Daily ReCAP March 16, 2017


The latest news on chronic, acute, and preventive care across the health care landscape.

Chronic: Treatment Developments for Chronic Bladder Diseases May Be on the Horizon

New findings may pave the way for the development of new treatments for chronic bladder diseases. In a study published inCell Death and Differentiation, investigators used lab-grown normal human urothelial cells to examine the process of urinary barrier formation. After enlisting a bioinformatics approach to map the transcription factors (TFs) binding to DNA, the investigators found that the TFs were arranged in a more complex or nonhierarchical pattern than previously believed. “Using experimental methods to silence individual TF genes, we confirmed that TFs interact to define whether cells become specialized or non-specialized,” said lead author Jennifer Southgate. “In particular, we have shown one TF [called P63] is dominant in the non-specialized cells. This understanding of how TFs drive cell specialization decisions will also help guide the search for drugs which can transform urothelial cell states as a therapeutic option.”

Acute: Young Patients with Diabetic Ketoacidosis Have Higher Risk of Acute Kidney Injury

Children with diabetic ketoacidosis (DKA) have an increased risk of acute kidney injury, a new study suggests. In a study published in JAMA Pediatrics, investigators used paper and electronic medical records from the tertiary British Columbia Children’s Hospital that included 165 patients with type 1 diabetes hospitalized for DKA. The results of the study showed that most of the children with DKA developed acute kidney injury during their hospital stay, with nearly all developing within the first 24 hours of hospitalization. The proportion of patients with acute kidney injury was prevalent among individuals admitted to the pediatric intensive care unit versus those treated in the general pediatric ward. Additionally, investigators found that stage 1 acute kidney injury for children with DKA was also linked to an initial corrected sodium level of 145 mEq/L or more.

Preventive: High-Dose Statins Increase Risk of Diabetes in Older Women

A new analysis found that high-dose statins are associated with an increased risk of diabetes in elderly women. Although statins are beneficial in reducing the risk of cardiovascular events and mortality, a vast majority of research has been conducted using men ages 40 to 70 years. In the new study, investigators sought to examine statin exposure in a cohort of older women. During the 10-year follow-up period, the findings showed that nearly half of the cohort had filled a prescription for statins and 5% had started treatment for new-onset diabetes. Statin exposure was associated with a higher risk of treatment for new onset-diabetes, according to the study. Furthermore, as the statin dosage rose so did the risk. The findings suggest that older women should not be exposed to higher doses of statins, the authors concluded.

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