Effectiveness and Safety of an Advanced Hybrid Closed-Loop System in Adolescents and Adults with Type 1 Diabetes Previously Treated with Continuous Subcutaneous Insulin Infusion and Flash Glucose Monitoring.

This study aimed to evaluate the effectiveness and safety of the MiniMed™ 780G advanced hybrid closed-loop (AHCL) system in people with type 1 diabetes (T1D) previously treated with continuous subcutaneous insulin infusion combined with flash glucose monitoring in a real-life setting. A total of 47 subjects (mean age 41 ± 13.6 years, 60% females, diabetes duration 28 ± 11 years) were included and switched to an AHCL system. Baseline and 6-month data were analyzed. Time in range 70-180 mg/dL increased from 65.3% at baseline to 73.8% at 6 months. Time in hyperglycemia >180 mg/dL decreased from 26.6% to 19.3%. Time in hypoglycemia <70 mg/dL decreased from 4.6% to 2.3%. The coefficient of variation also decreased from 36% to 31.6%. No episodes of severe hypoglycemia, diabetes ketoacidosis, or diabetes-related hospital admissions occurred. In conclusion, the MiniMed 780G AHCL system enables the safe achievement of recommended glycemic targets in people with T1D after 6 months of use.

Gender differences in quality of life in adults with long-standing type 1 diabetes mellitus.

BACKGROUND: To assess gender differences in Quality of life (QoL) and in sociodemographic, clinical and psychological factors associated with impaired QoL in adults with long-standing type 1 diabetes mellitus (DM1). METHODS: Cross-sectional evaluation in a random cohort of DM1 adult patients from a tertiary care hospital. QoL was evaluated using translated and validated self-administered Diabetes QoL questionnaire (Es-DQoL), and results transformed into a 0-100 scale. Psychological assessment included a planned psychological interview and self-reported questionnaires (Beck Depression Inventory II, State-Trait Anxiety Inventory Form Y, Fear of hypoglycaemia Scale, Medical Outcomes Study Social Support Survey). RESULTS: A total of 312 patients (51.6% male; 38.2 ± 12.7 years; HbA1c 7.5 ± 1.1% (58.5 ± 14.2 mmol/mol); 20.4 ± 12.0 years of DM1) were included in the analysis. Male and female subgroups showed similar sociodemographic and diabetes-related features and comparable social support. Among female patients, higher frequency of depression [31.7% (IC95% 26.2-40.8) vs. 14.9% (IC95% 10.1-20.8), p < 0.05] and anxiety [23.2% (IC95% 19.3-33.14) vs. 13.0% (IC95% 8.1-18.4), p < 0.05] and severity of depressive and anxious symptoms were also found. Compared to male patients, female patients showed lower QoL [75 (IC95% 73.6-77.5) vs. 80 (IC95% 75.7-83.1), p < 0.05] and scored significantly worse in subscale Diabetes-related worries [69 (IC95% 50.0-81.0) vs. 75 (IC95% 72.9-79.0), p < 0.05]. Fear of hypoglycemia and severity of depressive and anxious symptoms were factors independently associated to lower QoL in men and women while high frequency of glycemic excursions was a female-specific predictive one. CONCLUSIONS: Adult women with long-standing DM1 showed lower QoL probably related to higher frequency and severity of psychopathological syndromes. Depressive and anxious symptoms and, among women, exposure to glycemic excursions were identified as modifiable, QoL-related variables. Educational, technological and psychological interventions are needed in order to improve QoL in DM1 patients.

Spatial autocorrelation analysis of cargo trucks on highway crashes in Chile.

The growing number of cargo trucks on highway crashes in recent years due to the increase in freight movement in Chile motivates this study to identify the formation of persistent crash clusters on highway Ruta 5 (R5). Two spatial statistical methods (Moran's I and Getis-Ord Gi*) were used to determine whether crashes on this highway showed spatial clustering over time from a global and local perspective. Globally, recurrent crash clusters are spatially correlated on vertical curves and straight highway sections on northern R5 with different truck types and with the tractor-trailer units during rainy days on southern R5. The local spatial autocorrelation results suggest that the contributing causes related to the loss of control of the vehicle, the fatigue and imprudence of the driver, and crashes involving tractor units with trailer tend to cause persistent rollover crash clusters throughout R5. Overall, clustering of crash attributes with high values (i.e., hot spots) occurring on highway locations with vertical curves and on cloudy days predominated in the northern R5, and the largest number of recurrent hot spots occurred on sunny days along southern R5. A hot spot spatial co-occurrence analysis was further performed to identify the strong relationships between the studied crash attributes, and the crash and injury types as outcomes. The indication of high risk for the clustering of cargo trucks on highways crashes provides a basis for improving highway safety and reduce the associated social and economic costs.

The N-terminal region of Nurr1 (a.a 1-31) is essential for its efficient degradation by the ubiquitin proteasome pathway.

