RESISTÊNCIA AERÓBIA MUSCULAR PERIFÉRICA E CAPACIDADE FUNCIONAL EM IDOSOS COM DOENÇA PULMONAR OBSTRUTIVA CRÔNICA

The objective was to evaluate the peripheral muscular aerobic resistance of elderly people with Chronic Obstructive Pulmonary Disease (COPD) and to correlate it with the functional capacity. Anthropometric and clinical data, functional capacity and peripheral muscular aerobic resistance were evaluated, setting p≤ 0.05. The sample consisted of 14 individuals with COPD, presented London Chest Activity of Daily Living (LCADL) with impairment rates, 6-minute walk test (6MWT) within the normal range, TGlittre score below the reference values. 6MWT and TGlittre did not present a significant correlation with the performance time or the number of repetitions of the PPT. The evaluation of peripheral muscular resistance through the PPT was made difficult by the lack of reference values in the literature for the age group of the study population, however, a moderate significant correlation was found between the LCADL scale with the number of repetitions and the time of the PPT.El objetivo fue evaluar la resistencia aeróbica muscular periférica de ancianos con Enfermedad Pulmonar Obstructiva Crónica (EPOC) y correlacionarla con la capacidad funcional. Se evaluaron datos antropométricos, clínicos, capacidad funcional y resistencia aeróbica muscular periférica, fijándose una p≤ 0,05. La muestra estuvo compuesta por 14 personas con EPOC, presentaban London Chest Activity of Daily Living (LCADL) con tasas de deterioro, prueba de caminata de 6 minutos (6MWT) dentro del rango normal, puntaje TGlittre por debajo de los valores de referencia. 6MWT y TGlittre no presentaron una correlación significativa con el tiempo de ejecución o el número de repeticiones del PPT. La evaluación de la resistencia muscular periférica a través de la PPT se vio dificultada por la falta de valores de referencia en la literatura para el grupo etario de la población de estudio, sin embargo, se encontró una correlación significativa moderada entre la escala LCADL con el número de repeticiones y la hora del PPT.Objetivou-se avaliar a resistência aeróbia muscular periférica de idosos com Doença Pulmonar Obstrutiva Crônica (DPOC) e correlacionar com a capacidade funcional. Foram avaliados dados antropométricos e clínicos, capacidade funcional e resistência aeróbia muscular periférica, fixando-se o p≤ 0,05. A amostra foi composta por 14 indivíduos com DPOC, apresentaram London Chest Activity of Daily Living (LCADL) com índices de comprometimento, Teste de Caminhada de 6 minutos (TC6min) dentro da normalidade, escore de TGlittre abaixo dos valores de referência. TC6min e o TGlittre não apresentaram correlação significativa com o tempo de realização ou a quantidade de repetições do TPP. A avaliação da resistência muscular periférica através do TPP foi dificultada por não haver na literatura valores de referência para a faixa etária da população do estudo, porém foi encontrada uma correlação significativa moderada entre a escala LCADL com o número de repetições e o tempo do TPP

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline