2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-z18hg30pp1.pdf

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-53v7yllhiz.pdf

Depression, the most prevalent mental illness, is underdiagnosed and undertreated, highlighting the need to extend the scope of current screening methods. Here, we use language from Facebook posts of consenting individuals to predict depression recorded in electronic medical records. We accessed the history of Facebook statuses posted by 683 patients visiting a large urban academic emergency department, 114 of whom had a diagnosis of depression in their medical records. Using only the language preceding their first documentation of a diagnosis of depression, we could identify depressed patients with fair accuracy [area under the curve (AUC) = 0.69], approximately matching the accuracy of screening surveys benchmarked against medical records. Restricting Facebook data to only the 6 months immediately preceding the first documented diagnosis of depression yielded a higher prediction accuracy (AUC = 0.72) for those users who had sufficient Facebook data. Significant prediction of future depression status was possible as far as 3 months before its first documentation. We found that language predictors of depression include emotional (sadness), interpersonal (loneliness, hostility), and cognitive (preoccupation with the self, rumination) processes. Unobtrusive depression assessment through social media of consenting individuals may become feasible as a scalable complement to existing screening and monitoring procedures.

https://www.pnas.org/content/pnas/115/44/11203.full.pdf

Facebook language predicts depression in medical records.

Vitamin D is a precursor of the steroid hormone calcitriol that is crucial for bone and mineral metabolism. Both the high prevalence of vitamin D deficiency in the general population and the identification of the vitamin D receptor in the heart and blood vessels raised interest in the potential cardiovascular effects of vitamin D. Experimental studies have demonstrated various cardiovascular protective actions of vitamin D, but vitamin D intoxication in animals is known to induce vascular calcification. In meta-analyses of epidemiological studies, vitamin D deficiency is associated with an increased cardiovascular risk. Findings from Mendelian randomization studies and randomized, controlled trials (RCTs) do not indicate significant effects of a general vitamin D supplementation on cardiovascular outcomes. Previous RCTs, however, were not adequately designed to address extraskeletal events, and did not focus on vitamin D-deficient individuals. Therefore, currently available evidence does not support cardiovascular benefits or harms of vitamin D supplementation with the commonly used doses, and whether vitamin D has cardiovascular effects in individuals with overt vitamin D deficiency remains to be evaluated. Here, we provide an update on clinical studies on vitamin D and cardiovascular risk, discuss ongoing vitamin D research, and consider the management of vitamin D deficiency from a cardiovascular health perspective.

Vitamin D and cardiovascular disease prevention

Depression after heart failure and risk of cardiovascular and all-cause mortality: a meta-analysis.

Low ankle-brachial index and risk of stroke

Meta-analysis of circulating 25-hydroxyvitamin D levels and risk of cardiovascular and all-cause mortality in elderly population.

Summary
What is known and objective

Gabapentin has been used for the management of post-herpetic neuralgia (PHN). However, inconsistent results have been reported. This meta-analysis was performed to assess the efficacy and safety of gabapentin 1800 mg/day in PHN patients by conducting a meta-analysis.



Methods

Electronic databases were searched for relevant randomized controlled trials (RCTs) that compared gabapentin 1800 mg/day to placebo for PHN. The primary outcomes were reduction in 24-h average pain intensity scores, 50% and 30% pain intensity reduction and gabapentin-related side effects. The secondary outcomes were reduction in sleep rating scores and improvement in Patient Global Impression of Change (PGIC) or Clinician Global Impression of Change (CGIC).



Results and discussion

Six RCTs were included. Gabapentin 1800 mg/day reduced the 24-h average pain intensity scores [standard mean differences (SMD) −0·50; 95% confidence interval (CI) −0·88, −0·13; I2 = 86·3%] and average daily sleep rating scores [weighted mean differences (WMD) −0·71; 95% CI −1·11, −0·32; I2 = 0%]. Gabapentin treatment yielded an improvement in pain intensity (risk ratio (RR) 1·88; 95% CI 1·35, 2·29; I2 = 64·8%; for 50% reduction and RR 1·43; 95% CI 1·12, 1·83; I2 = 0% for 30% reduction, respectively), PGIC (RR 1·49; 95% CI 1·28, 1·74; I2 = 0%), and CGIC (RR 1·58; 95% CI 1·29, 1·92; I2 = 30·9%). However, gabapentin increased the somnolence (RR 2·03; 95% CI 1·39, 2·98; I2 = 2%), dizziness (RR 2·68; 95% CI 1·95, 3·69; I2 = 15%), peripheral oedema (RR 9·10; 95% CI 3·23, 25·60; I2 = 2%), total adverse effects (RR 1·28; 95% CI 1·16, 1·42; I2 = 0%) and withdrawal due to adverse events (RR 1·51; 95% CI 1·06, 2·16; I2 = 6%), but these adverse effects were often mild to moderate.



What is new and conclusion

Treatment with gabapentin 1800 mg/day yielded a significant reduction in PHN up to 14 weeks. Gabapentin 1800 mg appeared safe in treating PHN for up to 24 weeks.

Hongjie Fan

Papers

Depression after heart failure and risk of cardiovascular and all-cause mortality: a meta-analysis.

Low ankle-brachial index and risk of stroke

Meta-analysis of circulating 25-hydroxyvitamin D levels and risk of cardiovascular and all-cause mortality in elderly population.

Efficacy and safety of gabapentin 1800 mg treatment for post-herpetic neuralgia: a meta-analysis of randomized controlled trials