 months. Sensitivity analyses were performed using other indices of variability and in the standard glucose treatment group. RESULTS: Among 4,399 patients in the intensive group, an increase in VVV of HbA1c was associated with an increased risk of vascular events (P = 0.01) and with mortality (P < 0.001): highest versus lowest tenth hazard ratio (95% CI) 1.64 (1.05-2.55) and 3.31 (1.57-6.98), respectively, after multivariable adjustment. A clear association was also observed between VVV of fasting glucose and increased risk of vascular events (P < 0.001; 2.70 [1.65-4.42]). HbA1c variability was positively associated with the risk of macrovascular events (P = 0.02 for trend), whereas glucose variability was associated with both macro- and microvascular events (P = 0.005 and P < 0.001 for trend, respectively). Sensitivity analyses using other indices, and patients in the standard glucose treatment group, were broadly consistent with these results. CONCLUSIONS: Consistency of glycemic control is important to reduce the risks of vascular events and death in type 2 diabetes.

— Source (peer-reviewed): Yoichiro Hirakawa, Hisatomi Arima, Sophia Zoungas, et al. · (2014) · "Impact of Visit-to-Visit Glycemic Variability on the Risks of Macrovascular and Microvascular Events and All-Cause Mortality in Type 2 Diabetes: The ADVANCE Trial" · Diabetes Care · https://doi.org/10.2337/dc14-0199 · cited 374 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Georgios Pavlakos, Xiaowei Zhou, Kostas Daniilidis · (2018) · "Ordinal Depth Supervision for 3D Human Pose Estimation" · https://doi.org/10.1109/cvpr.2018.00763 · cited 441 times

Question: What does the peer-reviewed literature show about "Ordinal Depth Supervision for 3D Human Pose Estimation"? Cite a published source.

Answer:
Our ability to train end-to-end systems for 3D human pose estimation from single images is currently constrained by the limited availability of 3D annotations for natural images. Most datasets are captured using Motion Capture (MoCap) systems in a studio setting and it is difficult to reach the variability of 2D human pose datasets, like MPII or LSP. To alleviate the need for accurate 3D ground truth, we propose to use a weaker supervision signal provided by the ordinal depths of human joints. This information can be acquired by human annotators for a wide range of images and poses. We showcase the effectiveness and flexibility of training Convolutional Networks (ConvNets) with these ordinal relations in different settings, always achieving competitive performance with ConvNets trained with accurate 3D joint coordinates. Additionally, to demonstrate the potential of the approach, we augment the popular LSP and MPII datasets with ordinal depth annotations. This extension allows us to present quantitative and qualitative evaluation in non-studio conditions. Simultaneously, these ordinal annotations can be easily incorporated in the training procedure of typical ConvNets for 3D human pose. Through this inclusion we achieve new state-of-the-art performance for the relevant benchmarks and validate the effectiveness of ordinal depth supervision for 3D human pose.

— Source (peer-reviewed): Georgios Pavlakos, Xiaowei Zhou, Kostas Daniilidis · (2018) · "Ordinal Depth Supervision for 3D Human Pose Estimation" · https://doi.org/10.1109/cvpr.2018.00763 · cited 441 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


John Doupis, Georgios Festas, Christos Tsilivigos, et al. · (2020) · "Smartphone-Based Technology in Diabetes Management" · Diabetes Therapy · https://doi.org/10.1007/s13300-020-00768-3 · cited 138 times

Question: What does the peer-reviewed literature show about "Smartphone-Based Technology in Diabetes Management"? Cite a published source.

Answer:
Diabetes is a group of metabolic disorders characterized by elevated levels of blood glucose which leads over time to serious complications and significant morbidity and mortality worldwide. Self-management tasks in diabetes may be quite challenging because of lack of training, difficulties in sustaining lifestyle modifications, and limited access to specialized healthcare. Nowadays, the evolution of mobile technology provides a large number of health-related smartphone applications (apps), aiming to increase the self-management skills of the patient in chronic diseases, to facilitate the communication between the patient and healthcare providers, and to increase also the patient's compliance with the treatment. In the field of diabetes there are also many diabetes-related mobile apps mainly focusing on self-management of diabetes, lifestyle modification, and medication adherence motivation. The aim of this paper is to review the most important diabetes-related mobile smartphone applications, including only those supported by prospective randomized controlled trials.

— Source (peer-reviewed): John Doupis, Georgios Festas, Christos Tsilivigos, et al. · (2020) · "Smartphone-Based Technology in Diabetes Management" · Diabetes Therapy · https://doi.org/10.1007/s13300-020-00768-3 · cited 138 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Guillermo E. Umpierrez, David C. Klonoff · (2018) · "Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital" · Diabetes Care · https://doi.org/10.2337/dci18-0002 · cited 239 times

Question: What does the peer-reviewed literature show about "Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital"? Cite a published source.

