Gestational Diabetes and the New Screening Test's Impact

Introdução: Em 2011, foi introduzido um novo rastreio para a diabetes gestacional que permitiu um diagnóstico mais precoce e de maior número de casos com o intuito de reduzir complicações maternas e perinatais. O objectivo deste estudo foi avaliar a prevalência da diabetes gestacional, comparar resultados obstétricos e perinatais do anterior e presente rastreio e os resultados e realização da prova de reclassificação pós-parto. Material e Métodos: Estudo retrospectivo em gestações simples e diabetes gestacional diagnosticados em 2009 (n = 223) e 2012 (n = 237), vigiadas na Maternidade Dr. Alfredo da Costa, Portugal. Após consulta de processos clínicos procedeu-se à análise de características demográficas, história médica e obstétrica, aumento ponderal durante a gravidez, idade gestacional do diagnóstico, terapêutica utilizada, resultados perinatais e reclassificação pós-parto, seguida de comparação destas variáveis entre os anos de 2009 e 2012. Resultados: Em 2012, houve maior prevalência de diabetes gestacional, ganho ponderal inferior (p < 0,001), maior recurso à terapêutica farmacológica (p < 0,001) e aumento dos casos diagnosticados no primeiro e segundo trimestres (p < 0,001). Relativamente aos resultados neonatais, o peso médio do recém-nascido ao nascer foi significativamente menor (p = 0,001) com diminuição dos recém-nascidos grandes para a idade gestacional (p = 0,002). A taxa de reclassificação pós-parto foi semelhante nos dois anos mas em 2012 houve um aumento dos resultados normais e diminuição das anomalias da glicémia em jejum. Discussão: Critérios mais apertados do actual rastreio permitiram a redução da maioria das complicações da diabetes gestacional levantando novas questões. Conclusão: A introdução do actual rastreio resultou num aumento de prevalência, diagnóstico mais precoce e redução da macrossomia

Measurement of healing area using planimetry after applying low-intensity ultrasound to the skin of rats

CONTEXTUALIZAÇÃO: A planimetria é um método utilizado para avaliar a evolução da cicatrização de feridas. A planimetria computacional é um método ainda em experimentação, mas cujas vantagens têm sido demonstradas em várias investigações. OBJETIVOS: Avaliar os efeitos do ultra-som pulsado de baixa intensidade sobre a cicatrização de lesão cutânea produzida na região dorsal de ratos, por meio da planimetria computacional. MATERIAIS E MÉTODOS: Utilizou-se 60 ratos machos Wistar (peso médio de 300g) divididos em dois grupos com 30 animais cada, de acordo com o tratamento: 1) irradiação simulada (controle); 2) irradiação efetiva (Freqüência fundamental de 1,5MHz, freqüência de repetição de pulsos de 1KHz, largura de pulso de 200µs, intensidade de 30mW/cm² SATA, dez minutos de aplicação em dias alternados). Cada grupo foi subdividido em três grupos, de acordo com o período de irradiação ultra-sônica, de três, sete e 14 dias, respectivamente, e a cicatrização foi avaliada por meio da planimetria, um decalque da lesão sendo obtido em papel especial, digitalizado e medido ao computador por meio de um programa gráfico. Análise estatística pelo método não-paramétrico de Mann-Whitney. RESULTADOS: Houve aumento significante (p<0,05) da área cicatrizada no grupo 2 (141,88±18,50mm²) em relação ao grupo 1 (117,38±15,14mm²), no 14º dia. Não houve diferenças significantes entre os grupos nos demais períodos. CONCLUSÕES: O ultra-som pulsado de baixa intensidade estimula a cicatrização cutânea por segunda intenção em condições experimentais. A planimetria computacional mostrou-se um recurso de baixo custo, fácil manuseio e de aplicabilidade clínica.BACKGROUND: Planimetry is a method used to evaluate the progression of skin wound healing. Computerized planimetry is still an experimental method, but its advantages have been demonstrated in several investigations. OBJECTIVE: To evaluate the effects of low-intensity pulsed ultrasound on the healing of a skin lesion produced on the dorsal region of rats, by means of computerized planimetry. METHODS: Sixty male Wistar rats of mean weight 300g were used. They were divided into two groups according to the treatment applied: 1) simulated irradiation (control); 2) effective irradiation (fundamental frequency 1.5MHz, pulse repetition frequency 1KHz, pulse width 200µs, SATA intensity 30mW/cm² and application for ten minutes on alternate days). Each group was divided into three subgroups according to the length of time for which ultrasound irradiation was applied of three, seven and 14 days, respectively, and healing was evaluated by means of planimetry; a tracing of the wound was obtained on special paper and this was digitized and measured by means of a graphing software. Statistical analysis was performed using the Mann-Whitney non-parametric method. RESULTS: The healed area was significantly greater (p<0.05) in group 2 (141.88±18.50mm²) than in group 1 (117.38±15.14mm²) on the 14th day. There were no significant differences between the subgroups for the other experimental periods. CONCLUSIONS: Low-intensity pulsed ultrasound irradiation stimulated secondary skin healing under these experimental conditions. Computerized planimetry was shown to be a low cost method that was easy to use and present clinical applicability

Chronic Hypertension with Gestational Diabetes Mellitus: What About Complications?

