Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Análise da publicidade televisiva de alimentos no contexto das recomendações do Guia Alimentar para a População Brasileira

This study aimed to analyze TV food advertising in Brazil based on the recommendations of the Food Guide for the Brazilian Population, 2014. Programming from the four most popular TV channels was recorded on two non-consecutive days in January 2014. The commercials were categorized in (i) foods and beverages, (ii) restaurants, and (iii) non-food services, goods, and products, with those in the first category subdivided according to recommendations in the food guide. The commercials’ categories were described by means of their frequency (and 95% confidence interval), for all the records and according to the day of the week. Of the 2,732 commercials that were identified, food and beverage advertising was the third largest category, with 10.2% of the total. In this category, ultra-processed foods accounted for 60.7% of the commercials, while fresh or minimally processed foods at around 7%. The findings run counter to the guide’s recommendations, reinforcing the importance of measures to regulate food advertising in Brazil.O objetivo do estudo é analisar a publicidade televisiva de alimentos no Brasil com base nas recomendações do Guia Alimentar para a População Brasileira de 2014. A programação dos quatro canais mais populares de televisão foi gravada em janeiro de 2014, por dois dias não consecutivos. Os comerciais foram categorizados em (i) alimentos e bebidas, (ii) restaurantes e (iii) serviços, bens e produtos não alimentícios, sendo aqueles referentes à alimentação subdivididos conforme recomendações do guia. As categorias de comerciais foram descritas por meio de sua frequência (e intervalo de 95% de confiança), para o conjunto total dos registros e segundo o dia da semana. Dos 2.732 comerciais que foram identificados, a publicidade de alimentos e bebidas representou a terceira maior categoria anunciada, com 10,2%. Nessa categoria, os alimentos ultraprocessados corresponderam a 60,7% dos anúncios, e os alimentos in natura ou minimamente processados a cerca de 7%. A realidade evidenciada se opõe às recomendações do guia, reforçando a importância de ações para a regulamentação da publicidade de alimentos no Brasil.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorOutra Agênci

Common functional networks in the mouse brain revealed by multi-centre resting-state fMRI analysis

Preclinical applications of resting-state functional magnetic resonance imaging (rsfMRI) offer the possibility to non-invasively probe whole-brain network dynamics and to investigate the determinants of altered network signatures observed in human studies. Mouse rsfMRI has been increasingly adopted by numerous laboratories worldwide. Here we describe a multi-centre comparison of 17 mouse rsfMRI datasets via a common image processing and analysis pipeline. Despite prominent cross-laboratory differences in equipment and imaging procedures, we report the reproducible identification of several large-scale resting-state networks (RSN), including a mouse default-mode network, in the majority of datasets. A combination of factors was associated with enhanced reproducibility in functional connectivity parameter estimation, including animal handling procedures and equipment performance. RSN spatial specificity was enhanced in datasets acquired at higher field strength, with cryoprobes, in ventilated animals, and under medetomidine-isoflurane combination sedation. Our work describes a set of representative RSNs in the mouse brain and highlights key experimental parameters that can critically guide the design and analysis of future rodent rsfMRI investigations

Doenças infecciosas em crianças pré-escolares brasileiras assistidas em creches

The scope of this article is to analyze the prevalence and factors associated with the development of infectious diseases that affect children in daycare centers, namely respiratory infections, diarrheal disease and parasitic infections. Bibliographic research was conducted in the MEDLINE, LILACS and SciELO databases, and observational studies were included. 129 studies were identified, of which 21 were considered relevant to this study, namely two longitudinal and 19 cross-sectional studies. The systematization of the reviewed studies highlighted: i) the presence of intestinal parasites was the main outcome analyzed, followed by respiratory infections; ii) only one study investigated the occurrence of diarrheal disease; iii) the Giardia lamblia was the most prevalent parasitosis; iv) the variables that were most often associated with the development of intestinal parasitosis were child age, family income and maternal education; v) the attendance at daycare centers was a risk factor for intestinal parasites and respiratory infections. Respiratory and parasitic infections are major problems in institutionalized children in daycare centers. The reduction of such diseases involves a complex web of socio-economic, sanitation and daycare center infrastructure aspects.Univ Estadual Paulista, Programa Posgrad Saude Publ, BR-58109753 Campina Grande, Paraiba, BrazilFac Ciencias Med Campina Grande, Campina Grande, PB, BrazilUniv Estadual Paulista, Programa Posgrad Saude Publ, BR-58109753 Campina Grande, Paraiba, Brazi