Context: Receptor activator of nuclear factor-κB ligand (RANKL), receptor activator of nuclear factor-κB (RANK), and osteoprotegerin (OPG) play a central role in bone remodeling and disorders of ...mineral metabolism.
Evidence Acquisition: A PubMed search was conducted from January 1992 until 2007 for basic, observational, and clinical studies in subjects with disorders related to imbalances in the RANK/RANKL/OPG system.
Evidence Synthesis: RANK, RANKL, and OPG are members of the TNF receptor superfamily. The pathways involving them in conjunction with various cytokines and calciotropic hormones play a pivotal role in bone remodeling. Several studies involving mutations in the genes encoding RANK and OPG concluded in the discovery of a number of inherited skeletal disorders. In addition, basic and clinical studies established a consistent relationship between the RANK/RANKL/OPG pathway and skeletal lesions related to disorders of mineral metabolism. These studies were a stepping stone in further defining the role of the RANK/RANKL/OPG pathway in osteoporosis, rheumatoid arthritis, bone loss associated with malignancy-related skeletal diseases, and its relationship to vascular calcifications. Subsequently, the further understanding of this pathway led to the development of new therapeutic modalities including the human monoclonal antibody to RANKL and recombinant OPG as a target for treatment of postmenopausal osteoporosis and multiple myeloma.
Conclusions: The RANK/RANKL/OPG system mediates the effects of calciotropic hormones and, consequently, alterations in their ratio are key in the development of several clinical conditions. New agents with the potential to block effects of RANKL have emerged for treatment of postmenopausal osteoporosis and malignancy-related skeletal disease.
Weight reduction is essential for improving health outcomes in people with obesity and type 2 diabetes. We assessed the efficacy and safety of tirzepatide, a glucose-dependent insulinotropic ...polypeptide and glucagon-like peptide-1 receptor agonist, versus placebo, for weight management in people living with obesity and type 2 diabetes.
This phase 3, double-blind, randomised, placebo-controlled trial was conducted in seven countries. Adults (aged ≥18 years) with a body-mass index (BMI) of 27 kg/m2 or higher and glycated haemoglobin (HbA1c) of 7–10% (53–86 mmol/mol) were randomly assigned (1:1:1), using a computer-generated random sequence via a validated interactive web-response system, to receive either once-weekly, subcutaneous tirzepatide (10 mg or 15 mg) or placebo for 72 weeks. All participants, investigators, and the sponsor were masked to treatment assignment. Coprimary endpoints were the percent change in bodyweight from baseline and bodyweight reduction of 5% or higher. The treatment-regimen estimand assessed effects regardless of treatment discontinuation or initiation of antihyperglycaemic rescue therapy. Efficacy and safety endpoints were analysed with data from all randomly assigned participants (intention-to-treat population). This trial is registered with ClinicalTrials.gov, NCT04657003.
Between March 29, 2021, and April 10, 2023, of 1514 adults assessed for eligibility, 938 (mean age 54·2 years SD 10·6, 476 51% were female, 710 76% were White, and 561 60% were Hispanic or Latino) were randomly assigned and received at least one dose of tirzepatide 10 mg (n=312), tirzepatide 15 mg (n=311), or placebo (n=315). Baseline mean bodyweight was 100·7 kg (SD 21·1), BMI 36·1 kg/m2 (SD 6·6), and HbA1c 8·02% (SD 0·89; 64·1 mmol/mol SD 9·7). Least-squares mean change in bodyweight at week 72 with tirzepatide 10 mg and 15 mg was –12·8% (SE 0·6) and –14·7% (0·5), respectively, and –3·2% (0·5) with placebo, resulting in estimated treatment differences versus placebo of –9·6% percentage points (95% CI –11·1 to –8·1) with tirzepatide 10 mg and –11·6% percentage points (–13·0 to –10·1) with tirzepatide 15 mg (all p<0·0001). More participants treated with tirzepatide versus placebo met bodyweight reduction thresholds of 5% or higher (79–83% vs 32%). The most frequent adverse events with tirzepatide were gastrointestinal-related, including nausea, diarrhoea, and vomiting and were mostly mild to moderate in severity, with few events leading to treatment discontinuation (<5%). Serious adverse events were reported by 68 (7%) participants overall and two deaths occurred in the tirzepatide 10 mg group, but deaths were not considered to be related to the study treatment by the investigator.
