Resultados preliminares do uso de anti-hiperglicemiantes orais no diabetePreliminary results of the use of oral hypoglycemic drugs on gestational diabetes mellitusJean Carl Silva1, Wladimir Taborda2, Felipe Becker3, Gabriela Aquim3, Juliana Viese3, Anna Maria Bertini4 Objetivo: comparar a eficácia da glibenclamida e da acarbose com insulina no tratamento do diabete melito gestacional (DMG) em
Bardzo tanie apteki z dostawą w całej Polsce kupic viagra i ogromny wybór pigułek.
Climbing mount kilimanjaro - africaA division of Four Corners Travel Group Pty Ltd Climbing Mount Kilimanjaro - Africa
DAY 1) Melbourne/Dar es Salaam
This evening please make your own way to Melbourne Airport for your flight to Dar es Salaam via
Dubai.(Meals on Flights)
DAY 2) Dar es Salaam
On arrival you will be met and transferred to The Holiday Inn for an overnight stay. (B)
DAY 3)Dar es Salaam/Arusha/Moshi
This morning you will be transferred to the airport for your flight to Arusha.
On arrival you will transferred to Moshi for an overnight stay at The Keys Hotel. (B).
Keys is a small hotel (one of the best hotels in Moshi) with a swimming pool, indoor bar, M-Net
television coverage and restaurant which serves excellent food. The rooms are clean and
comfortable. Showers are en-suite with hot/cold water The staff are friendly, and will store excess
baggage, passports, air tickets, etc. and 'nothing is too much trouble'.
You will have a climb briefing tonight. If you need to hire any extra gear, advise the hotel this
evening. Leave any excess clothing and valuables at the hotel - they will lock them up for you. Pack
your bag carefully for the climb - remember the weight limit of 12kg. Leave some 'bin bags' in an
outer pocket of your bag, and show the porters where they are so that in case of rain they can
quickly cover your bag. Keep one out for your personal back pack too! Liaise with staff at
reception, and leave them your air tickets to be reconfirmed during your climb. It is your
responsibility to ensure that flights are reconfirmed, as any schedule changes will be advised at that
DAY 4) Moshi
You will be driven to Park Gate (approx one hour) where you will meet your guide and porters. The
guide has an amount of paperwork to do at the gate, as well as organising the porters - these things
take time (African time!) - please relax, sit down and enjoy the scenery - don't get anxious about
starting off - it will only get you stressed out!! The larger the group, the longer it will take - be
prepared to wait for anything from 1 - 2 hours. Discuss with your guide, in detail, the route and
each day's activity. A five hour walk through the spectacular forest will bring you to Machame Hut
at 3000 m. This day wear your hiking boots and ensure you keep your wet weather gear with you.
Shorts and t-shirt will be sufficient. There are patches on the route where it is VERY wet and
muddy, and you may end up with pretty wet boots this evening. Ensure your boots are
waterproofed, and that you have spare lightweight shoes to wear in camp this evening. ALWAYS
keep your boots and water bottles INSIDE the tent at night - otherwise they will freeze. Fill up your
water bottle at night, and purify it - allowing some of the chlorine fumes to dissipate. Take it
SLOWLY today, you will encounter some steep parts on the climb - but generally its not too
strenuous. The porters walk
A division of Four Corners Travel Group Pty Ltd
DAY 4) Moshi cont.
ahead and sometimes with you - make sure every day, that you have all your personal gear needed
with you as you will not have access to your bag. Camp will be set up by the porters and your meals
will be prepared by the guide. Conditions are difficult on this route, and your guide / porters will do
everything they can to make your climb pleasant and as comfortable as possible. Eat well - at higher
levels your appetite will diminish.
DAY 5) Trekking
Ascend to Shira Hut, 3 800 m. A short descent from Machame Hut followed by an hour or so of
hard uphill to the top of the forest, then 2 hours at a more gentle angle through the lower moorlands
brings one to the top of a rocky bluff. Lunch is normally taken here. From here, descend 50 ft then
start traversing westwards, up towards Shira Cathedral. The last sections of this route is relatively
flat and easy - but once again, take it very slowly. Take a jersey with you today, as it cools down
considerably during and after lunch. Again, keep your wet weather gear handy, and some snacks for
the route. Drink plenty of water. Today you should take Diamox (if planning to) - in the morning.
You may experience tingling fingers, toes and nose from this drug. As it is a diuretic, it is most
important to keep your fluid intake high. Camp at Shira - it's a pretty cold campsite, you may get
rain or sleet, and in the morning the ground and tents will be frozen over. Tonight you may
experience headaches and breathing problems.
