Cardiovascular outcomes with glucagon-like peptide 1 agonists and sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes: A meta-analysis.

BACKGROUND: According to available research, there have been no head-to-head studies comparing the effect of glucagon-like peptide 1 (GLP-1) agonists and sodium-glucose cotransporter 2 (SGLT-2) inhibitors on cardiovascular outcomes among patients with type 2 diabetes not reaching glycemic goal with metformin. METHODS: Relevant studies were identified through electronic searches of PubMed and EMBASE published up to January 15, 2020. Efficacy outcomes of interest included the composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke, its individual components, all-cause death, and hospitalization for heart failure (HF). Safety outcomes included all suggested side effects of both agents previously reported. RESULTS: Eleven studies, including 94,727 patients were used for the analysis. The risk of composite end point was significantly lower in both groups compared to the control group (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.85-0.92, p < 0.001). The risk of hospitalization for HF was significantly lower in both groups but the magnitude of the effect was more pronounced in the SGLT-2 inhibitors group (HR 0.68, 95% CI 0.60-0.76, p < 0.001) than the GLP-1 agonists group (HR 0.92, 95% CI 0.84-0.99, p = 0.03). Patients treated with GLP-1 agonists discontinued trial medications more frequently compared to conventionally treated patients because of serious side effects. CONCLUSIONS: Both GLP-1 agonists and SGLT-2 inhibitors showed comparable cardiovascular outcomes in patients with type 2 diabetes. However, the SGLT-2 inhibitors were associated with more pronounced reduction of hospitalization for HF and lower risk of treatment discontinuation than GLP-1 agonists.

Prediction of shelf-life and changes in the quality characteristics of semidried persimmons stored at different temperatures.

This study was performed to investigate changes in the quality characteristics and shelf-life of semidried persimmons stored at different temperatures using acceleration experiments. In order to estimate quality changes in the samples, we evaluated the physicochemical properties, microbiological changes, and sensory features of the samples periodically after storage at -20, -10, 0, and 10 °C. At all storage temperatures, CIE L * a * b * values decreased significantly. Based on the results of this study, regression equations are set up. L * had the highest correlation and were therefore used to determine quality factor. The activation energy, which was calculated using the Arrhenius equation, was found to be 12.98 kcal/mol, and the Q10-values were 3.81, 2.07, and 2.06 at -20 to -10 °C, -10 to 0 °C, and 0 to 10 °C, respectively. Therefore, the expected expiration dates of the semidried persimmons were estimated to be 203.83, 53.46, 22.00, and 8.71 days at -20, -10, 0, and 10 °C.

Primary Peritoneal Carcinoma Initially Presenting as Atypical Cervical Lymphadenopathy.

Primary peritoneal carcinoma (PPC) is a rare cancer arising from the extraovarian peritoneum and is of müllerian origin. PPC and epithelial ovarian carcinoma share similar clinical, histopathological, and immunohistochemical features. Clinical symptoms and findings include abdominal distension and ascites. We experienced 2 cases of PPC which initially presented with cervical lymphadenopathy. Here, we report the 2 cases and review the literature.