XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Prospective Cohort Study

https://publications.hse.ru/mirror/pubs/share/folder/myodg9xfxt/direct/143360779.pdf

Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents.

Toroviruses Affecting Animals and Humans: A Review

\n\nThe present study assessed the transdermal potential of transferosomes\nloaded with allopurinol for the treatment of gout.\n\n\n\nTransferosomes of allopurinol were composed of different ratios of tween-80, soya\nlecithin and solvent using a thin-film hydration method. Transferosomes were characterized for\nScanning Electron Microscopy (SEM), zeta potential, % entrapment efficiency (%EE), Fourier\nTransform Infrared Spectroscopy (FTIR), in-vitro drug release and kinetics as well as stability.\nThen, optimized formulation was incorporated in gel and evaluated for viscosity, pH, extrudability,\nhomogeneity, skin irritation study, spreadability, ex vivo skin permeation study, flux, and stability.\n\n\n\nSEM studies suggested that vesicles were spherical and zeta potential were in the range of\n-11.4 mV to -29.6 mV and %EE was 52.4- 83.87%. FTIR study revealed that there was no interaction\nbetween allopurinol and excipients during the preparation of transferosomes. The cumulative\npercentage of drug release from various transferosomes was ranged from 51.87 to 81.87%. A transferosomal\ngel of F8 formulation was prepared using dispersion method reported pseudoplastic\nrheological behavior, optimum pH, spreadability and maximum drug permeation i.e. 79.84% with\nflux 13.06 g/cm2/hr, followed zero-order release kinetics. Irritation and in-vivo studies of optimized\ntransferosomal gel G8 on rabbits revealed better results than the standard allopurinol.\n\n\n\nThis research suggested that allopurinol loaded transferosomal gel can be potentially\nused as a transdermal drug delivery system for the treatment of gout.\n

Allopurinol Loaded Transferosomes for the Alleviation of Symptomatic After-effects of Gout: An Account of Pharmaceutical Implications

After the appearance of first cases of 'pneumonia of unknown origin' in the Wuhan city, China, during late 2019, the disease progressed fast Its cause was identified as a novel coronavirus, named provisionally 2019-nCoV Subsequently, an official name was given as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) by the International Committee on Taxonomy of Viruses (ICTV) study group The World Health Organization (WHO) named the Coronavirus disease-2019 as COVID-19 The epidemics of COVID-2019 have been recorded over 113 countries/territories/areas apart from China and filched more than 4,292 humans, affecting severely around 1,18,326 cases in a short span The status of COVID-2019 emergency revised by the WHO within 42 days from Public Health International Emergency (January 30, 2020) to a pandemic (March 11, 2020) Nonetheless, the case fatality rate (CFR) of the current epidemic is on the rise (between 2-4%), relatively is lower than the previous SARS-CoV (2002/2003) and MERS-CoV (2012) outbreaks Even though investigations are on its way, the researchers across the globe have assumptions of animal-origin of current SARS-CoV-2 A recent case report provides evidence of mild COVID-2019 infection in a pet dog that acquired COVID-2019 infection from his owner in Hong Kong The news on travellers associated spread across the globe have also put many countries on alert with the cancellation of tourist visa to all affected countries and postponement of events where international visits were required A few diagnostic approaches, including quantitative and differential real-time polymerase chain reaction assays, have been recommended for the screening of the individuals at risk In the absence of any selective vaccine against SARS-CoV-2, re-purposed drugs are advocated in many studies This article discourse the current worldwide situation of COVID-2019 with information on virus, epidemiology, host, the role of animals, effective diagnosis, therapeutics, preventive and control approaches making people aware on the disease outcomes

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Emerging Coronavirus Disease (COVID-19), a Pandemic Public Health Emergency with Animal Linkages: Current Status Update

Identification of animal species based on biological samples such as blood, hair, bone, muscle and others is an important practice in forensic analysis of DNA, but need a standard analytical method particularly when the DNA is low or mixed. The mitochondrial genome contains several forensically informative nucleotide sequences (FINS) that can be utilized for both intra-species and inter-species differentiation. Mitochondrial DNA (mtDNA) has several advantages than nuclear genomes due to greater abundance in the samples and high number of copies in each cell. Therefore, amplification and sequencing of mtDNA genes could constitute relatively sensitive procedures in species identification even if the tested samples are old or degraded. Cytochrome b (Cyt b) gene is among the most important mitochondrial genes which have been used in forensic species identification. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis and sequencing of the mitochondrial cyt b gene could be used as a robust tool in identification of different animal species including domestic, wild and fish species and for determination of meat origin in processed food products due to the presence of species specific mutation sites. The mitochondrial cytochrome-b sequence based species identification has wide forensic and judicial applications. * Corresponding author

/pdf/forensic-applications-of-mitochondrial-cytochrome-b-gene-in-2gs98l0cdm.pdf

Ruchi Tiwari

Papers

Toroviruses Affecting Animals and Humans: A Review

Allopurinol Loaded Transferosomes for the Alleviation of Symptomatic After-effects of Gout: An Account of Pharmaceutical Implications

Emerging Coronavirus Disease (COVID-19), a Pandemic Public Health Emergency with Animal Linkages: Current Status Update

Forensic applications of mitochondrial cytochrome b gene in the identification of domestic and wild animal species

Equine encephalosis virus (EEV): A Review