Articles: health.
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Randomized Controlled Trial Multicenter Study
Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity.
Obesity increases the risk of heart failure with preserved ejection fraction. Tirzepatide, a long-acting agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, causes considerable weight loss, but data are lacking with respect to its effects on cardiovascular outcomes. ⋯ Treatment with tirzepatide led to a lower risk of a composite of death from cardiovascular causes or worsening heart failure than placebo and improved health status in patients with heart failure with preserved ejection fraction and obesity. (Funded by Eli Lilly; SUMMIT ClinicalTrials.gov number, NCT04847557.).
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High occupational stress is generally associated with poorer mental health and reduced performance in military personnel, whereas access to support resources is associated with positive outcomes. However, little research has examined the unique stressors and supports experienced by sailors on ships while underway at sea. The objectives of this study were to (1) identify sailors' underway stressors and supports and (2) examine how these differ as a function of demographic and operational factors. ⋯ Sailors experience many stressors while underway. Increasing the resources available to underway sailors may be warranted, especially for female and enlisted personnel. Additional research is necessary to develop targeted interventions and resources. Possible recommendations include noise mitigation, berthing area improvements, sleep and/or scheduling interventions, improved access to mental and physical health care, and interventions to reduce the stigma associated with seeking mental health care.
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Randomized Controlled Trial Multicenter Study Comparative Study
Continuation versus Interruption of Oral Anticoagulation during TAVI.
One third of patients undergoing transcatheter aortic-valve implantation (TAVI) have an indication for oral anticoagulation owing to concomitant diseases. Interruption of oral anticoagulation during TAVI may decrease the risk of bleeding, whereas continuation may decrease the risk of thromboembolism. ⋯ In patients undergoing TAVI with a concomitant indication for oral anticoagulation, periprocedural continuation was not noninferior to interruption of oral anticoagulation during TAVI with respect to the incidence of a composite of death from cardiovascular causes, stroke, myocardial infarction, major vascular complications, or major bleeding at 30 days. (Funded by the Netherlands Organization for Health Research and Development and the St. Antonius Research Fund; POPular PAUSE TAVI ClinicalTrials.gov number, NCT04437303.).