Additional electrodes on the Quartet™ LV lead provide more programmable pacing options than bipolar and tripolar equivalents.

Science.gov (United States)

O'Donnell, David; Sperzel, Johannes; Thibault, Bernard; Rinaldi, Christopher A; Pappone, Carlo; Gutleben, Klaus-Jürgen; Leclercq, Christopher; Razavi, Hedi; Ryu, Kyungmoo; Mcspadden, Luke C; Fischer, Avi; Tomassoni, Gery

2017-04-01

The aim of this study was to evaluate any benefits to the number of viable pacing vectors and maximal spatial coverage with quadripolar left ventricular (LV) leads when compared with tripolar and bipolar equivalents in patients receiving cardiac resynchronization therapy (CRT). A meta-analysis of five previously published clinical trials involving the Quartet™ LV lead (St Jude Medical, St Paul, MN, USA) was performed to evaluate the number of viable pacing vectors defined as capture thresholds ≤2.5 V and no phrenic nerve stimulation and maximal spatial coverage of viable vectors in CRT patients at pre-discharge (n = 370) and first follow-up (n = 355). Bipolar and tripolar lead configurations were modelled by systematic elimination of two and one electrode(s), respectively, from the Quartet lead. The Quartet lead with its four pacing electrodes exhibited the greatest number of pacing vectors per patient when compared with the best bipolar and the best tripolar modelled equivalents. Similarly, the Quartet lead provided the highest spatial coverage in terms of the distance between two furthest viable pacing cathodes when compared with the best bipolar and the best tripolar configurations (P tripolar configurations, elimination of the second proximal electrode (M3) resulted in the highest number of viable pacing options per patient. There were no significant differences observed between pre-discharge and first follow-up analyses. The Quartet lead with its four electrodes and the capability to pace from four anatomical locations provided the highest number of viable pacing vectors at pre-discharge and first follow-up visits, providing more flexibility in device programming and enabling continuation of CRT in more patients when compared with bipolar and tripolar equivalents. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Efficacy of aprons equivalent to 0.5 mm of lead in PET procedures using the Monte Carlo method

International Nuclear Information System (INIS)

Fonseca, R.B.; Amaral, A.; Campos, L.

2012-01-01

In positron emission tomography (PET), health staff is exposed to 511-keV photons, which is a result of the positron annihilation process. This energy is about four times greater than the 140 keV commonly found in studies based on single photon emission computed tomography (SPECT). Besides this different level of energy, 0.5 mm lead-equivalent aprons have being used either in SPECT or PET procedures. In this context, this work was designed for evaluating the effectiveness of such aprons in individual radioprotection of health professionals involved in positron emission tomography. For this, by using MCNP4C-based Monte Carlo simulations, the average energy delivered per particle to the regions corresponding to operational quantities Hp(10) and Hp(0.07) were calculated for two conditions of individual exposures: wearing and not wearing a 0.05 mm lead-equivalent apron. The results obtained pointed out that Hp(10) has similar value in both situations. On the other hand, for the region corresponding to Hp(0.07), wearing this lead apron will improve this dose in about 26%. On the basis of this work, 0.5 mm lead equivalent aprons do not offer adequate protection for medical staff working on positron emission tomography. (author)

Gestational Diabetes and Women

Centers for Disease Control (CDC) Podcasts

This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications.

Gestational lead exposure selectively decreases retinal dopamine amacrine cells and dopamine content in adult mice.

Science.gov (United States)

Fox, Donald A; Hamilton, W Ryan; Johnson, Jerry E; Xiao, Weimin; Chaney, Shawntay; Mukherjee, Shradha; Miller, Diane B; O'Callaghan, James P

2011-11-01

Gestational lead exposure (GLE) produces supernormal scotopic electroretinograms (ERG) in children, monkeys and rats, and a novel retinal phenotype characterized by an increased number of rod photoreceptors and bipolar cells in adult mice and rats. Since the loss of dopaminergic amacrine cells (DA ACs) in GLE monkeys and rats contributes to supernormal ERGs, the retinal DA system was analyzed in mice following GLE. C57BL/6 female mice were exposed to low (27 ppm), moderate (55 ppm) or high (109 ppm) lead throughout gestation and until postnatal day 10 (PN10). Blood [Pb] in control, low-, moderate- and high-dose GLE was ≤ 1, ≤ 10, ~25 and ~40 μg/dL, respectively, on PN10 and by PN30 all were ≤ 1 μg/dL. At PN60, confocal-stereology studies used vertical sections and wholemounts to characterize tyrosine hydroxylase (TH) expression and the number of DA and other ACs. GLE dose-dependently and selectively decreased the number of TH-immunoreactive (IR) DA ACs and their synaptic plexus without affecting GABAergic, glycinergic or cholinergic ACs. Immunoblots and confocal revealed dose-dependent decreases in retinal TH protein expression and content, although monoamine oxidase-A protein and gene expression were unchanged. High-pressure liquid chromatography showed that GLE dose-dependently decreased retinal DA content, its metabolites and DA utilization/release. The mechanism of DA selective vulnerability is unknown. However, a GLE-induced loss/dysfunction of DA ACs during development could increase the number of rods and bipolar cells since DA helps regulate neuronal proliferation, whereas during adulthood it could produce ERG supernormality as well as altered circadian rhythms, dark/light adaptation and spatial contrast sensitivity. Copyright © 2011 Elsevier Inc. All rights reserved.

Maternal rhabdomyolysis and twin fetal death associated with gestational diabetes insipidus.

Science.gov (United States)

Price, Joan T; Schwartz, Nadav

2013-08-01

Gestational diabetes insipidus is a rare, transient complication of pregnancy typically characterized by polyuria and polydipsia that may lead to mild electrolyte abnormalities. More severe sequelae of gestational diabetes insipidus are uncommon. We present a case of a 25-year-old woman at 23 weeks of gestation in a dichorionic-diamniotic twin pregnancy who developed severe symptomatic gestational diabetes insipidus complicated by rhabdomyolysis and death of both fetuses. Maternal rhabdomyolysis caused by gestational diabetes insipidus is extremely rare. Early recognition and treatment of gestational diabetes insipidus is necessary to prevent maternal and fetal morbidity and mortality.

Gestational Weight Gain and Breastfeeding Outcomes in Group Prenatal Care.

Science.gov (United States)

Brumley, Jessica; Cain, M Ashley; Stern, Marilyn; Louis, Judette M

2016-09-01

This study sought to examine the differences in pregnancy outcomes with a focus on gestational weight gain for women attending group prenatal care compared to standard individual prenatal care. A matched case-control study was conducted including 65 women who chose group care and 130 women who chose standard individual care. Women were matched based on prepregnancy body mass index (BMI) category, eligibility for midwifery care, and age within 5 years. Women choosing group prenatal care and women choosing standard individual care had similar gestational weight gain, birth weight, gestational age at birth, and mode of birth. Women choosing group prenatal care did have a significantly higher rate of exclusive breastfeeding at 6 weeks postpartum (odds ratio [OR], 4.07; 95% confidence interval [CI], 1.81-9.15; P care. Group prenatal care participation resulted in equivalent gestational weight gain as well as pregnancy outcomes as compared to standard individual care. Breastfeeding rates were improved for women choosing group prenatal care. Randomized controlled trials are needed in order to eliminate selection bias. © 2016 by the American College of Nurse-Midwives.

High-Fibre feeding in gestation

NARCIS (Netherlands)

Meunier-Salaün, M.C.; Bolhuis, J.E.

2015-01-01

Gestating sows are usually fed low levels of feed, which may not provide sufficient satiety, and does not allow sows to fully fulfil their motivation to express foraging and feeding behaviours. Feed restriction may therefore lead to high occurrences of non-feeding oral activities, including

Information Leakage from Logically Equivalent Frames

Science.gov (United States)

Sher, Shlomi; McKenzie, Craig R. M.

2006-01-01

Framing effects are said to occur when equivalent frames lead to different choices. However, the equivalence in question has been incompletely conceptualized. In a new normative analysis of framing effects, we complete the conceptualization by introducing the notion of information equivalence. Information equivalence obtains when no…

Galectins in angiogenesis: consequences for gestation.

Science.gov (United States)

Blois, Sandra M; Conrad, Melanie L; Freitag, Nancy; Barrientos, Gabriela

2015-04-01

Members of the galectin family have been shown to exert several roles in the context of reproduction. They contribute to placentation, maternal immune regulation and facilitate angiogenesis encompassing decidualisation and placenta formation during pregnancy. In the context of neo-vascularisation, galectins have been shown to augment signalling pathways that lead to endothelial cell activation, cell proliferation, migration and tube formation in vitro in addition to angiogenesis in vivo. Angiogenesis during gestation ensures not only proper foetal growth and development, but also maternal health. Consequently, restriction of placental blood flow has major consequences for both foetus and mother, leading to pregnancy diseases. In this review we summarise both the established and the emerging roles of galectin in angiogenesis and discuss the possible implications during healthy and pathological gestation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effects of ethanol on offspring of C57BL/6J mice alcoholized during gestation

Directory of Open Access Journals (Sweden)

Grinfeld Hermann

1999-01-01

Full Text Available The effects of chronic alcohol consumption during pregnancy were analysed in the gestation and offspring of alcoholized mice. Female C57BL/6J mice were placed overnight with stud males and the presence of a sperm plug in the next morning indicated the onset of gestation. Pregnant mice were distributed in two weight-matched groups. In the alcoholized group, the mice received a high protein liquid diet ad libitum containing 27.5% of ethanol-derived calories (5.28% v/v from gestation day 5 to 19. The control group received the same volume of diet containing isocaloric amounts of maltose-dextrin substituted for ethanol. After postnatal day zero, the dams received food pellets and tap water ad libitum. On postnatal day 6 the pups were counted and weighed at variable intervals up to the 60th day of life. The majority of the pregnant dams that have received ethanol completed the gestational period, and the chronic consumption of alcohol did not interfere with the number of dams that gave birth. The alcoholized and control dams gained an equivalent weight and consumed an equivalent volume of diet throughout the gestation. The number of pups from alcohol diet dams was 46,26% smaller compared with the control group. There were less male than female pups in the offspring of alcoholized mice. Teratogeny like gastroschisis and limb malformation were present in the offspring of alcoholized dams. The body weight of the offspring of alcoholized mice increased from the 18th to the 36th postnatal day.

Gestational Diabetes and Women

Centers for Disease Control (CDC) Podcasts

2009-05-12

This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications.  Created: 5/12/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/12/2009.

Proteinuria in aging rats due to low-protein diet during mid-gestation

NARCIS (Netherlands)

Joles, J. A.; Sculley, D. V.; Langley-Evans, S. C.

Nephrogenesis in the rat starts mid-gestation and continues into lactation. Maternal low protein (LP) intake leads to renal injury in rats and associates with mild renal injury in humans. We hypothesized that LP during early nephrogenesis or throughout gestation would induce more renal injury in rat

Surrogate markers of the kidney and liver in the assessment of gestational diabetes mellitus and fetal outcome.

Science.gov (United States)

Liu, Hong; Shao-Gang, Ma; Liang, Cheng; Feng, Bai; Wei, Xu

2015-01-01

To investigate whether serum levels of butyrylcho-linesterase activity, cystatin C, and pre-albumin has the potential value as γ-glutamyl transferase in reflecting gestational diabetes mellitus and its fetal outcome. Seventy-six gestational diabetes mellitus women and 76 pregnancies with normal glucose tolerance in the second trimester were enrolled. Maternal serum parameters of butyrylcholinesterase activity, γ-glutamyl transferase, cystatin C, and pre-albumin were detected and evaluated. The pregnant complications and fetal outcome were also evaluated. Levels of butyrylcholinesterase activity, γ-glutamyl transferase, cystatin C, pre-albumin and glycemic variables were higher in the gestational diabetes mellitus patients than in the controls. Levels of butyrylcholinesterase activity were significantly correlated to the levels of fasting plasma glucose, cystatin C, and γ- glutamyl transferase (p gestational diabetes mellitus group. There were statistical differences in cases of preterm delivery, preeclampsia and postpartum hemorrhage. Higher levels of γ-glutamyl transferase and pre-albumin were risk markers for gestational diabetes mellitus (p gestational diabetes mellitus status but not with the fetal outcome. Pre-albumin can be equivalent as γ-glutamyl transferase in reflecting the presence of gestational diabetes mellitus.

Gestational diabetes insipidus. Case Report.

Science.gov (United States)

Ejmocka-Ambroziak, Anna; Grzechocińska, Barbara; Jastrzebska, Helena; Kochman, Magdalena; Cyganek, Anna; Wielgoś, Mirosław; Zgliczyński, Wojciech

2015-01-01

Gestational diabetes insipidus is a very rare complication. However, undiagnosed and untreated may lead to serious complications in both mother and fetus. In this study, a case of 34-year-old female patient with diabetes insipidus associated with pregnancy was reported. We discussed process of diagnosis and treatment with particular emphasis on the monitoring of water-electrolyte imbalance during labor.

Exercise during pregnancy and its association with gestational weight gain.

Science.gov (United States)

Harris, Shericka T; Liu, Jihong; Wilcox, Sara; Moran, Robert; Gallagher, Alexa

2015-03-01

We examined the association between exercise during pregnancy and meeting gestational weight gain recommendations. Data came from the 2009 South Carolina Pregnancy Risk Assessment Monitoring System (n = 856). Women reported their participation in exercise/sports activities before and during pregnancy, including the number of months and types of exercise. We developed an exercise index (EI), the product of the number of months spent in exercise and average metabolic equivalents for specific exercise. The 2009 Institute of Medicine's guideline was used to categorize gestational weight gain into three classes: inadequate, adequate, and excessive. Multinomial logistic regression models were used to adjust for confounders. Over 46 % of women exceeded the recommended weight gain during pregnancy. Nearly one third (31.9 %) of women reported exercising ≥3 times a week at any time during pregnancy. Compared to women who did not report this level of exercise during pregnancy, exercising women were more likely to meet gestational weight gain recommendations (32.7 vs. 18.7 %) and had a lower odds of excessive gestational weight gain [adjusted odds ratio (AOR) 0.43, 95 % confidence interval 0.24-0.78]. Women with an EI above the median value of those women who exercised or women who exercised ≥3 times a week for 6-9 months during pregnancy had lower odds of excessive gestational weight gain (AOR for EI 0.20, 0.08-0.49; AOR for months 0.26, 0.12-0.56, respectively). Our findings support the need to promote or increase exercise during pregnancy to reduce the high proportion of women who are gaining excessive weight.

Radiation beans characterization and implantation for study of lead equivalent individual protection device used in radiodiagnostic practices

International Nuclear Information System (INIS)

Pereira, Leslie Silva

2004-01-01

The protective shielding (IPC) must be used by occupationally exposed professionals, patients and volunteers, in order to optimize the doses who receive due to radiological practices. International and national norms establish the methodology to be adopted for determination of the IPC attenuation. In this work, the IPC had been submitted to X-rays beams with known characteristics, standardized for determination of their attenuation equivalent thickness by comparison to an experimental lead attenuation slope. This comparison technique allowed insurance estimative of the IPC attenuation equivalent thickness in mm of lead. Thus, it was possible to verify the conformity of the attenuation equivalent thickness determined experimentally and the value of the thickness indicated by the manufacturer. To carry out this work, it was necessary the implementation of experimental setups stated in the specifics norms, the study of the X-rays beams original features and the determination of combined additional filters, in order to allow the X-ray equipment used operates in compliance with Norm IEC 61331-1 IEC. The radiation quality selected is characterized by a 100 kV voltage and a 0.25 mm of copper overall filtration. The implementation of this radiation quality it was carried through of its first and second HVL (Half Value Layer). Thus, a methodology according to the international Norms has been implemented in the laboratory. The results of the present work provide suitable and useful information about radiation beams features related to the determination techniques of the attenuation properties. Once implemented the procedures for conformity evaluation of the protection devices, it will be possible to carry out specific quality control tests, which will be helpful to manufacturers, customers, as well as authorities in the radiological protection and health areas. (author)

Some spectral equivalences between Schroedinger operators

International Nuclear Information System (INIS)

Dunning, C; Hibberd, K E; Links, J

2008-01-01

Spectral equivalences of the quasi-exactly solvable sectors of two classes of Schroedinger operators are established, using Gaudin-type Bethe ansatz equations. In some instances the results can be extended leading to full isospectrality. In this manner we obtain equivalences between PT-symmetric problems and Hermitian problems. We also find equivalences between some classes of Hermitian operators

Perceived psychosocial stress and gestational weight gain among women with gestational diabetes.

Directory of Open Access Journals (Sweden)

Ai Kubo

Full Text Available Growing evidence links perceived stress-a potentially modifiable psychosocial risk factor-with health behaviors and obesity. Yet little is known about the relationship between stress during pregnancy and gestational weight gain, particularly among women with pregnancy complications. We conducted a cross-sectional analysis to examine associations between psychosocial stress during pregnancy and gestational weight gain among women with gestational diabetes. We used baseline data from the Gestational Diabetes's Effects on Moms (GEM study: 1,353 women with gestational diabetes who delivered a term singleton within Kaiser Permanente Northern California were included. Perceived stress near the time of gestational diabetes diagnosis was measured using the validated Perceived Stress Scale (PSS10. Gestational weight gain was categorized according to the 2009 Institute of Medicine recommendations. Binomial regression analyses adjusted for gestational age and maternal age at the time of gestational diabetes diagnosis, and race/ethnicity and estimated rate ratios (RR and their 95% confidence interval (CI. Among women with a normal pregravid Body Mass Index (BMI 18.5-24.9 kg/m2, there was a significant association between high (Q4 PSS score and risk of both exceeding and gaining below the Institute of Medicine recommendations compared to those with lower stress (Q1 [adjusted RR = 2.16 95% CI 1.45-3.21; RR = 1.39 95% CI 1.01-1.91, respectively.] Among women with pregravid overweight/obesity (BMI≥25 kg/m2, there was no association. Although the temporal relationship could not be established from this study, there may be a complex interplay between psychosocial stress and gestational weight gain among women with gestational diabetes. Further studies examining stress earlier in pregnancy, risk of developing gestational diabetes and excess/inadequate gestational weight gain are warranted to clarify these complex relationships.

Characteristics of transplacental lead transfer in rat dams and fetuses

International Nuclear Information System (INIS)

Kopfler, F.C.; Miller, R.G.; Kowal, N.E.; Kelty, K.C.; Doerger, J.U.; Mills, T.

1987-01-01

This study was designed to quantitate the dose resulting from lead exposure during the critical periods of brain development during gestation by determining: (1) if blood lead concentration in rat dams is affected by pregnancy status or duration of lead exposure, (2) if lead concentration in fetuses is associated with the duration of dam exposure, (3) the rates of lead absorption and elimination in pregnant and nonpregnant dams; and (4) the effect that prebreeding exposure on lead kinetics in the dam and upon fetus blood lead concentrations. The results of experiments in which the dams' drinking water contained 50 mg/L lead indicate blood lead levels (after normalizing by water consumption on a body weight basis) of pregnant rats are significantly higher than blood lead levels of non-pregnant rats. Statistical differences in blood lead levels were observed by day 15 of gestation and continue through day 20 of gestation. These blood lead differences are not due to lead treatment prior to breeding as seen when comparing Figure 1 and Figure 2. The blood lead levels of the fetuses at day 20 of gestation were 50-60% higher than that of the corresponding dams. The results from the latter two phases were ambiguous, due to large variability in individual animal absorption and elimination rates. However, the following observations can be made. Preexposure to lead does not affect the percent of lead transferred from the dams' blood to the fetuses. The rate of elimination of lead from the dams' blood does not appear to be affected by prebreeding exposure to lead or by the status of pregnancy. The fraction of the 203 Pb dose transferred to the fetus increases dramatically toward the end of gestation. The data suggest that lead absorption from the gut of pregnant rats is higher than that for nonpregnant rats

Gestational diabetes

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/000896.htm Gestational diabetes To use the sharing features on this page, please enable JavaScript. Gestational diabetes is high blood sugar (glucose) that starts or ...

Candy twists as an alternative to the glucola beverage in gestational diabetes mellitus screening.

Science.gov (United States)

Racusin, Diana A; Antony, Kathleen; Showalter, Lori; Sharma, Susan; Haymond, Morey; Aagaard, Kjersti M

2015-04-01

Screening for gestational diabetes mellitus commonly uses an oral glucose challenge test with a 50-g glucola beverage and subsequent venous puncture. However, up to 30% of pregnant women report significant side-effects, and the beverage is costly. We hypothesized that equivalent glucose loads could be achieved from a popular candy twist (Twizzlers; The Hershey Company, Hershey, PA) and tested it as cost-effective, tolerable alternative with a test of equivalency. The glucose equivalent of the 50-g glucola was calculated as 10 candy twists. We initially used a triple crossover design in nonpregnant patients whereby each subject served as her own control; this ensured the safety and equivalency of this load before using it among pregnant subjects. We then recruited pregnant women with an abnormal screening at 1 hour (glucose challenge test) in a double crossover design study. Subjects consumed 10 candy twists with a 1-hour venous blood glucose assessment. All subjects subsequently completed the confirmatory 3-hour glucose tolerance test. Sensitivity, specificity, positive predictive values, negative predictive values, false-referral rates, and detection rates were calculated. At ≥130 mg/dL, the sensitivity (100%) was the same for candy twists and glucola. However, the false-referral rate (82% vs 90%), positive predictive value (18% vs 10%), and detection rate (18% vs 10%) were improved for candy twists when compared with the 50-g glucola beverage. Our results indicate that strawberry-flavored candy twists are potentially an equally effective screening test, compared with the gold standard glucola beverage but lead to fewer false-positive screens and therefore could be a cost-effective alternative. Copyright © 2015 Elsevier Inc. All rights reserved.

Glycemic Status During Pregnancy in Gestational Diabetic & Non-Gestational Diabetic Women & its Effect on Maternal & Fetal Outcome

Directory of Open Access Journals (Sweden)

A P Sawant

2012-01-01

to have GDM in first half of pregnancy showed a presence of PIH. The present study revealed no association between Polyhydramnios and GDM. We found 16.65% incidence of polyhydramnios in GDM and 4.35% in non-GDM women. In our study maternal hyperglycemia was present in all cases of polyhydramnios so that osmotic imbalance could be involved in the pathogenesis of polyhydramniosis. Conclusion: Diagnosis of gestational diabetes and subsequent treatment to attain normoglycemia will definitely lead to satisfactory maternal and /or fetal outcome.

An equivalent dipole analysis of PZT ceramics and lead-free piezoelectric single crystals

Science.gov (United States)

Bell, Andrew J.

2016-04-01

The recently proposed Equivalent Dipole Model for describing the electromechanical properties of ionic solids in terms of 3 ions and 2 bonds has been applied to PZT ceramics and lead-free single crystal piezoelectric materials, providing analysis in terms of an effective ionic charge and the asymmetry of the interatomic force constants. For PZT it is shown that, as a function of composition across the morphotropic phase boundary, the dominant bond compliance peaks at 52% ZrO2. The stiffer of the two bonds shows little composition dependence with no anomaly at the phase boundary. The effective charge has a maximum value at 50% ZrO2, decreasing across the phase boundary region, but becoming constant in the rhombohedral phase. The single crystals confirm that both the asymmetry in the force constants and the magnitude of effective charge are equally important in determining the values of the piezoelectric charge coefficient and the electromechanical coupling coefficient. Both are apparently temperature dependent, increasing markedly on approaching the Curie temperature.

Management of gestational diabetes mellitus at secondary health ...

African Journals Online (AJOL)

Background: Gestational Diabetes Mellitus (GDM) account for the majority of cases of Diabetes complicating pregnancy. It is amenable to risk reduction measures and if properly managed, complications leading to poor pregnancy outcome can be prevented. However, this requires a good knowledge of the disease by the ...

The equivalence theorem

International Nuclear Information System (INIS)

Veltman, H.

1990-01-01

The equivalence theorem states that, at an energy E much larger than the vector-boson mass M, the leading order of the amplitude with longitudinally polarized vector bosons on mass shell is given by the amplitude in which these vector bosons are replaced by the corresponding Higgs ghosts. We prove the equivalence theorem and show its validity in every order in perturbation theory. We first derive the renormalized Ward identities by using the diagrammatic method. Only the Feynman-- 't Hooft gauge is discussed. The last step of the proof includes the power-counting method evaluated in the large-Higgs-boson-mass limit, needed to estimate the leading energy behavior of the amplitudes involved. We derive expressions for the amplitudes involving longitudinally polarized vector bosons for all orders in perturbation theory. The fermion mass has not been neglected and everything is evaluated in the region m f ∼M much-lt E much-lt m Higgs

Gestational diabetes, preeclampsia and cytokine release: similarities and differences in endothelial cell function.

Science.gov (United States)

Rao, Rashmi; Sen, Suvajit; Han, Bing; Ramadoss, Sivakumar; Chaudhuri, Gautam

2014-01-01

Gestational diabetes, pre-eclampsia as well as intra-uterine infection during pregnancy affects the function of the endothelium both in the mother and the fetus leading to endothelial dysfunction. Gestational diabetes is also associated with an increased incidence of pre-eclampsia and it is likely that both the hyperglycemia as well as the release of cytokines especially TNFα during hyperglycemia may play an important role in the pathogenesis of endothelial dysfunction leading to preeclampsia. Similarly, some but not all studies have suggested that infection of the mother under certain circumstances can also lead to preeclampsia as women with either a bacterial or viral infection were at a higher risk of developing preeclampsia, compared to women without infection and infection also leads to a release in TNFα. Endothelial cells exposed to either high glucose or TNFα leads to an increase in the production of H2O2 and to a decrease in endothelial cell proliferation. The cellular and molecular mechanisms involved in this phenomenon are discussed.Gestational diabetes, pre-eclampsia as well as intra-uterine infection during pregnancy has profound effects on the fetus and long term effects on the neonate. All three conditions affect the function of the endothelium both in the mother and the fetus leading to endothelial dysfunction. Gestational diabetes is also associated with an increased incidence of pre-eclampsia and it is likely that both the hyperglycemia as well as the release of cytokines especially TNFα during hyperglycemia may play an important role in the pathogenesis of endothelial dysfunction leading to preeclampsia. It has also been suggested although not universally accepted that under certain circumstances maternal infection may also predispose to pre-eclampsia. Pre-eclampsia is also associated with the release of TNFα and endothelial dysfunction. However, the cellular and molecular mechanism(s) leading to the endothelial dysfunction by either

An equivalent dipole analysis of PZT ceramics and lead-free piezoelectric single crystals

Directory of Open Access Journals (Sweden)

Andrew J. Bell

2016-06-01

Full Text Available The recently proposed Equivalent Dipole Model for describing the electromechanical properties of ionic solids in terms of 3 ions and 2 bonds has been applied to PZT ceramics and lead-free single crystal piezoelectric materials, providing analysis in terms of an effective ionic charge and the asymmetry of the interatomic force constants. For PZT it is shown that, as a function of composition across the morphotropic phase boundary, the dominant bond compliance peaks at 52% ZrO2. The stiffer of the two bonds shows little composition dependence with no anomaly at the phase boundary. The effective charge has a maximum value at 50% ZrO2, decreasing across the phase boundary region, but becoming constant in the rhombohedral phase. The single crystals confirm that both the asymmetry in the force constants and the magnitude of effective charge are equally important in determining the values of the piezoelectric charge coefficient and the electromechanical coupling coefficient. Both are apparently temperature dependent, increasing markedly on approaching the Curie temperature.

Equivalence relations and the reinforcement contingency.

Science.gov (United States)

Sidman, M

2000-07-01

Where do equivalence relations come from? One possible answer is that they arise directly from the reinforcement contingency. That is to say, a reinforcement contingency produces two types of outcome: (a) 2-, 3-, 4-, 5-, or n-term units of analysis that are known, respectively, as operant reinforcement, simple discrimination, conditional discrimination, second-order conditional discrimination, and so on; and (b) equivalence relations that consist of ordered pairs of all positive elements that participate in the contingency. This conception of the origin of equivalence relations leads to a number of new and verifiable ways of conceptualizing equivalence relations and, more generally, the stimulus control of operant behavior. The theory is also capable of experimental disproof.

Theoretical and experimental estimation of the lead equivalent for some materials used in finishing of diagnostic x-ray rooms in Syria

International Nuclear Information System (INIS)

Shwekani, R.; Suman, H.; Takeyeddin, M.; Suleiman, J.

2003-11-01

This work aimed at estimating the lead equivalent values for finishing materials, which are frequently used in Syria. These materials are ceramic and marble. In the past, many studies were performed to estimate the lead equivalent values for different types of bricks, which are widely used in Syria. Therefore, this work could be considered as a follow up in order to be able to estimate the structural shielding of diagnostic X-ray rooms and accurately perform the shielding calculations to reduce unnecessary added shields. The work was done in two ways, theoretical using MCNP computer code and experimental in the secondary standard laboratory. The theoretical work was focused on generalizing the results scope to cover the real existing variations in the structure of the materials used in the finishing or the variations in the X-ray machines. Therefore, quantifying different sources of errors were strongly focused on using the methodology of sensitivity analysis. While, the experiment measurements were performed to make sure that their results will be within the error range produced by the theoretical study. The obtained results showed a strong correlation between theoretical and experimental data. (author)

"COMPARISON OF MATERNAL AND FETAL/NEONATAL COMPLICATIONS IN GESTATIONAL AND PRE-GESTATIONAL DIABETES MELLITUS "

OpenAIRE

F. Akhlaghi A. B. Hamedi

2005-01-01

Presence of maternal diabetes mellitus (DM) during pregnancy has important consequences for both mother and child. To determine maternal and fetal/neonatal complications of gestational DM and compare them with pre-gestational DM, a prospective study was performed in 100 diabetic women delivered in our hospital from January 2001 to April 2002. Pregnancy outcome in 27 women with gestational DM and 73 women with pre-gestational DM and their offspring were studied and analyzed. The mean age of wo...

[Effects of a coaching program on comprehensive lifestyle modification for women with gestational diabetes mellitus].

