Mechanisms of heart failure and chronic kidney disease protection by SGLT2 inhibitors in nondiabetic conditions.

Sodium-glucose cotransporter 2 inhibitors (SGLT2is), initially developed for type 2 diabetes (T2D) treatment, have demonstrated significant cardiovascular and renal benefits in heart failure (HF) and chronic kidney disease (CKD), irrespective of T2D. This review provides an analysis of the multifaceted mechanisms underlying the cardiorenal benefits of SGLT2i in HF and CKD outside of the T2D context. Eight major aspects of the protective effects of SGLT2i beyond glycemic control are explored: ) the impact on renal hemodynamics and tubuloglomerular feedback; ) the natriuretic effects via proximal tubule Na/H exchanger NHE3 inhibition; ) the modulation of neurohumoral pathways with evidence of attenuated sympathetic activity; ) the impact on erythropoiesis, not only in the context of local hypoxia but also systemic inflammation and iron regulation; ) the uricosuria and mitigation of the hyperuricemic environment in cardiorenal syndromes; ) the multiorgan metabolic reprogramming including the potential induction of a fasting-like state, improvement in glucose and insulin tolerance, and stimulation of lipolysis and ketogenesis; ) the vascular endothelial growth factor A (VEGF-A) upregulation and angiogenesis, and ) the direct cardiac effects.

Renal upregulation of NCC counteracts empagliflozin-mediated NHE3 inhibition in normotensive but not in hypertensive male rat.

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce blood pressure (BP) in patients with hypertension, yet the precise molecular mechanisms remain elusive. SGLT2i inhibits proximal tubule (PT) NHE3-mediated sodium reabsorption in normotensive rodents, yet no hypotensive effect is observed under this scenario. This study examined the effect of empagliflozin (EMPA) on renal tubular sodium transport in normotensive and spontaneously hypertensive rats (SHRs).

Partial stapled hemorrhoidopexy: clinical aspects and impact on anorectal physiology.

Objective:: to evaluate the impact of partial stapled hemorrhoidopexy on anorectal physiology, the complications related to this surgical technique, pain, postoperative bleeding and recurrence of hemorrhoidal disease one year after surgery.

Methods:: this is a prospective, descriptive study in consecutive patients with mixed or internal hemorrhoidal disease, the internal component being classified as grade III or IV, undergoing partial stapled hemorrhoidopexy.

Results:: we studied 17 patients, 82% of them with internal hemorrhoids grade III and 18% grade IV.

Patch test standard series recommended by the Brazilian Contact Dermatitis Study Group during the 2006-2011 period.

A retrospective study was carried out between 2006-2011. Six hundred and eighteen patients with suspected allergic contact dermatitis underwent the standard patch test series recommended by the Brazilian Contact Dermatitis Research Group. The aim of our study was to evaluate the variation of positive patch-test results from standard series year by year.