Evaluación de un programa de Atención Farmacéutica en pacientes con Diabetes Mellitus Tipo 2

Introducción: La Atención Farmacéutica es la provisión responsable de la farmacoterapia con el propósito de alcanzar resultados concretos que mejoren la calidad de vida de los pacientes. Objetivo: Evaluar el impacto de las intervenciones farmacéuticas en pacientes con Diabetes Mellitus Tipo 2.  Metodología: Ensayo Clínico Aleatorizado, con medición de variables antes y después. No probabilístico. De conveniencia. Participaron  30  pacientes del grupo  intervenido y 31 en grupo control. Se realizaron entrevistas mensuales en un periodo de intervención farmacéutica de 6 meses (desde octubre 2011 hasta junio 2012). Resultados: La edad de los pacientes fue 55,6±10,6 años. Los pacientes del grupo intervenido mejoraron la glicemia en 34% donde 24 pacientes tenían el valor (≤ 130 mg/dL); la hemoglobina glicosilada mejoró 1,9% donde 15 pacientes lograron los parámetros deseados (≤ 6,5%). La calidad de vida del grupo intervenido fue de (56,3 a 71,3 %) y en el grupo control disminuyó de (57,4 a 46,1 %). En el grupo intervenido se encontraron 80 PRM, en 27 pacientes, se resolvieron 59; al final del estudio 12 pacientes resolvieron todos los PRM; se realizaron 254 intervenciones farmacéuticas, el nivel de conocimiento de los pacientes sobre la enfermedad mejoro en  41%, y el conocimiento sobre sus medicamentos mejoro en  53%.      Conclusión: Se comprobó que las intervenciones farmacéuticas mejoraron la calidad de vida, los parámetros clínicos de glicemia, hemoglobina glicosilada, optimizaron el uso de medicamentos, disminuyeron los PRM, mejoraron la satisfacción de los pacientes

Evaluación de un programa de Atención Farmacéutica en pacientes con Diabetes Mellitus Tipo 2

Introducción: La Atención Farmacéutica es la provisión responsable de la farmacoterapia con el propósito de alcanzar resultados concretos que mejoren la calidad de vida de los pacientes. Objetivo: Evaluar el impacto de las intervenciones farmacéuticas en pacientes con Diabetes Mellitus Tipo 2.  Metodología: Ensayo Clínico Aleatorizado, con medición de variables antes y después. No probabilístico. De conveniencia. Participaron  30  pacientes del grupo  intervenido y 31 en grupo control. Se realizaron entrevistas mensuales en un periodo de intervención farmacéutica de 6 meses (desde octubre 2011 hasta junio 2012). Resultados: La edad de los pacientes fue 55,6±10,6 años. Los pacientes del grupo intervenido mejoraron la glicemia en 34% donde 24 pacientes tenían el valor (≤ 130 mg/dL); la hemoglobina glicosilada mejoró 1,9% donde 15 pacientes lograron los parámetros deseados (≤ 6,5%). La calidad de vida del grupo intervenido fue de (56,3 a 71,3 %) y en el grupo control disminuyó de (57,4 a 46,1 %). En el grupo intervenido se encontraron 80 PRM, en 27 pacientes, se resolvieron 59; al final del estudio 12 pacientes resolvieron todos los PRM; se realizaron 254 intervenciones farmacéuticas, el nivel de conocimiento de los pacientes sobre la enfermedad mejoro en  41%, y el conocimiento sobre sus medicamentos mejoro en  53%.      Conclusión: Se comprobó que las intervenciones farmacéuticas mejoraron la calidad de vida, los parámetros clínicos de glicemia, hemoglobina glicosilada, optimizaron el uso de medicamentos, disminuyeron los PRM, mejoraron la satisfacción de los pacientes

Self-labeling techniques for semi-supervised time series classification: an empirical study