Science.gov (United States)

Ko, Jung Mi; Lee, Jong Kyung

2014-12-01

The purpose of this study was to investigate the effects of using a Coaching Program on Comprehensive Lifestyle Modification with pregnant women who have gestational diabetes. The research design for this study was a non-equivalent control group quasi-experimental study. Pregnant women with gestational diabetes were recruited from D women's hospital located in Gyeonggi Province from April to October, 2013. Participants in this study were 34 for the control group and 34 for the experimental group. The experimental group participated in the Coaching Program on Comprehensive Lifestyle Modification. The program consisted of education, small group coaching and telephone coaching over 4weeks. Statistical analysis was performed using the SPSS 21.0 program. There were significant improvements in self-care behavior, and decreases in depression, fasting blood sugar and HbA1C in the experimental group compared to the control group. However, no significant differences were found between the two groups for knowledge of gestational diabetes mellitus. The Coaching Program on Comprehensive Lifestyle Modification used in this study was found to be effective in improving self-care behavior and reducing depression, fasting blood sugar and HbA1C, and is recommended for use in clinical practice as an effective nursing intervention for pregnant women with gestational diabetes.

Genetics Home Reference: gestational diabetes

Science.gov (United States)

... Email Facebook Twitter Home Health Conditions Gestational diabetes Gestational diabetes Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Gestational diabetes is a disorder characterized by abnormally high blood ...

How to Treat Gestational Diabetes

Science.gov (United States)

... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

Proportion hyperglycosylated hCG: a new test for discriminating gestational trophoblastic diseases.

Science.gov (United States)

Cole, Laurence A

2014-11-01

Hyperglycosylated human chorionic gonadotropin (hCG) is a variant of hCG with large oligosaccharide side chains. Although hCG is produced by syncytiotrophoblast cells, hyperglycosylated hCG marks cytotrophoblast cell. Hyperglycosylated hCG signals placental implantation. Total hCG in serum and urine is measured by the Siemens Immulite hCG pregnancy test; the result is in milli-international unit per milliliter. Hyperglycosylated hCG is determined by the B152 microtiter plate assay; the result is in nanogram per milliliter. Hyperglycosylated hCG results can be converted to milli-international unit per milliliter equivalents by multiplying by 11. The test measures proportion hyperglycosylated hCG, hyperglycosylated hCG / total hCG. Proportion hyperglycosylated hCG marks cases intent on developing persistent hydatidiform mole (68% detection at 17% false detection). Proportion hyperglycosylated hCG also marks persistent hydatidiform mole (100% detection at 5.1% false detection). Proportion hyperglycosylated hCG distinguishes choriocarcinoma and gestational trophoblastic neoplasm cases, absolutely discriminating aggressive cases and minimally aggressive cases. Proportion hyperglycosylated hCG identifies quiescent gestational trophoblastic disease cases. It recognizes quiescent cases that become persistent disease (100% detection at 0% false positive). Proportion hyperglycosylated hCG is an invaluable test for discriminating gestational trophoblastic diseases.

Gestational Weight Gain-for-Gestational Age Z-Score Charts Applied across U.S. Populations.

Science.gov (United States)

Leonard, Stephanie A; Hutcheon, Jennifer A; Bodnar, Lisa M; Petito, Lucia C; Abrams, Barbara

2018-03-01

Gestational weight gain may be a modifiable contributor to infant health outcomes, but the effect of gestational duration on gestational weight gain has limited the identification of optimal weight gain ranges. Recently developed z-score and percentile charts can be used to classify gestational weight gain independent of gestational duration. However, racial/ethnic variation in gestational weight gain and the possibility that optimal weight gain differs among racial/ethnic groups could affect generalizability of the z-score charts. The objectives of this study were (1) to apply the weight gain z-score charts in two different U.S. populations as an assessment of generalisability and (2) to determine whether race/ethnicity modifies the weight gain range associated with minimal risk of preterm birth. The study sample included over 4 million live, singleton births in California (2007-2012) and Pennsylvania (2003-2013). We implemented a noninferiority margin approach in stratified subgroups to determine weight gain ranges for which the adjusted predicted marginal risk of preterm birth (gestation gain between California and Pennsylvania births, and among several racial/ethnic groups in California. The optimal ranges decreased as severity of prepregnancy obesity increased in all groups. The findings support the use of weight gain z-score charts for studying gestational age-dependent outcomes in diverse U.S. populations and do not support weight gain recommendations tailored to race/ethnicity. © 2017 John Wiley & Sons Ltd.

Narrow Lead Aprons under Medical Fluoroscopy Procedures

International Nuclear Information System (INIS)

Ben-Shlomo, A.

2014-01-01

Lead aprons are the major protective item of the medical staff whose work involves x-ray exposure. Heart catheterization and angiography procedures represent the most common exposures of the medical staff. The lead equivalent thickness of lead aprons worn by the medical staff is defined by many national standards. The frontal side of the aprons should be 0.25 mm lead equivalent at working conditions under 100 kV, 0.35 mm for working conditions above 100 kV, and 0.5 mm for heart catheterization and angiography. The back side of the body needs less protection and usually is covered by 0.25 mm of lead equivalent. The lead equivalent thickness is defined at the 80 kV level

Refractive Status at Birth: Its Relation to Newborn Physical Parameters at Birth and Gestational Age

Science.gov (United States)

Varghese, Raji Mathew; Sreenivas, Vishnubhatla; Puliyel, Jacob Mammen; Varughese, Sara

2009-01-01

Background Refractive status at birth is related to gestational age. Preterm babies have myopia which decreases as gestational age increases and term babies are known to be hypermetropic. This study looked at the correlation of refractive status with birth weight in term and preterm babies, and with physical indicators of intra-uterine growth such as the head circumference and length of the baby at birth. Methods All babies delivered at St. Stephens Hospital and admitted in the nursery were eligible for the study. Refraction was performed within the first week of life. 0.8% tropicamide with 0.5% phenylephrine was used to achieve cycloplegia and paralysis of accommodation. 599 newborn babies participated in the study. Data pertaining to the right eye is utilized for all the analyses except that for anisometropia where the two eyes were compared. Growth parameters were measured soon after birth. Simple linear regression analysis was performed to see the association of refractive status, (mean spherical equivalent (MSE), astigmatism and anisometropia) with each of the study variables, namely gestation, length, weight and head circumference. Subsequently, multiple linear regression was carried out to identify the independent predictors for each of the outcome parameters. Results Simple linear regression showed a significant relation between all 4 study variables and refractive error but in multiple regression only gestational age and weight were related to refractive error. The partial correlation of weight with MSE adjusted for gestation was 0.28 and that of gestation with MSE adjusted for weight was 0.10. Birth weight had a higher correlation to MSE than gestational age. Conclusion This is the first study to look at refractive error against all these growth parameters, in preterm and term babies at birth. It would appear from this study that birth weight rather than gestation should be used as criteria for screening for refractive error, especially in developing

Refractive status at birth: its relation to newborn physical parameters at birth and gestational age.

Directory of Open Access Journals (Sweden)

Raji Mathew Varghese

Full Text Available Refractive status at birth is related to gestational age. Preterm babies have myopia which decreases as gestational age increases and term babies are known to be hypermetropic. This study looked at the correlation of refractive status with birth weight in term and preterm babies, and with physical indicators of intra-uterine growth such as the head circumference and length of the baby at birth.All babies delivered at St. Stephens Hospital and admitted in the nursery were eligible for the study. Refraction was performed within the first week of life. 0.8% tropicamide with 0.5% phenylephrine was used to achieve cycloplegia and paralysis of accommodation. 599 newborn babies participated in the study. Data pertaining to the right eye is utilized for all the analyses except that for anisometropia where the two eyes were compared. Growth parameters were measured soon after birth. Simple linear regression analysis was performed to see the association of refractive status, (mean spherical equivalent (MSE, astigmatism and anisometropia with each of the study variables, namely gestation, length, weight and head circumference. Subsequently, multiple linear regression was carried out to identify the independent predictors for each of the outcome parameters.Simple linear regression showed a significant relation between all 4 study variables and refractive error but in multiple regression only gestational age and weight were related to refractive error. The partial correlation of weight with MSE adjusted for gestation was 0.28 and that of gestation with MSE adjusted for weight was 0.10. Birth weight had a higher correlation to MSE than gestational age.This is the first study to look at refractive error against all these growth parameters, in preterm and term babies at birth. It would appear from this study that birth weight rather than gestation should be used as criteria for screening for refractive error, especially in developing countries where the

Analytical and numerical construction of equivalent cables.

Science.gov (United States)

Lindsay, K A; Rosenberg, J R; Tucker, G

2003-08-01

The mathematical complexity experienced when applying cable theory to arbitrarily branched dendrites has lead to the development of a simple representation of any branched dendrite called the equivalent cable. The equivalent cable is an unbranched model of a dendrite and a one-to-one mapping of potentials and currents on the branched model to those on the unbranched model, and vice versa. The piecewise uniform cable, with a symmetrised tri-diagonal system matrix, is shown to represent the canonical form for an equivalent cable. Through a novel application of the Laplace transform it is demonstrated that an arbitrary branched model of a dendrite can be transformed to the canonical form of an equivalent cable. The characteristic properties of the equivalent cable are extracted from the matrix for the transformed branched model. The one-to-one mapping follows automatically from the construction of the equivalent cable. The equivalent cable is used to provide a new procedure for characterising the location of synaptic contacts on spinal interneurons.

S-equivalents lagrangians in generalized mechanics

International Nuclear Information System (INIS)

Negri, L.J.; Silva, Edna G. da.

1985-01-01

The problem of s-equivalent lagrangians is considered in the realm of generalized mechanics. Some results corresponding to the ordinary (non-generalized) mechanics are extended to the generalized case. A theorem for the reduction of the higher order lagrangian description to the usual order is found to be useful for the analysis of generalized mechanical systems and leads to a new class of equivalence between lagrangian functions. Some new perspectives are pointed out. (Author) [pt

[Fetomaternal transfusion and diagnosis of gestational choriocarcinoma].

Science.gov (United States)

Emin, L; Izard, A; Schiavone, S; Kermanach, P; Deramecourt, M; Duclusaud, A; Gertych, W; Girard, S

2015-03-01

Choriocarcinoma is a rare but agressive malignant trophoblastic neoplasm. Fetomaternal transfusion can be the first sign of choriocarcinoma. We describe two cases of gestational choriocarinoma whose first manifestation was a fetomaternal transfusion. Fetomaternal transfusion is a rare demonstration of choriocarcinoma but its diagnosis must lead to a placenta examination with specific research of choriocarcinoma. The more the therapeutic care is precise, the better is the forecast. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Pre-prepregnancy body mass index and the risk of gestational diabetes mellitus

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Rudić-Grujić Vesna

2017-01-01

Full Text Available Introduction/Objective. Not only do pre-pregnancy overweight or obesity increase the risk of adverse maternal and perinatal outcomes but they also lead to the development of gestational diabetes mellitus. The objective of this study was to estimate the prevalence of pre-pregnancy overweight and obesity in the Republic of Srpska and to investigate its association with hyperglycemia and risk of gestational diabetes mellitus. Methods. A cross-sectional study was carried out during the period from February to October 2012 among 555 pregnant women in gestational period from 24 to 28 weeks. The criterion for exclusion from the sample was previously diagnosed type 1 or type 2 diabetes. Results. Before pregnancy, 20.39% of participants had increased body mass index, while 4.04 % [95% confidence interval (CI; 2.62–6.13] were obese. Gestational diabetes mellitus was diagnosed in 10.91% (95% CI, 8.44–13.98 of them. The increase in body mass index by 1 increased the risk of gestational diabetes mellitus by 1.09 times [odds ratio (OR = 1.09; 95% CI; 1.02–1.16]. Pregnant women who were overweight had a 4.88 times greater risk (OR = 4.88; 95% CI, 1.23–29.41 of developing gestational diabetes. Conclusion. Every fifth pregnant woman in this study was overweight or obese before pregnancy. The increase in body mass index by 1 increased the risk of gestational diabetes by 1.09 times (OR = 1.09; 95% CI; 1.02–1.16. Counselling is necessary for overweight and obese women planning pregnancy.

Gestational diabetes mellitus screening and outcomes.

Science.gov (United States)

Aktün, Hale Lebriz; Uyan, Derya; Yorgunlar, Betül; Acet, Mustafa

2015-01-01

To verify the usefulness of the World Health Organization criteria for the diagnosis of gestational diabetes mellitus in pregnant women and its effectiveness in the prevention of maternal and neonatal adverse results in women younger than 35 years without apparent risk factors for gestational diabetes mellitus. This is a retrospective study based on population involving 1360 pregnant women who delivered and who were followed-up in a university hospital in Istanbul. All women underwent the 75-g oral glucose tolerance test screening, usually in between the 24(th)-28(th) weeks of pregnancy. In all cases, the identification of gestational diabetes mellitus was determined in accordance with the World Health Organization criteria. Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn't showed any significant deviation between the groups. There was a moderate association between gestational diabetes mellitus and metabolic complications. Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organization criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonatal weight.

Kinetics of selenium 75 - methionine and its metabolites in various organs and the fetoplacentar unity of rats during normal and disturbed gestation

International Nuclear Information System (INIS)

Bender, G.

1980-01-01

Studies were carried out on the following 3 groups of rats: animals with normal gestation, disturbed gestation and non-gestating control animals. Relative organ activity of the mothers and of the fetoplacental unit was measured as a function of time following injection with the selenium-75 labelled amino acid, methionine. During gestation amino acid methabolism in the mothers was accelerated, this effect being less apparent in mothers with disturbed gestation; in the latter case an increased renal loss of plasma proteins and amino acids can be assumed. High activity in the methylation cycle is characteristic for the foetus. Foetal growth retardation as a consequence of reduced placental blood supply leads to a redistribution of methionine-utilisation, whereby transmethylation is favoured over protein incorporation. In addition to these systemic-dependent changes, the reduced placental diffusion leads to a local decrease in diaplacental transport. (orig./MG) [de

Gestational Diabetes and Pregnancy

Science.gov (United States)

... Pregnant Avoiding Pregnancy Zika and Pregnancy Articles Gestational Diabetes and Pregnancy Language: English (US) Español (Spanish) Recommend ... diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

Gestational diabetes mellitus results in a higher prevalence of small for gestational age babies

LENUS (Irish Health Repository)

Avalos, G

2011-09-01

Background and aims: Gestational Diabetes Mellitus (GDM) is associated with increased foetal and maternal morbidity and mortality. Previous studies have shown that babies of diabetic mothers are more likely to be large for gestational age (LGA). This retrospective study aimed to assess whether the converse may also be true, that there may also a higher rate of small for gestational age (SGA) amongst babies of mothers with GDM.\\r\

Maternal periodontal disease in early pregnancy and risk for a small-for-gestational-age infant.

Science.gov (United States)

Boggess, Kim A; Beck, James D; Murtha, Amy P; Moss, Kevin; Offenbacher, Steven

2006-05-01

The objective of the study was to determine whether periodontal disease is associated with delivery of a small-for-gestational-age infant. In a prospective study of oral health, periodontal disease was categorized as health, mild, or moderate/severe on the basis of clinical criteria. Small for gestational age was defined as birth weight less than the 10th percentile for gestational age. A risk ratio (95th percentile confidence interval) for a small-for-gestational-age infant among women with moderate or severe periodontal disease was calculated. Sixty-seven of 1017 women (6.6%) delivered a small-for-gestational-age infant, and 143 (14.3%) had moderate or severe periodontal disease. The small-for-gestational-age rate was higher among women with moderate or severe periodontal disease, compared with those with health or mild disease (13.8% versus 3.2% versus 6.5%, P periodontal disease was associated with a small-for-gestational-age infant, a risk ratio of 2.3 (1.1 to 4.7), adjusted for age, smoking, drugs, marital and insurance status, and pre-eclampsia. Moderate or severe periodontal disease early in pregnancy is associated with delivery of a small-for-gestational-age infant. Understanding the mechanism of periodontal disease-associated adverse pregnancy outcomes could lead to interventions to improve fetal growth.

Development of human skin equivalents mimicking skin aging : contrast between papillary and reticular fibroblasts as a lead

NARCIS (Netherlands)

Janson, D.

2017-01-01

This thesis describes the development of human skin equivalents that show characteristics of skin aging. The type of skin equivalent used was a fibroblast derived matrix equivalent, in which the dermal compartment is generated by fibroblasts and thus is fully of human origin. Two strategies are

Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening.

LENUS (Irish Health Repository)

Buckley, B S

2011-12-12

Background:  Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of its diagnosis. Methods:  The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices and barriers to screening. Results:  Prevalence is most often reported as 2-6% of pregnancies. Prevalence may be lower towards the Northern Atlantic seaboard of Europe and higher in the Southern Mediterranean seaboard. Screening practice and policy is inconsistent across Europe, hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. Conclusions:  Europe-wide agreement on screening approaches and diagnostic standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.

Genetic influence on prolonged gestation

DEFF Research Database (Denmark)

Laursen, Maja; Bille, Camilla; Olesen, Annette Wind

2004-01-01

OBJECTIVE: The purpose of this study was to test a possible genetic component to prolonged gestation. STUDY DESIGN: The gestational duration of single, first pregnancies by both female and male twins was obtained by linking the Danish Twin Registry, The Danish Civil Registration System, and the D...... factors. CONCLUSION: Maternal genes influence prolonged gestation. However, a substantial paternal genetic influence through the fetus was not found....

Thyroid equivalent dose in staffs that use neck lead protector in pediatric barium meal; Dose equivalente na tireoide dos profissionais que utilizam o protetor plumbifero nos exames de seed pediatrico

Energy Technology Data Exchange (ETDEWEB)

Filipov, Danielle; Sauzen, Jessica; Paschuk, Sergei A., E-mail: dfilipov@utfpr.edu.br [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Schelin, Hugo R.; Denyak, Valeriy [Instituto de Pesquisa Pele Pequeno Principe (IPPP), Curitiba, PR (Brazil); Legnani, Adriano [Hospital Pequeno Principe, Curitiba, PR (Brazil)

2015-08-15

The aim of this study is to estimate the thyroid equivalent dose in staffs that perform pediatric barium meal procedures and use neck lead protector. Thermoluminescent Dosimeters (TLDs) were positioned on the lead protectors, used by two professionals. After that, a solid state detector was exposed (with and without the protector above it). Therefore, it was possible to obtain both lead protectors attenuation factors. At the end, average and annual doses received by the TLDs and the thyroid (applying the attenuation factor over the dosimeters doses) were obtained. It was found that the average and annual equivalent doses in the thyroid gland are, respectively, higher than in comparative studies and within the established limits. With these data, it is concluded that the application of radiation protection optimization techniques is required. (author)

Gestational surrogacy.

Science.gov (United States)

Brinsden, Peter R

2003-01-01

Gestational surrogacy is a treatment option available to women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. IVF allows the creation of embryos from the gametes of the commissioning couple and subsequent transfer of these embryos to the uterus of a surrogate host. The indications for treatment include absent uterus, recurrent miscarriage, repeated failure of IVF and certain medical conditions. Treatment by gestational surrogacy is straightforward and follows routine IVF procedures for the commissioning mother, with the transfer of fresh or frozen-thawed embryos to the surrogate host. The results of treatment are good, as would be expected from the transfer of embryos derived from young women and transferred to fit, fertile women who are also young. Clinical pregnancy rates achieved in large series are up to 40% per transfer and series have reported 60% of hosts achieving live births. The majority of ethical or legal problems that have arisen out of surrogacy have been from natural or partial surrogacy arrangements. The experience of gestational surrogacy has been largely complication-free and early results of the follow-up of children, commissioning couples and surrogates are reassuring. In conclusion, gestational surrogacy arrangements are carried out in a few European countries and in the USA. The results of treatment are satisfactory and the incidence of major ethical or legal complications has been limited. IVF surrogacy is therefore a successful treatment for a small group of women who would otherwise not be able to have their own genetic children.

Diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds.

Science.gov (United States)

Carolan, Mary

2014-05-01

for targeted educational programmes for women with low literacy. Resources should be literacy appropriate, with photographs and simple text, and include culturally appropriate foods and information. This approach should lead to an improvement in the women's uptake of gestational diabetes mellitus information and may lead to a lessening of the workload burden for diabetes nurse educators. © 2013 John Wiley & Sons Ltd.

Gestational Diabetes Mellitus: Post-partum Risk and Follow Up.

Science.gov (United States)

Poola-Kella, Silpa; Steinman, Rachel A; Mesmar, Bayan; Malek, Rana

2018-01-31

Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. This review involves a comprehensive literature review on gestational diabetes and postpartum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and β cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation.

LENUS (Irish Health Repository)

Caritis, Steve N

2012-11-01

We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) concentration and gestational age at delivery and select biomarkers of potential pathways of drug action.

Chronic Gestational Stress Leads to Depressive-Like Behavior and Compromises Medial Prefrontal Cortex Structure and Function during the Postpartum Period

Science.gov (United States)

Leuner, Benedetta; Fredericks, Peter J.; Nealer, Connor; Albin-Brooks, Christopher

2014-01-01

Postpartum depression, which affects approximately 15% of new mothers, is associated with impaired mother-infant interactions and deficits in cognitive function. Exposure to stress during pregnancy is a major risk factor for postpartum depression. However, little is known about the neural consequences of gestational stress. The medial prefrontal cortex (mPFC) is a brain region that has been linked to stress, cognition, maternal care, and mood disorders including postpartum depression. Here we examined the effects of chronic gestational stress on mPFC function and whether these effects might be linked to structural modifications in the mPFC. We found that in postpartum rats, chronic gestational stress resulted in maternal care deficits, increased depressive-like behavior, and impaired performance on an attentional set shifting task that relies on the mPFC. Furthermore, exposure to chronic stress during pregnancy reduced dendritic spine density on mPFC pyramidal neurons and altered spine morphology. Taken together, these findings suggest that pregnancy stress may contribute to postpartum mental illness and its associated symptoms by compromising structural plasticity in the mPFC. PMID:24594708

Chronic gestational stress leads to depressive-like behavior and compromises medial prefrontal cortex structure and function during the postpartum period.

Directory of Open Access Journals (Sweden)

Benedetta Leuner

Full Text Available Postpartum depression, which affects approximately 15% of new mothers, is associated with impaired mother-infant interactions and deficits in cognitive function. Exposure to stress during pregnancy is a major risk factor for postpartum depression. However, little is known about the neural consequences of gestational stress. The medial prefrontal cortex (mPFC is a brain region that has been linked to stress, cognition, maternal care, and mood disorders including postpartum depression. Here we examined the effects of chronic gestational stress on mPFC function and whether these effects might be linked to structural modifications in the mPFC. We found that in postpartum rats, chronic gestational stress resulted in maternal care deficits, increased depressive-like behavior, and impaired performance on an attentional set shifting task that relies on the mPFC. Furthermore, exposure to chronic stress during pregnancy reduced dendritic spine density on mPFC pyramidal neurons and altered spine morphology. Taken together, these findings suggest that pregnancy stress may contribute to postpartum mental illness and its associated symptoms by compromising structural plasticity in the mPFC.

Automatic segmentation of the hippocampus for preterm neonates from early-in-life to term-equivalent age

Directory of Open Access Journals (Sweden)

Ting Guo

2015-01-01

Conclusions: MAGeT-Brain is capable of segmenting hippocampi accurately in preterm neonates, even at early-in-life. Hippocampal asymmetry with a larger right side is demonstrated on early-in-life images, suggesting that this phenomenon has its onset in the 3rd trimester of gestation. Hippocampal volume assessed at the time of early-in-life and term-equivalent age is linearly associated with GA at birth, whereby smaller volumes are associated with earlier birth.

Frequency and Factors Leading to Recurrent Pre-Eclampsia

International Nuclear Information System (INIS)

Emanuel, M.; Butt, S.

2015-01-01

Objective: To determine the frequency and factors leading to recurrent preeclampsia. Methods: The cross-sectional study was conducted at the Jinnah Post Graduate Medical Centre, Karachi, from January 2011 to February 2012, and comprised parous subjects <40 years of age with history of preeclampsia in previous pregnancy/pregnancies with singleton pregnancy and gestational age of >20 weeks. Gestational age was determined by early scan with preeclampsia in index pregnancy. Data was collected through a specialised questionnaire and analysed using SPSS 16. Results: Of the 479 patients seen with preeclampsia, 121(25.26 percent) were of recurrent preeclampsia. The mean age of such patients was 29.7±4.9 years (range: 20-39 years). Further, 84(69.42 percent) patients were multipara and 40(33.05 percent) were grand multipara. Mean body mass index was 29.97±6.2 (range: 18-54). Besides, 28(23.14 percent) patients had gestational diabetes; 7(5.78 percent) were known diabetics; 24(19.83 percent) had chronic hypertension; 2(1.7 percent) patients had chronic renal disease; and 1(0.8 percent) had connective tissue disorder. Conclusion: Being over-weight, having gestational diabetes and chronic hypertension were main risk factors leading to recurrent preeclampsia. (author)

Comparison of gestational dating methods and implications ...

Science.gov (United States)

OBJECTIVES: Estimating gestational age is usually based on date of last menstrual period (LMP) or clinical estimation (CE); both approaches introduce potential bias. Differences in methods of estimation may lead to misclassificat ion and inconsistencies in risk estimates, particularly if exposure assignment is also gestation-dependent. This paper examines a'what-if' scenario in which alternative methods are used and attempts to elucidate how method choice affects observed results.METHODS: We constructed two 20-week gestational age cohorts of pregnancies between 2000 and 2005 (New Jersey, Pennsylvania, Ohio, USA) using live birth certificates : one defined preterm birth (PTB) status using CE and one using LMP. Within these, we estimated risk for 4 categories of preterm birth (PTBs per 106 pregnancies) and risk differences (RD (95% Cl s)) associated with exposure to particulate matter (PM2. 5).RESULTS: More births were classified preterm using LMP (16%) compared with CE (8%). RD divergences increased between cohorts as exposure period approached delivery. Among births between 28 and 31 weeks, week 7 PM2.5 exposure conveyed RDs of 44 (21 to 67) for CE and 50 (18 to 82) for LMP populations, while week 24 exposure conveyed RDs of 33 (11 to 56) and -20 (-50 to 10), respectively.CONCLUSIONS: Different results from analyses restricted to births with both CE and LMP are most likely due to differences in dating methods rather than selection issues. Results are sensitive t

Association of newborn diseases with weight/length ratio and the adequacy of weight for gestational age

Directory of Open Access Journals (Sweden)

José Ricardo Dias Bertagnon

2011-09-01

Full Text Available Objective: To compare the frequencies of newborn diseases in thosenewborns classified according to a weight/length rate and thoseclassified by the adequacy weight for gestational age. Methods: Aretrospective cross-sectional study by record assessment was carriedout enclosing all the live newborns at Hospital Geral do Grajaú, fromSeptember to December, 2009 (n =577 classified according to therate weight/length and also to the adequacy weight for gestationalage. The 10 and 90 percentiles of the weight/length distribution, nowdesignated as “indices” were calculated leading to the followingclassification: low index, for newborns below 54.8 g/cm; high index,for those over 75.8 g/cm; and average index, for the remainingnewborns. According to the adequacy weight for gestational age thenewborns were designated as pre-term for gestational age; term smallfor gestational age; appropriate term and large term. In this samplethere were no small and large pre-term or post-term newborns. Majordiseases were related to the index and adequacy extracts by the χ2test for a contingency table. Results: A significant association wasfound among low index, pre-term for gestational age newborns andterm small for gestational age; between average index and appropriatefor gestational age term newborns; and high index with large termappropriate for gestational age newborns (p< 0.001. Hypoglycemia(3.4% was associated to both low and high indices, to appropriatefor gestational age preterm newborns and to small for gestational ageterm newborns. Sepsis (3.1% was associated to both low index andpre-term appropriate for gestational age newborns. The respiratorydistress syndrome (1.3% was associated to low index and pre-termappropriate for gestational age newborns. Other respiratory distresssyndromes (3.8% were associated to low and high indices but notto the adequacy for gestational age classification. Jaundice (14.9%was not associated to the studied classifications

The management of gestational diabetes

Directory of Open Access Journals (Sweden)

N Wah Cheung

2009-01-01

Full Text Available N Wah CheungCentre for Diabetes and Endocrinology Research, Westmead Hospital, and University of Sydney, NSW, AustraliaAbstract: The incidence of gestational diabetes is increasing. As gestational diabetes is associated with adverse pregnancy outcomes, and has long-term implications for both mother and child, it is important that it is recognized and appropriately managed. This review will examine the pharmacological options for the management of gestational diabetes, as well as the evidence for blood glucose monitoring, dietary and exercise therapy. The medical management of gestational diabetes is still evolving, and recent randomized controlled trials have added considerably to our knowledge in this area. As insulin therapy is effective and safe, it is considered the gold standard of pharmacotherapy for gestational diabetes, against which other treatments have been compared. The current experience is that the short acting insulin analogs lispro and aspart are safe, but there are only limited data to support the use of long acting insulin analogs. There are randomized controlled trials which have demonstrated efficacy of the oral agents glyburide and metformin. Whilst short-term data have not demonstrated adverse effects of glyburide and metformin on the fetus, and they are increasingly being used in pregnancy, there remain long-term concerns regarding their potential for harm.Keywords: gestational diabetes, insulin, oral antidiabetic agents, pregnancy, type 2 diabetes

Maternal homocysteine and small-for-gestational-age offspring: systematic review and meta-analysis

NARCIS (Netherlands)

Hogeveen, M.; Blom, H.J.; den Heijer, M.

2012-01-01

Background: Growth retardation in utero leading to small-for-gestational- age (SGA) newborns is associated with increased neonatal morbidity and mortality and with lifelong consequences such as poor cognitive function and cardiovascular diseases. Maternal total homocysteine (tHcy) concentrations

Severe gestational hypertriglyceridemia: A practical approach for clinicians

Science.gov (United States)

Wong, Bertha; Ooi, Teik C

2015-01-01

Severe gestational hypertriglyceridemia is a potentially life threatening and complex condition to manage, requiring attention to a delicate balance between maternal and fetal needs. During pregnancy, significant alterations to lipid homeostasis occur to ensure transfer of nutrients to the fetus. In women with an underlying genetic predisposition or a secondary exacerbating factor, severe gestational hypertriglyceridemia can arise, leading to devastating complications, including acute pancreatitis. Multidisciplinary care, implementation of a low-fat diet with nutritional support, and institution of a hierarchical therapeutic approach are all crucial to reduce maternal and fetal morbidity. To avoid maternal pancreatitis, close surveillance of triglycerides throughout pregnancy with elective hospitalization for refractory cases is recommended. Careful dietary planning is required to prevent neural and retinal complications from fetal essential fatty acid deficiency. Questions remain about the safety of fibrates and plasmapheresis in pregnancy as well as the optimal timing for induction and delivery of these women. PMID:27512474

Resistin role in development of gestational diabetes mellitus.

