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The discovery of proprotein convertase subtilisin/kexin type 9 (PCSK9) invigorated the cardiology community, refining our understanding of cholesterol metabolism and building on prior successes in the development of effective lipid-lowering medications. In 2003, Abifadel et al. discovered mutations in the PCSK9 gene linked to autosomal dominant hypercholesterolemia. The potential of a novel target for lipid-lowering emerged, and shortly thereafter, the development of PCSK9 inhibitors began. Early clinical trials demonstrated that PCSK9 inhibitors lowered low-density lipoprotein cholesterol (LDL-C) levels by approximately 60%, opening new avenues for potentially reducing adverse cardiovascular events in high-risk populations. [ABSTRACT FROM AUTHOR]

Purpose: Multiple hospitals in Alberta implemented the End PJ Paralysis – a multicomponent inpatient ambulation initiative aimed at preventing the adverse physical and psychological effects patients experience due to low mobility during admission. To inform a scale-up strategy, this study assessed the impact of the initiative based on select process and outcome measures. Materials and methods: Clinical and administrative data were obtained from the hospital Discharge Abstract Database, Research Electronic Data Capture (Redcaps), and Reporting and Learning System for Patient Safety. The variables explored were length of stay, inpatient falls, discharge disposition, pressure injury, patient ambulation, and patient dressed rates. We then used the Interrupted Time Series design for impact analysis. Results: The analysis included discharge abstracts for 32,884 patients and the results showed significant improvements in outcomes at the participating units. The length of stay and inpatient falls were reduced immediately by 1.8 days (B2=-1.80, p = 0.044, 95% CI [-3.54, −0.05]), and 2.2 events (B2=-2.22, p = 005, 95% CI [-3.75, −0.69]). The percentage of patients discharged home increased overtime (B2=.39, p=.006, 95% CI [.11,.66]). Mobilization and dressed rates also improved. Conclusions: The findings imply the interventions safely mitigated the risk of immobility-induced complications, including deconditioning and hospital-acquired disability. IMPLICATIONS FOR REHABILITATION: Immobility during hospitalization is endemic in hospitals and, without intervention, presents a significant risk of physiological deconditioning and subsequent adverse health outcomes, such as functional decline and hospital-acquired disability. This study elevates the importance of preserving functional capacity and dignity of hospitalized patients by encouraging them to get up, dress in personal clothes, and move as much possible. Function-focused initiatives, that include intentional patient ambulation, have the potential to mitigate the risk of immobility-induced deconditioning and other adverse outcomes, such as falls and pressure injury, in older adults. In this study, we have demonstrated the End PJ Paralysis had a positive impact on patient ambulation, length of stay, inpatient falls, and discharge disposition. The study also informed a proposed transformational roadmap to strengthen rehabilitation in the provincial health system and spread the initiative to all the major hospitals to potentially benefit more patients. [ABSTRACT FROM AUTHOR]

Introduction: Hearing loss (HL) is considered a potentially modifiable risk factor for dementia. We aimed to examine the relationship between HL and incident dementia diagnosis in a province-wide population-based cohort study with matched controls. Methods: Administrative healthcare databases were linked to generate a cohort of patients who were aged ≥40 years at their first claimed hearing amplification devices (HAD) between April 2007 and March 2016 through the Assistive Devices Program (ADP) (257,285 with claims and 1,005,010 controls). The main outcome was incident dementia diagnosis, ascertained using validated algorithms. Dementia incidence was compared between cases and controls using Cox regression. Patient, disease, and other risk factors were examined. Results: Dementia incidence rates (per 1,000 person-years) were 19.51 (95% confidence interval [CI]: 19.26–19.77) and 14.15 (95% CI: 14.04–14.26) for the ADP claimants and matched controls, respectively. In adjusted analyses, risk of dementia was higher in ADP claimants compared with controls (hazard ratio [HR]: 1.10 [95% CI: 1.09–1.12, p < 0.001]). Subgroup analyses showed a dose-response gradient, with risk of dementia higher among patients with bilateral HADs (HR: 1.12 [95% CI: 1.10–1.14, p < 0.001]), and an exposure-response gradient, with increasing risk over time from April 2007-March 2010 (HR: 1.03 [95% CI: 1.01–1.06, p = 0.014]), April 2010-March 2013 (HR: 1.12 [95% CI: 1.09–1.15, p < 0.001]), and April 2013-March 2016 (HR: 1.19 [95% CI: 1.16–1.23, p < 0.001]). Conclusion: In this population-based study, adults with HL had an increased risk of being diagnosed with dementia. Given the implications of HL on dementia risk, understanding the effect of hearing interventions merits further investigation. [ABSTRACT FROM AUTHOR]