Meredithsantos9972

Introduction Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a relatively novel glucose-lowering drugs (GLDs) which additionally promote weight loss and blood pressure reduction among other beneficial effects.Areas covered This review reflects on the extra-glycemic effects of SGLT2 inhibitors and their impact on important clinical endpoints, and provides an overview of data relating to a newer member of the SGLT2 inhibitor class, bexagliflozin.Expert opinion SGLT2 inhibitors, while consolidating glycemic control as adjunctive therapy, indisputably affect cardio-renal benefits in the T2D population which is prevalently afflicted by heightened cardiovascular risk and a disproportionately increased incidence of unfavorable cardiovascular and renal outcomes. The data from landmark trials demonstrate that beneficial effects of SGLT2 inhibitors extend to non-diabetic patients with chronic kidney disease (CKD) and/or heart failure with reduced ejection fraction (HFrEF). Preliminary findings from the BEST trial suggest that Bexagliflozin's effects reflect those of other licensed drugs in its class. Bexagliflozin has also been shown to be safe and effective in patients with diabetes and CKD stage 3b. If and when approved, it presents physicians with the prospect of an additional therapeutic option in managing patients with type 2 diabetes mellitus (T2D), and conceivably also, nondiabetic patients with established CKD and/or HFrEF.Individuals with personality disorders (PDs) comprise 30% to 40% of individuals receiving mental health treatment. Treatment of PDs is exceedingly difficult; therefore, research has focused on PD etiology and preventative factors. One known influence on PD etiology is adverse childhood experiences (ACEs). ACEs are associated with increased prevalence of several health risk behaviors (HRBs), including engagement in substance use, criminal, and risky sexual behavior. One protective factor, childhood resiliency, predicts lower prevalence of PDs and engagement in HRBs. We hypothesized that increased prevalence of ACEs would predict higher levels of PD symptoms and HRBs engagement. Furthermore, we predicted that childhood resiliency would moderate the relation between ACEs, PD symptoms, and HRBs. In the present study, students (N = 531) completed the Adverse Childhood Experiences survey, the Self-Administered - Standardized Assessment of Personality Abbreviated Scale, and the Childhood Youth and Resiliency Measure-28. They also responded to questions about substance use, criminal, and sexual behavior which were used to define a latent HRB variable. Structural equation modeling was conducted to examine study hypotheses. As hypothesized, we found positive relations between ACEs, PD symptoms, and our HRB latent variable. Childhood resiliency moderated both ACE and PD symptom paths. At lower levels of reported ACEs, individuals high in childhood resiliency reported fewer PD symptoms and HRBs than individuals low in childhood resiliency. At high levels of ACEs, childhood resiliency did not serve as a protective factor. Additionally, study findings suggest that childhood resiliency factors are integral for protecting against the development of these disorders.

There are 3.8 million mild traumatic brain injuries (mTBIs) that occur each year in the United States. Many are left with prolonged life-altering neurocognitive deficits, including difficulties in attention, concentration, mental fatigue, and distractibility. With extensive data on the safety and efficacy of stimulant medications in treating attention deficit, concentration difficulties and distractibility seen with attention deficit disorder, it is not surprising that interest continues regarding the application of stimulant medications for the persistent neurocognitive deficits in some mTBIs.

Studies were extracted from PubMed based on the topics of neurocognitive impairment, mTBI, stimulant use in mTBI, stimulants, and the association between attention deficit/hyperactivity disorder and mTBI. The search criteria included a date range of 1999 to 2020 in the English language.

Literature review.

Level 4.

Currently, there is very limited literature, and no guidelines for evaluating the use of stimulaference dependent. Given the limited encouraging data currently available, physicians may consider stimulant medication in appropriate patients to facilitate the recovery of prolonged neurocognitive deficits, while remaining cognizant of potential adverse effects.Introduction Guidelines recommend the use of amikacin in the treatment of nontuberculous mycobacterial (NTM) disease. The authors have evaluated the evidence for the position of amikacin in NTM disease treatment.Areas covered The authors performed a literature search for original research on amikacin in NTM disease, including its mechanism of action, emergence of resistance, pre-clinical and clinical investigations.Expert opinion Amikacin shows moderate in vitro activity against the clinically most relevant NTM species (M. avium complex and M. abscessus). It is synergistic with ethambutol, clofazimine, and macrolides and these combinations are effective in animal models. Liposomal encapsulation increases amikacin efficacy. Clinically, the recommended dose of 15 mg/kg intravenous amikacin does not lead to PK/PD target attainment in all patients and a positive impact on long-term treatment outcomes remains unproven in both M. avium complex and M. abscessus disease. Adding the amikacin liposome inhalation suspension did prove to be effective in short and long term in patients not responding to recommended treatment for M. avium complex pulmonary disease. selleck products Its optimal use in M. avium complex and M. abscessus pulmonary disease warrants further evaluation.The purpose of this article is to report the literature review findings of our larger deprescribing initiative, with the goal of developing a competency framework about deprescribing to be incorporated into the future geriatric nursing education curriculum. A literature review was conducted to examine the facilitators and barriers faced by nurses with regard to the process of deprescribing for older adults, and the development of deprescribing competency in nursing education. We adopted the seven steps of the Comprehensive Literature Review Process Model, which is sub-divided into the following three phases (a) Exploration; (b) Interpretation; and (c) Communication. A total of 24 peer-reviewed documents revealed three major facilitating factors (a) Effective education and training in deprescribing; (b) Need for continuing education and professional development in medication optimization; and (c) Benefits of multi-disciplinary involvement in medication management.