Density theorems for ideal points in vector optimization.

Several results are established concerning the density of the set of ideal points in the set of minimal solutions of positive support functionals of sets in normed linear spaces. The above ideal points are defined and several characterizations and sufficient conditions for their existence are also statedMathematical programming; Vector optimization; Efficient point; Density theorems; Normed linear spaces;

Detecció de sibilacions en l'exploració física en Atenció Primària de Salut

A partir de la documentació clínica realitzem un estudi retrospectiu sobre una població infantil d'edats compreses entre 8 i 13 anys observada per un espai de temps superior a un any, a fi de valorar la prevalença d'asma i la hiperreactivitat bronquial. En el grup d'estudi foren practicades sistemàticament maniobres d'espiració forçada; en resultà una prevalença del 42% enfront del 20% en el grup de comparació (p < 0,001). Atesa la transcendència clínica i terapèutica de la detecció de roncors i sibilacions en l'exploració física creiem convenient la pràctica sistemàtica de maniobres d'espiració forçada en tots els pacients que presenten tos o altres signes d'infecció respiratòria

A multi-stakeholder multicriteria decision analysis for the reimbursement of orphan drugs (FinMHU-MCDA study)

Background: Patient access to orphan medicinal products (OMPs) is limited and varies between countries, reimbursement decisions on OMPs are complex, and there is a need for more transparent processes to know which criteria should be considered to inform these decisions. This study aimed to determine the most relevant criteria for the reimbursement of OMPs in Spain, from a multi-stakeholder perspective, and using multicriteria decision analysis (MCDA). Methods: An MCDA was developed in 3 phases and included 28 stakeholders closely related to the field of rare diseases (6 physicians, 5 hospital pharmacists, 7 health economists, 4 patient representatives and 6 members from national and regional health authorities). Initially [phase A], a bibliographic review was conducted to identify the potential reimbursement criteria. Then, a reduced advisory board (8 members) proposed, selected, and defined the final list of criteria that could be relevant for reimbursement. A discrete choice experiment (DCE) [phase B] was developed to determine the relevance and relative importance weight of such criteria according to the stakeholders’ preferences by choosing between pairs of hypothetical financing scenarios. A multinomial logit model was fitted to analyze the DCE responses. Finally [phase C], the advisory board review the results using a deliberative process. Results: Thirteen criteria were selected, related to 4 dimensions: patient population, disease, treatment, and economic evaluation. Nine criteria were deemed relevant for decision-making and associated with a higher relative importance: Health-related quality of life (HRQL) (23.53%), treatment efficacy (14.64%), availability of treatment alternatives (13.51%), disease severity (12.62%), avoided costs (11.21%), age of target population (7.75%), safety (seriousness of adverse events) (4.72%), quality of evidence (3.82%) and size of target population (3.12%). The remaining criteria had a < 3% relative importance: economic burden of disease (2.50%), cost of treatment (1.73%), cost-effectiveness (0.83%) and safety (frequency of adverse events) (0.03%). Conclusion: The reimbursement of OMPs in Spain should be determined by its effect on patient’s HRQL, the extent of its therapeutic benefit from efficacy and the availability of other therapeutic options. Furthermore, the severity of the rare disease should also influence the decision along with the potential of the treatment to avoid associated costs

University quality measurement model based on balanced scorecard

A Higher Education Institution (HEI) has the responsibility to track the processes through indicators that guarantee the measurement of the results in almost real time. This article presents the design of a management and quality model of the processes in a university, through the integration of a Balance Scorecard (BSC) and the implementation of an information system. For which it was required: a review of existing tracing and monitoring systems in the academic sector, definition of the requirements of the proposed technological, a diagnosis of the current measurement system of the HEI analyzed, identify measurement indicators and develop a technological tool. The designed model presents a precise and clear methodological guide that can be replicated in any HEI to monitor its processes

