TYPE II DIABETES MELLITUS AND MANAGEMENT OF ISOLATED HYPERGLYCEMIA: A REVIEW

Type II Diabetes mellitus (T2DM) is the most common of two types of Diabetes disease. T2DM is a metabolic disease characterized mainly by insulin resistance, reduction of insulin secretion, and hyperglycemia. T2DM is a major public health cause of concern not only by the increase in morbidity and mortality associated with patients with the disease, but also by the significant reduction in quality of life and productivity among the economically active population. Isolated hyperglycemia refers to patients with T2DM with normal fasting plasma glucose and no ketoacidosis. With the rise of T2DM and the presence of hidden symptoms, it is vital to determine a diagnostic sequence, blood-glucose control with sulfonylureas or insulin, and diet and exercise

LUMBAR DISK HERNIATION: EVALUATION OF MEDICAL CARE AND PAIN MANAGEMENT AT THE SPECIALTIES HOSPITAL CREHVITAL AMBATO-ECUADOR: RETROSPECTIVE, CROSS-SECTIONAL STUDY, AND ASSESSMENT OF TWO CLINICAL CASES

Objectives: The objective of the study was to assess medical care and pain management of 237 lumbar disk herniation cases treated from 2011 to 2021 in the Specialties Hospital CREHVITAL, Ambato-Ecuador, and to provide a set of standards for appropriate management. Methods: Retrospective, cross-sectional analysis of archives, and registries of patient’s data provided by the Specialties Hospital CREHVITAL, Ambato-Ecuador. Participants: A total of 237 patients with lumbar disk herniation received medical services from 2011 to 2021; outcome measures were: Pain management, patient characteristics, surgical procedures, and medication after surgery. Results: The 40–50 age range had the highest prevalence of lumbar disk herniation and a higher percentage of the pathology in men (66%) than in women. Of the 237 patients, magnetic resonance imaging (MRI) showed the highest lumbar disk herniation of the L4–L5 (101 men and 20 women), followed by herniation of the L5–S1 (59 men and 51 women). Two types of surgeries were performed: Classical surgery on 157 patients and microsurgery on 80 patients. The average period before receiving treatment was 1.5 years of maintaining back pain, and the early post-operative management consisted of patients receiving diclofenac, ketorolac, and ceftriaxone. Analgesics were used in 73.43% of patients. All cases required strict control, follow-up, and post-operative check-ups. Conclusion: This study provides essential and conclusive evidence and information on treated cases of lumbar disk herniation and its incidence in the medical field

Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia

BackgroundA heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC).MethodsA population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff’s spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained.ResultsA total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed.ConclusionsThe identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL

The Caldera. No. 26

“La PALABRA tiene PODER”, más allá del lema que nos convocó en la décima versión del Concurso Inter colegiado de Oratoria, que en el marco de ULIBRO 2023, se llevó a cabo en NEOMUNDO, el 1 de septiembre pasado, esta frase es una profunda convicción que ha movido al Área de Lengua Castellana del Instituto Caldas, a propiciar y mantener este espacio en el que nuestros estudiantes son los protagonistas. Este año, al tratarse de una celebración especial, quisimos que el tema fundamental fuera el inmenso PODER que tiene la PALABRA; la palabra que construye, que transforma, que edifica, que fortalece, que acompaña, que “abriga”, a diario, al ser humano; en un mundo en el que se debe volver a entender y vivenciar, en el hogar, en la escuela, en la sociedad, el poder transformador de vocablos tan importantes como lo son: “Familia, Educación, Vida, Diversidad, Respeto, Literatura, Escritura, Creatividad, Lectura, Inclusión, Paz, Igualdad Social, Democracia, Ciudadanía y Diálogo”, la palabra cobró fuerza en las voces de nuestros educandos; de esta manera, analizar estos temas tiene que ver necesariamente con los “Futuros posibles”, que planteó la Gran Feria del Libro, ULIBRO, en su vigésima primera versión, para que sigamos trabajando por una sociedad mejor, razón de ser de todas las instituciones educativas del mundo entero.“The WORD has POWER”, beyond the motto that summoned us in the tenth version of the Intercollegiate Oratory Contest, which within the framework of ULIBRO 2023, was held in NEOMUNDO, last September 1, this phrase is a deep conviction that has moved the Spanish Language Area of ​​the Caldas Institute to promote and maintain this space in which our students are the protagonists. This year, as it is a special celebration, we wanted the fundamental theme to be the immense POWER that the WORD has; the word that builds, that transforms, that edifies, that strengthens, that accompanies, that “shelters”, daily, the human being; in a world in which we must understand and experience again, at home, at school, in society, the transformative power of words as important as: “Family, Education, Life, Diversity, Respect, Literature, Writing, Creativity, Reading, Inclusion, Peace, Social Equality, Democracy, Citizenship and Dialogue”, the word gained strength in the voices of our students; In this way, analyzing these issues necessarily has to do with the “Possible Futures”, which the Great Book Fair, ULIBRO, proposed in its twenty-first version, so that we continue working for a better society, the reason for being of all institutions. . educational institutions around the world.Modalidad Presencia