Answer:
The use of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems has gained wide acceptance in diabetes care. These devices have been demonstrated to be clinically valuable, improving glycemic control and reducing risks of hypoglycemia in ambulatory patients with type 1 diabetes and type 2 diabetes. Approximately 30-40% of patients with type 1 diabetes and an increasing number of insulin-requiring patients with type 2 diabetes are using pump and sensor technology. As the popularity of these devices increases, it becomes very likely that hospital health care providers will face the need to manage the inpatient care of patients under insulin pump therapy and CGM. The American Diabetes Association advocates allowing patients who are physically and mentally able to continue to use their pumps when hospitalized. Health care institutions must have clear policies and procedures to allow the patient to continue to receive CSII treatment to maximize safety and to comply with existing regulations related to self-management of medication. Randomized controlled trials are needed to determine whether CSII therapy and CGM systems in the hospital are associated with improved clinical outcomes compared with intermittent monitoring and conventional insulin treatment or with a favorable cost-benefit ratio.

— Source (peer-reviewed): Guillermo E. Umpierrez, David C. Klonoff · (2018) · "Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital" · Diabetes Care · https://doi.org/10.2337/dci18-0002 · cited 239 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Sean L. Zheng, Alistair Roddick, Rochan Aghar-Jaffar, et al. · (2018) · "Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes" · JAMA · https://doi.org/10.1001/jama.2018.3024 · cited 402 times

Question: Summarize the published evidence on "Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4…" with a citation.

Answer:
Importance: The comparative clinical efficacy of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucagon-like peptide 1 (GLP-1) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors for treatment of type 2 diabetes is unknown. Objective: To compare the efficacies of SGLT-2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors on mortality and cardiovascular end points using network meta-analysis. Data Sources: MEDLINE, Embase, Cochrane Library Central Register of Controlled Trials, and published meta-analyses from inception through October 11, 2017. Study Selection: Randomized clinical trials enrolling participants with type 2 diabetes and a follow-up of at least 12 weeks were included, for which SGLT-2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors were compared with either each other or placebo or no treatment. Data Extraction and Synthesis: Data were screened by 1 investigator and extracted in duplicate by 2 investigators. A Bayesian hierarchical network meta-analysis was performed. Main Outcomes and Measures: The primary outcome: all-cause mortality; secondary outcomes: cardiovascular (CV) mortality, heart failure (HF) events, myocardial infarction (MI), unstable angina, and stroke; safety end points: adverse events and hypoglycemia. Results: This network meta-analysis of 236 trials randomizing 176 310 participants found SGLT-2 inhibitors (absolute risk difference [RD], -1.0%; hazard ratio [HR], 0.80 [95% credible interval {CrI}, 0.71 to 0.89]) and GLP-1 agonists (absolute RD, -0.6%; HR, 0.88 [95% CrI, 0.81 to 0.94]) were associated with significantly lower all-cause mortality than the control groups. SGLT-2 inhibitors (absolute RD, -0.9%; HR, 0.78 [95% CrI, 0.68 to 0.90]) and GLP-1 agonists (absolute RD, -0.5%; HR, 0.86 [95% CrI, 0.77 to 0.96]) were associated with lower mortality than were DPP-4 inhibitors. DPP-4 inhibitors were not significantly associated with lower all-cause mortality (absolute RD, 0.1%; HR, 1.02 [95% CrI, 0.94 to 1.11]) than were the control groups. SGLT-2 inhibitors (absolute RD, -0.8%; HR, 0.79 [95% CrI, 0.69 to 0.91]) and GLP-1 agonists (absolute RD, -0.5%; HR, 0.85 [95% CrI, 0.77 to 0.94]) were significantly associated with lower CV mortality than were the control groups. SGLT-2 inhibitors were significantly associated with lower rates of HF events (absolute RD, -1.1%; HR, 0.62 [95% CrI, 0.54 to 0.72]) and MI (absolute RD, -0.6%; HR, 0.86 [95% CrI, 0.77 to 0.97]) than were the control groups. GLP-1 agonists were associated with a higher risk of adverse events leading to trial withdrawal than were SGLT-2 inhibitors (absolute RD, 5.8%; HR, 1.80 [95% CrI, 1.44 to 2.25]) and DPP-4 inhibitors (absolute RD, 3.1%; HR, 1.93 [95% CrI, 1.59 to 2.35]). Conclusions and Relevance: In this network meta-analysis, the use of SGLT-2 inhibitors or GLP-1 agonists was associated with lower mortality than DPP-4 inhibitors or placebo or no treatment. Use of DPP-4 inhibitors was not associated with lower mortality than placebo or no treatment.

— Source (peer-reviewed): Sean L. Zheng, Alistair Roddick, Rochan Aghar-Jaffar, et al. · (2018) · "Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes" · JAMA · https://doi.org/10.1001/jama.2018.3024 · cited 402 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Mee Kyoung Kim, Seung‐Hyun Ko, Bo‐Yeon Kim, et al. · (2019) · "2019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea" · Diabetes & Metabolism Journal · https://doi.org/10.4093/dmj.2019.0137 · cited 218 times

Question: Summarize the published evidence on "2019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea" with a citation.