An increasing amount of unlabeled time series data available render the semi-supervised paradigm a suitable approach to tackle classification problems with a reduced quantity of labeled data. Self-labeled techniques stand out from semi-supervised classification methods due to their simplicity and the lack of strong assumptions about the distribution of the labeled and unlabeled data. This paper addresses the relevance of these techniques in the time series classification context by means of an empirical study that compares successful self-labeled methods in conjunction with various learning schemes and dissimilarity measures. Our experiments involve 35 time series datasets with different ratios of labeled data, aiming to measure the transductive and inductive classification capabilities of the self-labeled methods studied. The results show that the nearest-neighbor rule is a robust choice for the base classifier. In addition, the amending and multi-classifier self-labeled-based approaches reveal a promising attempt to perform semi-supervised classification in the time series context

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

MUC1 Contributes to BPDE-Induced Human Bronchial Epithelial Cell Transformation through Facilitating EGFR Activation

Although it is well known that epidermal growth factor receptor (EGFR) is involved in lung cancer progression, whether EGFR contributes to lung epithelial cell transformation is less clear. Mucin 1 (MUC1 in human and Muc1 in animals), a glycoprotein component of airway mucus, is overexpressed in lung tumors; however, its role and underlying mechanisms in early stage lung carcinogenesis is still elusive. This study provides strong evidence demonstrating that EGFR and MUC1 are involved in bronchial epithelial cell transformation. Knockdown of MUC1 expression significantly reduced transformation of immortalized human bronchial epithelial cells induced by benzo[a]pyrene diol epoxide (BPDE), the active form of the cigarette smoke (CS) carcinogen benzo(a)pyrene (BaP)s. BPDE exposure robustly activated a pathway consisting of EGFR, Akt and ERK, and blocking this pathway significantly increased BPDE-induced cell death and inhibited cell transformation. Suppression of MUC1 expression resulted in EGFR destabilization and inhibition of the BPDE-induced activation of Akt and ERK and increase of cytotoxicity. These results strongly suggest an important role for EGFR in BPDE-induced transformation, and substantiate that MUC1 is involved in lung cancer development, at least partly through mediating carcinogen-induced activation of the EGFR-mediated cell survival pathway that facilitates cell transformation

HIV-1 assembly in macrophages

The molecular mechanisms involved in the assembly of newly synthesized Human Immunodeficiency Virus (HIV) particles are poorly understood. Most of the work on HIV-1 assembly has been performed in T cells in which viral particle budding and assembly take place at the plasma membrane. In contrast, few studies have been performed on macrophages, the other major target of HIV-1. Infected macrophages represent a viral reservoir and probably play a key role in HIV-1 physiopathology. Indeed macrophages retain infectious particles for long periods of time, keeping them protected from anti-viral immune response or drug treatments. Here, we present an overview of what is known about HIV-1 assembly in macrophages as compared to T lymphocytes or cell lines

Deciphering the sophomore slump: changes to student perceptions during the undergraduate journey

The second year of university is little-researched, despite being a focal point for declining performance, persistence, and satisfaction. It is important to establish appropriate methods for studying this ‘sophomore slump’ and to pinpoint specific antecedents from broad domains noted in literature (e.g. students’ social integration, perceptions of the curriculum). Using a novel methodology, 166 undergraduates were surveyed in successive years of study to derive a gold standard ‘within-subjects’ data sample. Under a replicated design, a ‘between-subjects’ sample of over 1000 students completed the same e-survey just once, in year one, two, or three. Quantitative comparison of the responses across years showed over 85% agreement between samples. This endorses between-subject approaches (i.e. simultaneously surveying students from different years) to facilitate rapid interventions that benefit students before they graduate. In terms of detailed findings, year two saw positive trends in students’ academic engagement (e.g. self-reported independent study time), social integration (e.g. feeling accepted, involvement in extra-curricular activities), and views on teaching staff (e.g. approachability). Although appraisals remained broadly favourable, there was, in contrast, significant deterioration in global perceptions of the learning atmosphere (e.g. course enjoyment), as well as specific elements of the teaching provision (e.g. contact hours, feedback). Notably, there appeared to be little progression in students’ academic self-perceptions (e.g. confidence to make presentations, enter class debates). Year two also saw increased thoughts of drop-out. These results highlight the unique character of the second year at university and indicate potential target areas for enhancing this phase of the undergraduate journey