Limaprost and the Risk of Bleeding: A Self-Controlled Case Series Study

Objective To investigate the association between the use of limaprost and the risk of bleeding. Methods A self-controlled case series analysis was conducted using the National Health Insurance Service-National Sample Cohort database in South Korea. We identified patients aged 18 years or older who had at least one prescription of limaprost and were diagnosed with at least one case of bleeding between 2003 and 2019. The incidence rate ratio (IRR) of bleeding was calculated by dividing the incidence rate in the exposed period to limaprost by that in the unexposed period and adjusted for age using conditional Poisson regression model. Results Among 72,860 patients with limaprost prescriptions and bleeding diagnoses, there were 184,732 events of bleeding. After adjusting for age, the IRR was 1.47 (95% confidence interval [CI], 1.43–1.50), wherein the IRR was the highest during the 0–7 days after limaprost initiation (IRR, 2.11; 95% CI, 2.03–2.18). Risk of bleeding was higher when limaprost was concomitantly used with antithrombotics or other drugs for spinal stenosis treatment, and when higher daily doses of limaprost were administered. Conclusion Our findings suggest that the risk of bleeding increased by 1.5-fold in periods of limaprost exposure compared to unexposed periods, with particularly higher risks observed during the first week after limaprost initiation, with concomitant drugs related to bleeding, and with a higher daily dose. A careful risk-benefit assessment is warranted when initiating limaprost, especially when administered with other medications or in higher daily doses

Association of sodium-glucose cotransporter 2 inhibitors with post-discharge outcomes in patients with acute heart failure with type 2 diabetes:a cohort study

BACKGROUND: Given the cumulative evidence on the effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT2is) on chronic heart failure, demand is emerging for further information on their effects in patients who are hospitalized for acute heart failure. However, there is still limited evidence about the class effect of SGLT2is on acute heart failure. We investigated whether initiating treatment with SGLT2is after an episode of acute heart failure reduces the risks of post-discharge heart failure readmission or cardiovascular mortality among patients with type 2 diabetes. METHODS: A retrospective cohort study was conducted in a cohort of patients with type 2 diabetes who hospitalized for heart failure, using Korean Health Insurance Review & Assessment database (2015-2020). The exposure was defined as initiation of SGLT2is during hospitalization or at discharge. We assessed hazards of post-discharge heart failure readmission and cardiovascular death at 1-year, and 30-, 60-, and 90-day from the date of discharge in the SGLT2is users and non-users. Cox proportional hazards models with propensity score-based inverse probability of treatment weighting were used to estimate hazard ratios and 95% confidence intervals. RESULTS: Among 56,343 patients with type 2 diabetes hospitalized for heart failure, 29,290 patients were included in the study cohort (mean [SD] age, 74.1 [10.8] years; 56.1% women); 818 patients (2.8%) were prescribed SGLT2is during index hospitalization or at discharge. Patients with a prescription for SGLT2i vs. those without prescription had lower rates of heart failure readmission or cardiovascular death at 1 year (22.4% vs. 25.3%; adjusted hazard ratio, 0.90 [95% confidence interval, 0.87-0.93]), and also at 30 days (7.0% vs. 7.7%%; 0.74 [0.69-0.79]). CONCLUSIONS: Among patients with type 2 diabetes, initiating SGLT2i treatment after an episode of acute heart failure was significantly associated with a reduced combined risk of heart failure readmission and cardiovascular mortality in a nationwide cohort reflecting routine clinical practice

Cardiovascular safety of evogliptin dual and triple therapy in patients with type 2 diabetes: a nationwide cohort study

