Articles: disease.
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The management of patients with coronary artery disease (CAD) is complex, especially after they have been discharged from hospital after an acute coronary syndrome (ACS), because each patient may have numerous healthcare providers, and follow-up after discharge may be disjointed, or even incomplete. During follow-up after ACS, few patients have treatment intensification; rather, there is actually a major tendency towards reductions in treatment intensity, to the potential detriment of outcomes. We present here guidance from a French expert panel for the optimal management of lipid-lowering therapy up to 1 year after ACS. ⋯ Then, the strategy should be rapidly intensified by adding a PCSK9 inhibitor if the patient does not reach LDL-c levels below 55 mg/dL. We advocate this intensive strategy, which has demonstrated a further reduction in ischemic events, without safety concerns, even for patients who reach very low LDL-cholesterol levels. This approach, comprising few therapeutic steps, aims to rapidly reach LDL-c goals, improve patient compliance, and is an efficient method to fight therapeutic inertia, which remains a major issue.
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Mayo Clinic proceedings · Jun 2023
Incidence, Risk Factors, and Outcomes of Incident Atrial Fibrillation in Patients With Graves Disease.
To describe the incidence, risk factors, and outcomes of incident atrial fibrillation (AF) in Graves disease (GD). ⋯ Late-onset AF comprised one-quarter of GD-related AF cases requiring surveillance even after restoring euthyroidism. Risk factors for AF in GD are similar to those in the general population although overt hyperthyroidism conferred the highest risk, especially for early AF. Treatment with thionamide was associated with late AF.
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Sleep-disordered breathing (SDB) is a group of sleep-related breathing disorders which includes obstructive sleep apnea (OSA), central sleep apnea (CSA), and obesity hypoventilation syndrome (OHS). OHS is characterized by a combination of obesity, daytime hypercapnia and hypoxemia, and sleep-disordered breathing without other known hypoventilation causes, such as severe obstructive or restrictive parenchymal lung disease, kyphoscoliosis, severe hypothyroidism, neuromuscular disease, or congenital central hypoventilation syndrome. Four hundred ninety potentially eligible references were identified; of these, 462 abstracts or full texts were excluded because they did not fulfil inclusion criteria. ⋯ On the other hand, there is often a delay in diagnosing these diseases in women as compared to men; therefore, they are often more advanced when diagnosed in women. Better understanding and clinical awareness of the higher OHS prevalence in postmenopausal women may lead to earlier diagnosis and a more timely and appropriate treatment. Further studies are needed to assess the prevalence of OHS in women, the effect of menopause on OHS, and the increased risk of OHS, which will hopefully lead to optimizing OHS patient care.
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J Pain Palliat Care Pharmacother · Jun 2023
Home Management and Prevention of Vaso-Occlusive Crisis of Sickle Cell Disease Knowledge among Nursing Students.
Sickle cell crisis, or vaso-occlusive crisis, is a painful complication of sickle cell disease that occurs in adolescents and adults, which is considered the most common reason these patients seek medical attention in an emergency room. Despite the high prevalence of sickle cell disease in the Jazan region, Saudi Arabia, there hasn't been a study looking at nursing students' knowledge about sickle cell disease and home management and prevention of vaso-occlusive crises associated with sickle cell disease. ⋯ A descriptive cross-sectional design was used in this study that involved 167 nursing students. The study revealed that Aldayer nursing students had adequate knowledge about the home management and prevention of sickle cell disease vaso-occlusive crises.
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Mayo Clinic proceedings · Jun 2023
Association Between Stable Coronary Artery Disease and Hospital Readmissions Following Catheter Ablation for Atrial Fibrillation.
To evaluate the association of stable coronary artery disease (CAD) with readmission following hospitalization for catheter ablation (CA) for atrial fibrillation (AF). ⋯ Results of this large-scale analysis suggest that among patients hospitalized for CA for AF, stable CAD is associated with hospital readmissions within 90 days, including admissions for ACS and decompensated HF.