Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science.

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent.Fil: Ibañez, Agustin Mariano. University of California; Estados Unidos. Trinity College Dublin; Irlanda. Universidad de San Andrés; Argentina. Universidad Adolfo Ibañez; Chile. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Yokoyama, Jennifer S.. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Possin, Katherine L.. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Matallana, Diana. Pontificia Universidad Javeriana; Colombia. Hospital Universitario San Ignacio; Colombia. Hospital Universitario Santa Fe de Bogotá; ColombiaFil: Lopera, Francisco. Universidad de Antioquia; ColombiaFil: Nitrini, Ricardo. Universidade de Sao Paulo; BrasilFil: Takada, Leonel T.. Universidade de Sao Paulo; BrasilFil: Custodio, Nilton. Instituto Peruano de Neurociencias; PerúFil: Sosa Ortiz, Ana Luisa. Universidad Nacional Autónoma de México; MéxicoFil: Avila Funes, José Alberto. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; México. Université de Bordeaux; FranciaFil: Behrens, Maria Isabel. Universidad de Chile; Chile. Universidad del Desarrollo; ChileFil: Slachevsky, Andrea. Universidad del Desarrollo; Chile. Centro de Gerociencia para la Salud Cerebral y el Metabolismo; Chile. Instituto de Ciencias Biomédicas, Neurociencias y Neurociencias de Oriente; Chile. Universidad de Chile; ChileFil: Myers, Richard M.. Hudson Alpha Institute for Biotechnology; Estados UnidosFil: Cochran, J. Nicholas. Hudson Alpha Institute for Biotechnology; Estados UnidosFil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina; Argentina. ALZAR; ArgentinaFil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina; Argentina. ALZAR; ArgentinaFil: Bruno, Martin. Universidad Nacional de Cuyo. Facultad de Ciencias Medicas. Departamento de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Brucki, Sonia M. D.. Hospital Santa Marcelina; Brasil. Universidade de Sao Paulo; BrasilFil: Pina Escudero, Stefanie Danielle. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Okada de Oliveira, Maira. University of California; Estados Unidos. Trinity College Dublin; Irlanda. Universidade de Sao Paulo; Brasil. Hospital Santa Marcelina; BrasilFil: Donnelly Kehoe, Patricio Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas. Universidad Nacional de Rosario. Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas; ArgentinaFil: García, Adolfo Martín. University of California; Estados Unidos. Trinity College Dublin; Irlanda. Universidad de San Andrés; Argentina. Universidad Catolica de Cuyo. Facultad de Educacion.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cardona Londoño, Juan Felipe. Universidad del Valle; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Santamaria Garcia, Hernando. Hospital Universitario San Ignacio; Colombia. Pontificia Universidad Javeriana; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Moguilner, Sebastian. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Duran Aniotz, Claudia. Universidad Adolfo Ibañez; ChileFil: Tagliazucchi, Enzo Rodolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Física de Buenos Aires; ArgentinaFil: Maito, Marcelo. Universidad de San Andrés; ArgentinaFil: Longoria Ibarrola, Erika Mariana. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; MéxicoFil: Pintado Caipa, Maritza. Trinity College Dublin; Irlanda. University of California; Estados Unidos. Instituto Peruano de Neurociencias; PerúFil: Godoy, Maria Eugenia. Universidad de San Andrés; ArgentinaFil: Bakman, Vera. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Javandel, Shireen. University of California; Estados UnidosFil: Kosik, Kenneth. University of California; Estados UnidosFil: Valcour, Victor. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Miller, Bruce L.. University of California; Estados Unidos. Trinity College Dublin; Irland

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science.

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent

Task Force of the Latin American Society of Hypertension

ABI, ankle-brachial index; ABPM, ambulatory blood pressure monitoring; ACCORD, Action to Control Cardiovascular Risk in Diabetes; ACE-I, angiotensin-converting-enzyme-inhibitors; ARB, AT1 blockers; BP, blood pressure; CARMELA, Cardiovascular Risk Factor Multiple Evaluation in Latin America; CARMEN, Community Actions for Multifactorial Reduction of Non- Communicable Diseases; CCB, calcium channel blocker; CCM, Wagner’s Chronic Care Model; CDC, Chronic Disease Center; CTA, computed tomography angiography; CV, cardiovascular; DALY, disability-adjusted life year; DPP- 4, dipeptidyl-peptidase-4; GLP-1, glucagon-like peptide 1; HBPM, home blood pressure monitoring; HOPE, Heart Outcomes Prevention Evaluation; HOT, Hypertension Optimal Treatment; HT, hypertension; LA, Latin America; LASH, Latin American Society of Hypertension; MRA, magnetic resonance angiography; NCD, noncommunicable disease; OSAS, obstructive apnea–hypopnea syndrome; PAD, peripheral artery disease; PAHO, Pan American Health Organization; RAAS, renin–angiotensin–aldosterone system; RISS, Redes Integradas de Servicios de Salud; SGLUT2, sodium–glucose cotransporter-2; SPRINT, SBP Intervention Trial; UKPDS, United Kingdom Prospective Diabetes Study; VIDA, Veracruz Initiative for Diabetes Awarenes

TIII - Arquitectura y Entorno - AR307 - 202101

Descripción: El curso TIII - Arquitectura y Entorno, es un curso de especialidad en la carrera de Arquitectura; parte del estudio del patrimonio edificado y la ciudad histórica, y propone el adiestramiento en el diseño arquitectónico a partir de la transformación y/o reciclaje de un objeto arquitectónico preexistente, y/o la propuesta de edificaciones nuevas relacionadas con el espacio urbano, desde un enfoque contemporáneo. Propósito: El TIII - Arquitectura y Entorno busca que el futuro arquitecto tome conciencia que todo proyecto arquitectónico está destinado a relacionarse con el contexto urbano. A través de la identificación y el análisis, el alumno adquiere las herramientas para diseñar respondiendo al entorno. El curso contribuye directamente al desarrollo de las competencias generales de Ciudadanía y Pensamiento Innovador y la competencia específica de Diseño Fundamentado (que corresponde a los criterios NAAB: PC2, PC3, PC5, PC8, SC3, SC5). Tiene como requisitos: Dibujo Arquitectónico (AR286) y TII - Arquitectura y Arte (AR306)

TIII - Arquitectura y Entorno - AR307 - 202102

Descripción: El curso TIII - Arquitectura y Entorno, es un curso de especialidad en la carrera de Arquitectura; parte del estudio del patrimonio edificado y la ciudad histórica, y propone el adiestramiento en el diseño arquitectónico a partir de la transformación y/o reciclaje de un objeto arquitectónico preexistente, y/o la propuesta de edificaciones nuevas relacionadas con el espacio urbano, desde un enfoque contemporáneo. Propósito: El TIII - Arquitectura y Entorno busca que el futuro arquitecto tome conciencia que todo proyecto arquitectónico está destinado a relacionarse con el contexto urbano. A través de la identificación y el análisis, el alumno adquiere las herramientas para diseñar respondiendo al entorno. El curso contribuye directamente al desarrollo de las competencias generales de Ciudadanía y Pensamiento Innovador y la competencia específica de Diseño Fundamentado (que corresponde a los criterios NAAB: PC2, PC3, PC5, PC8, SC3 y SC5). Tiene como requisito haber aprobado los cursos: Dibujo Arquitectónico (AR351) y TII - Arquitectura y Arte (AR334)