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Actas del V Congreso ISUF-H Costa Rica 2021: Ciudades espontáneas versus ciudades planificadas: distintos retos, distintas realidades

En el año 2021 celebramos en Costa Rica la V edición del Congreso ISUF-H, los días 1, 2 y 3 de diciembre, con la Escuela de Arquitectura de la Universidad de Costa Rica como anfitriona del evento. El congreso “Ciudades espontáneas versus ciudades planificadas: distintos retos, distintas realidades” propuso como eje central una reflexión crítica sobre los procesos de urbanización planificada y urbanización espontánea, en el cual se fomente un abordaje de las ciudades como expresión de organización social, económica, ambiental y cultural, enfatizando el carácter ideológico de la urbanización y subrayando su continua construcción como resultado de construcciones complejas. La celebración de un nuevo congreso en América Latina, permitió reforzar la tradición crítica en el abordaje de las ciudades, y reforzar también la necesidad de plantear una perspectiva latinoamericana de los estudios urbanos, y por consiguiente de una teoría urbana latinoamericana. En esta ocasión el congreso se centró en ahondar en la temática de la forma urbana, desde perspectivas transversales que involucren las amplias disciplinas que asumen como objeto de discusión las problemáticas de la ciudad contemporánea y cuestionan la dicotomía planteada entre lo espontáneo y lo planificado. Para la Escuela de Arquitectura de la Universidad de Costa Rica y su Laboratorio de Ciudad y Territorio es un honor haber podido llevar a cabo esta nueva edición del congreso de la Asociación ISUF-H como segunda sede en un país latinoamericano. Relevante para fortalecer la temática de la forma urbana en la región, reforzando alianzas y estableciendo nuevas redes que permitan compartir conocimientos a partir de las experiencias de esas diversidades urbanas. Auspiciar el debate en torno a la morfología urbana y las diferencias entre esas ciudades espontáneas y las planificadas, fue una oportunidad para reunir a expertos de las distintas latitudes hispánicas.UCR::Vicerrectoría de Docencia::Ingeniería::Facultad de Ingeniería::Escuela de Arquitectur

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| &lt; 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of b jet shapes in proton-proton collisions at root s=5.02 TeV

We present the first study of charged-hadron production associated with jets originating from b quarks in proton-proton collisions at a center-of-mass energy of 5.02 TeV. The data sample used in this study was collected with the CMS detector at the CERN LHC and corresponds to an integrated luminosity of 27.4 pb(-1). To characterize the jet substructure, the differential jet shapes, defined as the normalized transverse momentum distribution of charged hadrons as a function of angular distance from the jet axis, are measured for b jets. In addition to the jet shapes, the per-jet yields of charged particles associated with b jets are also quantified, again as a function of the angular distance with respect to the jet axis. Extracted jet shape and particle yield distributions for b jets are compared with results for inclusive jets, as well as with the predictions from the pythia and herwig++ event generators.Peer reviewe