XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

https://www.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1538-7836.2006.01753.x

International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS).

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Endothelial Cells in Physiology and in the Pathophysiology of Vascular Disorders

Synopsis: Before planning an assisted reproductive technology (ART), individual thromboembolic risk should be assessed Objective: A pilot study designed to investigate select haemostasis, endocrine and biochemical parameters in women who undergo IVF before and after stimulation with FSH Blood was collected and analysed before and after stimulation Study Design: Tests performed included Luteinising hormone (LH), estradiol (E2), progesterone, testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), FSH, thyroid stimulating hormone (TSH), free thyroxin (FT4), protein S, protein C, antithrombin, lupus antibodies, anticardiolipin antibody (IgG and IgM), von Willebrand factor antigen, collagen binding and the following factors (F); F II, F V, F VII, F VIII, F IX, F X, F XI, F XII  Also, urinary iodine was assessed to screen for thyroid disorders Results: After stimulation, there were statistically significant difference in the levels of FSH, LH, E2, Testosterone, FAI, and F XI Also, there was a significant negative correlation between E2 and FXII Conclusion: Before planning an ART, individual thromboembolic risk should be assessed Our findings warrant a more comprehensive investigation in this group of patients to examine the long term effects of observed changes and their relation to a possible ovarian hyperstimulation syndrome (OHSS)

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Annals of Clinical Pathology

An analysis of the sensitivity of the activated partial thromboplastin time assay (APTT), as used in a large laboratory network, to coagulation factor deficiencies

Welcome to the start of another year with Seminars in Thrombosis & Hemostasis (STH), this being my 15th year anniversary as Editor-in-Chief. As always, I will again sincerely thank all past and current contributors to STH over the many years, as well as to all past, current, and future Guest Editors who commit their time to advance STH, and of course the current and past Editorial team. There has been no major overhaul of the editorial team at time of writing, although some adjustments will continue to occur over coming years. 

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Welcome to Seminars in Thrombosis &amp; Hemostasis 2023

COVID-19 is now established to be associated with a thrombotic phenomenon, now called COVID-19 associated coagulopathy (CAC). Anti-Endothelial Cell Antibodies (AECA) are a heterogenous group of autoantibodies targeting various endothelial cell antigens or antigens adhering to endothelial cells, They are commonly observed in a variety of auto-immune and rheumatologic conditions, and were observed in patients with the severe acute respiratory syndrome (SARS) in 2005. We aimed to assess AECA status in patients with COVID-19 and their potential contributing role to endothelial injury and CAC. AECA identification was a relatively infrequent finding in COVID-19 patients on admission, and their presence, albeit in only 2/33 patients, was not associated with disease severity. However, as the autoantibodies were only measured at admission, we cannot exclude the possibility of pathogenic AECA developing later in the course of diseaseFurther studies using additional methods are needed to evaluate the presence and potential pathogenic role of AECA in later stages of COVID-19.

Emmanuel J. Favaloro

Papers

Annals of Clinical Pathology

An analysis of the sensitivity of the activated partial thromboplastin time assay (APTT), as used in a large laboratory network, to coagulation factor deficiencies

Welcome to Seminars in Thrombosis & Hemostasis 2023

Anti-Endothelial Cell Antibodies are not frequently elevated in hospitalized patients with COVID-19

Heparin-Induced Thrombotic Thrombocytopenia (HITT) and Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT): Similar but Different.

Emmanuel J. Favaloro

Papers

Annals of Clinical Pathology

An analysis of the sensitivity of the activated partial thromboplastin time assay (APTT), as used in a large laboratory network, to coagulation factor deficiencies

Welcome to Seminars in Thrombosis &amp; Hemostasis 2023

Anti-Endothelial Cell Antibodies are not frequently elevated in hospitalized patients with COVID-19

Heparin-Induced Thrombotic Thrombocytopenia (HITT) and Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT): Similar but Different.

Welcome to Seminars in Thrombosis & Hemostasis 2023