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

Televangelism in Sweden—Now? : Is Channel 10 in Älmhult in Fact a Telechurch?

Ever since televangelism started in the United States, Sweden has been considered an impossible arena for that type of enterprise. In the 1960’s almost all Swedes were formal members of the Lutheran Church of Sweden, were heavily secularized, and were considered to be anti-Charismatic and fairly averse to the expression of personal religiosity in public, as in televangelism. Furthermore, the state monopoly of Swedish radio and television closely regulated the transmission of church services, and thus impeded any such evangelization initiatives via TV. Nevertheless, in 2005, when the heyday of televangelism seemed to be over in the United States, a new Charismatic TV channel was founded in Älmhult in Småland. The new channel was called “Channel 10” (Kanal 10). “Kanal” was a neutral designation witout any religious connotations and the number “10” was not used by any television channel in Sweden at the time. In 10 years, Channel 10 has grown into a successful business whose principal product is Pentecostal or Charismatic preaching. The chapter initially asks the question: How can it be that televangelism attracts Swedes today, when this was considered impossible only 30 years ago? The study explores the actors behind the channel, its contents, and the reception of the programs in the light of contemporary changes in the Pentecostal landscape, especially intergenerational conflicts of interest and ongoing mediatization. The material presented is discussed from a theoretical perspective on identity, inspired by Paul Ricoeur (2005) and Erik Erikson (1964), and nostalgia as advocated by Clay Routledge (2015)