The aim of this study was to evaluate the impact of chronic hypertension and gestational diabetes on pregnancy outcomes. We conducted a historical cohort study of 334 women undergoing singleton births in a Portuguese tertiary care center in Lisbon during 2012. Women were categorized into gestational diabetes mellitus with or without chronic hypertension. Pregnancy outcomes were compared using nonparametric tests. Multivariable analysis was used to control for potential confounders. The rate of preeclampsia in women with both chronic hypertension and gestational diabetes was 26.8% versus 3.8% in women with only gestational diabetes (p<0.05). Preterm birth was significantly more frequent in women with diabetes and chronic hypertension, 22.9% versus 9.7%, compared with women who only had gestational diabetes (p<0.05). The rate of newborns small for gestational age in women with the two conditions was 19.1% versus 7.6% in women with only gestational diabetes (p<0.05), but the rate of large for gestational age newborns in women of chronic hypertension and gestational diabetes was 9.6% versus 3.8% in gestational diabetes (p<0.05). The impact of having both chronic hypertension and gestational diabetes in pregnancy leads to poor pregnancy and perinatal outcomes, represented by more maternal, obstetrical and neonatal morbidity.info:eu-repo/semantics/publishedVersio

Hyperthyroidism in Pregnancy - Case Report

Thyroid disease is common in pregnant women.We report a 10 weeks gestation pregnancy with hyperemesis gravidarum, hypertension crisis and hyperthyroidis

HELLP Syndrome a Severe Form of Preeclampsia: a Comparative Study of Clinical and Laboratorial Parameters

The objective of this study was to compare clinical, laboratorial, maternal and perinatal results between HELLP Syndrome and severe Preeclampsia. An observational study comparing women with HELLP Syndrome (n=71) to women with severe preeclampsia (n=253) was done. The authors analyzed the early course of the pathologies and the outcomes in both groups. HELLP syndrome occurred in 28% of all the cases and was more frequent at gestational age before 32 weeks (n=39 – 55%) than severe preeclampsia (n=108 - 42%), with more newborns weighting less than 1500g (27 – 38.6% vs 65 – 25.6%; p=0.036). Thrombocytopenia below 100 000/μL (aOR, 2.14; 95% CI, 1.49 – 3.06) and LDH>1 000 UI/L (aOR: 5.17; 95% CI 2.19 – 12.16) were risk factors for HELLP. Maternal morbidity (eclampsia, abruptio placentae, and acute renal failure) was similar in both cohorts; eight stillbirths (6 in severe preeclampsia and 2 in HELLP Syndrome) occurred. There were no maternal deaths. In conclusion, in this study the authors confirmed that HELLP Syndrome is a severe form of preeclampsia with an earlier presentation in pregnancy, worst laboratorial findings and more prematurity rates

Combined use of O3/H2O2 and O3/Mn2+ in flotation of dairy wastewater

This work investigated the degradation of organic matter present in synthetic dairy wastewater by the combination of ozonation (ozone (O 3 )/hydrogen peroxide (H 2 O 2 )) and catalytic ozonation (ozone (O 3 )/manganese (Mn 2+ )) associated with dispersed air flotation process. The effect of independent factors such as O 3 concentration, pH and H 2 O 2 and Mn 2+ concentration was evaluated. For the flotation/O 3 /H 2 O 2 treatment, the significant variables (p ≤ 0.05) were: O 3 concentration (linear and quadratic effect), H 2 O 2 concentration linear and quadratic effect, pH values (linear and quadratic effect) and interaction O3 concentration versus pH. For catalytic ozonation, it was observed that the significant variable was the linear effect of O 3 concentration. According to the desirability function, it was concluded that the optimal condition for the treatment of flotation/O 3 /H 2 O 2 can be obtained in acidic solution using O3 concentrations greater than 42.9 mg L -1 combined with higher concentrations of H 2 O 2 to 1071.5 mg L -1 . On other hand, at pH values higher than 9.0, the addition of O3 may be neglected when using higher concentrations than 1071.5 mg L -1 of H 2 O 2 . For flotation/ozonation catalyzed by Mn 2+ , it was observed that metal addition did not affect treatment, resulting in an optimum condition: 53.8 mg L -1 of O 3 and pH 3.6

Influence of the rotator cuff tear pattern in shoulder stability after arthroscopic superior capsule reconstruction: a computational analysis

