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Background: Interpretation of data collected from the CDC WONDER database and analysis of disparities in places of death for those patients diagnosed with intracerebral hemorrhage (ICH) in the United States from 1999 to 2020. Our research intends to uncover important insights into potential differences in end-of-life care for patients suffering from ICH and to provide solicited care during this crucial time. Methods: We conducted an epidemiological study in which all patient-specific demographics were extracted from the CDC WONDER database evaluated for disparities in place of death, and compared based on variables. The odds ratio was also calculated. Qualitative data was expressed in percentage and proportion, whereas statistical analysis was done using R programming software. Results: Data of 18,783,791 ICH deaths was aggregated. Data explained that patients in the 85+ age group are the most likely to die at home, and this particular age group also has seen the highest number (1,941,657) of fatalities in home or hospice and the highest number (4,937,395) of fatalities in medical or nursing facilities. Male patients in the 55� age group were most likely to die at home or hospice, whereas female patients in general were most likely to die in medical or nursing facilities. West census region patients were 1.424 times more likely to die at home or hospice, this number being the highest of all regions. Conclusions: Home or hospice mortality trend in patients with ICH, within a 22-year period, increased significantly, specifically in white male patients ages 85 and older from the west rural region.
RESUMEN
Objective@#To evaluate the effect of adding DPP4 inhibitor (DPP4-i) on glycemic variability (GV) in patients with type 2 diabetes mellitus (T2DM) treated with premixed human insulin (MHI).@*Methodology@#We conducted a prospective study in patients with T2DM on twice-daily MHI with or without metformin therapy. Blinded continuous glucose monitoring was performed at baseline and following 6 weeks of Vildagliptin therapy.@*Results@#Twelve patients with mean (SD) age of 55.8 (13.1) years and duration of disease of 14.0 (6.6) years were recruited. The addition of Vildagliptin significantly reduced GV indices (mmol/L): SD from 2.73 (IQR 2.12-3.66) to 2.11 (1.76-2.55), p=0.015; mean amplitude of glycemic excursions (MAGE) 6.94(2.61) to 5.72 (1.87), p=0.018 and CV 34.05 (8.76) to 28.19 (5.36), p=0.010. In addition, % time in range (3.9-10 mmol/l) improved from 61.17 (20.50) to 79.67 (15.33)%, p=0.001; % time above range reduced from 32.92 (23.99) to 18.50 (15.62)%, p=0.016; with reduction in AUC for hyperglycemia from 1.24 (1.31) to 0.47 (0.71) mmol/day, p=0.015. Hypoglycemic events were infrequent and the reduction in time below range and AUC for hypoglycemia did not reach statistical significance.@*Conclusion@#The addition of DPP4-I to commonly prescribed twice-daily MHI in patients with T2DM improves GV and warrants further exploration.