3,594 research outputs found
Relationship Between Social Determinants and the Evolution of Diabetes Mellitus in Obese Adults Undergoing Bariatric Surgery
No full textDigitalLa obesidad es una patología que va en aumento a nivel mundial y es reconocida como un factor de riesgo para otras comorbilidades como la diabetes mellitus, la hipertensión arterial y el síndrome metabólico y los determinantes sociales son las condiciones en las que se desarrolla cada persona. Teniendo en cuenta lo anterior, este trabajo se propone explorar la relación entre los determinantes sociales y la evolución de la diabetes mellitus en adultos obesos sometidos a cirugía bariátrica en el cual se incluyó a 118 adultos con obesidad y diabetes mellitus que se sometieron a cirugía bariátrica entre 2016 y 2021.
Este estudio muestra que más del 90% de los pacientes con obesidad y DM que se sometieron a CM (cirugía bariátrica) presentaron ausencia de DM al año del posoperatorio, es decir, un estado de remisión de la enfermedad. En contraste, todos los casos del área rural tuvieron remisión de DM. Además, se ha demostrado que los pacientes de áreas rurales tienen menores tasas de cirugía bariátrica en comparación con los de áreas urbanas, lo que debería promover la equidad en salud (54). Nuestra muestra se tomó únicamente de una institución de salud, con una alta tasa de ingreso de la población con mayor poder adquisitivo, por lo que puedeexistir un sesgo de selección. En los estudios revisados, la ruralidad se ha comportado como un determinante de riesgo para acceder a este tipo de cirugía, dadas las barreras geográficas que limitan el acceso al sistema de salud.Obesity is a pathology that is increasing worldwide and is recognized as a risk factor for other comorbidities such as diabetes mellitus, arterial hypertension and metabolic syndrome, and social determinants are the conditions in which each person develops. Taking into account the above, this work aims to explore the relationship between social determinants and the evolution of diabetes mellitus in obese adults undergoing bariatric surgery, which included 118 adults with obesity and diabetes mellitus who underwent bariatric surgery between 2016 and 2021.
This study shows that more than 90% of patients with obesity and DM who underwent MC (bariatric surgery) presented absence of DM one year postoperatively, that is, a state of remission of the disease. In contrast, all the cases from the rural area had DM remission. In addition, it has been shown that patients from rural areas have lower rates of bariatric surgery compared to those from urban areas, which should promote health equity (54). Our sample was taken only from a health institution, with a high admission rate of the population with greater purchasing power, so there may be a selection bias. In the reviewed studies, rurality has behaved as a determinant of risk for accessing this type of surgery, given the geographical barriers that limit access to the health system.
Cite This Document: Layton S. Relationship Between Social Determinants and the Evolution of Diabetes Mellitus in Obese Adults Undergoing Bariatric Surgery. Degree work. Bucaramanga: University of Santander; 2023.Resumen 16
Summary 18
Introducción 20
Planteamiento del Problema 24
Descripción del Problema 24
Pregunta de Investigación 26
Justificación 27
Objetivos 30
Objetivo General 30
Objetivos Específicos 30
Marco Referencial 31
Determinantes Sociales 35
La Obesidad 37
Cirugía Bariátrica 39
Diabetes Mellitus Tipo 2 40
Teoría Social, Salud y Enfermedad 42
Estructura Social 43
Metodología 44
Población 44
Criterios de Inclusión y de Exclusión 44
Criterios de Inclusión 44
Criterios de Exclusión 44
Resumen 16
Summary 18
Introducción 20
Planteamiento del Problema 24
Descripción del Problema 24
Pregunta de Investigación 26
Justificación 27
Objetivos 30
Objetivo General 30
Objetivos Específicos 30
Marco Referencial 31
Determinantes Sociales 35
La Obesidad 37
Cirugía Bariátrica 39
Diabetes Mellitus Tipo 2 40
Teoría Social, Salud y Enfermedad 42
Estructura Social 43
Metodología 44
Población 44
Criterios de Inclusión y de Exclusión 44
Criterios de Inclusión 44
Criterios de Exclusión 44
Muestra 44
Operacionalización de Variables 44
Procedimiento de Recolección de la Información 45
Análisis Estadístico 46
Consideraciones Éticas 47
Resultados 49
Caracterización Sociodemográfica 49
Caracterización Clínica 55
Tensión Arterial Inicial 60
Tipo de Cirugía y Complicaciones 61
Cambios en los Parámetros Farmacológicos, Metabólicos y Antropométricos Durante el Primer Año de Seguimiento Postquirúrgico 61
Evolución de las Comorbilidades. 63
Perfil bioquímico Durante el Estudio 63
Cambios Postquirúrgicos con Respecto a los Tratamientos 69
Antihipertensivos 69
Alimentación y Actividad Física en Pacientes Sometidos a cirugía Bariátrica al año de Seguimiento 70
Alimentación Nutricional 70
Actividad Física 71
Determinantes Sociales y Presencia de DM Después de la Cirugía Bariátrica 71
Comportamiento de las Principales Mediciones (Basal y al Año de la Cirugía) en los Grupos sin DM y con DM Después de la Cirugía Bariátrica por Determinantes Sociales 73
Relación entre el sexo y las principales mediciones de seguimiento entre los grupos sin DM después de la cirugía y con DM después de la cirugía. 73
Relación entre el régimen de afiliación y las principales mediciones de seguimiento entre los grupos con DM después de la cirugía y sin dm después de la cirugía. 74
Relación entre el estado civil y las principales mediciones de seguimiento entre los grupos con DM después de la cirugía y sin DM después de la cirugía. 77
Relación entre el nivel educativo y las principales mediciones de seguimiento entre los grupos con DM después de la cirugía y sin DM después de la cirugía. 77
Relación entre el estrato socioeconómico y las principales mediciones de seguimiento entre los grupos con DM después de la cirugía y sin DM después de la cirugía. 81
