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Methods: This study is a pilot, randomized, double blind, placebo-controlled trial (ThyRepair study). 52 patients were randomized and thirty-seven patients (n=16 placebo and n=21 LT3) were included in the final analysis. LT3 treatment started after stenting as an intravenous (i.v.) bolus injection of 0.8μg/kg of LT3 followed by a constant infusion of 0.113μg/kg/h i.v. for 48 hours. All patients had cardiac magnetic resonance (CMR) at hospital discharge and 6 months follow-up. The primary end point was CMR left ventricular (LV) ejection fraction (LVEF) and secondary endpoints were LV volumes, infarct volume (IV) and safety.
At this intervention timepoint in the disease development and with this dose, camostat mesilate treatment was not associated with increased adverse events during hospitalization for Covid-19 but the treatment did not significantly affect time to clinical improvement, progression to ICU admission or mortality.
Objectives: We aimed to quantify the burden of polypharmacy in patients that are referred to the palliative care team of a large teaching hospital in the United Kingdom, and to assess whether medications of questionable benefit were reviewed. We looked at whether advice was given regarding deprescribing and whether patients were still prescribed medications of questionable benefit at the point of death or discharge from hospital. We assessed the impact of education sessions and the implementation of deprescribing guidance.
Results: Analysis of deprescribing decisions was completed for 133 patients referred to the palliative care team in the first audit cycle and 50 patients in the follow-up cycle. Advice on medication deprescribing given by the palliative care team increased from 16% to 22% of patients referred following the intervention. Overall 6-month mortality was 85%. Despite recognition of limited life expectancy by the referring team, and the implementation of deprescribing guidance, 41% of all patients referred in February 2019 and 48% in June 2021 were still prescribed potentially inappropriate medicines at point of death or discharge from hospital. 041b061a72