Science.gov (United States)

Siddiqui, Khalid; George, Teena P

2017-07-01

Diabetes is estimated to be one of the major causes of deaths in most countries due to its high prevalence rate, which was 8.8% in 2015. Hyperglycemia detected during pregnancy is known as gestational diabetes mellitus and it increases the potential risk of development of Type 2 diabetes in mothers with its varying prevalence rate of 1-14% in different populations. It also leads to the higher risk of developing abnormal glucose tolerance and obesity in their child at an early age. Recent studies show that potential mediators of insulin resistance such as adipokines - adiponectin, leptin and resistin are important for glucose and lipid metabolism. Adipokines are directly involved in the regulation of insulin secretion and insulin sensitivity in the liver, muscle and adipose tissue. It is also involved in inflammation, adipose tissue accumulation, adverse fat distribution and subsequently affects glucose metabolism. This review highlights the role of resistin (an adipokine) in the development of gestational diabetes mellitus.

Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus.

Directory of Open Access Journals (Sweden)

Evgeny Viktorovich Mikhalev

2015-03-01

Full Text Available The article reviews the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes; possible mechanisms of their development are also highlighted. The review describes changes in blood glucose concentration in term newborns from women with gestational diabetes, and their impact on the child's condition. In addition to already known factors causing macrosomia and other metabolic disorders in term neonates, the role of leptin (peptide hormone that regulates energy metabolism is quite discussable. Low leptin levels lead to the development of obesity. It is also confirmed, that leptin influences brain development of the newborn, leading to later cognitive deficits in children from women with GDM. The aim of the review is to summarize the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes.

Estimating Gestational Age From Ultrasound Fetal Biometrics.

Science.gov (United States)

Skupski, Daniel W; Owen, John; Kim, Sungduk; Fuchs, Karin M; Albert, Paul S; Grantz, Katherine L

2017-08-01

To compare the accuracy of a new formula with one developed in 1984 (and still in common use) and to develop and compare racial and ethnic-specific and racial and ethnic-neutral formulas. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons was a prospective cohort study that recruited women in four self-reported racial-ethnic groups-non-Hispanic black, Hispanic, non-Hispanic white, and Asian-with singleton gestations from 12 U.S. centers (2009-2013). Women with a certain last menstrual period confirmed by first-trimester ultrasonogram had longitudinal fetal measurements by credentialed study ultrasonographers blinded to the gestational age at their five follow-up visits. Regression analyses were performed with linear mixed models to develop gestational age estimating formulas. Repeated cross-validation was used for validation. The estimation error was defined as the mean squared difference between the estimated and observed gestational age and was used to compare the formulas' accuracy. The new formula estimated the gestational age (±2 SD) within ±7 days from 14 to 20 weeks of gestation, ±10 days from 21 to 27 weeks of gestation, and ±17 days from 28 to 40 weeks of gestation. The new formula performed significantly better than a formula developed in 1984 with an estimation error of 10.4 compared with 11.2 days from 21 to 27 weeks of gestation and 17.0 compared with 19.8 days at 28-40 weeks of gestation, respectively. Racial and ethnic-specific formulas did not outperform the racial and ethnic-neutral formula. The NICHD gestational age estimation formula is associated with smaller errors than a well-established historical formula. Racial and ethnic-specific formulas are not superior to a racial-ethnic-neutral one.

Ethical issues in gestational surrogacy.

Science.gov (United States)

Ber, R

2000-01-01

The introduction of contraceptive technologies has resulted in the separation of sex and procreation. The introduction of new reproductive technologies (mainly IVF and embryo transfer) has led not only to the separation of procreation and sex, but also to the redefinition of the terms mother and family. For the purpose of this essay, I will distinguish between: 1. the genetic mother--the donor of the egg; 2. the gestational mother--she who bears and gives birth to the baby; 3. the social mother--the woman who raises the child. This essay will deal only with the form of gestational surrogacy in which the genetic parents intend to be the social parents, and the surrogate mother has no genetic relationship to the child she bears and delivers. I will raise questions regarding medical ethical aspects of surrogacy and the obligation(s) of the physician(s) to the parties involved. I will argue that the gestational surrogate is "a womb to rent," that there is great similarity between gestational commercial surrogacy and organ transplant marketing. Furthermore, despite claims to freedom of choice and free marketing, I will claim that gestational surrogacy is a form of prostitution and slavery, exploitation of the poor and needy by those who are better off. The right to be a parent, although not constitutional, is intuitive and deeply rooted. However, the issue remains whether this right overrules all other rights, and at what price to the parties involved. I will finally raise the following provocative question to society: In the interim period between today's limited technology and tomorrow's extra-corporeal gestation technology (ectogenesis), should utilizing females in PVS (persistent vehetative state) for gestational surrogacy be socially acceptable/permissible--provided they have left permission in writing?

Mathematical simulation of biologically equivalent doses for LDR-HDR

International Nuclear Information System (INIS)

Slosarek, K.; Zajusz, A.

1996-01-01

Based on the LQ model examples of biologically equivalent doses LDR, HDR and external beams were calculated. The biologically equivalent doses for LDR were calculated by appending to the LQ model the corrector for the time of repair of radiation sublethal damages. For radiation continuously delivered at a low dose rate the influence of sublethal damage repair time changes on biologically equivalent doses were analysed. For fractionated treatment with high dose rate the biologically equivalent doses were calculated by adding to the LQ model the formula of accelerated repopulation. For total biologically equivalent dose calculation for combine LDR-HDR-Tele irradiation examples are presented with the use of different parameters of the time of repair of sublethal damages and accelerated repopulation. The calculations performed show, that the same biologically equivalent doses can be obtained for different parameters of cell kinetics changes during radiation treatment. It also shows, that during biologically equivalent dose calculations for different radiotherapy schedules, ignorance of cell kinetics parameters can lead to relevant errors

Brain Development, Intelligence and Cognitive Outcome in Children Born Small for Gestational Age

NARCIS (Netherlands)

de Bie, H.M.A.; Oostrom, K.J.; Delemarre-van d Waal, H.A.

2010-01-01

Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with increased neonatal morbidity and mortality as well as short stature, cardiovascular disease, insulin resistance, diabetes mellitus type 2, dyslipidemia and end-stage renal

Gestational diabetes: A clinical update

DEFF Research Database (Denmark)

Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov

2015-01-01

Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance...

Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis.

Science.gov (United States)

Magro-Malosso, Elena R; Saccone, Gabriele; Di Tommaso, Mariarosaria; Roman, Amanda; Berghella, Vincenzo

2017-08-01

Gestational hypertensive disorders, including gestational hypertension and preeclampsia, are one of the leading causes of maternal morbidity and mortality. The aim of our study was to evaluate the effect of exercise during pregnancy on the risk of gestational hypertensive disorders. Electronic databases were searched from their inception to February 2017. Selection criteria included only randomized controlled trials of uncomplicated pregnant women assigned before 23 weeks to an aerobic exercise regimen or not. The summary measures were reported as relative risk with 95% confidence intervals. The primary outcome was the incidence of gestational hypertensive disorders, defined as either gestational hypertension or preeclampsia. Seventeen trials, including 5075 pregnant women, were analyzed. Of them, seven contributed data to quantitative meta-analysis for the primary outcome. Women who were randomized in early pregnancy to aerobic exercise for about 30-60 min two to seven times per week had a significant lower incidence of gestational hypertensive disorders (5.9% vs. 8.5%; relative risk 0.70, 95% confidence interval 0.53-0.83; seven studies, 2517 participants), specifically a lower incidence of gestational hypertension (2.5% vs. 4.6%; relative risk 0.54, 95% confidence interval 0.40-0.74; 16 studies, 4641 participants) compared with controls. The incidence of preeclampsia (2.3% vs. 2.8%; relative risk 0.79, 95% confidence interval 0.45-1.38; six studies, 2230 participants) was similar in both groups. The incidence of cesarean delivery was decreased by 16% in the exercise group. Aerobic exercise for about 30-60 min two to seven times per week during pregnancy, as compared with being more sedentary, is associated with a significantly reduced risk of gestational hypertensive disorders overall, gestational hypertension, and cesarean delivery. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Gestational Diabetes Mellitus

DEFF Research Database (Denmark)

McIntyre, H David; Jensen, Dorte M; Jensen, Richard C

2018-01-01

OBJECTIVE: To define the prevalence and pregnancy outcomes related to elevated fasting venous plasma glucose (FVPG) in a Danish pregnancy cohort. RESEARCH DESIGN AND METHODS: This was an observational cohort study including 1,516 women without gestational diabetes mellitus (GDM) by Danish criteria....... FVPG measured at 28 weeks' gestation was related to pregnancy outcomes. RESULTS: With use of the World Health Organization 2013 threshold of FVPG ≥5.1 mmol/L, 40.1% of the cohort qualified as having GDM. There was no evidence of excess fetal growth, hypertension in pregnancy, or caesarean delivery...

Screening for gestational diabetes mellitus

NARCIS (Netherlands)

van Leeuwen, M.

2012-01-01

Gestational diabetes mellitus is associated with increased risk of complications for mother and child. Along with the growing epidemic of obesity and type 2 diabetes, the prevalence of gestational diabetes is expected to rise. With adequate and timely treatment, the risk of complications is reduced.

HbA1c and Gestational Weight Gain Are Factors that Influence Neonatal Outcome in Mothers with Gestational Diabetes.

Science.gov (United States)

Barquiel, Beatriz; Herranz, Lucrecia; Hillman, Natalia; Burgos, Ma Ángeles; Grande, Cristina; Tukia, Keleni M; Bartha, José Luis; Pallardo, Luis Felipe

2016-06-01

Maternal glucose and weight gain are related to neonatal outcome in women with gestational diabetes mellitus (GDM). The aim of this study was to explore the influence of average third-trimester HbA1c and excess gestational weight gain on GDM neonatal complications. This observational study included 2037 Spanish singleton pregnant women with GDM followed in our Diabetes and Pregnancy Unit. The maternal HbA1c level was measured monthly from GDM diagnosis to delivery. Women were compared by average HbA1c level and weight gain categorized into ≤ or > the current Institute of Medicine (IOM) recommendations for body mass index. The differential effects of these factors on large-for-gestational-age birth weight and a composite of neonatal complications were assessed. Women with an average third-trimester HbA1c ≥5.0% (n = 1319) gave birth to 7.3% versus 3.8% (p = 0.005) of large-for-gestational-age neonates and 22.0% versus 16.0% (p = 0.006) of neonates with complications. Women with excess gestational weight gain (n = 299) delivered 12.5% versus 5.2% (p gestational-age neonates and 24.7% versus 19.0% (p = 0.022) of neonates with complications. In an adjusted multiple logistic regression analysis among mothers exposed to the respective risk factors, ∼47% and 52% of large-for-gestational-age neonates and 32% and 37% of neonatal complications were potentially preventable by attaining an average third-trimester HbA1c level gestational weight gain. Average third-trimester HbA1c level ≥5% and gestational weight gain above the IOM recommendation are relevant risk factors for neonatal complications in mothers with gestational diabetes.

Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age

NARCIS (Netherlands)

de Bie, Henrica M. A.; de Ruiter, Michiel B.; Ouwendijk, Mieke; Oostrom, Kim J.; Wilke, Marko; Boersma, Maria; Veltman, Dick J.; Delemarre-van de Waal, Henriette A.

2015-01-01

Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic

Children’s Brain Development Benefits from Longer Gestation

Directory of Open Access Journals (Sweden)

Elysia Poggi Davis

2011-02-01

Full Text Available Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging (MRI in 100 healthy right-handed six to ten year old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in grey matter density. Further, the benefit of longer gestation for brain development was present even when only full term infants were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.

Evaluation of passive avoidance learning and spatial memory in rats exposed to low levels of lead during specific periods of early brain development.

Science.gov (United States)

Rao Barkur, Rajashekar; Bairy, Laxminarayana K

2015-01-01

Widespread use of heavy metal lead (Pb) for various commercial purposes has resulted in the environmental contamination caused by this metal. The studies have shown a definite relationship between low level lead exposure during early brain development and deficit in children's cognitive functions. This study investigated the passive avoidance learning and spatial learning in male rat pups exposed to lead through their mothers during specific periods of early brain development. Experimental male rats were divided into 5 groups: i) the normal control group (NC) (N = 12) consisted of rat offspring born to mothers who were given normal drinking water throughout gestation and lactation, ii) the pre-gestation lead exposed group (PG) (N = 12) consisted of rat offspring, mothers of these rats had been exposed to 0.2% lead acetate in the drinking water for 1 month before conception, iii) the gestation lead exposed group (G) (N = 12) contained rat offspring born to mothers who had been exposed to 0.2% lead acetate in the drinking water throughout gestation, iv) the lactation lead exposed group (L) (N = 12) had rat offspring, mothers of these rats exposed to 0.2% lead acetate in the drinking water throughout lactation and v) the gestation and lactation lead exposed group (GL) (N = 12) contained rat offspring, mothers of these rats were exposed to 0.2% lead acetate throughout gestation and lactation. The study found deficit in passive avoidance learning in the G, L and GL groups of rats. Impairment in spatial learning was found in the PG, G, L and GL groups of rats. Interestingly, the study found that gestation period only and lactation period only lead exposure was sufficient to cause deficit in learning and memory in rats. The extent of memory impairment in the L group of rats was comparable with the GL group of rats. So it can be said that postnatal period of brain development is more sensitive to neurotoxicity compared to prenatal exposure. This work is available in Open

PA/Lateral chest X-ray is equivalent to cine-fluoroscopy for the detection of conductor externalization in defibrillation leads.

Science.gov (United States)

Steinberg, Christian; Sarrazin, Jean-François; Philippon, François; Champagne, Jean; Molin, Franck; Nault, Isabelle; Blier, Louis; Bouchard, Marc-André; Arsenault, Jean; O'Hara, Gilles

2015-01-01

Riata™ and Riata ST defibrillation leads (St. Jude Medical, Sylmar, CA, USA) are susceptible to insulation defects with conductor externalization. Cine-fluoroscopy is considered to be the gold standard for the documentation of insulation defects, but similar detection rates have been reported for posterior-anterior (PA)/lateral chest x-ray (CXR) with zooming. Prospective single-center study to assess the diagnostic equivalence of a PA/lateral CXR with zooming for the detection of Riata insulation defects in a direct comparison to cine-fluoroscopy. Seventy-eight consecutive patients underwent 3-view cine-fluoroscopy and a PA/lateral CXR. All CXRs and cine-fluoroscopy images were reviewed by blinded electrophysiologists and staff radiologists. Forty-four of 78 patients had an abnormal cine-fluoroscopy (56%). The diagnostic correlation between PA/lateral CXR and cine-fluoroscopy was excellent (κ = 0.90; 95% confidence interval 0.80-1.00). PA/lateral CXR was equivalent to cine-fluoroscopy for the detection of conductor externalization showing a sensitivity of 97.7% and a specificity of 91.2%. The mean radiation effective dose of CXR was significantly lower compared to cine-fluoroscopy (0.09 millisievert [mSV] vs 0.85 ± 0.47 mSv; P cine-fluoroscopy for the detection of Riata insulation defects and should be considered as the preferred screening method. ©2014 Wiley Periodicals, Inc.

Placental Nutrient Transport in Gestational Diabetic Pregnancies

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Marisol Castillo-Castrejon

2017-11-01

Full Text Available Maternal obesity during pregnancy is rising and is associated with increased risk of developing gestational diabetes mellitus (GDM, defined as glucose intolerance first diagnosed in pregnancy (1. Fetal growth is determined by the maternal nutrient supply and placental nutrient transfer capacity. GDM-complicated pregnancies are more likely to be complicated by fetal overgrowth or excess adipose deposition in utero. Infants born from GDM mothers have an increased risk of developing cardiovascular and metabolic disorders later in life. Diverse factors, such as ethnicity, age, fetal sex, clinical treatment for glycemic control, gestational weight gain, and body mass index among others, represent a challenge for studying underlying mechanisms in GDM subjects. Determining the individual roles of glucose intolerance, obesity, and other factors on placental function and fetal growth remains a challenge. This review provides an overview of changes in placental macronutrient transport observed in human pregnancies complicated by GDM. Improved knowledge and understanding of the alterations in placenta function that lead to pathological fetal growth will allow for development of new therapeutic interventions and treatments to improve pregnancy outcomes and lifelong health for the mother and her children.

Radiation brain dose to vascular surgeons during fluoroscopically guided interventions is not effectively reduced by wearing lead equivalent surgical caps.

Science.gov (United States)

Kirkwood, Melissa L; Arbique, Gary M; Guild, Jeffrey B; Zeng, Katie; Xi, Yin; Rectenwald, John; Anderson, Jon A; Timaran, Carlos

2018-03-12

Radiation to the interventionalist's brain during fluoroscopically guided interventions (FGIs) may increase the incidence of cerebral neoplasms. Lead equivalent surgical caps claim to reduce radiation brain doses by 50% to 95%. We sought to determine the efficacy of the RADPAD (Worldwide Innovations & Technologies, Lenexa, Kan) No Brainer surgical cap (0.06 mm lead equivalent at 90 kVp) in reducing radiation dose to the surgeon's and trainee's head during FGIs and to a phantom to determine relative brain dose reductions. Optically stimulated, luminescent nanoDot detectors (Landauer, Glenwood, Ill) inside and outside of the cap at the left temporal position were used to measure cap attenuation during FGIs. To check relative brain doses, nanoDot detectors were placed in 15 positions within an anthropomorphic head phantom (ATOM model 701; CIRS, Norfolk, Va). The phantom was positioned to represent a primary operator performing femoral access. Fluorography was performed on a plastic scatter phantom at 80 kVp for an exposure of 5 Gy reference air kerma with or without the hat. For each brain location, the percentage dose reduction with the hat was calculated. Means and standard errors were calculated using a pooled linear mixed model with repeated measurements. Anatomically similar locations were combined into five groups: upper brain, upper skull, midbrain, eyes, and left temporal position. This was a prospective, single-center study that included 29 endovascular aortic aneurysm procedures. The average procedure reference air kerma was 2.6 Gy. The hat attenuation at the temporal position for the attending physician and fellow was 60% ± 20% and 33% ± 36%, respectively. The equivalent phantom measurements demonstrated an attenuation of 71% ± 2.0% (P < .0001). In the interior phantom locations, attenuation was statistically significant for the skull (6% ± 1.4%) and upper brain (7.2% ± 1.0%; P < .0001) but not for the middle brain (1.4% ± 1.0%; P = .15

Distinct alterations in motor & reward seeking behavior are dependent on the gestational age of exposure to LPS-induced maternal immune activation.

Science.gov (United States)

Straley, Megan E; Van Oeffelen, Wesley; Theze, Sarah; Sullivan, Aideen M; O'Mahony, Siobhain M; Cryan, John F; O'Keeffe, Gerard W

2017-07-01

The dopaminergic system is involved in motivation, reward and the associated motor activities. Mesodiencephalic dopaminergic neurons in the ventral tegmental area (VTA) regulate motivation and reward, whereas those in the substantia nigra (SN) are essential for motor control. Defective VTA dopaminergic transmission has been implicated in schizophrenia, drug addiction and depression whereas dopaminergic neurons in the SN are lost in Parkinson's disease. Maternal immune activation (MIA) leading to in utero inflammation has been proposed to be a risk factor for these disorders, yet it is unclear how this stimulus can lead to the diverse disturbances in dopaminergic-driven behaviors that emerge at different stages of life in affected offspring. Here we report that gestational age is a critical determinant of the subsequent alterations in dopaminergic-driven behavior in rat offspring exposed to lipopolysaccharide (LPS)-induced MIA. Behavioral analysis revealed that MIA on gestational day 16 but not gestational day 12 resulted in biphasic impairments in motor behavior. Specifically, motor impairments were evident in early life, which were resolved by adolescence, but subsequently re-emerged in adulthood. In contrast, reward seeking behaviors were altered in offspring exposed MIA on gestational day 12. These changes were not due to a loss of dopaminergic neurons per se in the postnatal period, suggesting that they reflect functional changes in dopaminergic systems. This highlights that gestational age may be a key determinant of how MIA leads to distinct alterations in dopaminergic-driven behavior across the lifespan of affected offspring. Copyright © 2016 Elsevier Inc. All rights reserved.

Correlation between self-reported gestational age and ultrasound measurements

DEFF Research Database (Denmark)

Olesen, Annette Wind; Westergaard, Jes Grabow; Thomsen, Sten Grove

2004-01-01

BACKGROUND: We studied the agreement between different measurements of gestational age, i.e. self-reported gestational age in the Danish National Birth Cohort Study, ultrasound-estimated gestational age from the medical records in one Danish county and gestational age from the Danish National...

Clinical diagnosis of gestational diabetes.

Science.gov (United States)

Ryan, Edmond A

2013-12-01

Gestational diabetes mellitus (GDM) diagnosis remains controversial. ACOG criteria are based on the long-term risk of maternal diabetes. ADA recently suggested diagnosing GDM with 1 elevated value on an oral glucose tolerance test based on a 1.75-fold risk of large-for-gestational age infants resulting in a 17.8% rate of GDM. Given the lack of neonatal-based outcomes for the traditional position and problems of reproducibility and benefit/harm balance of the ADA approach, an alternative is presented herein based on a 2-fold risk of a large-for-gestational age baby, requiring 2 separate abnormalities to reduce false positives giving a more balanced benefit/harm ratio (10% GDM rate).

Fetal programming and gestational diabetes mellitus.

Science.gov (United States)

Monteiro, Lara J; Norman, Jane E; Rice, Gregory E; Illanes, Sebastián E

2016-12-01

Gestational diabetes mellitus is defined by new-onset glucose intolerance during pregnancy. About 2-5% of all pregnant women develop gestational diabetes during their pregnancies and the prevalence has increased considerably during the last decade. This metabolic condition is manifested when pancreatic β-cells lose their ability to compensate for increased insulin resistance during pregnancy, however, the pathogenesis of the disease remains largely unknown. Gestational diabetes is strongly associated with adverse pregnancy outcome as well as with long-term adverse effects on the offspring which likely occurs due to epigenetic modifications of the fetal genome. In the current review we address gestational diabetes and the short and long term complications for both mothers and offspring focusing on the importance of fetal programming in conferring risk of developing diseases in adulthood. Copyright © 2015 Elsevier Ltd. All rights reserved.

Perceptions among women with gestational diabetes.

Science.gov (United States)

Parsons, Judith; Ismail, Khalida; Amiel, Stephanie; Forbes, Angus

2014-04-01

Women with gestational diabetes are at high risk of developing type 2 diabetes, which could be prevented or delayed by lifestyle modification. Lifestyle interventions need to take into account the specific situation of women with gestational diabetes. We aimed to gain a deeper understanding of women's experiences of gestational diabetes, their diabetes risk perceptions, and their views on type 2 diabetes prevention, to inform future lifestyle interventions. We conducted a metasynthesis that included 16 qualitative studies and identified 11 themes. Factors that require consideration when developing a type 2 diabetes prevention intervention in this population include addressing the emotional impact of gestational diabetes; providing women with clear and timely information about future diabetes risk; and offering an intervention that fits with women's multiple roles as caregivers, workers, and patients, and focuses on the health of the whole family.

Politico-economic equivalence

DEFF Research Database (Denmark)

Gonzalez Eiras, Martin; Niepelt, Dirk

2015-01-01

Traditional "economic equivalence'' results, like the Ricardian equivalence proposition, define equivalence classes over exogenous policies. We derive "politico-economic equivalence" conditions that apply in environments where policy is endogenous and chosen sequentially. A policy regime and a st......Traditional "economic equivalence'' results, like the Ricardian equivalence proposition, define equivalence classes over exogenous policies. We derive "politico-economic equivalence" conditions that apply in environments where policy is endogenous and chosen sequentially. A policy regime...... their use in the context of several applications, relating to social security reform, tax-smoothing policies and measures to correct externalities....

Gestational Trophoblastic Disease—Health Professional Version

Science.gov (United States)

Gestational trophoblastic disease (GTD) is a broad term encompassing both benign and malignant growths arising from products of conception in the uterus. GTDs contain paternal chromosomes and are placental in origin. Find evidence-based information on gestational trophoblastic disease treatment.

[Small for gestational age newborns--definition, etiology and neonatal treatment].

Science.gov (United States)

Slancheva, B; Mumdzhiev, Hr

2013-01-01

Newborns with intrauterine hypotrophy are at particular risk group of neonates. Diagnosis based on an adequate estimated gestational age, compared with accurate anthropometric measurements after birth. Among children born with low birth weight (leading experts in obstetrics, perinatal and neonatal medicine, pediatricians endocrinologists, pharmacologists and epidemiologists, with the following main tasks: the definition of small for gestational age children, diagnosis of SGA, SGA children growth and role of growth hormone in their treatment. Subsequent meetings of this committee discuss consensus on SGA infants who acquire their final form at a meeting in Prague in 2009 Small for gestational age (SGA, SGA), is described children whose body weight and/or height is lower than the average by more than 2 standard deviations (< - 2SD). Some authors use the boundary 3rd, 5th, or 10th percentile, but most believe that the use of indicators (< - 2SD) comprises the largest percentage of newborns with fetal growth disorders. Small for gestational age children are divided into: newborn weight retardation (SGAW), growth retardation (SGAL), matched up in weight and height (SGAWL). "Intrauterine growth retardation" (Intra-Uterine Growth Retardation (IUGR) are born with fetal growth retardation, documented at least two ultrasound scans, one of which in the 1st trimester Intrauterine hypotrophy is the second most common cause of perinatal death after prematurity. Hypotrophy is present in about 53% of premature and stillborn at 26% of full-term stillborn children. The incidence of asphyxia in SGA intrapartum is about 50%. Neonatal care includes effective primary resuscitation, treatment of existing and prevention of complications anticipated adaptation. These children are subject to follow-up for later risk of socially significant diseases in the adult.

What is correct: equivalent dose or dose equivalent

International Nuclear Information System (INIS)

Franic, Z.

1994-01-01

In Croatian language some physical quantities in radiation protection dosimetry have not precise names. Consequently, in practice either terms in English or mathematical formulas are used. The situation is even worse since the Croatian language only a limited number of textbooks, reference books and other papers are available. This paper compares the concept of ''dose equivalent'' as outlined in International Commission on Radiological Protection (ICRP) recommendations No. 26 and newest, conceptually different concept of ''equivalent dose'' which is introduced in ICRP 60. It was found out that Croatian terminology is both not uniform and unprecise. For the term ''dose equivalent'' was, under influence of Russian and Serbian languages, often used as term ''equivalent dose'' even from the point of view of ICRP 26 recommendations, which was not justified. Unfortunately, even now, in Croatia the legal unit still ''dose equivalent'' defined as in ICRP 26, but the term used for it is ''equivalent dose''. Therefore, in Croatian legislation a modified set of quantities introduced in ICRP 60, should be incorporated as soon as possible

Gestational overgrowth and undergrowth affect neurodevelopment: similarities and differences from behavior to epigenetics.

Science.gov (United States)

Grissom, Nicola M; Reyes, Teresa M

2013-10-01

The size of an infant at birth, a measure of gestational growth, has been recognized for many years as a biomarker of future risk of morbidity. Both being born small for gestational age (SGA) and being born large for gestational age (LGA), are associated with increased rates of obesity and metabolic disorder, as well as a number of mental disorders including attention deficit/hyperactivity disorder, autism, anxiety, and depression. The common risks raise the question of what neurobiological mechanisms are altered in SGA and LGA offspring. Here we review recent findings allowing for direct comparison of neurobiological outcomes of SGA and LGA in human and animal models. We also present new data highlighting similarities and differences in behavior and neurobiology in our mouse models of SGA and LGA. Overall, there is significant data to support aberrant epigenetic mechanisms, particularly related to DNA methylation, in the brains of SGA and LGA offspring, leading to disruptions in the cell cycle in development and gene expression in adulthood. Copyright © 2012 ISDN. Published by Elsevier Ltd. All rights reserved.

Placental Oxidative Status throughout Normal Gestation in Women with Uncomplicated Pregnancies

Directory of Open Access Journals (Sweden)

Jayasri Basu

2015-01-01

Full Text Available The effects of gestational age on placental oxidative balance throughout gestation were investigated in women with uncomplicated pregnancies. Placental tissues were obtained from normal pregnant women who delivered at term or underwent elective pregnancy termination at 6 to 23 + 6 weeks of pregnancy. Placental tissues were analyzed for total antioxidant capacity (TAC and lipid peroxide (malondialdehyde, MDA levels using commercially available kits. Two hundred and one placental tissues were analyzed and the mean ± SD MDA (pmol/mg tissue and TAC (µmol Trolox equivalent/mg tissue levels for first, second, and third trimester groups were 277.01 ± 204.66, 202.66 ± 185.05, and 176.97 ± 141.61, P < 0.004 and 498.62 ± 400.74, 454.90 ± 374.44, and 912.19 ± 586.21, P < 0.0001 by ANOVA, respectively. Our data reflects an increased oxidative stress in the placenta in the early phase of normal pregnancy. As pregnancy progressed, placental antioxidant protective mechanisms increased and lipid peroxidation markers decreased resulting in diminution in oxidative stress. Our findings provide a biochemical support to the concept of a hypoxic environment in early pregnancy. A decrease in placental oxidative stress in the second and third trimesters appears to be a physiological phenomenon of normal pregnancy. Deviations from this physiological phenomenon may result in placental-mediated disorders.

Neonatal and infant outcomes in twin gestations with preterm premature rupture of membranes at 24-31 weeks of gestation.

