ABSTRACT
AIMS: To assess the effect of the GLP-1 analogue liraglutide on measures of cardiac function and physical performance in patients with type 2 diabetes (T2D). METHODS: In this phase-IV randomized double-blind placebo-controlled parallel-group clinical trial at a tertiary hospital, T2D patients with HbA1c levels of 7-10% with oral agents and/or intermediate-/long-acting insulin were allocated (computer-generated randomization, ratio 1:1) to either liraglutide 1.8 mg/day or a placebo for 6 months. The primary endpoint was maximum oxygen consumption (VO2max) during cycle ergometry, while other procedures included a 6-min walk test, echocardiography, anthropometry and blood tests. Safety endpoints were also monitored, and an intention-to-treat analysis was performed. RESULTS: A total of 24 patients (15 women) aged 52 (11.7) years, with diabetes duration of 8.7 (5.8) years, BMI 34.98 (6.2) kg/m2 and HbA1c 8.2% (0.68%), were randomized to liraglutide 1.8 mg daily or placebo. There were no differences in VO2max [17.98 (4.8) vs. 15.90 (4.96) mL/kg/min; P > 0.10], VE/VCO2 slope [30.18 (4.8) vs. 32 (4.49)], left ventricular ejection fraction or 6-min walk test [530.7 (86) vs. 503.9 (84) m] at 6 months. HbA1c was lower (6.7% vs. 7.7%; P = 0.005), with a trend towards lower maximum systolic blood pressure during ergometry [171.7 (24.4) vs. 192.5 (25.6); P = 0.052] in the liraglutide group at the end of the study. There were no severe adverse events. CONCLUSION: In this trial, liraglutide improved glycaemic control in T2D, but had no significant effects on either physical performance or myocardial function.
Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/pharmacology , Liraglutide/pharmacology , Oxygen Consumption/drug effects , Physical Functional Performance , Adult , Aged , Blood Glucose , Double-Blind Method , Exercise Test , Female , Humans , Hypoglycemic Agents/therapeutic use , Liraglutide/therapeutic use , Male , Middle Aged , Stroke Volume/drug effectsABSTRACT
Un niño de 6 años y medio presenta un abdomen agudo quirúrgico 5 años después de una cirugía apendicular complicada. La gravedad clínica, por el cuadro de sepsis, exige una laparotomía exploradora inmediata, encontrando una masa retroperitoneal que resulta ser el riñón derecho con proceso infeccioso crónico, que se continúa con un uréter dilatado que termina cerrado en la vecindad de la zona ileocal. Este hallazgo no permite efectuar cirugía conservadora, por lo que se debe realizar nefroureterectomía derecha. La anatomía patológica muestra una pienefrosis, con daño avanzado del riñón contralateral sano, con hipertrofia compensadora. Egresa en 8 días, sin complicaciones precoces
Subject(s)
Humans , Male , Child , Appendectomy/adverse effects , Ureteral Obstruction/diagnosis , Sepsis , Ureteral Obstruction/etiology , Ureteral Obstruction/drug therapyABSTRACT
Most cases of atrial fibrillation are converted with antiarrhythmic medications or external electric defibrillation. However, in some refractory patients, an internal transcatheter defibrillation must be attempted. We report a 50 years old male with an atrial fibrillation of one year duration that was refractory to pharmacological treatment and in whom external cardioversion was unsuccessful. After the application of a bifasic shock of 10 joules between a catheter in the right atrium and another one located at the coronary sinus, the patient was converted to sinus rhythm. At two months of follow up, the patient continues in sinus rhythm.
