Calidad de vida en pacientes trasplantados renales de una institución prestadora de servicios de salud en Medellín, Colombia

Introduction: Renal transplantation performed on patients with chronic renal disease (CRD) stage five, is an alternative treatment that prolongs survival, reduces morbidity, accelerate social and medical rehabilitation. However it is necessary to carry out studies to evaluate the quality of life of these patients. Objective: Establishing the socio-demographic, clinical and service characteristics of the health insurer that explain the life quality of kidney transplanted patients who consulted a health institution in Medellin in 2016. Materials and methods: Quantitative and transversal survey carried out in 228 patients to whom the SF-36 instrument were applied. There were calculated the statistical tests of Kolmogorov Smirnov for normality, U de Mann Whitney, Kruskal Wallis and the Spearman correlation coefficient. In the multivariate analysis the median regression model was selected. Results: 50% of the patients got 83.3 or less in its life quality score. The multivariate regression model shown significant differences in the time variables after transplantation and readmission to hospital in the last year; by each readmission to hospital, the values of life quality decreased in 3.82 points; according to the time after the transplantation, it was found that going from a state where the patient has a term between 7 and 36 months, to a state where the patient has a term over 36 months, shown a decrease of 12.03 points in life quality, adjusted by the other variables. Conclusions: The variables that best explained the life quality of the kidney transplanted patients who consulted a health institution were the time of transplantation and the number of readmissions to hospital

Applying acceptance requirements to requirements modeling tools via gamification: a case study on privacy and security.

Requirements elicitation, analysis and modeling are critical activities for software success. However, software systems are increasingly complex, harder to develop due to an ever-growing number of requirements from numerous and heterogeneous stakeholders, concerning dozens of requirements types, from functional to qualitative, including adaptation, security and privacy, ethical, acceptance and more. In such settings, requirements engineers need support concerning such increasingly complex activities, and Requirements Engineering (RE) modeling tools have been developed for this. However, such tools, although effective, are complex, time-consuming and requiring steep learning curves. The consequent lack of acceptance and abandonment in using such tools, by engineers, paves the way to the application of RE techniques in a more error-prone, low-quality way, increasing the possibility to have failures in software systems delivered. In this paper, we identify main areas of lack of acceptance, affecting RE engineers, for such tools, and propose an approach for making modeling tools more effective in engaging the engineer in performing RE in a tool-based way, receiving adequate feedback and staying motivated to use modeling tools. This is accomplished by performing acceptance requirements analysis (through the Agon Framework) and using gamification to increase the engagement of engineers during the usage of RE modeling tools. Towards this end, we performed a case study, within the VisiOn European Project, for enhancing a tool for modeling privacy and security requirements. Our case study provides preliminary evidence that our approach supports in making RE modeling tools more engaging from the engineer perspective

Bioanthropological analysis of Békés 103 (Jégvermi-kert, Lipcsei-tanya), a Bronze Age cemetery from southeastern Hungary

The analysis of human skeletal remains is an important tool for reconstructing aspects of health, diet, disease, and population structure (such as demographics, life expectancy, and mortality) in past populations. This study presents the recovery techniques and initial bioanthropological analysis of cremation and inhumation burials from the archaeological site of Békés 103, a Bronze Age cemetery located in southeastern Hungary. In all possible cases, analysts microexcavated cremation urns in a laboratory setting to ensure recovery of all fragmentary skeletal material and allow detailed spatial documentation of each burial’s contents. This report presents estimated age and sex information for each individual, provides a preliminary assessment of observable trends in the population, and offers a paleodemographic profile of the cemetery for comparison with contemporary prehistoric communities in Hungary

Age at natural menopause in three Central and Eastern European urban populations: The HAPIEE study

Objectives: To investigate the age at menopause in three urban populations in Central and Eastern Europe and to assess whether the (suspected) differences can be explained by a range of socioeconomic, reproductive and behavioural factors. Methods: The Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) Study examined random samples of populations aged 45-69 years in Novosibirsk (Russia), Krakow (Poland) and six Czech towns. Participants completed a questionnaire and attended an examination in clinic. A total of 12,676 of women were included in these analyses. Results: The median age at menopause was 50 years in Novosibirsk, 51 years in Czech towns and 52 years in Krakow; the Cox regression hazard ratios of menopause, compared with Krakow, were 1.47 (95% CI 1.40-1.55) for Novosibirsk and 1.10 (1.04-1.16) for Czech women. In multivariate analyses, higher education, using vitamin and mineral supplements and ever use of oral contraceptives were associated with later menopause, while smoking, abstaining from alcohol and low physical activity were associated with earlier menopause. These factors, however, did not explain the differences between populations; the multivariate hazard ratios of menopause, compared with Krakow, were 1.48 (1.40-1.57) for Novosibirsk and 1.11 (1.05-1.17) for Czech women. Conclusions: In this large population based study, differences in age at menopause between Central and Eastern Europe populations were substantial and unexplained by a range of risk factors. Associations of age at menopause with risk factors were largely consistent with studies in other populations. © 2013 Elsevier Ireland Ltd

From Secure Business Process Models to Secure Artifact-Centric Specifications

Making today's systems secure is an extremely difficult and challenging problem. Socio and technical issues interplay and contribute in creating vulnerabilities that cannot be easily prevented without a comprehensive engineering method. This paper presents a novel approach to support process-aware secure systems modeling and automated generation of secure artifact-centric implementations. It combines social and technical perspectives in developing secure complex systems. This work is the result of an academic and industrial collaboration, where SecBPMN2, a research prototype, has been integrated with SAP River, an industrial artifact-centric language

Clinical and genetic characteristics in patients under 30 years with sporadic pituitary adenomas

[Objective] Pituitary adenomas (PA) are rare in young patients, and additional studies are needed to fully understand their pathogenesis in this population. We describe the clinical and genetic characteristics of apparently sporadic PA in a cohort of young patients.[Design] Clinical and molecular analysis of 235 patients (age ≤ 30 years) with PA. Clinicians from several Spanish and Chilean hospitals provided data.[Methods] Genetic screening was performed via next-generation sequencing and comparative genomic hybridization array. Clinical variables were compared among paediatric, adolescent (<19 years) and young adults’ (≥19–30 years) cohorts and types of adenomas. Phenotype–genotype associations were examined.[Results] Among the total cohort, mean age was 17.3 years. Local mass effect symptoms were present in 22.0%, and prolactinomas were the most frequent (44.7%). Disease-causing germline variants were identified in 22 individuals (9.3%), more exactly in 13.1 and 4.7% of the populations aged between 0–19 and 19–30 years, respectively; genetically positive patients were younger at diagnosis and had larger tumour size. Healthy family carriers were also identified.[Conclusions] Variants in genes associated with syndromic forms of PAs were detected in a large cohort of apparently sporadic pituitary tumours. We have identified novel variants in well-known genes and set the possibility of incomplete disease penetrance in carriers of MEN1 alterations or a limited clinical expression of the syndrome. Despite the low penetrance observed, screening of AIP and MEN1 variants in young patients and relatives is of clinical value.Peer reviewe

Platform for Modeling and Simulation of Photovoltaic Generation Systems

Se presenta el desarrollo de una plataforma de modelado y simulación usando Matlab. La plataforma tiene cuatro modelos de paneles fotovoltaicos predeterminados. Identifica los parámetros de cada uno, para un panel fotovoltaico dado, con base en datos experimentales de voltaje, corriente y condiciones ambientales. También genera cuatro bloques de simulación en Matlab-Simulink y Psim que modelan el panel seleccionado. Para la validación de la plataforma se utilizaron los paneles disponibles en el Instituto Tecnológico Metropolitano (ITM).A platform for modeling and simulation using Matlab is presented. The platform has four models of photovoltaic panels. It identifies the parameters of each one, for a given solar panel, based on experimental data of voltage, current and environmental conditions. Also the platform generates four blocks, for using in Matlab-Simulink and Psim simulation tools. The experimental validation of the platform was made using the PV panels of the Metropolitan Technological Institute (ITM) Lab