Science.gov (United States)

Mendez-Figueroa, Hector; Dahlke, Joshua D; Viteri, Oscar A; Chauhan, Suneet P; Rouse, Dwight J; Sibai, Baha M; Blackwell, Sean C

2014-08-01

To describe the perinatal and infant and early childhood morbidity associated with preterm premature rupture of membranes (PROM) in a cohort of twin pregnancies evaluated prospectively with neonatal follow-up to 2 years of age. This was a secondary analysis of a randomized controlled trial of magnesium sulfate for prevention of cerebral palsy. Inclusion criteria were twin gestation with preterm PROM diagnosed between 24 0/7 and 31 6/7 weeks of gestation and planned expectant management. Latency (time from membrane rupture to delivery) and perinatal outcomes were evaluated by gestational age at membrane rupture. Long-term neonatal outcomes were also analyzed. Among 151 women who met inclusion criteria, the median gestational age at preterm PROM was 28.1 weeks (range 24.1-31.6 weeks). Approximately one-third of women achieved a latency of at least 1 week. Gestational age at preterm PROM (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.63-0.90 for each week after 24 weeks of gestation) and cervical dilation at admission (OR 0.66, 95% CI 0.49-0.90 for each centimeter of dilation) were inversely associated with a latency period of at least 1 week. There were no stillbirths (95% CI 0-1%), but the rate of neonatal mortality was 90 per 1,000 newborns (95% CI 57-112) with a 7.3% cerebral palsy rate among survivors (95% CI 4.4-10.3%). In twin pregnancies, preterm PROM from 24 to 31 weeks of gestation is associated with a neonatal mortality rate of 9.0% and an overall cerebral palsy rate of 7.3%. A longer latency period is associated with less advanced cervical dilation and later gestational age at PROM. LEVEL OF EVIEDENCE: II.

Foundations of gravitation theory: the principle of equivalence

International Nuclear Information System (INIS)

Haugan, M.P.

1978-01-01

A new framework is presented within which to discuss the principle of equivalence and its experimental tests. The framework incorporates a special structure imposed on the equivalence principle by the principle of energy conservation. This structure includes relations among the conceptual components of the equivalence principle as well as quantitative relations among the outcomes of its experimental tests. One of the most striking new results obtained through use of this framework is a connection between the breakdown of local Lorentz invariance and the breakdown of the principle that all bodies fall with the same acceleration in a gravitational field. An extensive discussion of experimental tests of the equivalence principle and their significance is also presented. Within the above framework, theory-independent analyses of a broad range of equivalence principle tests are possible. Gravitational redshift experiments. Doppler-shift experiments, the Turner-Hill and Hughes-Drever experiments, and a number of solar-system tests of gravitation theories are analyzed. Application of the techniques of theoretical nuclear physics to the quantitative interpretation of equivalence principle tests using laboratory materials of different composition yields a number of important results. It is found that current Eotvos experiments significantly demonstrate the compatibility of the weak interactions with the equivalence principle. It is also shown that the Hughes-Drever experiment is the most precise test of local Lorentz invariance yet performed. The work leads to a strong, tightly knit empirical basis for the principle of equivalence, the central pillar of the foundations of gravitation theory

Wheat shorts in diets of gestating swine.

Science.gov (United States)

Young, L G; King, G L

1981-03-01

Sixty-four gilts were assigned to be bred at first or third observed estrus and fed gestation diets of pelleted wheat shorts with a free choice mineral-vitamin supplement or fortified corn-soybean meal. Only the dietary effects are included in this report. The gilts were fed their respective diets starting at 25 days after insemination. The experiment continued through three gestation-lactation cycles. Females fed the wheat shorts received less digestible energy during gestation and weighed less at day 109 of gestation and days 1, 7 and 21 of lactation in each of the three gestation-lactation periods. Females fed wheat shorts had lighter pigs at birth, weaned more pigs per litter in each parity and returned to estrus more slowly after weaning than females fed a corn-soybean meal diet. Results of a metabolism trial conducted with 12 barrows revealed that wheat shorts contained approximately 2.93 kcal digestible energy/kg dry matter and had an apparent protein digestibility of 72%, compared with values of 4.0 kcal and 86%, respectively, for the corn-soybean meal diets.

Equivalence of ADM Hamiltonian and Effective Field Theory approaches at next-to-next-to-leading order spin1-spin2 coupling of binary inspirals

Energy Technology Data Exchange (ETDEWEB)

Levi, Michele [Institut d' Astrophysique de Paris, Université Pierre et Marie Curie, CNRS-UMR 7095, 98 bis Boulevard Arago, 75014 Paris (France); Steinhoff, Jan, E-mail: michele.levi@upmc.fr, E-mail: jan.steinhoff@ist.utl.pt [Centro Multidisciplinar de Astrofisica, Instituto Superior Tecnico, Universidade de Lisboa, Avenida Rovisco Pais 1, 1049-001 Lisboa (Portugal)

2014-12-01

The next-to-next-to-leading order spin1-spin2 potential for an inspiralling binary, that is essential for accuracy to fourth post-Newtonian order, if both components in the binary are spinning rapidly, has been recently derived independently via the ADM Hamiltonian and the Effective Field Theory approaches, using different gauges and variables. Here we show the complete physical equivalence of the two results, thereby we first prove the equivalence of the ADM Hamiltonian and the Effective Field Theory approaches at next-to-next-to-leading order with the inclusion of spins. The main difficulty in the spinning sectors, which also prescribes the manner in which the comparison of the two results is tackled here, is the existence of redundant unphysical spin degrees of freedom, associated with the spin gauge choice of a point within the extended spinning object for its representative worldline. After gauge fixing and eliminating the unphysical degrees of freedom of the spin and its conjugate at the level of the action, we arrive at curved spacetime generalizations of the Newton-Wigner variables in closed form, which can also be used to obtain further Hamiltonians, based on an Effective Field Theory formulation and computation. Finally, we make use of our validated result to provide gauge invariant relations among the binding energy, angular momentum, and orbital frequency of an inspiralling binary with generic compact spinning components to fourth post-Newtonian order, including all known sectors up to date.

Gestational weight gain.

Science.gov (United States)

Kominiarek, Michelle A; Peaceman, Alan M

2017-12-01

Prenatal care providers are advised to evaluate maternal weight at each regularly scheduled prenatal visit, monitor progress toward meeting weight gain goals, and provide individualized counseling if significant deviations from a woman's goals occur. Today, nearly 50% of women exceed their weight gain goals with overweight and obese women having the highest prevalence of excessive weight gain. Risks of inadequate weight gain include low birthweight and failure to initiate breast-feeding whereas the risks of excessive weight gain include cesarean deliveries and postpartum weight retention for the mother and large-for-gestational-age infants, macrosomia, and childhood overweight or obesity for the offspring. Prenatal care providers have many resources and tools to incorporate weight and other health behavior counseling into routine prenatal practices. Because many women are motivated to improve health behaviors, pregnancy is often considered the optimal time to intervene for issues related to eating habits and physical activity to prevent excessive weight gain. Gestational weight gain is a potentially modifiable risk factor for a number of adverse maternal and neonatal outcomes and meta-analyses of randomized controlled trials report that diet or exercise interventions during pregnancy can help reduce excessive weight gain. However, health behavior interventions for gestational weight gain have not significantly improved other maternal and neonatal outcomes and have limited effectiveness in overweight and obese women. Copyright © 2017 Elsevier Inc. All rights reserved.

Gestational weight gain and body mass indexes have an impact on the outcomes of diabetic mothers and infants.

Science.gov (United States)

Maayan-Metzger, Ayala; Schushan-Eisen, Irit; Strauss, Tzipora; Globus, Omer; Leibovitch, Leah

2015-11-01

This study evaluated mothers with diabetes to determine whether prepregnancy body mass index (BMI), BMI on delivery or gestational weight gain (GWG) had the greatest impact on maternal and neonatal outcomes. We retrospectively examined the medical charts of 634 full-term infants born to mothers with gestational diabetes mellitus not requiring insulin (n = 476), gestational diabetes mellitus requiring insulin (n = 140) and insulin-dependent diabetes mellitus (n = 18). Data regarding maternal BMI before pregnancy and on delivery were recorded, as well as maternal and neonatal complications. Infants born to women who gained more than the recommended weight during pregnancy had higher birthweights, higher rates of meconium-stained amniotic fluid and neonatal hypoglycaemia. Using logistic regression, Caesarean section delivery was predicted by gestational diabetes requiring insulin, with an odds ratio (OR) of 1.76, maternal hypertension (OR 2.4), infants born large for gestational age (OR 2.78) and maternal BMI ≥ 30 on delivery (OR 1.06). Neonatal complications were predicted by maternal insulin-dependent diabetes (OR 5.21), lower gestational age (OR 0.8) and GWG above the recommended amount (OR 1.56). Women with diabetes should be made aware that higher GWG can lead to Caesarean section delivery, infant macrosomia and other neonatal complications. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Equivalency of two-dimensional algebras

International Nuclear Information System (INIS)

Santos, Gildemar Carneiro dos; Pomponet Filho, Balbino Jose S.

2011-01-01

Full text: Let us consider a vector z = xi + yj over the field of real numbers, whose basis (i,j) satisfy a given algebra. Any property of this algebra will be reflected in any function of z, so we can state that the knowledge of the properties of an algebra leads to more general conclusions than the knowledge of the properties of a function. However structural properties of an algebra do not change when this algebra suffers a linear transformation, though the structural constants defining this algebra do change. We say that two algebras are equivalent to each other whenever they are related by a linear transformation. In this case, we have found that some relations between the structural constants are sufficient to recognize whether or not an algebra is equivalent to another. In spite that the basis transform linearly, the structural constants change like a third order tensor, but some combinations of these tensors result in a linear transformation, allowing to write the entries of the transformation matrix as function of the structural constants. Eventually, a systematic way to find the transformation matrix between these equivalent algebras is obtained. In this sense, we have performed the thorough classification of associative commutative two-dimensional algebras, and find that even non-division algebra may be helpful in solving non-linear dynamic systems. The Mandelbrot set was used to have a pictorial view of each algebra, since equivalent algebras result in the same pattern. Presently we have succeeded in classifying some non-associative two-dimensional algebras, a task more difficult than for associative one. (author)

Gestational dating by metabolic profile at birth: a California cohort study.

Science.gov (United States)

Jelliffe-Pawlowski, Laura L; Norton, Mary E; Baer, Rebecca J; Santos, Nicole; Rutherford, George W

2016-04-01

Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications. We sought to evaluate whether metabolic markers in newborns measured as part of routine screening for treatable inborn errors of metabolism can be used to develop a population-level metabolic gestational dating algorithm that is robust despite intrauterine growth restriction and can be used when fetal ultrasound dating is not available. We focused specifically on the ability of these markers to differentiate preterm births (PTBs) (PTBs and term births. Using a linear discriminate analyses-derived linear function, we were able to sort PTBs and term births accurately with sensitivities and specificities of ≥95% in both the training and testing subsets. Assignment of a specific week of gestation in those identified as PTBs resulted in the correct assignment of week ±2 weeks in 89.8% of all newborns in the training and 91.7% of those in the testing subset. When PTB rates were modeled using the metabolic dating algorithm compared to fetal ultrasound, PTB rates were 7.15% vs 6.11% in the training subset and 7.31% vs 6.25% in the testing subset. When considered in combination with birthweight and hours of age at test, metabolic profile evaluated within 8 days of birth appears to be a useful measure of PTB and, among those born preterm, of specific week of gestation ±2 weeks. Dating by metabolic profile may be useful in instances where there is no fetal ultrasound due to lack of availability or late entry into care. Copyright © 2016 The Authors. Published

GESTATIONAL AGE AT BIRTH AND RISK OF TESTICULAR CANCER

Science.gov (United States)

Crump, Casey; Sundquist, Kristina; Winkleby, Marilyn A.; Sieh, Weiva; Sundquist, Jan

2011-01-01

Most testicular germ cell tumors originate from carcinoma in situ cells in fetal life, possibly related to sex hormone imbalances in early pregnancy. Previous studies of association between gestational age at birth and testicular cancer have yielded discrepant results and have not examined extreme preterm birth. Our objective was to determine whether low gestational age at birth is independently associated with testicular cancer in later life. We conducted a national cohort study of 354,860 men born in Sweden in 1973–1979, including 19,214 born preterm (gestational age testicular cancer incidence through 2008. A total of 767 testicular cancers (296 seminomas and 471 nonseminomatous germ cell tumors) were identified in 11.2 million person-years of follow-up. Extreme preterm birth was associated with an increased risk of testicular cancer (hazard ratio 3.95; 95% CI, 1.67–9.34) after adjusting for other perinatal factors, family history of testicular cancer, and cryptorchidism. Only five cases (three seminomas and two nonseminomas) occurred among men born extremely preterm, limiting the precision of risk estimates. No association was found between later preterm birth, post-term birth, or low or high fetal growth and testicular cancer. These findings suggest that extreme but not later preterm birth may be independently associated with testicular cancer in later life. They are based on a small number of cases and will need confirmation in other large cohorts. Elucidation of the key prenatal etiologic factors may potentially lead to preventive interventions in early life. PMID:22314417

State-Dependent Implication and Equivalence in Quantum Logic

Directory of Open Access Journals (Sweden)

Fedor Herbut

2012-01-01

Full Text Available Ideal occurrence of an event (projector leads to the known change of a state (density operator into (the Lüders state. It is shown that two events and give the same Lüders state if and only if the equivalence relation is valid. This relation determines equivalence classes. The set of them and each class, are studied in detail. It is proved that the range projector of the Lüders state can be evaluated as , where denotes the greatest lower bound, and is the null projector of . State-dependent implication extends absolute implication (which, in turn, determines the entire structure of quantum logic. and are investigated in a closely related way to mutual benefit. Inherent in the preorder is the state-dependent equivalence , defining equivalence classes in a given Boolean subalgebra. The quotient set, in which the classes are the elements, has itself a partially ordered structure, and so has each class. In a complete Boolean subalgebra, both structures are complete lattices. Physical meanings are discussed.

Late-gestation heat stress abatement on performance and behavior of Holstein dairy cows.

Science.gov (United States)

Karimi, M T; Ghorbani, G R; Kargar, S; Drackley, J K

2015-10-01

The objective of this study was to evaluate cooling to lessen the effects of heat stress during the last 3 wk of gestation on performance and behavior of multiparous Holstein cows. Twenty nonlactating cows were randomly assigned to treatments approximately 21 d before their expected calving date based on mature equivalent milk production and parity. Treatments were only imposed during the last 3 wk of gestation and included heat stress (HT; n=10) and cooling (CL; n=10), both under a similar photoperiod (14 h of light and 10 h of dark). Dry cows were housed in a sand-bedded stall with the stall areas for CL cows equipped with sprinklers and fans that were on from 0700 to 1900 h, whereas those for the HT cows were not. After parturition, all cows were housed in a barn with cooling devices. Rectal temperatures were measured daily at 1400 h and respiration rates were recorded by counting the flank movements for 1 min at 1500 h on odd days over the last 3 wk of gestation to calving. Daily dry matter intake was measured from -21 d relative to expected calving to 21 d after calving and milk production was recorded daily up to 180 d in milk. Behavioral changes of dry cows were studied continuously for 24 h at -10 d relative to expected calving. The average temperature-humidity index during the last 3 wk of gestation was 69.7 and was not significantly different between treatments. Heat-stressed cows exhibited greater rectal temperatures (39.5 vs. 39.2°C), greater respiration rates (70.4 vs. 63.3 breaths/min), and decreased dry matter intake (13.7 vs. 15.5 kg/d) compared with CL cows. Compared with HT cows, CL cows produced more milk during 180 d in milk (40.5 vs. 44.6 kg/d). Heat stress decreased ruminating (243.2 vs. 282.5 min/d) and chewing times (390.6 vs. 448.7 min/d) at -10 d before calving. The CL cows had shorter standing times than their HT counterparts (390.4 vs. 474.0 min/d). These results confirm that heat stress abatement in the late gestation period improves

Dietary Patterns during Pregnancy Are Associated with Risk of Gestational Diabetes Mellitus.

Science.gov (United States)

Shin, Dayeon; Lee, Kyung Won; Song, Won O

2015-11-12

Maternal dietary patterns before and during pregnancy play important roles in the development of gestational diabetes mellitus (GDM). We aimed to identify dietary patterns during pregnancy that are associated with GDM risk in pregnant U.S. women. From a 24 h dietary recall of 253 pregnant women (16-41 years) included in the National Health and Nutrition Examination Survey (NHANES) 2003-2012, food items were aggregated into 28 food groups based on Food Patterns Equivalents Database. Three dietary patterns were identified by reduced rank regression with responses including prepregnancy body mass index (BMI), dietary fiber, and ratio of poly- and monounsaturated fatty acids to saturated fatty acid: "high refined grains, fats, oils and fruit juice", "high nuts, seeds, fat and soybean; low milk and cheese", and "high added sugar and organ meats; low fruits, vegetables and seafood". GDM was diagnosed using fasting plasma glucose levels ≥5.1 mmol/L for gestation education, family poverty income ratio, marital status, prepregnancy BMI, gestational weight gain, energy intake, physical activity, and log-transformed C-reactive protein (CRP). All statistical analyses accounted for the appropriate survey design and sample weights of the NHANES. Of 249 pregnant women, 34 pregnant women (14%) had GDM. Multivariable AOR (95% CIs) of GDM for comparisons between the highest vs. lowest tertiles were 4.9 (1.4-17.0) for "high refined grains, fats, oils and fruit juice" pattern, 7.5 (1.8-32.3) for "high nuts, seeds, fat and soybean; low milk and cheese" pattern, and 22.3 (3.9-127.4) for "high added sugar and organ meats; low fruits, vegetables and seafood" pattern after controlling for maternal sociodemographic variables, prepregnancy BMI, gestational weight gain, energy intake and log-transformed CRP. These findings suggest that dietary patterns during pregnancy are associated with risk of GDM after controlling for potential confounders. The observed connection between a high

Lead-free primary explosives

Science.gov (United States)

Huynh, My Hang V.

2010-06-22

Lead-free primary explosives of the formula (cat).sub.Y[M.sup.II(T).sub.X(H.sub.2O).sub.6-X].sub.Z, where T is 5-nitrotetrazolate, and syntheses thereof are described. Substantially stoichiometric equivalents of the reactants lead to high yields of pure compositions thereby avoiding dangerous purification steps.

Multiple roads lead to Rome: combined high-intensity aerobic and strength training vs. gross motor activities leads to equivalent improvement in executive functions in a cohort of healthy older adults.

Science.gov (United States)

Berryman, Nicolas; Bherer, Louis; Nadeau, Sylvie; Lauzière, Séléna; Lehr, Lora; Bobeuf, Florian; Lussier, Maxime; Kergoat, Marie Jeanne; Vu, Thien Tuong Minh; Bosquet, Laurent

2014-01-01

The effects of physical activity on cognition in older adults have been extensively investigated in the last decade. Different interventions such as aerobic, strength, and gross motor training programs have resulted in improvements in cognitive functions. However, the mechanisms underlying the relationship between physical activity and cognition are still poorly understood. Recently, it was shown that acute bouts of exercise resulted in reduced executive control at higher relative exercise intensities. Considering that aging is characterized by a reduction in potential energy ([Formula: see text] max - energy cost of walking), which leads to higher relative walking intensity for the same absolute speed, it could be argued that any intervention aimed at reducing the relative intensity of the locomotive task would improve executive control while walking. The objective of the present study was to determine the effects of a short-term (8 weeks) high-intensity strength and aerobic training program on executive functions (single and dual task) in a cohort of healthy older adults. Fifty-one participants were included and 47 (age, 70.7 ± 5.6) completed the study which compared the effects of three interventions: lower body strength + aerobic training (LBS-A), upper body strength + aerobic training (UBS-A), and gross motor activities (GMA). Training sessions were held 3 times every week. Both physical fitness (aerobic, neuromuscular, and body composition) and cognitive functions (RNG) during a dual task were assessed before and after the intervention. Even though the LBS-A and UBS-A interventions increased potential energy to a higher level (Effect size: LBS-A-moderate, UBS-A-small, GMA-trivial), all groups showed equivalent improvement in cognitive function, with inhibition being more sensitive to the intervention. These findings suggest that different exercise programs targeting physical fitness and/or gross motor skills may lead to equivalent improvement in

Recent Declines in Induction of Labor by Gestational Age

Science.gov (United States)

... for singleton births per 100 singleton births. Gestational age categories : Early preterm: Births prior to 34 completed weeks of ... delivery is managed for multiple gestation pregnancies. The primary measure used to determine gestational age is the interval between the first day of ...

Risk factors for gestational diabetes mellitus in Sudanese pregnant ...

African Journals Online (AJOL)

McRoy

Key words: Diabetes mellitus, gestation, risk factors, Sudan. INTRODUCTION. Gestational diabetes mellitus (GDM) is a universal risk factor for maternal and neonatal morbidity and mortality.[1] Low gestational age, neonatal macrosomia, hypoglycemia, respiratory distress syndrome are frequent complications of GDM and ...

Understanding Gestational Diabetes: A Practical Guide to a Healthy Pregnancy.

Science.gov (United States)

National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

This brochure addresses the problem of gestational diabetes and answers the most frequently asked questions about the disease. It begins by defining gestational diabetes and discussing its cause, then addresses such topics as: (1) how gestational diabetes differs from other types of diabetes; (2) who is at risk for developing gestational diabetes…

Am I at Risk for Gestational Diabetes?

Science.gov (United States)

... they control their blood sugar levels. Babies whose mothers had gestational diabetes are at higher risk for certain health ... best way to improve outcomes for babies whose mothers have gestational diabetes. Later in Life Babies whose mothers had ...

Trends and outcomes of gestational surrogacy in the United States.

Science.gov (United States)

Perkins, Kiran M; Boulet, Sheree L; Jamieson, Denise J; Kissin, Dmitry M

2016-08-01

To evaluate trends and reproductive outcomes of gestational surrogacy in the United States. Retrospective cohort study. Infertility clinics. IVF cycles transferring at least one embryo. Use of a gestational carrier. Trends in gestational carrier cycles during 1999-2013, overall and for non-U.S. residents; reproductive outcomes for gestational carrier and nongestational carrier cycles during 2009-2013, stratified by the use of donor or nondonor oocytes. Of 2,071,984 assisted reproductive technology (ART) cycles performed during 1999-2013, 30,927 (1.9%) used a gestational carrier. The number of gestational carrier cycles increased from 727 (1.0%) in 1999 to 3,432 (2.5%) in 2013. Among gestational carrier cycles, the proportion with non-U.S. residents declined during 1999-2005 (9.5% to 3.0%) but increased during 2006-2013 (6.3% to 18.5%). Gestational carrier cycles using nondonor oocytes had higher rates of implantation (adjusted risk ratio [aRR], 1.22; 95% confidence interval [CI], 1.17-1.26), clinical pregnancy (aRR, 1.14; 95% CI, 1.10-1.19), live birth (aRR, 1.17; 95% CI, 1.12-1.21), and preterm delivery (aRR, 1.14; 95% CI, 1.05-1.23) compared with nongestational carrier cycles. When using donor oocytes, multiple birth rates were higher among gestational carrier compared with nongestational carrier cycles (aRR, 1.13; 95% CI, 1.08-1.19). Use of gestational carriers increased during 1999-2013. Gestational carrier cycles had higher rates of ART success than nongestational carrier cycles, but multiple birth and preterm delivery rates were also higher. These risks may be mitigated by transferring fewer embryos given the higher success rates among gestational carrier cycles. Published by Elsevier Inc.

Obstetric ultrasound aids prompt referral of gestational trophoblastic disease in marginalized populations on the Thailand-Myanmar border

NARCIS (Netherlands)

McGregor, Kathryn; Min, Aung Myat; Karunkonkowit, Noaeni; Keereechareon, Suporn; Tyrosvoutis, Mary Ellen; Tun, Nay Win; Rijken, Marcus J.; Hoogenboom, Gabie; Boel, Machteld; Chotivanich, Kesinee; Nosten, François; McGready, Rose

2017-01-01

Background: The use of obstetric ultrasound in the diagnosis of gestational trophoblastic disease (GTD) in high-income settings is well established, leading to prompt management and high survival rates. Evidence from low-income settings suggests ultrasound is essential in identifying complicated

Equivalent Lagrangians

International Nuclear Information System (INIS)

Hojman, S.

1982-01-01

We present a review of the inverse problem of the Calculus of Variations, emphasizing the ambiguities which appear due to the existence of equivalent Lagrangians for a given classical system. In particular, we analyze the properties of equivalent Lagrangians in the multidimensional case, we study the conditions for the existence of a variational principle for (second as well as first order) equations of motion and their solutions, we consider the inverse problem of the Calculus of Variations for singular systems, we state the ambiguities which emerge in the relationship between symmetries and conserved quantities in the case of equivalent Lagrangians, we discuss the problems which appear in trying to quantize classical systems which have different equivalent Lagrangians, we describe the situation which arises in the study of equivalent Lagrangians in field theory and finally, we present some unsolved problems and discussion topics related to the content of this article. (author)

[Gestational diabetes insipidus during a twin pregnancy].

Science.gov (United States)

De Mesmay, M; Rigouzzo, A; Bui, T; Louvet, N; Constant, I

2013-02-01

Gestational diabetes insipidus is an uncommon clinical disease whose prevalence is approximately two to three pregnancies per 100,000. It may be isolated or associated with preeclampsia. We report a case of gestational diabetes insipidus in a twin pregnancy, originally isolated during two months, and secondarily complicated by HELLP-syndrome. We recall the specific pathophysiology of polyuric-polydipsic syndrome during pregnancy and summarize its various causes. Finally, we discuss the indications, in case of isolated gestational diabetes insipidus, of treatment by dDAVP. Copyright © 2013. Published by Elsevier SAS.

Hormones of Adipose Tissue and Gestational Diabetes

Directory of Open Access Journals (Sweden)

O.S. Payenok

2013-10-01

Full Text Available Obesity and gestational diabetes are the risk factors for complications both in the mother and in the fetus. Adipose tissue hormones (leptin, adiponectin, resistin are secreted by the human placenta and regulate the function of trophoblast. The review presents data from the literature on the role of adipocytokines in the development of gestational diabetes and preeclampsia in obese women. The article considers the criteria and algorithms for the diagnosis of gestational diabetes recommended by the World Health Organization and the International Association of Diabetes and Pregnancy Study Group.

Mortality and morbidity pattern in small-for gestational age and appropriate-for-gestational age very preterm babies: a hospital based study

International Nuclear Information System (INIS)

Muhammad, T.; Khattak, A.A.; Rehman, S.U.

2009-01-01

Very preterm babies are important group of paediatric babies who require special attention. These babies are known to have increased risk of morbidity and mortality. Studying the morbidity and mortality pattern for this important paediatric group can help in better understanding of their care in the hospital settings. Objective of the study was to compare the mortality and morbidity pattern in Small-for-gestational age and appropriate-for-gestational age very preterm babies. This hospital based prospective (cohort) study was conducted at the department of Paediatrics, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from March 2008 to April 2009. One hundred Small-for-gestational age (SGA) live born very preterm babies were compared with 100 appropriate-for-gestational age (AGA) very preterm babies having similar gestational ages. Information regarding gestational age, birth weight, mortality, and morbidity (in terms of various biochemical and clinical markers) were recorded on a pre-designed questionnaire. Data analysis was done using SPSS version 15. Results were interpreted in terms of descriptive (mean, proportions, standard deviation) and inferential statistical tests (with p-values). There was no difference between the two groups (SGA Vs AGA) with regards to gestational age and gender of the babies The mean weight of SGA babies was significantly lower as compared to AGA babies (1.1+-0.16 Kg Vs 1.5+-0.2 Kg; p=0.001). As compared to AGA babies, the SGA babies had a higher mortality (40% Vs 22%, p=0.006), and higher morbidity in terms of hyperbilirubinaemia (67% Vs 51%, p=0.02) and hypocalcaemia (24% Vs 10%, p=0.02). The difference in the mortality between the two groups was more prominent in babies with gestational age < 31 weeks (71.4% for SGA as compared to 39.3 % for AGA very preterm babies with gestational age < 31 weeks). Very preterm SGA infants have significantly higher mortality and morbidity in comparison to the AGA babies. In deciding

ACOG Committee Opinion No. 660: Family Building Through Gestational Surrogacy.

Science.gov (United States)

2016-03-01

Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated. The practice of gestational surrogacy involves a woman known as a gestational carrier who agrees to bear a genetically unrelated child with the help of assisted reproductive technologies for an individual or couple who intend(s) to be the legal and rearing parent(s), referred to as the intended parent(s). Obstetrician-gynecologists may become involved in gestational surrogacy through caring for the gestational carrier or by caring for the intended parent(s). Although gestational surrogacy increases options for family building, this treatment also involves ethical, medical, psychosocial, and legal complexities that must be taken into account to minimize risks of adverse outcomes for the gestational carrier, intended parent(s), and resulting children. The purpose of this document is to provide an overview of gestational surrogacy and to describe the ethical responsibilities for obstetrician-gynecologists who take part in the care of women who participate in these arrangements.

The gestational age pattern of human mortality

DEFF Research Database (Denmark)

Schöley, Jonas; Vaupel, James W.; Jacobsen, Rune

-infant lifetable by gestational age spanning week 23 until week 100 after the last menstrual period of the mother. This joint lifetable shows a remarkable regularity in the gestational age profile of fetal- and infant mortality: Mortality rates are declining over the whole observed age range with the exception......In order to check hypotheses about the cause for "ontogenescense" -- the phenomenon of a declining force of mortality prior to maturity -- I analyse data on human mortality by gestational age. Based on extensive microdata on births, fetal- and infant deaths in the US 2009 I calculate a joint fetal...... of a "birth hump" peaking week 38. The absolute rate of decline slows down over age. The observed gestational age pattern of the force of mortality is consistent with three hypotheses concerning the causes for ontogenescense: 1) Adaptation: as the organism growths it becomes more resilient towards death, 2...

Exposure to Folate Receptor Alpha Antibodies during Gestation and Weaning Leads to Severe Behavioral Deficits in Rats: A Pilot Study.

