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Comparative efficacy of sodium glucose cotransporter-2 inhibitors in the management of type 2 diabetes mellitus:A real-world experience

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World Journal of Diabetes 2024年第3期15卷 463-474页

作者： Lubna Islam Dhanya Jose Mohammed Alkhalifah Dania Blaibel Vishnu Chandrabalan Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Community Medicine Goa Medical CollegeGoa 403202India Department of Family Medicine King Faisal Specialist HospitalRiyadh 11564Saudi Arabia Department of Data Science Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityAll Saints BuildingManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

BACKgROUND Sodium glucose cotransporter-2 inhibitors(SgLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SgLT-2i medications is *** To study the comparative efficacy and safety of SgLT-2i using real-world clinical *** We evaluated the comparative efficacy data of 3 SgLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes *** on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded *** Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were *** diabetes duration was 16.0(9.0)years,and the duration of SgLT-2i use was 3.6(2.1)***-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)*** respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(Pgnificant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)*** reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(Pgnificant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects

关键词： Sodium glucose cotransporter-2 inhibitors Empagliflozin Canagliflozin Dapagliflozin Type 2 diabetes mellitus Cardiovascular disease Albumin creatinine ratio Diabesity

Post Blast Tympanic Perforations, clinical and Paraclinical Study at Six Yaounde hospitals

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 126-134页

作者： Andjock Nkouo Yves Christian Lekassa Pierrette Meva’a Biouele Roger Christian Moboung Prudence Mindja Eko David Djomou Francois Njock Richard Ndjolo Alexis Ophthalmology-Ear-Nose-Throat (ENT)-Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon ENT-Cervico-Facial-Surgery (CFS) Service Yaounde General Hospital Yaounde Cameroon ENT-CFS Service Omar Bongo Ondimba Military Teaching Hospital Libreville Gabon ENT-CFS Service Yaounde Central Hospital Yaounde Cameroon ENT-CFS Service Yaounde Teaching Hospital Yaounde Cameroon ENT-CFS Service Douala General Hospital Douala Cameroon

Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.

关键词： Tympanic Perforation Blast Yaounde

Application of Sigma Metric Analysis to Evaluate the Performance of the Biochemistry Analytical System in a Medical Biology laboratory in Côte d’Ivoire

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Journal of Analytical Sciences, Methods and Instrumentation 2024年第1期14卷 14-21页

作者： Koffi Akissi Joelle Kouakou Francisk Kouadio Charlotte Yeo Karna Ahiboh Hugues Hauhouot-Attoungbré Marie-Laure Biochemistry and clinical Chemistry Unit CeDReS University Hospital of Treichville Abidjan Ivory Coast Department of Biochemistry Clinical Chemistry and Molecular Biology Faculty of Pharmaceutical and Biological Sciences University Felix Houphouet-Boigny Abidjan Ivory Coast

Introduction: The Six Sigma methodology is an opportunity for a better understanding of the performance of analytical methods and for a better adaptation of the quality control management policy of the medical biology laboratory. Using the sigma metric, this study assessed the performance of the Biochemistry analytical system of a medical biology laboratory in Côte d'Ivoire. Methods: Six Sigma methodology was applied to 3 analytes (alanine aminotransferase, glucose and creatinine). Performance indicators such as measurement imprecision and bias were determined based on the results of internal and external quality controls. The sigma number was calculated using the total allowable error values proposed by Ricos et al. Results: For both control levels, ALT had a sigma number greater than 6 (7.6 for normal control and 7.9 for pathological control). However, low sigma numbers, less than or equal to 2 for creatinine (1.4 for normal control and 2 for pathological control) and less than 1 for glucose were found. Conclusion: This study revealed good analytical performance of ALT from the point of view of 6 sigma analysis. However, modifications to the overall quality control procedure for glucose and creatinine are needed to improve their analytical performance. The study should be extended to the entire laboratory’s analytes in order to modify the strategies of quality control procedures based on metric analysis for an overall improvement in analytical performance.

关键词： Six Sigma Qualities Controls Bias Imprecision Total Allowable Error

Adenosine triphosphate mediates the pain tolerance effect of manual acupuncture at Zusanli(ST36) in mice

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Journal of Traditional Chinese Medicine 2024年第4期44卷 660-669页

作者： LI Zhongzheng ZHAO Yadan Ma Weigang Zhang Yonglong XU Zhifang XI Qiang LI Yanqi QIN Siru ZHANg Zichen WANg Songtao ZHAO Xue LIU Yangyang gUO Yi gUO Yongming Research Center of Experimental Acupuncture Science Tianjin University of Traditional Chinese Medicine National clinical Research Center for Chinese Medicine Acupuncture and Moxibustion Department of Acupuncture and Moxibustion Qingdao Hiser Hospital Affiliated of Qingdao University(Qingdao Traditional Chinese Medicine Hospital) School of Traditional Chinese Medicine Tianjin University of Traditional Chinese Medicine School of Acupuncture and Moxibustion and Tuina Tianjin University of Traditional Chinese Medicine

