Medicine JournalFeeds

The good news about cancer in developing countries–pathology answers the call.

Lancet. 2012 Feb 25;379(9817):712

Authors: Roberts DJ, Wilson ML, Nelson AM, Adesina AM, Fleming KA, Milner D, Guarner J, Rebbeck TR, Castle P, Lucas S

PMID: 22364759 [PubMed - in process]

New studies cast dark cloud over air pollution.

Lancet. 2012 Feb 25;379(9817):697

Authors: Devi S

PMID: 22371962 [PubMed - in process]

Thrombocytopenia in a nutshell.

Lancet. 2012 Feb 25;379(9817):776

Authors: Achterbergh R, Vermeer HJ, Curtis BR, Porcelijn L, Aster RH, Deenik W, Daemen-Gubbels C

PMID: 22364760 [PubMed - in process]

India probes corruption in flagship health programme.

Lancet. 2012 Feb 25;379(9817):698

Authors: Shukla S

PMID: 22371963 [PubMed - in process]

A first step in bringing typhoid fever out of the closet.

Lancet. 2012 Feb 25;379(9817):699-700

Authors: Maurice J

PMID: 22371964 [PubMed - in process]

Spectacular anatomy: plastination and salutary dread.

Lancet. 2012 Feb 25;379(9817):704-5

Authors: Bouffard C, Bouffard M

PMID: 22371965 [PubMed - in process]

TAK-875 versus placebo or glimepiride in type 2 diabetes mellitus: a phase 2, randomised, double-blind, placebo-controlled trial.

Lancet. 2012 Feb 24;

Authors: Burant CF, Viswanathan P, Marcinak J, Cao C, Vakilynejad M, Xie B, Leifke E

Abstract

BACKGROUND: Activation of free fatty acid receptor 1 (FFAR1; also known as G-protein-coupled receptor 40) by fatty acids stimulated glucose-dependent β-cell insulin secretion in preclinical models. We aimed to assess whether selective pharmacological activation of this receptor by TAK-875 in patients with type 2 diabetes mellitus improved glycaemic control without hypoglycaemia risk. METHODS: We undertook a phase 2, randomised, double-blind, and placebo-controlled and active-comparator-controlled trial in outpatients with type 2 diabetes who had not responded to diet or metformin treatment. Patients were randomly assigned equally to receive placebo, TAK-875 (6·25, 25, 50, 100, or 200 mg), or glimepiride (4 mg) once daily for 12 weeks. Patients and investigators were masked to treatment assignment. The primary outcome was change in haemoglobin A(1c) (HbA(1c)) from baseline. Analysis included all patients randomly assigned to treatment groups who received at least one dose of double-blind study drug. The trial is registered at ClinicalTrials.gov, NCT01007097. FINDINGS: 426 patients were randomly assigned to TAK-875 (n=303), placebo (n=61), and glimepiride (n=62). At week 12, significant least-squares mean reductions in HbA(1c) from baseline occurred in all TAK-875 (ranging from -1·12% [SE 0·113] with 50 mg to -0·65% [0·114] with 6·25 mg) and glimepiride (-1·05% [SE 0·111]) groups versus placebo (-0·13% [SE 0·115]; p value range 0·001 to <0·0001). Treatment-emergent hypoglycaemic events were similar in the TAK-875 and placebo groups (2% [n=7, all TAK-875 groups] vs 3% [n=2]); significantly higher rates were reported in the glimepiride group (19% [n=12]; p value range 0·010-0·002 vs all TAK-875 groups). Incidence of treatment-emergent adverse events was similar in the TAK-875 overall (49%; n=147, all TAK-875 groups) and placebo groups (48%, n=29) and was lower than in the glimepiride group (61%, n=38). INTERPRETATION: TAK-875 significantly improved glycaemic control in patients with type 2 diabetes with minimum risk of hypoglycaemia. The results show that activation of FFAR1 is a viable therapeutic target for treatment of type 2 diabetes. FUNDING: Takeda Global Research and Development.

PMID: 22374408 [PubMed - as supplied by publisher]

Could FFAR1 assist insulin secretion in type 2 diabetes?

Lancet. 2012 Feb 24;

Authors: Bailey CJ

PMID: 22374407 [PubMed - as supplied by publisher]

People with disabilities: the forgotten victims of violence.

Lancet. 2012 Feb 27;

Authors: Fuller-Thomson E, Brennenstuhl S

PMID: 22377289 [PubMed - as supplied by publisher]

Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies.

Lancet. 2012 Feb 27;

Authors: Hughes K, Bellis MA, Jones L, Wood S, Bates G, Eckley L, McCoy E, Mikton C, Shakespeare T, Officer A

Abstract

BACKGROUND: About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities. METHODS: In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis. FINDINGS: Of 10 663 references initially identified, 26 were eligible for inclusion, with data for 21 557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3-31·0) in people with mental illnesses, 6·1% (2·5-11·1) in those with intellectual impairments, and 3·2% (2·5-4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I(2) >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09-2·05) for all studies combined, 1·31 (0·93-1·84) for people with non-specific impairments, 1·60 (1·05-2·45) for people with intellectual impairments, and 3·86 (0·91-16·43) for those with mental illnesses. INTERPRETATION: Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries. FUNDING: WHO Department of Violence and Injury Prevention and Disability.

PMID: 22377290 [PubMed - as supplied by publisher]