Thirty-Day Morbidity and Mortality of the Laparoscopic Ileal Interposition Associated with Sleeve Gastrectomy for the Treatment of Type 2 Diabetic Patients with BMI < 35: An Analysis of 454 Consecutive Patients

Background The objective of this study was to evaluate the early results of the laparoscopic interposition of a segment of ileum associated with a sleeve gastrectomy (LII-SG) in order to treat patients with type 2 diabetes mellitus (T2DM) and BMI <35. Data regarding morbidly obese diabetic patients subjected to surgery has consistently been validated. To date, there is scarce information about morbidity and mortality related to the surgical treatment of a ""true"" typical diabetic population with BMI <35. Methods The procedures were performed in 454 patients (322 male, 132 female). Mean age was 53.6 +/- 8 years (range = 27-75). Mean BMI was 29.7 +/- 3.6 kg/m(2) (range = 19-34.8). All patients had the diagnosis of T2DM for at least 3 years. Insulin therapy was used by 45.6% of patients. Mean duration of T2DM was 10.8 +/- 5.9 years (range = 3-35). Mean hemoglobin A(1c) was 8.8 +/- 1.9%. Dyslipidemia was observed in 78.4%, hypertension in 64.8%, nephropathy in 28.6%, retinopathy in 32.6%, neuropathy in 34.6%, and coronary heart disease in 13%. Results There was no conversion to open surgery. All patients were evaluated postoperatively. Mortality was 0.4%. There were 29 major complications (6.4%) in 22 patients (4.8%) and 51 minor complications (11.2%). Reoperations were performed on 8 patients (1.7%). Twenty patients (4.4%) were readmitted to the hospital. Mean postoperative BMI was 25.8 +/- 3.5 kg/m(2). Mean fasting plasma glucose decreased from 198 +/- 69 to 128 +/- 67 mg/dl and mean postprandial plasma glucose decreased from 262 +/- 101 to 136 +/- 43 mg/dl. Conclusions The laparoscopic ileal interposition associated with a sleeve gastrectomy was considered a safe operation with low rates of morbidity and mortality in a diabetic population with BMI < 35. An early control of postprandial glycemia was observed.

Primary Oral Mucosal Melanoma: A Series of 35 New Cases From South America

Oral mucosal melanoma is rare and reported to be more aggressive than its cutaneous counterpart. Due to the rarity of this entity, data on epidemiology, tumor behavior, treatment, follow-up, and Survival of patients are mainly based oil single case reports. The few existing series of patients show that oral mucosa melanoma has its peak between 4 1 and 60 years of age, and male to female ratio is 2: 1. Preferred oral sites include hard palate and maxillary alveolar crests. Risk factors have not been clearly identified, and surgical treatment is still the treatment of choice for oral mucosal melanomas. The authors retrospectively studied 35 patients with primary melanoma of the oral cavity to report their clinical and pathological features, Such as age, sex, site of the tumor, metastasis, treatment, response to therapy, and Outcome. We found no significant sex predominance, and the mean age of the patients was 60.6 years, with a range From 9 to 91 years. The majority of the patients (71.42%) had palate commitment, and invasive histopathological aspect was observed in 80% of the specimens (grade 3). Long-distance metastasis was found in 60% of the cases. Fourteen patients were submitted to wide Surgical resections, with local relapse being observed in 11 of them (78.5%). The authors Suggest that improved outcome in oral malignant melanoma requires the development of new therapies and the prevention of distant metastasis.

Poor ovarian response in patients younger than 35 years: Is it also a qualitative decline in ovarian function?

Objective. To investigate whether poor response to controlled ovarian stimulation (COS) is due to a qualitative decline in ovarian function. Methods. This retrospective cohort study included 436 patients younger than 35-years old, undergoing COS for intracytoplasmic sperm injection (ICSI). Patients with four or fewer MII oocytes after COS (poor-responder group, PR, n = 52) were age-matched with normoresponder patients (NR, n = 364). Results. Although similar duration of stimulation (10.5 +/- 0.4 and 9.3 +/- 0.8 days; p = 0.1358), increased doses of gonadotrophins (2510 +/- 865 and 2253 +/- 572 IU; p = 0.0061) were used in the PR. The results show a increased chance of cycle ending of PR (PR: 26.9% and NR: 3.1%; p < 0.0001). Although the lower total number of oocytes retrieved (2.4 +/- 1.4 and 16.2 +/- 9.3; p < 0.0001), equal rate of fertilization (70.2% and 72.0%, p = 0.1190) and high quality embryos were obtained (50.0% and 45.2%; p = 0.4895), resulting in similar implantation (14.5% and 19.7%; p = 0.2246) and abortion (10.0% and 15.4%; p = 1.00) rates, respectively. A trend towards increased pregnancy rate per embryo transfer in NR group was noted (PR: 26.3% and NR: 42.2%; p = 0.0818). Conclusions. Low ovarian response could be associated mainly with a quantitative rather than a qualitative decline in ovarian function. Therefore, even if the ovarian response to stimulation is low, patients aged <= 35 years should process to oocyte retrieval.

