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vrijdag 24 februari 2017

The Lancet: [Comment] Treating prediabetes in the obese: are GLP-1 analogues the answer?

[Comment] Treating prediabetes in the obese: are GLP-1 analogues the answer?
Glucagon-like peptide 1 (GLP-1) analogues are increasingly recognised for their considerable clinical effects on weight loss and diabetes. Increasing evidence has shown their use can improve cardiovascular disease risk, decrease mortality, and provide other metabolic improvements.1
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[Comment] Early life deprivation: is the damage already done?
"Sir—The evacuation of small children between the ages of 2 and 5 introduces major psychological problems." This sentence by John Bowlby and colleagues published in The BMJ in 1939 warns against the detrimental effects of separation of young children from their mothers.1 During World War 2, children in the UK were evacuated to unfamiliar families for reasons of safety. The professional attention to the effects of family disruption preceded the attention to serious physical and emotional deprivation of children raised in residential institutions such as orphanages as a result of war.
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[Articles] Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study
Notwithstanding the resilience shown by some adoptees and the adult remission of cognitive impairment, extended early deprivation was associated with long-term deleterious effects on wellbeing that seem insusceptible to years of nurturance and support in adoptive families.
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[Articles] 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial
In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3·0 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes.
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[Health Policy] Ethical issues in dialysis therapy
Treatment for end-stage kidney disease is a major economic challenge and a public health concern worldwide. Renal-replacement therapy poses several practical and ethical dilemmas of global relevance for patients, clinicians, and policy makers. These include how to: promote patients' best interests; increase access to dialysis while maintaining procedural and distributive justice; minimise the influence of financial incentives and competing interests; ensure quality of care in service delivery and access to non-dialytic supportive care when needed; minimise the financial burden on patients and health-care system; and protect the interests of vulnerable groups during crisis situations.
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