Pulmonary stenosis in a dog submitted to valvuloplasty

The Congenital heart diseases are characterized by morphological defects in the embryonic development and the most frequent in dogs are: pulmonary and aortic valve stenosis, ventricular septal defect and persistente ductus arteriosus.  They may occur asymptomatically or even evolve to congestive heart failure. The definitive diagnosis is made through the visualization of the alterations in the echocardiogram. In the present report, a French Bulldog, three month old, asymptomatic was presented to a private Veterinary practice in Rio de Janeiro, Brazil. Cardiac auscultation evidenced a systolic heart murmur in tricuspid focus and diastolic murmur in pulmonary focus. To better evaluate the dog  chest radiography, electrocardiogram and echocardiogram were perfomed and  allowed the diagnosis of pulmonary stenosis. The clinical treatment with beta-blocker was installed and the surgical procedure was performed with the ballon valvuloplasty. The aim of this study was to report a case of pulmonary artery stenosis in a puppy, treated clinically and surgically, emphasizing the importance of the physical and complementary cardiological exams

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk