A363 life. When possible, meta-analysis was performed, evaluating the presence of heterogeneity and risk of publication bias. Otherwise, descriptive analysis of the available data was done. Results: Of the 10.348 original references scanned, 17 studies were finally selected, 7 experimental and 10 analytical. The population included was mainly adults, with type 2 diabetes. Important risk of bias was found in all of the articles, particularly the experimental ones. Meta-analysis was performed for glycemic control, hypoglycemia, adherence and persistence. Pen devices showed better results in mean HbA1c change, frequency of hypoglycemia, adherence and persistence compared to vial and syringes. No difference was observed in number of patients achieving < 7% of HbA1c. Studies regarding preference showed a clear tendency favorable to pen devices, but measurement methods were generally not well validated. One study on quality of life showed improvements in some subscales of SF-36. ConClusions: There is evidence that pen devices offer benefits regarding glycemic control, hypoglycemia, adherence, persistence, patient preference and quality of life compared to vial and syringes for insulin administration. However, data had considerable risk of bias, more methodologically sound studies are needed.

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Objectives: To estimate the efficacy and safety of glycopirronium-indacaterol (GLN/IND) as maintenance therapy for moderate to severe chronic obstructive pulmonary disease (COPD) compared to other first-line treatments, through a systematic review and meta-analysis. MethOds: A detailed search was performed in eight electronic databases (MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects (DARE), LILACS, Cochrane Central Register of Randomized Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov) searching for clinical trials that compared efficacy and/or safety of glycopirronium (GLN) alone or GLN/IND as first-line drugs for moderate to severe COPD. Seven functional and quality of life outcomes were collected. An expert panel supported and validated the methodology. Finally, a meta-analysis was performed when the homogeneity of the information permitted. Results: 14.349 references were originally identified, 13.253 were left after eliminating duplicates, and were reviewed by two researchers; 112 full-text articles were retrieved, and finally 13 provided useful information and were included in the analysis. Studies comparing tiotropium (TIO) with GLN didn't show statistically significant differences in efficacy or safety. Studies comparing GLN/IND against TIO, showed statistically significant results, favoring GLN/IND, for "trough FEV1 " (a functional indicator), as well as for, both quality of life scales (Transition Dyspnea Index TDI and Saint Georges Respiratory Questionnaire SGRQ). With respect to safety, GLN/ IND and all first drugs have a similar profile. cOnclusiOns: We conclude that GLN/ IND is more effective than other first-line drugs in the management of moderate to severe COPD, with a similar safety profile.

La neuroética, problema emergente en la bioéticaresumen Se hace una revisión somera de las posturas frente al funcionamiento del cerebro humano y su comparación con el funcionamiento de una computadora, se revisan algunos conocimientos sobre la llamada inteligencia artificial y la mente humana y algunas de sus características que la hacen diferente de las má-quinas; finalmente, se hacen unas consideraciones sobre la libertad humana y la ética.Palabras clave: neuroética, inteligencia artificial, ética, libertad humana. neuroethics, an emerging problem in bioethics abstractA brief revision of the positions concerning the way the human brain works and its comparison with the way computers do is made in this text. Some of the knowledge about the so called artificial intelligence and the human mind is also revised, remarking the characteristics that make the latter different from machines. Finally, some considerations about human freedom and ethics are made.

A199sion (hazard ratio) and the binary logistic regression (odds ratio). Several sensitivity analyses were conducted including controlling for time-dependent covariates and using propensity score covariate adjustment. Results: The proportion (3.4%) of statin users (N= 53,212) who had incident diabetes was higher compared to the proportion (1.2%) of non-statin users (N= 53,212) who had incident diabetes. Compared to no statin use and controlling for demographic and clinical covariates, statin use was significantly associated with increased risk of incident diabetes (hazard ratio= 2.01; 99% C.I.= 1.74 -2.33; p< 0.0001). In addition, risk of diabetes was highest, respectively, among users of lovastatin, atorvastatin, simvastatin, and fluvastatin. Diabetes risk was lowest among pravastatin and rosuvastatin users. ConClusions: Because the potential for diabetogenicity differs among different statin types, health care professionals should individualize statin therapy by identifying patients who would benefit more from less diabetogenic statin types.