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https://www.readbyqxmd.com/read/28432748/future-challenges-and-therapeutic-opportunities-in-type-2-diabetes-changing-the-paradigm-of-current-therapy
#1
REVIEW
D R Owens, L Monnier, A H Barnett
Most algorithms for type 2 diabetes mellitus (T2DM) do not recommend treatment escalation until glycated haemoglobin (HbA1c) fails to reach the recommended target of 7% (53 mmol/mol) within approximately 3 months on any treatment regimen ('treat to failure'). Clinical inertia and/or poor adherence to therapy contribute to patients not reaching glycaemic targets when managed according to this paradigm. Clinical inertia exists across the entire spectrum of anti-diabetes therapies, although it is most pronounced when initiating and optimizing insulin therapy...
April 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28432615/fabrication-physicochemical-characterization-and-performance-evaluation-of-biodegradable-polymeric-microneedle-patch-system-for-enhanced-transcutaneous-flux-of-high-molecular-weight-therapeutics
#2
Viral Shah, Bijaya Krushna Choudhury
A revolutionary paradigm shift is being observed currently, towards the use of therapeutic biologics for disease management. The present research was focused on designing an efficient dosage form for transdermal delivery of α-choriogonadotropin (high molecular weight biologic), through biodegradable polymeric microneedles. Polyvinylpyrrolidone-based biodegradable microneedle arrays loaded with high molecular weight polypeptide, α-choriogonadotropin, were fabricated for its systemic delivery via transdermal route...
April 21, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28432575/liver-transplantation-the-role-of-metabolic-syndrome
#3
REVIEW
Brian C Davis, M Shadab Siddiqui
The long-term survival in liver transplant recipients (LTRs) is currently at an historical high level stemming from improvement in perioperative care, infection control, and immunosuppression medications. However, compared to the general population, LTRs have decreased survival. Metabolic diseases like hypertension, dyslipidemia, type 2 diabetes, and obesity are key determinants of long-term mortality in LTRs. The incidence and prevalence of these metabolic comorbidities is considerably higher in LTRs and likely results from a combination of factors including exposure to chronic immunosuppression, weight gain, and recurrence of chronic liver disease after liver transplantation (LT)...
April 21, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28432511/environmental-management-zoning-for-coal-mining-in-mainland-china-based-on-ecological-and-resources-conditions
#4
Haiqing Geng, Fan Chen, Zhiyuan Wang, Jie Liu, Weihua Xu
The purpose of this research is to establish an environmental management zoning for coal mining industry which is served as a basis for making environmental management policies. Based on the specific impacts of coal mining and regional characteristics of environment and resources, the ecological impact, water resources impact, and arable land impact are chose as the zoning indexes to construct the index system. The ecological sensitivity is graded into three levels of low, medium, and high according to analytical hierarchy processes and gray fixed weight clustering analysis, and the water resources sensitivity is divided into five levels of lower, low, medium, high, and higher according to the weighted sum of sub-indexes, while only the arable land sensitive zone was extracted on the basis of the ratio of arable land to the county or city...
May 2017: Environmental Monitoring and Assessment
https://www.readbyqxmd.com/read/28431668/glp-1-receptor-agonists-in-nafld
#5
J-M Petit, B Vergès
Non-alcoholic fatty liver disease (NAFLD) is very common in patients with type 2 diabetes (T2D), with approximately two-thirds having a diagnosis of the disease. Currently, the only validated treatment for NAFLD is weight loss. A number of studies of animal models and human trials have evaluated the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on liver fat content and suggest that the treatment could represent a new alternative for NAFLD management. In this review, our focus is on the main studies regarding the effects of GLP-1RAs on NAFLD...
April 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28431667/the-potential-and-pitfalls-of-glp-1-receptor-agonists-for-renal-protection-in-type-2-diabetes
#6
Merlin C Thomas
Glucagon-Like Peptide-1 Receptor agonists (GLP-1 RA) offer substantial benefits for the management of glucose levels in type 2 diabetes. In addition, recent data from clinical trials have demonstrated that treatment with Glucagon-Like Peptide-1 Receptor agonists (GLP-1 RA) are also able to reduce new onset macroalbuminuria. These benefits may be consistent with the known effects of GLP-1 RA on traditional risk factors for progressive kidney disease including glucose lowering, blood pressure lowering, reduced insulin levels and weight reduction...
April 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28431302/quality-of-life-in-survivors-of-oropharyngeal-cancer-a%C3%A2-systematic-review-and-meta-analysis-of-1366-patients
#7
REVIEW
Sanne Høxbroe Michaelsen, Christian Grønhøj, Jacob Høxbroe Michaelsen, Jeppe Friborg, Christian von Buchwald
Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is rapidly increasing in incidence and has a favourable prognosis compared with HPV-negative disease. Current combined therapies include significant risks of morbidity for the growing group of survivors. This systematic review and meta-analysis investigates how treatment affects quality of life (QoL) in survivors of oropharyngeal cancer. PubMed, EMBASE and the Cochrane Library were systematically searched for all studies reporting patient-assessed QoL at least 1 year after treatment for OPC...
