Validation of Continuous Glucose Monitoring in Children and Adolescents With Cystic Fibrosis: A prospective cohort study

OBJECTIVE: To validate continuous glucose monitoring (CGM) in children and adolescents with cystic fibrosis. RESEARCH DESIGN AND METHODS: Paired oral glucose tolerance tests (OGTTs) and CGM monitoring was undertaken in 102 children and adolescents with cystic fibrosis (age 9.5-19.0 years) at baseline (CGM1) and after 12 months (CGM2). CGM validity was assessed by reliability, reproducibility, and repeatability. RESULTS: CGM was reliable with a Bland-Altman agreement between CGM and OGTT of 0.81 mmol/l (95% CI for bias +/- 2.90 mmol/l) and good correlation between the two (r = 0.74-0.9; P < 0.01). CGM was reproducible with no significant differences in the coefficient of variation of the CGM assessment between visits and repeatable with a mean difference between CGM1 and CGM2 of 0.09 mmol/l (95% CI for difference +/- 0.46 mmol/l) and a discriminant ratio of 13.0 and 15.1, respectively. CONCLUSIONS: In this cohort of children and adolescents with cystic fibrosis, CGM performed on two occasions over a 12-month period was reliable, reproducible, and repeatable

Insulin versus oral agents in the management of Cystic Fibrosis Related Diabetes: a case based study

BACKGROUND: Insulin is the recommend therapeutic agent of choice for the management of Cystic Fibrosis Related Diabetes (CFRD), despite only sub-optimal reductions in glycemic control and increased morbidity and mortality reported by centers using this agent. The newer insulin sensitizing agents demonstrated to have anti-inflammatory mechanisms may provide an alternative management option for CFRD. METHODS: A prospective case based therapeutic comparison between insulin, sulfonylurea, metformin and thiazolidinedione was observed over one decade with 20 CFRD patients diagnosed using American Diabetes Association guideline standards. Patients entering the study elected treatment based on risk and benefit information provided for treatment options. Patients receiving organ transplant or requiring combination diabetic medications were excluded from the study. RESULTS: No statistical advantage was achieved regarding overall glycemic control for oral agents over insulin. Additional outcome measures including changes in weight, liver function testing and FEV(1 )were not statistically significant. CONCLUSION: Insulin alone may not be the only therapeutic option in managing CFRD. Oral hypoglycemic agents were equally effective in treating CFRD and may provide an alternative class of agents for patients reluctant in using insulin

Older peoples’ preferences and challenges when using digital technology: a systematic review with particular reference to digital games

Digital games offer an increasingly important way for older people to access new knowledge and skills particularly in terms of improving health and well-being. Currently there is limited research exploring how older people interact with digital games, and this review of the literature contributes insights into the preferences and limitations that older users encounter when using digital technology. Although older users of technology do not present as a homogeneous group due to differences linked to experience, specific older age cohort, dexterity and sensory loss, several key considerations are identified. Key factors include those linked to usability, learnability, efficiency, and satisfaction for the user and the article concludes with a suggestion that bespoke tools should be developed in an inclusive way with older peoples’ needs and experiences as a central consideration

Genetic Determinants and Epidemiology of Cystic Fibrosis–Related Diabetes: Results from a British cohort of children and adults

OBJECTIVE—Longer survival of patients with cystic fibrosis has increased the occurrence of cystic fibrosis–related diabetes (CFRD). In this study we documented the incidence of CFRD and evaluated the association between mutations responsible for cystic fibrosis and incident CFRD, while identifying potential risk factors

Efectos y beneficios del entrenamiento de fuerza en pacientes con cáncer: revisión sistemática de la literatura

Introduction: cancer is among the diseases having the greatest mortality rates and the cause of many disabilities worldwide. The practice of exercise is developed as an adjuvant therapy along with the cancer treatment to reduce mortality and disability in the different types of cancer.Objective: to identify the effects of strength training on cancer patients.Methods: a complete review of the medical literature was conducted until December 2018, scientific articles published in indexed bases from 2015 to 2018. The studies included were in population over 18 years old with cancer diagnosis regardless of sociodemographic characteristics, type or stage of cancer. The data extracted were on the population, intervention and control groups, type of cancer, period, frequency of intervention and results.Results: during the first search 36071 titles of clinical study were found in specialized journals. 10 experimental studies were chosen. Multiple positive effects were found, as well as components that should be taken into account when performing strength training on cancer patients or cancer survivors.Conclusions: strength training in patients with cancer or survivors of this disease, helps them to improve their symptoms as well as their quality of life, strength, improved mobility and pain, among others. Also, strength training is beneficial to patients without causing adverse effects or long-term complications.Introducción: El cáncer se encuentra entre las enfermedades con mayor mortalidad y causante de un gran número de discapacidades a nivel mundial. El ejercicio surge como un coadyuvante del tratamiento oncológico para disminuir la mortalidad y discapacidad en los diferentes tipos de cáncer.Objetivo: Identificar los efectos del entrenamiento de fuerza en pacientes con cáncer.Método:  Se realizó una revisión de la literatura hasta diciembre del 2018, de artículos científicos publicados en bases de indexadas desde 2015 y hasta 2018. Los estudios incluidos fueron en población mayor a 18 años con diagnóstico de cáncer sin importar características sociodemográficas, tipo o estadio del cáncer. Los datos extraídos fueron sobre la población, grupos de intervención y control, tipo de cáncer, periodo, frecuencia de la intervención y resultados.Resultados: Durante la primera búsqueda 36071 títulos de estudios clínicos fueron encontrados en revistas especializadas. Al final 10 estudios de carácter experimental fueron seleccionados. En dichos estudios, múltiples efectos fueron encontrados, así como componentes que se deben tener en cuenta a realizar un entrenamiento de fuerza en pacientes con cáncer o sobrevivientes del mismo.Conclusiones: El entrenamiento de fuerza en pacientes con cáncer o sobrevivientes de esta enfermedad, les ayuda a mejorar su sintomatología al igual que su calidad de vida, fatiga, fuerza, mejoría en la movilidad y el dolor, entre otros. Así mismo, el entrenamiento de fuerza es beneficioso para los pacientes sin causar efectos adversos o complicaciones a largo plazo