Answer:
The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the 6th Clinical Practice Guidelines in 2019. Targets of glycemic, blood pressure, and lipid control in type 2 diabetes mellitus (T2DM) were updated. The obese and overweight population is increasing steadily in Korea, and half of the Koreans with diabetes are obese. Evidence-based recommendations for weight-loss therapy for obesity management as treatment for hyperglycemia in T2DM were provided. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations.

— Source (peer-reviewed): Mee Kyoung Kim, Seung‐Hyun Ko, Bo‐Yeon Kim, et al. · (2019) · "2019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea" · Diabetes & Metabolism Journal · https://doi.org/10.4093/dmj.2019.0137 · cited 218 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Lawrence A. Leiter, Bertrand Cariou, Dirk Müller‐Wieland, et al. · (2017) · "Efficacy and safety of alirocumab in insulin‐treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The <scp>ODYSSEY DM‐INSULIN</scp> randomized trial" · Diabetes Obesity and Metabolism · https://doi.org/10.1111/dom.13114 · cited 140 times

Question: What does the peer-reviewed literature show about "Efficacy and safety of alirocumab in insulin‐treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The…"? Cite a published source.

Answer:
AIMS: To investigate the efficacy and safety of alirocumab in participants with type 2 (T2D) or type 1 diabetes (T1D) treated with insulin who have elevated LDL cholesterol levels despite maximally tolerated statin therapy. METHODS: Participants at high cardiovascular risk with T2D (n = 441) or T1D (n = 76) and LDL cholesterol levels ≥1.8 mmol/L (≥70 mg/dL) were randomized 2:1 to alirocumab:placebo administered subcutaneously every 2 weeks, for 24 weeks' double-blind treatment. Alirocumab-treated participants received 75 mg every 2 weeks, with blinded dose increase to 150 mg every 2 weeks at week 12 if week 8 LDL cholesterol levels were ≥1.8 mmol/L. Primary endpoints were percentage change in calculated LDL cholesterol from baseline to week 24, and safety assessments. RESULTS: Alirocumab reduced LDL cholesterol from baseline to week 24 by a mean ± standard error of 49.0% ± 2.7% and 47.8% ± 6.5% vs placebo (both P < .0001) in participants with T2D and T1D, respectively. Significant reductions were observed in non-HDL cholesterol (P < .0001), apolipoprotein B (P < .0001) and lipoprotein (a) (P ≤ .0039). At week 24, 76.4% and 70.2% of the alirocumab group achieved LDL cholesterol <1.8 mmol/L in the T2D and T1D populations (P < .0001), respectively. Glycated haemoglobin and fasting plasma glucose levels remained stable for the study duration. Treatment-emergent adverse events were observed in 64.5% of alirocumab- vs 64.1% of placebo-treated individuals (overall population). CONCLUSIONS: Alirocumab produced significant LDL cholesterol reductions in participants with insulin-treated diabetes regardless of diabetes type, and was generally well tolerated. Concomitant administration of alirocumab and insulin did not raise any safety concerns (NCT02585778).

— Source (peer-reviewed): Lawrence A. Leiter, Bertrand Cariou, Dirk Müller‐Wieland, et al. · (2017) · "Efficacy and safety of alirocumab in insulin‐treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The <scp>ODYSSEY DM‐INSULIN</scp> randomized trial" · Diabetes Obesity and Metabolism · https://doi.org/10.1111/dom.13114 · cited 140 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.


Francesco Saverio Sorrentino, Michael Allkabes, Giulia Salsini, et al. · (2016) · "The importance of glial cells in the homeostasis of the retinal microenvironment and their pivotal role in the course of diabetic retinopathy" · Life Sciences · https://doi.org/10.1016/j.lfs.2016.08.001 · cited 143 times

Question: What does the peer-reviewed literature show about "The importance of glial cells in the homeostasis of the retinal microenvironment and their pivotal role in the course of diabetic…"? Cite a published source.

Answer:
Diabetic retinopathy (DR) is a remarkable microvascular complication of diabetes and it has been considered the leading cause of legal blindness in working-age adults in the world. Several overlapping and interrelated molecular pathways are involved in the development of this disease. DR is staged into different levels of severity, from the nonproliferative to the advanced proliferative form. Over the years the progression of DR evolves through a series of changes involving distinct types of specialized cells: neural, vascular and glial. Prior to the clinically observable vascular complications, hyperglycemia and inflammation affect retinal glial cells which undergo a wide range of structural and functional alterations. In this review, we provide an overview of the status of macroglia and microglia in the course of DR, trying to briefly take into account the complex biochemical mechanisms that affect the intimate relationship among neuroretina, vessels and glial cells.

— Source (peer-reviewed): Francesco Saverio Sorrentino, Michael Allkabes, Giulia Salsini, et al. · (2016) · "The importance of glial cells in the homeostasis of the retinal microenvironment and their pivotal role in the course of diabetic retinopathy" · Life Sciences · https://doi.org/10.1016/j.lfs.2016.08.001 · cited 143 times

Note: This summarizes published research findings. It is not individualized medical advice. For your situation, please discuss with your healthcare provider.