The American College of Obstetricians and Gynecologists this week recommended women receive treatment for a "fourth trimester," beginning within three weeks of birth and focusing on maternal physical, social and psychological well-being. The recommendation for ongoing care, published in Obstetrics & Gynecology, called for an initial postpartum assessment and follow-up to include issues such as emotional well-being, infant care, sexuality, contraception and sleep.
Patients with type 2 diabetes had lower aortic distensibility, an indication of aortic stiffness, and increased concentric left ventricular remodeling and LV mass, compared with those without diabetes, according to a study in Diabetes. UK researchers suggested focusing treatment on aortic stiffness to help patients with diabetes prevent the development of heart failure.
A study in Acta Diabetologica showed a significant association between increased sedentary time and higher depression symptoms and lower diabetes self-efficacy among women with type 2 diabetes, but not among male patients. Researchers conducted a cross-sectional study involving 163 diabetes patients, mean age of 62.7, and found that increased physical activity was associated with higher diabetes self-efficacy in male patients and higher social support rates in female patients.
UK researchers evaluated 54,803 adults with type 1 or type 2 diabetes, age at least 70, and found a substantial increase in mortality risk as A1C variability increased in gender-based analyses and in all models for the overall cohort. The findings were published in The Lancet Diabetes & Endocrinology.
Jeffrey Veale, director of the University of California at Los Angeles Kidney Transplantation Exchange Program, has transplanted three previously donated kidneys since 2017 and says reusing organs that are in high demand can ease shortages and save lives. "This breaks all policies and procedures. But we shouldn't be discarding these young, healthy kidneys," Veale said.
Infants whose mothers received tenofovir, emtricitabine and ritonavir-boosted lopinavir for HIV had a similar likelihood of being born preterm or with low birth weight, compared with those whose mothers received either tenofovir, emtricitabine and ritonavir-boosted atazanavir or zidovudine, lamivudine and ritonavir-boosted lopinavir, researchers reported in The New England Journal of Medicine. The findings also showed similar odds of very preterm birth or very low birth weight across the HIV treatment regimens.
IBM Watson Health's list of the top 15 US health systems included nine that were on the list in 2017. Health systems that made the list were more consistent in their clinical and operational performance and had fewer in-hospital deaths, complications and health care-associated infections than systems that did not make the list.
Hospital emergency departments that did three daily cross-checks, allowing physicians to present their cases and get feedback from their peers, saw a reduction in some medical errors but not in serious adverse events, according to a study in JAMA Internal Medicine. Researchers said cross-checking allows more patients to get the benefit of a second opinion, but because emergency departments see a variety of patients and conditions, implementation is difficult.
Japanese researchers found that the synthetic vitamin A derivative acyclic retinoid destroyed EpCAM-positive hepatocellular cancer stem cells with elevated expression of the MYCN gene, while liver biopsies of 12 individuals whose HCC was removed through liver resection or ablation showed those who received 600 mg of acyclic retinoid daily for eight weeks had lower MYCN expression than those who only took 300 mg of the compound daily. The findings in the Proceedings in the National Academy of Sciences suggest that acyclic retinoid may curb HCC recurrence, researchers said.
An Express Scripts poll found that two-thirds of 800 adults with chronic diseases said they would be more likely to comply with their medication schedule if they received a reward for doing so, and that percentage rose to 88% among patients ages 18-34. Of all of those surveyed, 82% expressed a preference for personal monetary rewards, while 3% opted for charitable contributions.
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