1,891 research outputs found
Patient perceptions of insulin therapy in diabetes self-management with insulin injection devices
No full textAims Several insulin delivery systems are available to control glycemia in patients with diabetes. Recently introduced devices feature connectivity enabling data transfer to smartphone applications to provide decision support and reduce errors in dosing and timing, while reducing the cognitive burden.MethodsWe conducted an online survey in Italian patients with a self-reported diagnosis of diabetes to assess patient perceptions of insulin therapy management, and their impressions of connection-enabled insulin pens compared to standard insulin pens. The Morisky Medication Adherence Scale-8 was used to assess adherence to insulin therapy.ResultsAmong 223 respondents (108 with type 1 diabetes; 115 with type 2 diabetes), the most prominent unmet need was the necessity to overcome the cognitive burden of care associated with measuring, calculating, timing, and recording therapy. Only 25% of respondents had high adherence; 28% had low adherence.ConclusionsWhen asked to compare the attributes of a non-connected insulin pen with those of a new connected device, 71% of patients rated the new proposal "very useful". The cognitive burden associated with self-management of diabetes therapy may influence preferences for advanced insulin delivery systems
Do thiazolidinediones still have a role in treatment of type 2 diabetes mellitus?
No full textThiazolidinediones have been introduced in the treatment of type 2 diabetes mellitus (T2DM) since the late 1990s. Although troglitazone was withdrawn from the market a few years later due to liver toxicity, both rosiglitazone and pioglitazone gained widespread use for T2DM treatment. In 2010, however, due to increased risk of cardiovascular events associated with its use, the European Medicines Agency recommended suspension of rosiglitazone use and the Food and Drug Administration severely restricted its use. Thus pioglitazone is the only thiazolidinedione still significantly employed for treating T2DM and it is the only molecule of this class still listed in the American Diabetes Association-European Association for the Study of Diabetes 2012 Position Statement. However, as for the other thiazolidinediones, use of pioglitazone is itself limited by several side effects, some of them potentially dangerous. This, together with the development of novel therapeutic strategies approved in the last couple of years, has made it questionable whether or not thiazolidinediones (namely pioglitazone) should still be used in the treatment of T2DM. This article will attempt to formulate an answer to this question by critically reviewing the available data on the numerous advantages and the potentially worrying shortcomings of pioglitazone treatment in T2DM
Physiology and pathophysiology of oxLDL uptake by vascular wall cells in atherosclerosis
No full textAtherosclerosis is a progressive disease in which endothelial cell dysfunction, macrophage foam cell formation, and smooth muscle cell migration and proliferation, lead to the loss of vascular homeostasis. Oxidized low-density lipoprotein (oxLDL) may play a pre-eminent function in atherosclerotic lesion formation, even if their role is still debated. Several types of scavenger receptors (SRs) such as SR-AI/II, SRBI, CD36, lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), toll-like receptors (TLRs) and others can promote the internalization of oxLDL. They are expressed on the surface of vascular wall cells (endothelial cells, macrophages and smooth muscle cells) and they mediate the cellular effects of oxLDL. The key influence of both oxLDL and SRs on the atherogenic process has been established in atherosclerosis-prone animals, in which antioxidant treatment and/or silencing of SRs has been shown to reduce atherogenesis. Despite some discrepancies, the indication from cohort studies that there is an association between oxLDL and cardiovascular (CV) events seems to point toward a role for oxLDL in atherosclerotic plaque progress and disruption. Finally, randomized clinical trials using antioxidants have demonstrated benefits only in high-risk patients, suggesting that additional proofs are still needed to better define the involvement of each type of modified LDL in the development of atherosclerosis. © 2016 Elsevier Inc
A comparative safety review between GLP-1 receptor agonists and SGLT2 inhibitors for diabetes treatment
No full textIntroduction: Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium glucose cotransporter 2 inhibitors (SGLT2i) are of particular interest in type 2 diabetes treatment strategies, due to their efficacy in reducing HbA1c with a low risk of hypoglycaemia, to their positive effects on body weight and blood pressure and in light of their effects on cardiovascular risk and on nephroprotection emerged from the most recent cardiovascular outcome trials.
Since it is therefore very likely that GLP-1RA and SGLT2i use will become more and more common, it is more and more important to gather and discuss information about their safety profile.
Area Covered: adverse events and the safety concerns most often emerged in trials with GLP-1RA namely, exenatide long acting release (LAR), dulaglutide, liraglutide, semaglutide, lixisenatide or SGLT2i, namely empagliflozin, dapagliflozin, canagliflozin and SGLT2i with an attempt at comparing the safety profiles of molecules of these two classes.
