Journal of Health Care and Research [ISSN: 2582-8967]

The discussion of chronic kidney disease (CKD), kidney replacement therapy (KRT), and end-stage kidney disease (ESKD) has been important. Recently, a useful predictive model of CKD progression to renal failure was reported by the German CKD study group. They include a novel 6-variable risk score (Z6), composed of creatinine, albumin, cystatin C, urea, hemoglobin, and urinary alb/cre ratio (UACR). CKD patients were studied in 3 groups based on educational attainment. Hazard ratios compared to low vs high groups showed mortality of 1.48, MACE 1.37, and renal failure 1.54, respectively. For the prediction of CKD progression, UACR and estimated glomerular filtration rate (eGFR) are useful.

Sodium–glucose cotransporter 2 inhibitor (SGLT2i) has been attracting attention for novel agent for patients with diabetes and also heart failure (HF), in which the left ventricular ejection fraction (LVEF) has decreased. For standard cardiovascular treatment, 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure is recently presented. Some important perspectives were found, which are HF with mildly reduced EF (HFmrEF), HF with improved EF (HFimpEF) and HF with preserved EF (HFpEF). For patients with HFmrEF, SGLT2i can contribute reducing HF hospitalizations and cardiovascular death. From now, the guideline-directed medical therapy (GDMT) will contribute the standard and beneficial therapy.

Background: Many studies have found that Veterans and their family members have experienced more mental health disorders and substance use. The purpose of this study compared mental health and substance use risk indicators between U.S. military Veteran and non-Veteran- connected families, so earlier and more targeted interventions can be developed.
Methods: The data for this study were based on the 2016 and 2019 Behavioral Risk Factor Surveillance System (BRFSS) survey in Nebraska. The comparisons between Veterans and non-Veteran connected families were made on a set of 9 indicators, including general health status (fair/poor), poor mental health defined as not good on 14 or more of the past 30 days (yes/no), ever told they had depression (yes/no), current cigarette smoker (yes/no), current smokeless tobacco use (yes/no), current e-cigarette use (yes/ no), any tobacco use (yes/no), any alcohol consumption in the past 30 days (yes/no), and binge drank in the past 30 days (yes/no). A Chi-Square test was used to determine significant differences between the indicators.
Results: When comparisons were made between Veterans and non-Veterans, some significant differences were found in both 2016 and 2019. For example, in 2016, non-Veterans were more likely to have poor mental health, ever told they had depression, be a current smoker, and engage in binge alcohol drinking. Significant differences were also found between non-Veterans and the spouses and significant others of Veterans for selective risk factors in 2016 and 2019. For example, in both years, spouses and significant others of Veterans were considerably more likely to have greater mental health distress and depression. However, they were less likely to use alcohol or engage in binge drinking.
Conclusion: These results indicate that spouses and significant others of Veterans are more likely to suffer from depression and other mental health conditions than Veterans themselves and the non-Veteran population. Organizations serving military families should develop a greater knowledge and understanding of the culture of military families to implement strategies that effectively support Veteran spouses and partners.