Solving the stellar 62Ni problem with AMS

An accurate knowledge of the neutron capture cross sections of 62,63Ni is crucial since both isotopes take key positions which affect the whole reaction flow in the weak s process up to A=90. No experimental value for the 63Ni(n,gamma) cross section exists so far, and until recently the experimental values for 62Ni(n,gamma) at stellar temperatures (kT=30 keV) ranged between 12 and 37 mb. This latter discrepancy could now be solved by two activations with following AMS using the GAMS setup at the Munich tandem accelerator which are also in perfect agreement with a recent time-of-flight measurement. The resulting (preliminary) Maxwellian cross section at kT=30 keV was determined to be 30keV = 23.4 +/- 4.6 mb. Additionally, we have measured the 64Ni(gamma,n)63Ni cross section close to threshold. Photoactivations at 13.5 MeV, 11.4 MeV and 10.3 MeV were carried out with the ELBE accelerator at Forschungszentrum Dresden-Rossendorf. A first AMS measurement of the sample activated at 13.5 MeV revealed a cross section smaller by more than a factor of 2 compared to NON-SMOKER predictions.Comment: Proceedings of the 11th International Conference on Accelerator Mass Spectrometry in Rome, Sept. 14-19, 2008; to be published in Nucl. Instr. Meth.

Manejo práctico del paciente con diabetes mellitus en la Atención Primaria de Salud

La diabetes mellitus es una enfermedad de primera importancia a nivel de salud pública en todo el mundo, por ser una de las enfermedades no transmisibles más frecuentes, y por la severidad y diversidad de sus complicaciones crónicas. Se realiza una revisión actualizada sobre el manejo de las personas con diabetes mellitus. Incluye definición, diagnóstico y clasificación, algoritmo para el pesquisaje de la enfermedad, conducta ante una persona con diabetes mellitus en la Atención Primaria de Salud, pilares de tratamiento y metas de control metabólico. Tiene como objetivo exponer elementos prácticos para el abordaje del paciente con diabetes mellitus tipo.</p

The Radiative Strength Function Using the Neutron-Capture Reaction on 151,153Eu

Radiative strength functions in {sup 152,154}Eu nuclei for {gamma}-ray energies below 6 MeV have been investigated. Neutron capture for incident neutron energies &lt;1eV up to 100 keV has been measured for {sup 151,153}Eu targets. Properties of resonances in these two nuclei are examined. The measurements are compared to simulation of cascades performed with various models for the radiative strength function. Comparison between experimental data and simulation suggests an existence of the low-energy resonance in these two nuclei

Investigation of the Statistical Properties of Stable Eu Nuclei using Neutron-Capture Reactions

Neutron capture for incident neutron energies &lt;1eV up to 100 keV has been measured for {sup 151,153}Eu targets. The highly efficient DANCE (Detector for Advanced Neutron Capture Experiments) array coupled with the intense neutron beam at Los Alamos Neutron Science Center is used for the experiment. Stable Eu isotopes mass separated and electroplated on Be backings were used. Properties of well-resolved, strong resonances in two Eu nuclei are examined. The parameters for most of these resonances are known. Detailed multiplicity information for each resonance is obtained employing the high granularity of the DANCE array. The radiative decay cascades corresponding to each resonance are obtained in the experiment. The measurements are compared to simulation of these cascades which calculated with various models for the radiative strength function. Comparison between the experimental data and simulation provides an opportunity to investigate the average quantities

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Characterization of Type 2 Diabetic Patients Admitted to the Diabetes Care Center of Cienfuegos

Foundation: to know the clinical characteristicas of people who suffer from diabetis mellitus is indispensable to undertake comprehensive and effective actions in its control and treatment. Objective: to know the clinical characteristics and the frequency of chronic complations in people with type 2 diabetis mellitus admitted to Diabetic Education and Care Center in Cienfuegos in the year 2013.Method: a descriptive study was carried out in which 396 patients were included, admitted to the center from January to December 2013. The variable analyzed were age, sex, body mass index, presence of obesity and altered waist circumference. It was explored the treatment on admission and discharge, parameters of fasting blood glucose glycemia, total cholesterol, uric acid, micro albuminuria, so as the presence of some of the most frequent chronic complications. Results: femile sex predominated, average age was 54,42 years and toxics habits which prevailed were smoking and alcohol comsumption. Half of the patients has a body mass index higher or similar to 30.0 Kg and 77.8 % had obesity at the momentof being diagnosed as diabetic. The 78.3 % has altered waist circumference. Degree 1 of the risk of developing a diabetic foot predominated. Diabetic retinopathy and diabetic nephropathy were the most frequent followed by ischemic cardiopathy. Conclusion: diabetis mellitus is appearing at ages every time earlier a dat the moment of the diagnosis there are established already macro and microvascular complications.</p

Manejo práctico del paciente con diabetes mellitus en la Atención Primaria de Salud

La diabetes mellitus es una enfermedad de primera importancia a nivel de salud pública en todo el mundo, por ser una de las enfermedades no transmisibles más frecuentes, y por la severidad y diversidad de sus complicaciones crónicas. Se realiza una revisión actualizada sobre el manejo de las personas con diabetes mellitus. Incluye definición, diagnóstico y clasificación, algoritmo para el pesquisaje de la enfermedad, conducta ante una persona con diabetes mellitus en la Atención Primaria de Salud, pilares de tratamiento y metas de control metabólico. Tiene como objetivo exponer elementos prácticos para el abordaje del paciente con diabetes mellitus tipo.</p

Practical Management of Patients with Diabetes Mellitus in Primary Health Care

Diabetes mellitus is a disease of major importance for public health throughout the world. This is mainly caused by its status as one of the most common non-communicable diseases and the severity and diversity of its chronic complications. An updated literary review on the management of patients with diabetes mellitus was conducted. It includes definition, diagnosis and classification, algorithm for disease’s screening, appropriate management of a patient with diabetes mellitus in primary health care, treatment pillars and goals for metabolic control. This review is aimed at exposing practical elements when approaching a patient suffering from diabetes mellitus

Practical Management of Patients with Diabetes Mellitus in Primary Health Care

Diabetes mellitus is a disease of major importance for public health throughout the world. This is mainly caused by its status as one of the most common non-communicable diseases and the severity and diversity of its chronic complications. An updated literary review on the management of patients with diabetes mellitus was conducted. It includes definition, diagnosis and classification, algorithm for disease’s screening, appropriate management of a patient with diabetes mellitus in primary health care, treatment pillars and goals for metabolic control. This review is aimed at exposing practical elements when approaching a patient suffering from diabetes mellitus