Irish journal of medical science
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Diabetes mellitus is a major health problem with a variety of implications: cellular, metabolic, and hematological. Hematological alterations observed in type 2 diabetes are related to hyperglycemia and have a vital role in vascular-associated diabetes complications which could be used as a marker for these complications. The aim of this study is to assess the association between hematological indices and blood glucose levels in patients with type 2 diabetes attending outpatient clinics in Mosul. ⋯ This study revealed statistically significant differences in various hematological parameters between patients with type 2 diabetes and healthy controls. Regular testing of hematological indices helps in early detection and proper management of diabetic complications.
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Review Meta Analysis
The effect of Empagliflozin on echocardiographic parameters in diabetic patients after acute myocardial infarction: A systematic review and meta-analysis with trial sequential analysis.
Patients with diabetes mellitus (DM) are at higher risk of cardiovascular events, particularly acute myocardial infarction (MI). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) can improve cardiac outcomes among heart failure individuals, however, the effects on acute myocardial infarction remain unclear. This meta-analysis investigates the impact of empagliflozin in diabetic patients following acute myocardial infarction. ⋯ Empagliflozin initiation in diabetic patients following acute MI may improve echocardiographic parameters. However, empagliflozin might not be effective in heart failure prevention and optimal glycemic control in this patient population. Further large-scale trials are warranted to ascertain our findings.
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Confronted by the many barriers and deficiencies which currently face those responsible for the training of doctors, the concept of a logic model applied in real time may seem aspirational. However, several of the necessary of logic-based practices are already in place - these include quantified training effect and performance, learning analytics, and applied reflective practice. A nationally or internationally co-ordinated effort is required to harness these disciplines (which currently exist disparately) to create a sustainable and effective training system which is adaptive to its own performance and to society's changing needs. This will mean making better use of the data currently being generated by and around training, and its presentation in a timely and comprehensible form to the person(s) who is responsible, prepared, and able to use it to best effect.
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Review
Can social adversity alter the epigenome, trigger oral disease, and affect future generations?
The nature versus nurture debate has intrigued scientific circles for decades. Although extensive research has established a clear relationship between genetics and disease development, recent evidence has highlighted the insufficiency of attributing adverse health outcomes to genetic factors alone. In fact, it has been suggested that environmental influences, such as socioeconomic position (SEP), may play a much larger role in the development of disease than previously thought, with extensive research suggesting that low SEP is associated with adverse health conditions. ⋯ Although little is known about the biological mechanisms underlying this relationship, epigenetic modifications resulting from environmental influences have been suggested to play an important role. This review explores the intersection of health inequalities and epigenetics, the role of early-life social adversity and its long-term epigenetic impacts, and how those living within the lower hierarchies of the socioeconomic pyramid are indeed at higher risk of developing diseases, particularly in relation to oral health. A deeper understanding of these mechanisms could lead to the development of targeted interventions for individuals of low SEP to improve oral health or identify those who are at higher risk of developing oral disease.
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Comparative Study Observational Study
A comparison of two weaning strategies for non-invasive ventilation in chronic obstructive pulmonary disease patients with acute respiratory failure.
Non-Invasive Ventilation (NIV) is a crucial therapy for managing acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD) with hypercapnic respiratory failure. Research has shown that NIV can decrease the rate of endotracheal intubation, length of hospital and Intensive Care Unit stays, and mortality. There are three main strategies for weaning patients off NIV: gradual reduction of NIV duration, gradual reduction of NIV pressure support, and immediate cessation of NIV. ⋯ On comparison of two methods of NIV withdrawal, it was found that neither method is superior to the other in terms of weaning failure, intubation rates, and average length of hospital stay.