Glargine vs. NPH insulin therapy in pregnancies complicated by diabetes: An observational cohort study

Aims: The effects of glargine insulin therapy in pregnancies are not well established. We compared maternal and neonatal outcomes of women with pregestational and gestational diabetes treated with glargine or NPH insulin.Methods: A prospective cohort study was conducted analyzing outcomes from 56 women with pregestational and 82 with gestational diabetes treated with either insulin regimen.Results: Comparisons were performed among 138 women: 56 with pregestational and 82 with gestational diabetes. In relation to maternal complications, worsening of retinopathy and nephropathy, preeclampsia, micro and macroalbuminuria, and all kinds of hypoglycemia were found higher in women with pregestational diabetes NPH-treated vs. glargine-treated. In women with gestational diabetes NPH-treated, it was observed increased incidence of prepregnancy and new-onset pregnancy hypertension, micro and macroalbuminuria, as well as mild and frequent hypoglycemia, compared to glargine-treated. Among the neonatal outcomes, 1-min Apgar score <7, necessity of intensive care unit and fetal death in pregestational, while jaundice and congenital malformations in gestational diabetes, respectively, were more frequently observed in infants born to NPH-treated, compared to glargine-treated.Conclusions: Glargine use during pregnancy from preconception through delivery, showed to be safe since it is associated with decreased maternal and neonatal adverse outcomes compared with NPH insulin-treated patients. (C) 2010 Elsevier B.V. All rights reserved.

Bioética e odontologia: um perfil dos problemas éticos vividos por cirurgiões-dentistas

Bioethics studies human behavior in the fields ofbiological sciences and health care. Tt strives for humanization in health services along with promoting the rights of patients. In view of the lack of dental research dealing with this topic, the present study was undertaken to identify, from the viewpoint of dental surgeons, ethical problems experienced in dental practice,understand how they occur and how professionals deal with them. It is a descriptive exploratory investigation within a qualitative approach. Empirical material was collected through semi-structured interviews performed with 15 dental surgeons who work both in private and public practice in the state of Rio Grande do Norte, Brazil. The content of the interviews was systemized and organized, resulting in the identification of topics, from which were grouped the ethical problems reported by the participants. The resu1ts indicate that many of the ethical problems coincide with infringements of the norms and mIes of the Dental Code of Ethics, confirming a dental ethic acquired during professional formation and therefore, inadequate for solving the problems that emerge in professional practice. Other questions stand out such as low salaries, competition and poor working conditions. Associated to these problems are lack of commitment and professional responsibility with the patients. Concem with maintaining user autonomy, guaranteeing access to specialized services, and the need for performing only procedures for which they are technically qualified arise in the responses, leading to difficulties in consolidating the principIes proclaimed by bioethics: autonomy, justice, nonmaleficence and beneficence. We concluded that the ethical problems identified in professional practice need to be understood beyond the dental dimension, towards a human approach. It is therefore necessary to incorporate health care management technologies into health practices, including dentistry, which implies recognizing the difTerent dimensions that surround individuaIs, that is, social, economic, political and cultural

Setting the preheating and steady-state operation of electronic ballasts, considering electrodes of hot-cathode fluorescent lamps

This paper presents a new methodology for the adjustment of the preheating process and steady-state operation of electronic ballasts intended for hot-cathode fluorescent lamps. The classical series-resonant parallel-loaded half-bridge inverter is the power stage analyzed in this paper. In addition, the preheating process is based on the imposition of a constant rms current through the electrodes, in order to provide a proper value of the R-h/R-c ratio before the lamp start. According to the proposed methodology, it is possible to set suitable operating points for, the electronic ballast, considering optimal conditions for the lamps electrodes. Therefore, the proposed methodology for setting the preheating and steady-state operation is a complete platform to the design of electronic ballasts for hot-cathode fluorescent lamps.