DAY 6) Trekking
From Shira you will set off to Barranco (3 900 m), skirting just below Lava Tower - you are now
walking at approx altitude of 4 000 m, around the southern side of the mountain. A few steep
sections and valleys, a small section of scree and rock, some sand 'dunes' - it's a long and fairly
tiring day. This is part of your acclimatisation - walking in height from 3 800 m up to 4 800 m, and
then overnighting at 3 900 m. Once again, pace yourself to graduate slowly. Tonight you may
experience further headaches, nausea and breathing problems. Night temperature - again cold (night
Continue from Barranco across and up towards Barafu Hut (4 600 m). Today you will cross the
Barranco Wall - it's a climb over rock - not technical, but tiring and hard/long - ending up in the
valley for lunch. After lunch you start to ascend - to Barafu - again you will probably get more
headaches / nausea, some sections of sand/scree. It's a long day - your guide will set the pace. Learn
to pace yourself with your breathing - do not try to rush to catch up with anyone, go at your own,
most comfortable speed and you will arrive at base camp relatively comfortably. Listen to your
guide/s, they will help you. It will be very cold today - especially when you stop for lunch and rest -
dress warmly, again you may expect some sleet on this day. You will be walking through the cloud.
After supper, drink as much tea as possible, settle down for an early night. You are likely to have a
pretty bad headache at this stage. If you are vomiting, or hallucinating, talk to your guide. He will
make the decision as to whether you are able to continue. If you plan to take Decadron, do so before
going to bed. Drink plenty of fluids, as you are in a 'desert' area - albeit cold, and tomorrow will be
a long hard day.
A division of Four Corners Travel Group Pty Ltd DAY 8) Trekking
Today is a very long and strenuous day. Drink lots of fluid before you start, you will be very thirsty
by the end of the day - if you manage, carry 3 litres of fluid with you today. You will be woken at
about 00h30 or 01h00 with tea and a biscuit. Put on all your clothing ready for the final ascent. You
will be climbing up scree for approximately 4-5 hours. The guide will stop frequently to rest and
check on his group. It is very important to listen to your body and breathing and try to get into a
rhythm. Because of the slowness of your walk, your fingers and toes are likely to get extremely cold
- three pairs of socks should be considered for today and two pairs of gloves (inner and warm
The views from the mountain (on the way up) are spectacular - you gain incredible height over a
short distance. You arrive at Stella Point (5 750 m), just at the top of the crater, have a rest - the sun
should be shining! From here continue on a relatively easy path up to Uhuru peak (5 895 m), the
highest point in Africa. Your water bottle is probably frozen at this stage, and on reaching the
summit there will be a certain relief amongst the group. You will descend from Stella to Barafu.
Depending on the timing of your summit, you will be able to have a short rest here (maybe a sleep)
and something to eat, before continuing down the Mweka Route. You will travel down quickly on
the scree gasping in more oxygen, step by step. This is a long descent, and Mweka always seems to
be on the 'next hill' - never arriving. It is likely you may experience seizure of joints - particularly
knees today - keep a support bandage with you for this descent, and perhaps some anti-
inflammatory pills/cream. Arrival Mweka (3 100 m), late afternoon, on the edge of the rainforest,
overnight camping. Time to reflect on the day's achievements.
DAY 9) Trekking/Moshi
A three to four hour pretty descent through the rainforest to the Park Gate, where you will be met
by the vehicle. There are generally beers and cokes for sale at the park gate. Transfer by vehicle to
the hotel (approximately 45 minutes drive) ready for an evening of celebration by the swimming
pool. Your certificates are generally handed out by the guides (either at the gate or on occasion they
may join you for a celebratory drink at the hotel). Overnight Keys hotel, with dinner, bed &
continental breakfast included.
DAY 10) Moshi/Serengeti
This morning you will met at your hotel and transferred to the Serengeti with picnic lunch boxes.
(Approximately 8 hours).
Overnight at Serengeti Serena Lodge with all meals included.
Serengeti Serena Lodge is located high on a hill offering magnificent views of the Serengeti Plains, the
lodge is pure Africa. Rustic and natural, circular like an African
village, its 66 rooms make up a series of rondavels. The simple
style is enhanced with sophisticated detail in the form of
traditional handicraft, such as wood carvings, beadwork and
pottery designs. The lodge offers its own unique game trails
devised in conjunction with park consultants to allow enjoyment of
the Serengeti’s unequaled variety of game.
A division of Four Corners Travel Group Pty Ltd DAYS 11 & 12) Serengeti
Early morning and afternoon game drive in the Serengeti.
Meals and overnight at Serengeti Serena Lodge.
DAY 13) Serengeti/Arusha/Melbourne
After breakfast you will be transferred to airstrip for your flight to Arusha at 1030. On arrival you will be met and assisted to connect to your scheduled flight to Dar es Salaam at 1230.
Connecting to your flight to Melbourne via Dar es Salaam with Emirates.
DAY 15) Arrive Melbourne
_______________________________________________________ Welcome Home !
PALUDISME : FEMME ENCEINTE ET NOUVEAU-NE Version : 0 Mots-clés : Paludisme, nouveau-né, femme enceinte Rédaction Relecture Validation 1: OBJECTIFS Faire le point des recommandations actuelles concernant le traitement curatif et préventif du paludisme de la femme enceinte et du nouveau-né . 2: DOMAINES D'APPLICATION Médecins et sage-femmes des services d