This study aimed to assess the long-term effects of tofogliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, on atherosclerosis progression and major clinical parameters in patients with ...type 2 diabetes lacking an apparent history of cardiovascular disease.
This was a prospective observational 2-year extension study of the "Using TOfogliflozin for Possible better Intervention against Atherosclerosis for type 2 diabetes patients (UTOPIA)" trial, a 2-year randomized intervention study. The primary endpoints represented changes in the carotid intima-media thickness (IMT). Secondary endpoints included brachial-ankle pulse wave velocity (baPWV) and biomarkers for glucose metabolism, lipid metabolism, renal function, and cardiovascular risks.
The mean IMT of the common carotid artery (IMT-CCA) significantly decreased in both the tofogliflozin (- 0.067 mm, standard error 0.009, p < 0.001) and conventional treatment groups (- 0.080 mm, SE 0.009, p < 0.001) throughout the follow-up period; however, no significant intergroup differences in the changes (0.013 mm, 95% confidence interval (CI) - 0.012 to 0.037, p = 0.32) were observed in a mixed-effects model for repeated measures. baPWV significantly increased in the conventional treatment group (82.7 ± 210.3 cm/s, p = 0.008) but not in the tofogliflozin group (- 17.5 ± 221.3 cm/s, p = 0.54), resulting in a significant intergroup difference in changes (- 100.2 cm/s, 95% CI - 182.8 to - 17.5, p = 0.018). Compared to the conventional treatment group, tofogliflozin significantly improved the hemoglobin A1c and high-density lipoprotein cholesterol levels, body mass index, abdominal circumference, and systolic blood pressure. The frequencies of total and serious adverse events did not vary significantly between the groups.
Tofogliflozin was not associated with improved inhibition of carotid wall thickening but exerted long-term positive effects on various cardiovascular risk factors and baPWV while showing a good safety profile.
Bioglass 45S5 is a bioactive glass that can create a layer of calcium-phosphate crystals on mineralized hard tissues. In this study, 45S5 bioglass was mixed with phosphoric acid and irradiated with ...CO2 laser and examined as a possible aid in the treatment of dentin hypersensitivity. The dentinal surface modified by the aforementioned technique was chemically and micro-morphologically examined with a field emission scanning electron microscope (FE-SEM) equipped with an energy-dispersive x-ray spectroscope (EDS), and the crystalline structures of the examined dentinal surfaces were examined by x-ray diffraction (XRD). Moreover, the mechanical properties of the newly formed layer were examined by nanoindentation. The results showed that 45S5 bioglass could occlude the dentinal tubule orifices with calcium-phosphate crystals. The application of CO2 laser potentially improved the mechanical organization of these crystals.
Effective ablation of dental hard tissues by means of the erbium-doped:yttrium-aluminum garnet (Er:YAG) laser has been reported recently, and its application to caries removal and cavity preparation ...has been expected. However, few studies have investigated the capability of the Er:YAG laser to treat caries. In the present study, the effectiveness of caries removal by using an Er:YAG laser in vitro was compared with that of conventional mechanical treatment. Thirty-one extracted human teeth with root caries were used. Half of the caries in each tooth was treated with the Er:YAG laser, and the other was removed with a conventional bur or was left untreated as a control. Laser treatment was performed by means of a combination of contact and non-contact irradiation modes with cooling water spray, with a new fiber delivery and contact probe system. Conventional bur treatment was conducted by means of a low-speed micromotor. Measurements of the time required for caries removal, histopathological observations of decalcified serial sections, scanning electron microscope (SEM) observations, and hardness measurements of the treated cavity-floor dentin were performed for each treatment. Due to the careful irradiation technique, a longer treatment time was required for the complete removal of carious dentin by the Er:YAG laser. However, the Er:YAG laser ablated carious dentin effectively with minimal thermal damage to the surrounding intact dentin, and removed infected and softened carious dentin to the same degree as the bur treatment. In addition, a lower degree of vibration was noted with the Er:YAG laser treatment. The SEM examination revealed characteristic micro-irregularities of the lased dentin surface. Our results show that the Er:YAG laser system is promising as a new technical modality for caries treatment.
