Danish medical journal
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Danish medical journal · Sep 2015
Randomized Controlled TrialIncretin hormones and maturity onset diabetes of the young--pathophysiological implications and anti-diabetic treatment potential.
Maturity onset diabetes of the young (MODY) designates monogenic forms of non-autoimmune diabetes characterised by autosomal dominant inheritance, non-insulin dependent diabetes at onset and diagnosis often before 25 years of age. MODY constitutes genetically and clinically heterogeneous forms of diabetes. More than 8 different genes are known to cause MODY, among which hepatocyte nuclear factor 1 alpha (HNF1A) (MODY3) and glucokinase (GCK) (MODY2) mutations are the most common. ⋯ This effect was greater with glimepiride, although insignificant, but at the expense of a higher risk of hypoglycaemia (predominantly mild). GLP-1RAs may have a place in treatment of patients with HNF1A-diabetes, especially when hypoglycaemia is a problem. Future studies are required to clarify this.
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Danish medical journal · Sep 2015
Arterial waveform-analysis is of limited value in daily clinical practice in the intensive care unit.
It is difficult to identify the patients who will respond to fluid therapy, but the arterial waveform-derived variables have reasonably predictive values for fluid responsiveness. However, the patient must fulfil a number of prerequisites for these variables to be valid. We assessed the proportion of intensive care unit (ICU) patients with shock who at the time of resuscitation fulfilled the prerequisites for using the arterial waveform-derived variables. ⋯ Less than a quarter of the ICU patients with shock fulfilled all the prerequisites for the use of arterial waveform-derived variables to predict fluid responsiveness. Thus, these variables may be of limited use during resuscitation in the ICU.
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Danish medical journal · Sep 2015
Diagnosis and prognosis of anomalous origin of the left coronary artery from the pulmonary artery.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an uncommon congenital heart abnormality. The aim of this study was to describe a single-centre experience with surgical repair of this condition. ⋯ All ten patients survived with recovery of left ventricular function within 12 months. An early diagnosis and prompt surgical intervention is warranted in the treatment of ALCAPA.