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Importantly, kidney and lung function also remained stable in both groups, and no one experienced serious side effects such as high potassium levels. At the end of 12 months, cardiac function remained stable in both groups, meaning there was no change in the appearance of heart muscle tissue and in pumping capacity. At 24 months, the proportions on each drug were 63% and 31%, respectively, as switching was permitted. The drug also reduced the key CV secondary outcomes albeit with a smaller effect size. Neither the patients nor the researchers knew which drug they were assigned. To conduct their trial, researchers enrolled 52 boys with DMD between the ages of 12 and 18 at seven academic medical centers across the country. In their previous work, the team showed that lower dose eplerenone is better than placebo in protecting the heart in boys with DMD. All of the boys started with preserved cardiac function. Raman’s many years of research was inspired by 32-year-old Ryan Ballou of Pittsburgh, a young man with DMD who, along with his father, started BallouSkies to raise awareness and funding for Raman’s research of heart disease in muscular dystrophy patients.
We have developed good understandigs of the betting process with years of observing, analizing and using all sorts of platforms and witnessed many people winning and also losing. If you use only one you might be blocked by the bookmaker for winning too much. In addition, the relief from symptoms lasted much longer than is usually seen in patients with tennis elbow that use traditional treatments such as braces and painkillers. In addition, visual acuity and retinal morphological parameters improved at a steady but statistically significant rate during therapy, suggesting that “prolonged MRa treatment leads to long-term visual and anatomical improvement in long-standing forms of CSC,” write Francine Behar-Cohen (Université Sorbonne Paris Cité, France) and colleagues in the British Journal of Ophthalmology. Journalist Mitchel Zoler has nice coverage of the FIDELO-DKD trial which was published in the New England Journal of Medicine and presented at Kidney Week. Results of this multi-center trial are in today’s Journal of the American Heart Association.
This week, JAMA Cardiology published a consensus document on COVID and the heart relative to athletics. Their paper is a much-needed antidote to the excess of fear-mongering surrounding COVID myocarditis. Due to the danger to healthcare workers, at least in our hospital, we have protocols that basically say COVID positive patients only get tests that are felt to be absolutely necessary. There are observational studies that at least attempt to have a control group, an attempt at matching these groups. Behar-Cohen and team studied 16 eyes from 16 patients (mean age 53 years; 88% men) with chronic non-resolving CSC who were treated with either eplerenone or spironolactone (each at 25 or 50 mg/day) for at least 6 months (mean 21 months). It doesn’t help that Buffalo has three other players – Rasmus Dahlin (19 shots), Jeff Skinner (18 shots) and Brandon Montour (15 shots) – who also rank among the unenviable leaders in the NHL’s most-shots-with-zero-goals category.
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But this paper tells us nothing useful. The authors criticize the Puntmann (German) paper as having included patients with co-morbid conditions, or ongoing COVID-19 symptoms. They caution against screening athletes with COVID-19 with CMR based on inconsistency of CMR parameters; a dearth of normative CMR data; the current data lacks appropriate control groups; and no current agreement on the CMR myocarditis criteria in asymptomatic healthy patients. They criticize the Ohio State 26-patient study based on the fact that little is known about what is normal on the CMR scans in athletes who have recovered from any viral disease. Today I do not have any pain in my knee and I no longer have flat feet. Chronic non-resolving CSC was defined as the presence of foveal subretinal fluid (SRF) lasting longer than 4 months (median 11.2 months) accompanied by retinal pigment epithelium (RPE) alterations. There were also significant progressive improvements from baseline to 24 months in mean foveal SRF height (100 vs 27 µm), central macular thickness (346 vs 254 µm) and subfoveal choroidal thickness (431 vs 371 µm).
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