Impact of Continuous Glucose Monitoring and its Glucometrics in Clinical Practice in Spain and Future Perspectives: A Narrative Review.

Introduction: Continuous glucose monitoring (CGM) devices allow for 24-h real-time measurement of interstitial glucose levels and have changed the interaction between people with diabetes and their health care providers. The large amount of data generated by CGM can be analyzed and evaluated using a set of standardized parameters, collectively named glucometrics. This review aims to provide a summary of the existing evidence on the use of glucometrics data and its impact on clinical practice based on published studies involving adults and children with type 1 diabetes (T1D) in Spain.

Exploring transitions of sewer wastewater infrastructure towards decentralisation using the modular model TURN-Sewers.

We present a new modular model called TURN-Sewers for exploring different adaptations of centralised wastewater infrastructure towards more decentralised wastewater systems under different urban development scenarios. The modular model is flexible and computationally efficient in exploring transitions at the city scale, allowing for the comparison of different policies and management strategies for sanitary wastewater infrastructure. TURN-Sewers includes independent modules that simulate the generation, dimensioning, deterioration, management, and calculation of performance indicators for different wastewater systems.

When does infrastructure hybridisation outperform centralised infrastructure paradigms? - Exploring economic and hydraulic impacts of decentralised urban wastewater system expansion.

We explore the dynamics of centralised and decentralised wastewater infrastructure across various scenarios and introduce novel insights into their performance regarding structural vulnerability, hydraulic capacity, and costs. This study determines circumstances under which infrastructure hybridisation outperforms traditional centralised infrastructure paradigms. We combined system analysis to map out the modelling problem with the model-based exploration of the transition space using the novel TURN-Sewers model.

The Burden of Suboptimal Insulin Dosing in People with Diabetes in Spain: Barriers and Solutions from the Physician Perspective.

Background: This study aimed to determine physicians' perceptions of the extent of suboptimal insulin dosing and the barriers and solutions to optimal dosing in people with diabetes (PwD) treated with insulin.

Methods: A cross-sectional online survey was conducted in four countries with primary care physicians and endocrinologists treating PwD using insulin pens, which included 53 questions on physicians' characteristics and their perceptions of the behaviors of PwD in relation to insulin dosing routines, unmet needs and potential solutions. Analyses were descriptive.

Which people with diabetes are treated with a disposable, half-unit insulin pen? A real-world, retrospective, database study in Spain.

Introduction: Insulin lispro 100 units/mL Jr KwikPen is the first prefilled, disposable, half-unit insulin pen that delivers 0.5-30 units in increments of 0.5 units for the treatment of patients with diabetes.

Profile of Patients with Diabetes Treated with Insulin Lispro 200 U/ml: A Real-World Study from Spain.

Introduction: Insulin lispro 200 U/ml (IL200) is a rapid-acting concentrated insulin used for the treatment of adults with diabetes requiring daily doses of > 20 units of rapid-acting insulin. The aim of this study was to describe the clinical/demographic and treatment characteristics of patients who initiated insulin IL200 therapy in Spain in a real-world setting (PROFILE-IL200).

Methods: This retrospective observational study based on the IQVIA database included adult (≥ 18 years) patients with type 1 (T1D) or type 2 (T2D) diabetes who initiated IL200 between June 2015 and December 2019.

A Simplified Sanitary Sewer System Generator for Exploratory Modelling at City-Scale.

Future climatic, demographic, technological, urban and socio-economic challenges call for more flexible and sustainable wastewater infrastructure systems. Exploratory modelling can help to investigate the consequences of these developments on the infrastructure. In order to explore large numbers of adaptation strategies, we need to re-balance the degree of realism of sewer network and ability to reflect key performance characteristics against the model's parsimony and computational efficiency.

Real-World Use of Insulin Glargine U100 and U300 in Insulin-Naïve Patients with Type 2 Diabetes Mellitus: DosInGlar Study.

Introduction: In the EDITION clinical trial programme, patients with type 2 diabetes mellitus (T2DM) receiving insulin glargine (IGlar) U300 required 10-15% more insulin than those receiving IGlar U100. This study sought to determine whether this difference was apparent in real-world practice.

Methods: In this observational, retrospective cohort study, electronic medical records in the Big-Pac® database (Real Life Data) relating to adult insulin-naïve patients with T2DM who initiated IGlar U100 or U300 treatment in Spain in 2016-2017 and remained on treatment for 18 months were selected.

New PAX2 Mutation Associated with Polycystic Kidney Disease: A Case Report.

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of end stage renal disease in children. Diagnosis by genetic testing has proven challenging due to its genetic and phenotypic heterogeneity, as well as incomplete penetrance. We report a case on a 16-months old female with a history of renal cysts and a mutation.

Review of the renal endpoints used in cardiovascular safety clinical trials in type 2 diabetes mellitus patients and their importance in primary care.

