Efficacy of benfluorex in combination with sulfonylurea in type 2 diabetic patients: an 18 to 34-week, open-label, extension period.

AIM: The aim of this trial was to obtain further data on the efficacy and safety of benfluorex as an add-on therapy in type 2 diabetic patients insufficiently controlled by sulfonylurea monotherapy who had a limitation for the use of metformin during a 4-month extension period following a 4-month double-blind trial. METHODS: Patients who completed the 18-week double-blind period entered the 16-week extension period. Patients in the benfluorex group during the double-blind period continued benfluorex 450 mg/day (B-B group), whilst patients in the placebo group switched to benfluorex 450 mg/day (P-B group). The main efficacy criterion was HbA(1c), analyzed as the change from week 18 (W18) to the end of treatment using a two-sided Student paired t-test. Secondary criteria were fasting plasma glucose (FPG), insulin resistance and lipids. RESULTS: Between W18 and the end of treatment, HbA(1c) decreased in the P-B group from 8.53+/-1.37% to 7.49+/-1.04% (P<0.001) and remained stable in the B-B group from 7.52+/-1.07% to 7.53+/-1.14% (NS). In the P-B group, parameters of glycemic control showed improvements from W18 to week 34 (W34) which were similar to those observed from baseline to W18 in the B-B group. Overall, the target HbA(1c) (

[Complete left branch block and electrocardiographic diagnosis of left ventricular hypertrophy]. / Bloc complet de la branche gauche et diagnostic électrocardiographique de l'hypertrophie ventriculaire gauche.

The electrocardiogrammes of 71 patients (39 men and 32 women) with transient or intermittent complete left bundle branch block (LBBB) were studied. Two tracings, one with and the other without LBBB were analysed in each case. The interval between the two recordings was less than 90 days in all cases (average 10 days). The diagnosis of left ventricular hypertrophy (LVH) was established from the ECG without LBBB. The sensitivity and specificity of the classical criteria or indices of LVA and of different associations of indices of LVH were assessed on the ECGs with LBBB. The best criteria of LVH in the presence of LBBB were the SV2 + RV6 greater than or equal to 32 mm (sensitivity 80%; specificity 81%), Sokolow's index greater than or equal to 33 mm (sensitivity 78%, specificity 81%); followed by SV1 greater than or equal to 23 mm (sensitivity 73%, specificity 86%), SV1 + SV2 + RV6 + RV7 greater than or equal to 65 mm (sensitivity 88%, specificity 63%), SV1 + SV2 greater than or equal to 54 mm (sensitivity 73%, specificity 74%). These six parameters allow correct diagnosis of LVH in 81%, 79%, 78%, 79% and 73% of cases, respectively. The SV1 + SV2 + RV5 + RV7 and the SV1 + SV2 + RV6 + RV7 greater than or equal to 65 mm indices are the most stable (same sensitivity and specificity for several consecutive threshold values, i.e. 62 to 67 mm and 64 to 66 mm respectively); the results obtained with these two indices are therefore more likely to be reproducible than those of the other indices as they seem less dependent on the sampling. The indices of LVH based on the QRS amplitude in the precordial leads remain valid in the presence of LBBB and are sufficiently reliable for the diagnosis of LVH to be clinically useful.

[Lipoprotein-lipase-activity in human milk (author's transl)]. / Activité lipoprotéine-lipase du lait de femme: etude des facteurs de variation. Relation avec le pouvoir galactogène.

Lipoprotein-lipase-activity has been determined in human milk between the 3rd and the 10th post-partum days in women from different ethnic origins. This activity is low in the colostrum, it increases at the 4th and 5th days and remains stable between the 6th and the 10th day. There are important variations of the LPL-activity from one woman to another. Two variation-factors have been noticed. The first is an ethnic factor. It is apparent event if the diet is exactly the same in all women. In the milk, indeed, the activity of French women is much lower. It is about three times less than the activity of Yugoslavian of African women. The second is the galactogenic powder that has been estimated by the natural duration of lactation. We can see that the activity of women, who have to stop breast-feeding because of insufficient milk, is lower than the activity of women who can decide how long they will breast-feed their child. We took as a hypothesis that the milk is a means of elimination for the mammary-LPL. This enzyme is supposed to have done first its physiological action at the surface of mammary glandular cells. Ours results show more facts in favor of this hypothesis.