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Fenofibrate may reduce heart disease risk in some patients with type 2 diabetes

Fenofibrate may reduce heart disease risk in some patients with type 2 diabetes

A new study shows that the drug fenofibrate might reduce the risk of cardiovascular events in patients with type 2 diabetes who have high levels of triglycerides and low levels of ‘good’ cholesterol, despite being treated with statins. Fenofibrate is primarily used to help reduce elevated levels of triglycerides, or fat, in the blood. But the researchers wanted to know if the drug, when combined with statin treatment, could also reduce the risk of heart disease in people with type 2 diabetes. People with type 2 diabetes are at high risk of cardiovascular-related events, such as heart attacks, stroke, and even death, often because their levels of triglycerides are so high, and their high-density lipoprotein (HDL) cholesterol levels are low. To answer their question, the researchers followed 4,640 participants from the NHLBI-funded Action to Control Cardiovascular Risk in Diabetes (ACCORD) Lipid Study for five years after the conclusion of the trial in 2009. The findings suggest that fenofibrate therapy may be beneficial in the way the researchers hoped: by reducing cardiovascular events in patients with type 2 diabetes who take statins but still have especially high triglycerides levels and low HDL cholesterol levels. However, a randomized study is needed to confirm these findings, according to the...
To Standardize or Not to Standardize?

To Standardize or Not to Standardize?

How much can we standardize medicine, and even if we can, is that a good thing? There was a meeting yesterday for all of our Ambulatory Care Network to bring the directors of the multiple practices together, to find out what we could standardize across the practices, what made sense, what was feasible, what might help, and what might be good for patients, providers, and the regulatory requirements that weigh so heavily on our shoulders. During a recent institution-wide Joint Commission Mock Survey, one of the many comments that were received from the surveyors was the apparent lack of standardization in how we do things. From site to site, practice to practice, how packages are received and processed, how supplies are stored, how patient identification and verification is done, how facility administered medications are given, seemed to vary so much, that it apparently seemed to the surveyors that each practice had made up their policies and procedures on their own. The leadership, in reviewing these comments, had decided that it was worth looking at all the things we do across all of our practices, and perhaps try to standardize things. To try and ensure that patients moving from one practice to another get the same experience on the phones, at registration, with nursing, with their providers, with every interaction throughout our healthcare system. The question I have is, is this a good thing? Ever? Always? Never? Standardization in healthcare can certainly improve efficiencies, decrease errors, improve patient and provider experiences, but at what cost? Where do we put the standardization in, where do we enforce it, how much leeway...
Final trial results confirm Ebola vaccine provides high protection against disease

Final trial results confirm Ebola vaccine provides high protection against disease

An experimental Ebola vaccine was highly protective against the deadly virus in a major trial in Guinea, according to results published in The Lancet. The vaccine is the first to prevent infection from one of the most lethal known pathogens, and the findings add weight to early trial results published last year. The vaccine, called rVSV-ZEBOV, was studied in a trial involving 11,841 people in Guinea during 2015. Among the 5,837 people who received the vaccine, no Ebola cases were recorded 10 days or more after vaccination. In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine. The trial was led by the World Health Organization, together with Guinea’s Ministry of Health and other international partners. “While these compelling results come too late for those who lost their lives during West Africa’s Ebola epidemic, they show that when the next Ebola outbreak hits, we will not be defenceless,” said Dr Marie-Paule Kieny, WHO’s Assistant Director-General for Health Systems and Innovation, and the study’s lead author. The vaccine’s manufacturer, Merck, Sharpe & Dohme, this year received Breakthrough Therapy Designation from the United States Food and Drug Administration and PRIME status from the European Medicines Agency, enabling faster regulatory review of the vaccine once it is submitted. Since Ebola virus was first identified in 1976, sporadic outbreaks have been reported in Africa. But the 2013-2016 West African Ebola outbreak, which resulted in more than 11,300 deaths, highlighted the need for a vaccine. The trial took place in the coastal region of Basse-Guinée, the area of Guinea still experiencing new Ebola cases...
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