NURR1/NR4A2 is an orphan nuclear receptor that is critical for the development and maintenance of mesencephalic dopaminergic neurons and regulates transcription of genes involved in the function of dopaminergic neurons directly via specific NGFI-B response elements (NBRE).and substantial data support a possible role of Nurr1 in the pathogenesis of Parkinson's disease (PD). Here we show that Nurr1 is degraded by the ubiquitin-proteasome pathway and determined that N-terminal region (a.a 1-31) of Nurr1 is essential for an efficient targeting of Nurr1 to degradation in the cell. Nurr1 Δ1-31 has a much longer half-life, and as a consequence its steady-state protein levels were higher, than full-length Nurr1 in the cell. Nurr1 Δ1-31 was as potent as Nurr1 full length in transcriptional luciferase reporter assays after normalization with the corresponding steady-state protein expression levels, either in trans-activation of NBRE or trans-repression of iNOS (inducible NO synthase) reporters. These results suggest that Nurr1 Δ1-31, because of longer persistence in the cell, can be a good candidate for gene and cell therapies in the treatment of PD.

Efecto de la modulacion del receptor nuclear PPAR en la diferenciacion de celulas de preadipocitos de fibroblastos / Effects from modulation of the PPAR nuclear receptor in cell differentiation of fibroblast preadipocytes

La adipogénesis a partir de preadipocitos de fibroblastos de ratón es evaluada mediante la utilización de Rosiglitazona e Insulina, para ello se incuban preadipoctos de ratón de la línea celular 3T3.-L1 en presencia de un coctel de diferenciación con Rosiglitazona e Insulina, realizándose observaciones entre los 0 y 10 días de diferenciación con una frecuencia de cada 2 días. El proceso de diferenciación de los adipocitos fue valorado mediante la cantidad de triglicéridos presentes de las células grasas mediante métodos cualitativos a través de tinciones y métodos cuantitativos producto de la extracción de los ácidos grasos con isopropanol y la medición de la absorbancia a 510 nm. Los resultados obtenidos nos permitieron corroborar el efecto adipogénico tanto de la Rosiglitazona como de la Insulina, aunque ambos presentaron diferencias en su capacidad adipogénica, dado que la Rosiglitazona es un ligando sintético del receptor nuclear PPAR¦Ã cuya activación induce la expresión de los genes involucrados en la adipog¨¦nesis mientras que la insulina act¨²a sobre el receptor de membrana para el factor de crecimiento tipo Insulina (IGF-1) cuya ruta no activa directamente el receptor nuclear PPAR¦Ã trayendo como consecuencia un proceso adipog¨¦nico m¨¢s lento con respecto a la Rosiglitazona. Estos resultados nos permitir¨¢n en el futuro el desarrollo de nuevos medicamentos para el tratamiento de enfermedades como la obesidad y la diabetes tipo 2.

Effects of human recombinant growth hormone on donor-site healing in burned adults.

Patients suffering severe burns have an accelerated catabolism with a highly negative nitrogen balance that may worsen their prognosis. Somatropin treatment has been shown to improve this balance in different hypercatabolic situations. Moreover, in children with extensive burns it also reduces the healing time of the skin graft donor site and shortens the hospital stay. In the existing literature there are no controlled prospective clinical trials in adult patients that confirm these data. Our aim was to demonstrate the efficacy of recombinant growth hormone (somatropin) in reducing the healing time of the skin graft donor sites and the length of stay in the burn unit in adult patients with severe burns. A randomized, double-blind, placebo-controlled clinical trial was carried out in 24 adult patients with severe burns (more than 40% of the total body surface burned or more than 15% full-thickness burns). Patients received placebo (n = 11) or somatropin (n = 13) at a dosage of 0.15 mg/kg/day divided into two equal doses (every 12 hours) via intramuscular injection. Treatment was initiated the day the first autograft was performed and terminated the day the patient was discharged from the burn unit. The mean number (+/- SD) of skin grafts per patient was similar between the two groups (4.2 +/- 1.8 vs 3.4 +/- 1.8 in the placebo and somatropin groups, respectively). No reduction in the healing time of the skin graft donor site was observed in the somatropin group compared to the placebo group. Likewise, the time admitted to the burn unit was not significantly different, either in the absolute number of days (36.2 +/- 19.7 vs 30.1 +/- 16.8 days in the placebo and somatropin groups, respectively) or in relation to the percentage of the total body surface burned or the body surface with full-thickness burns. Growth hormone and insulin-like growth factor I (IGF-I) levels were three and five times higher, respectively, in the somatropin group than in the placebo group. Ten of the patients treated with somatropin experienced hyperglycemia, and seven of them required insulin treatment. No other adverse side effect was observed. One patient in the placebo group died as a result of sepsis and multiple organ failure. Somatropin, with the treatment regimen and dosage used in these studies, did not reduce the healing time of the skin graft donor sites or the length of hospitalization in the burn unit in adult patients with severe burns.