April 18, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28430170/current-management-of-gout-practical-messages-from-eular-2016-guidelines
#8
George Nuki, Michael Doherty, Pascal Richette
The European League Against Rheumatism published updated recommendations for the management of gout in 2016, comprising 3 overarching principles and 11 key recommendations for clinical practice. Patient education about the pathophysiology of gout and its comorbidities, as well as the existence of effective treatments are important, and understanding the principles of managing acute attacks and eliminating urate crystals by lifelong lowering of the serum urate (SU) below a target level are essential. Advice about lifestyle, diet, weight, and other risk factors, as well as the need to screen for, and manage, comorbidities is emphasized...
April 21, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28430159/efficacy-of-low-molecular-weight-fucoidan-as-a-supplemental-therapy-in-metastatic-colorectal-cancer-patients-a-double-blind-randomized-controlled-trial
#9
Hsiang-Lin Tsai, Chi-Jung Tai, Ching-Wen Huang, Fang-Rong Chang, Jaw-Yuan Wang
BACKGROUND: Low-molecular-weight fucoidan (LMF) is widely used as a food supplement for cancer patients. However, all of the studies are in vitro or were conducted using mice. Therefore, powerful clinical evidence for LMF use is relatively weak. This study aimed to evaluate the efficacy of LMF as a supplemental therapy to chemo-target agents in metastatic colorectal cancer (mCRC) patients. METHODS: We conducted a prospective, randomized, double-blind, controlled trial to evaluate the efficacy of LMF as a supplemental therapy to chemotarget agents in patients with metastatic colorectal cancer (mCRC)...
April 21, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28430045/laparoscopic-sleeve-gastrectomy-changes-in-the-last-decade-differences-in-morbidity-and-weight-loss
#10
Andrea Balla, Silvia Quaresima, Frida Leonetti, Emanuela Paone, Marco Brunori, Teresa Messina, Ardit Seitaj, Alessandro M Paganini
PURPOSE: Aim is to report the learning curve and standardization process of Laparoscopic Sleeve Gastrectomy (LSG), describing the evolution in surgical technique and patient management in the authors' experiences. METHODS: One hundred twenty-seven patients were divided in three Groups (A, B, and C), based on bougie size and technical details, and included 36, 46, and 45 patients, respectively. RESULTS: Mean operative time in Groups A, B, and C was 201...
April 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28429642/selected-weight-management-interventions-for-military-populations-in-the-united-states-a-narrative-report
#11
Jessica Murray, Basil H Aboul-Enein, Joshua Bernstein, Joanna Kruk
Overweight and obesity continues to be a significant public health burden in the US and particularly among military personnel. Although the US Department of Defense mandates standardized physical activity requirements for military members, incidence and prevalence of overweight and obesity among military personnel continue to increase. Each military department controls their own interventional strategies for physical fitness and weight control. However, unique challenges such as geographic transients, lack of central standardization and empirical efficacy data across military departments, and chronic stress associated with military service adversely affect program outcomes...
January 1, 2017: Nutrition and Health
https://www.readbyqxmd.com/read/28429583/a-qualitative-study-of-the-role-of-australian-general-practitioners-in-the-surgical-management-of-obesity
#12
K Jose, A Venn, M Nelson, F Howes, S Wilkinson, D Ezzy
General practitioners (GPs) are increasingly managing patients with class 2 and 3 obesity (body mass index [BMI] > 35 and 40 kg/m(2) , respectively). Bariatric surgery is considered for patients with class 2 obesity and comorbidities or class 3 obesity where sustained weight loss using non-surgical interventions has not been achieved. In Australia, GPs facilitate access to surgery through referral processes, but the nature of GP involvement in bariatric pre- and post-surgery care is currently unclear...
April 20, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28429577/investigating-general-medication-prescription-by-general-practitioners-during-a-12-month-randomized-controlled-weight-loss-trial
#13
N R Fuller, N S Lau, T P Markovic, I D Caterson
Much healthcare expenditure is on pharmaceutical drugs. Expenditure on medications has increased both in absolute terms, and as a proportion of total health expenditure. No previous studies have investigated the prescribing costs by general practitioners when managing patients during a weight loss intervention. This study evaluated the medication costs by individual class during a 1-year study in which 268 participants were randomized to one of two weight loss programmes, either standard care (SC) as defined by national guidelines, or a commercial provider (Weight Watchers) (CP)...
