9 research outputs found
Psychosocial risks analysis for employees in public administration
Nowadays psychosocial risks at work have a serious impact not only on the health of
employees, but also on the economic performance of organisations, and this is the biggest
challenge in working environment. In Latvia, employees in public administration comprise 11%
of the total population. Hence the aim of this study was to analyse the causes of psychosocial
risks and the differences in their prevalence among inspectorate officials employed in the State
Administration compared to office staff employed by the State Administration. A modified
Copenhagen Psychosocial Questionnaire from the Danish National Research Centre for the
Working Environment was used to assess psychosocial risks at work. One public administration
organisation was selected for the study, which involved 111 staff (60 inspecting officers and 51
office staff). The analysis of the results of the psychosocial risk assessment shows that there are
statistically significant differences in the assessment of four out of 11 psychosocial risks to the
working environment. The most common psychosocial work environment risk factor among
inspectors is the inadequate attitude of management, but the most common risk factor among
office employees is the lack of impact on work. To reduce the spread of psychosocial risks more
effectively, an individual approach is required for each worker
Biomarkers of Multiple Sclerosis
The search for an ideal multiple sclerosis biomarker with good diagnostic value, prognostic reference and an impact on clinical outcome has yet to be realized and is still ongoing. The aim of this review is to establish an overview of the frequent biomarkers for multiple sclerosis that exist to date. The review summarizes the results obtained from electronic databases, as well as thorough manual searches. In this review the sources and methods of biomarkers extraction are described; in addition to the description of each biomarker, determination of the prognostic, diagnostic, disease monitoring and treatment response values besides clinical impact they might possess. We divided the biomarkers into three categories according to the achievement method: laboratory markers, genetic-immunogenetic markers and imaging markers. We have found two biomarkers at the time being considered the gold standard for MS diagnostics. Unfortunately, there does not exist a single solitary marker being able to present reliable diagnostic value, prognostic value, high sensitivity and specificity as well as clinical impact. We need more studies to find the best biomarker for MS.publishersversionPeer reviewe
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
Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.
Abstract
BACKGROUND:
The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown.
METHODS:
We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy.
RESULTS:
In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups.
CONCLUSIONS:
Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)
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,
120.29 percentage points; 95% confidence interval [CI], 120.32 to 120.27). 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.
(Funded by Merck Sharp & Dohme; TECOS ClinicalTrials.gov number, NCT00790205.