Evidence-based veterinary nursing – it’s more sexy than you might think!

Evidence-based veterinary medicine is a concept that is increasingly integral to the practice of veterinary nursing. This article was based on the experiences of three recipients of a veterinary nursing bursary to attend the Veterinary Evidence conference this year as they learnt how important it is to develop the skill set needed to review the evidence and apply it to clinical practice. Support for nurses to develop these skills is widely available and RCVS Knowledge, in particular, provides a range of resources – from conferences and workshops to guides and online CPD tools – that nurses are encouraged to take advantage of.     

Diabetes prevention: is there more to it than lifestyle changes?

Over the past years, there has been an explosive increase in the prevalence of type 2 diabetes (T2DM) and this is expected to continue, entailing associated morbidity and mortality. An increasing number of studies explore the different ways T2DM could be prevented. On-going lifestyle modifications need to be addressed. High-risk patients should be given counselling on weight loss, possibly using a low glycaemic index diet, with a target of around 7-10% over 6-12 months, as well as instruction for increasing physical activity to around 150 min of physical exercise weekly (NNT = 4-8). Moderate alcohol consumption and coffee consumption may also be of benefit (NNT = 89 and 66, respectively). Metformin (NNT = 14), acarbose (NNT = 11) and troglitazone (NNT = 6) have been shown to prevent/delay T2DM and angiotensin-converting enzyme (ACE) inhibitors and statins appear to have an adjunctive role (NNT = 42 and 112, respectively). Trials with orlistat and bariatric surgery have also prevented T2DM (NNT = 36 and 6, respectively), and forthcoming treatment with GLP1 mimetics appears promising. Diabetes prevention studies should help create well-defined strategies for screening and treating high-risk populations in the real world, as prevention is our only chance to alleviate the ever growing burden of diabetes mellitus in the world.     

Perioperative statins: more than lipid-lowering?

Preliminary evidence indicates that statin drugs may be beneficial when given in the perioperative period. Although more studies are needed to draw firm conclusions, the acute nonlipid pleiotropic effects of statins may improve patient outcomes, especially for patients at the highest risk.     

Erythropoietin in the critically ill - is it more than just blood?

Erythropoietin (EPO) has been in clinical use for the treatment of anemia for over 15 years. Recently it has been demonstrated that EPO has actions other than stimulating the bone marrow. It has been suggested that due to its tissue protecting effect, EPO may be effective in improving outcome in the critically ill.     

Are girls more insulin-resistant than boys?

ObjectiveThe objective was to determine whether girls were more insulin-resistant than boys.Design and methodsData from 1009 children (508 males) in 10 elementary schools, between April and September, 2007 were collected. BMI, waist circumference (WC), blood pressure, Tanner stage, lipids, insulin, and glucose were obtained.ResultsOne hundred and sixty five (16.4%) of the children were obese (> 95%ile), and 166 (16.5%) were overweight (85–95%ile). Mean HOMA-IR and insulin were higher among 10.0–13.9-year-old girls than boys. Multiple logistic regression using the 3rd quartile of HOMA-IR as the dependent variable showed that only BMI OR = 1.18 (95% CI 1.12–1.24; p  < 0.001), Tanner OR = 1.39 (95% CI 1.12–1.73; p  = 0.003) and triglycerides 1.005 (95% CI 1.00–1.01; p  = 0.04) were significantly associated with insulin resistance while sex and HDL-C were not.ConclusionsThis study showed that no significant sex-related differences were found, and HOMA-IR was associated with adiposity and pubertal stage suggesting that the higher values of HOMA-IR in girls than in boys could be due to their earlier pubertal development.