The gene encoding the immunoregulatory signaling molecule CMRF-35A localized to human chromosome 17 in close proximity to other members of the CMRF-35 family

The immunoregulatory signaling (IRS) family includes several molecules, which play major roles in the regulation of the immune response. The CMRF-35A and CMRF-35H molecules are two new members of the IRS family of molecules, that are found on a wide variety of haemopoietic lineages. The extracellular functional interactions of these molecules is presently unknown, although CMRF-35H on initiate an inhibitory signal and is internalized when cross-linked. In this paper, we described the gene structure for the CMRF-35A gene and its localization to human chromosome 17. The gene consists of four exons spanning approximately 4.5 kb. Exon 1 encodes the 5' untranslated region and leader sequence, exon 2 encodes the immunoglobulin (Ig)-like domain, exon 3 encodes the membrane proximal region and exon 4 encodes the transmembrane region, the cytoplasmic tail and the 3' untranslated region. A region in the 5' flanking sequence of the CMRF-35A gene, that promoted expression of a reporter gene was identified. The genes for the CMRF-35A and CMRF-35H molecules are closely linked on chromosome 17. Similarity between the Ig-like exons and the preceding intron of the two genes suggests exon duplication was involved in their evolution. We also identified a further member of the CMRF-35 family, the CMRF-35J pseudogene. This gene appears to have arisen by gene duplication of the CMRF-35A gene. These three loci-the CMRF-35A, CMRF-35J and CMRF-35H genes-form a new complex of IRS genes on chromosome 17.

Texto para discuss??o 35: modelo para informatiza????o das administra????es p??blicas municipais

O presente trabalho ?? resultado de um estudo onde observamos planos diretores de inform??tica e, considerando sua l??gica, verificamos que eles, na forma como s??o propostos para empresas do setor privado, n??o se aplicam ao setor p??blico

Parâmetros bioquímicos foliares das espécies Licania tomentosa (Benth.) e Bauhinia forficata (Link.) para avaliação da qualidade do ar

Foliar analysis of biochemical parameters were carried out in order to investigate the influence of air pollutants on two tropical tree species (Licania tomentosa (Benth.) and Bauhinia forfícata (Link.)). Special attention was given to tropospheric ozone due to the fact that concentration levels in the region were found to be up to 140 µg m-3 for a 4 h average time, which is well above the value that can cause injuries to orchides and tobacco (59 µg m-3). Other pollutants such as nitrogen and sulphur oxides were measured and their ambient concentrations were also associated to biochemical alterations in the investigated species.

A moção de censura em Portugal nos últimos 35 anos, a sua utilização como instrumento político de controlo

O presente artigo intenta plasmar o uso da moção de censura enquanto instituto de controlo político do Governo na actividade parlamentar portuguesa das últimas três décadas. Da análise às diversas legislaturas e sessões legislativas dos vários governos constitucionais sistematizam-se aqueles mecanismos de controlo com referência à responsabilidade política do Governo.

Relación entre resultado empresarial y valoración bursátil de las empresas que conforman el IBEX 35

El objetivo de este trabajo es alcanzar conclusiones acerca de si existe relación entre los resultados empresariales, medidos a través de ratios tanto de tipo económicofinancieros como bursátiles, y el precio de mercado de las acciones de las empresas que conforman el Ibex 35, como índice que recoge la evolución diaria de los 35 valores más importantes del mercado español. La conclusión fundamental es que las variables rentabilidad económica, valor contable y ratio PER son consideradas estadísticamente significativas en la explicación del precio de mercado de las acciones del Ibex 35.

L'APPORT DE LA SOCIOLOGIE PRAGMATIQUE FRANÇAISE AUX ÉTUDES CRITIQUES EN MANAGEMENT

La sociologie pragmatique française (SP), inspirée des travaux de Luc Boltanski et Laurent Thévenot, est de plus en plus utilisée par les études organisationnelles en management. Pourtant, la dimension critique de cette approche n'a pas encore été intégrée au profit de la connaissance en management et organisations (MOK). Dans cet article, nous explicitons l'apport que cette sociologie peut représenter pour les études critiques en management (CMS). En tant que science de la science des acteurs, nous suggérons que la SP est fertile pour développer une approche de performativité critique. En particulier, nous démontrons que l'approche permet de mettre en lumière les nouvelles formes de domination plus complexes s'exerçant dans les organisations contemporaines. En utilisant des études empiriques d'organisations mobilisant la SP, nous montrons comment les concepts de compromis et d'épreuve développés par cette approche présentent un outillage permettant de renouveler la critique des organisations au profit de la MOK.

DRhoGEF2 regulates cellular tension and cell pulsations in the Amnioserosa during Drosophila dorsal closure

Coordination of apical constriction in epithelial sheets is a fundamental process during embryogenesis. Here, we show that DRhoGEF2 is a key regulator of apical pulsation and constriction of amnioserosal cells during Drosophila dorsal closure. Amnioserosal cells mutant for DRhoGEF2 exhibit a consistent decrease in amnioserosa pulsations whereas overexpression of DRhoGEF2 in this tissue leads to an increase in the contraction time of pulsations. We probed the physical properties of the amnioserosa to show that the average tension in DRhoGEF2 mutant cells is lower than wild-type and that overexpression of DRhoGEF2 results in a tissue that is more solid-like than wild-type. We also observe that in the DRhoGEF2 overexpressing cells there is a dramatic increase of apical actomyosin coalescence that can contribute to the generation of more contractile forces, leading to amnioserosal cells with smaller apical surface than wild-type. Conversely, in DRhoGEF2 mutants, the apical actomyosin coalescence is impaired. These results identify DRhoGEF2 as an upstream regulator of the actomyosin contractile machinery that drives amnioserosa cells pulsations and apical constriction.

Unesp Informa, 2012, número 35

Boletim elaborado pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

Unesp Ciência, 2012, ano 4, número 35

Revista elaborada pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

A importância dos activos intangíveis nas empresas não financeiras dos índices PSI 20, IBEX 35 e CAC 40

Mestrado em Contabilidade

Perceived health in the Portuguese population aged ? 35

OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001), with chronic disease (p < 0.0001), who consumed < 3 meals per day (p ≤ 0.01), who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence) and with different areas of life satisfaction. CONCLUSIONS Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over health attitudes and behaviors.