Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Excited singlet states of "hairpin" polyenes

The synthesis and UV-visible, polarized-fluorescence and MCD spectra of 6 U-shaped hairpin polyenes (e.g., I) are reported. Qual. arguments and results of p-electron calcns. permit the identification of 4 excited singlet states and their assignment to mixts. of singly and doubly excited configurations. The hairpin polyenes represent a link between the all-trans-polyenes on the 1 hand and the annulenes and acenes on the other; they have the topol. of the former and a geometry near that of the latter

Exercise and sports after COVID‐19—Guidance from a clinical perspective

SARS-CoV-2 infection has emerged as not only a pulmonary but also potentially multi-organ disease, which may cause long-term structural damage of different organ systems including the lung, heart, vasculature, brain, liver, kidney, or intestine. As a result, the current SARS-CoV-2/COVID-19 pandemic will eventually yield substantially increased numbers of chronically diseased patients worldwide, particularly suffering from pulmonary fibrosis, post-myocarditis, chronic heart failure, or chronic kidney disease. Exercise recommendations for rehabilitation are complex in these patients and should follow current guidelines including standards for pre-exercise medical examinations and individually tailored exercise prescription. It is of utmost importance to start exercise training at an early stage after COVID-19 infection, but at the same time paying attention to the physical barriers to ensure safe return to exercise. For exercise recommendations beyond rehabilitation programs particularly for leisure time and elite athletes, more precise advice is required including assessment of sports eligibility and specific return-to-sports exercise programs. Because of the current uncertainty of long-term course of SARS-CoV-2 infection or COVID disease, long-term follow-up seems to be necessary.Peer Reviewe

Berichte - Dokumentation - Chronik

BerichteGeorg Nürnberger20 Jahre Medienarbeit in Japan Hermann BoventerKirche braucht Öffentlichkeit. Weihbischof Walther Kampe 85 Jahre Wilhelm BetteckenKatholisches Filmwerk besteht 40 Jahre DokumentationAndrzej M. Kardinal DeskurZur Entwicklung des Medienwelttages der Kirche Hermann Josef SpitalKirche in der KommunikationsgesellschaftGünther MeesVerkündigung des Glaubens an Christus durch katholische Organisationen im Medienbereich Chroni

Berichte - Dokumentation - Chronik

BerichteBerichteWACC-Zentralkomitee-Tagung in Vancouver 1978Kirche in den Medien - Ein Seminar in ErlangenBistumsblatt-Auflage und PfarrblätterMDG - Pilotprojekt FürstenfeldbruckLeserbefragung 1978 bei Österreichischen KirchenzeitungenDie "Linzer Kirchenzeitung" - ein enfant terrible?Der Informationsdienst der Schweizer Bischofskonferenz: Modell oder situationsgerechtes Handeln?Katholikentage als Wegbereiter katholischer Publizistik: Vor 100 Jahren wurde der Augustinusverein gegründetPublizistische Aktionen aus Anlaß des 85. Deutschen Katholikentages 1978DokumentationChronik

Minimal-invasive Stabilisierung bei thorakolumbalen osteoporotischen Frakturen

Background: Minimally invasive stabilization of thoracolumbar osteoporotic fractures (OF) in neurologically intact patients is well established. Various posterior and anterior surgical techniques are available. The OF classification and OF score are helpful for defining the indications and choice of operative technique. Objective: This article gives an overview of the minimally invasive stabilization techniques, typical complications and outcome. Material and methods: Selective literature search and description of surgical techniques and outcome. Results: Vertebral body augmentation alone can be indicated in painful but stable fractures of types OF 1 and OF 2 and to some extent for type OF 3. Kyphoplasty has proven to be an effective and safe procedure with a favorable clinical outcome. Unstable fractures and kyphotic deformities (types OF 3-5) should be percutaneously stabilized from posterior. The length of the pedicle screw construct depends on the extent of instability and deformity. Bone cement augmentation of the pedicle screws is indicated in severe osteoporosis but increases the complication rate. Restoration of stability of the anterior column can be achieved through additional vertebral body augmentation or rarely by anterior stabilization. Clinical and radiological short and mid-term results of the stabilization techniques are promising; however, the more invasive the surgery, the more complications occur. Conclusion: Minimally invasive stabilization techniques are safe and effective. The specific indications for the individual procedures are guided by the OF classification and the individual clinical situation of the patient

Illustrierte geschichte des Kunstgewerbes;

Title of v. 2 varies slightly; each volume has also special t.-p."Literaturnachweise": v. 2, p. 795-817.1. Bd. Das Kunstgewerbe im Altertum, im Mittelalter und zur Zeit der Renaissance von W. Behncke, O. von Falke, E. Pernice und G. Swarzenski.--2. Bd. Das Kunstgewerbe in Barock, Rokoko, Louis-XVI, Empire und neuester Zeit, im Gebiete des Islams und in Ostasien, von E.W. Braun, M. Dreger und J. Folnesics, O. Kümmel und G. Lehnert.Mode of access: Internet