Although inflammation is an important component of atherosclerosis, it is unknown whether inhaled corticosteroids (ICS) as anti-inflammatory drugs prevent atherosclerosis. In the present study, ...carotid atherosclerosis was evaluated by ultrasonography in 150 asthmatic patients who had been regularly treated with ICS, and in 150 matched nonasthmatic controls, with an assessment of atherosclerotic risk factors. Carotid intima-media thickness was significantly lower in the asthmatic patients than in the controls. The prevalence of carotid plaque tended to be lower in the asthmatic patients than in the controls. Defined carotid atherosclerosis was diagnosed in 51 of the asthmatic patients, who were older, with a higher prevalence of males, a higher prevalence of dyslipidaemia and a lower mean daily dose of ICS than the 99 patients without carotid atherosclerosis. Stepwise multiple logistic regression analysis identified age, male sex and dyslipidaemia as positive risk factors for carotid atherosclerosis. The mean daily dose of ICS was a negative risk factor. Carotid atherosclerosis is reduced in asthmatic patients treated with ICS compared with matched controls. This study suggests that ICS may have protective effects against atherosclerosis.
In the Tokaido Shinkansen, the instantaneous feeding power of substations has increased because of the high-density train schedule and the improved acceleration performance of the rolling stock. If ...the load power of feeding substations increases any further, it will not be possible to maintain the feeder voltage when the power converter supplies only reactive power. In consideration of such a situation in the frequency conversion section, an electronic frequency converter that controls the ac voltage using a fixed power factor method was developed. The superiority of the proposed control method is confirmed with electromagnetic transient program calculations and field test results. The electronic frequency converter has been in operation since February 2009 with good performance, showing the success of the system development described in this paper.
Acute pancreatitis is a common disease with an annual incidence of between 5 and 80 people per 100,000 of the population. The two major etiological factors responsible for acute pancreatitis are ...alcohol and cholelithiasis (gallstones). The proportion of patients with pancreatitis caused by alcohol or gallstones varies markedly in different countries and regions. The incidence of acute alcoholic pancreatitis is considered to be associated with high alcohol consumption. Although the incidence of alcoholic pancreatitis is much higher in men than in women, there is no difference in sexes in the risk involved after adjusting for alcohol intake. Other risk factors include endoscopic retrograde cholangiopancreatography, surgery, therapeutic drugs, HIV infection, hyperlipidemia, and biliary tract anomalies. Idiopathic acute pancreatitis is defined as acute pancreatitis in which the etiological factor cannot be specified. However, several studies have suggested that this entity includes cases caused by other specific disorders such as microlithiasis. Acute pancreatitis is a potentially fatal disease with an overall mortality of 2.1%-7.8%. The outcome of acute pancreatitis is determined by two factors that reflect the severity of the illness: organ failure and pancreatic necrosis. About half of the deaths in patients with acute pancreatitis occur within the first 1-2 weeks and are mainly attributable to multiple organ dysfunction syndrome (MODS). Depending on patient selection, necrotizing pancreatitis develops in approximately 10%-20% of patients and the mortality is high, ranging from 14% to 25% of these patients. Infected pancreatic necrosis develops in 30%-40% of patients with necrotizing pancreatitis and the incidence of MODS in such patients is high. The recurrence rate of acute pancreatitis is relatively high: almost half the patients with acute alcoholic pancreatitis experience a recurrence. When the gallstones are not treated, the risk of recurrence in gallstone pancreatitis ranges from 32% to 61%. After recovering from acute pancreatitis, about one-third to one-half of acute pancreatitis patients develop functional disorders, such as diabetes mellitus and fatty stool; the incidence of chronic pancreatitis after acute pancreatitis ranges from 3% to 13%. Nevertheless, many reports have shown that most patients who recover from acute pancreatitis regain good general health and return to their usual daily routine. Some authors have emphasized that endocrine function disorders are a common complication after severe acute pancreatitis has been treated by pancreatic resection.
PDF
