Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

A case of ventricular standstill in a patient with acute gastrointestinal bleeding

Ventricular stand still is an electrophysiologic phenomenon characterized by the absence of ventricular activity or contraction. It is the result of the lack of impulse formation in ventricles (absence of idioventricular automaticity) or the failure of impulse transmission to ventricles (conduction disturbance) [1]. It is an uncommon condition that can affect a wide range of age groups with life threatening consequences. There are no set guidelines on the treatment of ventricular standstill – swift and sound clinical judgment is required. The condition should be treated as a cardiac arrest, with resolution of precipitating factors. Here we present a case of a 59-year-old man with multiple comorbidities, who presented with massive gastrointestinal hemorrhage and recurrent episodes of ventricular standstill during hospitalization, with his immediate treatment and stabilization

Growth and Characterization of Electrospun LaMnO3 Nanofibers by Electrospinning Technique

The polycrystalline perovskite structure of LaMnO3 nanofibers was obtained by calcination of the PVA/[LaCl3+MnCl2+(NH4)2CO3] composite at 600°C with electrospinning technique. The decomposition and crystalline behavior of sample were examined by Thermogravimetric and Simultaneous Differential Thermal Analysis (TG-DTA). The crystal structure and phase formation were characterized by X-ray Diffraction (XRD). Scanning Electron Microscopy (SEM) was performed and the diameters of the LaMnO3 nanofibers were calculated to be 42 nm and 55 nm with different spinning intervals at 600°C. SEM analysis was also carried out to examine the fiber diameters and morphological properties

Synthesis and Characterization of LaMnO3Nanofibers by Electrospinning Techique

This paper aimed to prepare the synthesis of LaMnO3 nanofibers by electrospinning technique using a solution that contained polyvinyl alcohol (PVA) and a sol-gel solution of LaMnO3. LaMnO3/PVA perovskite-type nanofibers were obtained after annealed at 500°C, 600°C, 700°C and 800°C for 2h respectively. Thermal properties of LaMnO3 samples were examined by TG-DTA. Phase formation and crystal structure of LaMnO3 nanopowders were characterized by X-ray diffraction (XRD). FESEM images revealed that LaMnO3 as-spun nanofibers on Al foils were attracted to be between 60-120 nm in diameters with electrospinning set-up for 15 min. The crystal structure, fiber diameters and morphology of LaMnO3 nanofibers were influenced by the calcination temperatures. The qualifications of LaMnO3 nanofibers were successfully yielded by the electronspinning technique as final products

Dielectric properties of composite LaMnO3 nanofiber by electrospinning technique

Electrospinning technique has been extensively developed as a simple and vasatile method for drawing nanofibers from polymer solutions. Lanthanum Maganite La1-x MnxO3 (x = 0.02 mol) nanofibers were obtained by calcinations of PVA/LaMnO3 composite at different temperatures with electrospinning utilizing sol-gel precursors. Novel polycrystalline LaMnO3 nanofibers were yielded at 500 °C, 600 °C and 700 °C for 2 h as the final products. Field Emission Scanning Electron Microscopy (FESEM) was employed to study the fiber diameter of samples. The average diameter of the LaMnO3 nanofibers was found to be in the range of 85 nm to 150 nm at different temperatures. The dielectric properties of LaMnO3 nanofibers were identified by C-f, r-f, tan - f and ac-f characteristics. The results obtained from this research will lead to enable new levels of electronic applications, biomedical applications and protective clothing

Characterization and Dielectric Properties of LaMnO3 Thin Films by Spin Coating Method

This paper presents LaMnO3 nanostructured thin films were deposited on silicon substrate by using Single Wafer Spin Processor. LaMnO3 powder was firstly prepared by pyrolysis method. The structural, morphology and thermal properties of LMO powder was examined by XRD, SEM and TG-DTA. The films obtained from spin coating technique have been annealed at 500 ºC and 600 ºC for 1 h. Morphology, and structural properties of fabricated LaMnO3 thin films were investigated by SEM and XRD analysis. The objective of this research is to explore the structure, dielectric properties and processing of thin films that contain nanoscale embedded hard particles

Study on Lanthanum Manganite Ultra-fine Fibres

Local-made electrospinning experimental set-up is firstly constructed. Lanthanum Manganite (La0.98Mn0.02O3) nano fibres are fabricated by electrospinning utilizing sol-gel precursors. The crystal structure and thermal analysis are studied by Scanning Electron Microscope (SEM), X-ray diffraction (XRD) and Thermogravimetry and simultaneous Differential Thermal Analysis (TG-DTA) respectively

Adverse Drug Reactions in Selected Wards of the Yangon General Hospital and Yangon Specialty Hospital During the First Quarter of 2019 : An Active Pharmacovigilance Study in Myanmar

Previous studies in Europe and the USA have reported a high prevalence of adverse drug reactions (ADRs), but data on local ADRs in Myanmar are sparse. Our objective was to study ADRs in patients admitted to selected wards of Yangon General Hospital (YGH) and Yangon Specialty Hospital (YSH), Myanmar. This was a prospective observational study in three hospital wards during the first quarter of 2019. Suspected ADRs were carefully investigated in a face-to-face interview with each patient and via review of clinical records. Patients transferred to other wards or discharged were followed-up by the researchers until day 28 after admission. ADRs were divided into those that (1) led to the admission and (2) occurred during the hospital stay or after discharge (up to day 28 after admission). A total of 65 ADRs were identified, with 47 (29.4%) of 160 patients experiencing at least one ADR. Among these, 16 (24.6%) had led to hospital admission and 49 (75.4%) occurred in 31 patients during their hospital stay. Of 160 patients, 21 had taken at least one herbal remedy and six of these developed an ADR. Five ADR-drug associations (hypokalaemia with methylprednisolone, increased transaminase levels with standard antituberculosis drugs, upper gastrointestinal bleeding with nonsteroidal anti-inflammatory drugs, constipation with tramadol, and increased transaminase levels with herbal remedies) represented 18 (27.7%) of the 65 ADRs in this study. According to the Schumock and Thornton preventability scale, more than half of these ADRs (35 [53.9%]) were preventable. The present study highlights the existence of ADRs among patients attending these hospitals. The implementation of active pharmacovigilance in hospitals could be a helpful first step to improving the awareness of unwanted effects of medicines and patient safety, as well as a way to strengthen the national pharmacovigilance system in countries such as Myanmar. The online version of this article (10.1007/s40801-020-00180-0) contains supplementary material, which is available to authorized users