Background: Coronary artery disease (CAD), its acute form, and acute coronary syndrome (ACS) are the leading cause of death all over the world. For initial assessment of a patient with ACS, ECG, imaging techniques and serum biomarkers all contribute in confirming the diagnosis. Cardiac Troponin (cTn) I and T are the current gold standard for the detection of myocardial necrosis. However, there is also emerging evidence suggesting that with the use of sensitive or highsensitive cTn assays, a blood sample collected 2 or 3 h after presentation might be appropriate for an earlier rule in and rule out diagnosis of AMI compared with the recommended second blood draw 6-9 h after admission using conventional Troponin assay.
moderate-to-severe disease. However, these drugs tend to perform less well in the maintenance of remission. Route of administration may influence efficacy and network meta-analyses of trial data indicate a superiority of intravenous drugs (IV; Infliximab; IFX) over subcutaneous (SC; adalimumab; ADA). We conducted a retrospective multicentre case-control study to compare the efficacy of these two drugs. Methods Patients administered IFX or ADA as their first biologic, identified from therapy databases of five UK hospitals, were included, if they had completed induction dosing and entered maintenance. Patients receiving IFX as 'rescue' therapy were excluded. Data was collected for pre-biologic disease activity (Simple Clinical Colitis Activity Index (SCCAI), Creactive protein and calprotectin) and throughout anti-TNF therapy. The primary end-point for comparison was the number of patients in clinical remission at 52 weeks (combined features of continuing IFX or ADA therapy and SCCAI score £3). Data was collected for duration of therapy, or up to last follow-up, if beyond 52 weeks. Results 78 IFX (40.3±14.6 years, 33F) and 63 ADA (36.8 ±14.6 years, 27F) patients were analysed. There were no statistically significant differences in demographics or pre-biologic disease activity between the two groups. At 52 weeks, 58 (74%) IFX patients and 29 (46%) ADA patients remained on therapy (p=0.009) and in remission (26 (33%) vs 5 (8%), p=0.0003). Primary non response was the reason for treatment cessation in 15 (24%) ADA patients and 4 (5%) IFX patients (p=0.0012). Conclusions Our results from a real-world cohort mirror those produced in the network meta-analyses of clinical trials for these agents, suggesting that IFX is superior to ADA in UC maintenance of remission, demonstrated by improvement in SCCAI scores and treatment continuation at 52 weeks. There were no significant differences in colectomy rates, hospital admission for acute flares or adverse events in the study timeframe.
Background
GLIS3 (Gli-similar 3), a transcription factor, is involved in the maturation of pancreatic beta cells in fetal life, maintenance of cell mass as well as the control of insulin gene expression in adults. As a result, GLIS3 was reported as a susceptibility gene for type 1 diabetes, type 2 diabetes, and neonatal diabetes. Therefore, the goal of this study was to look into the association between the rs10758593 single nucleotide polymorphism (SNP) in the GLIS3 gene and T2DM in the Egyptian population.
Methods
Frequencies of the rs10758593 (A/G) SNPs were determined in 100 T2DM patients (cases) and in 100 non-diabetic healthy subjects (controls) using real-time PCR.
Results
The prevalence of the mutant genotypes, AA and AG, differed significantly between patients and controls. The AA genotype was more prevalent in the patients' group. The (AA) was found in 39% of the patients and 18% of the controls. While AG (heterozygous) genotype was found in 61% of the patients and 81% of the controls (p = 0.003). The AA genotype was significantly associated with T2DM. Moreover, The GLIS3 rs 10758593 mutation was found to be associated with the presence of diabetic retinopathy and nephropathy. In diabetic patients, a significant correlation between HbA1c with fasting glucose, fasting insulin, and HOMA-IR was found.
Conclusion
The rs10758593 polymorphism of the GLIS3 gene was found to be significantly associated with T2DM in an Egyptian population sample. Additionally, significant association between GLIS3 rs 10758593 mutation and the glycemic control was found.
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