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Picon Heras R.,Hospital Universitario Virgen Of Valme

Brugada syndrome is still one of the most important channelopathies studied in the major experimental laboratories with the aim of finding a drug capable of eliminating secondary damages. The current indications for genetic testing, the limitations of provocative drug challenge testing, and intracardiac electrophysiology study and the therapeutics possibilities are reviewed in detail. © 2012 SAC. Source

Baena-Antequera F.,Hospital Universitario Virgen Of Valme | Jurado-Garcia E.,Enfermeria Obstetrico Ginecologica Matrona
Enfermeria Clinica

Within the assistance and support to coping with perinatal death, it must be considered that there is a group of women whose process has some features that give specific connotations. We talked about when the perinatal loss occurs due to a maternal decision to the presence of a fetal malformation. These cases today, thanks to advances in the techniques of control fetal development, are not uncommon. In their assistance, healthcare professionals should be aware that they often present a great sense of guilt and ambivalence between well-made decision and the hardness of having to come to it. A case of a pregnant woman undergoing a fetal fetolisis and care plan developed in her assistance for the induction of labor, delivery and immediate postpartum period is presented. This plan includes the problems of collaboration and the independent problems that are formulated according to the NANDA, NOC and NIC taxonomies. The implication for practice after studying this case leads to the duty to equally address the coping with a stillbirth, whether it was spontaneous or had it been determined by fetal malformation completion, giving parents the ability to view and contact with their child. © 2015 Elsevier España, S.L.U. Source

Wolffenbuttel B.H.R.,University of Groningen | Van Gaal L.,University of Antwerp | Duran-Garcia S.,Hospital Universitario Virgen Of Valme | Han J.,Pharmapace Inc
Diabetes, Obesity and Metabolism

This post hoc analysis assessed the evidence behind common reimbursement practices by evaluating the relationship of body mass index (BMI) ranges (<30, 30–35 and >35 kg/m2) with treatment effects of exenatide twice daily among patients with type 2 diabetes. Patients received exenatide twice daily added to insulin glargine in two 30-week studies (exenatide twice daily vs insulin lispro, n = 627; exenatide twice daily vs placebo, n = 259). No association of baseline BMI with changes in efficacy variables was observed. Glycated haemoglobin (HbA1c) reductions were significant (p < 0.0001) and similar across BMI range groups in the lispro-comparator study and greater for exenatide versus placebo in the placebo-controlled study. Significant weight loss occurred with exenatide across BMI range groups (p < 0.0001), while weight increased with both comparators. Achievement of HbA1c <7.0% (<53 mmol/mol) without weight gain was greater for exenatide versus comparators. Systolic blood pressure decreased across BMI range groups with exenatide in the lispro-comparator study (p < 0.0001); changes in lipids were not clinically meaningful. Minor hypoglycaemia was less frequent for exenatide versus insulin lispro. These findings suggest that BMI alone should not limit clinical decision-making or patient access to medication. © 2016 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. Source

Garcia S.D.,Hospital Universitario Virgen Of Valme | Sanz S.D.,University of Seville | Sanz A.D.,University of Seville
Medicina Clinica

In this article, we review the results that can be expected after significant weight loss in patients with type 2 diabetes mellitus. We provide consensus-based documentation supported by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation on the importance of physical exercise, metabolic-bariatric surgery, and drug therapy. Lastly, we report the results of studies published in the last few years on glucagon-like peptide-1 analogs and the new family of oral drugs known as gliflozins, specifically studies published on dapagliflozin. © 2013 Elsevier España, S.L. All rights reserved. Source

Lozano De Leon-Naranjo F.,Hospital Universitario Virgen Of Valme
Medicine (Spain)

The access to antiretroviral treatment has contributed to a global decrease in the number of new HIV infections, although the HIV pandemia continues to be a global challenge. In Spain, HIV transmission is mainly attributed to sexual relations among men. A 46 % of the new diagnoses has made lately. HIV infects CD4+ T lymphocytes, inducing an important reduction of the number of these cells, favoring the opportunistic and neoplastic entities defining AIDS. Likewise, HIV infection induces a persistent immune activation and a chronic inflammatory state, both implicated in the decrease of CD4+ T cells number, premature aging, multiorganic damage and non-AIDS defining neoplasias. The antiretroviral therapy has a limited activity against these immune and inflammatory activation-related diseases. Source

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