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SGLT2 Inhibitors in Combination Therapy: From Mechanisms to Clinical Considerations in Type 2 Diabetes Management.


30 Oct | Categories : Diabetology Start a topic Comment Mail Share Download
sulfonylurea, thiazolidinedione, or insulin) to treat patients with T2D.ReadMore">

The Effects of Vitamin D Supplementation on Thyroid Function in Hypothyroid Patients: A Randomized, Double blind, Placebo controlled Trial


30 Oct | Categories : Endocrinology Start a topic Comment Mail Share Download
Abstract: Overall, the current study demonstrated that vitamin D supplementationamong hypothyroid patients for 12 weeks improved serum TSH and calciumconcentrations compared with the placebo, but it did not alter serum T3, T4,ALP, PTH, and albumin levels. ReadMore">

   Meta-Analysis of Usefulness of Psyllium Fiber as Adjuvant Antilipid Therapy to Enhance Cholesterol Lowering Efficacy of Statins

Brum J, Ramsey D,  McRorie J,  Bauer B, Kopecky SL. Meta-Analysis of Usefulness of P.....

Brum J, Ramsey D,  McRorie J,  Bauer B, Kopecky SL. Meta-Analysis of Usefulness of P.....


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   Reaching ‘an ACCORD’ with ‘a SPRINT’

Beddhu S, Chertow GM, Greene T, Whelton PK. Ambrosius WT, Cheung AK, et al. Effects of Intensi.....

Beddhu S, Chertow GM, Greene T, Whelton PK. Ambrosius WT, Cheung AK, et al. Effects of Intensi.....


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   Tips thru tables: Which drug as first line treatment for SVT: Adenosine or CCA?

Source: Alabed S, Providência R and Chico TJA. Cochrane corner: .....

Source: Alabed S, Providência R and Chico TJA. Cochrane corner: .....


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. Drug

Adenosine

CCA (Verapamil or Diltiazem)

Recommended by guidelines

1st line drug

2nd line drug

Safety in situations

Poor LV function, concomitant beta-blocker use,  broad complex tachycardia and in children

Stable patients, asthmatics, previous unpleasant experience with adenosine, people with frequent relapses on adenosine, in people with frequent atrial or ventricular ectopics at risk of an early recurrence of the arrhythmia

Cost

Expensive

Cheaper

How administered

6 mg and followed this up with another dose of 12 mg if SVT was not terminated with the first dose.

Verapamil : 5 mg boluses or infusion over up to 5 min. Diltiazem : slow intravenous infusion at a rate of 2.5 mg/min, to a maximum dose of 50 mg.

Effectiveness

No significant difference found

In this study

Abbreviations- LV- left ventricular, SVT- supraventricular tachycardia

Conclusion:  

Since both adenosine and verapamil have similar reversion rates and are readily available and simple to administer, patient preference and treatment costs may be some of the only crucial differences deserving consideration and may suggest revision of guidelines.

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   Bye Bye Aspirin for Primary Prevention

Aspirin is being taken by millions of people all over the world  with the hope that it wi.....

Aspirin is being taken by millions of people all over the world  with the hope that it wi.....


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1.   Dai Y, Ge J. Clinical use of aspirin in treatment and prevention of cardiovascular disease. Thrombosis. 2012;2012:245037.

2.   Cadavid AP. Aspirin: The mechanism of action revisited in the context of pregnancy complications. Front Immunol. 2017 Mar 15;8:261.

3.   Using aspirin for the primary prevention of cardiovascular disease [Internet]. Available at: https://www.uspreventiveservicestaskforce.org/Home/GetFileByID/768. Accessed on Oct 2,2018.

4.   Gaziano JM, Brotons C, Coppolecchia R, Cricelli C, Darius H, Gorelick PB, et al. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): A randomized, double-blind, placebo-controlled trial.Lancet. 2018 Sep 22;392(10152):1036–46.

5.   ASCEND Study Collaborative Group. Effects of aspirin for primary prevention in persons with diabetes mellitus. N Engl J Med. 2018 Aug 26.

McNeil JJ, Nelson MR, Woods RL, Lockery JE, Wolfe R, Reid CM, et al. Effect of aspirin on all-cause mortality in the healthy elderly. N Engl J Med. 2018 Sep 16.

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   ASPREE Study: Aspirin Effects On All-Cause Mortality in The Elderly

In ASPREE (Aspirin in Reducing Events in the Elderly) trial, 19,114 participants were randomly.....

In ASPREE (Aspirin in Reducing Events in the Elderly) trial, 19,114 participants were randomly.....


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   ASCEND Study: Primary Prevention of Aspirin in Patients with Diabetes Mellitus

In ASCEND study, among 15,480 participants with diabetes but no evident cardiovascular disease.....

In ASCEND study, among 15,480 participants with diabetes but no evident cardiovascular disease.....


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   ARRIVE Trial: Aspirin Usage To Reduce Initial CV Events In Patients At Moderate CVD Risk

A randomized, double-blind, placebo-controlled and multicentre study aimed to address the role.....

A randomized, double-blind, placebo-controlled and multicentre study aimed to address the role.....


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   GLOBAL LEADERS Trial: Ticagrelor Combination Therapy & Monotherapy Outcomes After Percutaneous Coronary Intervention vs Standard Antiplatelet Regimens

GLOBAL LEADERS is the largest trial (randomized and open-label superiority at 130 sites in 18 .....

GLOBAL LEADERS is the largest trial (randomized and open-label superiority at 130 sites in 18 .....


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