Objectives: To assess the ability of the arthroscopic superior capsule reconstruction (SCR) in restoring glenohumeral stability in the presence of different preoperative patterns of irreparable rotator cuff tears (RCTs). Methods: A computational musculoskeletal (MSK) model of the upper limb was used to simulate isolated SCR and to estimate the stability of the shoulder. Four patterns of preoperative irreparable RCTs were modeled: Supraspinatus (SSP); SSP ​+ ​Subscapularis (SSC); SSP ​+ ​Infraspinatus (ISP); and SSP ​+ ​SSC ​+ ​ISP. The muscles involved in the irreparable RCT were removed from the MSK model to simulate an irreparable full-thickness tear. In the MSK model, the muscle and joint forces were estimated for a set of upper limb positions, from four types of motions (abduction in the frontal plane, forward flexion in the sagittal plane, reaching behind the back, and combing the hair) collected in a biomechanics laboratory, through inverse dynamic analysis. The stability of the shoulder was estimated based on the tangential and compressive components of the glenohumeral joint reaction force. The comparison of pre- and post-operative conditions, for the four patterns of irreparable RCTs, with the healthy condition, was performed using ANOVA and Tukey's tests (statistical level of p ​< ​0.05). Results: In the setting of an isolated irreparable SSP tear, SCR statistically significantly improved stability compared with the preoperative condition (p ​< ​0.001). For the irreparable SSP ​+ ​SSC pattern, a statistically significant loss in stability was observed (p ​< ​0.001) when SCR was applied. For the irreparable SSP ​+ ​ISP and SSP ​+ ​SSC ​+ ​ISP patterns, the postoperative condition increased shoulder stability, compared to the preoperative condition; however, the improvement was not statistically significantly different. Conclusion: Isolated SCR for irreparable RCTs extending beyond the SSP does not statistically significantly improve the stability of the glenohumeral jointinfo:eu-repo/semantics/publishedVersio

CHARACTERIZATION OF SINGLE-MODE FIBERS FROM WAVELENGTH DEPENDENCE OF MODAL FIELD AND FAR FIELD

2433434

Removal of diethyltoluamide, paracetamol, caffeine and triclosan from natural water by photo-Fenton process using powdered zero-valent iron

The removal of four pharmaceuticals and personal care products (PPCPs), namely diethyltoluamide (DEET), paracetamol (PAR), caffeine (CAF) and triclosan (TCS) (at a spiked concentration of 25 μg/L), from natural water using the photo (UVC)-Fenton (powdered zero-valent iron, pZVI) process was investigated. The results show that a molar ratio of H2O2/pZVI of 2.0, pZVI concentration of 22.4 mg/L and pH of 3.0 maximised the removal of the target compounds at 71.1%, 100%, 64.2% and 87.1%, for DEET, PAR, CAF and TCS, respectively, after 30 min in Fenton (pZVI) process. When this process was coupled with UVC radiation, 29.6%, 80.3%, 3.1% and 88.4% of DEET, PAR, CAF and TCS, respectively, were removed within the first minute, and 99.0%, 100%, 99.5% and 100%, respectively, were removed after 30 min. The pseudo first-order kinetic model best fitted the degradation data of DEET, PAR and CAF (1–20 min); and because 80% of TCS and PAR degraded within the first minutes, it is suggested to explore the kinetics during the initial period. Characterisations of pZVI after the photo-Fenton (pZVI) process indicated the corrosion of the surface of iron powder and the presence of iron oxides and iron hydroxides. Lower removals of nitrate (35–50%), phosphate (<35%) and total organic carbon (TOC, <18%) were observed, which may be attributed to the small H2O2/pZVI dosage used. Results of this investigation show that the photo-Fenton (pZVI) process has potential for efficient and cost-effective removal of PPCPs

Addressing drinking water salinity due to sea water intrusion in Praia de Leste, Parana, by a brackish water desalination pilot plant

Seawater intrusion into the Pombas River, source of freshwater to Praia de Leste on the coast of Parana in Brazil presents a problem to the water utility as most water treatment plants in Brazil are conventional. To find a solution to this problem, a pilot plant (1 m3 /h) consisting of ultrafiltration (UF) followed by reverse osmosis (RO) was developed and evaluated. For testing, brackish water was produced with a concentration of 1,500 ± 100 mg/L of total dissolved solids (TDS), mixing seawater and fresh water. To evaluate the water quality, TDS, electrical conductivity, pH, temperature, apparent color, turbidity, alkalinity, total hardness, calcium, chloride and sulfate were monitored. For operational performance, flowrates, osmotic pressure, filtration rate, recovery rate and mass balance were analyzed. On average, the UF system removed 96.4% of turbidity and 98.6% of apparent color; whereas the RO system removed 99.4% of TDS. The overall average recovery (UF and RO) was 45.81% with average osmotic pressure of 8.21 bar, filtration rate of 30.7 L/h/m2 in the UF system and 21.7 L/h/m2 in the RO system. From a water quality point of view, the system was effective in processing brackish into fresh water of high quality