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Source: PubMed
The pCAD-POAF Randomized Clinical Trial

Objective:

To assess if partial cardiac denervation reduces postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG).

Methods:

Randomized trial with 430 patients undergoing CABG in China.

▪️Intervention: CABG + partial cardiac denervation.
▪️Control: CABG only.
▪️Monitored POAF for 6 days post-surgery.

Results:

POAF incidence:
▪️Intervention: 18.1%
▪️Control: 31.6% (Risk Ratio 0.57, P = .001).
▪️No additional complications; reduced costs in the intervention group.

Conclusion:
Partial cardiac denervation effectively reduces POAF after CABG and is a safe, cost-effective option.

G6PD Testing

Qualitative Tests: Identify G6PD deficiency (70% activity.

3. Consequences of HAIs and AMR:

▪️Increased mortality: Mortality rates among patients infected with resistant microorganisms are 2–3 times higher than for those with sensitive microorganisms.

▪️Economic and social burden: HAIs and AMR lead to prolonged hospital stays, long-term disabilities, and significant healthcare costs.

▪️In ICUs, healthcare associated sepsis results in a mortality rate of 24.4%, rising to 52.3% in severe cases.

4. Preventability:

IPC (Infection Prevention and Control) measures can significantly reduce the burden:

▪️In LMICs, improved IPC could prevent 137,000 AMR-associated deaths annually.

▪️Globally, IPC strategies could avert 821,000 deaths per year by 2050.

5. Projected Global Impact:

▪️Without interventions, 3.5 million deaths annually could result from HAIs by 2050, far surpassing deaths from HIV/AIDS and sexually transmitted diseases combined.

1. Prevalence of HAIs:

▪️Nearly 30% of patients in intensive care units (ICUs) are affected by HAIs, with rates 2–20 times higher in low- and middle-income countries (LMICs) compared to high-income countries (HICs).

▪️One in four cases (23.6%) of sepsis treated in hospitals is healthcare-associated, increasing to 48.7% in adult ICUs.

2. Global and Regional Data:

▪️In Europe (EU/EEA), about 4.8 million episodes of HAIs occur annually in acute care hospitals.

▪️In HICs, 7 out of 100 patients in acute care hospitals acquire at least one HAI during their stay; this figure rises to 15 in LMICs.

Source: PubMed

Background: While valproate's teratogenic risks during pregnancy are well known, the long-term safety of other antiseizure medications (ASMs) remains unclear.

Methods: Data from UK primary care and Swedish registries were analyzed, covering 3,182,773 children, including 17,495 exposed to ASMs during pregnancy.

Results:

▪️Valproate: Increased risk of autism, intellectual disability, and ADHD.
▪️Topiramate: 2.5x higher risk of intellectual disability (95% CI: 1.23–4.98).
▪️Carbamazepine: 1.25x higher risk of autism (95% CI: 1.05–1.48) and 1.30x higher risk of intellectual disability (95% CI: 1.01–1.69).
▪️Lamotrigine: No significant association with neurodevelopmental diagnoses.

Conclusion: Valproate and certain other ASMs may pose neurodevelopmental risks. Safer treatment options should be considered before conception when possible.