Dapagliflozin, a sodium-glucose co-transporter-2 inhibitor and semaglutide, a glucagon-like peptide 1 receptor agonist, have both demonstrated efficacy in glycemic control, reducing blood pressure, ...body weight, risk of renal and heart failure in type 2 diabetes mellitus. In this observational, real-world, study we aimed to investigate the efficacy of the combination therapy with those two agents over glycemic control. We thus obtained the data of 1335 patients with type 2 diabetes followed by 11 Diabetes centers in Lombardia, Italy. A group of 443 patients was treated with dapagliflozin alone, the other group of 892 patients was treated with the combination therapy of dapagliflozin plus oral semaglutide. We analyzed changes in glycated hemoglobin from baseline to 6 months of follow-up, as well as changes in fasting glycemia, body weight, body mass index, systolic and diastolic pressure, heart rate, creatinine, estimated glomerular filtration rate and albuminuria. Both groups of patients showed an improvement of glycometabolic control after 6 months of treatment; indeed, the treatment with dapagliflozin plus oral semaglutide showed a reduction of glycated hemoglobin of 1.2% as compared to the 0.5% reduction observed in the dapagliflozin alone group. Significant changes were observed in body mass index, fasting plasmatic glucose, blood pressure, total cholesterol, LDL and albumin to creatinine ratio, with a high rate (55%) of near-normalization of glycated hemoglobin. Our real world data confirmed the potential of the oral combination therapy dapagliflozin with semaglutide in inducing pharmacological remission of type 2 diabetes mellitus.
Dapagliflozin has been demonstrated to improve glycemic control, blood pressure, and body weight in type 2 diabetes mellitus (T2D); indeed, it can also reduce the risk of progression to renal ...failure, of hospitalization for heart failure and of cardiovascular death. We aim to investigate the acute effect of Dapagliflozin on kidney function in the common clinical practice in T2D. This is a study including 1402 patients with T2D recruited from 11 centers in Lombardia, Italy, who were evaluated at baseline and after 6 months of treatment with Dapagliflozin 10 mg per day. The primary outcome of the study was the change in HbA1c, while the secondary outcomes were modification of weight, BMI, systolic and diastolic pressure, creatinine, eGFR and albuminuria status. After 24 weeks of treatment with Dapagliflozin, a reduction in Hb1Ac was observed (−0.6 ± 1.8%) as well as in BMI (−1.5 ± 5.2 kg/m2). Statistically significant changes were also found for systolic and diastolic blood pressure, cholesterol and triglycerides. Interestingly, a statistically significant acute improvement of kidney function was evident. Our analyses confirm the beneficial effects of dapagliflozin after 6 months of therapy, with improvements of glycemic and lipid profiles, blood pressure, BMI. Finally, an acute positive effect on albuminuria and KIDGO classes was observed during a 6 months treatment with dapagliflozin in patients with T2D.
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Abstract The aim of this study was to analyse the health status of breast cancer survivors and the effects of 12 weeks of aerobic training. Twenty-three breast cancer survivors (51.71 ± 3.17 years) ...and 23 healthy women (50.73 ± 2.97 years) were investigated for body composition, daily physical activity, quality of life, salivary cortisol, and DHEA-S. Breast cancer survivors were then aerobically trained for 12 weeks. Breast cancer survivors have a worse psychophysical health than healthy women. Aerobic training increased salivary DHEA-S, aerobic fitness, self-reported health, and nocturnal sleeping time and reduced salivary cortisol in breast cancer survivors. Salivary cortisol variation correlated with change of sleeping time and self-reported health. Salivary DHEA-S correlated with change of self-reported physical pain and general health as well. Breast cancer survivors can live in a situation of continuous distress, requiring a multidisciplinary approach. Twelve weeks of aerobic training improve the psychophysical health of breast cancer survivors.
Purpose
Physical exercise has been shown effective for bone health, across lifespan, if proper characteristics have been ensured during exercise prescription and conduction. The aim of our study was ...to verify if workout organization, in postmenopausal women, may have a central role in determining the entity of the osteogenic effect of a physical exercise program.
Methods
Thirty-two postmenopausal women (mean age 59.35 ± 3.65 years) were eligible for the study. Plasma BAP and CTx-I were collected, and DEXA, anthropometry, dietary habits, and fitness tests have been ascertained before and after their participation in 12-week supervised workouts. One sub-group (TWs-s) was trained according to a traditional workout scheme, while the other sub-group (BBs-s) was trained following a bone-based scheme of exercise rotation.
Results
BBs-s significantly increased BAP plasma values (
p
= 0.004) and Six-Minute Walking Test result (
p
< 0.001), while TWs-s not. Both the sub-groups significantly increased Flamingo Balance Test (
p
= 0.05), Plank Position Test (
p
< 0.001), Handgrip Test (
p
= 0.004), Squat Test (
p
< 0.001), and Arm Curl Test (
p
< 0.001).
