Telemedicine, Psychology and Diabetes: Evaluation of results and cost analysis

The Psychosocial Aspects of Diabetes (PSAD) Study Group is an official Study Group of the European Association for the Study of Diabetes (EASD).AIMS: Evidences of benefits of telemedicine in T1DM patients on continuous subcutaneous insulin infusion (CSII) treatment are limited. Aims: 1) to analyse the differences in clinical and psychological variables between subjects with T1DM on CSII treatment who were included in a Telecare (TC) program, and subjects with T1DM on CSII treatment who received Conventional care (CC); 2) Perform a cost analysis of the use of telemedicine in DM1 patients treated with CSII (TC versus CC). METHODS and PARTICIPANTS: Cross-over randomized clinical trial with duration of 18 months. 51 patients signed informed consent. Participants were randomly assigned to receive TC program or CC during 6 months, and after a 3 months wash-out period, patients changed to CC or to TC respectively. TC program included monthly visits using an Internet platform. CC comprised face-to-face visits every three months. Sociodemographic, clinical and psychological data was measured at the beginning and at the end of TC and CC. The direct and indirect costs were also measured. T Student was performed to assess differences between first and last visits in both groups (TC / CC). RESULTS: Patients with telemedicine at the end of treatment, have fewer hyperglycemia / week, less distress and greater adherence. Considering both direct and indirect costs, the cost per treatment (TC / CC) is similar. CONCLUSIONS: Telemedicine has significant implications for clinical and psychological variables and has the same cost (total) than the conventional treatment. Therefore, it can be a useful alternative for treatment of DM1 patients with CSII. However, studies with a larger sample size are needed.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Pruebas diagnósticas in vivo en alergia inmediata a penicilina: estudio piloto

Antecedentes: La alergia a antibióticos notificada con más frecuencia es la penicilina. La falsa etiqueta de "alergia" a la penicilina afecta negativamente la calidad de vida del paciente y la atención médica. Objetivo:  Determinar la frecuencia de alergia a penicilina y amoxicilina mediante pruebas de exposición in vivo, en pacientes con antecedente de reacción inmediata a esta clase de medicamentos. Métodos.  Estudio observacional, transversal, descriptivo y prolectivo en pacientes entre 12 y 60 años con antecedente de reacción inmediata a penicilina y/o amoxicilina. Se realizaron pruebas cutáneas por prick e intradérmicas con bencilpeniciloil polilisina y penicilina G, y prueba de reto oral con amoxicilina.  La frecuencia de positividad y negatividad en estas pruebas fue calculado con un IC del 95%. Los resultados se analizaron en Epi info 7.2.5.0 Resultados.  Se incluyeron 13 pacientes (10 mujeres), con una media de edad  de 39 años (DE 12.14) y diagnóstico predominante de rinitis alérgica (61,5%). En 84,6% de casos la última reacción adversa a medicamentos ocurrió 10 años atrás y en todos se manifestó con urticaria. Sólo en cinco pacientes (38,4%) se corroboró alergia a penicilina y la reacción adversa más frecuente tras las pruebas in vivo fue prurito (23 %). Conclusiones. La historia clínica por sí sola no es suficiente, todos los pacientes con sospecha de alergia a penicilina deben ser evaluados mediante pruebas  de exposición in vivo con los determinantes mayores y menores para corroborar o descartar alergia a esta clase farmacológica

Diagnóstico de alergia inmediata para penicilina: estudio piloto

Objetivos: Confirmar la presencia de alergia a penicilina y amoxicilina mediante pruebas de exposición in vivo, en pacientes que refieren antecedente de reacción inmediata con estos medicamentos. Métodos: Estudio observacional, transversal, descriptivo y prolectivo. Se incluyeron pacientes entre 12 y 60 años con antecedente de reacción inmediata tras administración de penicilina y/o amoxicilina. Se realizaron pruebas cutáneas por prick e intradérmicas con bencilpeniciloil polilisina y penicilina G, así como desafío oral con amoxicilina. Resultados: Se incluyeron 10 pacientes femeninos y 3 masculinos. La edad promedio fue 39 años. En 84,6% de los casos la última reacción adversa a medicamentos ocurrió 10 años atrás y en todos los casos se manifestó con urticaria. Sólo en el 38,4% se corroboró alergia a penicilina. La reacción adversa más frecuente, tras las pruebas de exposición in vivo fue prurito en el 23%. Conclusiones: Los pacientes con sospecha de alergia a penicilina se deben evaluar mediante pruebas de exposición in vivo con los determinantes mayores y menores, para corroborar o descartar reacciones alérgicas y mejorar las condiciones de tratamiento

Endoscopic Intragastric Injection of Botulinum Toxin A in Obese Patients Accelerates Weight Loss after Bariatric Surgery: Follow-Up of a Randomised Controlled Trial (IntraTox Study)