Objective: To investigate the risk of cardiovascular events associated with commonly used dual and triple therapies of evogliptin, a recently introduced dipeptidyl peptidase-4 inhibitor (DPP4i), for managing type 2 diabetes in routine clinical practice. Design: A retrospective cohort study. Setting: Korean Health Insurance Review and Assessment database. Participants: Patients who initiated metformin-based dual therapy and metformin+sulfonylurea-based triple therapy in South Korea from 2014 to 2018. Interventions: Initiation of combination therapy with evogliptin. Primary and secondary outcome measures: Hazards of cardiovascular events, a composite endpoint of myocardial infarction, heart failure and cerebrovascular events, and its individual components. Cox proportional hazards model with propensity score-based inverse probability of treatment weighting were used to estimate HRs and 95% CIs. Results: From the dual and triple therapy cohorts, 5830 metformin+evogliptin users and 2198 metformin+sulfonylurea+evogliptin users were identified, respectively. Metformin+evogliptin users, as compared with metformin+non-DPP4i, had a 29% reduced risk of cardiovascular events (HR 0.71, 95% CI 0.62 to 0.82); HRs for individual outcomes were cerebrovascular events (0.71, 95% CI 0.53 to 0.95), heart failure (0.70, 95% CI 0.59 to 0.82), myocardial infarction (0.89, 95% CI 0.60 to 1.31). Metformin+sulfonylurea+evogliptin users, compared with metformin+sulfonylurea+non-DPP4i, had a 24% reduced risk of cardiovascular events (0.76, 95% CI 0.59 to 0.97); HRs for individual outcomes were myocardial infarction (0.57, 95% CI 0.27 to 1.19), heart failure (0.74, 95% CI 0.55 to 1.01), cerebrovascular events (0.96, 95% CI 0.61 to 1.51). Conclusions: These findings suggest that dual or triple therapies of evogliptin for the management of type 2 diabetes in routine clinical practice present no cardiovascular harms, but could alternatively offer cardiovascular benefits in this patient population

Novel Bio-Optoelectronics Enabled by Flexible Micro Light-Emitting Diodes

Optical health monitoring and treatment have been spotlighted due to their biocompatible properties. Several researchers are investigating optical devices for obtaining health signals and curing diseases without any damage to the body. In particular, μLEDs have received a lot of attention as a future light source due to their superior optical/electrical properties, environmental stability, and structural advantages. According to their strengths, μLEDs have been used for various biomedical applications, such as optogenetics and hair regrowth. In this paper, we introduce the research tendency of μLEDs and the latest bio-applications

Terahertz spectroscopy of Alzheimer’s Amyloid Fibrils

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Sweat-permeable electronic skin with a pattern of eyes for body temperature monitoring

Abstract Human-machine interface has been considered as a prominent technology for numerous smart applications due to their direct communication between humans and machines. In particular, wearable electronic skins with a free form factor have received a lot of attention due to their excellent adherence to rough and wrinkled surfaces such as human skin and internal organs. However, most of the e-skins reported to date have some disadvantages in terms of mechanical instability and accumulation of by-products at the interface between the human skin and the device. Here, we report a mechanically stable e-skin via a newly designed pattern named the “eyes.” The ingeniously designed pattern of the eyes allowed mechanical stress and strain to be dissipated more effectively than other previously reported patterns. E-skin permeability of by-product was experimentally confirmed through sweat removal tests, showing superior sweat permeability compared to conventional e-skins. Finally, the real-time monitoring of the body temperature was carried out using our resistive-type thermometer in the e-skin

In Vivo Reprogramming Using Yamanaka Factors in the CNS: A scoping review

This scoping review aims to explore in vivo reprogramming for the central nervous system (CNS) using Yamanaka factors, mapping the existing literature and identify areas for future research

Light‐Induced Thin‐Film Transfer Processes Based on Phase Transition of GeSbTe and ITO Sacrificial Layers

Abstract In the upcoming ubiquitous era, wearable/flexible electronics are spotlighted to get various types of numerous information in real time. Several researchers have investigated flexible materials, and developed diverse thin‐film transfer methods. However, there are some limitations of the intrinsic material unstabilities, and low production yield. Here, light‐induced thin‐film transfer methods are reported by using new transfer mechanism of phase transition in sacrificial materials. Lift‐off conditions with high‐energy laser are delicately optimized by theoretical calculations and experiments to minimize mechanical/thermal damages of the upper thin‐film devices. The selected sacrificial materials of GeSbTe (GST) and indium tin oxide (ITO) with the 300 nm thickness are delaminated from a transparent and rigid glass substrate by irradiating the excimer laser to the surface of the sacrificial layer. The laser‐based exfoliation mechanism of GST and ITO films are comprehended by various material surface analyses. Eventually, flexible oxide thin‐film transistors (TFTs) are successfully demonstrated through light‐induced exfoliation process, showing the usability of the developed transfer technique to future practical applications