Directory of Open Access Journals (Sweden)

Jeffrey M Sequeira

Full Text Available The central nervous system continues to develop during gestation and after birth, and folate is an essential nutrient in this process. Folate deficiency and folate receptor alpha autoantibodies (FRα-AuAb have been associated with pregnancy-related complications and neurodevelopmental disorders. In this pilot study, we investigated the effect of exposure to FRα antibodies (Ab during gestation (GST, the pre-weaning (PRW, and the post weaning (POW periods on learning and behavior in adulthood in a rat model. In the open field test and novel object recognition task, which examine locomotor activity and anxiety-like behavior, deficits in rats exposed to Ab during gestation and pre-weaning (GST+PRW included more time spent in the periphery or corner areas, less time in the central area, frequent self-grooming akin to stereotypy, and longer time to explore a novel object compared to a control group; these are all indicative of increased levels of anxiety. In the place avoidance tasks that assess learning and spatial memory formation, only 30% of GST+PRW rats were able to learn the passive place avoidance task. None of these rats learned the active place avoidance task indicating severe learning deficits and cognitive impairment. Similar but less severe deficits were observed in rats exposed to Ab during GST alone or only during the PRW period, suggesting the extreme sensitivity of the fetal as well as the neonatal rat brain to the deleterious effects of exposure to Ab during this period. Behavioral deficits were not seen in rats exposed to antibody post weaning. These observations have implications in the pathology of FRα-AuAb associated with neural tube defect pregnancy, preterm birth and neurodevelopmental disorders including autism.

Aspects of fetal physiology from 18 to 37 weeks' gestation as assessed by blood sampling.

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Nava, S; Bocconi, L; Zuliani, G; Kustermann, A; Nicolini, U

1996-06-01

To construct reference ranges for fetal pH, oxygen pressure (PO2), and hematologic and biochemical blood constituents, which can be used to analyze changes with gestation and differences with maternal values, thus elucidating some aspects of fetal biology and the effects of the maternal and placental environments. We assayed venous pH, PO2, hematocrit, glucose, uric acid, urea, creatinine, total protein, total and direct bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, lactic dehydrogenase, amylase, pseudocholinesterase, creatine kinase, triglycerides, and cholesterol concentrations in 157 fetuses and 134 mothers who underwent fetal blood sampling from 18 to 37 weeks' gestation. None of the fetuses was infected or had chromosomal, hematologic, or hormonal abnormalities. All the variables analyzed were similar in fetuses sampled at the placental cord insertion (n = 125) or at the intrahepatic vein (n = 32). Maternal and fetal concentrations of glucose (r = 0.79, P PO2 decreased with gestational age, whereas hematocrit increased, similar to what has been described previously. All of the other variables, with the exception of amylase and cholesterol, changed significantly during the investigated period of pregnancy. Gestational age explained at least 40% of the variance in values of fetal total protein, pseudocholinesterase, alanine aminotransferase, creatine kinase, and triglycerides, but only 3-25% of the variation in the remainder. Most enzymes were higher in the fetus than in the maternal circulation, and all except alkaline phosphatase increased with gestational age. The maternal-fetal glucose difference correlated significantly with hematocrit, pH, and PO2, independent of gestational age and independent of each other. With the exception of aspartate aminotransferase, all of the analyzed fetal variables were different from the maternal values, and most changed with gestational age. The mechanisms

Electrical gearbox equivalent by means of dynamic machine operation

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Gerrits, T.; Wijnands, C.G.E.; Paulides, J.J.H.; Duarte, J.L.

2011-01-01

A dynamic propulsion system using variable torque/speed characteristics, designed to realize a machine integrated equivalent of a gearbox is presented. This is achieved through adaption of the machine characteristics, and driven by specialized power electronics, leading to a reconfigurable stator

Factors affecting gestation duration in the bitch.

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Eilts, Bruce E; Davidson, Autumn P; Hosgood, Giselle; Paccamonti, Dale L; Baker, David G

2005-07-15

A retrospective analysis was performed to determine the effects of age, breed, parity, and litter size on the duration of gestation in the bitch. Bitches at two locations were monitored from breeding to whelping. A total of 764 litters whelped from 308 bitches (36 large hounds, 34 Golden Retrievers, 23 German Shepherd Dogs (GSD), and 215 Labrador Retrievers). By breed, the number of whelpings was 152, 72, 58, and 482 for the hounds, Golden Retrievers, German Shepherd Dogs, and Labrador Retrievers, respectively. Whelping was predicted to be 57 d from the first day of cytologic diestrus in the hounds or 65 d from the initial progesterone rise in the other breeds. The average gestation duration (calculated as 8 d prior to Day 1 of cytologic diestrus in hounds or measured from the initial progesterone rise in other breeds) by breed (days +/- S.D.) was 66.0 +/- 2.8, 64.7 +/- 1.5, 63.6 +/- 2.1, and 62.9 +/- 1.3 for the hounds, Golden Retrievers, German Shepherd Dogs, and Labrador Retrievers, respectively. The relationship of age, breed, parity, and litter size with the difference in gestation duration was evaluated using log linear modeling. Age or parity had no effect on gestation duration. Compared to Labrador Retrievers, the German Shepherd Dogs, Golden Retrievers and hounds were more likely to have a longer gestation duration; three, four and nearly eight times as likely, respectively. Bitches whelping four or fewer pups were significantly more likely to have a longer gestation duration than those whelping five or more pups; the prolongation averaging 1 d.

Lean body mass in small for gestational age and appropriate for gestational age infants

International Nuclear Information System (INIS)

Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

1988-01-01

Dual photon absorptiometry using 153 Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation

Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial.

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Riitta Luoto

2011-05-01

Full Text Available BACKGROUND: Our objective was to examine whether gestational diabetes mellitus (GDM or newborns' high birthweight can be prevented by lifestyle counseling in pregnant women at high risk of GDM. METHOD AND FINDINGS: We conducted a cluster-randomized trial, the NELLI study, in 14 municipalities in Finland, where 2,271 women were screened by oral glucose tolerance test (OGTT at 8-12 wk gestation. Euglycemic (n = 399 women with at least one GDM risk factor (body mass index [BMI] ≥ 25 kg/m(2, glucose intolerance or newborn's macrosomia (≥ 4,500 g in any earlier pregnancy, family history of diabetes, age ≥ 40 y were included. The intervention included individual intensified counseling on physical activity and diet and weight gain at five antenatal visits. Primary outcomes were incidence of GDM as assessed by OGTT (maternal outcome and newborns' birthweight adjusted for gestational age (neonatal outcome. Secondary outcomes were maternal weight gain and the need for insulin treatment during pregnancy. Adherence to the intervention was evaluated on the basis of changes in physical activity (weekly metabolic equivalent task (MET minutes and diet (intake of total fat, saturated and polyunsaturated fatty acids, saccharose, and fiber. Multilevel analyses took into account cluster, maternity clinic, and nurse level influences in addition to age, education, parity, and prepregnancy BMI. 15.8% (34/216 of women in the intervention group and 12.4% (22/179 in the usual care group developed GDM (absolute effect size 1.36, 95% confidence interval [CI] 0.71-2.62, p = 0.36. Neonatal birthweight was lower in the intervention than in the usual care group (absolute effect size -133 g, 95% CI -231 to -35, p = 0.008 as was proportion of large-for-gestational-age (LGA newborns (26/216, 12.1% versus 34/179, 19.7%, p = 0.042. Women in the intervention group increased their intake of dietary fiber (adjusted coefficient 1.83, 95% CI 0.30-3.25, p = 0.023 and

Preeclampsia and gestational hypertension are associated with childhood blood pressure independently of family adiposity measures: the Avon Longitudinal Study of Parents and Children.

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Geelhoed, J J Miranda; Fraser, Abigail; Tilling, Kate; Benfield, Li; Davey Smith, George; Sattar, Naveed; Nelson, Scott M; Lawlor, Debbie A

2010-09-21

Offspring of women with hypertensive disorders of pregnancy are at increased risk of cardiovascular complications later in life, but the mechanisms underlying these associations are unclear. Our aim was to examine whether adjusting for birth weight and familial adiposity changed the association of hypertensive disorders of pregnancy with offspring blood pressure. Using data from 6343 nine-year-old participants in the Avon Longitudinal Study of Parents and Children, we examined the association between hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) and offspring blood pressure. Both preeclampsia and gestational hypertension were associated with systolic and diastolic blood pressures in the 9-year-old offspring; after adjustment for parental and own adiposity and for other potential confounders, the mean difference in systolic blood pressure was 2.05 mm Hg (95 confidence interval, 0.72 to 3.38) and 2.04 mm Hg (95 confidence interval, 1.42 to 2.67) for preeclampsia and gestational hypertension, respectively, compared with those with no hypertensive disorders of pregnancy. Equivalent results for diastolic blood pressure were 1.00 mm Hg (95 confidence interval, -0.01 to 2.10) and 1.07 mm Hg (95 confidence interval, 0.60 to 1.54). The association of preeclampsia with offspring systolic and diastolic blood pressures attenuated toward the null with further adjustment for birth weight and gestational age, whereas these adjustments did not attenuate the association of gestational hypertension with offspring blood pressure. The associations of hypertensive disorders of pregnancy with higher offspring blood pressure are not explained by familial adiposity. The mechanisms linking preeclampsia and gestational hypertension with offspring blood pressure may differ, with the former mediated at least in part by the effect of preeclampsia on intrauterine growth restriction.

Secular trends in gestational age and birthweight in twins.

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Gielen, M; van Beijsterveldt, C E M; Derom, C; Vlietinck, R; Nijhuis, J G; Zeegers, M P A; Boomsma, D I

2010-09-01

In recent decades, the overall rate of preterm births has increased. The aim of the present study was to examine whether this trend is also seen for multiple gestations. More specifically, we examined if there has been a decrease in gestational age for live born monozygotic (MZ) and dizygotic (DZ) twins and if there has been a simultaneous change in birthweight. The contributions of fertility treatments and Caesarean sections were taken into consideration. All analyses were carried out in two large European twin cohorts. Cross-sectional study of 6310 live born twin pairs, born between 1964-2007, from the Belgian East Flanders Prospective Twin Survey and 14,712 twin pairs, born between 1990-2006, from the Netherlands Twin Register. Multiple regression analyses were performed with gestational age as outcome variable, and multilevel analysis with birthweight as outcome variable. All analyses were performed with and without adjustment for zygosity, parity, maternal age, mode of conception and delivery and, for the analyses of birthweight, gestational age. Gestational age decreased in a linear fashion from 1964 to 2007 with a decrease of 0.25 days per year in a similar way for MZ and DZ twins. Changes in birthweight depended on gestational age: up to 32 weeks, birthweight decreased and after 32 weeks birthweight increased. The frequency of infertility treatment and Caesarean sections, primiparity and advanced maternal age increased over the years, but none of these factors influenced the secular trends in gestational age and birthweight. The decrease in gestational age and change in birthweight in twins are sources of concern, especially for very preterm twins, for whom birthweight decreased. For twins born after 32 weeks, an increase in birthweight was observed and this is very likely the explanation for the decrease in gestational age.

Serum chromium levels in gestational diabetes mellitus

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P G Sundararaman

2012-01-01

Full Text Available Objective: To measure serum chromium level in women with gestational diabetes mellitus (GDM from Chennai, South India. Materials and Methods: Thirty women with gestational diabetes, 60 age matched controls. Inclusion criteria: Gestational age 22-28 weeks, age group 20-35 years. Exclusion Criteria: Gestational age beyond 28 weeks, malnutrition or presence of infection. Serum chromium was measured using inductive couple plasma emission spectrometer. Results: Serum chromium levels of women with GDM, 1.59+/-0.02 ng/ml (range: 0.16-4.0 ng/ml were lower than in controls (4.58+/-0.62 ng/ml; range 0.82-5.33 ng/ml (P < 0.001. However, there were no significant differences among cases and controls when subdivided by parity. Conclusions: Women with GDM from a South Indian city had lower levels of serum chromium compared to pregnant women without GDM. Studies may be done whether chromium supplementation is useful in this group of women.

Ultrasound Measurements of Thyroid Gland Volume at 36 Weeks' Corrected Gestational Age in Extremely Preterm Infants Born before 28 Weeks' Gestation.

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Ng, Sze May; Turner, Mark A; Avula, Shivaram

2018-01-01

Thyroid ultrasound is a non-invasive imaging tool and provides good evaluation of thyroid anatomy, location, vascularisation, and echogenicity. The aim of this study was to assess thyroid function and thyroid volume in extremely preterm infants born before 28 weeks' gestation evaluated at 36 weeks' corrected gestational age (CGA) compared to term infants' normative data in the literature. In this largest prospective UK study of extremely premature infants born at less than 28 weeks' gestation, thyroid volume measurement was assessed at 36 weeks' CGA. Fifty-five extremely preterm infants (28 males) who were born before 28 weeks' gestation were recruited to the study. All infants had ultrasound assessment of the thyroid gland at 36 weeks' CGA. We also prospectively measured thyroid stimulating hormone (TSH) and free thyroxine (FT 4 ) in all infants at the time of recruitment (within 5 days of birth), at days 14, 21, and 28, and at 36 weeks' CGA. The mean thyroid volume was measured at 0.57 mL (SD ±0.18). There was no association between mean thyroid volume and thyroid function (TSH or FT 4 ). No associations were found between mean thyroid volume and gestation or birth weight in these infants. Our findings provide a reference range with a mean thyroid volume of 0.57 mL (SD ±0.18) in this extremely preterm age group if less than 28 weeks' gestation. Thyroid volume at birth can vary from country to country due to variations in iodine intake as well as gestational age.

Polycystic ovary disease. A risk factor for gestational diabetes?

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Lanzone, A; Caruso, A; Di Simone, N; De Carolis, S; Fulghesu, A M; Mancuso, S

1995-04-01

We investigated the impact of pregestationally elevated insulin plasma levels on glycemic control in pregnant women with polycystic ovary disease (PCOD). Twelve patients with PCOD who became pregnant within six months following evaluation of their metabolic status were the study subjects. Four were obese and six (two obese) had a hyperinsulinemic response to the oral glucose tolerance test (OGTT). They were tested with the OGTT at 28-30 weeks of gestation. We also tested 12 normal patients and 10 consecutive patients with gestational diabetes; all were at the same gestational age. Plasma levels of insulin and glucose were determined in the samples collected for a period of four hours after glucose load (100 g). All PCOD patients significantly increased their insulin secretion in pregnancy. The hyperinsulinemic PCOD patients developed gestational diabetes (two patients) and impaired gestational glucose tolerance (three patients). The area under the insulin curve was greater in PCOD patients than in control and gestational diabetes patients (P PCOD may develop a derangement of glycemic control, probably related to their pregestational insulinemic status.

Baseline HbA1c to Identify High-Risk Gestational Diabetes: Utility in Early vs Standard Gestational Diabetes.

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Sweeting, Arianne N; Ross, Glynis P; Hyett, Jon; Molyneaux, Lynda; Tan, Kris; Constantino, Maria; Harding, Anna Jane; Wong, Jencia

2017-01-01

The increasing prevalence of gestational diabetes mellitus (GDM) necessitates risk stratification directing limited antenatal resources to those at greatest risk. Recent evidence demonstrates that an early pregnancy glycated hemoglobin (HbA1c ≥5.9% (41 mmol/mol) predicts adverse pregnancy outcomes. To determine the optimal HbA1c threshold for adverse pregnancy outcomes in GDM in a treated multiethnic cohort and whether this differs in women diagnosed HbA1c (single-laboratory) measurement at the time of GDM diagnosis. Maternal clinical and pregnancy outcome data were collected prospectively. The association between baseline HbA1c and adverse pregnancy outcomes in early vs standard GDM. HbA1c was measured at a median of 17.6 ± 3.3 weeks' gestation in early GDM (n = 844) and 29.4 ± 2.6 weeks' gestation in standard GDM (n = 2254). In standard GDM, HbA1c >5.9% (41 mmol/mol) was associated with the greatest risk of large-for-gestational-age (odds ratio [95% confidence interval] = 2.7 [1.5-4.9]), macrosomia (3.5 [1.4-8.6]), cesarean section (3.6 [2.1-6.2]), and hypertensive disorders (2.6 [1.1-5.8]). In early GDM, similar HbA1c associations were seen; however, lower HbA1c correlated with the greatest risk of small-for-gestational-age (P trend = 0.004) and prevalence of neonatal hypoglycemia. Baseline HbA1c >5.9% (41 mmol/mol) identifies an increased risk of large-for-gestational-age, macrosomia, cesarean section, and hypertensive disorders in standard GDM. Although similar associations are seen in early GDM, higher HbA1c levels do not adequately capture risk-limiting utility as a triage tool in this cohort. Copyright © 2017 by the Endocrine Society

The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study.

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Alberico, Salvatore; Montico, Marcella; Barresi, Valentina; Monasta, Lorenzo; Businelli, Caterina; Soini, Valentina; Erenbourg, Anna; Ronfani, Luca; Maso, Gianpaolo

2014-01-15

It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia. A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample included 14109 women with complete records. Associations between exposure variables and newborn macrosomia were analyzed using Pearson's chi squared test. Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia. Maternal obesity (adjusted OR 1.7, 95% CI 1.4-2.2), excessive gestational weight gain (adjusted OR 1.9, 95% CI 1.6-2.2) and diabetes (adjusted OR 2.1, 95% CI 1.5-3.0 for gestational; adjusted OR 3.0, 95% CI 1.2-7.6 for pre-gestational) resulted to be independent predictors of macrosomia, when adjusted for other recognized risk factors. Since no significant interaction was found between pre-gestational BMI and gestational weight gain, excessive weight gain should be considered an independent risk factor for macrosomia. In the sub-group of women affected by gestational or pre-gestational diabetes, pre-gestational BMI was not significantly associated to macrosomia, while excessive pregnancy weight gain, maternal height and gestational age at delivery were significantly associated. In this sub-population, pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia. Our findings indicate that maternal obesity, gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia. To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored.

Transvaginal ultrasound in threatened abortions with empty gestational sacs.

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Tongsong, T; Wanapirak, C; Srisomboon, J; Sirichotiyakul, S; Polsrisuthikul, T; Pongsatha, S

1994-09-01

To determine whether transvaginal ultrasound criteria alone can distinguish viable from non-viable gestational sacs at a single examination. A prospective descriptive study was undertaken and analysis performed on 211 pregnancies complicated by threatened abortion and empty gestation sacs diagnosed by transvaginal ultrasound. The main outcome measure was the final diagnosis of viable or non-viable gestation on subsequent transvaginal sonography. The study shows that a single transvaginal ultrasound examination is useful in differentiating viable from non-viable gestation sacs. The mean sac diameter (MSD) was found to be the most useful criterion for determining non-viability. An MSD of > or = 17 mm that lacked an embryo and an MSD of > or = 13 mm without visible yolk sac were reliable predictors of non-viable gestation sacs at a single examination with 100% specificity and 100% positive predictive value. An MSD > or = 13 mm without visible yolk sac was the most sensitive criterion. Using MSD criteria, 73% of non-viable gestations could be reliably identified without any false-positive diagnoses. Deformed shape, low position and thin decidual reaction are strong indicators of non-viable gestations but are not 100% accurate. There is still a significant proportion of empty sacs, where no accurate distinction between viable and non-viable can be made according to one criterion at a single examination and in these cases serial examinations should be carried out before any active management is advocated. In most cases, transvaginal sonographic criteria alone can distinguish viable from non-viable empty gestational sacs at a single examination.

Combined Influence of Gestational Weight Gain and Estimated Fetal Weight on Risk Assessment for Small- or Large-for-Gestational-Age Birth Weight: A Prospective Cohort Study.

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Pugh, Sarah J; Hinkle, Stefanie N; Kim, Sungduk; Albert, Paul S; Newman, Roger; Grobman, William A; Wing, Deborah A; Grantz, Katherine L

2018-04-01

To evaluate the frequency with which gestational weight gain and estimated fetal weight do not track across gestation and to assess the risk of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth weight as a function of tracking. This study included a pregnancy cohort (2009-2013) of 2438 women from 4 racial/ethnic groups in the United States. We calculated race- and trimester-specific gestational weight gain and estimated fetal weight z scores. The prevalence of how often gestational weight gain and estimated fetal weight did not or did directly track was examined by grouping z scores into measure-specific categories (1 SD) and then examining 2-measure combinations. Trimester-specific relative risks for SGA and LGA births were estimated with a gestational weight gain and estimated fetal weight z score interaction. We estimated coefficients for selected gestational weight gain and estimated fetal weight values (-1 SD, 0 SD, and +1 SD) compared with the referent of 0 SD for both measures. Small and large for gestational age were calculated as birth weight below the 10th and at or above the 90th percentiles, respectively. Gestational weight gain and estimated fetal weight were within 1 SD 55.5%, 51.5%, and 48.2% of the time in the first, second, and third trimesters, respectively. There was no significant interaction between gestational weight gain and estimated fetal weight on the risk of SGA in the first and second trimesters (interaction term P = .48; P = .79). In the third trimester, there was a significant interaction (P = .002), resulting in a 71% (95% confidence interval, 1.45-2.02) increased risk of SGA when estimated fetal weight was low and gestational weight gain was high. These relationships were similar for the risk of LGA. Deviations in either measure, even in the presence of average gestational weight gain or estimated fetal weight, still suggest an increased risk of SGA and LGA. © 2017 by the American Institute of

Gestational dating by metabolic profile at birth: a California cohort study

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Jelliffe-Pawlowski, Laura L.; Norton, Mary E.; Baer, Rebecca J.; Santos, Nicole; Rutherford, George W.

2016-01-01

Background Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications. Objective We sought to evaluate whether metabolic markers in newborns measured as part of routine screening for treatable inborn errors of metabolism can be used to develop a population-level metabolic gestational dating algorithm that is robust despite intrauterine growth restriction and can be used when fetal ultrasound dating is not available. We focused specifically on the ability of these markers to differentiate preterm births (PTBs) (PTBs and term births. Using a linear discriminate analyses-derived linear function, we were able to sort PTBs and term births accurately with sensitivities and specificities of ≥95% in both the training and testing subsets. Assignment of a specific week of gestation in those identified as PTBs resulted in the correct assignment of week ±2 weeks in 89.8% of all newborns in the training and 91.7% of those in the testing subset. When PTB rates were modeled using the metabolic dating algorithm compared to fetal ultrasound, PTB rates were 7.15% vs 6.11% in the training subset and 7.31% vs 6.25% in the testing subset. Conclusion When considered in combination with birthweight and hours of age at test, metabolic profile evaluated within 8 days of birth appears to be a useful measure of PTB and, among those born preterm, of specific week of gestation ±2 weeks. Dating by metabolic profile may be useful in instances where there is no fetal ultrasound due to lack of availability or late entry into care. PMID

Attitudes towards gestational diabetes among a multiethnic cohort in Australia.

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Carolan, Mary; Steele, Cheryl; Margetts, Heather

2010-09-01

This study aimed to examine the attitudes and beliefs towards gestational diabetes of a multiethnic sample of pregnant women with gestational diabetes. Women from non-Caucasian background are disproportionately represented in gestational diabetes statistics. This is of particular importance in multicultural Australia, where increasing numbers of non-Caucasian women give birth. Cross-sectional survey. The Diabetes Attitude Scale, version 3 was administered to 200 women with gestational diabetes from Vietnamese, Indian, Filipino and Caucasian backgrounds. A total of 143 questionnaires were returned indicating a response rate of 71·5%. There were significant between group differences in terms of educational level (p = 0·001) and English fluency (p = 0·001). Lower educational level, though not English language fluency, was associated with poorer appreciation of gestational diabetes as a serious condition and also with a lower valuing of tight glucose control. This effect was seen irrespective of ethnic group. Indian and Vietnamese women indicated a lower valuing of patient autonomy and also reported less negative psychological effects than Caucasian and Filipino women. Women from non-Caucasian ethnicities may be at risk of poorer self-management of gestational diabetes related to lower education, lower health literacy and a lower appreciation of gestational diabetes as a serious condition. Nurses and midwives provide information and advice to women with gestational diabetes. Knowledge about factors that impact on attitude towards gestational diabetes among multiethnic populations is important for developing educational programmes to address their needs. © 2010 Blackwell Publishing Ltd.

[Potential role of the angiogenic factor "EG-VEGF" in gestational trophoblastic diseases].

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Boufettal, H; Feige, J-J; Benharouga, M; Aboussaouira, T; Nadifi, S; Mahdaoui, S; Samouh, N; Alfaidy, N

2013-10-01

Gestational trophoblastic disease (MGT) includes a wide spectrum of pathologies of the placenta, ranging from benign precancerous lesions, with gestational trophoblastic tumors. Metastases are the leading causes of death as a result of this tumor. They represent a major problem for obstetrics and for the public health system. To date, there is no predictor of the progression of molar pregnancies to gestational trophoblastic tumor (GTT). Only an unfavorable plasma hCG monitoring after evacuation of hydatidiform mole is used to diagnose a TTG. The causes of the development of this cancer are still poorly understood. Increasing data in the literature suggests a close association between the development of this tumor and poor placental vascularization during the first trimester of pregnancy. The development of the human placenta depends on a coordination between the trophoblast and endothelial cells. A disruption in the expression of angiogenic factors could contribute to uterine or extra-uterine tissue invasion by extravillous trophoblast, contributing to the development of TTG. This review sheds lights on the phenomenon of angiogenesis during normal and abnormal placentation, especially during the MGT and reports preliminary finding concerning, the variability of expression of "Endocrine Gland-Derived Vascular Endothelial Growth Factor" (EG-VEGF), a specific placental angiogenic factor, in normal and molar placentas, and the potential role of differentiated expressions of the main placental angiogenic factors in the scalability of hydatidiform moles towards a recovery or towards the development of gestational trophoblastic tumor. Deciphering the mechanisms by which the angiogenic factor influences these processes will help understand the pathophysiology of MGT and to create opportunities for early diagnosis and treatment of the latter. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

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Bruner, David I.; Pritchard, Amy M.; Clarke, Jonathan

2013-01-01

While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia. PMID:24106538

Inertia and Double Bending of Light from Equivalence

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Shuler, Robert L., Jr.

2010-01-01

Careful examination of light paths in an accelerated reference frame, with use of Special Relativity, can account fully for the observed bending of light in a gravitational field, not just half of it as reported in 1911. This analysis also leads to a Machian formulation of inertia similar to the one proposed by Einstein in 1912 and later derived from gravitational field equations in Minkowsky Space by Sciama in 1953. There is a clear inference from equivalence that there is some type of inertial mass increase in a gravitational field. It is the purpose of the current paper to suggest that equivalence provides a more complete picture of gravitational effects than previously thought, correctly predicting full light bending, and that since the theory of inertia is derivable from equivalence, any theory based on equivalence must take account of it. Einstein himself clearly was not satisfied with the status of inertia in GRT, as our quotes have shown. Many have tried to account for inertia and met with less than success, for example Davidson s integration of Sciama s inertia into GRT but only for a steady state cosmology [10], and the Machian gravity theory of Brans and Dicke [11]. Yet Mach s idea hasn t gone away, and now it seems that it cannot go away without also disposing of equivalence.

Investigation of 1-cm dose equivalent for photons behind shielding materials

International Nuclear Information System (INIS)

Hirayama, Hideo; Tanaka, Shun-ichi

1991-03-01

The ambient dose equivalent at 1-cm depth, assumed equivalent to the 1-cm dose equivalent in practical dose estimations behind shielding slabs of water, concrete, iron or lead for normally incident photons having various energies was calculated by using conversion factors for a slab phantom. It was compared with the 1-cm depth dose calculated with the Monte Carlo code EGS4. It was concluded from this comparison that the ambient dose equivalent calculated by using the conversion factors for the ICRU sphere could be used for the evaluation of the 1-cm dose equivalent for the sphere phantom within 20% errors. Average and practical conversion factors are defined as the conversion factors from exposure to ambient dose equivalent in a finite slab or an infinite one, respectively. They were calculated with EGS4 and the discrete ordinates code PALLAS. The exposure calculated with simple estimation procedures such as point kernel methods can be easily converted to ambient dose equivalent by using these conversion factors. The maximum value between 1 and 30 mfp can be adopted as the conversion factor which depends only on material and incident photon energy. This gives the ambient dose equivalent on the safe side. 13 refs., 7 figs., 2 tabs

Modeling Fetal Weight for Gestational Age: A Comparison of a Flexible Multi-level Spline-based Model with Other Approaches

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Villandré, Luc; Hutcheon, Jennifer A; Perez Trejo, Maria Esther; Abenhaim, Haim; Jacobsen, Geir; Platt, Robert W

2011-01-01

We present a model for longitudinal measures of fetal weight as a function of gestational age. We use a linear mixed model, with a Box-Cox transformation of fetal weight values, and restricted cubic splines, in order to flexibly but parsimoniously model median fetal weight. We systematically compare our model to other proposed approaches. All proposed methods are shown to yield similar median estimates, as evidenced by overlapping pointwise confidence bands, except after 40 completed weeks, where our method seems to produce estimates more consistent with observed data. Sex-based stratification affects the estimates of the random effects variance-covariance structure, without significantly changing sex-specific fitted median values. We illustrate the benefits of including sex-gestational age interaction terms in the model over stratification. The comparison leads to the conclusion that the selection of a model for fetal weight for gestational age can be based on the specific goals and configuration of a given study without affecting the precision or value of median estimates for most gestational ages of interest. PMID:21931571

Gestational Protein Restriction Impairs Glucose Disposal in the Gastrocnemius Muscles of Female Rats

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Blesson, Chellakkan S.; Chinnathambi, Vijayakumar; Kumar, Sathish

2017-01-01

Gestational low-protein (LP) diet causes hyperglycemia and insulin resistance in adult offspring, but the mechanism is not clearly understood. In this study, we explored the role of insulin signaling in gastrocnemius muscles of gestational LP-exposed female offspring. Pregnant rats were fed a control (20% protein) or an isocaloric LP (6%) diet from gestational day 4 until delivery. Normal diet was given to mothers after delivery and to pups after weaning until necropsy. Offspring were euthanized at 4 months, and gastrocnemius muscles were treated with insulin ex vivo for 30 minutes. Messenger RNA and protein levels of molecules involved in insulin signaling were assessed at 4 months. LP females were smaller at birth but showed rapid catchup growth by 4 weeks. Glucose tolerance test in LP offspring at 3 months showed elevated serum glucose levels (P insulin levels. In gastrocnemius muscles, LP rats showed reduced tyrosine phosphorylation of insulin receptor substrate 1 upon insulin stimulation due to the overexpression of tyrosine phosphatase SHP-2, but serine phosphorylation was unaffected. Furthermore, insulin-induced phosphorylation of Akt, glycogen synthase kinase (GSK)–3α, and GSK-3β was diminished in LP rats, and they displayed an increased basal phosphorylation (inactive form) of glycogen synthase. Our study shows that gestational protein restriction causes peripheral insulin resistance by a series of phosphorylation defects in skeletal muscle in a mechanism involving insulin receptor substrate 1, SHP-2, Akt, GSK-3, and glycogen synthase causing dysfunctional GSK-3 signaling and increased stored glycogen, leading to distorted glucose homeostasis. PMID:28324067

Plasticity in the olfactory bulb of the maternal mouse is prevented by gestational stress

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Belnoue, Laure; Malvaut, Sarah; Ladevèze, Elodie; Abrous, Djoher Nora; Koehl, Muriel

2016-01-01

Maternal stress is associated with an altered mother-infant relationship that endangers offspring development, leading to emotional/behavioral problems. However, little research has investigated the stress-induced alterations of the maternal brain that could underlie such a disruption of mother-infant bonding. Olfactory cues play an extensive role in the coordination of mother-infant interactions, suggesting that motherhood may be associated to enhanced olfactory performances, and that this effect may be abolished by maternal stress. To test this hypothesis, we analyzed the impact of motherhood under normal conditions or after gestational stress on olfactory functions in C57BL/6 J mice. We report that gestational stress alters maternal behavior and prevents both mothers’ ability to discriminate pup odors and motherhood-induced enhancement in odor memory. We investigated adult bulbar neurogenesis as a potential mechanism of the enhanced olfactory function in mothers and found that motherhood was associated with an increased complexity of the dendritic tree of newborn neurons. This motherhood-evoked remodeling was totally prevented by gestational stress. Altogether, our results may thus provide insight into the neural changes that could contribute to altered maternal behavior in stressed mothers. PMID:27886228

Hypoglycemia in small for gestational age neonates based on gestational age, gender, birth weight and mode of delivery

International Nuclear Information System (INIS)

Ramzan, M.; Razzaq, A.; Kiyani, A.N.

