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. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.

Chroniques de Espa[n]ya fins aci no diuulgades : que tracta d[e]ls Nobles e Inuictissims Reys dels Gots, y gestes de aquells, y dels Co[n]tes de Barcelona, e Reys de Arago, ab moltes coses dignes de perpetua memoria / compilada per lo honorable y discret

Nouament imprimida en lany M.D.xlvij.

Characterization of an 241AmBe neutron irradiation facility by different spectrometric techniques

An automated panoramic irradiator with a 3 Ci 241Am-Be neutron source is installed in a bunker-type large room at the Universidad Politécnica de Madrid (UPM). It was recently modified and a neutron spectrometry campaign was organized to characterize the neutron fields in different measurement points along the irradiation bench. Four research groups working with different Bonner Sphere Spectrometers (BSS) and using different spectral unfolding codes took part to this exercise. INFN-LNF used a BSS formed by 9 spheres plus bare detector, with cylindrical, almost point like, 6LiI(Eu) scintillator (4 mm x 4 mm, from Ludlum); UAZ-UPM employed a similar system but with only 6 spheres plus bare detector; UAB worked with a 3He filled proportional counter at 8kPa filling pressure, cylindrical 9 mm x 10 mm (05NH1 from Eurisys) with 11 spheres configuration; and CIEMAT used 12 spheres with an spherical 3He SP9 counter (Centronic Ltd., UK) with very high sensitivity due to the large diameter (3.2 cm) and the filling pressure of the order of 228 kPa. Each group applied a different spectral unfolding method: INFN and UAB worked with FRUIT ver. 3.0 with their own response matrixes; UAZ-UPM used the BUNKIUT unfolding code with the response matrix UTA4 and CIEMAT employed the GRAVEL-MAXED-IQU package with their own response matrix. The paper shows the main results obtained in terms of neutron spectra at fixed distances from the source as well as total neutron fluence rate and ambient dose equivalent rate H*(10) determined from the spectra. The latter are compared with the readings of a common active survey-meter (LB 6411). The small differences in the results of the various groups are discussed.

Les obres de mossen Ausias March ab una declaratio en los marges de alguns vocables scurs

Pie de imp. tomado de colofón

Normes d'ortografia valenciana

Hay un ejemplar encuadernado con: "Bocetos al pastel y otras menudencias" (Carreres/4460)

Breve diccionario valenciano-castellano

Sign. : *8, 2*3, A-H8, I3

Breves instrucciones en practica para los escrivanos de las poblaciones de este Reyno de Valencia, que asisten a los Ayuntamientos, u Alcaldes legos

Sign. : []7, 2[calderon]-3[calderon]8, A-N8, O4

Correccion de vozes y phrases que el vulgo, u comun de Valencia usa, o ha introducido hablando... en su materno idioma

Sign. : []8, B8, C7

Epitome del origen, y grandezas del idioma valenciano

Sign.: []8, [calderón]8, A-D8, E4

Formularios de escrituras publicas

Indice alfabetico de los formularios, p. 374-383