In this 72-week trial in adults living with obesity and type 2 diabetes, once-weekly tirzepatide 10 mg and 15 mg provided substantial and clinically meaningful reduction in bodyweight, with a safety profile that was similar to other incretin-based therapies for weight management.
Eli Lilly and Company.
Conference Report: Third Qualitative Research Encounter Labrín, Soledad Martínez; Urrutia, Bruno Bivort; Fonseca, Cristian Orellana ...
Forum, qualitative social research,
01/2014, Letnik:
15, Številka:
1
Journal Article
Recenzirano
This report gives an account of the main topics discussed during the Third Qualitative Research Encounter, framed within the work of the Research Group: Gender, Citizenship, and Equity Investigación ...Género, Ciudadanía y Equidad at the University of Bio-Bio, Chile. The event centered on the thematic axis that gives the group its name: gender, citizenship and equity. At the same time, each axis was subdivided, resulting in the formation of three panels, with presentations of qualitative research carried out in Chile (in addition from other South American countries and Spain). We present the main themes of discussion and the main conclusions each group arrived in each axis and panel. Finally, we appreciate the activity as a whole, including its projections for a next event.
Background: it’s necessary to know in depth all the factors that influence, favor, predispose and trigger the occurrence of violent acts leading to death. In this sense, the epidemiological ...characterization of violent death can lead to better performance of professionals and institutions responsible for addressing it.
Objective: to characterize the occurrence of violent deaths in the province of Cienfuegos.
Methods: a retrospective descriptive study was conducted from January to December 2012, involving 144 subjects who died as a result of violent death by suicide, accident or homicide. The variables analyzed were: age, sex, origin, place of occurrence, primary cause of death and medicolegal etiology of death.
Results: violent deaths occurred more frequently in men (76.3 %) and the most affected age group was over 6O years. The most frequent medicolegal etiology was accidental death. Violent acts occurred mainly in public places (49.3%). Hanging and different types of traffic accidents (running over, collision, swerve and overturn) were the most common causes of violent death.
Conclusion: it is concluded that in 2012 most violent deaths in Cienfuegos took place in public places due to accidental causes, although suicide by hanging accounted for a considerable proportion.
The research was carried out using a qualitative approach, and semi-structured interviews as a technique for data production. The main findings show a semantic universe where a new vision of the ...child, as a subject of rights, coexists together with the image of a child as an object of protection. The caregiver anchors his or her identity to the exercise of care, defining a relationship with the child where traditional care behaviors (satisfaction of basic needs) prevail, with the development of well-treating behaviors linked to values, to the recognition of the other, to emotional expression and to a strong affective component. En este anclaje, proveniente de la antigua, pero no obsoleta, doctrina del menor en situación irregular, coexiste la noción de niño sujeto de derechos y de niño como sujeto pasivo, incapaz, inestable, y básicamente receptor de los cuidados suministrados en virtud de su condición de niño vulnerable. '... (los niños) no tienen a sus papás, pero nos tienen a nosotros, entonces...yo siento que ellos lo perciben... por el cariño. (ellos) perciben que ese derecho lo tienen adquirido de forma innata digamos,. su alimentación entonces ellos saben que tienen sus derechos y que nosotros se los entregamos y ellos lo viven en el día a día. nosotros estamos, digámoslo así entre comillas, obligados a asegurar esas cosas, ya sea partir de lo básico: un techo, alimentación, un bienestar' (E3) '... a los grandes también les dejamos su ropa doblada... que ellos lo guarden en su clóset... preocuparnos de que no anden con la misma ropa, que se bañen en las mañanas... lavar a los chicos en la mañana... enseñarles a cómo hacer su cama, que tienen que vivir en un espacio limpio... después venimos a tomar desayuno... la alimentación sería otro derecho... tenerles su uniforme, mandarles sus colaciones, que lleven su mochila ordenada. subirlos al furgón y asegurarnos de que van al colegio' (E5) Esta unidad de significado en el universo semántico del cuidador/a, podría ser producto de la propia naturalización del sistema de pensamiento preexistente en ellos por el prolongado ejercicio de su rol y por la institucionalización a la que están sometidos.
