Postgraduate medicine
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Postgraduate medicine · Sep 2022
Oral versus subcutaneous semaglutide for prevention of major adverse cardiovascular events: cost per outcome analysis of SUSTAIN-6 and PIONEER-6.
Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP1a), reduces the risk of major adverse cardiovascular events (MACE) in patients with Type 2 diabetes mellitus (T2DM). An oral version of semaglutide is now available, and patients may prefer it over the subcutaneous form. Our objective was to compare the value for money of the two modalities by assessing the cost needed to treat (CNT) to prevent MACE. ⋯ Oral and subcutaneous semaglutide prescribed to prevent MACE in patients with T2DM provide similar value for money. The choice between both therapies should be guided mainly by patient preferences.
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Postgraduate medicine · Sep 2022
A retrospective study of diabetes treatment in older adults: what should we aim for?
Management of diabetes in elderly individuals requires a complex approach, considering the negative consequences. Glycemic overtreatment and undertreatment are relatively common conditions among this population. This study aimed to determine the potential overtreatment and undertreatment frequencies in older adults and the factors associated with these conditions. ⋯ Our study has shown that potential glycemic overtreatment and undertreatment are common problems in diabetic older adults. It was found that agents with a high risk of hypoglycemia, such as insulin and sulfonylureas, were more closely associated with potential overtreatment. In the management of diabetes in the elderly, it should be aimed to choose treatment agents that lead to less negative consequences and to follow up the patients more closely.
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Postgraduate medicine · Sep 2022
Utility of the systemic immune-inflammation index to predict serious bacterial infections in infants with fever without a source.
This study analyzed the utility of the systemic immune-inflammation index (SII) in predicting serious bacterial infections (SBIs) in infants with fever without a source (FWS). ⋯ We found that high CRP and SII values could be predictive for UTI without bacteremia in infants with FWS. The SII may be preferred because it can be easily calculated using the hemogram results, is not accompanied by extra costs, and does not require further blood collection.
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Postgraduate medicine · Sep 2022
Prediction of the severity of acute pancreatitis using machine learning models.
Acute pancreatitis (AP) is the most common pancreatic disease. Predicting the severity of AP is critical for making preventive decisions. However, the performance of existing scoring systems in predicting AP severity was not satisfactory. The purpose of this study was to develop predictive models for the severity of AP using machine learning (ML) algorithms and explore the important predictors that affected the prediction results. ⋯ The results showed that the XGBoost algorithm can accurately predict the severity of AP, which can provide an assistance for the clinicians to identify severe AP at an early stage.
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Postgraduate medicine · Sep 2022
Natural progress history of asymptomatic bacterial vaginosis in Chinese Han women and associated risk factors.
Asymptomatic bacterial vaginosis (aBV) is prevalent in the general population, while a previous study only investigated the natural history of aBV in women at high-risk. This stage study was to investigate the natural history of aBV in Chinese Han women at general risk and examine risk factors associated with different outcomes. ⋯ Without intervention, a large proportion of aBV would progress, compared to the very few patients whose aBV self-cured spontaneously. It is necessary to clinically intervene aBV patients. Condom utilization can be used as an effective method to improve the outcome of aBV.