RESUMEN
In advanced renal cell carcinoma, few randomized controlled trials involving immunotherapy plus antiangiogenic therapy have shown survival benefits relative to Sunitinib. Our meta-analysis aimed to evaluate the efficacy and safety of combined immunotherapy and antiangiogenic therapy compared to Sunitinib therapy alone in patients with advanced renal cell carcinoma. Six phase III randomized controlled trials were analyzed, including 4,119 patients. The primary endpoints were overall survival and progression-free survival, and the secondary endpoints were objective response rate and serious adverse events. The results showed that combined immunotherapy and antiangiogenic therapy significantly improved overall survival, progression-free survival, and objective response rate compared to Sunitinib alone. No significant difference was observed in adverse events between the two groups. This study suggests that combined immunotherapy and antiangiogenic therapy is a great treatment option for advanced renal cell carcinoma.
RESUMEN
Diabetic ketoacidosis (DKA) is one of the serious complications of diabetes, especially type 1. It is defined by the triad of hyperglycemia (>250 mg/dL [>13.9 mmol/L]), high anion-gap metabolic acidosis, and increased plasma ketones. Euglycemic ketoacidosis is characterized by DKA without hyperglycemia. We present a rare case of a 28-year-old type 1 diabetic male, presenting with abdominal pain, fatigue, and dizziness after one week of starting a keto diet. He was diagnosed with euglycemic DKA, managed with DKA protocol and given detailed dietary counselling to avoid the keto diet in future.