BACKGROUND: A knowledge gap remains in how the rate of body weight reduction impacts efficacy and safety of obesity management medications. This SURMOUNT-5 post hoc analysis aimed to define rapid responders and evaluated...BACKGROUND: A knowledge gap remains in how the rate of body weight reduction impacts efficacy and safety of obesity management medications. This SURMOUNT-5 post hoc analysis aimed to define rapid responders and evaluated efficacy and safety of tirzepatide versus. semaglutide in rapid responders versus non-rapid responders. METHODS: Rapid responders and non-rapid responders were defined as participants that obtained ≥ 15% and < 15% body weight reduction by Week 24, respectively. Baseline characteristics, and proportion of participants achieving body weight reduction thresholds by Week 72 were assessed. End-of-study safety and gastrointestinal adverse events measures were summarized. RESULTS: Overall, 32.3% were rapid responders (tirzepatide: 44%, semaglutide: 21%). The proportions of participants achieving body weight reduction thresholds by Week 72 were higher for rapid responders versus non-rapid responders. Safety trends for tirzepatide and semaglutide were similar between responder groups. A numerically higher number of gastrointestinal/hepatobiliary adverse events were reported in rapid responders. Study treatment completion was similar among rapid responders and non-rapid responders for both treatments. CONCLUSIONS: In this post hoc analysis of SURMOUNT-5, a greater proportion of tirzepatide-treated participants in both responder groups achieved all body weight reduction thresholds versus semaglutide. Although rapid responders experienced more gastrointestinal/hepatobiliary adverse events in both treatments, this did not affect rates of study treatment completion relative to non-rapid responders. TRIAL REGISTRATION: clinicaltrials.gov identifier NCT05822830.
Dementia affects more than 55 million people worldwide, and prevention remains a global priority. Pet ownership is a modifiable factor hypothesized to improve cognitive health, but longitudinal evidence is mixed. We sear...Dementia affects more than 55 million people worldwide, and prevention remains a global priority. Pet ownership is a modifiable factor hypothesized to improve cognitive health, but longitudinal evidence is mixed. We searched PubMed, Embase, CINAHL, Web of Science, and PsycINFO for prospective cohort, case-control, or nested case-control studies in adults without dementia reporting incident dementia and/or dementia-related outcomes. Two reviewers screened, extracted data, and assessed risk of bias. Since studies reporting incident dementia were too few (n = 3) and heterogeneous, we conducted a narrative synthesis rather than a meta-analysis. We included six studies. Outcomes spanned conversion to mild cognitive impairment/dementia and worsening neuropsychological trajectories. Two studies suggested a protective association between pet ownership, especially dogs, and incident dementia, while one study found no significant association. For secondary outcomes, dog or cat ownership, with dog walking, was associated with slower cognitive decline, whereas exposure to non-companion animals was associated with increased risk of cognitive impairment. Risk of bias was moderate to high. The type of pets and related behaviors may be more critical than ownership alone.
BACKGROUND: Association between serum albumin levels and bleeding events in patients with venous thromboembolism was unclear. METHODS: In this Japanese multi-center registry, we enrolled 993 consecutive patients diagnose...BACKGROUND: Association between serum albumin levels and bleeding events in patients with venous thromboembolism was unclear. METHODS: In this Japanese multi-center registry, we enrolled 993 consecutive patients diagnosed with acute venous thromboembolism and treated with anticoagulants between 2015 and 2024, where 732 patients were finally analysed. The primary outcome was 180-day bleeding events, defined as moderate or severe bleeding according to the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries criteria. The effect of serum albumin level on the outcome was determined using a multivariate Cox proportional hazard regression model adjusted for conventional bleeding risk scoring systems. RESULTS: The mean age was 68.6 ± 14.5 years, and 37.2% were men. In total, 38.4% had concomitant active cancer, 6% had a previous history of venous thromboembolism, and 90% were treated with direct oral anticoagulants. The primary outcome occurred in 36 patients (5%), and serum albumin level was significantly lower in the event group than in the event-free group (2.9 ± 0.7 g/dL versus. 3.2 ± 0.7 g/dL, P = 0.014). In multivariate Cox proportional risk analysis, serum albumin level was independently associated with the outcome (adjusted hazard ratio 1.77, per 1 g/dL decrease; 95% confidence interval, 1.12-2.75; P = 0.013). This was consistent in patients with active cancer (adjusted hazard ratio 2.15, per 1 g/dL decrease; 95% confidence interval, 1.29-3.57; P = 0.003), but not in patients without it. CONCLUSIONS: Decreased serum albumin levels were associated with 180-day bleeding events in patients with venous thromboembolism treated with anticoagulants, especially in those with concomitant active cancer.
Fluoroquinolones are widely used antibiotics, however, concerns about QTc prolongation often limit their use in inpatient care. Ciprofloxacin, despite demonstrating minimal QTc effects and the lowest arrhythmic risk with...Fluoroquinolones are widely used antibiotics, however, concerns about QTc prolongation often limit their use in inpatient care. Ciprofloxacin, despite demonstrating minimal QTc effects and the lowest arrhythmic risk within its class, is frequently avoided due to non-specific electronic medical record warnings. This perspective reviews pharmacologic and real-world data to understand the real QTc risk, emphasizing ciprofloxacin's favorable cardiac safety profile. Aligning evidence with clinical practice may reduce unnecessary hospitalization, avoid prolonged intravenous therapy, and support safer transitions to oral antibiotics.