Chronic kidney disease (CKD) is one of the most common complications of type 2 diabetes mellitus (T2DM). Furthermore, CKD confers a considerable increase in the risk of cardiovascular (CV) morbidity and mortality. In line with the need to improve knowledge in this field, this article aims to describe the renal endpoints used in the different cardiovascular outcome trials (CVOTs).

Managing the open abdomen: negative pressure closure versus mesh-mediated fascial traction closure: a randomized trial.

Purpose: To compare the effectiveness of abdominal wall closure using the vacuum-assisted closure (NPC) as described by Barker et al. with an institutional protocol using a double polyvinyl bag in the first surgery, which is changed in subsequent surgeries to a polyvinyl bag placed over the bowel loops and a prolene mesh attached to the abdominal fascia (MMFC).

Methods: Randomized controlled trial.

Visualization and clustering of sleep states in a frequency domain feature space.

Sleep studies assess the recurrent manifestation of stereotype configurations of relevant biosignals. These configurations are known as states (Wake, REM sleep and NonREM sleep) and stages (N1-N3 within NREM sleep). These two fundamental descriptive domains, time course and variable configuration, can be readily rendered available through improved visualization techniques.

Risk factors for Trypanosoma cruzi human infection in Barinas State, Venezuela.

This study attempted to quantify the transmission of Trypanosoma cruzi in children less than 15 years of age in Barinas State, Venezuela and investigate risk factors for infection. Among 3,296 children, 4 (0.12%) were seropositive.

Proapoptotic Fas ligand is expressed by normal kidney tubular epithelium and injured glomeruli.

Fas ligand (FasL) is a cell membrane cytokine that can promote apoptosis through activation of Fas receptors. Fas receptor activation induces glomerular cell apoptosis in vivo and participates in tubular cell death during acute renal failure. However, there is little information on the expression of FasL in the kidney.

Administration of IgG Fc fragments prevents glomerular injury in experimental immune complex nephritis.

Most human nephritis is due to glomerular deposition and/or formation of immune complexes (IC). In cultured mesangial cells, Fc receptor stimulation induces proliferation, matrix synthesis, and release of several mediators implicated in the initiation and progression of glomerular injury. Since Ig Fc fragments in vitro modified these phenomena, we studied the effects of systemic administration of IgG Fc fragments on the evolution of experimental IC nephritis.

Long-term protective effect of UR-12670 after warm renal ischemia in uninephrectomized rats.

Background: The phospholipid platelet-activating factor (PAF) participates in the pathogenesis of renal ischemia/reperfusion injury, and in vitro, it induces synthesis of extracellular matrix proteins by mesangial and tubular epithelial cells. This study investigated the long-term effects of the potent orally active PAF antagonist UR-12670 in warm ischemic uninephrectomized rats, which was given according to different therapeutic schedules.

Methods: Uninephrectomized male Sprague-Dawley rats were divided into five groups and were followed for 52 weeks: rats without ischemia (SK); ischemic kidney for 60 minutes (SIK); ischemic kidney and UR-12670 from 0 to the 7th day (UR 0-7); ischemic kidney and UR-12670 from day 0 to 52 weeks (UR 0-E); and ischemic kidney and UR-12670 from day 8 to week 52 (UR 8-E).

Mesangial cells possess an asialoglycoprotein receptor with affinity for human immunoglobulin A.

Asialoglycoprotein receptor (ASGP-R), a hepatic lectin involved in the clearance of galactose-terminal glycoproteins, is also present in extrahepatic tissues, but its expression in renal cells is not well established. This study examines the presence of ASGP-R in cultured mesangial cells (MC), key cells involved in the removal of macromolecules deposited in the glomerulus. The binding of asialo-orosomucoid (ASOR) to rat MC was saturable and galactose-specific.

Interaction of IgA with Fc alpha receptors of human mesangial cells activates transcription factor nuclear factor-kappa B and induces expression and synthesis of monocyte chemoattractant protein-1, IL-8, and IFN-inducible protein 10.

The mechanisms of glomerular damage in IgA nephropathy remain undefined. Mesangial cells (MC) possess Fc receptors for IgA (Fc alpha R), and their occupancy triggers cytokine expression, cell proliferation, and extracellular matrix synthesis. In cultured human MC we examined the effects of soluble IgA aggregates (AIgA) on the activation of nuclear factor-kappa B (NF-kappa B) and the production of proinflammatory chemokines monocyte chemoattractant protein-1 (MCP-1), IL-8, and IFN-inducible protein-10 (IP-10).

Stimulation of Fc(alpha) receptors induces tyrosine phosphorylation of phospholipase C-gamma(1), phosphatidylinositol phosphate hydrolysis, and Ca2+ mobilization in rat and human mesangial cells.

Although knowledge of IgA Fc receptor (Fc(alpha)R) structure and gene organization has progressed in the past few years, signal transduction pathways elicited by its activation have hardly been studied. Previously, we have demonstrated that mesangial cells (MC) possess Fc(alpha)R stimulation triggers several biologic responses. In this work, we studied the early biochemical signals triggered by Fc(alpha)R stimulation in MC.