Relación entre el área de residencia y las principales mediciones de seguimiento entre los grupos con DM después de la cirugía y sin DM después de la cirugía. 81
Relación entre la etnia y las principales mediciones de seguimiento entre los grupos con DM después de la cirugía y sin DM después de la cirugía. 81
Otros Resultados Importantes: Cambio del IMC con Respecto a los Determinantes Sociales 86
Comportamiento de las Principales Mediciones (Basal y al Año de la Cirugía) en los Grupos sin DM y con DM Después de la Cirugía Bariátrica 87
Discusión 89
Conclusiones 96
Recomendaciones 97
Referencias Bibliográficas 99EspecializaciónEspecialista en Medicina Familia
Monovalent cation leaks in human red cells caused by single amino-acid substitutions in the transport domain of the band 3 chloride-bicarbonate exchanger, AE1.
No full textAbstract
We identified 11 human pedigrees with dominantly inherited hemolytic anemias in both the hereditary stomatocytosis and spherocytosis classes. Affected individuals in these families had an increase in membrane permeability to Na and K that is particularly marked at 0 degrees C. We found that disease in these pedigrees was associated with a series of single amino-acid substitutions in the intramembrane domain of the erythrocyte band 3 anion exchanger, AE1. Anion movements were reduced in the abnormal red cells. The 'leak' cation fluxes were inhibited by SITS, dipyridamole and NS1652, chemically diverse inhibitors of band 3. Expression of the mutated genes in Xenopus laevis oocytes induced abnormal Na and K fluxes in the oocytes, and the induced Cl transport was low. These data are consistent with the suggestion that the substitutions convert the protein from an anion exchanger into an unregulated cation channel
Entanglement and quantity in quantum space - About quantum measurement (II)
No full textAs a continuation and extension of "quantity in phase space" "quantity in quantum space" is introduced. With that, the disappearing of quantum interference discussed in a previous paper [S. Durr, et al., Nature 395 (1998) 33] is explained in the same spirit as our recent papers [Ren De-Ming, Commun. Theor. Phys. (Beijing, China) 41 (2004) 685, 833].Physics, MultidisciplinarySCI(E)中国科学引文数据库(CSCD)1ARTICLE133-364
Sneutrino DM in the NMSSM with inverse seesaw mechanism
No full textIn supersymmetric theories like the Next-to-Minimal Supersymmetric Standard Model (NMSSM), the lightest neutralino with bino or singlino as its dominant component is customarily taken as dark matter (DM) candidate. Since light Higgsinos favored by naturalness can strength the couplings of the DM and thus enhance the DM-nucleon scattering rate, the tension between naturalness and DM direct detection results becomes more and more acute with the improved experimental sensitivity. In this work, we extend the NMSSM by inverse seesaw mechanism to generate neutrino mass, and show that in certain parameter space the lightest sneutrino may act as a viable DM candidate, i.e. it can annihilate by multi-channels to get correct relic density and meanwhile satisfy all experimental constraints. The most striking feature of the extension is that the DM-nucleon scattering rate can be naturally below its current experimental bounds regardless of the higgsino mass, and hence it alleviates the tension between naturalness and DM experiments. Other interesting features include that the Higgs phenomenology becomes much richer than that of the original NMSSM due to the relaxed constraints from DM physics and also due to the presence of extra neutrinos, and that the signatures of sparticles at colliders are quite different from those with neutralino as DM candidate.National Natural Science Foundation of China (NNSFC) [11575053]SCI(E)ARTICLE1
Classical mechanics and quantum mechanics
No full textThe Newton equation of motion is derived from quantum mechanics.Physics, MultidisciplinarySCI(E)中国科学引文数据库(CSCD)2ARTICLE5685-6884
Policy-driven Data Sharing over Attribute-Based Encryption supporting Dual Membership
No full textAttribute-Based Encryption (ABE) plays an important role in current secure data sharing through fine-grained customizable policies. However, the existing ABE schemes only support simple predicates, = and ≠, but cannot express a more general membership predicates, ∈ and ∉, in policies. The low expressivity of ABE will enlarge the ciphertext storage and reduce the communication efficiency. To overcome this problem, we propose an ABE supporting Dual Membership (DM-ABE). The core problem for implementing this scheme is how to use cryptographic methods to decide the membership between the verified element and the given set. In order to solve this problem, we design a cryptographic algorithm, called Secure Decision of Membership (SDM), based on aggregation functions. In this algorithm, any set can be aggregated into one cryptographic element, and the verified element and the given set can be converted into another cryptographic element in decision process. The membership between them can be decided by the above two cryptographic elements. Furthermore, we construct the DM-ABE by using SDM. Because of the good expressivity of our DM-ABE, we further propose a novel cryptographic data sharing framework by integrating DM-ABE and attribute-based access control to provide fine-grained access control and security protection for private data. In the security proof of DM-ABE, we prove that the DM-ABE satisfies the semantic security against chosen-plaintext attacks under the DBDHE assumption in the standard model through a unified way, considering both two encryption methods for ∈ and ∉ at the same time. Finally, we analyze our scheme in terms of time and space complexity, and compare it with some existing schemes. The results show that our DM-ABE has a better expressive ability on the boolean logic of general membership predicates, ∈ and ∉.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Cyber Securit
Constraining the Inner Galactic DM Density Profile with H.E.S.S.