A comparative study of the non-isothermal degradation of natural rubber from Mangabeira (Hancornia speciosa Gomes) and Seringueira (Hevea brasiliensis)

Due to the increasing search for alternative sources of natural rubber (NR) whose properties are similar to Hevea brasiliesis, several sources have been studied in the past few years. Among them, Mangabeira (Hancornia speciosa Gomes), which is native to Amazon rainforest and other regions of Brazil, has a potential as another viable rubber source. As a continuation of a series of comparative studies between Hancornia and Hevea (clone RRIM 600) these two species by our research team, their thermal behavior was analyzed by thermogravimetry (TG) using Flynn-Wall-Ozawa's approach in order to obtain kinetic parameters (reaction order, pre-exponential factor and activation energy) of the decomposition process. Results indicated that the thermal behavior of NR from Hancornia was comparable to Hevea with some differences observed as follows: reaction order for Hancornia was higher than for Hevea at the beginning of degradation and very close for temperatures over 350 A degrees C; activation energy and pre-exponential factor had the same trend, i.e., increased with increasing degree of conversion remaining almost constant between 20 and 70% and then increasing for higher degrees, although Hevea was slightly more thermally stable than Hancornia. These major influences in the degradation process in the early stage are attributed to differences in non-rubber constituents present in these two species.

Estudo das ligas titânio-zircônio resultantes do processo de fundição plasma-skull para aplicações como biomateriais

The aim of this work was to study a series of 11 different compositions of Ti-Zr binary alloys resistance to aggressive environment, i. e., their ability to keep their surface properties and mass when exposed to them as a way to evaluate their performance as biomaterials. The first stage was devoted to the fabrication of tablets from these alloys by Plasma-Skull casting method using a Discovery Plasma machine from EDG Equipamentos, Brazil. In a second stage, the chemical composition of each produced tablet was verified. In a third stage, the specimen were submitted to: as-cast microstructure analysis via optical and scanning electron microscopy (OM and SEM), x-ray dispersive system (EDS) chemical analysis via SEM, Vickers hardness tests for mechanical evaluation and corrosion resistence tests in a 0.9% NaCl solution to simulate exposition to human saliva monitored by open circuit potential and polarization curves. From the obtained results, it was possible to infer that specimens A1 (94,07 wt% Ti and 5,93% wt% Zr), A4 (77,81 wt % Ti and 22,19 wt % Zr) and A8 (27,83 wt% Ti and 72,17 wt% Zr), presented best performance regarding to corrosion resistance, homogeneity and hardness which are necessary issues for biomaterials to be applied as orthopedic and odontological prosthesis

Comparative Study on the Technological Properties of Latex and Natural Rubber from Hancornia speciosa Gomes and Hevea brasiliensis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Confecção e caracterização físico-química de filmes compósitos autossustentáveis NaAlg-TiO2-WO3

A new self-sustainable film was prepared through the sol-gel modified method, previously employed in our research group; sodium alginate was used as the polymer matrix, along with plasticizer glycerol, doped with titanium dioxide (TiO2) and tungsten trioxide (WO3). By varying WO3 concentration (0,8, 1,6, 2,4 and 3,2 μmol) and keeping TiO2 concentration constant (059 mmol), it was possible to study the contribution of these oxides on the obtained films morphological and electrical properties. Self-sustainable films have analyzed by Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XDR), Scanning Electron Microscope (SEM), Energy Dispersive X-ray Spectroscopy (EDS) and Electrochemical Impedance Spectroscopy (EIS). By the IR specters, it was possible identify the TiO2, and posteriorly WO3, addition has provided dislocation of alginate characteristics bands to smaller vibrations frequencies indicating an electrostatic interaction between the oxides and the polymer matrix. Diffractograms show predominance of the amorphous phase in the films. SEM, along with EDX, analysis revealed self-sustainable films showed surface with no cracks and relative dispersion of the oxides throughout the polymer matrix. From Impedance analysis, it was observe increasing WO3 concentration to 2,4 μmol provided a reduction of films resistive properties and consequent improvement of conductive properties

Análise das avaliações realizadas na disciplina de arquitetura atômica e molecular no curso de química, modalidade a distância da UFRN