OBJECTIVE: To investigate the mechanisms behind the effects of acupuncture in Traditional Chinese Medicine,we delved into the adenosine triphosphate/peripheral purinergic P2X receptor 3(ATP/P2X3) receptor signaling system as an indicator of the body's energy state,commonly referred to as "Qi".METHODS: The tail-flick test was utilized to explore the impact of acupuncture on pain tolerance threshold(PTT)in mice, while also assessing adenosine(ADO) levels and adenylate energy charge(EC) at Zusanli(ST36). The study further investigated the dose-dependent effects of acupuncture on PTT and ADO levels at Zusanli(ST36).To shed light on the underlying mechanisms of acupuncture's effects, the study examined the impact of ATP, a P2X3 receptor antagonist, and adenosine disodium on PTT following acupuncture administration. RESULTS: Acupuncture at Zusanli(ST36) led to significant improvements in PTT in mice, with the most effective interventions being twirling for 2 min and needle retention for 28 min. These interventions also resulted in significant increases in ATP levels. The effects of acupuncture were further augmented by administration of different doses of ATP at Zusanli(ST36), and pretreatment with a P2X3 receptor antagonist decreased PTT. Adenylate EC peaked at 30 min after intraperitoneal injection of ATP, and pretreatment with various doses of i.p. ATP 30 min prior to acupuncture increased PTT in a dose-dependent manner. Additionally, pretreatment with an i.p. or intramuscular injection of adenosine disodium enhanced the effects of acupuncture. CONCLUSION: This research provides compelling evidence that ATP is involved in the regulation of PTT through acupuncture, revealing new avenues for achieving enhanced clinical outcomes.

关键词： acupuncture adenosine triphosphate energy state point ST36 (Zusanli) receptors, purinergic P2X3

clinical Epidemiology and Surgical Treatment of Spontaneous Perforations of the Terminal Ileum: A Multicentre Study in Cameroon

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Surgical Science 2024年第5期15卷 311-320页

作者： Eric Patrick Savom Richard II Mbele Mahamat Yannick Ekani Boukar Abdal Deudeu Cédric Paterson Atangana Fred Dikongue Dikongue guy Aristide Bang Marc Leroy guifo Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the university of Yaoundé I Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the university of Dschang Dschang Cameroon Yaoundé teaching hospital Yaoundé Cameroon

Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.

关键词： Perforation of the Terminal Ileum Simple Suture Resection Morbidity Mortality

Progress in the Study of the Hepatoprotective Effect of SgLT2i on NAFLD Patients with T2DM

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Journal of Biosciences and Medicines 2024年第1期12卷 115-125页

作者： Fan Yang Xiaoping Tan Department of gastrosenterology First Hospital of Yangtze University Jingzhou China Digestive Disease Research Institution of Yangtze university Jingzhou China clinical Medical College Yangtze University Jingzhou China

In recent years, the progress of NAFLD has become an important health problem, and the prevention or delay of progress in NAFLD is a major key point. Whether or not to combine T2MD, people are interested in the mechanisms and efficacy of SgLT2i for NAFLD. In this review, we summarized the current clinical research on SgLT2i for the combination of T2MD’s NAFLD patients, and the latest evidence of external or animal experiments. These evidences will help us to more accurately understand the protective effects of SgLT2i in NAFLD. Lifestyle changes are still essential to prevent and treat NAFLD, and for all kinds of drugs that treat NAFLD in clinical trials, SgLT2i may be one of the promising treatments.

关键词： Sodium-glucose Cotransporter-2 Inhibitors Non-Alcoholic Fatty Liver Disease Diabetes Mellitus

Identifying Qingkailing(清开灵)ingredients-dependent mesenchymal-epithelial transition factor-axiation“π”structuring module with angiogenesis and neurogenesis effects

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Journal of Traditional Chinese Medicine 2024年第1期44卷 35-43页

作者： CHENg Kunming YUAN Jianan LIU Jun ZHANg Shengpeng XU Qixiang XIE Yong ZHAO Jingfeng ZHANg Xiaoxu TANg Xudong ZHENg Yongqiu WANg Zhong Provincial Engineering laboratory for Screening and Re-evaluation of Active Compounds of Herbal Medicines in Southern Anhui Teaching and Research Section of Traditional Chinese MedicineSchool of PharmacyWannan Medical CollegeWuhu 241000China Institute of Basic Research in clinical Medicine China Academy of Chinese Medical SciencesBeijing 100700China Key laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine Ministry of EducationDepartment of Medicinal Plant DevelopmentChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100193China Department of gastroenterology Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing 100091China

