Research examines CV prognosis, survival after stroke in diabetes patients | Increased risk for rare form of diabetes tied to family history of diabetes | Inflammation during pregnancy tied to brain changes in infant
A study in Diabetes Care showed that 72% of adults with type 1 diabetes and incident stroke had a vascular composite endpoint in 3.4 years of follow-up, including 32% who experienced a hard cardiovascular event, 32% who experienced a recurrent stroke and 8% who experienced multiple strokes. Finnish researchers evaluated data on 144 patients and found a steady drop in overall survival from 76% during the first year to 58% at five years.
Individuals who had first- or second-degree relatives with either type 1 or type 2 diabetes were at a twofold increased risk of developing latent autoimmune diabetes of adults, a rare form of type 1 diabetes, according to a study in Diabetes and Metabolism. Swedish researchers analyzed data on a previous study involving more than 3,000 people and found that those with LADA were more likely to be carriers of a high-risk genotype known as DR4-DQ8, which was common among those with a family history of type 1 diabetes, but were less likely to carry a low-risk genotype called DRX/X, compared with people with type 2 diabetes.
A study in Biological Psychiatry found elevated inflammatory markers in pregnant women during the first trimester were associated with an enlarged amygdala in infants and changes in amygdala connectivity. The changes to the amygdala were linked to impaired impulse control at age 2.
A database analysis estimated 86% of more than 105,000 patients with cardiovascular disease could reduce their LDL cholesterol to less than 70 mg/dl just using statin intensification with ezetimibe added as needed. An estimated 14% would hit maximum levels of the oral treatments and need to move on to a proprotein convertase subtilisin/kexin type 9 inhibitor, according to the study in JAMA Cardiology.
A Swedish study in Annals of the Rheumatic Diseases found women who used oral contraceptives were at a 13% lower risk of rheumatoid arthritis, compared with nonusers. The findings, based on 4,129 controls and 2,578 women with rheumatoid arthritis who tested positive for anticitrullinated protein antibodies, also showed that use of oral contraceptives for at least seven years was associated with 19% lower odds of developing the disease.
Two international studies in the online journal Hepatology showed how a three-drug regimen successfully eliminated the hepatitis C virus in treatment-resistant patients who were previously taking a two-drug combo of direct-acting antivirals. Participants in both trials received the triple-drug regimen once a day, which consisted of a combination of grazoprevir, ruzasvir and uprifosbuvir.
Researchers analyzed data on diabetes from the Blue Cross Blue Shield Health Index and found that the disease accounts for 9.3% of the health impact of more than 200 conditions on commercially insured US adults, with the highest impact seen in communities in the Central South and Southeast regions. The findings also showed that the health impact of diabetes continues to grow, especially among patients ages 18 to 34.
EHR access helps emergency medical services organizations improve clinical decision-making during high-stakes transitions of care and allows long-term post-acute care facilities to improve care coordination between providers and prescribers, experts say. Integrating EHR use and adopting health information exchange can also boost care management and collaboration among providers in specialty care facilities.
An oximeter-based automated apnea-hypopnea index had high agreement with traditional polysomnography index in identifying children with obstructive sleep apnea, yielding 75.2% accuracy at one event per hour, 81.7% accuracy at five events per hour and 90.2% accuracy at 10 events per hour. The findings in the American Journal of Respiratory and Clinical Care Medicine suggest the test may be a simpler and more cost-effective method of evaluating at-risk youths, researchers said.
More than 800 ICD-10 code changes that were approved by the CMS and the CDC for fiscal 2017 will be implemented Oct. 1, according to a blog written by Jerris Heaton, marketing coordinator at ChartLogic. These code changes, which include 123 deleted codes, 273 revised codes and 419 added codes, will be in effect through the end of September 2018, according to Heaton.
Nominate a deserving nurse practitioner or nurse practitioner advocate today for an AANP State Award for Excellence. You do not have to be an AANP member to nominate someone or to be nominated. The AANP 2018 State Award for Excellence Call for Nominations will close on Tuesday, October 10. To be considered for the 2018 awards, nominations must be submitted electronically to AANP on the official 2018 State Award Nomination Form. Thank you in advance for taking the time to nominate deserving NPs and NP advocates.
NAPNAP names new president
Congratulations to AANP member Tresa Zielinski, DNP, RN, APN-NP, CRNP-PC, who has been named president of the National Association of Pediatric Nurse Practitioners (NAPNAP). AANP looks forward to continuing to work with Dr. Zielinski and NAPNAP on projects and programs in the future.