No full text© 2024 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).In this short review, corresponding to a talk given at the conference “Cosmology 2023 in Miramare”, we combine an analysis of five regions observed by H.E.S.S. in the Galactic Center, intending to constrain the Dark Matter (DM) density profile in a WIMP annihilation scenario. For the analysis, we include the state-of-the-art Galactic diffuse emission Gamma-optimized model computed with DRAGON and a wide range of DM density profiles from cored to cuspy profiles, including different kinds of DM spikes. Our results are able to constrain generalized NFW profiles with an inner slope ≳1.3 . When considering DM spikes, the adiabatic spike is completely ruled out. However, smoother spikes given by the interactions with the bulge stars are compatible if ≲0.8 , with an internal slope of sp-stars=1.5.This work has been supported by the grants PID2021-125331NB-I00, PID2022-139841NB-I00, and CEX2020-001007-S, funded by MCIN/AEI/10.13039/501100011033, by “ERDF A way of making Europe”, and the MULTIDARK Project RED2022-134411-T. The author’s contribution to this work has been supported by the FPI Severo Ochoa PRE2021-099137 grant.With funding from the Spanish government through the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2020-001007-S).Peer reviewe
Diabetes mellitus (DM) related lower extremity amputations (LEA) rate and risk factors.
No full textAuthor: Ieva Vasiliūtė Title: Diabetes mellitus (DM) related lower extremity amputations (LEA) rate and risk factors. Aim: To investigate LEA rate and risk factors in patients with DM. Objectives: To evaluate DM related LEA rate. To determine DM related LEAs levels and patients demographic factors relation. To determine DM related LEAs levels and type of DM relation. To determine DM related LEAs levels and DM duration, body mass index (BMI), glycated hemoglobin (HbA1c) meanings relation. To evaluate expected mathematically based risk factors. Methods: Retrospective medical records study of 153 patients with DM, who underwent LEAs at the Hospital of Lithuanian University of Health Sciences Kaunas clinics was performed during the 2012 01 01 – 2014 12 31 period. Statistical analysis was performed using the standard SPSS 20.0 program. Results: 33,33% of legs amputations occured among people with DM and 66,67% of them were male (p<0,001). Major LEAs were performed mostly in patients with type 2 DM (86,96%) than those with type 1 DM (p<0,001). Male patients LEAs were performed in patients suffering for shorter duration of DM than in women (19,18 m. (±95% PI 16,71-21,65) vs. 23,36 m. (±95% PI 20,07-26,65), p=0,053). Patients with type 2 DM underwent LEAs had DM for shorter durations (16,19 m. (±95% PI 14,32-18,06)) than those with type 1 DM patients (31,43 m. (±95% PI 28,40-34,45)) ( p<0,001). Major LEAs remove patients had BMI (32,86±5,55 kg/m2) than minor LEAs remove patients (29,13±5,91 kg/m2) (p=0,027). No significant relation was found with amputation level and HbA1c average (p=0,246). DM related eye damage increases the risk of minor LEAs 3,10 times (p=0,001). Obesity/overweight the risk of major LEAs increases 5,65 times (p=0,036) and 2,56 times with obliterate atherosclerosis (p=0,006). Patients with type 2 DM have a 3,2 times (p=0,002) higher risk of undergoing major LEA. Conclusions: A third of patients who had undergone LEAs had DM. Amputations were carried out more frequently in men. DKA arose more often in patients with type 2 DM. LEAs were performed a shorter duration male DM patients. Type 2 DM patients suffered LEAs nearly 2 times shorter duration. Major LEAs experienced patients had a higher BMI. The average of HbA1c is not significantly related with amputation levels. DM related eye damage increases the minor LEAs risk by 3,10 times. Obesity/being overweight increases the risk of major LEAs 5,65 times, obliterate atherosclerosis - 2,56 times. Patients with type 2 DM have a 3,2 times higher risk of major LEA
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