2017-01-01

To determine the frequency of hypoglycemia in small for gestational age neonates based on gestational age, gender, birth weight and mode of delivery. Study Design: Cross sectional study. Place and Duration of Study: Neonatal Intensive Care Unit (NICU), Military Hospital Rawalpindi, from Dec 2011 to Jul 2012. Material and Methods: We included 383 small for gestational age (SGA) neonates admitted in NICU. Blood glucose levels were checked in all neonates. Variables included in study were gestational age, gender, birth weight and mode of delivery. Results: Out of 383 SGA neonates enrolled by non-probability consecutive sampling, 191 (49.87%) were males and 192 (50.13%) were females. Out of these 203 (53%) were preterm, 165 (43.08%) were delivered at term and 15 (3.92%) were post-term SGA neonates with mean gestational age of 34 weeks 5 days. Out of the total 383 SGA neonates 208 (54.31%) developed hypoglycemia during stay in NICU and 175 (45.69%) remained euglycemic. Extremely low birth weight (ELBW) neonates were at highest risk to develop hypoglycemia (82.35%). It was seen that SGA neonates delivered by instrumental vaginal delivery had highest risk of developing hypoglycemia i.e. 20 (76.92) out of 26 neonates. Out of 103 vaginal deliveries 41 (39.81%) had hypoglycemia and out of 254 Caesarean section 147 (57.87%) had hypoglycemia. Conclusion: Low birth weight neonates delivered by instrumental vaginal delivery were found to be at a higher risk of developing hypoglycemia. (author)

Gestational exposure to high perchlorate concentrations in drinking water and neonatal thyroxine levels.

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Amitai, Yona; Winston, Gary; Sack, Joseph; Wasser, Janice; Lewis, Matthew; Blount, Benjamin C; Valentin-Blasini, Liza; Fisher, Nirah; Israeli, Avi; Leventhal, Alex

2007-09-01

To assess the effect of gestational perchlorate exposure through drinking water on neonatal thyroxine (T(4)). T(4) values were compared among newborns in Ramat Hasharon, Israel, whose mothers resided in suburbs where drinking water contained perchlorate water exclusively (as determined by a telephone interview) were analyzed as a subset. Serum perchlorate levels in blood from donors residing in the area were used as proxy indicators of exposure. Neonatal T(4) values (mean +/- SD) in the very high, high, and low exposure groups were 13.9 +/- 3.8, 13.9 +/- 3.4, and 14.0 +/- 3.5 microg/dL, respectively (p = NS). Serum perchlorate concentrations in blood from donors residing in areas corresponding to these groups were 5.99 +/- 3.89, 1.19 +/- 1.37, and 0.44 +/- 0.55 microg/L, respectively. T(4) levels of neonates with putative gestational exposure to perchlorate in drinking water were not statistically different from controls. This study finds no change in neonatal T(4) levels despite maternal consumption of drinking water that contains perchlorate at levels in excess of the Environmental Protection Agency (EPA) drinking water equivalent level (24.5 microg/L) based on the National Research Council reference dose (RfD) [0.7 microg/(kg.day)]. Therefore the perchlorate RfD is likely to be protective of thyroid function in neonates of mothers with adequate iodide intake.

Iron, Oxidative Stress and Gestational Diabetes

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Taifeng Zhuang

2014-09-01

Full Text Available Both iron deficiency and hyperglycemia are highly prevalent globally for pregnant women. Iron supplementation is recommended during pregnancy to control iron deficiency. The purposes of the review are to assess the oxidative effects of iron supplementation and the potential relationship between iron nutrition and gestational diabetes. High doses of iron (~relative to 60 mg or more daily for adult humans can induce lipid peroxidation in vitro and in animal studies. Pharmaceutical doses of iron supplements (e.g., 10× RDA or more for oral supplements or direct iron supplementation via injection or addition to the cell culture medium for a short or long duration will induce DNA damage. Higher heme-iron intake or iron status measured by various biomarkers, especially serum ferritin, might contribute to greater risk of gestational diabetes, which may be mediated by iron oxidative stress though lipid oxidation and/or DNA damage. However, information is lacking about the effect of low dose iron supplementation (≤60 mg daily on lipid peroxidation, DNA damage and gestational diabetes. Randomized trials of low-dose iron supplementation (≤60 mg daily for pregnant women are warranted to test the relationship between iron oxidative stress and insulin resistance/gestational diabetes, especially for iron-replete women.

The leaded apron revisited: does it reduce gonadal radiation dose in dental radiology

Energy Technology Data Exchange (ETDEWEB)

Wood, R.E.; Harris, A.M.; van der Merwe, E.J.; Nortje, C.J. (Ontario Cancer Institute, Princess Margaret Hospital, Toronto (Canada))

1991-05-01

A tissue-equivalent anthropomorphic human phantom was used with a lithium fluoride thermoluminescent dosimetry system to evaluate the radiation absorbed dose to the ovarian and testicular region during dental radiologic procedures. Measurements were made with and without personal lead shielding devices consisting of thyroid collar and apron of 0.25 mm lead thickness equivalence. The radiation absorbed dose with or without lead shielding did not differ significantly from control dosimeters in vertex occlusal and periapical views (p greater than 0.05). Personal lead shielding devices did reduce gonadal dose in the case of accidental exposure (p less than 0.05). A leaded apron of 0.25 mm lead thickness equivalent was permeable to radiation in direct exposure testing.

The leaded apron revisited: does it reduce gonadal radiation dose in dental radiology

International Nuclear Information System (INIS)

Wood, R.E.; Harris, A.M.; van der Merwe, E.J.; Nortje, C.J.

1991-01-01

A tissue-equivalent anthropomorphic human phantom was used with a lithium fluoride thermoluminescent dosimetry system to evaluate the radiation absorbed dose to the ovarian and testicular region during dental radiologic procedures. Measurements were made with and without personal lead shielding devices consisting of thyroid collar and apron of 0.25 mm lead thickness equivalence. The radiation absorbed dose with or without lead shielding did not differ significantly from control dosimeters in vertex occlusal and periapical views (p greater than 0.05). Personal lead shielding devices did reduce gonadal dose in the case of accidental exposure (p less than 0.05). A leaded apron of 0.25 mm lead thickness equivalent was permeable to radiation in direct exposure testing

Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

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K. H. Odubamowo

2014-01-01

Full Text Available Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide. Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.

Is Doppler ultrasound useful for evaluating gestational trophoblastic disease?

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Lawrence H. Lin

Full Text Available Doppler ultrasound is a non-invasive method for evaluating vascularization and is widely used in clinical practice. Gestational trophoblastic neoplasia includes a group of highly vascularized malignancies derived from placental cells. This review summarizes data found in the literature regarding the applications of Doppler ultrasound in managing patients with gestational trophoblastic neoplasia. The PubMed/Medline, Web of Science, Cochrane and LILACS databases were searched for articles published in English until 2014 using the following keywords: “Gestational trophoblastic disease AND Ultrasonography, Doppler.” Twenty-eight articles met the inclusion criteria and were separated into the 4 following groups according to the aim of the study. (1 Doppler ultrasound does not seem to be capable of differentiating partial from complete moles, but it might be useful when evaluating pregnancies in which a complete mole coexists with a normal fetus. (2 There is controversy in the role of uterine artery Doppler velocimetry in the prediction of development of gestational trophoblastic neoplasia. (3 Doppler ultrasound is a useful tool in the diagnosis of gestational trophoblastic neoplasia because abnormal myometrial vascularization and lower uterine artery Doppler indices seem to be correlated with invasive disease. (4 Lower uterine artery Doppler indices in the diagnosis of gestational trophoblastic neoplasia are associated with methotrexate resistance and might play a role in prognosis. CONCLUSION: Several studies support the importance of Doppler ultrasound in the management of patients with gestational trophoblastic neoplasia, particularly the role of Doppler velocimetry in the prediction of trophoblastic neoplasia and the chemoresistance of trophoblastic tumors. Doppler findings should be used as ancillary tools, along with human chorionic gonadotropin assessment, in the diagnosis of gestational trophoblastic neoplasia.

Is Doppler ultrasound useful for evaluating gestational trophoblastic disease?

Science.gov (United States)

Lin, Lawrence H; Bernardes, Lisandra S; Hase, Eliane A; Fushida, Koji; Francisco, Rossana P V

2015-12-01

Doppler ultrasound is a non-invasive method for evaluating vascularization and is widely used in clinical practice. Gestational trophoblastic neoplasia includes a group of highly vascularized malignancies derived from placental cells. This review summarizes data found in the literature regarding the applications of Doppler ultrasound in managing patients with gestational trophoblastic neoplasia. The PubMed/Medline, Web of Science, Cochrane and LILACS databases were searched for articles published in English until 2014 using the following keywords: "Gestational trophoblastic disease AND Ultrasonography, Doppler." Twenty-eight articles met the inclusion criteria and were separated into the 4 following groups according to the aim of the study. (1) Doppler ultrasound does not seem to be capable of differentiating partial from complete moles, but it might be useful when evaluating pregnancies in which a complete mole coexists with a normal fetus. (2) There is controversy in the role of uterine artery Doppler velocimetry in the prediction of development of gestational trophoblastic neoplasia. (3) Doppler ultrasound is a useful tool in the diagnosis of gestational trophoblastic neoplasia because abnormal myometrial vascularization and lower uterine artery Doppler indices seem to be correlated with invasive disease. (4) Lower uterine artery Doppler indices in the diagnosis of gestational trophoblastic neoplasia are associated with methotrexate resistance and might play a role in prognosis. Several studies support the importance of Doppler ultrasound in the management of patients with gestational trophoblastic neoplasia, particularly the role of Doppler velocimetry in the prediction of trophoblastic neoplasia and the chemoresistance of trophoblastic tumors. Doppler findings should be used as ancillary tools, along with human chorionic gonadotropin assessment, in the diagnosis of gestational trophoblastic neoplasia.

Gestational Trophoblastic Disease -Choriocarcinoma

International Nuclear Information System (INIS)

Bozik, M.

2011-01-01

Gestational trophoblastic tumors are a group of a diseases from the benign hydatidiform mole, through the invasive mole to the highly malignant form of a choriocarcinoma. Choriocarcinoma is a rare tumor and it is the most malignant and aggressive neoplasm of all the gestational trophoblastic diseases. It grows rapidly and metastasizes to the lung, liver, and, less frequently, to the brain. The author presents the case of a 26-year-old woman who is indicated to the CT examination for suspected brain tumor based on the previous examinations. The patient was diagnosed with metastatic choriocarcinoma to the brain, kidney and adrenal gland on the basis of an anamnesis by her husband, a high value of beta-hCG and a gynecological examination. (author)

ACOG Committee Opinion No. 660 Summary: Family Building Through Gestational Surrogacy.

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Ryan, Ginny L

2016-03-01

Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated. The practice of gestational surrogacy involves a woman known as a gestational carrier who agrees to bear a genetically unrelated child with the help of assisted reproductive technologies for an individual or couple who intend(s) to be the legal and rearing parent(s), referred to as the intended parent(s). Obstetrician-gynecologists may become involved in gestational surrogacy through caring for the gestational carrier or by caring for the intended parent(s). Although gestational surrogacy increases options for family building, this treatment also involves ethical, medical, psychosocial, and legal complexities that must be taken into account to minimize risks of adverse outcomes for the gestational carrier, intended parent(s), and resulting children. The purpose of this document is to provide an overview of gestational surrogacy and to describe the ethical responsibilities for obstetrician-gynecologists who take part in the care of women who participate in these arrangements.

The Effects of Mild Gestational Hyperglycemia on Exclusive Breastfeeding Cessation

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Sergio Verd

2016-11-01

Full Text Available Gestational diabetes increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure, but the best cut-off point for gestational diabetes is unknown. The purpose of this study was to evaluate the association between mild gestational glucose tolerance impairment and the early cessation of exclusive breastfeeding (EBF. This is an observational study of 768 women with full term pregnancies that were screened for gestational diabetes at 24–28 weeks gestation. Subjects were divided into two groups: those with a normal 1-h glucose challenge test and those with an elevated 1-h glucose challenge test but still did not qualify for gestational diabetes. We constructed multivariable logistic regression models using data from 616 women with normal gestational glucose tolerance and 152 women with an isolated positive 1-h glucose challenge test. The risk of early exclusive breastfeeding cessation was found to increase in women with mildly impaired glucose tolerance during pregnancy (adjusted OR, 1.65; 95% CI: 1.11, 2.45. Risks of early EBF cessation were also independently associated with the amount of neonatal weight loss and admission to the neonatal ward. Instead, parity was associated with a decreased risk for shorter EBF duration. Insulin resistance—even in the absence of gestational diabetes mellitus—may be an impeding factor for EBF.

Exercise: An Alternative Therapy for Gestational Diabetes.

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Artal, Raul

1996-01-01

Exercise is encouraged in the management of pregnant women with gestational diabetes or women with Type II diabetes who become pregnant. Although non-weight-bearing exercises may be best for sedentary women, moderate workouts appear to be safe for most women with gestational diabetes. The role of exercise, risk factors, warning signs, and examples…

Trends in Survival and Incidence of Bronchopulmonary Dysplasia in Extremely Preterm Infants at 23–26 Weeks Gestation

Science.gov (United States)

2016-01-01

The aim of this study was to investigate the relationship between survival and incidence of bronchopulmonary dysplasia (BPD) in extremely premature infants, and identify clinical factors responsible for this association. Medical records of 350 infants at 23–26 weeks gestation from 2000 to 2005 (period I, n = 137) and 2006 to 2010 (period II, n = 213) were retrospectively reviewed. The infants were stratified into 23–24 and 25–26 weeks gestation, and the survival, BPD incidence, and clinical characteristics were analyzed. BPD was defined as oxygen dependency at 36 weeks postmenstrual age. The overall survival rate was significantly improved in period II compared to period I (80.3% vs. 70.0%, respectively; P = 0.028), especially in infants at 23–24 weeks gestation (73.9% vs. 47.4%, respectively; P = 0.001). The BPD incidence in survivors during period II (55.0%) was significantly decreased compared to period I (67.7%; P = 0.042), especially at 25–26 weeks gestation (41.7% vs. 62.3%, respectively; P = 0.008). Significantly improved survival at 23–24 weeks gestation was associated with a higher antenatal steroid use and an improved 5-minute Apgar score. A significant decrease in BPD incidence at 25–26 weeks gestation was associated with early extubation, prolonged use of less invasive continuous positive airway pressure, and reduced supplemental oxygen. Improved perinatal and neonatal care can simultaneously lead to improved survival and decreased BPD incidence in extremely premature infants. PMID:26955244

Greater early and mid-pregnancy gestational weight gain are associated with increased risk of gestational diabetes mellitus: A prospective cohort study.

Science.gov (United States)

Zhong, Chunrong; Li, Xiating; Chen, Renjuan; Zhou, Xuezhen; Liu, Chaoqun; Wu, Jiangyue; Xu, Shangzhi; Wang, Weiye; Xiao, Mei; Xiong, Guoping; Wang, Jing; Yang, Xuefeng; Hao, Liping; Yang, Nianhong

2017-12-01

Gestational diabetes mellitus is associated with adverse short- and long-term consequences for both the mother and the offspring. To examine the relationship between the rates of gestational weight gain (RGWG) during early and mid-pregnancy and the risk of gestational diabetes mellitus (GDM). 2090 singleton pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) without overt diabetes before pregnancy were analyzed in our study. Gestational weight were measured regularly in every antenatal visit. Gestational diabetes mellitus was assessed with the 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation. Multivariable logistic regression was performed to estimate effect of RGWG on GDM. A total of 8.3% (n = 173) of pregnant women were diagnosed with GDM. Women with elevated rate of gestational weight gain prior to glucose screening test (RGWG-PG) increased the risk of GDM (adjusted p-trend = 0.004; odds ratios (OR) 1.64, 95% confidence intervals (CI) 1.01-2.68 and OR 2.30,95% CI 1.44-3.66 for 0.297-0.384 kg/wk and 0.385 kg/wk or more vs. 0.213 kg/wk or less, respectively). Women with greater rate of gestational weight gain in the first trimester (RGWG-F) increased the risk of GDM (adjusted p-trend = 0.048; OR 1.83, 95% CI 1.14-2.94 and OR 1.76, 95% CI 1.10-2.83 for 0.086-0.200 kg/wk and 0.201 kg/wk or more vs. -0.025 kg/wk or less, respectively). The rate of gestational weight gain in the second trimester (RGWG-S) was significantly associated with GDM only among women with RGWG-F more than 0.086 kg/wk (adjusted p-trend = 0.035; OR 2.04, 95% CI 1.16-3.59 for 0.658 kg/wk or more vs. 0.418 kg/wk or less). Greater early pregnancy weight gain are associated with increased risk of GDM. Elevated weight gain in mid-pregnancy increased the risk of GDM only among pregnant women with greater weight gain in the first trimester. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All

The Therapeutic Effect of Zuogui Wan in Gestational Diabetes Mellitus Rats

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Feng, Qianjin; Niu, Xin; Liu, Xinshe; Xu, Kaixia; Yang, Xiangzhu; Wang, Huifeng

2014-01-01

In this experiment, we established an animal model of gestational diabetes mellitus rats using streptozotocin. Using the rat model of GDM, the pregnant rats in 1-19d were divided into three groups: (1) Zuogui Wan gestational diabetes mellitus group (group I, n = 12), (2) gestational diabetes mellitus rats as the control group (group II, n = 11), and (3) rats of normal pregnancy group (group III, n = 11). Compared with gestational diabetes mellitus rats as the control group, Zuogui Wan can change the indexes of fasting blood glucose, body weight, total cholesterol, insulin, and metabolism cage index significantly in Zuogui Wan gestational diabetes mellitus group. We can conclude that Zuogui Wan has the therapeutic effect on gestational diabetes mellitus. PMID:25136475

Dietary Patterns during Pregnancy Are Associated with Risk of Gestational Diabetes Mellitus

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Dayeon Shin

2015-11-01

Full Text Available Maternal dietary patterns before and during pregnancy play important roles in the development of gestational diabetes mellitus (GDM. We aimed to identify dietary patterns during pregnancy that are associated with GDM risk in pregnant U.S. women. From a 24 h dietary recall of 253 pregnant women (16–41 years included in the National Health and Nutrition Examination Survey (NHANES 2003–2012, food items were aggregated into 28 food groups based on Food Patterns Equivalents Database. Three dietary patterns were identified by reduced rank regression with responses including prepregnancy body mass index (BMI, dietary fiber, and ratio of poly- and monounsaturated fatty acids to saturated fatty acid: “high refined grains, fats, oils and fruit juice”, “high nuts, seeds, fat and soybean; low milk and cheese”, and “high added sugar and organ meats; low fruits, vegetables and seafood”. GDM was diagnosed using fasting plasma glucose levels ≥5.1 mmol/L for gestation <24 weeks. Multivariable logistic regression models were used to estimate adjusted odds ratio (AOR and 95% confidence intervals (CIs for GDM, after controlling for maternal age, race/ethnicity, education, family poverty income ratio, marital status, prepregnancy BMI, gestational weight gain, energy intake, physical activity, and log-transformed C-reactive protein (CRP. All statistical analyses accounted for the appropriate survey design and sample weights of the NHANES. Of 249 pregnant women, 34 pregnant women (14% had GDM. Multivariable AOR (95% CIs of GDM for comparisons between the highest vs. lowest tertiles were 4.9 (1.4–17.0 for “high refined grains, fats, oils and fruit juice” pattern, 7.5 (1.8–32.3 for “high nuts, seeds, fat and soybean; low milk and cheese” pattern, and 22.3 (3.9–127.4 for “high added sugar and organ meats; low fruits, vegetables and seafood” pattern after controlling for maternal sociodemographic variables, prepregnancy BMI, gestational

Reproductive performance of rats treated with defatted jojoba meal or simmondsin before or during gestation.

Science.gov (United States)

Cokelaere, M; Daenens, P; Decuypere, E; Flo, G; Kühn, E; Van Boven, M; Vermaut, S

1998-01-01

The effects on food intake, growth and reproductive performance parameters of defatted jojoba meal and pure simmondsin, an extract from jojoba meal, were compared in female Wistar rats. Rats fed 0.15% simmondsin or 3% defatted jojoba meal (equivalent to 0.15% simmondsin) for 8 weeks before conception showed a similar reduction in food intake (about 20%) and a similar growth retardation compared with controls. Both treatments induced a reduction in the number of corpora lutea on gestation day 16: this effect could be ascribed to the lower food intake before conception because it was also observed in rats pair-fed to the treated ones. Rats given feed containing 0.15% simmondsin or 3% defatted jojoba meal during days 1-16 of gestation showed a similar reduction in food intake relative to controls. Foetal and placental weights were reduced, relative to controls, to a similar extent in both groups, and the reductions were slightly greater than in the corresponding pair-fed groups. We conclude that the effects on food intake, growth and reproductive performance that were seen after feeding rats defatted jojoba meal were due to the simmondsin content of the meal. The simmondsin induced reduction in food intake and probably also a relative protein shortage.

Gestational diabetes mellitus in Tanzania : public health perspectives

NARCIS (Netherlands)

Mwanri, A.W.

2015-01-01

Gestational diabetes mellitus in Tanzania – public health perspectives

Abstract

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or

Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

OpenAIRE

Burlina, S.; Dalfr?, M. G.; Chilelli, N. C.; Lapolla, A.

2016-01-01

The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of contai...

Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

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David I Bruner

2013-09-01

Full Text Available While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia. [West J Emerg Med. 2013;14(5:444–447.

Prevention of preterm delivery in twin gestations (PREDICT)

DEFF Research Database (Denmark)

Rode, L; Klein, K; Nicolaides, K H

2011-01-01

-blind, placebo-controlled randomized trial performed in 17 centers in Denmark and Austria. Women with twin gestations were randomized to daily treatment with progesterone pessaries or apparently identical placebo pessaries, starting from 20-24 weeks until 34 weeks' gestation. Primary outcome was incidence...

Fasting glycaemia to simplify screening for gestational diabetes.

Science.gov (United States)

Ryser Rüetschi, J; Jornayvaz, F R; Rivest, R; Huhn, E A; Irion, O; Boulvain, M

2016-12-01

Recommendations in Switzerland on screening for gestational diabetes endorse the International Association of Diabetes in Pregnancy Study Group consensus. As universal testing is time consuming and glucose loading is unpleasant, the recommendations include a simplification, not performing the glucose loading in women with fasting glycaemia fasting glycaemia was fasting glycaemia. The prevalence of gestational diabetes was 10.9% in our population. Among 251 women with gestational diabetes, fasting glycaemia was ≥5.1 mmol/l in 119 women (47.4%), between 4.4 and fasting glycaemia between 4.4 and fasting glycaemia is an attractive alternative to universal screening with the complete 75-g glucose tolerance test. This strategy is, however, slightly less sensitive than previously reported in higher-risk populations. Fasting glycaemia can be considered as an alternative to the complete test for gestational diabetes screening. © 2016 Royal College of Obstetricians and Gynaecologists.

Conditions for equivalence of statistical ensembles in nuclear multifragmentation

International Nuclear Information System (INIS)

Mallik, Swagata; Chaudhuri, Gargi

2012-01-01

Statistical models based on canonical and grand canonical ensembles are extensively used to study intermediate energy heavy-ion collisions. The underlying physical assumption behind canonical and grand canonical models is fundamentally different, and in principle agree only in the thermodynamical limit when the number of particles become infinite. Nevertheless, we show that these models are equivalent in the sense that they predict similar results if certain conditions are met even for finite nuclei. In particular, the results converge when nuclear multifragmentation leads to the formation of predominantly nucleons and low mass clusters. The conditions under which the equivalence holds are amenable to present day experiments.

Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight.

Science.gov (United States)

Zhao, R; Xu, L; Wu, M L; Huang, S H; Cao, X J

2018-02-01

Evidence suggests that pre-pregnancy body mass index and gestational weight gain have impact on pregnancy and birth weight, yet whether maternal gestational weight gain has a differential effect on the rates of adverse birth weight among women with different pre-pregnancy body mass index categories are unknown. We selected 1617 children matched with their mothers as study subjects. The subjects were divided into three categories: weight gain below the American Institute of Medicine guidelines, weight gain within the American Institute of Medicine guidelines and weight gain above the American Institute of Medicine guidelines. The prevalence of pre-pregnancy underweight and overweight/obese women was 16.3% and 12.3%. And nearly 15.2% of the women had gestational weight gain below American Institute of Medicine guideline, 52.1% of the women had gestational weight gain above American Institute of Medicine guideline. Maternal overweight and obese was associated with increased risk for macrosomia and large-for-gestational age. Women had gestational weight gain below American Institute of Medicine guideline were more likely to have low birth weight and small-for-gestational age than women who had gestational weight gain within American Institute of Medicine guideline. Furthermore, the risks for macrosomia and large-for-gestational age were increased in women with above American Institute of Medicine guideline. And for women with a normal weight before pregnancy, gestational weight gain above the American Institute of Medicine guidelines were associated with higher rates of macrosomia and large-for-gestational age, compared with the women of similar pre-pregnancy weight category but with gestational weight gain within the American Institute of Medicine guidelines. Women with abnormal pre-pregnancy body mass index and gestational weight gain are at risk for adverse birth weight outcomes. Moreover, gestational weight gain has a differential effect on the rates of adverse

Effects of advancing gestation and non-Caucasian race on ductus arteriosus gene expression

Science.gov (United States)

Waleh, Nahid; Barrette, Anne Marie; Dagle, John M.; Momany, Allison; Jin, Chengshi; Hills, Nancy K.; Shelton, Elaine L.; Reese, Jeff; Clyman, Ronald I.

2015-01-01

Objective To identify genes affected by advancing gestation and racial/ethnic origin in human ductus arteriosus (DA). Study design We collected three sets of DA tissue (n=93, n=89, n=91; total = 273 fetuses) from second trimester pregnancies. We examined four genes, with DNA polymorphisms that distribute along racial lines, to identify "Caucasian" and "Non-Caucasian" DA. We used RT-PCR to measure RNA expression of 48 candidate genes involved in functional closure of the DA, and used multivariable regression analyses to examine the relationships between advancing gestation, "Non-Caucasian" race, and gene expression. Results Mature gestation and Non-Caucasian race are significant predictors for identifying infants who will close their patent DA when treated with indomethacin. Advancing gestation consistently altered gene expression in pathways involved with oxygen-induced constriction (e.g., calcium-channels, potassium-channels, and endothelin signaling), contractile protein maturation, tissue remodeling, and prostaglandin and nitric oxide signaling in all three tissue sets. None of the pathways involved with oxygen-induced constriction appeared to be altered in "Non-Caucasian" DA. Two genes, SLCO2A1 and NOS3, (involved with prostaglandin reuptake/metabolism and nitric oxide production, respectively) were consistently decreased in "Non-Caucasian" DA. Conclusions Prostaglandins and nitric oxide are the most important vasodilators opposing DA closure. Indomethacin inhibits prostaglandin production, but not nitric oxide production. Because decreased SLCO2A1 and NOS3 expression can lead to increased prostaglandin and decreased nitric oxide concentrations, we speculate that prostaglandin-mediated vasodilation may play a more dominant role in maintaining the "Non-Caucasian" PDA, making it more likely to close when inhibited by indomethacin. PMID:26265282

Gestational diabetes: How risky are the mothers of rural Bengal,India

OpenAIRE

Sonali Sain

2012-01-01

Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA) risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28...