Anti-diabetic effects of Campomanesia xanthocarpa (Berg) leaf decoction

The objective of this research was to identify the effects of 3-week treatment of normal and streptozotocin-induced diabetic rats using a leaf decoction of Campomanesia xanthocarpa Berg. (20 g/L) on physiological, biochemical and histological parameters. Streptozotocin (STZ, 70 mg/kg in citrate buffer, pH 4.5) was administered IP to induce experimental diabetes one week prior to the treatment. STZ caused typical diabetic symptoms: polydypsia, polyuria, polyphagia, hyperglycemia, hypertriglyceridemia and histopathological modifications in the pancreas, liver and kidney. The treatment of diabetic rats using the decoction decreased blood glucose levels, inhibited hepatic glycogen loss, and prevented potential histopathological alterations in the pancreas and kidneys. No differences were found between the control rats treated with the decoction and the control rats maintained on water only. In conclusion, these results suggest that C. xanthocarpa leaf decoction (20g/L) might be useful for diabetes mellitus management, but further pharmacological and toxicological studies are needed.O objetivo deste trabalho foi identificar os efeitos do tratamento com o decocto das folhas de Campomanesia xanthocarpa Berg. (20 g/L), durante 3 semanas, sobre parâmetros fisiológicos, bioquímicos e histológicos de ratos normais e diabéticos induzidos por estreptozotocina. O diabete melito foi induzido uma semana antes de iniciar o tratamento experimental, pela administração IP de estreptozotocina (STZ, 70 mg/kg em tampão citrato, pH 4.5). Os ratos tratados com STZ apresentaram sintomas típicos de diabete: polifagia, polidipsia, hiperglicemia, hipertrigliceridemia e alterações histopatológicas no pâncreas, fígado e rim. O tratamento dos ratos diabéticos com o decocto diminuiu os níveis de glicose sanguínea, inibiu a degradação do glicogênio hepático e preveniu possíveis alterações histopatológicas no pâncreas e no rim. Nos ratos controles tratados com o decocto não foram verificadas diferenças significativas em relação aos controles tratados com água. Em conclusão, os resultados sugerem que o tratamento com o decocto das folhas de C. xanthocarpa leaf decoction (20 g/L) possa ser útil para o manejo do diabete melito, porém estudos farmacológicos e toxicológicos ainda são necessários

Passive smoking in babies: The BIBE study (Brief Intervention in babies. Effectiveness)

Background: There is evidence that exposure to passive smoking in general, and in babies in particular, is an important cause of morbimortality. Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome, acute respiratory diseases, worsening of asthma, acute-chronic middle ear disease and slowing of lung growth. The objective of this article is to describe the BIBE study protocol. The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care, directed to mothers and fathers that smoke, in order to reduce the exposure of babies to passive smoking (ETS). Methods/Design: Cluster randomized field trial (control and intervention group), multicentric and open. Subject: Fathers and/or mothers who are smokers and their babies (under 18 months) that attend pediatric services in Primary Care in Catalonia. The measurements will be taken at three points in time, in each of the fathers and/or mothers who respond to a questionnaire regarding their baby's clinical background and characteristics of the baby's exposure, together with variables related to the parents' tobacco consumption. A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit (biological determination of nicotine). The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care. Discussion: Exposure to ETS is an avoidable factor related to infant morbimortality. Interventions to reduce exposure to ETS in babies are potentially beneficial for their health. The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits. Interventions in the form of advice, conducted by pediatric professionals, are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS

Multicentre, randomised, single-blind, parallel group trial to compare the effectiveness of a Holter for Parkinson's symptoms against other clinical monitoring methods: study protocol

Introduction In recent years, multiple studies have aimed to develop and validate portable technological devices capable of monitoring the motor complications of Parkinson's disease patients (Parkinson's Holter). The effectiveness of these monitoring devices for improving clinical control is not known. Methods and analysis This is a single-blind, cluster-randomised controlled clinical trial. Neurologists from Spanish health centres will be randomly assigned to one of three study arms (1:1:1): (a) therapeutic adjustment using information from a Parkinson?s Holter that will be worn by their patients for 7 days, (b) therapeutic adjustment using information from a diary of motor fluctuations that will be completed by their patients for 7 days and (c) therapeutic adjustment using clinical information collected during consultation. It is expected that 162 consecutive patients will be included over a period of 6 months. The primary outcome is the efficiency of the Parkinson?s Holter compared with traditional clinical practice in terms of Off time reduction with respect to the baseline (recorded through a diary of motor fluctuations, which will be completed by all patients). As secondary outcomes, changes in variables related to other motor complications (dyskinesia and freezing of gait), quality of life, autonomy in activities of daily living, adherence to the monitoring system and number of doctor?patient contacts will be analysed. The noninferiority of the Parkinson's Holter against the diary of motor fluctuations in terms of Off time reduction will be studied as the exploratory objective. Ethics and dissemination approval for this study has been obtained from the Hospital Universitari de Bellvitge Ethics Committee. The results of this study will inform the practical utility of the objective information provided by a Parkinson's Holter and, therefore, the convenience of adopting this technology in clinical practice and in future clinical trials. We expect public dissemination of the results in 2022.Funding This work is supported by AbbVie S.L.U, the Instituto de Salud Carlos III [DTS17/00195] and the European Fund for Regional Development, 'A way to make Europe'