Atlas de lesiones benignas de la mama (categoria 2 BI-RADS). Servicio de radiolog\ueda y diagn\uf3stico por im\ue1genes "Dr. Theoscar Sanoja". Hospital Central Universitario \u93Dr. Antonio Mar\ueda Pineda\u94. Barquisimeto, Estado Lara

La patolog\ueda mamaria es un desaf\uedo para la salud p\ufablica, no solo por su frecuencia, sino tambi\ue9n porque a trav\ue9s de la detecci\uf3n temprana se puede hacer el diagn\uf3stico de lesiones benignas y malignas, con lo cual se pudiera reducir en un alto porcentaje la mortalidad. De ah\ued la importancia de conocer las patolog\uedas benignas de la mama y su presentaci\uf3n radiol\uf3gica. La presente investigaci\uf3n tuvo como objetivo dise\uf1ar un Atlas de lesiones benignas de la mama (categor\ueda 2 BI-RADS). Para tal fin se elabor\uf3 una propuesta dirigida a Residentes del Postgrado de Diagn\uf3stico por Im\ue1genes del Hospital Central Universitario "Dr. Antonio Mar\ueda Pineda". El estudio estuvo enmarcado dentro de la modalidad de proyecto factible con apoyo de investigaci\uf3n documental y de campo, estructurado metodol\uf3gicamente en tres fases: una fase diagn\uf3stica en donde se aplicaron dos cuestionarios a la poblaci\uf3n conformada por 30 m\ue9dicos, entre residentes y especialistas del postgrado y se determin\uf3 la necesidad del desarrollo del Atlas; para la fase de factibilidad se determin\uf3 el estudio de mercadeo a trav\ue9s de la demanda y los costos, y el componente Acad\ue9mico-Curricular, a trav\ue9s del contenido del programa de "Patolog\ueda por Im\ue1genes" del Postgrado en Diagn\uf3stico por Im\ue1genes de la Universidad Centro Occidental "Lisandro Alvarado" y a la opini\uf3n de expertos en el \ue1rea; y culmin\uf3 con la tercera fase o dise\uf1o del atlas de lesiones benignas de la mama (categor\ueda 2 BI-RADS). De acuerdo a los resultados obtenidos, en las fases mencionadas, se justifica el desarrollo del atlas de lesiones benignas de la mama, (categor\ueda 2 BI-RADS), conteniendo cap\uedtulos referentes a anatom\ueda normal, radiol\uf3gica y desarrollo, proyecciones radiol\uf3gicas y hallazgos radiogr\ue1ficos de la patolog\ueda benigna en mamas femeninas

The Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support improves HbA1c in poorly controlled type 1 diabetic patients: a 6-month, randomized, open-label, parallel-group, multicenter trial (TeleDiab 1 Study).

International audienceOBJECTIVE: To demonstrate that Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support significantly improves HbA(1c) in poorly controlled type 1 diabetic patients. RESEARCH DESIGN AND METHODS: In a six-month open-label parallel-group, multicenter study, adult patients (n = 180) with type 1 diabetes (>1 year), on a basal-bolus insulin regimen (>6 months), with HbA(1c) ≥ 8%, were randomized to usual quarterly follow-up (G1), home use of a smartphone recommending insulin doses with quarterly visits (G2), or use of the smartphone with short teleconsultations every 2 weeks but no visit until point end (G3). RESULTS: Six-month mean HbA(1c) in G3 (8.41 ± 1.04%) was lower than in G1 (9.10 ± 1.16%; P = 0.0019). G2 displayed intermediate results (8.63 ± 1.07%). The Diabeo system gave a 0.91% (0.60; 1.21) improvement in HbA(1c) over controls and a 0.67% (0.35; 0.99) reduction when used without teleconsultation. There was no difference in the frequency of hypoglycemic episodes or in medical time spent for hospital or telephone consultations. However, patients in G1 and G2 spent nearly 5 h more than G3 patients attending hospital visits. CONCLUSIONS: The Diabeo system gives a substantial improvement to metabolic control in chronic, poorly controlled type 1 diabetic patients without requiring more medical time and at a lower overall cost for the patient than usual care

Continuous intraperitoneal insulin infusion does not increase the risk of organ-specific autoimmune disease in type 1 diabetic patients: results of a multicentric, comparative study.

AIM: The purpose of this national multicenter prospective study by the French EVADIAC group was to investigate the possibility that continuous intraperitoneal insulin infusion using an implanted pump (CIpii) increases the risk of autoimmune disease in type 1 diabetic patients as it increased anti-insulin immunogenicity.METHODS: Prevalence of clinical (Hashimoto's disease, hyperthyroidism, gastric atrophic disease and vitiligo) and subclinical (presence of anti-thyroperoxidase antibodies, anti-intrinsic factor antibodies, abnormal TSH levels) autoimmune diseases was estimated by comparing two groups of patients already treated by either CIpii (n=154) or external pump (CSII) (n=121) for an average of 6 years. Incidence of autoimmune disease was determined by comparing the same measurements one year after inclusion.RESULTS: No significant difference was observed for the total prevalence of clinical and subclinical auto-immune thyroid and gastric di-seases (35.6% and 3.2% respectively in the CIpii group versus 40.4% and 2.6% in the CSII group). No significant difference for the incidence of clinical and subclinical auto-immune diseases was observed: 7.2% and 0% in CIpii and 7.3% and 1.7% in CSII.CONCLUSION: As previously shown AIA (anti-insulin antibodies) levels were higher in CIpii than in CSII (32.9% vs 20.2%, P<0.0001) but no correlation was observed with either clinical or subclinical autoimmune disease. This large-scale study eliminates the possibility that CIpii increases the risk of autoimmune disease

Reduction of clinically important low glucose excursions with a long‐term implantable continuous glucose monitoring ( CGM ) system in adults with type 1 diabetes prone to hypoglycemia. France Adoption randomized clinical trial

International audienceAim: This trial assessed the outcomes on glucose control of the implantable Eversense real-time continuous glucose monitoring (CGM) system compared to self-monitoring of blood glucose or intermittently scanned CGM in patients with type 1 or type 2 diabetes (T1D or T2D).Patients and methods: This was a randomized (2:1), prospective, national, multicenter study. All participants, aged >18, on multiple daily insulin injections or insulin pump had a sensor inserted, activated only in the enabled group. Included patients had T1D or T2D with an HbA1c level >8% (cohort 1) or T1D with a time below range 1.5 hour/day during the previous 28 days (cohort 2). The primary outcomes were the HbA1c change at D180 (cohort 1) or the change in TBR180 ) was observed. In cohort 2, the mean adjusted difference in TBR<54 was -1.6% [-3.1; -0.1], p=0.039 during D90-D120 and remained at -2.6%, [-4.5; -0.6], p=0.011 during D150-D180 (pre-specified secondary outcome). There was no safety issue.Conclusion: This study shows that the Eversense CGM system can significantly decrease TBR<54 in patients with T1D prone to hypoglycemia