ABSTRACT
INTRODUCTION: Atrial fibrillation (AF) is associated with a fivefold increased risk of stroke. Oral anticoagulation reduces the risk of stroke, but AF is elusive. A machine learning algorithm (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)) developed to predict incident AF within 6 months using data in primary care electronic health records (EHRs) could be used to guide AF screening. The objectives of the FIND-AF pilot study are to determine yields of AF during ECG monitoring across AF risk estimates and establish rates of recruitment and protocol adherence in a remote AF screening pathway. METHODS AND ANALYSIS: The FIND-AF Pilot is an interventional, non-randomised, single-arm, open-label study that will recruit 1955 participants aged 30 years or older, without a history of AF and eligible for oral anticoagulation, identified as higher risk and lower risk by the FIND-AF risk score from their primary care EHRs, to a period of remote ECG monitoring with a Zenicor-ECG device. The primary outcome is AF diagnosis during ECG monitoring, and secondary outcomes include recruitment rates, withdrawal rates, adherence to ECG monitoring and prescription of oral anticoagulation to participants diagnosed with AF during ECG monitoring. ETHICS AND DISSEMINATION: The study has ethical approval (the North West-Greater Manchester South Research Ethics Committee reference 23/NW/0180). Findings will be announced at relevant conferences and published in peer-reviewed journals in line with the Funder's open access policy. TRIAL REGISTRATION NUMBER: NCT05898165.
Subject(s)
Atrial Fibrillation , Stroke , Humans , Atrial Fibrillation/diagnosis , Atrial Fibrillation/drug therapy , Pilot Projects , Electronic Health Records , Stroke/prevention & control , Anticoagulants/adverse effects , AlgorithmsSubject(s)
Anesthesia, Intravenous/adverse effects , Gangrene/etiology , Hand Injuries/complications , Histamine H1 Antagonists/adverse effects , Promethazine/adverse effects , Abortion, Induced , Adult , Amputation, Surgical , Female , Fingers/surgery , Gangrene/surgery , Hand/blood supply , Histamine H1 Antagonists/administration & dosage , Humans , Injections, Intra-Arterial , Obesity/complications , Promethazine/administration & dosage , Risk FactorsSubject(s)
Bone Neoplasms/surgery , Carcinoma, Squamous Cell/surgery , Orbital Neoplasms/surgery , Adult , Bone Neoplasms/diagnostic imaging , Carcinoma, Squamous Cell/diagnostic imaging , Epidermal Cyst/diagnostic imaging , Epidermal Cyst/surgery , Female , Frontal Bone/pathology , Frontal Bone/surgery , Humans , Magnetic Resonance Imaging , Orbital Neoplasms/diagnostic imaging , Sphenoid Bone/pathology , Sphenoid Bone/surgery , Tomography, X-Ray Computed , Treatment Outcome , Zygoma/pathology , Zygoma/surgeryABSTRACT
BACKGROUND: This article reviews the unique physiology of patients who have type 1 diabetes mellitus (insulin-dependent diabetes mellitus, or IDDM); allays some common physiological misconceptions; and updates dental practitioners on the emerging technology of insulin infusion pump therapy, now available to patients who have type 1 diabetes mellitus. DESCRIPTION: The authors review the physiology of stress and describe the dawn phenomenon. They also describe insulin infusion pump therapy, as well as its advantages and disadvantages, to familiarize dentists with new technologies in caring for patients who have diabetes. Emergencies that may present themselves as a result of these advances in biotechnology are discussed. CLINICAL IMPLICATIONS: Dental practitioners who treat patients who have IDDM need to have a solid foundation in the basic medical sciences and emerging biomedical technology as they each relate to diabetes. Practitioners must become familiar with infusion pump therapy, not only for cases of medical emergencies, but also to customize treatment for patients who have diabetes. Practitioners also need to remain up to date in the rapidly changing realm of caring for people who have diabetes.