Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

Background To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated. Methods This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians) aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years (<1 to 50 years). Results Overall, 18.4% patients had HbA1c levels <7.0%, and 47.5% patients had HbA1c levels ≥ 9%. HbA1c levels were associated with lower economic status, female gender, age and the daily frequency of self-blood glucose monitoring (SBGM) but not with insulin regimen and geographic region. Hypertension was more frequent in the mid-west (32%) and north/northeast (25%) than in the southeast (19%) and south (17%) regions (p<0.001). More patients from the southeast region achieved LDL cholesterol goals and were treated with statins (p<0.001). Fewer patients from the north/northeast and mid-west regions were screened for retinopathy and nephropathy, compared with patients from the south and southeast. Patients from the south/southeast regions had more intensive insulin regimens than patients from the north/northeast and mid-west regions (p<0.001). The most common insulin therapy combination was intermediate-acting with regular human insulin, mainly in the north/northeast region (p<0.001). The combination of insulin glargine with lispro and glulisine was more frequently used in the mid-west region (p<0.001). Patients from the north/northeast region were younger, non-Caucasian, from lower economic status, used less continuous subcutaneous insulin infusion, performed less SBGM and were less overweight/obese (p<0.001). Conclusions A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.

Apuntes para escribir una bibliografía eucarística valenciana

Port. con marca tip.

Carta del Doctor D. Matheo de la Vega y Xea a un amigo en que le da noticia de las fiestas que la juventud valenciana ... consagró a la reyna del cielo en su concepcion en Gracia, y ... San Luis Gonzaga ... en los dias 20, 21 y 22 de junio de ... 1744

Hay un ejemplar encuadernado con: VILLANCICOS que se han de cantar la noche de Nauidad, en la Iglesia Metropolitana de Valencia, este año de 1687 (XVIII/211).

Estudio geotécnico para la cimentación del terraplén de acceso a un paso superior. Línea de alta velocidad Madrid-Castilla la Mancha-Comunidad Valenciana-Región de Murcia

Este proyecto aborda el estudio geotécnico para la cimentación del terraplén de acceso a un paso superior sobre el tramo Albatera-Elche, incluido en la Línea de Alta Velocidad Madrid-Castilla La Mancha-Comunidad Valenciana-Región de Murcia. Con el fin de identificar y clasificar los materiales del terreno de cimentación, se analiza el marco geológico regional y local del área de estudio. En el proyecto se presentan los resultados obtenidos en la campaña de reconocimiento de campo y en los ensayos realizados en laboratorio, a partir de los cuales se realiza la caracterización geotécnica de los materiales y se determinan sus parámetros geotécnicos. Asimismo, se considera la singular problemática geotécnica de la zona de estudio, por lo que se analiza la estabilidad global del terraplén, los tiempos de consolidación del terreno y se realiza una estimación de asientos. De acuerdo a todos los cálculos y consideraciones realizadas, se determinan los tratamientos de mejora y refuerzo del terreno de cimentación. Por último, se evalúan los costes derivados de la campaña de reconocimiento geotécnico y de la redacción del presente estudio. ABSTRACT This project is a geotechnical report for the foundation of the access embankment to an overpass in the railway section Albatera-Elche, included in the High Speed Rail line Madrid-Castilla La Mancha-Comunidad Valenciana-Región de Murcia. In order to identify and classify the foundation soil materials, the regional and local geological frame of the study area is analyzed. The results of the field survey and laboratory tests performed are displayed in the project, from which the geotechnical characterization of materials is made and geotechnical parameters have been determined. It is also considered the special geotechnical problems in the study area, so the overall stability of the embankment and ground consolidation times are analyzed, as well as an estimate of ground settlement is also made. According to all calculations and considerations made, treatments to improve and strengthen the foundation soil are determined. Finally, the costs of the geotechnical campaign and the elaboration of this report are evaluated.

Qualidades y blasones de la lengua valenciana

Contiene: Indice de las obras de Carlos Ros, p. 19-24

Crónica del primer Congreso Eucarístico Nacional celebrado en Valencia en noviembre de 1893

Contiene: v.1. Sermones predicados en la Santa Iglesia Metropolitana Basílica. Reseña de las memorias y trabajos presentados en las secciones de dicha asamblea -- v. 2. Exposición artístico-eucarística nacional. Certamen eucarístico. Procesión eucarística

Himne [Manuscrito]: escrit expresament per a la inauguració de la Asosiassió coral de la Rechió Valenciana

Número 238 en el catálogo de Vicente Galbis e Hilari García

El Mole: Número 1 - Día 1 de febrero de 1837

Microfilme. Valencia: BV, ca. 1990