A Randomized Comparison of Postprandial Glucose Excursion Using Inhaled Insulin Versus Rapid-Acting Analog Insulin in Adults With Type 1 Diabetes Using Multiple Daily Injections of Insulin or Automated Insulin Delivery.

OBJECTIVE: To compare postprandial glucose excursions following a bolus with inhaled technosphere insulin (TI) or subcutaneous rapid-acting analog (RAA) insulin. RESEARCH DESIGN AND METHODS: A meal challenge was completed by 122 adults with type 1 diabetes who were using multiple daily injections (MDI), a nonautomated pump, or automated insulin delivery (AID) and who were randomized to bolus with their usual RAA insulin (n = 61) or TI (n = 61). RESULTS: The primary outcome, the treatment group difference in area under the curve for glucose >180 mg/dL over 2 h, was less with TI versus RAA (adjusted difference -12 mg/dL, 95% CI -22 to -2, P = 0.02). With TI, the glucose excursion was smaller (P = 0.01), peak glucose lower (P = 0.01), and time to peak glucose shorter (P = 0.006). Blood glucose <70 mg/dL occurred in one participant in each group. CONCLUSIONS: Postmeal glucose excursion was smaller with TI than with RAA insulin in a cohort that included both AID and MDI users.

Caracterización clínico-epidemiológica de criptorquidia en pacientes internados del Hospital del Niño Ovidio Aliaga Uría / Clinical and epidemiological characterization of cryptorquidsm in patients of the Hospital del Niño Ovidio Aliaga Uría

OBJETIVO: Establecer las características clínico epidemiológicas de criptorquidia en pacientes internados en los meses de septiembre a diciembre de 2016 DISEÑO: estudio descriptivo y prospectivo donde se realizó la recolección de datos de una serie de casos de pacientes internados con criptorquidia LUGAR: Hospital del Niño "Dr. Ovidio Aliaga Uría" (La Paz- Bolivia) MÉTODOS: Se incluyeron 64 pacientes de edades entre 1 y 10 años. Se realizó una entrevista estructurada a los padres aplicando un instrumento precodificado, previo consentimiento verbal. Luego se realizó una revisión del expediente clínico para completar datos. Se ingresó los datos a una base Excel, se procedió al análisis de los mismos a través del uso de la estadística descriptiva. RESULTADOS: El rango de edad de tratamiento fue 1 año a 10 años y 2meses, con promedio de 3 años y 8 meses; la edad al momento del diagnóstico en promedio fue 2 años y 9 meses. El tiempo transcurrido entre diagnóstico y tratamiento fue 11 meses. La criptorquidia derecha fue más frecuente con 53%. El hallazgo diagnóstico se realizó en primera instancia por un familiar en 28% y en 72% por un personal de salud. El 68% fue diagnosticado en el primer nivel, 9% en segundo y 23% en el tercero. CONCLUSIONES: La edad en la que se opera y diagnostica la criptorquidia en nuestro medio no está dentro de las recomendaciones americanas y europeas.

OBJECTIVE: To establish the clinical epidemiological characteristics of cryptorchidism in hospitalized patients from September to December 2016 DESIGN: descriptive and prospective study where the data collection of a series of inpatient cases with cryptorchidism PLACE: Hospital del Niño "Dr. Ovidio Aliaga Uría "(La Paz- Bolivia) METHODS: We included 64 patients aged 1 to 10 years. A structured interview was conducted with parents using a pre-coded instrument, with prior verbal consent. A review of the clinical file was completed to complete data. The data were entered into an Excel database, and the analysis was performed through the use of descriptive statistics. RESULTS: The age range of treatment was 1 year to 10 years and 2 months, with an average of 3 years and 8 months; The average age at diagnosis was 2 years and 9 months. The time elapsed between diagnosis and treatment was 11 months. The most common type of cryptorchidism was the right one with 53%. The diagnostic finding was made in the first instance by a relative in 28% and in 72% by a health personnel. 68% were diagnosed in the first level, 9% in the second and 23% in the third. CONCLUSIONS: The age at which cryptorchidism is operated and diagnosed in our country is not within the American and European recommendations.

Obstetric antiphospholipid syndrome.

Antiphospholipid syndrome (APS) in pregnancy has a serious impact on maternal and fetal morbidity. It causes recurrent pregnancy miscarriage and it is associated with other adverse obstetric findings like preterm delivery, intrauterine growth restriction, preeclampsia, HELLP syndrome and others. The 2006 revised criteria, which is still valid, is used for APS classification. Epidemiology of obstetric APS varies from one population group to another largely due to different inclusion criteria and lack of standardization of antibody detection methods. Treatment is still controversial. This topic should include a multidisciplinary team and should be individualized. Success here is based on strict control and monitoring throughout pregnancy and even in the preconception and postpartum periods. Further research in this field and unification of criteria are required to yield better therapeutic strategies in the future.