Shielding effect of lead glasses on radiologists' eye lens exposure in interventional procedures

International Nuclear Information System (INIS)

Hu, Panpan; Kong, Yan; Chen, Bo; Liu, Qianqian; Zhuo, Weihai; Liu, Haikuan

2017-01-01

To study the shielding effect of radiologists' eye lens with lead glasses of different equivalent thicknesses and sizes in interventional radiology procedures. Using the human voxel phantom with a more accurate model of the eye and MCNPX software, eye lens doses of the radiologists who wearing different kinds of lead glasses were simulated, different beam projections were taken into consideration during the simulation. Measurements were also performed with the physical model to verify simulation results. Simulation results showed that the eye lens doses were reduced by a factor from 3 to 9 when wearing a 20 cm"2-sized lead glasses with the equivalent thickness ranging from 0.1 to 1.0 mm Pb. The increase of dose reduction factor (DRF) was not significant whenever increase the lead equivalent of glasses of which larger than 0.35 mm. Furthermore, the DRF was proportional to the size of glass lens from 6 to 30 cm"2 with the same lead equivalent. The simulation results were in well agreements with the measured ones. For more reasonable and effective protection of the eye lens of interventional radiologists, a pair of glasses with a lead equivalent of 0.5 mm Pb and large-sized (at least 27 cm"2 per glass) lens are recommended (authors)

Maternal hepatitis B infection and gestational diabetes mellitus.

Science.gov (United States)

Lao, Terence T; Chan, Ben C P; Leung, Wing-Cheong; Ho, Lai-Fong; Tse, Ka-Yu

2007-07-01

This retrospective cohort study was performed to examine the relationship between maternal hepatitis B virus infection, as indicated by the surface antigen status, with the development of gestational diabetes mellitus in a normal-risk Chinese obstetric population. Maternal demographics, risk factors, and pregnancy outcome of 13,683 singleton pregnancies delivering in 1998-2001 were analysed according to maternal hepatitis B surface antigen status, which was routinely screened. Multiple logistic regression analysis was performed to examine the role of hepatitis B infection in the development of gestational diabetes mellitus. The 1138 women (8.3%) with hepatitis B infection had lower mean weight and body mass index, similar prevalence of chronic medical diseases and smokers, but increased prevalence of gestational diabetes mellitus, which remained significant (odds ratio 1.24, 95% confidence interval 1.01-1.51) after adjustment for confounding variables. However, there was no difference in pregnancy outcome. Our results confirmed the independent association between hepatitis B infection with gestational diabetes mellitus. The magnitude of chronic hepatitis B infection in the developing world and certain ethnic groups could have contributed to the high prevalence of gestational and possibly type 2 diabetes in these populations. Further studies on the long-term implications of our finding are warranted.

Effect of parents occupational exposures on risk of stillbirth, preterm delivery, and small-for-gestational-age in infants

International Nuclear Information System (INIS)

Savitz, D.A.; Whelan, E.A.; Kleckner, R.C.

1989-01-01

Epidemiologic research on the effects of parental occupational exposures on fetal development has been limited. The National Natality and Fetal Mortality surveys obtained applicable data of probability samples of live births and fetal deaths which occurred in the US in 1980 among married women. Analyses were conducted for case groups of stillbirths (2,096 mothers, 3,170 fathers), preterm deliveries (<37 weeks completed gestation) (363 mothers, 552 fathers), and small-for gestational-age infants (218 mothers, 371 fathers) compared with controls. Occupational exposures were defined by industry of employment and by imputed exposures based on a job-exposure linkage system. For stillbirth, maternal work in the rubber, plastics, and synthetics industry and lead exposure and paternal employment in the textile industry had the largest odds ratios. Preterm birth was most strongly associated with maternal lead exposure, corroborating previous findings. Twofold increased risk of preterm delivery was found with paternal employment in the glass, clay, and stone; textile; and mining industries. Paternal exposures to x-rays and polyvinyl alcohol were associated with 1.5-fold increase in risk. The occupation of the mother was not associated with delivery of a small-for-gestational-age infant, in contrast to paternal employment in the art and textile industries. Several toxic agents were associated with risk elevation of 1.3 or greater for fathers, most notably benzene

Determination of dose equivalent with tissue-equivalent proportional counters

International Nuclear Information System (INIS)

Dietze, G.; Schuhmacher, H.; Menzel, H.G.

1989-01-01

Low pressure tissue-equivalent proportional counters (TEPC) are instruments based on the cavity chamber principle and provide spectral information on the energy loss of single charged particles crossing the cavity. Hence such detectors measure absorbed dose or kerma and are able to provide estimates on radiation quality. During recent years TEPC based instruments have been developed for radiation protection applications in photon and neutron fields. This was mainly based on the expectation that the energy dependence of their dose equivalent response is smaller than that of other instruments in use. Recently, such instruments have been investigated by intercomparison measurements in various neutron and photon fields. Although their principles of measurements are more closely related to the definition of dose equivalent quantities than those of other existing dosemeters, there are distinct differences and limitations with respect to the irradiation geometry and the determination of the quality factor. The application of such instruments for measuring ambient dose equivalent is discussed. (author)

Outcomes for Gestational Carriers Versus Traditional Surrogates in the United States.

Science.gov (United States)

Fuchs, Erika L; Berenson, Abbey B

2018-05-01

Little is known about the obstetric and procedural outcomes of traditional surrogates and gestational carriers. Participants included 222 women living in the United States who completed a brief online survey between November 2015 and February 2016. Differences between gestational carriers (n = 204) and traditional surrogates (n = 18) in demographic characteristics, pregnancy outcomes, and procedural outcomes were examined using chi-squared tests, Fisher's exact tests, and t-tests. Out of 248 eligible respondents, 222 surveys were complete, for a response rate of 89.5%. Overall, obstetric outcomes were similar among gestational carriers and traditional surrogates. Traditional surrogates were more likely than gestational carriers to have a Center for Epidemiologic Studies Depression Scale Revised score of 16 or higher (37.5% vs. 4.0%). Gestational carriers reported higher mean compensation ($27,162.80 vs. $17,070.07) and were more likely to travel over 400 miles (46.0% vs. 0.0%) than traditional surrogates. Procedural differences, but not differences in obstetric outcomes, emerged between gestational carriers and traditional surrogates. To ensure that both traditional surrogates and gestational carriers receive optimal medical care, it may be necessary to extend practice guidelines to ensure that traditional surrogates are offered the same level of care offered to gestational carriers.

Comparison of gestational dating methods and implications for exposure-outcome associations: an example with PM2.5 and preterm birth

Science.gov (United States)

OBJECTIVES: Estimating gestational age is usually based on date of last menstrual period (LMP) or clinical estimation (CE); both approaches introduce potential bias. Differences in methods of estimation may lead to misclassificat ion and inconsistencies in risk estimates, particu...

Fluoxetine effect on gestation and fetal development

Directory of Open Access Journals (Sweden)

Ösz Bianca Eugenia

2014-08-01

Full Text Available The prenatal exposure to selective serotonin reuptake inhibitors (SSRIs is very controversial. There is no conclusive evidence for increased risk of malformations after SSRI use in pregnancy. The aim of the study was to determine how fluoxetine is affecting gestation and fetal development in rats. Twenty sexually mature female Wistar rats weighting between 250-260 g received 20 mg/kg body weight fluoxetine from the first day of gestation and during the entire gestation period.The drug was administered by oral route. Healthy, primipareus animals were selected along with 20 female Wistar rats, as control group. Mature males were caged with virgin females for an entire week. Rat’s behaviour during gestation, after birth and rats body weight was examined. The number of healthy pups was also noted. The females not giving birth after 21 days to any pup were anesthetized (halothane through gas scavenging apparatus untilled death and the gravid uterus were dissected out and examined. Compared to the controlled group, in which weight gain was more significant, the animals from the experimental group had a slight increase in body weight. The weight gain normally induced by gestation, is less significant in fluoxetine treated rats due to the increase serotonin levels in the brain. The uteri examination of pregnant rats showed an increase in the number of dead and resorbed rat embryos. Preclinical studies suggest that the inclusion of fluoxetine in pregnancy category C is justified and the appropriateness of its administration in pregnancy is still an unresolved issue.

Gestational diabetes: How risky are the mothers of rural Bengal, India

OpenAIRE

Sonali Sain; Prianka Mukhopadhyay; Tushar Kanti Saha; Ritu Ghosh

2013-01-01

Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA) risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28 weeks were interv...

Polymorphism of the renalase gene in gestational diabetes mellitus.

Science.gov (United States)

Fatima, Syeda Sadia; Jamil, Zehra; Alam, Faiza; Malik, Hajira Zafar; Madhani, Sarosh Irfan; Ahmad, Muhammad Saad; Shabbir, Tayyab; Rehmani, Muhammed Noman; Rabbani, Amna

2017-01-01

Renalase is considered as a novel candidate gene for type 2 diabetes. In this study, we aimed to investigate the relationship of serum renalase and two single nucleotide polymorphisms with gestational diabetes mellitus. One hundred and ninety-eight normotensive pregnant females (n = 99 gestational diabetes mellitus; n = 99 euglycemic pregnant controls) were classified according to the International Association of the Diabetes and Pregnancy Study criteria. Fasting and 2-h post glucose load blood levels and anthropometric assessment was performed. Serum renalase was measured using enzyme-linked immunosorbent assay, whereas DNA samples were genotyped for renalase single nucleotide polymorphisms rs2576178 and rs10887800 using Polymerase chain reaction-Restriction fragment length polymorphism method. In an age-matched case control study, no difference was observed in the serum levels of renalase (p > 0.05). The variant rs10887800 showed an association with gestational diabetes mellitus and remained significant after multiple adjustments (p gestational diabetes. Although gestational diabetes mellitus is self-reversible, yet presence of this minor G allele might predispose to metabolic syndrome phenotypes in near the future.

Duration of gestation in pregnant dogs carrying cloned fetuses.

Science.gov (United States)

Kim, Min Jung; Oh, Hyun Ju; Park, Jung Eun; Kim, Geon A; Park, Eun Jung; Jo, Young Kwang; Lee, Byeong Chun

2013-01-15

The aim of this study was to investigate gestation duration and the physiologic characteristics of pregnant dogs bearing cloned fetuses, especially in the prepartum period. A retrospective study was performed to compare gestation duration in females pregnant with cloned (somatic cell nuclear transfer) fetuses (cloned group) with those bearing noncloned fetuses (control group), and effects of litter size, birth weight, and breed of somatic cell donors on gestation duration in the cloned group were evaluated. Clinical delivery onset signs associated with serum progesterone concentration and rectal temperature were also compared in both groups. The gestation duration calculated from day of ovulation was significantly longer in the cloned (62.8 ± 0.3 days) versus the control group (60.9 ± 0.5 days; P dogs bearing cloned fetuses might be because of the smaller litter size in this group. Also, the weaker drop in serum progesterone levels in the prepartum period in cloned dog pregnancies indicates that the parturition signaling process might be altered resulting in longer gestation periods. Copyright © 2013 Elsevier Inc. All rights reserved.

Arsenite binding-induced zinc loss from PARP-1 is equivalent to zinc deficiency in reducing PARP-1 activity, leading to inhibition of DNA repair

Energy Technology Data Exchange (ETDEWEB)

Sun, Xi; Zhou, Xixi [Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Du, Libo [Center for Molecular Science, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190 (China); Liu, Wenlan [Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Liu, Yang [Center for Molecular Science, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190 (China); Hudson, Laurie G. [Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Liu, Ke Jian, E-mail: kliu@salud.unm.edu [Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States)

2014-01-15

Inhibition of DNA repair is a recognized mechanism for arsenic enhancement of ultraviolet radiation-induced DNA damage and carcinogenesis. Poly(ADP-ribose) polymerase-1 (PARP-1), a zinc finger DNA repair protein, has been identified as a sensitive molecular target for arsenic. The zinc finger domains of PARP-1 protein function as a critical structure in DNA recognition and binding. Since cellular poly(ADP-ribosyl)ation capacity has been positively correlated with zinc status in cells, we hypothesize that arsenite binding-induced zinc loss from PARP-1 is equivalent to zinc deficiency in reducing PARP-1 activity, leading to inhibition of DNA repair. To test this hypothesis, we compared the effects of arsenite exposure with zinc deficiency, created by using the membrane-permeable zinc chelator TPEN, on 8-OHdG formation, PARP-1 activity and zinc binding to PARP-1 in HaCat cells. Our results show that arsenite exposure and zinc deficiency had similar effects on PARP-1 protein, whereas supplemental zinc reversed these effects. To investigate the molecular mechanism of zinc loss induced by arsenite, ICP-AES, near UV spectroscopy, fluorescence, and circular dichroism spectroscopy were utilized to examine arsenite binding and occupation of a peptide representing the first zinc finger of PARP-1. We found that arsenite binding as well as zinc loss altered the conformation of zinc finger structure which functionally leads to PARP-1 inhibition. These findings suggest that arsenite binding to PARP-1 protein created similar adverse biological effects as zinc deficiency, which establishes the molecular mechanism for zinc supplementation as a potentially effective treatment to reverse the detrimental outcomes of arsenic exposure. - Highlights: • Arsenite binding is equivalent to zinc deficiency in reducing PARP-1 function. • Zinc reverses arsenic inhibition of PARP-1 activity and enhancement of DNA damage. • Arsenite binding and zinc loss alter the conformation of zinc finger

Arsenite binding-induced zinc loss from PARP-1 is equivalent to zinc deficiency in reducing PARP-1 activity, leading to inhibition of DNA repair

International Nuclear Information System (INIS)

Sun, Xi; Zhou, Xixi; Du, Libo; Liu, Wenlan; Liu, Yang; Hudson, Laurie G.; Liu, Ke Jian

2014-01-01

Inhibition of DNA repair is a recognized mechanism for arsenic enhancement of ultraviolet radiation-induced DNA damage and carcinogenesis. Poly(ADP-ribose) polymerase-1 (PARP-1), a zinc finger DNA repair protein, has been identified as a sensitive molecular target for arsenic. The zinc finger domains of PARP-1 protein function as a critical structure in DNA recognition and binding. Since cellular poly(ADP-ribosyl)ation capacity has been positively correlated with zinc status in cells, we hypothesize that arsenite binding-induced zinc loss from PARP-1 is equivalent to zinc deficiency in reducing PARP-1 activity, leading to inhibition of DNA repair. To test this hypothesis, we compared the effects of arsenite exposure with zinc deficiency, created by using the membrane-permeable zinc chelator TPEN, on 8-OHdG formation, PARP-1 activity and zinc binding to PARP-1 in HaCat cells. Our results show that arsenite exposure and zinc deficiency had similar effects on PARP-1 protein, whereas supplemental zinc reversed these effects. To investigate the molecular mechanism of zinc loss induced by arsenite, ICP-AES, near UV spectroscopy, fluorescence, and circular dichroism spectroscopy were utilized to examine arsenite binding and occupation of a peptide representing the first zinc finger of PARP-1. We found that arsenite binding as well as zinc loss altered the conformation of zinc finger structure which functionally leads to PARP-1 inhibition. These findings suggest that arsenite binding to PARP-1 protein created similar adverse biological effects as zinc deficiency, which establishes the molecular mechanism for zinc supplementation as a potentially effective treatment to reverse the detrimental outcomes of arsenic exposure. - Highlights: • Arsenite binding is equivalent to zinc deficiency in reducing PARP-1 function. • Zinc reverses arsenic inhibition of PARP-1 activity and enhancement of DNA damage. • Arsenite binding and zinc loss alter the conformation of zinc finger

Diagnostic criteria for gestational diabetes mellitus (WS 331-2011)

Institute of Scientific and Technical Information of China (English)

Medical Service Specialty Standard Committee of Mi

2012-01-01

The criteria provide the screening and diagnosis for gestational diabetes mellitus and it should be applied to all medical institutions and health care practitioners for gestational diabetes mellitus (DM) diagnosis in China.

Excessive Gestational Weight Gain and Subsequent Maternal Obesity at Age 40: A Hypothetical Intervention.

Science.gov (United States)

Abrams, Barbara; Coyle, Jeremy; Cohen, Alison K; Headen, Irene; Hubbard, Alan; Ritchie, Lorrene; Rehkopf, David H

2017-09-01

To model the hypothetical impact of preventing excessive gestational weight gain on midlife obesity and compare the estimated reduction with the US Healthy People 2020 goal of a 10% reduction of obesity prevalence in adults. We analyzed 3917 women with 1 to 3 pregnancies in the prospective US National Longitudinal Survey of Youth, from 1979 to 2012. We compared the estimated obesity prevalence between 2 scenarios: gestational weight gain as reported and under the scenario of a hypothetical intervention that all women with excessive gestational weight gain instead gained as recommended by the Institute of Medicine (2009). A hypothetical intervention was associated with a significantly reduced estimated prevalence of obesity for first (3.3 percentage points; 95% confidence interval [CI] = 1.0, 5.6) and second (3.0 percentage points; 95% CI = 0.7, 5.2) births, and twice as high in Black as in White mothers, but not significant in Hispanics. The population attributable fraction was 10.7% (95% CI = 3.3%, 18.1%) in first and 9.3% (95% CI = 2.2%, 16.5%) in second births. Development of effective weight-management interventions for childbearing women could lead to meaningful reductions in long-term obesity.

Derivation of Accident-Specific Material-at-Risk Equivalency Factors

Energy Technology Data Exchange (ETDEWEB)

Jason P. Andrus; Dr. Chad L. Pope

2012-05-01

A novel method for calculating material at risk (MAR) dose equivalency developed at the Idaho National Laboratory (INL) now allows for increased utilization of dose equivalency for facility MAR control. This method involves near-real time accounting for the use of accident and material specific release and transport. It utilizes all information from the committed effective dose equation and the five factor source term equation to derive dose equivalency factors which can be used to establish an overall facility or process MAR limit. The equivalency factors allow different nuclide spectrums to be compared for their respective dose consequences by relating them to a specific quantity of an identified reference nuclide. The ability to compare spectrums to a reference limit ensures that MAR limits are in fact bounding instead of attempting to establish a representative or bounding spectrum which may lead to unintended or unanalyzed configurations. This methodology is then coupled with a near real time material tracking system which allows for accurate and timely material composition information and corresponding MAR equivalency values. The development of this approach was driven by the complex nature of processing operations in some INL facilities. This type of approach is ideally suited for facilities and processes where the composition of the MAR and possible release mechanisms change frequently but in well defined fashions and in a batch-type nature.

A description of externally recorded womb sounds in human subjects during gestation.

Science.gov (United States)

Parga, Joanna J; Daland, Robert; Kesavan, Kalpashri; Macey, Paul M; Zeltzer, Lonnie; Harper, Ronald M

2018-01-01

Reducing environmental noise benefits premature infants in neonatal intensive care units (NICU), but excessive reduction may lead to sensory deprivation, compromising development. Instead of minimal noise levels, environments that mimic intrauterine soundscapes may facilitate infant development by providing a sound environment reflecting fetal life. This soundscape may support autonomic and emotional development in preterm infants. We aimed to assess the efficacy and feasibility of external non-invasive recordings in pregnant women, endeavoring to capture intra-abdominal or womb sounds during pregnancy with electronic stethoscopes and build a womb sound library to assess sound trends with gestational development. We also compared these sounds to popular commercial womb sounds marketed to new parents. Intra-abdominal sounds from 50 mothers in their second and third trimester (13 to 40 weeks) of pregnancy were recorded for 6 minutes in a quiet clinic room with 4 electronic stethoscopes, placed in the right upper and lower quadrants, and left upper and lower quadrants of the abdomen. These recording were partitioned into 2-minute intervals in three different positions: standing, sitting and lying supine. Maternal and gestational age, Body Mass Index (BMI) and time since last meal were collected during recordings. Recordings were analyzed using long-term average spectral and waveform analysis, and compared to sounds from non-pregnant abdomens and commercially-marketed womb sounds selected for their availability, popularity, and claims they mimic the intrauterine environment. Maternal sounds shared certain common characteristics, but varied with gestational age. With fetal development, the maternal abdomen filtered high (500-5,000 Hz) and mid-frequency (100-500 Hz) energy bands, but no change appeared in contributions from low-frequency signals (10-100 Hz) with gestational age. Variation appeared between mothers, suggesting a resonant chamber role for intra

Gender- and Gestational Age-Specific Body Fat Percentage at Birth.

LENUS (Irish Health Repository)

Hawkes, Colin P

2011-08-08

Background: There is increasing evidence that in utero growth has both immediate and far-reaching influence on health. Birth weight and length are used as surrogate measures of in utero growth. However, these measures poorly reflect neonatal adiposity. Air-displacement plethysmography has been validated for the measurement of body fat in the neonatal population. Objective: The goal of this study was to show the normal reference values of percentage body fat (%BF) in infants during the first 4 days of life. Methods: As part of a large population-based birth cohort study, fat mass, fat-free mass, and %BF were measured within the first 4 days of life using air-displacement plethsymography. Infants were grouped into gestational age and gender categories. Results: Of the 786 enrolled infants, fat mass, fat-free mass, and %BF were measured in 743 (94.5%) infants within the first 4 days of life. %BF increased significantly with gestational age. Mean (SD) %BF at 36 to 37 weeks\\' gestation was 8.9% (3.5%); at 38 to 39 weeks\\' gestation, 10.3% (4%); and at 40 to 41 weeks\\' gestation, 11.2% (4.3%) (P < .001). Female infants had significantly increased mean (SD) %BF at 38 to 39(11.1% [3.9%] vs 9.8% [3.9%]; P = .012) and at 40 to 41 (12.5% [4.4%] vs 10% [3.9%]; P < .001) weeks\\' gestation compared with male infants. Gender- and gestational age-specific centiles were calculated, and a normative table was generated for reference. Conclusion: %BF at birth is influenced by gestational age and gender. We generated accurate %BF centiles from a large population-based cohort.

Neonatal outcomes according to different therapies for gestational diabetes mellitus,

Directory of Open Access Journals (Sweden)

Amanda L. da Silva

Full Text Available Abstract: Objectives: To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus. Methods: This was a retrospective cohort study. The study population comprised pregnant women with gestational diabetes treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for gestational diabetes mellitus. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, Apgar at 1 and 5 min, and need for intensive care unit admission. Results: The sample consisted of 705 pregnant women. The neonatal outcomes were analyzed based on the treatment received. Women treated with metformin were less likely to have children who were small for gestational age (95% CI: 0.09-0.66 and more likely to have a newborn adequate for gestational age (95% CI: 1.12-3.94. Those women treated with insulin had a lower chance of having a preterm child (95% CI: 0.02-0.78. The combined treatment with insulin and metformin resulted in higher chance for a neonate to be born large for gestational age (95% CI: 1.14-11.15 and lower chance to be born preterm (95% CI: 0.01-0.71. The type of treatment did not affect the mode of delivery, Apgar score, and intensive care unit admission. Conclusions: The pediatrician in the delivery room can expect different outcomes for diabetic mothers based on the treatment received.

Working hours and risk of gestational hypertension and pre-eclampsia.

Science.gov (United States)

Chang, Pei-Jen; Chu, Li-Ching; Hsieh, Wu-Shiun; Chuang, Yi-Li; Lin, Shio-Jean; Chen, Pau-Chung

2010-01-01

The potential impact of employment on maternal health, particularly in relation to gestational hypertension and pre-eclampsia, has been subject to research. However, there is limited evidence on associations between shift work and long working hours on the incidence of these conditions. To evaluate potential associations between maternal shift work and long working hours during pregnancy and gestational hypertension or pre-eclampsia. Multistage stratified systematic sampling was used to recruit 24 200 post-partum women from the Taiwan national birth registration database in 2005. Subjects underwent home interview 6 months after their deliveries by structured questionnaire to obtain characteristics of maternal employment and potential confounders. Diagnosis of gestational hypertension and pre-eclampsia was obtained from the birth registration. There was no association between employment status and gestational hypertension or pre-eclampsia. Also, no significant association between gestational hypertension or pre-eclampsia and maternal shift work or long working hours during pregnancy was found in all or primiparous women. There was no convincing evidence that maternal shift work or long working hours had a higher risk of gestational hypertension or pre-eclampsia. However, further research is warranted to confirm these negative findings.

The effects of polycystic ovary syndrome on gestational diabetes mellitus.

Science.gov (United States)

Aktun, Hale Lebriz; Yorgunlar, Betul; Acet, Mustafa; Aygun, Banu Kumbak; Karaca, Nilay

2016-01-01

The aim of this study was to explore the inter-relationship between polycystic ovary syndrome and gestational diabetes mellitus, and demonstrate maternal and fetal outcomes. This was a case-control study in 1360 pregnant women who received a diagnosis of gestational diabetes mellitus between 24 and 28 weeks of gestational age. Among all diagnosed with gestational diabetes mellitus, 150 pregnant women had received a polycystic ovary syndrome, and 160 women who did not have polycystic ovary syndrome were designated as controls. The incidence of pregnancy-induced hypertension was 26.3% and 12% in the case and control groups, respectively. Preeclampsia was seen at an incidence of 12% and 6% in case and in control groups, respectively. The difference in neonatal hypoglycemia between the two groups was statistically significant, with an incidence of 17% and 5% in the case and in control groups, respectively. This study demonstrated that the presence of polycystic ovary syndrome along with gestational diabetes mellitus increases the risk of pregnancy induced hypertension by 2.4 fold, preeclampsia by 2 fold and neonatal hypoglycemia by 3.2 fold, compared to gestational diabetes mellitus alone.

Irregular menses: an independent risk factor for gestational diabetes mellitus.

Science.gov (United States)

Haver, Mary Claire; Locksmith, Gregory J; Emmet, Emily

2003-05-01

Our purpose was to determine whether a history of irregular menses predicts gestational diabetes mellitus independently of traditional risk factors. We analyzed demographic characteristics, body mass index, and menstrual history of 85 pregnant women with gestational diabetes mellitus and compared them with 85 systematically selected control subjects who were matched for age, race, and delivery year. Subjects with pregestational diabetes mellitus, previous gestational diabetes mellitus, family history of diabetes mellitus, weight >200 pounds, previous macrosomic infants, or previous stillbirth were excluded. Demographic characteristics between case and control groups were similar. Mean body mass index was higher among cases (26.5 kg/m(2)) versus control subjects (24.5 kg/m(2), P =.004). Irregular cycles were more prevalent in the cases (24% vs 7%, P =.006). With the use of body mass index as a stratification factor, menstrual irregularity maintained a strong association with gestational diabetes mellitus (P =.014). A history of irregular menstrual cycles was a significant independent predictor of gestational diabetes mellitus. If selective screening is implemented for gestational diabetes mellitus, such history should be considered in the decision of whom to test.

Factors associated with delivery at or after 28 weeks gestation in women with bulging fetal membranes before 26 weeks gestation.

Science.gov (United States)

Ito, Akiko; Maseki, Yoshiaki; Ikeda, Sayako; Tezuka, Atsuko; Kuribayashi, Momoko; Furuhashi, Madoka

2017-09-01

To elucidate the factors that contribute to prolonged pregnancy and promote neonate survival in women with bulging fetal membranes. A database was reviewed to identify women with singleton pregnancies who underwent amniocentesis on admission to determine amniotic fluid neutrophil elastase levels before 26 + 0 weeks gestation between July 2001 and January 2015. Following delivery, the placentas of these patients were examined for histologic chorioamnionitis. Ninety-seven women delivered before 28 weeks gestation, and 117 women delivered at or after 28 weeks gestation. Rescue cerclage performed via the McDonald procedure (adjusted odds ratio [aOR]: 3.78; 95% confidence interval [CI]: 1.35-11.80) was associated with a higher likelihood of reaching at least 28 weeks gestation before delivery, whereas protruding membranes (aOR: 0.38; 95% CI: 0.18-0.78), elevated amniotic neutrophil elastase levels (≥0.15 μg/ml) (aOR, 0.41; 95% CI: 0.20-0.82) and elevated peripheral C-reactive protein levels (≥0.4 mg/dl) (aOR: 0.34; 95% CI: 0.180.65) were associated with a significantly reduced likelihood of reaching this gestational age before delivery. Among women who underwent rescue cerclage, amniorrhexis was associated with a negative prognosis (aOR: 0.18; 95% CI: 0.05-0.51). Intra-amniotic inflammation, protrusion of fetal membranes and amniorrhexis are factors that may prevent pregnancy prolongation. Rescue cerclage improves pregnancy outcomes.

Lead induces similar gene expression changes in brains of gestationally exposed adult mice and in neurons differentiated from mouse embryonic stem cells.

Directory of Open Access Journals (Sweden)

Francisco Javier Sánchez-Martín

Full Text Available Exposure to environmental toxicants during embryonic life causes changes in the expression of developmental genes that may last for a lifetime and adversely affect the exposed individual. Developmental exposure to lead (Pb, an ubiquitous environmental contaminant, causes deficits in cognitive functions and IQ, behavioral effects, and attention deficit hyperactivity disorder (ADHD. Long-term effects observed after early life exposure to Pb include reduction of gray matter, alteration of myelin structure, and increment of criminal behavior in adults. Despite growing research interest, the molecular mechanisms responsible for the effects of lead in the central nervous system are still largely unknown. To study the molecular changes due to Pb exposure during neurodevelopment, we exposed mice to Pb in utero and examined the expression of neural markers, neurotrophins, transcription factors and glutamate-related genes in hippocampus, cortex, and thalamus at postnatal day 60. We found that hippocampus was the area where gene expression changes due to Pb exposure were more pronounced. To recapitulate gestational Pb exposure in vitro, we differentiated mouse embryonic stem cells (ESC into neurons and treated ESC-derived neurons with Pb for the length of the differentiation process. These neurons expressed the characteristic neuronal markers Tubb3, Syp, Gap43, Hud, Ngn1, Vglut1 (a marker of glutamatergic neurons, and all the glutamate receptor subunits, but not the glial marker Gafp. Importantly, several of the changes observed in Pb-exposed mouse brains in vivo were also observed in Pb-treated ESC-derived neurons, including those affecting expression of Ngn1, Bdnf exon IV, Grin1, Grin2D, Grik5, Gria4, and Grm6. We conclude that our ESC-derived model of toxicant exposure during neural differentiation promises to be a useful model to analyze mechanisms of neurotoxicity induced by Pb and other environmental agents.

Diagnostic protocol for gestational diabetes mellitus (GDM) (IADPSG/ADA, 2011): influence on the occurrence of GDM and mild gestational hyperglycemia (MGH) and on the perinatal outcomes.

