Endocrine Reviews,
Journal Year:
2023,
Volume and Issue:
45(1), P. 69 - 94
Published: July 11, 2023
Primary
aldosteronism
(PA)
is
an
endocrinopathy
characterized
by
dysregulated
aldosterone
production
that
occurs
despite
suppression
of
renin
and
angiotensin
II,
non-suppressible
volume
sodium
loading.
The
effectiveness
surgical
adrenalectomy
for
patients
with
lateralizing
PA
the
attenuation
excess
leading
to
blood
pressure
reduction,
correction
hypokalemia,
increases
in
renin-biomarkers
collectively
indicate
a
reversal
pathophysiology
restoration
normal
physiology.
Even
though
vast
majority
will
ultimately
be
treated
medically
rather
than
surgically,
there
lack
guidance
on
how
optimize
medical
therapy
key
metrics
success.
Herein,
we
review
evidence
justifying
approaches
management
biomarkers
reflect
endocrine
principles
restoring
We
current
arsenal
therapies,
including
dietary
restriction,
steroidal
nonsteroidal
mineralocorticoid
receptor
antagonists,
epithelial
channel
inhibitors,
synthase
inhibitors.
It
crucial
clinicians
recognize
multimodal
treatment
can
highly
effective
at
reducing
risk
adverse
cardiovascular
kidney
outcomes
when
titrated
intention.
reflective
optimized
are
unsurprisingly
similar
physiologic
expectations
following
adrenalectomy:
control
fewest
number
antihypertensive
agents,
normalization
serum
potassium
without
supplementation,
rise
renin.
Pragmatic
achieve
these
objectives
while
mitigating
effects
reviewed.
European Journal of Vascular and Endovascular Surgery,
Journal Year:
2023,
Volume and Issue:
66(4), P. 454 - 483
Published: Sept. 20, 2023
Diabetes
related
foot
complications
have
become
a
major
cause
of
morbidity
and
are
implicated
in
most
minor
amputations
globally.
Approximately
50%
people
with
diabetes
ulcer
peripheral
artery
disease
(PAD)
the
presence
PAD
significantly
increases
risk
adverse
limb
cardiovascular
events.
The
International
Working
Group
on
Diabetic
Foot
(IWGDF)
has
published
evidence
based
guidelines
management
prevention
since
1999.
This
guideline
is
an
update
2019
IWGDF
diagnosis,
prognosis,
mellitus
ulcer.
For
this
updated
guideline,
IWGDF,
European
Society
for
Vascular
Surgery,
Surgery
decided
to
collaborate
develop
consistent
suite
recommendations
relevant
clinicians
all
countries.
three
new
systematic
reviews.
Using
Grading
Recommendations,
Assessment,
Development
Evaluation
framework
clinically
questions
were
formulated,
literature
was
systematically
reviewed.
After
assessing
certainty
evidence,
formulated
which
weighed
against
balance
benefits
harms,
patient
values,
feasibility,
acceptability,
equity,
resources
required,
when
available,
costs.
Through
process
five
developed
diagnosing
person
diabetes,
without
or
gangrene.
Five
prognosis
relating
estimating
likelihood
healing
amputation
outcomes
Fifteen
treatment
encompassing
prioritisation
revascularisation,
choice
procedure
post-surgical
care.
In
addition,
Writing
Committee
highlighted
key
research
where
current
lacking.
believes
that
following
these
will
help
healthcare
professionals
provide
better
care
reduce
burden
complications.
Diabetes Obesity and Metabolism,
Journal Year:
2023,
Volume and Issue:
25(6), P. 1658 - 1667
Published: Feb. 15, 2023
Abstract
Aims
SURE
Italy,
a
multicentre,
prospective,
open‐label,
observational,
real‐world
study,
investigated
once‐weekly
semaglutide
in
patients
with
type
2
diabetes
(T2D)
routine
clinical
practice.
Materials
and
Methods
Adults
T2D
≥1
documented
glycated
haemoglobin
(HbA1c)
level
within
12
weeks
of
initiation
were
enrolled.
The
primary
endpoint
was
change
HbA1c
from
baseline
to
end
study
(EOS;
~30
weeks).
Other
endpoints
included
changes
body
weight,
waist
circumference
patient‐reported
outcomes,
the
proportion
achieving
<7.0%
or
<6.5%,
weight
loss
≥5%
post‐hoc
composite
(HbA1c
reduction
≥1%‐point
≥5%).
These
reported
for
on
at
EOS
[effectiveness
analysis
set
(EAS)].
Safety
data
full
set.
Results
Of
579
who
initiated
(full
set),
491
completed
treatment
(EAS).
Mean
8.0%,
20.7%
(120
579)
had
<7.0%.
dose
0.66
±
0.28
mg.
In
EAS,
mean
decreased
by
1.1%‐point
(95%
confidence
interval
1.20,
1.05;
P
<
.0001)
4.2
kg
4.63,
3.67;
.0001),
respectively.
At
EOS,
61.7%
40.8%
achieved
respectively,
40.5%
25.3%
endpoint.
Patient‐reported
outcomes
improved
EOS.
No
new
safety
concerns
identified.
Conclusions
practice
treated
30
clinically
significant
improvements
HbA1c,
other
outcomes.
