Articles related to Endocrinology, Diabetes, Metabolism

Delve into the changes in the updated Beers criteria and their implications for medication use in older patients. The American Geriatrics Society (AGS) has recently revised the Beers criteria. Significantly, these guidelines advise physicians to be cautious when prescribing medications like warfarin and sodium-glucose cotransporter-2 (SGLT2) inhibitors for patients over 65. Importantly, warfarin is now a drug to avoid in initial therapy for venous thromboembolism or nonvalvular atrial fibrillation unless alternatives are contraindicated or face significant usage barriers. The Beers criteria are organized into five distinct categories. These include potentially inappropriate medications, ones that might be inappropriate for patients with certain conditions, medications requiring careful usage, potential drug-drug interactions, and medications needing renal function-based dosage adjustments. An expert panel sifted through evidence from June 1, 2017, to May 31, 2022, to create these updates. These guidelines apply to patients aged 65 years and older in most care settings in the US, excluding hospice and end-of-life care situations. Among the notable changes since 2019 is the inclusion of warfarin. For older patients using warfarin long-term, continuation might be reasonable if they show well-controlled international normalized ratios and no adverse effects. Additional drugs introduced since 2019 include ticagrelor and SGLT2 inhibitors (use […]

A retrospective cohort study was conducted to investigate the effectiveness of glucagon-like peptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) in preventing major adverse cardiac events (MACE) for individuals without preexisting cardiovascular disease. The study included US veterans aged 18 or older who were receiving care from the Veterans Health Administration. The cohort consisted of patients who added either GLP1RA, SGLT2i, or dipeptidyl peptidase-4 inhibitors (DPP4i) to their existing diabetes treatments. The outcomes measured were MACE and heart failure hospitalization. The results showed that the addition of GLP1RA was associated with a lower incidence of MACE and heart failure compared to DPP4i. However, the addition of SGLT2i did not show a significant association with primary prevention of MACE.

A 37-year-old man presented with persistent swelling, limited range of motion, and loss of hand dexterity in both hands. He had a history of IV drug use, including opiates and methamphetamine. The examination showed diffuse swelling without joint inflammation. Lab tests were normal, and imaging revealed soft-tissue swelling. The diagnosis was puffy hand syndrome, a common complication of IV drug use. Treatment options are mainly symptomatic, including discontinuation of IV drug use and the use of low-stretch bandages and compression gloves. Puffy hand syndrome, often unrecognized by general practitioners, should be considered in patients with swelling and limited hand function who have a history of IV drug use. The syndrome involves progressive fibrosis of subcutaneous tissues due to repeated injection-induced vascular and dermal sclerosis. Diagnosis is based on clinical presentation, history, and evaluation ruling out other conditions. Treatment focuses on symptomatic relief and cessation of IV drug use.

Adding to the evidence that good nutrition supports healthy aging, this study shows that blood levels of certain saturated fatty acids, along with omega-6, -7 and -9 fatty acids, correlated with improved memory as well as larger frontal, temporal, parietal lobes.

In the first update in more than five years, these new guidelines review dosing recommendations for 41 antimicrobials, as applicable for patients with a BMI greater than or equal to 30 kg/m.

Given at a higher dose than for DM2, a weekly semaglutide injection sustainably reduced weight by an average of 15% together with diet. What are the precautions? And what else is on the horizon in the class?