Intragastric injection of botulinum toxin A (BT-A) has been shown to be effective for weight loss up to six months after administration, according to previous studies. Our objective was to determine, in patients on bariatric surgery waiting lists, the effect of BT-A on weight loss in the pre- and postoperative period and to analyse if there are different responses based on Body Mass Index (BMI). Methods: We performed a follow-up analysis of the IntraTox study, which included 46 patients on bariatric surgery waiting lists in a single-centre, randomised, double-blind, placebo-controlled clinical trial. The treatment group received intragastric BT-A, whereas the control group received physiological saline solution. The one-time procedure was performed at the time of diagnostic endoscopy 7–8 months before surgery. Weight loss was evaluated at admission and after 4 and 12 weeks from the bariatric surgery. Our analysis was stratified by BMI at randomisation. Results: weight loss percentage on the day of surgery, with respect to the initial visit, was −4.5 ± 3.9% for the control group vs. −7.6 ± 4.2%, for the treatment group (p = 0.013). Weight loss percentage tended to remain greater in the treatment group one month after the intervention (−12.7 ± 4.7% vs. −15.2 ± 4.6%, p = 0.07) and become similar three months after (−21.6 ± 4.7% vs. −21.6 ± 4.6%). After stratifying by BMI, only patients with BMI over 50 kg/m2 allocated to the treatment group obtained a greater weight loss at the end of the trial, the day of surgery, and one month after, compared with the placebo group (−4.9 ± 4.9%, −10.8 ± 5.3% and −17.1 ± 3.8% vs. −0.1 ± 2.6%, −4.3 ± 3.2% and −12.8 ± 4.1%, respectively (p < 0.05). Conclusions: intragastric injection of BT-A is effective to achieve significant weight loss, especially in extreme obesity. Its use before bariatric surgery enhances perioperative weight loss.Merz Pharma (Frankfurt am Main, Germany) collaborated with a non-restricted grant. The study was co-funded by the Sociedad Andaluza de Endocrinología, Diabetes y Nutrición (SAEDYN) and the Sociedad Andaluza de Nutrición, Clínica y Dietética (SANCYD). This research was supported by the Plataforma Española de Investigación Clínica y Ensayos Clínicos, SCReN (Spanish Clinical Research Network), funded by ISCIII-Subdirección General de Evaluación y Fomento de la Investigación, through the projects PT13/0002/0020 and PT17/0020, integrated in the Plan Estatal de I+D+I 2013-2016 and co-funded by the European Regional Development Fund (ERDF). Partial funding for open access charge: Universidad de Málag

Rich oleocanthal and oleacein extra virgin olive oil and inflammatory and antioxidant status in people with obesity and prediabetes. The APRIL study: A randomised, controlled crossover study

Background: Oleocanthal and oleacein are olive oil phenolic compounds with well known anti inflammatory and anti-oxidant properties. The main evidence, however, is provided by experimental studies. Few human studies have examined the health benefits of olive oils rich in these biophenols. Our aim was to assess the health properties of rich oleocanthal and oleacein extra virgin olive oil (EVOO), compared to those of common olive oil (OO), in people with prediabetes and obesity. Methods: Randomised, double-blind, crossover trial done in people aged 40e65 years with obesity (BMI 30e40 kg/m2 ) and prediabetes (HbA1c 5.7e6.4%). The intervention consisted in substituting for 1 month the oil used for food, both raw and cooked, by EVOO or OO. No changes in diet or physical activity were recommended. The primary outcome was the inflammatory status. Secondary outcomes were the oxidative status, body weight, glucose handling and lipid profile. An ANCOVA model adjusted for age, sex and treatment administration sequence was used for the statistical analysis. Results: A total of 91 patients were enrolled (33 men and 58 women) and finished the trial. A decrease in interferon-g was observed after EVOO treatment, reaching inter-treatment differences (P ¼ 0.041). Total antioxidant status increased and lipid and organic peroxides decreased after EVOO treatment, the changes reaching significance compared to OO treatment (P < 0.05). Decreases in weight, BMI and blood glucose (p < 0.05) were found after treatment with EVOO and not with OO. Conclusions: Treatment with EVOO rich in oleocanthal and oleacein differentially improved oxidative and inflammatory status in people with obesity and prediabetes.Funding for open access charge: Universidad de Málaga/CBU

Caracterización de la red urbana y generación de modelo de proyección de viajes en la ciudad de Estelí, Nicaragua

