atilio castillo ruiz

Que Lilian Thuram, central duro y de la élite europea en su momento, solamente exprese "Paraguay, Paraguay" te dice lo guerrera que era esa @Albirroja del 98 por ejemplo. Somos la SELECCIÓN a la que nadie quiere enfrentar en un Mundial! 🇵🇾🇵🇾⚽🔥

@VinnyJay87 @fdzmurillo superior en descenso de peso y a1c , lo demas aun no demostro y no se si lo demostrara

@fdzmurillo Lilly has tirze which is far superior to sema. No one should be taking sema in 2026.

Everyone in longevity is searching for the anti-aging pill. It already exists. It's just not called that. Semaglutide ($NVO) — one molecule, one delivery platform (SNAC), expanding across: ✅ Obesity (Wegovy) — approved ✅ Type 2 diabetes (Ozempic/Rybelsus) — approved ✅ Cardiovascular protection — approved (SELECT: -20% heart attacks, strokes, CV death) ✅ Liver disease / MASH — approved (Aug 2025) ✅ Chronic kidney disease — in trials ✅ Sleep apnea — in trials ✅ Osteoarthritis — in trials ✅ Heart failure — in trials ✅ Peripheral artery disease — in trials ✅ Signals in addiction, neuroinflammation, Alzheimer's One molecule that reduces weight, protects the heart, heals the liver, and may protect the kidneys and brain. The FDA doesn't have a category called "rejuvenation." So Novo files for diseases. One by one. Indication by indication. Each one approved on its own clinical data. But zoom out and look at what they're building: A single oral pill that treats the root metabolic dysfunction behind most age-related disease. And SNAC — the delivery platform patented until ~2040 — isn't limited to semaglutide. It can deliver ANY peptide orally. Amycretin. Cagrilintide. Future molecules that don't exist yet. SNAC is not a drug. It's a platform. And platforms compound. $LLY has orforglipron. One molecule. One indication. One dose ceiling. No platform. $NVO has semaglutide + SNAC. One platform. 11 indications. No ceiling. Novo doesn't sell rejuvenation. They sell 11 FDA-approved indications that happen to rejuvenate. The longevity community should be paying attention. $NVO $LLY #GLP1 #SNAC #longevity #aging #Wegovy #semaglutide

nature.com/articles/s4159… Análisis preespecificado del estudio SELECT: sema2.4 mg ⏬MACE 26% (HR 0.74; IC 0.63–0.88) en pacientes con sobrepeso/obesidad y riesgo de fibrosis hepática (FIB-4 ≥ 1.3) sin diabetes. 1️⃣Protección CV:⏬ consistente de eventos en subgrupos estratificados por FIB-4, incluyendo una tendencia del 34% en riesgo alto (>2.67) 2️⃣Mejora Metabólica:⏬28% en el Índice de Hígado Graso (FLI)frente a placebo (P<0.0001) 3️⃣Bioquímica Hepática: ⏬significativa y temprana de **ALT, AST y GGT**, sugiriendo beneficios que trascienden la pérdida de peso aislada Los hallazgos refuerzan el papel de semaglutida como terapia multifacética para abordar el eje **MASLD-ASCVD** de forma integral #Semaglutida #SELECTTrial #MASLD

@almucastro01 @NEJM es una revisión muy narrativa, comentarios ambiguos en todos los puntos. Decepcion total

Decepcionante esta revisión del @NEJM sobre GLP-1, donde: - no se explican los beneficios de estos fármacos sobre la inflamación - se explica mal el estudio SELECT: no es un estudio de obesidad ni de alto riesgo. Es un estudio de pacientes con enfermedad CV sin diabetes y con sobrepeso u obesidad. - no mencionan la aprobación para enfermedad CV. - pasan por alto el gran beneficio de estos fármacos en ICFEp Es el reflejo de que gran parte de la comunidad científica no ha entendido el valor de este grupo farmacológico y peor aún, no están trasladando su beneficio a los pacientes que podrían mejorar con ellos. nejm.org/doi/full/10.10…

⏬64,6% LDL ⏬26,2%LPa ⏬54,6% ApoB 🚀🚀🚀 Efficacy and Safety of #Enlicitide, an Oral Inhibitor of PCSK9, Compared With Bempedoic Acid and Ezetimibe in Statin-Treated Adults With Hypercholesterolemia: Phase 3 #CORALreef AddOn Trial #ACC26

@CristobMorales es asi Cristobal, hace un tiempo realizamos el 1er foro nacional y ahora en setiembre hacemos el 1er Foro Latam de EHM en Paraguay, en DM2 en Paraguay tenemos una prevalencia del 65%

En busca de la “Enfermedad Hepatica Metabólica perdida” Gracias a todos los MetabolicsIndiana Jones del mundo que estáis concienciando sobre la necesidad del diagnóstico y abordaje precoz de esta enfermedad oculta… Hoy en día es obligatorio 🕵️‍♂️🕵️‍♀️🕵

1: 🚨 Did you know liver disease is quietly becoming the "𝟰𝘁𝗵 𝗺𝗮𝗷𝗼𝗿 𝗰𝗼𝗺𝗽𝗹𝗶𝗰𝗮𝘁𝗶𝗼𝗻" of Type 2 Diabetes? A massive new study from India (the DiaFib-Liver Study) involving over 9,200 patients is exposing a hidden crisis. Let’s dive into the alarming data. 🧵👇

@jorgericof @CristobMorales

Se llama Lice Chamorro (@ChamorroLice), es paraguaya, capitana de la Albirroja y en España están hablando de ella: Anotó este GOLAZO al Barcelona para el Badalona en semis de la Copa de la Reina. Catastrófica aceleración. ¿Le regalas un RT? Viralicemos.

I am pleased to share our recent publication in WJN on Efficacy and safety of finerenone in diabetic kidney disease: Latin American experience from FINDKDLATAM trial . Link : wjgnet.com/2220-6124/full… @SLANH_ @SLANHJoven @visanpolo @DrOsoriow

@Rocio_La_Negra @MaritoAbdo Realmente tu nivel de vacai y pulp es terrible

El día más NEFASTO DE LA HISTORIA CONTEMPORÁNEA, cuando @MaritoAbdo NOS ENCERRÓ POR DECRETO para FUNDIRNOS!

Retired physician, 40 years in practice—I’ve watched statins, NSAIDs, and rofecoxib get hailed as miracles, only to look different once real scrutiny set in. Now tirzepatide is in the spotlight. That March 2026 Optum claims analysis reports ~20% lower modified MACE and ~40% lower all-cause mortality vs dulaglutide in adults with T2D + ASCVD. Compelling at first glance—but context matters. Here’s what I see (and what busy clinicians should know) 1) It’s observational—not randomized. Propensity matching (~9,000 patients) helps, but can’t eliminate residual confounding: frailty, socioeconomic status, adherence, prescriber channeling, lifestyle. These routinely drive differences in real-world cohorts. That’s the core limitation—not isolated outliers. 2) Follow-up and event density matter. Most real-world incretin comparisons run ~12–24 months with modest event counts. Effect estimates can shift meaningfully with modeling assumptions or sensitivity choices. That doesn’t invalidate the signal—it just limits certainty. 3) Endpoint construction: modified vs classic MACE. They used modified MACE rather than the classic 3-point composite (CV death, nonfatal MI, nonfatal stroke) used in RCTs like REWIND trial and SUSTAIN-6. Claims datasets often proxy CV death or substitute all-cause mortality. That’s understandable but complicates cross-trial comparison and may miss outcomes that matter clinically (HF admissions, unstable angina, revascularization). Not wrong—just narrower. 4) Relative vs absolute risk. The headline reductions are relative. Without absolute risk differences and NNT, the clinical impact is hard to judge. In many CVOT contexts, absolute differences are modest despite strong relative effects. 5) External consistency. A favorable CV signal isn’t surprising mechanistically or epidemiologically. GLP-1–based therapies already show benefit across trials (e.g., LEADER, SUSTAIN-6, REWIND trial). So this analysis fits the trajectory—but doesn’t establish superiority. 6) Comparator choice matters. Dulaglutide has proven CV benefit but less metabolic potency than some alternatives. A head-to-head vs semaglutide would be more informative clinically. 7) Safety signal reality check. Known issues remain GI (including rare ileus/gastroparesis). Current evidence doesn’t show a consistent MI or thrombosis signal; long-term safety remains incompletely defined simply because exposure time is short. 8) Data transparency & sponsorship context. This analysis uses payer claims (Optum). Lilly cites it. That doesn’t invalidate the findings—but access to raw data and expanded sensitivity analyses would strengthen confidence. Bottom line: This is a plausible, hypothesis-supportive signal—not definitive evidence that tirzepatide reduces CV events or mortality more than other incretins. We still need a large randomized CV outcomes trial to establish hierarchy. Clinicians—especially endocrinology, cardiology, and PCPs managing T2D + ASCVD—should read it critically. You’re slammed with visits, prior auths, inboxes. Tools like Grok (or any AI) help triage the literature—but they don’t replace clinical judgment. My take: promising drug, real signal, incomplete certainty. Stay skeptical and stay practical. Patients deserve both. @kamleshkhunti @MichaelAlbertMD @DrDeepakBhatt @SJNicholls1 @EricTopol

VAMOS JOSHUA ORGULLO LATINO CARAJO 🇵🇾🇵🇾🇵🇾🇵🇾

Ladies and gentlemen, Joshua Dürksen 👏🇵🇾 #F2 #AusGP

VAMOS JOSHUAAA!! 👊 O paraguaio vence de forma maiúscula na Feature Race em Melbourne! 👏

JOSHUA WINS THE SPRINT RACE IN AUSTRALIA 🏆 #F2 #Formula2 #InvincibleInSpirit #AusGP

VAMOSSSS 🇵🇾 @JoshuaDuerksen1 wins the F2 Sprint in Melbourne!! What a way to start the season 🙌

El impacto de los aGLP1 mas allá de la Diabetes y de la Obesidad

@desimasi2 @cyzal @SantiPenap Y la heladera vacía, sin Insulinas

Ahora, vaya y visite el Pediatrico de Acosta Ñu. Ahí los recursos de salud están denunciando la realidad de su gobierno criminal @SantiPenap y hable con las flias angustiadas de los niños/as con cardiopatías complejas cuyas cirugías fueron suspendidas o postergadas por falta de insumos. Pregunte al @MEF_Paraguay y al @msaludpy. Esa infancia, por culpa de Uds, “no tienen para rato”. Provida y profamilia las pelotas!

@Rocio_La_Negra Si , heladeras vacías. Pero de Medicina esencial para los pacientes con Diabetes

ah pero las "heladeras vacías"...