Postgraduate medicine
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Postgraduate medicine · Jun 2015
Type 2 diabetes mellitus treatment patterns in U.S. nursing home residents.
The prevalence of type 2 diabetes mellitus (diabetes) in nursing home residents (NHRs) is increasing, concurrently with obesity and other comorbid conditions. NHR would benefit greatly from antidiabetic medications that would improve glycemic control and give a lower risk of hypoglycemia but that do not contribute to weight gain in obese individuals. ⋯ Considerations other than glycemic control may drive prescribing decisions, contrary to recommendations from the American Diabetes Association, American Medical Directors Association, and European Association for the Study of Diabetes.
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Postgraduate medicine · Jun 2015
Individual and societal consequences of hypoglycemia: A cross-sectional survey.
Hypoglycemia and fear of hypoglycemia threaten individuals' ability to work and drive. We studied the effect of hypoglycemia on the individual and society, with a focus on possible implications of new European union legislation on patients' continued ability to drive. ⋯ A high proportion of insulin-treated patients experience hypoglycemia resulting in fear of hypoglycemia and changes in self-care behavior that may compromise glycemic control. Many patients with a history of severe hypoglycemia consider underreporting hypoglycemic events through concern over retaining their driving license.
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Postgraduate medicine · Jun 2015
Meta AnalysisEfficacy and safety of the dipeptidyl peptidase-4 inhibitor linagliptin in black/African American patients with type 2 diabetes: Pooled analysis from eight Phase III trials.
The prevalence of type 2 diabetes in black/African Americans from North and South America is high; yet data evaluating antidiabetic agents in this population is scarce. To address this gap, we pooled data from the clinical development program for linagliptin. ⋯ Linagliptin provided clinically significant improvements in glycemic control without increased risk of hypoglycemia and without weight gain, representing a useful type 2 diabetes therapy option for the black/African American population.
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Postgraduate medicine · Jun 2015
Meta AnalysisDiagnostic accuracy of endostatin for malignant pleural effusion: A clinical study and meta-analysis.
The diagnosis of malignant pleural effusion (MPE) remains a clinical challenge. Many studies suggest that endostatin is a potential marker for MPE. This study aimed to determine the diagnostic value of endostatin with respect to MPE and to summarize the overall diagnostic performance of endostatin via a meta-analysis. ⋯ Pleural levels of endostatin are increased in the setting of MPE. However, endostatin exhibits a limited efficacy for the diagnosis of MPE and shows a relatively low sensitivity. The assessment of endostatin in combination with CEA may enhance diagnostic accuracy with respect to MPE.
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Postgraduate medicine · Jun 2015
ReviewHispanic Americans living in the United States and their risk for obesity, diabetes and kidney disease: Genetic and environmental considerations.
The Hispanic American, the largest minority population in the United States, is at increased risk for obesity, diabetes and end-stage renal disease. Here we review genetic and environmental factors that might account for their increased risk for these conditions. Whereas many environmental and genetic factors have important roles in driving the increased risk for obesity and kidney disease in this population, a case is made that excessive intake of sugary beverages is a contributory cause. Studies focusing on decreasing intake of sugary beverages among the Hispanic American could potentially reduce renal and cardiovascular complications in this population.