The field of education is very rich and allows us to research in various aspects. The area of chemical education has been growing more and more, and an important aspect that has been researching this area is about the learning difficulties of students. The approach of the themes atomic structure and chemical bonds are developed in high school and have many problems that are often brought to higher education becoming an obstacle to the advancement of learning. It is necessary for these initial themes - the atomic structure and chemical bonds - are well understood by the student to the other contents of Chemistry will be understood more easily. This paper aims to describe, analyze errors and difficulties presented in the assessments of the discipline Atomic and Molecular Architecture, the students of the degree course in Chemistry - EAD, with respect to the contents of " Atomic Structure and Chemical Bonding ", by of the assessments made by the students and the Virtual Learning Environment (VLE), taking into account the activities , discussion forum and access to materials . AVA allows obtaining reports which were used to analyze regarding access / participation to assess their contribution to learning and its relation to the final result (pass / fail). It was observed that the most frequent errors in the assessments are related to the early part of the chemistry that is the understanding of atomic structure and evolution models. Students who accessed the extra material and participated in the activities and forums were students who achieved success in the course. Ie, the difficulties were emerging and the use of available teaching strategies, students could minimize such difficulties, making their performance in activities and assessments were better. Was also observed by attending the AVA, the discipline began with a large withdrawal from the page access as well as the frequency of face- evidence from observation in Listing presence of classroom assessments

Síntese, caracterização, propriedades e aplicação dos sistemas Mg- Al, Zn-Al e Mg-Fe

The Layered Double Hydroxides has become extremely promising materials due to its range of applications, easily obtained in the laboratory and reusability after calcination, so the knowledge regarding their properties is of utmost importance. In this study were synthesized layered double hydroxides of two systems, Mg-Al and Zn-Al, and such materials were analyzed with X-ray diffraction and, from these data, we determined the volume density, planar atomic density, size crystallite, lattice parameters, interplanar spacing and interlayer space available. Such materials were also subjected to thermogravimetric analysis reasons for heating 5, 10, 20 and 25 ° C / min to determine kinetic parameters for the formation of metaphases HTD and HTB based on theoretical models Ozawa, Flynn-Wall Starink and Model Free Kinetics. In addition, the layered double hydroxides synthesized in this working ratios were calcined heating 2.5 ° C / min and 20 ° C / min, and tested for adsorption of nitrate anion in aqueous solution batch system at time intervals 5 min, 15 min, 30 min, 1h, 2h and 4h. Such calcined materials were also subjected to exposure to the atmosphere and at intervals of 1 week, 2 weeks and 1 month were analyzed by infrared spectroscopy to study the kinetics of regeneration determining structural called "memory effect"

Influence of carrion smell and rebaiting time on the efficiency of pitfall traps to dung beetle sampling

Dung beetles (Coleoptera: Scarabaeidae: Scarabaeinae) are very useful insects, as they improve the chemo-physical properties of soil, clean pastures from dung pads, and help control symbovine flies associated with bovine cattle. Their importance makes it fundamental to sample and survey them adequately. The objectives of the present study were to determine the influence of decaying insects trapped in pitfalls on the attractiveness of Moura pig Sus scrofa L. (Suidae) and collared peccary Tayassu tajacu (L.) (Tayassuidae) dung used as baits to lure dung beetles, and to establish how long these baits remain attractive to dung beetles when used in these traps. Some dung beetle species seemed to be able to discriminate against foul smell from decaying insects within the first 24 h, hence decreasing trap efficiency. This was more evident in peccary dung-baited traps, which proved to be the least attractive bait. Attractiveness lasted only 24 h for peccary dung, after which it became unattractive, whereas the pig dung bait was highly attractive for 48 h, after which its attractiveness diminished but was not completely lost.

Opinion of hepatic transplant waiting list patients regarding split liver transplantation

Background. Split liver transplantation (SLT) increases organ supply for hepatic transplantation. Long-term patient survival and complication rates seem to be equivalent between orthotopic liver transplantation (OLT) and SLT. There are controversies among transplant physicians due to an ethical dilemma between benefiting individual needs or those of society. Barshes and Goss (Am J Transplant 5:2047, 2005) demonstrated that the majority of adult liver transplant candidates are favorable to SLT. The aim of our study was to evaluate the opinions of patients at a Brazilian university hospital regarding SLT.Materials and Methods. A questionnaire with 14 questions was applied to 50 patients included in a hepatic transplant waiting list regarding SLT.Results. The overall attitudes of 66% of the participants were classified as utilitarian, 31% were classified as self-preserving, and 3% were undecided. Ninety-one percent of patients would be willing to share even if their expected survival after SLT was shorter than that with OLT. For 77% of patients, children must have priority over adults. However, 83% were unaware of the donors for pediatric transplantations.Conclusions. SLT is a consistent solution for organ demand despite controversies among transplant physicians. The present study demonstrated that most patients were favorable to SLT. In conclusion, attitudes toward graft sharing are not barriers to SLT.