Craniopharyngioma in the elderly: a multicenter and nationwide study in Spain

[Abstract] Background: Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population. Aim: To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly. Patients and Methods: This was a retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated. Results: From a total of 384 adult CP patients, we selected 53 (13.8%) patients (27 women [50.9%], mean age 72.3 ± 5.1 years [range 65–83 years]) diagnosed after the age of 65 years. The most common clinical symptoms were visual field defects (71.2%) followed by headache (45.3%). The maximum tumor diameter was 2.9 ± 1.1 cm. In most patients, the tumor was suprasellar (96.2%) and mixed (solid-cystic) (58.5%). The surgical approach most commonly used was transcranial surgery (52.8%), and more than half of the patients (54.7%) underwent subtotal resection (STR). Adamantinomatous CP and papillary CP were present in 51 and 45.1%, respectively, with mixed forms in the remaining. Surgery was accompanied by an improvement in visual field defects and in headaches; however, pituitary hormonal hypofunction increased, mainly at the expense of an increase in the prevalence of diabetes insipidus (DI) (from 3.9 to 69.2%). Near-total resection (NTR) was associated with a higher prevalence of DI compared with subtotal resection (87.5 vs. 53.6%, p = 0.008). Patients were followed for 46.7 ± 40.8 months. The mortality rate was 39.6% with a median survival time of 88 (95% CI: 57–118) months. DI at last visit was associated with a lower survival. Conclusion: CP diagnosed in the elderly shows a similar distribution by sex and histologic forms than that diagnosed at younger ages. At presentation, visual field alterations and headaches are the main clinical symptoms which improve substantially with surgery. However, surgery, mainly NTR, is accompanied by worsening of pituitary function, especially DI, which seems to be a predictor of mortality in this population

Factors associated with therapeutic response in acromegaly diagnosed in the elderly in Spain

ContextSome reports suggest that acromegaly in elderly patients has a more benign clinical behavior and could have a better response to first-generation long-acting somatostatin receptor ligands (SRL). However, there is no specific therapeutic protocol for this special subgroup of patients. ObjectiveThis study aimed at identifying predictors of response to SRL in elderly patients. DesignMulticentric retrospective nationwide study of patients diagnosed with acromegaly at or over the age of 65 years. ResultsOne-hundred and eighteen patients (34 men, 84 women, mean age at diagnosis 71.7 +/- 5.4 years old) were included. Basal insulin-like growth factor type 1 (IGF-1) above the upper limit of normal (ULN) and growth hormone (GH) levels (mean +/- SD) were 2.7 +/- 1.4 and 11.0 +/- 11.9 ng/ml, respectively. The mean maximal tumor diameter was 12.3 +/- 6.4 mm, and up to 68.6% were macroadenoma. Seventy-two out of 118 patients (61.0%) underwent surgery as primary treatment. One-third of patients required first-line medical treatment due to a rejection of surgical treatment or non-suitability because of high surgical risk. After first-line surgery, 45/72 (63.9%) were in disease remission, and 16/34 (46.7%) of those treated with SRL had controlled disease. Patients with basal GH at diagnosis <= 6 ng/ml had lower IGF-1 levels and had smaller tumors, and more patients in this group reached control with SRL (72.7% vs. 33.3%; p < 0.04) [OR: 21.3, IC: 95% (2.4-91.1)], while male patients had a worse response [OR: 0.09, IC 95% (0.01-0.75)]. The predictive model curve obtained for SRL response showed an AUC of 0.82 CI (0.71-0.94). ConclusionsThe most frequent phenotype in newly diagnosed acromegaly in the elderly includes small adenomas and moderately high IGF-1 levels. GH at diagnosis <= 6 ng/ml and female gender, but not age per se, were associated with a greater chance of response to SRL