Objectives: The study was to determine the impact of using the FreeStyle Libre<sup>TM</sup> flash glucose monitoring system on glycemic control and the rate of events due to diabetes in people with diabete...Objectives: The study was to determine the impact of using the FreeStyle Libre<sup>TM</sup> flash glucose monitoring system on glycemic control and the rate of events due to diabetes in people with diabetes from different types and age groups. Methods: a retrospective cohort chart review study was carried out at three centers in the Taif region in the Kingdom of Saudi Arabia: The study was approved by an accredited centralized institutional review board. Paper or electronic medical records were included for individuals of any age with diabetes (type 1, type 2, gestational diabetes) managed with diet, insulin therapy, or/and oral antihyperglycemic medication and/or non-insulin injection therapy. The primary outcome measure was the laboratory HbA1c level as well as reduction. Secondary outcome measures were frequency of severe hypoglycemia, admission to hospital or ER visit related to diabetes complications, and severe hyperglycemia (DKA or HHS). Results: Data was analyzed from 1695 patients. The average HbA1c before using the flash glucose monitoring system was 9.60% ± 1.44% and 3 months HbA1c after using the FreeStyle Libre<sup>TM</sup> flash glucose monitoring system was 8.70% + 1.45% for a difference of -0.90% ([95% CI -0.92: -0.88];p 65 years, (p-values Conclusion: The benefits of using the FreeStyle Libre<sup>TM</sup> flash glucose monitoring system are self-evident in reducing HbA1c and events due to hyperglycemia or hypoglycemia.展开更多
Background: Structural valve deterioration is the major cause of bioprosthetic valve failure. Because of the unique design features and anti-calcification treatment of the Freestyle(Medtronic Inc, Minneapolis, Minn) s...Background: Structural valve deterioration is the major cause of bioprosthetic valve failure. Because of the unique design features and anti-calcification treatment of the Freestyle(Medtronic Inc, Minneapolis, Minn) stentless bioprosthesis, development of structural valve deterioration may differ in comparison with other bioprosthetic valves. This study evaluates the mechanisms and clinical presentation of structural valve deterioration in the Freestyle stentless bioprosthesis. Methods: Between January 1993 and August 2005, 608 patients underwent aortic valve replacement with a Freestyle stentless bioprosthesis. The implantation technique was subcoronary in 475 patients and a root replacement in 133 patients. Mean overall follow-up was 5.6±3.4 years. Follow-up was complete in all patients. Clinical and echocardiographic follow-ups were conducted prospectively. Results: Freedom from structural valve deterioration was 95.8%at 10 years. Twelve patients showed evidence of structural valve deterioration and underwent reoperation for aortic regurgitation(n=10) or aortic stenosis(n=2). The mean age of patients with structural valve deterioration was significantly lower than patients without structural valve deterioration(62.6±8.2 years vs 68.6±8.3 years, P=.02). The median time between implantation and explantation was 8.7 years(range: 1.9-13.3 years). Eleven structural valve deteriorations occurred after subcoronary implantation, and 1 structural valve deterioration occurred after root implantation(P=.4). The mechanisms of structural valve deterioration were leaflet tears in 10 patients(6 in the left coronary cusp and 4 in the right coronary cusp), severe valve calcification in 1 patient, and cusp fibrosis in 1 patient. The interval between onset of symptoms and reoperation was acute or subacute in 10 patients. Conclusion: At 10 years, the Freestyle stentless bioprosthesis shows excellent freedom from structural valve deterioration. Structural valve deterioration in the Freestyle stentless bioprosthesis relates to leaflet tear with minimal calcification in the majority of cases. Because of the fast onset of symptoms with leaflet tear, patients with a Freestyle stentless bioprosthesis should be informed of the preferential mode of failure and time-frame of symptoms.展开更多
文摘Objectives: The study was to determine the impact of using the FreeStyle Libre<sup>TM</sup> flash glucose monitoring system on glycemic control and the rate of events due to diabetes in people with diabetes from different types and age groups. Methods: a retrospective cohort chart review study was carried out at three centers in the Taif region in the Kingdom of Saudi Arabia: The study was approved by an accredited centralized institutional review board. Paper or electronic medical records were included for individuals of any age with diabetes (type 1, type 2, gestational diabetes) managed with diet, insulin therapy, or/and oral antihyperglycemic medication and/or non-insulin injection therapy. The primary outcome measure was the laboratory HbA1c level as well as reduction. Secondary outcome measures were frequency of severe hypoglycemia, admission to hospital or ER visit related to diabetes complications, and severe hyperglycemia (DKA or HHS). Results: Data was analyzed from 1695 patients. The average HbA1c before using the flash glucose monitoring system was 9.60% ± 1.44% and 3 months HbA1c after using the FreeStyle Libre<sup>TM</sup> flash glucose monitoring system was 8.70% + 1.45% for a difference of -0.90% ([95% CI -0.92: -0.88];p 65 years, (p-values Conclusion: The benefits of using the FreeStyle Libre<sup>TM</sup> flash glucose monitoring system are self-evident in reducing HbA1c and events due to hyperglycemia or hypoglycemia.
文摘Background: Structural valve deterioration is the major cause of bioprosthetic valve failure. Because of the unique design features and anti-calcification treatment of the Freestyle(Medtronic Inc, Minneapolis, Minn) stentless bioprosthesis, development of structural valve deterioration may differ in comparison with other bioprosthetic valves. This study evaluates the mechanisms and clinical presentation of structural valve deterioration in the Freestyle stentless bioprosthesis. Methods: Between January 1993 and August 2005, 608 patients underwent aortic valve replacement with a Freestyle stentless bioprosthesis. The implantation technique was subcoronary in 475 patients and a root replacement in 133 patients. Mean overall follow-up was 5.6±3.4 years. Follow-up was complete in all patients. Clinical and echocardiographic follow-ups were conducted prospectively. Results: Freedom from structural valve deterioration was 95.8%at 10 years. Twelve patients showed evidence of structural valve deterioration and underwent reoperation for aortic regurgitation(n=10) or aortic stenosis(n=2). The mean age of patients with structural valve deterioration was significantly lower than patients without structural valve deterioration(62.6±8.2 years vs 68.6±8.3 years, P=.02). The median time between implantation and explantation was 8.7 years(range: 1.9-13.3 years). Eleven structural valve deteriorations occurred after subcoronary implantation, and 1 structural valve deterioration occurred after root implantation(P=.4). The mechanisms of structural valve deterioration were leaflet tears in 10 patients(6 in the left coronary cusp and 4 in the right coronary cusp), severe valve calcification in 1 patient, and cusp fibrosis in 1 patient. The interval between onset of symptoms and reoperation was acute or subacute in 10 patients. Conclusion: At 10 years, the Freestyle stentless bioprosthesis shows excellent freedom from structural valve deterioration. Structural valve deterioration in the Freestyle stentless bioprosthesis relates to leaflet tear with minimal calcification in the majority of cases. Because of the fast onset of symptoms with leaflet tear, patients with a Freestyle stentless bioprosthesis should be informed of the preferential mode of failure and time-frame of symptoms.
