Tight blood sugar control reduces the risk of developing microvascular diabetes complications. The evidence of benefit is mainly from studies in younger patients at early stages of the disease. Benefits need to be weighed against risks including severe hypoglycaemia, and patient training is an important aspect in practice. The effects of tight blood sugar control seem to become weaker once complications have been manifested. However, further research is needed on this issue. Furthermore, there is a lack of evidence from RCTs on the effects of tight blood sugar control in older patient populations or patients with macrovascular disease. There is no firm evidence for specific blood glucose targets and treatment goals need to be individualised taking into account age, disease progression, macrovascular risk, as well as the patient's lifestyle and disease management capabilities. Fullerton B, Jeitler K, Seitz M, Horvath K, Berghold A, Siebenhofer A.
Cochrane Database Syst Rev. 2014 Feb 14;2:CD009122. [Epub ahead of print] PMID: 24526393
Continuous versus interrupted skin sutures for non-obstetric surgery
Superficial wound dehiscence may be reduced by using continuous subcuticular sutures. However, there is uncertainty about this because of the quality of the evidence. Besides, the nature of the suture material used may have led to this observation, as the continuous suturing technique used suture material that did not need to be removed, whereas the comparator used interrupted (non-absorbable) sutures that did need to be removed. Differences in the methods of skin closure have the potential to affect patient outcomes and use of healthcare resources. Further well-designed trials at low risk of bias are necessary to determine which type of suturing is better. Gurusamy KS, Toon CD, Allen VB, Davidson BR. Cochrane Database Syst Rev. 2014 Feb 14;2:CD010365. [Epub ahead of print] PMID: 24526375
Impact of Anticholinergic Discontinuation on Cognitive Outcomes in Older People: A Systematic Review
The impact of anticholinergic discontinuation on cognitive function remains poorly researched and poorly understood. A larger sample size, longer duration of follow-up and better methods of assessing anticholinergic-induced cognitive impairment are warranted. Salahudeen MS, Duffull SB, Nishtala PS. Drugs Aging. 2014 Feb 14. [Epub ahead of print] PMID: 24526293
Hypoglycemia in Insulin-Treated Adults on Established Nasogastric Feeding in the General Ward: A Systematic Review
ConclusionsHypoglycemia is not uncommon in this population, but further research is needed for quantification. Standardized documentation and reporting methods incorporating sample size and study duration, such as hypoglycemic events per patient-days, would facilitate interstudy comparisons, as would documentation of hypoglycemia at the 2 most commonly defined levels: < 63 mg/dL (3.5 mmol/L) and < 70 mg/dL (3.9 mmol/L). Vindedzis SA, Sherriff JL, Stanton KG. Diabetes Educ. 2014 Feb 13. [Epub ahead of print] PMID: 24525570
Change in mental health after smoking cessation: systematic review and meta-analysis
Smoking cessation is associated with reduced depression, anxiety, and stress and improved positive mood and quality of life compared with continuing to smoke. The effect size seems as large for those with psychiatric disorders as those without. The effect sizes are equal or larger than those of antidepressant treatment for mood and anxiety disorders. Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P. BMJ. 2014 Feb 13;348:g1151. PMID: 24524926
A Systematic Review and Pooled Analysis of CPR-Associated Cardiovascular and Thoracic InjuriesThe incidence of reported CPR-associated cardiovascular and thoracic wall injuries varies widely. CPR with active compression-decompression devices has a higher reported incidence of cardiopulmonary injuries. Bedside ultrasound may be a useful adjunct to assess and risk-stratify patients to identify serious or life-threatening CPR-associated injuries. Miller AC, Rosati SF, Suffredini AF, Schrump DS. Resuscitation. 2014 Feb 10. pii: S0300-9572(14)00062-8. [Epub ahead of print] Review. PMID: 24525116
MiRNAs as Biomarkers of Myocardial Infarction: A Meta-Analysis
MiRNAs, especially miR-499 and miR-133a, may be suitable for use as diagnostic biomarkers of myocardial infarction. Cheng C, Wang Q, You W, Chen M, Xia J. PLoS One. 2014 Feb 12;9(2):e88566. eCollection 2014. PMID: 24533109
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