A new multidisciplinary home care telemedicine system to monitor stable chronic human immunodeficiency virus-infected patients: a randomized study.

Background: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. Methodology: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. Findings: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4 + T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels 90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. Conclusions: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection.

High mass microquasars and low latitude gamma-ray sources

Population studies of unidentified EGRET sources suggest that there exist at least three different populations of galactic gamma-ray sources. One of these populations is formed by young objects distributed along the galactic plane with a strong concentration toward the inner spiral arms of the Galaxy. Variability, spectral and correlation analysis indicate that this population is not homogeneous. In particular, there is a subgroup of sources that display clear variability in their gamma-ray fluxes on timescales from days to months. Following the proposal by Kaufman Bernad\'o et al. (2002), we suggest that this group of sources might be high-mass microquasars, i.e. accreting black holes or neutron stars with relativistic jets and early-type stellar companions. We present detailed inhomogeneous models for the gamma-ray emission of these systems that include both external and synchrotron self-Compton interactions. We have included effects of interactions between the jet and all external photon fields to which it is exposed: companion star, accretion disk, and hot corona. We make broadband calculations to predict the spectral energy distribution of these objects from radio up to GeV energies. The results and predictions can be tested by present and future gamma-ray instruments like INTEGRAL, AGILE, and GLAST.

Microquasar models for 3EG J1828+0142 and 3EG J1735-1500

Microquasars are promising candidates to emit high-energy gamma-rays. Moreover, statistical studies show that variable EGRET sources at low galactic latitudes could be associated with the inner spiral arms. The variable nature and the location in the Galaxy of the high-mass microquasars, concentrated in the galactic plane and within 55 degrees from the galactic center, give to these objects the status of likely counterparts of the variable low-latitude EGRET sources. We consider in this work the two most variable EGRET sources at low-latitudes: 3EG J1828+0142 and 3EG J1735-1500, proposing a microquasar model to explain the EGRET data in consistency with the observations at lower energies (from radio frequencies to soft gamma-rays) within the EGRET error box.

La Palma - Nova Classis: a Publius Cornelius Scipio Africanus encampment during the Second Punic War in Iberia

This paper presents the discovery of the oldest Roman camp on the Iberian Peninsula, a camp from the Second Punic War situated in La Palma (Tarragona, Spain), by the mouth of the River Ebro. Although no structural remains have been found, the site's strategic in- terest along with many coins, arms and fragments of amphoras and other objects indicate that a military camp was established here between 218 and 209 BC. Written sources, mainly Polybius and Livy, suggest that La Palma was where the legions of Publius Cornelius Scipio gathered before the attack on Carthago Nova in 209 BC. The paper ends by suggesting that La Palma may be the Roman camp of Nova Classis mentioned by Livy during the events of the war in 217 BC.