Publication highlights 1 to 8 Aug 2023

1. #SGLT2 Inhibitors and #GLP1 receptor agonists?Could Confer CardioRenal Benefits in #Type1Diabetes

This study included 196,691 individuals with #type1diabetes, 13% of whom were treated with adjunctive glucose-lowering therapy in addition to insulin. In all, 1822 patients were treated with a #GLP1 receptor agonist, and 992 were treated with an #SGLT2 inhibitor. Both agents provided clinically meaningful reductions in HbA1c. The #SGLT2 cohort showed preservation of eGFR over a 5-year period compared with the GLP-1 RA treated cohort (+3.5 ml/min per 1.73 m2?vs -7.2 ml/min per 1.73 m2, respectively), including patients with established chronic kidney disease (CKD). The SGLT2 cohort experienced higher rates of diabetic ketoacidosis and urinary tract infection/pyelonephritis. However, patients in the SGLT2 cohort were less likely to develop #heartfailure, chronic kidney disease (#CKD ), and be hospitalized for any cause.

2. Comparison of #nasotracheal versus #orotracheal #intubation for sedation, assisted spontaneous breathing, mobilization, and outcome in critically ill patients

This was a retrospective study on patients intubated in the intensive care unit (ICU) and ventilated for > 48?h. In all, 988 patients received orotracheal #intubation (OTI) and 221 received nasotracheal #intubation (NTI). On days 1–3, a Richmond Agitation and Sedation Scale (RASS) of 0 or ? 1 was attained in the OTI for 4.0 ± 6.1?h/d group vs. 9.4 ± 8.4?h/d in the NTI group, p < 0.001. Propofol, sufentanil, and norepinephrine were required less frequently in NTI and doses were lower. The NTI group showed a higher proportion of spontaneous breathing from day 1 to 7. OTI was an independent predictor for mortality. No difference in the rate of tracheostomy was found. NTI was associated with less sedation, more spontaneous breathing, and a higher degree of mobilization during physiotherapy.?

3. Systemic Antipsoriatic Therapy Decreased Cardio-Cerebrovascular Disease (CCVD) in Patients with #Psoriasis

This was a retrospective study. Systemic antipsoriatic therapy was categorized into conventional agents (such as methotrexate, cyclosporine, or retinoids) and biologics (including anti-IL-12/23p40, TNF-α inhibitors, IL-17A antagonists, or IL-23 antagonists). In all, 251,813 participants were included, of whom 6,262 experienced CCVD events at the time of the study period (CCVD arm). The non-CCVD arm had a higher proportion of the treatment period with systemic antipsoriatic therapy (PTP) versus the CCVD group (CCVD: 2.12 ± 7.92, non-CCVD: 2.64 ± 9.64; P < 0.001). Following an adjustment for sex, age, hypertension, diabetes, and dyslipidemia in multiple logistic regression analysis, the PTP was reported to have had an inverse association with the risk of CCVD.

Specifically, the investigators found that a 10% increase in PTP led to a substantial 0.96 reduction in the risk of CCVD development (95% CI, 0.93 - 0.99). Additionally, this diminished risk of CCVD was shown to be consistent for both conventional antipsoriatic therapy and for biologic treatments.

4. Left ventricular #diastolic function might be worse in female patients with #type2diabetes.

This was a cross-sectional study included patients with #type2diabetes. Patients with hypertension, history of heart disease or ejection fraction < 50% were excluded from the study. The study included 1205 (70%) males and 573 (30%) females. Compared with males, females had higher total cholesterol and LDL cholesterol levels but lower #diastolicpressure, body mass index (BMI), visceral fat area, HbA1c, blood urea nitrogen (BUN), serum creatinine, and triglyceride. Females had a relatively higher ejection fraction than males (68.17 ± 6.055 vs 67.5 ± 6.096, P < 0.05). More female patients than male patients in the age group of 45– 60 years old had left ventricular diastolic dysfunction (female vs male, 54.5% vs 46.9%, P < 0.05). Female gender was independently associated with left ventricular diastolic dysfunction, after adjusting for important clinical factors.

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