Non-invasive indirect monitoring of intra-abdominal pressure using microwave reflectometry: system design and proof-of-concept clinical trial

Journal of Clinical Monitoring and Computing - Monitoring intra-abdominal pressure (IAP) has become a standard in intensive care units. Correlation between the abdominal wall’s thickness...     

Positioning sulphonylureas in a modern treatment algorithm for patients with type 2 diabetes: Expert opinion from a European consensus panel

The large number of pharmacological agents available to treat type 2 diabetes (T2D) makes choosing the optimal drug for any given patient a complex task. Because newer agents offer several advantages, whether and when sulphonylureas (SUs) should still be used to treat T2D is controversial. Published treatment guidelines and recommendations should govern the general approach to diabetes management. However, expert opinions can aid in better understanding local practices and in formulating individual choices. The current consensus paper aims to provide additional guidance on the use of SUs in T2D. We summarize current local treatment guidelines in European countries, showing that SUs are still widely proposed as second-line treatment after metformin and are often ranked at the same level as newer glucose-lowering medications. Strong evidence now shows that sodium-glucose co-transporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with low hypoglycaemia risk, promote weight loss, and exert a positive impact on vascular, cardiac and renal endpoints. Thus, using SUs in place of SGLT-2is and GLP-1RAs may deprive patients of key advantages and potentially important cardiorenal benefits. In subjects with ascertained cardiovascular disease or at very high cardiovascular risk, SGLT-2is and/or GLP-1RAs should be used as part of diabetes management, in the absence of contraindications. Routine utilization of SUs as second-line agents continues to be acceptable in resource-constrained settings.     

Preventing all-cause hospitalizations in type 2 diabetes with sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists: A narrative review and proposed clinical approach

Patients with type 2 diabetes (T2D) are at increased risk for hospital admissions, and acute hospitalizations are associated with a worse prognosis. However, outcomes related to all-cause hospital admissions (ACHAs) were often overlooked in trials that demonstrated the cardiovascular and kidney benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs). This review includes a contemporary literature summary of emerging data regarding the effects of SGLT2 inhibitors and GLP-1RAs on ACHAs. The role of SGLT2 inhibitors in preventing ACHAs was shown in exploratory investigations of several randomized controlled trials (RCTs) and was further supported by real-world evidence (RWE). However, the association between GLP-1RA use and lower ACHA risk was mainly shown through RWE, with minimal available RCT data. We also discuss the advantages and challenges of studying ACHAs. Finally, we propose an easily memorized (“ABCDE” acronym) clinical approach to evaluating T2D status and treatment in admitted patients, as they transition from hospital to community care. This systematic approach may assist clinicians in recognizing possible pitfalls in T2D management, thereby preventing subsequent hospitalizations and improving patient prognoses. While acute admission can sometimes be perceived as a management failure, it should also be viewed as an opportunity to take action to prevent the next hospitalization.     

Efficacy of etretinate (Tigason) in symptomatic oral lichen planus.

This study evaluated the maximum permitted dosage of etretinate (75 mg/day) as the first mode of systemic treatment of patients with symptomatic oral lichen planus. Six patients were treated and examined objectively and subjectively every 2 weeks for 2 months. At the end of the study 50% of patients reached an asymptomatic stage; improvement of clinical signs and symptoms was noted in all patients. However, on reevaluation 2 months after treatment was discontinued some clinical signs of recurrence were seen in all patients. Further follow-up for more than a year showed that the patients had reverted to the same frequency of recurrence as before the systemic use of etretinate.     

The Efficacy of a Pilot Prevention Program for Children and Caregivers Coping with Economic Strain

Poverty and economic stress are risk factors for child psychopathology; however, primary and secondary control coping can buffer children against the negative effects of these risks. A 4-week (12 h) pilot prevention program aimed at enhancing coping skills and preventing symptoms of psychopathology among children growing up in poverty was evaluated using a multiple baseline design. Participants were 24 children (ages 8–12) and their primary caregivers. Attrition was low and parent-reports of program satisfaction were high. Children’s ability to generate positive coping thoughts and high quality solutions to problems improved from pre- to post-intervention. At the post-intervention measurement, parents’ and children’s involuntary engagement stress responses had declined and parents’ secondary control coping had increased. Children’s internalizing and externalizing symptoms also decreased from pre- to post-intervention, according to parent-reports. Results provide preliminary evidence for the feasibility and efficacy of the intervention.