OBJECTIVE:To explore the functional role of the drugdependent mesenchymal-epithelial transition(Met)-axiation"π"structural module of neurogenesis after processing by three components of Qingkailing injection in neurogenesis and angiogenesis in cerebral ***:We used a glutathione S-transferase(gST)-pull down assay,isothermal titration calorimetry assay,and other related methods to identify the relationships among Met,inositol polyphosphate phosphatase like 1(Inppl1),and death associated protein kinase 3(Dapk3)in this allosteric *** biological effects of the modules of neurons generation composed of Met,Inppl1,and Dapk3 were measured through Western blot,apoptosis analysis,and double immunofluorescence ***:The gST-pull down assay revealed that proline-serine-threonine rich domain of Met binds to the Src homology domain of Inppl1 to form a protein-protein complex;Dapk3 with a C-terminal domain interacts weakly with the protein kinase C domain of Met in the intracellular ***,we obtained a“π”structuring module considered a neural regeneration *** biological effects of angiogenesis and neurogenesis modules composed of Met,Inppl1,and Dapk3 were also ***:The study suggested that understanding the functional modules that contribute to pharmaceutics might provide novel signatures that can be used as endpoints to define disease processes under stroke or cerebral ischemia conditions.

关键词： brain ischemia stroke neurogenesis angiogenesis modular pharmacology Met-axiation allosteric module

Acute worsening of microvascular complications of diabetes mellitus during rapid glycemic control:The pathobiology and therapeutic implications

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World Journal of Diabetes 2024年第3期15卷 311-317页

作者： Dania Blaibel Cornelius James Fernandez Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Endocrinology and Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

While chronic hyperglycaemia resulting from poorly controlled diabetes mellitus(DM)is a well-known precursor to complications such as diabetic retinopathy,neuropathy(including autonomic neuropathy),and nephropathy,a paradoxical intensification of these complications can rarely occur with aggressive glycemic management resulting in a rapid reduction of glycated ***,acute onset or worsening of retinopathy and treatment induced neuropathy of diabetes are more common among these complications,rarely other problems such as albuminuria,diabetic kidney disease,Charcot’s neuroarthropathy,gastroparesis,and urinary bladder dysfunction are also *** World Journal of Diabetes recently published a rare case of all these complications,occurring in a young type 1 diabetic female intensely managed during pregnancy,as a case report by Huret et *** is essential to have a comprehensive understanding of the pathobiology,prevalence,predisposing factors,and management strategies for acute onset,or worsening of microvascular complications when rapid glycemic control is achieved,which serves to alleviate patient morbidity,enhance disease management compliance,and possibly to avoid medico-legal issues around this rare clinical *** editorial delves into the dynamics surrounding the acute exacerbation of microvascular complications in poorly controlled DM during rapid glycaemic control.

关键词： Diabetes mellitus Microvascular complications Diabetic retinopathy Treatment induced neuropathy of diabetes Diabetic nephropathy Charcot’s neuropathy

A retrospective analysis of carbapenem-resistant Acinetobacter baumannii infections in critically ill patients:Experience at a tertiary-care teaching hospital ICU

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Journal of Intensive Medicine 2024年第2期4卷 181-186页

作者： Leyla Ferlicolak Neriman Defne Altintas Fugen Yoruk Department of Internal Medicine Division of Intensive Care Unit Ankara University Faculty of MedicineAnkaraTurkey Department of Infectious Diseases and clinical Microbiology Ankara University Faculty of MedicineAnkaraTurkey

Background Acinetobacter baumannii is a clinically significant pathogen with a high incidence of multidrug resistance that is associated with life-threatening nosocomial ***,we aimed to provide an insight into the clinical characteristics and outcomes of a unique group of *** infections in which the isolates were resistant to carbapenems and most other antibiotic groups in a tertiary-care intensive care unit(ICU).Methods We performed a retrospective observational study in which records of patients hospitalized in the ICU between June 1,2021 and June 1,2023 were *** checked the clinical,laboratory,and microbiological records of all adult patients who had carbapenem-resistant ***(CRAB)*** antibiotic treatments and definitive antibiotic treatments after culture positivity and susceptibility test results were recorded.C-reactive protein(CRP)and procalcitonin levels and leukocyte counts were *** of ICU stay and 30-day mortality were defined as the outcome *** During the study period,57 patients were diagnosed with CRAB *** respiratory tract was the leading infection site(80.7%).In non-survivors,bloodstream infections(21.9%vs.4.0%P=0.05)and colistin-resistant(col-R)CRAB infections(43.8%vs.24.0%,P=0.12)were more common than in survivors,but these parameters were not statistically *** length of ICU stay was not different between survivors and ***,the rate of col-R among CRAB clinical isolates was 35.1%.The 30-day mortality in all patients with CRAB infection was 56.1%.Mortality in col-R CRAB and colistin-susceptible(col-S)CRAB infections was 70.0%and 48.6%,respectively(P=0.12).Prior carbapenem use was 56.1%.Prior colistin use before col-R and col-S CRAB infections was not significant(35.0%vs.27.0%,P=0.53).Conclusions Our study provides real-world data on highly resistant *** infections and shares the characteristics of infections with such resistant stra

关键词： Mortality Colistin-resi stant gram-negative bacteria MDR Intensive care unit