Expert opinion: GLP-1RA and SGLT2i, although each associated with different specific side effects, share a 'similar' safety profile and are both drugs relatively easy to handle. The potentially complementary mechanisms of action, the cardio and nephroprotective effects demonstrated by molecules of both classes, make these drugs potentially useful even in add on to each other
Il reportage alla maniera di Tiziano Terzani: Buonanotte, Signor Lenin e le epifanie dei luoghi
No full textIn this paper, Gloria Politi embarks upon an analysis of Goodnight, Mister Lenin seen
as an interpretation of the genre of reportage in the peculiar way by its author Tiziano
Terzani. In terms of methodology, this approach draws on theories of literary criticism,
textual hermeneutics and narratology. The analysis shows how the depiction of the flow
of events before the reader’s eyes reveals an inner gaze that, according to Pavel Florensky,
almost creates a figurative mark, just like the impressions conveyed by poetry. Terzani’s
word thus expresses all its evocative potential as a narrative transfer of the rendering of
space in the visual arts
European island landscape and seascape
No full textThe chapter explores several issues related to island biocultural diversity, and in particular to cultural heritage and European island landscapes and seascapes. New concepts and definitions of island landscape and seascape are proposed from previous fundamental studies and current ongoing research on the topic. The aim is to provide a conceptual background to the miscellanea of topics covered in the book Island Landscapes edited by the author
Lu Xun's Revolution : Writing in a Time of Violence /
No full textRecognized as modern China’s preeminent man of letters, Lu Xun (1881–1936) is revered as the nation’s conscience, a writer comparable to Shakespeare or Tolstoy. Gloria Davies’s vivid portrait gives readers a better sense of this influential author by situating the man Mao Zedong hailed as "the sage of modern China" in his turbulent time and place.Widely recognized as modern China’s preeminent man of letters, Lu Xun (1881–1936) is revered as the voice of a nation’s conscience, a writer comparable to Shakespeare and Tolstoy in stature and influence. Gloria Davies’s portrait now gives readers a better sense of this influential author by situating the man Mao Zedong hailed as "the sage of modern China" in his turbulent time and place. In Davies’s vivid rendering, we encounter a writer passionately engaged with the heady arguments and intrigues of a country on the eve of revolution. She traces political tensions in Lu Xun’s works which reflect the larger conflict in modern Chinese thought between egalitarian and authoritarian impulses. During the last phase of Lu Xun’s career, the so-called "years on the left," we see how fiercely he defended a literature in which the people would speak for themselves, and we come to understand why Lu Xun continues to inspire the debates shaping China today. Although Lu Xun was never a Communist, his legacy was fully enlisted to support the Party in the decades following his death. Far from the apologist of political violence portrayed by Maoist interpreters, however, Lu Xun emerges here as an energetic opponent of despotism, a humanist for whom empathy, not ideological zeal, was the key to achieving revolutionary ends. Limned with precision and insight, Lu Xun’s Revolution is a major contribution to the ongoing reappraisal of this foundational figure.Recognized as modern China’s preeminent man of letters, Lu Xun (1881–1936) is revered as the nation’s conscience, a writer comparable to Shakespeare or Tolstoy. Gloria Davies’s vivid portrait gives readers a better sense of this influential author by situating the man Mao Zedong hailed as "the sage of modern China" in his turbulent time and place.Widely recognized as modern China’s preeminent man of letters, Lu Xun (1881–1936) is revered as the voice of a nation’s conscience, a writer comparable to Shakespeare and Tolstoy in stature and influence. Gloria Davies’s portrait now gives readers a better sense of this influential author by situating the man Mao Zedong hailed as "the sage of modern China" in his turbulent time and place. In Davies’s vivid rendering, we encounter a writer passionately engaged with the heady arguments and intrigues of a country on the eve of revolution. She traces political tensions in Lu Xun’s works which reflect the larger conflict in modern Chinese thought between egalitarian and authoritarian impulses. During the last phase of Lu Xun’s career, the so-called "years on the left," we see how fiercely he defended a literature in which the people would speak for themselves, and we come to understand why Lu Xun continues to inspire the debates shaping China today. Although Lu Xun was never a Communist, his legacy was fully enlisted to support the Party in the decades following his death. Far from the apologist of political violence portrayed by Maoist interpreters, however, Lu Xun emerges here as an energetic opponent of despotism, a humanist for whom empathy, not ideological zeal, was the key to achieving revolutionary ends. Limned with precision and insight, Lu Xun’s Revolution is a major contribution to the ongoing reappraisal of this foundational figure.Electronic reproduction. :Mode of access: Internet via World Wide Web.DaviesGloria: Gloria Davies is a literary scholar and historian of China at Monash University in Australia. She is also Adjunct Director of the Australian Centre on China in the World at the Australian National University.Description based on online resource; title from PDF title page (publisher’s Web site, viewed May 26, 2011
Diabetes and Its Cardiovascular Complications: Potential Role of the Acetyltransferase p300
No full textDiabetes has been shown to accelerate vascular senescence, which is associated with chronic inflammation and oxidative stress, both implicated in the development of endothelial dysfunction. This condition represents the initial alteration linking diabetes to related cardiovascular (CV) complications. Recently, it has been hypothesised that the acetyltransferase, p300, may contribute to establishing an early vascular senescent phenotype, playing a relevant role in diabetes-associated inflammation and oxidative stress, which drive endothelial dysfunction. Specifically, p300 can modulate vascular inflammation through epigenetic mechanisms and transcription factors acetylation. Indeed, it regulates the inflammatory pathway by interacting with nuclear factor kappa-light-chain-enhancer of activated B cells p65 subunit (NF-κB p65) or by inducing its acetylation, suggesting a crucial role of p300 as a bridge between NF-κB p65 and the transcriptional machinery. Additionally, p300-mediated epigenetic modifications could be upstream of the activation of inflammatory cytokines, and they may induce oxidative stress by affecting the production of reactive oxygen species (ROS). Because several in vitro and in vivo studies shed light on the potential use of acetyltransferase inhibitors, a better understanding of the mechanisms underlying the role of p300 in diabetic vascular dysfunction could help in finding new strategies for the clinical management of CV diseases related to diabetes
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