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Unmet needs della terapia insulinica: l’iniezione di insulina, ovvero un problema dimenticato.
No full text
PRECOCITÀ DI ACCESSO AL SERVIZIO DI DIABETOLOGIA CO ME INDICATORE DI CONDIZIONE CLINICA NEL DIABETE TIPO 2
No full textIn un precedente lavoro
1
abbiamo già documentato in una coorte di soggetti
con diabete tipo 2 (DM2) come
l’accesso precoce rispetto alla diagnosi (ER) al Se
rvizio di Diabetologia (SD) sia un fattore cruciale
,
determinando un minor carico assistenziale ed un pe
so economico inferiore rispetto all’accesso tardivo
(LR).
Scopo
del presente lavoro è di valutare in un follow-up
di cinque anni quali parametri siano correlabili co
n
ER iniziale. Pazienti e metodi: 313 soggetti con DM
2 sono stati arruolati e seguiti per 5 anni, 111 co
n ER
(intervallo tra diagnosi e accesso < 1 anno) e 202
con LR (intervallo medio 5 ± 4 anni), rispettivamen
te di età
62 ± 16 vs 64 ± 14 (p ns), rapporto M/F 1,18 vs 1,1
0 (p ns), BMI (kg/m2) 27,2 ± 12 vs 28,2 ± 14 (p ns)
,
HbA1c (%) 7,7 ± 2,1 vs 10,8 ± 2,2 (p < 0,01). All’a
rruolamento, in 36 (17,8%) del gruppo LR era
documentabile un evento cardiovascolare CV-E) (stro
ke, angina, infarto miocardico (AMI),
rivascolarizzazione coronarica o carotidea o perife
rica o by-pass aorto-coronarico, scompenso cardiaco
[HF]), rispetto a 4 (3,6%) del gruppo ER (p < 0,001
). Tutti i pazienti sono stati trattati per portare
a target
iperglicemia, ipertensione arteriosa, dislipidemia,
aggregazione. Risultati: complessivamente dopo 5 a
nni, 7
pazienti hanno avuto un evento fatale (4 AMI, 1 Str
oke, 2 HF) e tutti nel gruppo LR, nonostante che i
valori
medi di HbA1c fossero sovrapponibili tra i due grup
pi già dopo i primi 12 mesi di terapia e che la fre
quenza
di ipoglicemie maggiori fosse rimasta bassa e sovra
pponibile per tutta la durata del follow-up (2,5% v
s 1,8%,
rispettivamente tra LR e ER, p ns). Infine, la nece
ssità di trattamento insulinico si era raddoppiata
in 5 anni,
sia nel gruppo ER (8,1 vs 18,3; p < 0,01), che nel
gruppo LR (15,8 vs 36,4; p < 0,001).
Conclusioni:
la precocità di accesso al SD condiziona il destin
o dei diabetici tipo 2, riducendo
significativamente complicanze e carico assistenzia
le ridotto rispetto a diabetici che vi accedono più
tardivamente. I parametri complessivi degli ER a 5
anni sono significativamente migliori del LR
all’arruolamento (durata media di DM2 di circa 5 an
ni) e questi ultimi, al follow-up di 5 anni, necess
itano di
insulina due volte di più dei primi, hanno signific
ativamente più eventi CV (più spesso mortali) nonos
tante il
migliorato compenso metabolico. Questi dati raccolt
i in condizioni di
real life
concordano pienamente con le
conclusioni dei grandi trials sulla necessità di un
trattamento precoce per ridurre le complicanze CV
d
Comment to: Assessment of insulin injection techniques among diabetes patients in a tertiary care centre
No full textGravity vector changes induce alterations in nervous and testicular cells in culture and testis slices
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Metabolic Effects of an Inositol-Resveratrol Nutraceutical Combination in Non-Diabetic Overweight/Obese Subjects with Altered Glucose Tolerance.
No full textMicrogravity as a model of ageing.
No full textPurpose of review: Longevity with good health and long-term survival in space are two of the many challenges that scientists face in the twenty-first century. Ageing and life in space are both associated with undesirable effects on normal physiological processes. This review will outline how the endocrine, metabolic, immune and musculoskeletal systems are affected by microgravity and ageing, drawing analogies between the observed changes in an attempt to highlight common mechanisms. Recent findings: Mild hypothyroidism, increased stress hormones (mainly catecholamines), decreased sex steroids, insulin resistance, impaired anabolic response to food intake, anorexia, altered mitochondrial function and systemic inflammatory response are common features of both ageing and microgravity. Both conditions lead to progressive bone and muscle atrophy, compromising mobility and the ability to perform essential daily tasks. In skeletal muscle, both ageing and space flight lead to weakness from whole muscle to single fibre level, accompanied by marked alterations in muscle architecture and in tendon mechanical properties. Summary: What makes microgravity an interesting and unique tool for gerontologists is that many space-related physiological changes resemble those observed during ageing, but are more or less quickly restored after re-entry, thus allowing the biology of ageing to be investigated both ways, not only during its development but also during recovery. © 2003 Lippincott Williams & Wilkins
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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