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Preterm Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Evidence for effectiveness (Table 19.5): There is currently insufficient evidence to support the routine administration of nitric oxide donors (NODs) for prevention of PTB in women with PTL [63]. Compared with placebo, there was no evidence that NOD prolonged pregnancy beyond 48 hours or improved neonatal outcomes. When compared with other tocolytic agents (betamimetics, magnesium sulfate, CCBS, or a combination of tocolytics), there was no evidence that NODs perform better than other tocolytics. Nitroglycerine has been the only NOD used in trials.
Complex scenarios
Published in Peter Tate, Francesca Frame, The Doctor's Communication Handbook, 2019
With all of these variables it can be rather like consulting while wearing a motorcycle helmet with a dirty visor. Familiar signals may not mean the same thing, eye contact may be abhorred, a nod may not indicate acceptance, and so on, so your only resort is to keep checking your patient's understanding as best you can. There are now several good texts on this subject, and you should read at least one of them.
The Promise of Therapy with Embryonic Stem Cells
Published in Howard Green, Therapy with Cultured Cells, 2019
There are two ways of obtaining keratinocytes from hES cells. One is to form embryoid bodies in vitro, allow them to undergo differentiation and harvest the resulting keratinocytes. These cells grow very poorly, although they can be made to grow by introducing the E6E7 genes of HPV16 (see below and Iuchi et al., 2006). A more convenient method is to inject hES cells into scid mice and allow them to grow into nodules in which differentiation into keratinocytes will take place. We call keratinocytes recovered in vitro from such nodules Nod cells to indicate that they are recovered from nodules.
Comparison of real-world effectiveness between valsartan and non-RAS inhibitor monotherapy on the incidence of new diabetes in Chinese hypertensive patients: An electronic health recording system based study
Published in Clinical and Experimental Hypertension, 2019
Tian Shen, Jiwei Wang, Yingjun Yu, Jinming Yu
Type-2 diabetes mellitus is also an important cause of cardiovascular morbidity and mortality (5), and hypertension is recognized as an independent risk factor for the development of diabetes (6). In a recent retrospective analysis of over 4 million adults, the incidence of new-onset diabetes (NOD) was associated with both systolic blood pressure (SBP; a 58% higher risk for a 20 mmHg increase) and diastolic blood pressure (DBP; a 52% higher risk for a 10 mmHg increase) (7). Risk factors for the development of NOD in people with hypertension include serum levels of glucose, triglycerides and potassium, body mass index (BMI), non-Caucasian race, age, heart rate, history of coronary heart disease and timing of antihypertensive medication (8–12). The incidence of NOD in patients with hypertension has been reported to range from 8.2–33.6/1000 person years (13–20). Furthermore, long-term studies have shown that patients with hypertension who develop NOD have higher morbidity and mortality than those who remain free of diabetes (9,17,21–23). This highlights the importance of minimizing the risk of NOD in patients being treated for hypertension.
A safety evaluation of evolocumab
Published in Expert Opinion on Drug Safety, 2018
New-onset diabetes (NOD) occurred more frequently in patients with IFG versus those with normal FPG as has been previously reported [23]. NOD was defined as any one of the following, post baseline: FPG ≥7.0 mmol/L (126 mg/dL), HbA1c ≥6.5%, AE report of diabetes mellitus or initiation of new glucose-lowering therapy. In the evolocumab patients with IFG, NOD occurred in 10.3% and in 14.1% of placebo IFG patients. In patients with normal FPG (<5.6 mmol/l or 100 mg/dL), NOD occurred in 2.7% of evolocumab patients and 1.9% of placebo patients. Overall incidence of NOD was 5.6% in the evolocumab patients and 6.6% in the placebo-treated patients. There was no statistically significant difference in NOD for any of the evolocumab versus placebo groups.
Impact of new-onset diabetes on clinical outcomes after ST segment-elevated myocardial infarction
Published in Scandinavian Cardiovascular Journal, 2019
Ji-Yeoun Seo, Jin-Sun Park, Kyoung-Woo Seo, Hyoung-Mo Yang, Hong-Seok Lim, Byoung-Joo Choi, So-Yeon Choi, Myeong-Ho Yoon, Gyo-Seung Hwang, Seung-Jea Tahk, Joon-Han Shin
Of 901 patients, 208 (23%) had diabetes at admission. Patients with diabetes were older than patients without diabetes. Patients with diabetes had higher rates of hypertension, end-stage renal disease, and multi-vessel disease but lower rates of smoking than patients without diabetes. Other baseline characteristics were not different between the diabetes group and the non-diabetes group (Supplementary Table 1). During mean follow-up period of 59 ± 28 months (range, 6 to 156 months), 81 (12%) patients of the non-diabetes group (n = 693) were diagnosed as NOD. The NOD group (n = 81, 54 ± 7 years old) was older than the non-NOD group (n = 612, 52 ± 12 years old). Other baseline characteristics were not different between the two groups (Supplementary Table 2). There are only about 66% of STEMI patients were prescribed statins at hospital discharge and the proportion of NOD patients was even less (59% in NOD, 67% in non-NOD). However, this was not meaningful statistically (p-value=.167). After 1:2 propensity score matching, the NOD group (n = 68, 54 ± 11 years old) and the non-NOD group (n = 136, 53 ± 12 years old) had no difference in baseline characteristics (Table 1). After diagnosis of NOD, oral antidiabetic drugs were prescribed for 61 patients (90%) of the 68 NOD patients, no antidiabetic medication were prescribed for 6 patients (9%) and just life style modifications were recommended. For only 1 patient (1%), insulin was prescribed. Incidences of MACE and all-cause of death in patients with diabetes were higher than those in patients without diabetes (MACE: 31.7% vs. 24.5%, p = .038; all-cause of death: 20.2% vs. 13.7%, p = .022, Supplementary Table 3). The incidence of all-cause of death in the non-NOD group was higher than that in the NOD group (15% vs. 5%, p = .015, Supplementary Table 4). However, MACEs or other secondary end-points did not show statistical differences between NOD and non-NOD groups. After 1:2 propensity score matching, primary or secondary end-points were not different between NOD and non-NOD groups (Table 2). Although there were no definite criteria of time to define ‘early NOD’ or ‘late NOD’, we defined the ‘early NOD’ (n = 32) as NOD was diagnosed within 1 year after index STEMI and the ‘late NOD’ (n = 36) was diagnosed 1 year after index STEMI. The primary and secondary endpoints were not different between early NOD and late NOD (Table 3). Among non-diabetes group (n = 204), number of patients with killip class 4 were 6. Three out of six patients were diagnosed with NOD. All 3 NOD patients did not have MACE. In Kaplan–Meier survival curve and Cox’s proportional hazard model, there were no statistical differences in event-free survival rates or hazard ratio between the two groups (Figure 2, Table 4).