Conclusions
When bone health is considered, the establishment of the right exercise order, in a circuit training workout, is very important, because it could amplify or delay mechanoreceptor desensitizing. The experimented bone-based scheme of exercise rotation seems able to furnish positive effects on bone, muscle, and aerobic fitness.
PurposePhysical exercise has been shown effective for bone health, across lifespan, if proper characteristics have been ensured during exercise prescription and conduction. The aim of our study was ...to verify if workout organization, in postmenopausal women, may have a central role in determining the entity of the osteogenic effect of a physical exercise program.MethodsThirty-two postmenopausal women (mean age 59.35 ± 3.65 years) were eligible for the study. Plasma BAP and CTx-I were collected, and DEXA, anthropometry, dietary habits, and fitness tests have been ascertained before and after their participation in 12-week supervised workouts. One sub-group (TWs-s) was trained according to a traditional workout scheme, while the other sub-group (BBs-s) was trained following a bone-based scheme of exercise rotation.ResultsBBs-s significantly increased BAP plasma values (p = 0.004) and Six-Minute Walking Test result (p < 0.001), while TWs-s not. Both the sub-groups significantly increased Flamingo Balance Test (p = 0.05), Plank Position Test (p < 0.001), Handgrip Test (p = 0.004), Squat Test (p < 0.001), and Arm Curl Test (p < 0.001).ConclusionsWhen bone health is considered, the establishment of the right exercise order, in a circuit training workout, is very important, because it could amplify or delay mechanoreceptor desensitizing. The experimented bone-based scheme of exercise rotation seems able to furnish positive effects on bone, muscle, and aerobic fitness.
Background:
The logic behind the outcome of endocrine therapy in breast cancer has long remained poorly understood. The prognostic role of DNA damage and repair biomarkers (DDR) was explored in ...postmenopausal, hormone-receptor-positive breast cancer patients treated with neoadjuvant hormone therapy (NAHT).
Methods:
Data on 55 patients were included. The phosphorylated ataxia-teleangectasia and Rad3-related protein (pATR), phosphorylated ataxia-telangiectasia mutated (ATM) kinase, and phosphorylated H2A Histone Family Member X (γ-H2AX) were evaluated by immunohistochemistry in paired tissues collected at baseline and following NAHT. Biomarkers were considered both singularly and within signatures. Ki-67 percentage change was the primary biomarker endpoint. Classical endpoints were also considered.
Results:
The most favorable Ki-67 outcome was associated with the γ-H2AX/pATM signature (p = 0.011). In models of Ki-67 reduction, ‘luminal B’ subtype, higher grade of anaplasia, and the γ-H2AX/pATM signature tested as significant (p < 0.05 for all). Results were confirmed in multivariate analysis. No association was observed with pathologic response. An increase of ∆γ-H2AX in paired breast tissues was associated with longer event-free survival (p = 0.027) and overall survival (p = 0.042). In Cox models, both survival outcomes were solely affected by grade of anaplasia, with less favorable prognosis in the highest grades (p < 0.05 for both).
Conclusions:
We report novel evidence of the prognostic role of DDR biomarkers on important patient outcomes in postmenopausal hormone-receptor-positive breast cancer patients treated with NAHT. If confirmed in future and adequately sized trials, our results may help inform therapeutic decisions and clarify underlying biological mechanisms.
Background
Aromatase inhibitors (AIs) are more effective than tamoxifen as neoadjuvant endocrine therapy (NET) for hormone receptor (HR)-positive breast cancer. Here we report the surgical and ...long-term outcome of elderly postmenopausal patients with locally advanced, HR-positive breast cancer treated with preoperative AIs.
Methods
Between January 2003 and December 2012, 144 postmenopausal patients inoperable with breast conservative surgery (BCS) received letrozole, anastrozole, or exemestane as NET. Patients underwent breast surgery and received adjuvant AIs. Adjuvant systemic therapy, chemotherapy and/or trastuzumab, and adjuvant radiotherapy were administered as appropriate, but limited to high-risk patients with few or no comorbidities.
Results
After a median follow-up of 49 months, 4 (3.0 %) patients had local relapse, 18 (12.5 %) had distant metastases, and 24 (17.0 %) died. BCS was performed in 121 (84.0 %) patients. A tumor size <3 cm and human epidermal growth factor receptor 2 (HER2) negativity were predictors of BCS. The achievement of BCS and grade G1 were significantly associated with longer disease-free survival (DFS) (
p
= 0.009 and
p
= 0.01, respectively) and overall survival (
p
= 0.002 and
p
= 0.005, respectively). Residual tumor ≤2 cm (yT0–yT1) in the longest diameter after NET was also statistically associated with longer DFS (
p
= 0.005).
Conclusions
The results of this retrospective study indicate that elderly breast cancer patients with a tumor size <3 cm at diagnosis and HER2 negativity have a higher probability of achieving BCS after NET. Moreover, patients treated with BCS and with grade G1 tumor have a reduced risk of recurrence and death in the long-term follow-up.
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