Effect of Momordica charantia Administration on Anthropometric Measures and Metabolic Profile in Patients with Obesity: A Pilot Clinical Trial.

The aim of this study was to evaluate the effect of Momordica charantia (MC) administration on anthropometric measures in patients with obesity. A randomized, double-blind, placebo-controlled pilot clinical trial was carried out in 24 patients with obesity. Twelve patients randomly received MC (2000 mg/day) for 12 weeks, and 12 patients received placebo. Body weight (BW), body mass index (BMI), waist circumference (WC), body fat percentage, as well as clinical and laboratory determinations, were evaluated before and after the intervention. Results showed that while reductions in BW, BMI, WC, and body fat percentage were observed in the MC group, these differences did not reach statistical significance. Significant decreases in triglycerides (TG) (1.9 ± 0.6 mM vs. 1.7 ± 0.7 mM, P ≤ .05) and very low-density lipoprotein (VLDL) (0.4 ± 0.1 mM vs. 0.3 ± 0.1 mM, P ≤ .05) levels were found after the intervention with MC. In contrast, significant increases in BW (83.0 ± 10.7 kg vs. 84.6 ± 9.1 kg, P ≤ .05) and BMI (31.9 ± 1.5 kg/m2 vs. 33.0 ± 1.3 kg/m2, P ≤ .05) were observed in the placebo group. In conclusion, no significant reductions in BW, BMI, WC, and body fat percentage were observed after MC administration; however, MC significantly decreased TG and VLDL levels. The protocol was registered at ClinicalTrials.gov with the identifier NCT04916379.

Reactive hydrocele after laparoscopic Palomo varicocele ligation in pediatrics.

OBJECTIVES: To evaluate the incidence of hydrocele following laparoscopic Palomo varicocele ligation in pediatric and adolescents in our institution. METHODS: Between 1997 and 2009, 180 boys diagnosed as having varicocele who underwent Palomo laparoscopic ligation were evaluated retrospectively. Outcome variables recorded for analysis were age at presentation, symptoms, varicocele grade (Dubin-Amelar classification), testicular atrophy, length of hospital stay, perioperative complications, recurrence and hydrocele formation after surgery. Mean follow up was 5.8 years (6 months- 9 years). RESULTS: Age at diagnosis ranged between 9 and 19 years. Mean age at operation was 14.1 ± 1.8 years. There were 177 left-side varicoceles (98%) and four cases were bilateral. Testicular atrophy was noted in 45. Mean operative time was 38 min. The last 63 surgeries were performed on a two-trocar basis with Ligasure vascular sealing device and operative time decreased significantly to 22 min. Median hospital stay was 31h. Twenty-three patients developed hydrocele (13%); 11 of these underwent Winkelman-Lord's hydrocelectomy at least 1 year after Palomo (9% of total). Of the remaining 12, two resolved spontaneously and 10 were stable at mean 4-year follow up. CONCLUSIONS: Laparoscopic Palomo procedure is a safe successful method to correct varicoceles in pediatric and adolescent males. Reactive hydrocele formation following laparoscopic varicocelectomy is a worrisome problem particularly in cases with longer follow-up.

Effects of dapagliflozin on blood pressure variability in patients with prediabetes and prehypertension without pharmacological treatment: a randomized trial.

AIM: The aim of the study was to evaluate the effect of dapagliflozin on blood pressure variability (BPV) in patients with prediabetes and prehypertension without pharmacological treatment. METHODS: A double-blind, randomized, placebo-controlled clinical study was performed in 30 patients (30-60 years) diagnosed with prediabetes and prehypertension. Study subjects were divided into two groups: a 10-mg dose of dapagliflozin was administered daily before breakfast for 12 weeks in 15 patients or placebo in the remaining 15 patients. At the beginning and end of the study, clinical and metabolic evaluations were performed, and the 24-h BPV was calculated. RESULTS: Dapagliflozin significantly decreased body weight (P = 0.010), BMI (P = 0.011), fasting plasma glucose (P = 0.002), glycated hemoglobin A1c (P = 0.004), office systolic blood pressure (SBP) (P = 0.001), office diastolic blood pressure (DBP) (P = 0.011), 24-h SBP (121 ± 8 vs. 117 ± 11 mmHg, P = 0.046), nighttime SBP (114 ± 11 vs. 108 ± 10 mmHg, P = 0.017), nocturnal mean arterial pressure (P = 0.043), and nocturnal hypertensive load (P = 0.015); and it significantly increased the percentage of the dipper circadian BP pattern (16.7 vs. 30.8%, P = 0.047). After the administration of dapagliflozin, some of the patients did not meet the diagnostic criteria for prediabetes (26.9%) or prehypertension (26.9%). CONCLUSIONS: The administration of 10 mg dapagliflozin once daily for 90 days in patients with prediabetes and prehypertension decreased BPV by reducing 24-h and nighttime SBP, and increasing the dipper circadian BP pattern.

Ambulatory arterial stiffness index in diabetic patients / Índice de rigidez arterial ambulatorio en pacientes diabéticos

ABSTRACT Background The ambulatory arterial stiffness index (AASI), derived from 24 h ambulatory blood pressure monitoring (ABPM) can be a good indicator of arterial stiffness. Aim To assess the correlation between AASI and brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) in patients with type 2 diabetes mellitus without hypertension. Material and Methods Cross sectional study in 28 diabetic patients aged 49 ± 7 years (40% women). AASI was calculated as 1 minus the regression slope of diastolic on systolic blood pressure, using ABPM data. ABPM was measured in the arm using an oscillometric device. ABI was calculated as the ratio between ankle and brachial systolic blood pressure. CAVI was derived from pulse wave velocity using the Vasera VS-1000 device. Correlations were calculated using a bivariate Spearman correlation. Results The mean values for AASI, ABI, baPWV and CAVI were 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s and 7.60 ± 1.90, respectively. There was a significant negative correlation between AASI and ABI (r = -0.491, p < 0.01). Conclusions In these diabetic patients, there was an association between AASI, an arterial stiffness marker and ABI, an indicator for the presence of atherosclerosis.

Antecedentes El índice de rigidez arterial ambulatorio (AASI), derivado del monitoreo ambulatorio de presión arterial de 24 h (MAPA), puede ser un buen indicador de rigidez arterial. Objetivo Evaluar la correlación entre el AASI y la velocidad de onda de pulso braquial (VOP), el índice tobillo-brazo (ITB) y el índice vascular cardio-tobillo (CAVI) en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Material y Métodos Estudio transversal en 28 pacientes con diabetes de 49 ± 7 años (40% mujeres). El AASI se calculó como 1 menos la pendiente de regresión de la presión arterial diastólica sobre la sistólica, usando datos del MAPA de 24 h, el cual se midió en el brazo, usando un dispositivo oscilométrico. El ITB se calculó como la razón entre la presión arterial sistólica del tobillo sobre la del brazo. El CAVI se derivó de la velocidad de onda de pulso medida con el dispositivo Vasera VS-1000. Para el análisis estadístico se utilizó el coeficiente de correlación bivariada de Spearman. Resultados Los valores de AASI, VOP, ITB y CAVI fueron 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s y 7.60 ± 1.90, respectivamente. Hubo una correlación negativa significativa entre AASI e ITB (r = -0.491, p < 0.01). Conclusiones Hay una asociación entre AASI, un marcador de rigidez arterial e ITB, un indicador de aterosclerosis, en estos pacientes con diabetes mellitus tipo 2.