37 research outputs found
Open, laparoscopic, and robotic-assisted hepatectomy in resection of liver tumors : a non-systematic review.
Nas ?ltimas d?cadas, in?meros fatores transformaram as hepatectomias
em opera??es mais seguras. A quimioterapia, juntamente com novas drogas para o tratamento
de met?stases propiciaram melhores respostas, o que possibilitou a indica??o cir?rgica em
pacientes que inicialmente n?o eram candidatos a ela. Les?es hep?ticas muitas vezes requerem
ressec??o, que pode ser realizada tanto por laparotomia, por videolaparoscopia ou assistida
por plataforma rob?tica.Several factors have made hepatectomy an increasingly safe surgery
and new drugs allowed surgical treatment for patients who initially were not candidates for
resection. Lesions often require resection, which can be performed by open, laparoscopic, or
robotic assisted hepatectomy
Regional differences in the number and type of myenteric neurons in the descending colon of rats
Elaboração de questionário de frequência alimentar semiquantitativo para adolescentes da região metropolitana do Rio de Janeiro, Brasil
Short-term effects of a spinosyn's family insecticide on energy metabolism and liver morphology in frugivorous bats Artibeus lituratus (Olfers, 1818)
Evaluation by computerized morphometry of histopathological alterations of the colon wall in segments with and without intestinal transit in rats
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 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 m 2), 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