Aim In order to increase the database related to the antineoplastic potential of metformin, association between the use of metformin and risk of cancer occurence in patients with diabetes mellitus type 2 (DM2) was investigated. Methods In this cross-sectional study, medical records of patients with DM2 were reviewed for cancer occurence. Data on age, body mass index (BMI), alcohol and nicotine consumption, glucose and HbA1c levels, duration of DM2, medication used in the treatment of DM2 and cancer occurence were collected and analyzed. Unpaired Student's t-test or Mann-Whitney U test were used for comparisons between treatment groups, and logistic regression to asses how well our set of predictor variables predicts occurence of carcinoma. P-value less than 0.05 was considered statistically significant. Results The mean age of 234 included patients was 66.8±11.5 years, and DM2 duration was 7± 6.49 years. Mean glucose value was 8.51±4.17mmol/L, and HbA1c 7.74±1.53. Metformin therapy was prescribed in 190 (81%) patients. Cancer was diagnosed in 16 (6.8%) patients: prostate cancer in eight (3.4%), breast cancer in four (1.7%), rectal cancer in two (0.9%) and cancer of the uterus and cervix in one patient. Age, duration of DM2 and BMI did not contribute significantly to the model, while metformin use was shown to be a significant independent predictor (OR=0.049; 95% CI=0.013-0.181; p=0.001). Conclusion Our findings support the hypothesis that the use of metformin compared to the use of other oral antidiabetic drugs is associated with a lower risk of cancer in patients with DM2.

Introduction: Epilepsy is one of the most common neurological diseases in childhood and adolescence. Carbamazepine (CBZ) and valproate (VPA) have been widely used as the first generation of antiepileptic drugs (AED). Aim: The aim of the study has been to evaluate and compare the effect of CBZ and VPA monotherapy on aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) serum levels in children. Material and methods: The study has included 100 patients (boys 57/girls 43, age range 1 to 18 years), who have been treated with CBZ or VPA, as initial monotherapy, for at least 12 months. Patients with liver lesions or patients who have been treated with other drugs have been excluded from the study. The initial serum enzyme levels (AST, ALT and GGT) and after 12 months of treatment have been compared. Results: 53/100 (53%) patients have been treated with CBZ and 47/100 (47%) patients have been treated with VPA.The initial level of enzymes were within the referece range. After one year-long treatment AST was elevated at 4/53 (7.5%) CBZ patients and 9/47 (19.15%) VPA patients (x2 test =3.965, p<0.05). ALT was elevated at 5/53 (9.4%) CBZ patients and 9/47 (19.15%) VPA patients (x2 test =6.953, p<0.05). GGT was elevated at 18/53 (34%) CBZ patients and 7/47 (14.9%) VPA patients (x2 test =4.831, p<0.05). Conclusion: The levels of enzymes AST and ALT have been elevated statistically significant in VPA group and GGT in CBZ group.

Although two-lane roundabouts theoretically exhibit excellent operating performance, in practice, safety problems arise because of inappropriate driving behavior. Turbo roundabouts, which are characterized by a much higher level of safety, are alternatives to classic two-lane roundabouts, but the capacity-related benefits derived from such roundabouts remain an open issue. Accordingly, this study uses an equilibrium traffic flow allocation approach to evaluate multi-lane roundabout capacity based on gap acceptance theory. Capacity levels are calculated and compared for different gap acceptance parameters, including local parameters, and different traffic flow scenarios. It is found that the capacity of minor approaches on turbo roundabouts is always higher than on two-lane roundabouts, but that the main approaches on two-lane roundabouts exhibit better performance in terms of fully equilibrium traffic allocation. This state, however, cannot be achieved for every demand scenario. The results depend strongly on traffic movements and gap acceptance parameters indicating the need for local calibration processes.

O presente artigo tem como pergunta norteadora: Quais sao os aspectos peculiares das empresas familiares? O objetivo principal da pesquisa e identificar na bibliografia eletronica publicacoes entre o ano de 2010 a 2016 que apresentem as peculiaridades da cultura organizacional nas empresas familiares. A pesquisa foi realizada por meio de uma revisao sistematica e seus dados analisados segundo a metodologia da metassintese. Foram selecionados artigos nas bases de dados academicos SCIELO, BDTD E PEPSIC, utilizando-se os descritores: Empresa familiar e sucessao; valores organizacionais em empresas familiares; empresa familiar e cultura; empreendimentos familiares; empresa familiar. A escolha do tema ocorreu por notar que trabalhos nesta tematica predominam nas producoes cientificas de administradores.  Alguns pontos como lealdade, confianca entre as relacoes familiares, o baixo custo de transacao, o respeito mutuo, o menor custo com recrutamento, a linguagem familiar, valores, hereditariedade, sucessao, gestao familiar, sao caracteristicas que segundo os autores podem se tornar vantagens competitivas quando potencializadas. Os aspectos peculiares identificados foram: influencia da familia na tomada de decisoes; transmissao de valores pessoais do fundador; relacoes tradicionais; sucessao familiar; gestao familiar. A cultura organizacional esta relacionada com a tradicao e a historia da organizacao.

The growing field of metabolomics has opened up new opportunities for prediction of type 2 diabetes (T2D) going beyond the classical biochemistry assays. We aimed to identify markers from different pathways which represent early metabolic changes and test their predictive performance for T2D, as compared to the performance of traditional risk factors (TRF). We analyzed 2776 participants from the Erasmus Rucphen Family study from which 1571 disease free individuals were followed up to 14-years. The targeted metabolomics measurements at baseline were performed by three different platforms using either nuclear magnetic resonance spectroscopy or mass spectrometry. We selected 24 T2D markers by using Least Absolute Shrinkage and Selection operator (LASSO) regression and tested their association to incidence of disease during follow-up. The 24 markers i.e. high-density, low-density and very low-density lipoprotein sub-fractions, certain triglycerides, amino acids, and small intermediate compounds predicted future T2D with an area under the curve (AUC) of 0.81. The performance of the metabolic markers compared to glucose was significantly higher among the young (age < 50 years) (0.86 vs. 0.77, p-value <0.0001), the female (0.88 vs. 0.84, p-value =0.009), and the lean (BMI < 25 kg/m2) (0.85 vs. 0.80, p-value =0.003). The full model with fasting glucose, TRFs, and metabolic markers yielded the best prediction model (AUC = 0.89). Our novel prediction model increases the long-term prediction performance in combination with classical measurements, brings a higher resolution over the complexity of the lipoprotein component, increasing the specificity for individuals in the low risk group.