The study aimed to characterize the urban network, model travel and make projections within the urban area in the city of Estelí, through household surveys and surveys of ups and downs. The urban route belonging to the Rosario was selected because it is the one that runs throughout the city. The following statistical travel model was obtained (number of trips made in one day) depends on age, income and the number of people living in a home, under the formula Y = 1.11 + 0.01 (age) - 5.57 * 10 -5 (income) +0.06 (number of people in the household) with p-value = 0.03. The 2.43 km stretch of road between the NACSA Tobacco Company and Las Segovias supermarket is the one with the highest demand with a value of 222,125 passengers per month. The most visited points are Universidad UNAN Managua FAREM - Estelí, tobacco factories and the San Juan de Dios Hospital, within the 53 existing stops. A proposal for a route change was also made in the principal avenues of the Estelícity, to reduce traffic congestion and a replacement analysis of electric bus units to improve supply, reduce environmental pollution and obtain better benefits; Economically speaking, the project proved convenient because a cost-benefit ratio of 1.35 and a net present value of C $56,951,947.10 was obtained, all with a total investment of C$ 59,427,675.00, recoverable in 1 year, 6 months and 8 days. In general, if the proposed models and solutions are applied, it will be possible to improve the urban transport system of the city of Estelí, increasing the quality of life of the inhabitants.El estudio tuvo como objetivo caracterizar la red urbana, modelar los viajes y realizar proyecciones dentro del casco urbano en la ciudad de Estelí, a través de encuestas al hogar y encuestas de sube y bajar de la ruta. Se seleccionó la ruta urbana perteneciente al barrio el Rosario por ser la que recorre toda la ciudad. &nbsp;Se obtuvo el siguiente modelo estadístico de viaje (número de viajes realizados en un día) depende de la edad, los ingresos y la cantidad de personas que habitan en un domicilio, bajo la fórmula Y=1.11 + 0.01 (edad) - 5.57*10-5 (ingresos) +0.06 (cantidad de personas en el hogar) con p-valor = 0.03. El tramo vial de 2.43 km entre la tabacalera NACSA hasta el Supermercado las Segovias es el que tiene más demanda con un valor 222,125 pasajeros por mes. Los puntos más visitados son Universidad UNAN Managua FAREM - Estelí, fábricas de tabaco y el Hospital San Juan de Dios, dentro de las 53 paradas existentes. También se realizó una propuesta de cambio de ruta en&nbsp; vías principales de la ciudad de Estelí, para disminuir el congestionamiento del tráfico y un análisis de reemplazo por &nbsp;unidades de buses eléctricas para mejorar la oferta, disminuir la contaminación ambiental y obtener mejores beneficios; económicamente hablando el proyecto resultó ser conveniente porque se obtuvo una relación &nbsp;beneficio-costo de 1.35 y un valor presente neto de C$56,951,947.10, todo ello con una inversión total de C$ 59,427,675.00, recuperable en 1 año, 6 meses y 8 días. En general, si se aplican los modelos y soluciones propuestas, será posible mejorar el sistema de transporte urbano de la ciudad de Estelí, incrementando la calidad de vida de los habitantes

Rich oleocanthal and oleacein extra virgin olive oil and inflammatory and antioxidant status in people with obesity and prediabetes. The APRIL study: A randomised, controlled crossover study

10 Páginas.-- 2 Figuras.-- 6 TablasOleocanthal and oleacein are olive oil phenolic compounds with well known anti-inflammatory and anti-oxidant properties. The main evidence, however, is provided by experimental studies. Few human studies have examined the health benefits of olive oils rich in these biophenols. Our aim was to assess the health properties of rich oleocanthal and oleacein extra virgin olive oil (EVOO), compared to those of common olive oil (OO), in people with prediabetes and obesity.his study was funded by Consejeria de Salud y Familias, Junta de Andalucia (PI-0247-2016) and Instituto de Salud Carlos III, Ministerio de Sanidad, Gobierno de España, (PI17/01004). FJBS, GRM and REB belong to the regional “Nicolás Monardes” research program from Consejería de Salud, Junta de Andalucía, Spain (C-0070-2012, C-0060-2012 and C-0030-2016). IRG holds a Río Hortega contract from Instituto de Salud Carlos III (CM20/00225) cofunded by European Social Fund 2014–2020, EU “The ESF invests in your future”. CIBERDEM is an initiative of the Instituto de Salud Carlos III, EU. Funding for Open Access charge: Universidad de Málaga/CBUA.Peer reviewe

Particle-flow reconstruction and global event description with the CMS detector

The CMS apparatus was identified, a few years before the start of the LHC operation at CERN, to feature properties well suited to particle-flow (PF) reconstruction: a highly-segmented tracker, a fine-grained electromagnetic calorimeter, a hermetic hadron calorimeter, a strong magnetic field, and an excellent muon spectrometer. A fully-fledged PF reconstruction algorithm tuned to the CMS detector was therefore developed and has been consistently used in physics analyses for the first time at a hadron collider. For each collision, the comprehensive list of final-state particles identified and reconstructed by the algorithm provides a global event description that leads to unprecedented CMS performance for jet and hadronic tau decay reconstruction, missing transverse momentum determination, and electron and muon identification. This approach also allows particles from pileup interactions to be identified and enables efficient pileup mitigation methods. The data collected by CMS at a centre-of-mass energy of 8 TeV show excellent agreement with the simulation and confirm the superior PF performance at least up to an average of 20 pileup interactions

Pseudorapidity and transverse momentum dependence of flow harmonics in pPb and PbPb collisions

info:eu-repo/semantics/publishe

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis