Type 2 diabetes in children and adolescents: literature review

OBJECTIVE: the objective of this manuscript was to perform a critical review of epidemiology, pathophysiology, diagnosis e treatment of T2DM in youth. SOURCES OF DATA: this review is based on the relevant literature published. The sources available for the authors were integrated with sources identified through Medline database. The key words used for searching were Type 2 Diabetes in the Youth in the last ten years. SUMMARY OF THE FINDINGS: the pathophysiology (altered beta-cell function and insulin resistance) of T2DM in youth is similar to adult's pathophysiology. Familiar Type 2 diabetes history, presence of obesity, acanthosis nigricans, high fasting plasma C-peptide levels and absence of islet-cell auto-antibodies are important clues to diagnostic the T2DM in youth. Five to 25% of these patients can present ketosis at diagnosis. Insulin therapy can be discontinued during the evolution. Compliance to diet and an exercise program essential aspects of the treatment of adolescents. CONCLUSION: as obesity in the young is currently increasing in several developed or developing countries, T2DM in the youth can be consider an emergent problem also in our population.OBJETIVO: análise crítica dos estudos sobre a epidemiologia, fisiopatologia, diagnóstico e tratamento do DM2 no jovem. MÉTODOS: revisão da literatura nos últimos 10 anos, através de pesquisa no banco de dados Medline, utilizando os termos diabetes do tipo 2 no jovem. RESULTADOS: a fisiopatologia do DM2 no jovem é semelhante à do adulto, e compreende tanto a resistência à ação da insulina como uma alteração na função da célula beta-pancreática. O antecedente familiar para DM2, a presença de obesidade, a acanthosis nigricans, o peptídeo C de jejum superior a 0,6 ng/ml, a ausência de auto-anticorpos antiilhotas pancreáticas, em combinações variáveis, são pontos importantes para o diagnóstico desse tipo de DM. Cinco a 25% dos jovens com esse tipo de DM podem apresentar cetoacidose no diagnóstico. Nesses pacientes, o tratamento inicial com insulina é possível de ser descontinuado durante a evolução. A aderência à dieta e ao exercício físico são os elementos mais importantes do tratamento destes adolescentes. CONCLUSÃO: como a obesidade nos jovens tem aumentado, tanto em países industrializados como nos países em industrialização, o DM2 no jovem pode ser considerado um problema emergente também na nossa população.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Centro de DiabetesUNIFESP, EPM, Centro de DiabetesSciEL

Supplement: "Localization and broadband follow-up of the gravitational-wave transient GW150914" (2016, ApJL, 826, L13)

This Supplement provides supporting material for Abbott et al. (2016a). We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. We compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Fattori predittivi di colite ulcerosa severa in una coorte italiana

ABSTRACT BACKGROUND La colite acuta severa (ASC) presenta dei criteri diagnostici ben definiti (4,111) che permettono di seguirne l’evoluzione ed aiutano nella gestione dei pazienti. Ancora nel 2019 rimane una condizione potenzialmente mortale: in uno studio retrospettivo inglese, la mortalità complessiva di 2981 pazienti ricoverati con colite severa era dell’ 1.2%, dell’ 1.9% in pazienti di età compresa tra 50-59 anni, 3.5% tra 60-69 anni e oltre il 10% in pazienti con età superiore agli 80 anni. Inoltre , 93/750 (12%) pazienti con colite ulcerosa (UC) diagnosticati e seguiti nel follow-up presso l’università di Oxford, hanno fatto ricorso alla colectomia proprio per colite severa non responsiva a trattamenti medici, facendo di questa condizione la principale causa di colectomia (20). SCOPO DELLO STUDIO Lo scopo del presente studio è stato quello di validare un indice prognostico di rischio di sviluppo di un episodio di colite severa entro tre anni dalla diagnosi in una coorte italiana per la prima volta. METODI Disegno dello studio e pazienti: Il nostro è stato uno studio retrospettivo, caso-controllo, che ha incluso pazienti con colite ulcerosa diagnosticati a Roma, presso l’Università “Sapienza” tra il settembre del 2007 e il Settembre del 2010. RISULTATI Demografica dei pazienti 243 pazienti sono stati inclusi nello studio (median follow-up 46m, range 36-60). Su 243 pazienti inclusi nello studio, 88/243 (36%) sono stati ricoverati almeno una volta entro i tre anni dalla diagnosi con colite severa, mentre 155/243 (64%) non sono mai stati ricoverati. Alla regressione multivariata l’estensione di malattia, i livelli di PCR ed Hb e l’apparenza endoscopica risultavano tutti fattori di rischio significativamente diversi tra i due gruppi alla diagnosi di malattia. In particolare la pancolite e l’apparenza endoscopica severa risultavano piu frequenti alla diagnosi e la PCR e l’Hb si presentavano rispettivamente piu alta e piu bassa alla diagnosi nei pazienti che avrebbero sviluppato colite severa entro 3 anni. Il passo successivo, dal momento che le la variabile “apparenza endoscopica” anche se significativa è stata ottenuta senza l’utilizzo di uno score validato e standardizzato, e quindi riproducibile, è stato quello di escludere questa voce dall’analisi finale. Un modello predittivo semplificato è stato quindi individuato basato su 3 componenti: estensione della malattia, PCR, Hb alla diagnosi di colite ulcerosa