Medição de desempenho organizacional nas imobiliárias: um estudo na cidade do Natal-RN

The purpose of this paper is to identify how real estate companies from the city of Natal measure their organizational performance. Traditionally these companies measure their performance using financial measures; however, the technological improvement, the internationalization of the economy and the change in consumer behavior all demand better products and services, and other measuring models. Those changes motivate organizations to continually improve the quality of their products and services. In this way, these companies need to associate their financial results to their global performance. Therefore, it is necessary to have organizational performance models that associate financial and non-financial measures to the strategies of the companies. The research also tries to identify which performance indicators are used by these companies, as well as to test a model who questions: a) if there is any relationship between managers´ characteristics and performance measuring systems´ characteristics; b) if there is any relationship between the company s characteristics and the characteristics of the measuring system used to evaluate its organizational performance and c) finally to verify if there is a relationship between the characteristics of the measuring system and the company s performance. The information which served as a basis for the study was obtained through an empirical research, with questionnaires, answered by 66 (sixty six) companies from the city of Natal, capital of the state of Rio Grande do Norte. The results show that none of the companies investigated use any of the performance measurement models proposed in the modern literature. However, they use on an isolated way some of the measures those models, including some measures from adopted in the Balanced Scorecard, as well as the benchmarking process, making comparisons with the performance of their competitors. The research also reveals that either bigger companies, companies with more experienced managers or with better performance show better performance measurement systems

A utilização da informação contábil na atividade pecuária do Estado do Rio Grande do Norte: um enfoque nos demonstrativos gerados para tomada de decisão

This work deals with the cattle raising activity in Brasil, it´s importance for the stete of Rio Grande do Norte. A conceptual review is done regarding accounting information and considering it as an essencial input for economical and finantial decision making, related to the state cattle rainsing environment. It also aims to expose visions related to the role and the importance of Accounting as system that colects, treats and supplies managerial information. A brief historic of Accounting is done, emphasizing the Accounting Demonstration Structure and its use in the decision making process, as well as the contribution it has node for the cattle raising activity in Brazil. The research´s results show that accounting information is used partially in the finantial decision making process, and it is pointed out that the Inventory was the most relevant tool with 95,% of the cases, followed by the Income and Outlay reports with 85.0%,Production with 82,0% and Cost reports with 80,0%, the Demonstrative of the Cash Flow (DFC) with 82.5%, the Patrimonial Balance (PB) with 22.5%, and the Demonstrative of the Exercise Result (DER) with 20.0% of use. The research concludes that Accounting information is not throughly used in the economic and finantial decision making of the managers of cattle raising in the Rio Grande do Norte State, although, 95% of the sample consider then important. This may imply that there are diffilculties in measurement of the managerial decisions as well as the business whole

Mannheimiose pulmonar experimental em bezerros: swab nasal e nasofaringeano como auxílio diagnóstico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Acquired hepatocerebral degeneration and hepatic encephalopathy: correlations and variety of clinical presentations in overt and subclinical liver disease

A degeneração hepatocerebral adquirida (AHD) e a degeneração hepatolenticular podem ter apresentações clínicas semelhantes, mas quando uma doença hepática crônica e achados motores atípicos coexistem, a distinção entre AHD e encefalopatia hepática (HE) pode ser ainda mais complicada. Descrevemos três casos de AHD (dois tendo HE) com diferentes achados em neuroimagem, doenças hepáticas distintas e apresentações motoras semelhantes, todos com hipertensão arterial e perda de peso antes das manifestações motoras. O diagnóstico e a fisiopatologia são comentados e comparados com relatos prévios. Concluímos que existem muitas correlações entre HE, degeneração hepatolenticular e AHD, mas a sobreposição de HE e AHD pode ser mais comum dependendo do conhecimento clínico e da acurácia dos critérios diagnósticos adotados para cada enfermidade. Como a AHD não é considerada prioridade na lista de transplante hepático, o prognóstico dos pacientes com AHD permanece ruim, e a interrupção do fluxo nos shunts portossistêmicos deve ser sempre considerada.