El presente trabajo describe las experiencias de violencia obstétrica que vivieron mujeres en sus procesos de parto y el rol de sus acompañantes. Se utilizó metodología cualitativa, con un diseño ...descriptivo de casos múltiples. Se empleó el método biográfico, específicamente relatos de vida recolectados con la técnica de entrevista en profundidad. La muestra se configuró por selección intencional y los datos fueron analizados empleando análisis de contenido. Los resultados principales son que las mujeres experimentaron violencia gineco-obstétrica en la atención de urgencia maternal por alto riesgo obstétrico, en el trabajo de parto, puerperio y post parto. Los acompañantes cumplieron un rol de apoyo permanente, contención afectiva y resguardo del bienestar de sus parejas.
Topiramate (TPM) is a neuromodulatory agent that was initially approved as an antiepileptic drug and is increasingly used in the treatment of a number of neurological and metabolic disorders. Among ...its various pharmacological actions, TPM has been shown to inhibit the activity of specific carbonic anhydrase enzymes in the kidney. This action is associated with the development of metabolic acidosis, hypocitraturia, hypercalciuria and elevated urine pH, leading to an increased risk of kidney stone disease. Despite the cautionary note in the package insert of TPM, the extent of these complications has not been fully explored. Few prescribing physicians are aware of these complications, underscoring the need for improved surveillance. Because the drug is among the most frequently prescribed agents in the US, more controlled studies are required to determine the prevalence of kidney stone disease among TPM users, and the optimal approach to prevent and treat nephrolithiasis in these individuals.
Receptor activator of nuclear factor-kappaB ligand (RANKL), receptor activator of nuclear factor-kappaB (RANK), and osteoprotegerin (OPG) play a central role in bone remodeling and disorders of ...mineral metabolism.
A PubMed search was conducted from January 1992 until 2007 for basic, observational, and clinical studies in subjects with disorders related to imbalances in the RANK/RANKL/OPG system.
RANK, RANKL, and OPG are members of the TNF receptor superfamily. The pathways involving them in conjunction with various cytokines and calciotropic hormones play a pivotal role in bone remodeling. Several studies involving mutations in the genes encoding RANK and OPG concluded in the discovery of a number of inherited skeletal disorders. In addition, basic and clinical studies established a consistent relationship between the RANK/RANKL/OPG pathway and skeletal lesions related to disorders of mineral metabolism. These studies were a stepping stone in further defining the role of the RANK/RANKL/OPG pathway in osteoporosis, rheumatoid arthritis, bone loss associated with malignancy-related skeletal diseases, and its relationship to vascular calcifications. Subsequently, the further understanding of this pathway led to the development of new therapeutic modalities including the human monoclonal antibody to RANKL and recombinant OPG as a target for treatment of postmenopausal osteoporosis and multiple myeloma.
The RANK/RANKL/OPG system mediates the effects of calciotropic hormones and, consequently, alterations in their ratio are key in the development of several clinical conditions. New agents with the potential to block effects of RANKL have emerged for treatment of postmenopausal osteoporosis and malignancy-related skeletal disease.
Background: it’s necessary to know in depth all the factors that influence, favor, predispose and trigger the occurrence of violent acts leading to death. In this sense, the epidemiological ...characterization of violent death can lead to better performance of professionals and institutions responsible for addressing it.
Objective: to characterize the occurrence of violent deaths in the province of Cienfuegos.
Methods: a retrospective descriptive study was conducted from January to December 2012, involving 144 subjects who died as a result of violent death by suicide, accident or homicide. The variables analyzed were: age, sex, origin, place of occurrence, primary cause of death and medicolegal etiology of death.
Results: violent deaths occurred more frequently in men (76.3 %) and the most affected age group was over 6O years. The most frequent medicolegal etiology was accidental death. Violent acts occurred mainly in public places (49.3%). Hanging and different types of traffic accidents (running over, collision, swerve and overturn) were the most common causes of violent death.
Conclusion: it is concluded that in 2012 most violent deaths in Cienfuegos took place in public places due to accidental causes, although suicide by hanging accounted for a considerable proportion.
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