April 20, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#14
Matthew J Damasiewicz, Peter R Ebeling
The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. All patients active on transplant waiting lists should be screened for bone disease...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429405/child-body-mass-index-genotype-and-parenting-in-the-prediction-of-restrictive-feeding
#15
K K Bost, M Teran-Garcia, S M Donovan, B H Fiese
BACKGROUND: Restrictive feeding is implicated in pediatric obesity, and caregivers increase controlling feeding practices on the basis of higher child weight status. However, few studies have examined how child genetic and parenting characteristics together impact restrictive feeding. OBJECTIVES: We examined whether child body mass index (BMI) status predicts caregiver use of restrictive feeding and if this association is moderated by (i) caregiver strategies to manage their children's distress and (ii) child variations in the catechol-O-methyltransferase (COMT) gene (Val(158) Met, rs4680)...
April 21, 2017: Pediatric Obesity
https://www.readbyqxmd.com/read/28429150/short-term-high-fat-diet-induces-obesity-enhancing-changes-in-mouse-gut-microbiota-that-are-partially-reversed-by-cessation-of-the-high-fat-diet
#16
Yue Shang, Ehsan Khafipour, Hooman Derakhshani, Lindsei K Sarna, Connie W Woo, Yaw L Siow, Karmin O
The gut microbiota is proposed as a "metabolic organ" involved in energy utilization and is associated with obesity. Dietary intervention is one of the approaches for obesity management. Changes in dietary components have significant impacts on host metabolism and gut microbiota. In the present study, we examined the influence of dietary fat intervention on the modification of gut mucosa-associated microbiota profile along with body weight and metabolic parameter changes. Male C57BL/6J mice (6-week old) were fed a low fat diet (10% kcal fat) as a control or a high fat diet (HFD 60% kcal fat) for 7 weeks...
April 20, 2017: Lipids
https://www.readbyqxmd.com/read/28429032/obstructive-sleep-apnoea-and-type-2-diabetes-mellitus-are-they-connected
#17
Yingjuan Mok, Chee Wei Tan, Hang Siang Wong, Choon How How, Kah Leong Alvin Tan, Pon Poh Hsu
Obstructive sleep apnoea (OSA), a sleep-related breathing condition, is diagnosed based on a patient's apnoea-hypopnea index from a sleep study, and the presence or absence of symptoms. Diabetes mellitus (DM) and OSA share a significant common risk factor, obesity, with all three conditions contributing to the risk of developing cardiovascular diseases. The pathophysiological links between OSA and DM are still unclear, but intermittent hypoxia may be an important mechanism. More awareness of the possible link between OSA and DM is needed, given their increasing prevalence locally and worldwide...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28428913/comparison-of-magnetic-resonance-imaging-and-radiographs-for-evaluation-of-carpal-osteoarthritis
#18
Angela E Li, Steve K Lee, Schneider K Rancy, Alissa J Burge, Hollis G Potter, Scott W Wolfe
Background We sought to evaluate the interobserver and intraobserver reliability of radiographs and magnetic resonance imaging (MRI) for grading of osteoarthritis in patients with scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC), and to determine whether MRI is more likely than radiographs to detect carpal osteoarthritis. Methods Radiographs and MR studies of 46 patients with SLAC and SNAC arthritis were reviewed by two hand surgeons and two radiologists and were graded according to severity of osteoarthritis at seven carpal joints...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28428706/gastroesophageal-reflux-disease-and-morbid-obesity-to-sleeve-or-not-to-sleeve
#19
EDITORIAL
Fabrizio Rebecchi, Marco E Allaix, Marco G Patti, Francisco Schlottmann, Mario Morino
Laparoscopic sleeve gastrectomy (LSG) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight loss results and effects on comorbid conditions. However, there are concerns regarding the effects of LSG on gastroesophageal reflux disease (GERD). The interpretation of the current evidence is challenged by the fact that the LSG technique is not standardized, and most studies investigate the presence of GERD by assessing symptoms and the use of acid reducing medications only...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28428168/testing-the-feasibility-and-usability-of-a-novel-smartphone-based-self-management-support-system-for-dialysis-patients-a-pilot-study
#20
Aki Hayashi, Satoko Yamaguchi, Kayo Waki, Katsuhito Fujiu, Norio Hanafusa, Takahiro Nishi, Hyoe Tomita, Haruka Kobayashi, Hideo Fujita, Takashi Kadowaki, Masaomi Nangaku, Kazuhiko Ohe
BACKGROUND: Diet and fluid restrictions that need continuous self-management are among the most difficult aspects of dialysis treatment. Smartphone applications may be useful for supporting self-management. OBJECTIVE: Our objective is to investigate the feasibility and usability of a novel smartphone-based self-management support system for dialysis patients. METHODS: We developed the Self-Management and Recording System for Dialysis (SMART-D), which supports self-monitoring of three mortality-related factors that can be modified by lifestyle: interdialytic weight gain and predialysis serum potassium and phosphorus concentrations...
April 20, 2017: JMIR Research Protocols
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