Efficacy and safety of triple therapy with dapagliflozin add-on to saxagliptin plus metformin over 52 weeks in patients with type 2 diabetes.

We previously reported that dapagliflozin versus placebo as add-on to saxagliptin plus metformin resulted in greater reductions in glycated haemoglobin (A1C), fasting plasma glucose (FPG) and body weight (BW) after 24 weeks of treatment in patients with type 2 diabetes (T2D). Here we report results after 52 weeks of treatment. Patients stabilized on open-label metformin and saxagliptin 5 mg/day for 8-16 weeks were randomized to placebo or dapagliflozin 10 mg/day plus open-label saxagliptin plus metformin for 52 weeks. Changes from baseline to week 52 were greater with dapagliflozin versus placebo in A1C (-0.74% vs. 0.07%), FPG (-27 vs. 10 mg/dL) and BW (-2.1 vs. -0.4 kg). More patients achieved A1C <7% with dapagliflozin (29.4%) versus placebo (12.6%). Adverse events were similar with dapagliflozin (66%) and placebo (71%), and hypoglycaemia was rare (≤2%). Genital infections occurred more often with dapagliflozin (6%) than with placebo (1%); frequency of urinary tract infections was similar between the two groups (9% vs. 10%). Triple therapy with dapagliflozin add-on to saxagliptin plus metformin is a durable, effective and well-tolerated intervention for the treatment of T2D.

Efectividad de la aplicación de ultrasonido terapéutico y ejercicio de estiramiento a músculos isquiotibiales en niños con parálisis cerebral tipo diparesia espástica leve / Effectivity of the application of therapeutic ultrasound and muscle stretching exercise of the hamstring muscle in child with mild spastic diparesis cerebral palsy+5

Objetivo. Conocer si la aplicación de ultrasonido terapéutico seguido de ejercicios de estiramiento muscular es eficaz para el tratamiento de las contracturas de los músculos isquiotibiales. Diseño. Estudio cuasiexperimental, tipo antes y después, sin grupo control, donde se estudiaron 11 pacientes (22 rodillas) con parálisis cerebral infantil tipo diparesia espástica leve, con duración de 6 meses; se aplicó ultrasonido terapéutico de baja intensidad seguido de una serie de 3 estiramientos por sesión, divididas en dos bloques de 10 sesiones cada una con un periodo mínimo de descanso entre estos de 15 días. Las mediciones se realizaron al inicio y al final de cada bloque de tratamiento, consistieron en: mediciones goniométricas del ángulo poplíteo, elevación recta de la pierna, extensión, flexión y arco total de movimiento de la rodilla, tomadas por el médico especialista en rehabilitación que es ajeno al estudio. Se utilizó la prueba t de Student, del paquete estadístico SPSS 17.0, tomando un valor de p ≤0,05 como estadísticamente significativo. Resultados. Se observó una disminución en la medición del ángulo poplíteo (media basal de 47,77°; media final 23,55°; p=0,001), aumento en la elevación recta de la pierna (media basal de 49,67°; media final de 67,42°; p=0,001), aumento en el arco de movimiento de la extensión (media basal −7,05°; media final −1,95°; p=0,003) después del tratamiento. Conclusiones. El ultrasonido terapéutico seguido de ejercicios de estiramiento, es un tratamiento eficaz para las contracturas musculares de isquiotibiales (AU)

Objective. To know if the application of therapeutic ultrasound followed by muscle stretching exercises is effective in the treatment of hamstring muscle contractures. Design. An interventional, quasi-experimental, before and after design, without control group trial in which 11 patients (22 knees) with spastic diparesis infantile cerebral palsy were studied during 6 months. Low density therapeutic ultrasound was applied following by a 3 stretch series per session, divided into 2 blocks of 10 sessions each one, with at least one period of rest of 15 days between them. The clinical measurements were obtained at the onset and completion of treatment block. These consisted in: measurement of the popliteal angle, straight leg raising test, extension, flexion and total knee joint range of motion, measured by the physical medicine and rehabilitation doctor. We used the Student's T test from the SPSS statistics program version 17.0 defining a p value ≤0.05 as significant. Results. We observed a reduction in the measurement of the popliteal angle (baseline mean 47.77°; final mean 23.55°; p=0.001), an increase in the straight leg raising test (baseline mean 49.67°; final mean 67.42°; p=0.001), an increase in the extension range of motion (baseline mean −7.05°; final mean −1.95°; p=0.003), after the treatment. Conclusions. The application of therapeutic ultrasound followed by muscle stretching exercise is an effective treatment for the hamstring muscle contractures(AU)