The beneficial cardiorenal outcomes of sodium-glucose cotransporter 2 inhibitors(SGLT2i)in patients with type 2 diabetes mellitus(T2DM)have been substantiated by multiple clinical trials,resulting in increased interes...
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The beneficial cardiorenal outcomes of sodium-glucose cotransporter 2 inhibitors(SGLT2i)in patients with type 2 diabetes mellitus(T2DM)have been substantiated by multiple clinical trials,resulting in increased interest in the multifarious pathways by which their mechanisms *** principal effect of SGLT2i(-flozin drugs)can be appreciated in their ability to block the SGLT2 protein within the kidneys,inhibiting glucose reabsorption,and causing an associated osmotic *** ameliorates plasma glucose elevations and the negative cardiorenal sequelae associated with the *** include aberrant mitochondrial metabolism and oxidative stress burden,endothelial cell dysfunction,pernicious neurohormonal activation,and the development of inimical *** outcomes within these domains have been validated with SGLT2i ***,by modulating the sodium-glucose cotransporter in the proximal tubule(PT),SGLT2i consequently promotes sodium-phosphate cotransporter activity with phosphate ***,even at physiologic levels,poses a risk in cardiovascular disease burden,more so in patients with type 2 diabetes mellitus(T2DM).There also exists an association between phosphatemia and renal impairment,the latter hampering cardiovascular function through an array of physiologic roles,such as fluid regulation,hormonal tone,and ***,increased phosphate flux is associated with an associated increase in fibroblast growth factor 23 levels,also detrimental to homeostatic cardiometabolic function.A contemporary commentary concerning this notion unifying cardiovascular outcome trial data with the translational biology of phosphate is scant within the *** the apparent beneficial outcomes associated with SGLT2i administration notwithstanding negative effects of phosphatemia,we discuss in this review the effects of phosphate on the cardiometabolic status in patients with T2DM and cardiorenal disease,as well as the
We describe the first two conventional, laparoscopic renal operations with a new multi-degree of freedom articulated single-use laparoscopic instrument (ArtiSentialTM). The two patients underwent different laparoscopi...
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We describe the first two conventional, laparoscopic renal operations with a new multi-degree of freedom articulated single-use laparoscopic instrument (ArtiSentialTM). The two patients underwent different laparoscopic interventions at Ukrb University (Neuruppin, Germany): nephrectomy and Anderson-Hynes-pyeloplasty. all procedures were completed, with no need for conversion or placement of additional ports. No intraoperative complications or technical failure of the instrument was recorded. The mean operative time was 180 min median length of stay was 11.5 d. The instrument could be opened out of the sterile packaging and used at once when it was needed, because it is a single-use instrument. There was real haptical feedback and the costs are minimal compared to robot surgery. The use was straightforward and rapid processes after an intensive training of 4 h in a dry lap. Awaiting future investigations in larger series, this study proves the safety and feasibility of renal surgery with ArtiSentialTM and provides relevant data that may help early adopters of this surgical instrument.
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