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Sirimarco, Mariana Pinto; Guerra, Helena Maciel; Lisboa, Eduardo Guimarães; Vernini, Joice Monalisa; Cassetari, Bianca Nicolosi; de Araujo Costa, Roberto Antonio; Rudge, Marilza Vieira Cunha; de Mattos Paranhos Calderon, Iracema

2017-01-01

In August 2011, the Specialized Center for Diabetes and Pregnancy of the Botucatu Medical School/Unesp adopted a new diagnostic protocol for gestational diabetes mellitus, recommended by the American Diabetes Association and the International Association of the Diabetes and Pregnancy Study Group. The glycemic profile was evaluated using the 75-g oral glucose tolerance test (OGTT) used to diagnose mild gestational hyperglycemia, recognized and treated in our department as gestational diabetes mellitus. The cost-effectiveness of the new guidelines and the continued need for the evaluation of the glycemic profile, as part of our Service protocol, are controversial and require further investigation. We aimed to assess the impact of the new guidelines on the evaluation of mild gestational hyperglycemia and gestational diabetes mellitus, the incidence of adverse perinatal outcomes, and the association between the 75-g OGTT and the glycemic profile for the diagnosis of mild gestational hyperglycemia. This cross-sectional study was performed identifying a convenience sample of pregnant women and their newborns. The women used our Service for diagnostic procedures, prenatal care and delivery, both before (January 2008 to August 14, 2011) and after (August 15, 2011 to December 2014) the protocol modification. The following variables were compared, following stratification according to diagnostic protocol: prevalence of gestational diabetes mellitus and mild gestational hyperglycemia, newborns large for gestational age, macrosomia, first cesarean delivery, and newborn hospital stay. Statistical analysis was performed using Poisson regression, the Student's t test, the Chi square or Fisher's exact test and risk estimate. The statistical significance threshold was set at 95% (p gestational hyperglycemia, despite a normal 75-g OGTT. The new guidelines did not affect perinatal outcome. These results support the validity of maintaining the glycemic profile as part of the

Gestational Weight Gain and Post-Partum Weight Loss Among Young, Low-Income, Ethnic Minority Women

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ROTHBERG, Bonnie E. Gould; MAGRIPLES, Urania; KERSHAW, Trace S.; RISING, Sharon Schindler; ICKOVICS, Jeannette R.

2010-01-01

Objective Document weight change trajectories that lead to gestational weight gain or postpartum weight loss outside clinical recommendations established by Institute of Medicine (IOM). Methods Women aged 14-25 receiving prenatal care and delivering singleton infants at term (N=427). Medical record review and four structured interviews conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling to evaluate weight change trajectories. Results Only 22% of participants gained gestational weight within IOM guidelines. 62% exceeded maximum recommendations -- more common among those overweight/obese (BMI≥25.0; phypertension; breastfeeding promoted postpartum weight loss (all p<.02). BMI by race interaction suggested healthier outcomes for Latinas (p=0.02). Conclusion Excessive pregnancy weight gain and inadequate postpartum weight loss are highly prevalent among young low-income ethnic minority women. Pregnancy and postpartum are critical junctures for weight management interventions. PMID:20974459

Improving the equivalent-photon approximation in electron-positron collisions

CERN Document Server

Schuler, G A

1996-01-01

The validity of the equivalent-photon approximation for two-photon processes in electron--positron collisions is critically examined. Commonly used forms to describe hadronic two-photon production are shown to lead to sizeable errors. An improved two-photon luminosity function is presented, which includes beyond-leading-logarithmic effects and scalar-photon contributions. Comparisons of various approximate expressions with the exact calculation in the case of the total hadronic cross section are given. Furthermore, effects of the poorly known low-Q2 behaviour of the virtual hadronic cross sections are discussed.

Gestational surrogacy: Viewpoint of Iranian infertile women.

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Rahmani, Azad; Sattarzadeh, Nilofar; Gholizadeh, Leila; Sheikhalipour, Zahra; Allahbakhshian, Atefeh; Hassankhani, Hadi

2011-09-01

Surrogacy is a popular form of assisted reproductive technology of which only gestational form is approved by most of the religious scholars in Iran. Little evidence exists about the Iranian infertile women's viewpoint regarding gestational surrogacy. To assess the viewpoint of Iranian infertile women toward gestational surrogacy. This descriptive study was conducted at the infertility clinic of Tabriz University of Medical Sciences, Iran. The study sample consisted of 238 infertile women who were selected using the eligible sampling method. Data were collected by using a researcher developed questionnaire that included 25 items based on a five-point Likert scale. Data analysis was conducted by SPSS statistical software using descriptive statistics. Viewpoint of 214 women (89.9%) was positive. 36 (15.1%) women considered gestational surrogacy against their religious beliefs; 170 women (71.4%) did not assume the commissioning couple as owners of the baby; 160 women (67.2%) said that children who were born through surrogacy would better not know about it; and 174 women (73.1%) believed that children born through surrogacy will face mental problems. Iranian infertile women have positive viewpoint regarding the surrogacy. However, to increase the acceptability of surrogacy among infertile women, further efforts are needed.

Association of Group Prenatal Care With Gestational Weight Gain.

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Kominiarek, Michelle A; Crockett, Amy; Covington-Kolb, Sarah; Simon, Melissa; Grobman, William A

2017-04-01

To compare gestational weight gain among women in group prenatal care with that of women in individual prenatal care. In this retrospective cohort study, women who participated in group prenatal care from 2009 to 2015 and whose body mass indexes (BMIs) and gestational weight gain were recorded were matched with the next two women who had the same payer type, were within 2-kg/m prepregnancy BMI and 2-week gestational age at delivery, and had received individual prenatal care. Bivariate comparisons of demographics and antenatal complications were performed for women in group and individual prenatal care, and weight gain was categorized as "below," "met," or "exceeded" goals according to the 2009 Institute of Medicine guidelines. Logistic regression analysis estimated the association between excessive weight gain and model of care, with adjustment for confounders, stratified by BMI. Women in group prenatal care (n=2,117) were younger and more commonly non-Hispanic black, nulliparous, and without gestational diabetes (P≤.005 for all). Women in group prenatal care more commonly exceeded the weight gain goals (55% compared with 48%, Pprenatal care, compared with individual prenatal care, is associated with excessive gestational weight gain.

Proposed ethical guidelines and legislative framework for permitting gestational surrogacy in Singapore.

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Heng, Boon Chin

2007-09-01

Gestational surrogacy is currently banned in Singapore but is much debated. Some ethical guidelines and legislation for permitting gestational surrogacy in Singapore are proposed and discussed including: (i) review and approval of gestational surrogacy by the Ministry of Health on a case-by-case basis; (ii) stringent guidelines for gonadotrophin stimulation, IVF and ICSI procedures in 'traditional' surrogacy; (iii) restriction of gestational surrogates to parous married women with stable family relationships; (iv) exclusion of foreign women from acting as gestational surrogates, except for close relatives of the recipient couple; (v) reimbursement and/or compensation of gestational surrogates based on the direct expenses model; (vi) exclusion of medical professionals from surrogate recruitment and reimbursement; (vii) the surrogacy contract must make it legally binding for the prospective recipient couple to accept the child, even if it is born with congenital deformities; (viii) stringent guidelines for combining surrogacy with egg donation from a third woman, who is neither the social nor gestational mother. Policymakers in Singapore should conduct a public referendum on the legalization of gestational surrogacy and actively consult the views of healthcare professionals, religious and community leaders, as well as the general public, before reaching any decision.

Zinc-Associated Variant in SLC30A8 Gene Interacts With Gestational Weight Gain on Postpartum Glycemic Changes: A Longitudinal Study in Women With Prior Gestational Diabetes Mellitus.

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Wang, Tiange; Liu, Huikun; Wang, Leishen; Huang, Tao; Li, Weiqin; Zheng, Yan; Heianza, Yoriko; Sun, Dianjianyi; Leng, Junhong; Zhang, Shuang; Li, Nan; Hu, Gang; Qi, Lu

2016-12-01

Zinc transporter 8 genetic variant SLC30A8 has been associated with postpartum risk of type 2 diabetes among women with gestational diabetes mellitus (GDM). Gestational weight gain is one of the strongest risk factors for postpartum hyperglycemia. We assessed the interaction between type 2 diabetes-associated SLC30A8 rs13266634 and gestational weight gain on 1-5 years of postpartum glycemic changes in 1,071 women with prior GDM in a longitudinal study. Compared with gestation of 26-30 weeks, postpartum levels of fasting glucose, oral glucose tolerance test 2-h glucose, and hemoglobin A 1c (HbA 1c ) increased across rs13266634 TT, CT, and CC genotypes in women with excessive gestational weight gain, whereas opposite genetic associations were found in women with inadequate or adequate gestational weight gain. Postpartum changes in fasting glucose per additional copy of the C allele were -0.18, -0.04, and 0.12 mmol/L in women with inadequate, adequate, and excessive gestational weight gain, respectively (P for interaction = 0.002). We also found similar interactions for changes in 2-h glucose and HbA 1c (P for interaction = 0.003 and 0.005, respectively). Our data indicate that gestational weight gain may modify SLC30A8 variant on long-term glycemic changes, highlighting the importance of gestational weight control in the prevention of postpartum hyperglycemia in women with GDM. © 2016 by the American Diabetes Association.

Probabilistic diffusion tractography of the optic radiations and visual function in preterm infants at term equivalent age.

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Bassi, Laura; Ricci, Daniela; Volzone, Anna; Allsop, Joanna M; Srinivasan, Latha; Pai, Aakash; Ribes, Carmen; Ramenghi, Luca A; Mercuri, Eugenio; Mosca, Fabio; Edwards, A David; Cowan, Frances M; Rutherford, Mary A; Counsell, Serena J

2008-02-01

Children born prematurely have a high incidence of visual disorders which cannot always be explained by focal retinal or brain lesions. The aim of this study was to test the hypothesis that visual function in preterm infants is related to the microstructural development of white matter in the optic radiations. We used diffusion tensor imaging (DTI) with probabilistic diffusion tractography to delineate the optic radiations at term equivalent age and compared the fractional anisotropy (FA) to a contemporaneous evaluation of visual function. Thirty-seven preterm infants (19 male) born at median (range) 28(+4) (24(+1)-32(+3)) weeks gestational age, were examined at a post-menstrual age of 42 (39(+6)-43) weeks. MRI and DTI were acquired on a 3 Tesla MR system with DTI obtained in 15 non-collinear directions with a b value of 750 s/mm(2). Tracts were generated from a seed mask placed in the white matter lateral to the lateral geniculate nucleus and mean FA values of these tracts were determined. Visual assessment was performed using a battery of nine items assessing different aspects of visual abilities. Ten infants had evidence of cerebral lesions on conventional MRI. Multiple regression analysis demonstrated that the visual assessment score was independently correlated with FA values, but not gestational age at birth, post-menstrual age at scan or the presence of lesions on conventional MRI. The occurrence of mild retinopathy of prematurity did not affect the FA measures or visual scores. We then performed a secondary analysis using tract-based spatial statistics to determine whether global brain white matter development was related to visual function and found that only FA in the optic radiations was correlated with visual assessment score. Our results suggest that in preterm infants at term equivalent age visual function is directly related to the development of white matter in the optic radiations.

Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

Directory of Open Access Journals (Sweden)

S. Burlina

2016-01-01

Full Text Available The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected.

Morbidity and Mortality in Small for Gestational Age Infants at 22 to 29 Weeks' Gestation.

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Boghossian, Nansi S; Geraci, Marco; Edwards, Erika M; Horbar, Jeffrey D

2018-02-01

To identify the relative risks of mortality and morbidities for small for gestational age (SGA) infants in comparison with non-SGA infants born at 22 to 29 weeks' gestation. Data were collected (2006-2014) on 156 587 infants from 852 US centers participating in the Vermont Oxford Network. We defined SGA as sex-specific birth weight thin plate spline term on GA by SGA were used to calculate the adjusted relative risks and 95% confidence intervals for outcomes by GA. Compared with non-SGA infants, the risk of patent ductus arteriosus decreased for SGA infants in early GA and then increased in later GA. SGA infants were also at increased risks of mortality, respiratory distress syndrome, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease. These risks of adverse outcomes, however, were not homogeneous across the GA range. Early-onset sepsis was not different between the 2 groups for the majority of GAs, although severe intraventricular hemorrhage was decreased among SGA infants for only gestational week 24 through week 25. SGA was associated with additional risks to mortality and morbidities, but the risks differed across the GA range. Copyright © 2018 by the American Academy of Pediatrics.

An Equivalent Circuit of Longitudinal Vibration for a Piezoelectric Structure with Losses.

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Yuan, Tao; Li, Chaodong; Fan, Pingqing

2018-03-22

Equivalent circuits of piezoelectric structures such as bimorphs and unimorphs conventionally focus on the bending vibration modes. However, the longitudinal vibration modes are rarely considered even though they also play a remarkable role in piezoelectric devices. Losses, especially elastic loss in the metal substrate, are also generally neglected, which leads to discrepancies compared with experiments. In this paper, a novel equivalent circuit with four kinds of losses is proposed for a beamlike piezoelectric structure under the longitudinal vibration mode. This structure consists of a slender beam as the metal substrate, and a piezoelectric patch which covers a partial length of the beam. In this approach, first, complex numbers are used to deal with four kinds of losses-elastic loss in the metal substrate, and piezoelectric, dielectric, and elastic losses in the piezoelectric patch. Next in this approach, based on Mason's model, a new equivalent circuit is developed. Using MATLAB, impedance curves of this structure are simulated by the equivalent circuit method. Experiments are conducted and good agreements are revealed between experiments and equivalent circuit results. It is indicated that the introduction of four losses in an equivalent circuit can increase the result accuracy considerably.

Neighbourhood food environment and gestational diabetes in New York City

OpenAIRE

Janevic, Teresa; Borrell, Luisa N.; Savitz, David A.; Herring, Amy H.; Rundle, Andrew

2010-01-01

The association between neighbourhood characteristics and gestational diabetes has not been examined previously. We investigated the relationship between the number of healthy food outlets (supermarkets; fruit/vegetable and natural food stores), and unhealthy food outlets (fast food; pizza; bodegas; bakeries; convenience, candy/nut and meat stores) in census tract of residence, and gestational diabetes in New York City. Gestational diabetes, census tract and individual-level covariates were a...

Neonatal outcomes according to different therapies for gestational diabetes mellitus.

Science.gov (United States)

Silva, Amanda L da; Amaral, Augusto R do; Oliveira, Daniela S de; Martins, Lisiane; Silva, Mariana R E; Silva, Jean Carl

To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus. This was a retrospective cohort study. The study population comprised pregnant women with gestational diabetes treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for gestational diabetes mellitus. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, Apgar at 1 and 5min, and need for intensive care unit admission. The sample consisted of 705 pregnant women. The neonatal outcomes were analyzed based on the treatment received. Women treated with metformin were less likely to have children who were small for gestational age (95% CI: 0.09-0.66) and more likely to have a newborn adequate for gestational age (95% CI: 1.12-3.94). Those women treated with insulin had a lower chance of having a preterm child (95% CI: 0.02-0.78). The combined treatment with insulin and metformin resulted in higher chance for a neonate to be born large for gestational age (95% CI: 1.14-11.15) and lower chance to be born preterm (95% CI: 0.01-0.71). The type of treatment did not affect the mode of delivery, Apgar score, and intensive care unit admission. The pediatrician in the delivery room can expect different outcomes for diabetic mothers based on the treatment received. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

A longitudinal analysis of regional brain volumes in macaques exposed to X-irradiation in early gestation.

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Kristina Aldridge

Full Text Available Early gestation represents a period of vulnerability to environmental insult that has been associated with adult psychiatric disease. However, little is known about how prenatal perturbation translates into adult brain dysfunction. Here, we use a longitudinal study design to examine the effects of disruption of early gestational neurogenesis on brain volume in the non-human primate.Five Rhesus macaques were exposed to x-irradiation in early gestation (E30-E41, and four control monkeys were sham-irradiated at comparable ages. Whole brain magnetic resonance imaging was performed at 6 months, 12 months, and 3 and 5 years of age. Volumes of whole cerebrum, cortical gray matter, caudate, putamen, and thalamus were estimated using semi-automated segmentation methods and high dimensional brain mapping. Volume reductions spanning all ages were observed in irradiated monkeys in the putamen (15-24%, p = 0.01 and in cortical gray matter (6-15%, p = 0.01. Upon covarying for whole cerebral volume, group differences were reduced to trend levels (putamen: p = 0.07; cortical gray matter: p = 0.08. No group-by-age effects were significant.Due to the small number of observations, the conclusions drawn from this study must be viewed as tentative. Early gestational irradiation may result in non-uniform reduction of gray matter, mainly affecting the putamen and cerebral cortex. This may be relevant to understanding how early prenatal environmental insult could lead to brain morphological differences in neurodevelopmental diseases.

Is sonographically measured cervical length at 37 weeks of gestation associated with intrapartum cesarean section? A prospective cohort study.

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de Vries, Bradley; Narayan, Rajit; McGeechan, Kevin; Santiagu, Stanley; Vairavan, Ramesh; Burke, Minke; Phipps, Hala; Hyett, Jon

2018-02-16

Cesarean section rates continue to increase globally. Prediction of intrapartum cesarean section could lead to preventive measures. Our aim was to assess the association between sonographically measured cervical length at 37 weeks of gestation and cesarean section among women planning a vaginal birth. The population was women with a low-risk pregnancy or with gestational diabetes. This was a prospective cohort study conducted in a tertiary referral hospital in Sydney, Australia. In all, 212 women with a low-risk pregnancy or with gestational diabetes were recruited including 158 nulliparous and 54 parous women. Maternal demographic, clinical and ultrasound characteristics were collected at 37 weeks of gestation. Semi-Bayesian logistic regression and Markov chain Monte Carlo simulation were used to assess the relationship between cervical length and cesarean section in labor. Rates of cesarean section were 5% (2/55) for cervical length ≤20 mm, 17% (17/101) for cervical length 20-32 mm, and 27% (13/56) for cervical length >32 mm. These rates were 4, 22 and 33%, respectively, in nulliparous women. In the semi-Bayesian analysis, the odds ratio for cesarean section was 6.2 (95% confidence interval 2.2-43) for cervical length 20-32 mm and 10 (95% confidence interval 4.8-74) for cervical length >32 mm compared with the lowest quartile of cervical length, after adjusting for maternal age, parity, height, prepregnancy body mass index, gestational diabetes, induction of labor, neonatal sex and birthweight centile. Cervical length at 37 weeks of gestation is associated with intrapartum cesarean section. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

EAMJ Feb. gestation.indd

African Journals Online (AJOL)

2009-02-02

Feb 2, 2009 ... Majority of the women studied were at a gestation of 8 to 11 weeks (38.9%). Most patients ... foetal risks, and management and follow-up of both entities are .... thyrotoxicosis in Asian women in Singapore and found-out that the ...

Late gestational nutrient restriction

DEFF Research Database (Denmark)

Tygesen, Malin Plumhoff; Nielsen, Mette Olaf; Nørgaard, Peder

2008-01-01

We investigated the effect of 50% nutrient restriction during the last 6 weeks of gestation on twin-pregnant ewes' plasma glucose, non-esterified fatty acid, ß-hydroxybutyrate, insulin, IGF-1 and leptin concentrations and the effects on lamb birth weight and ewes' lactation performance. Plasma...

Intra-gestational sac injection for tubal pregnancy: an interventional approach

International Nuclear Information System (INIS)

Wang Yitang; Sun Xiaobo; Xu Xiaojun; Zhang Feiyue; Wu Ke; Song Yingxin; Han Mingjun

2002-01-01

Objective: It's an investigation of the procedure, effects and clinical application of the interventional intra-gestational sac injection as a treatment of tubal pregnancy. Methods: Under DSA guidance a selective salpingography was performed and MTX was injected into the gestational sac or oviduct. The procedure was performed in 13 cases with oviductal pregnancy before the gestational sac ruptured. Results: Technical success was obtained in all cases. The serum HCG began to fall in 7 days after the procedure, and dropped to normal level in 2-4 weeks of the procedure. Conclusion: Interventional selective salpingography and intra-gestational sac injection is a simple, safe and effective treatment of the un-ruptured tubal pregnancy

A STUDY ON PLACENTAL MORPHOLOGY IN GESTATIONAL DIABETES

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Katadi Venkata Sudha Madhuri

2017-01-01

Full Text Available BACKGROUND Gestational Diabetes Mellitus (GDM refers to any degree of glucose intolerance with onset or first recognition during pregnancy. Maternal diabetes constitutes an unfavourable environment for embryonic and foetoplacental development. The histomorphological changes in the placenta are associated with increased perinatal morbidity, increased risk of diabetes in the offspring and the mother in the ensuing years of life. Present study aims to study the morphological changes in the placenta along with maternal and foetal outcomes in pregnancies complicated by GDM. MATERIALS AND METHODS A descriptive observational case-controlled study was conducted from January 2013 to November 2016 in King George Hospital, Visakhapatnam. Hundred and sixty four women diagnosed with GDM and hundred women with normal gestation were enrolled in the study. Foetal surveillance was done by Doppler ultrasound and kick count technique during the gestation. Foetal and maternal outcome was evaluated and compared to the outcome of normal gestation. Placental specimens from term gestations (38-42 weeks diagnosed with GDM and normal full-term gestations were studied to assess the morphological parameters. Statistical analysis was done using descriptive statistical measures. RESULTS In the present study, 62.19% of the GDM cases terminated as normal gestations. Recurrent UTI was the most common complication (14.02% during the antenatal period. 17.68% of the foetuses from GDM mothers presented with macrosomia, however, there were no cases of congenital anomalies or shoulder dystocia. Placental tissue from the GDM cases was larger, heavier and more cotyledonous as compared to placenta from normal subjects. The umbilical cord showed eccentric and central attachment in all the controls and most of the cases and 5.48% of the cases showed marginal attachment of the umbilical cord. CONCLUSION The study describes the various maternal, foetal and placental outcomes in pregnancies

Equivalent Dynamic Models.

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Molenaar, Peter C M

2017-01-01

Equivalences of two classes of dynamic models for weakly stationary multivariate time series are discussed: dynamic factor models and autoregressive models. It is shown that exploratory dynamic factor models can be rotated, yielding an infinite set of equivalent solutions for any observed series. It also is shown that dynamic factor models with lagged factor loadings are not equivalent to the currently popular state-space models, and that restriction of attention to the latter type of models may yield invalid results. The known equivalent vector autoregressive model types, standard and structural, are given a new interpretation in which they are conceived of as the extremes of an innovating type of hybrid vector autoregressive models. It is shown that consideration of hybrid models solves many problems, in particular with Granger causality testing.

Increasing incidence of diabetes after gestational diabetes

DEFF Research Database (Denmark)

Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

2004-01-01

To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

Characterizing gestational weight gain in a cohort of Indigenous Australian women.

Science.gov (United States)

Schumacher, Tracy L; Weatherall, Loretta; Keogh, Lyniece; Sutherland, Kathryn; Collins, Clare E; Pringle, Kirsty G; Rae, Kym M

2018-05-01

to determine the adequacy of gestational weight gain for a cohort of Indigenous Australian women and investigate whether it is associated with pre-pregnancy body mass index. analysis of observational data collected from a longitudinal cohort study that follows Indigenous Australian women through pregnancy. women recruited through antenatal clinics in regional and remote towns in NSW, Australia to the Gomeroi gaaynggal program. 110 pregnant women who either identified as being an Indigenous Australian or as carrying an Indigenous child. measurements included weight and height, self-reported pre-pregnancy weight and smoking status, parity and health conditions that may contribute to gestational weight gain, such as hypertensive or diabetic disorders. Compared to the 2009 Institute of Medicine recommendations for gestational weight gain and based on prepregnancy body mass index, the rate of adequate gestational weight gain in this cohort was very low (15%). 32% of women had inadequate weight gain and 54% had excessive weight gain. The highest rate of excessive gestational weight gain was found in overweight women (74%), with rates of 48% and 50% found in healthy and obese (all classes) categories, respectively. Parity (coefficient 4.5, p<0.01) and hypertension (coefficient 4.8, p = 0.04) were found to be significantly associated with gestational weight gain in mixed model linear regression. few women gained adequate gestational weight gain in this study. Culturally acceptable ways of addressing this issue are needed for this group of women, as inadequate and excessive rates of gestational weight gain have health implications for women and their offspring. a systematic approach to addressing gestational weight gain within antenatal care is required, including asking about diet and exercise, for all women identifying as Indigenous Australian. Copyright © 2018 Elsevier Ltd. All rights reserved.

Perinatal outcome in relation to fetal sex in offspring to mothers with pre-gestational and gestational diabetes--a population-based study.

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Persson, M; Fadl, H

2014-09-01

The objective of the present study was to investigate if perinatal outcome differs with fetal sex in pregnancies with maternal Type 1 diabetes, Type 2 diabetes or gestational diabetes. This was a population-based cohort study, with data from the Medical Birth Registry in Sweden throughout the period 1998-2007. Singleton pregnancies with maternal Type 1 diabetes (n = 4092), Type 2 diabetes (n = 412) and gestational diabetes (n = 8602) were identified based on the International Classification of Diseases, 10th edition code. For comparison, 905 565 pregnancies without diabetes were included. The primary outcome was a composite outcome, consisting of any of the following diagnoses: perinatal mortality rate, major malformation, preterm delivery, acute respiratory disorders and neonatal hypoglycaemia. Logistic regression was used to obtain odds ratios for adverse outcomes in male offspring within the diabetic and reference cohorts, respectively. In pregnancies with diabetes, maternal characteristics did not differ with fetal sex, except for a higher rate of Caesarean delivery in male offspring of women with Type 1 diabetes. Male infants to mothers with Type 1 diabetes and gestational diabetes had significantly increased odds of respiratory disorders [adjusted odds ratio (confidence interval) Type 1 diabetes: 1.50 (1.12-2.02); gestational diabetes: 1.81 (1.27-2.57)]. Male infants to mothers with gestational diabetes also had significantly increased odds of major malformations [adjusted odds ratio: 1.44 (1.07-1.93)]. In offspring of mothers with Type 2 diabetes, odds ratios of most outcomes were higher in male infants; however, not significantly different from female infants. In pregnancies without diabetes, male infants had significantly higher odds of all adverse outcomes, except perinatal mortality rate. The risk of adverse perinatal outcome in offspring of mothers with Type 1 diabetes and gestational diabetes did not differ by sex, except for a higher risk in male

Gestational weight gain among minority adolescents predicts term birth weight.

Science.gov (United States)

Ekambaram, Maheswari; Irigoyen, Matilde; DeFreitas, Johelin; Rajbhandari, Sharina; Geaney, Jessica Lynn; Braitman, Leonard Edward

2018-03-07

In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers. This was a retrospective cohort study of 411 singleton live term infants born to mothers ≤ 18 years. Data were abstracted from electronic medical records. Gestational weight gain was related to infant birth weight (ρ = 0.36, P gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval (CI) 1.07-1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6-19.5). Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.

Metformin in gestational diabetes: An emerging contender

Directory of Open Access Journals (Sweden)

Awadhesh Kumar Singh

2015-01-01

Full Text Available Gestational diabetes mellitus (GDM is defined as any degree of glucose intolerance occurring first time during pregnancy. Its prevalence is simultaneously increasing with the global rise of diabesity. GDM commonly develops, when maternal glucose metabolism is unable to compensate for the progressive development of insulin resistance, arising primarily from the consistently rising diabetogenic placental hormones. It classically develops during the second or third trimester. Theoretically, insulin sensitizers should have been the ideal agent in its treatment, given the insulin resistance, the major culprit in its pathogenesis. Fortunately, majority of women can be treated satisfactorily with lifestyle modification, and approximately 20% requires more intensive treatment. For several decades, insulin has been the most reliable treatment strategy and the gold standard in GDM. Metformin is effective insulin sensitizing agent and an established first line drug in type 2 diabetes currently. As it crosses the placenta, a safety issue remains an obstacle and, therefore, metformin is currently not recommended in the treatment of GDM. Nevertheless, given the emerging clinically equivalent safety and efficacy data of metformin compared to insulin, it appears that it may perhaps open a rather new door in managing GDM. The aim of this review is to critically analyze, the safety and efficacy data of metformin regarding its use in GDM and pregnant mothers with polycystic ovarian disease, which has emerged in past decades.

Generating carbyne equivalents with photoredox catalysis

Science.gov (United States)

Wang, Zhaofeng; Herraiz, Ana G.; Del Hoyo, Ana M.; Suero, Marcos G.

2018-02-01

Carbon has the unique ability to bind four atoms and form stable tetravalent structures that are prevalent in nature. The lack of one or two valences leads to a set of species—carbocations, carbanions, radicals and carbenes—that is fundamental to our understanding of chemical reactivity. In contrast, the carbyne—a monovalent carbon with three non-bonded electrons—is a relatively unexplored reactive intermediate; the design of reactions involving a carbyne is limited by challenges associated with controlling its extreme reactivity and the lack of efficient sources. Given the innate ability of carbynes to form three new covalent bonds sequentially, we anticipated that a catalytic method of generating carbynes or related stabilized species would allow what we term an ‘assembly point’ disconnection approach for the construction of chiral centres. Here we describe a catalytic strategy that generates diazomethyl radicals as direct equivalents of carbyne species using visible-light photoredox catalysis. The ability of these carbyne equivalents to induce site-selective carbon-hydrogen bond cleavage in aromatic rings enables a useful diazomethylation reaction, which underpins sequencing control for the late-stage assembly-point functionalization of medically relevant agents. Our strategy provides an efficient route to libraries of potentially bioactive molecules through the installation of tailored chiral centres at carbon-hydrogen bonds, while complementing current translational late-stage functionalization processes. Furthermore, we exploit the dual radical and carbene character of the generated carbyne equivalent in the direct transformation of abundant chemical feedstocks into valuable chiral molecules.

Maternal Obesity, Gestational Weight Gain, and Asthma in Offspring.

Science.gov (United States)

Polinski, Kristen J; Liu, Jihong; Boghossian, Nansi S; McLain, Alexander C

2017-11-09

Obesity is common among women of childbearing age; intrauterine exposure to maternal obesity or gestational weight gain may influence the development of asthma in early childhood. We examined the relationships of maternal obesity and gestational weight gain with asthma in offspring. We used data from the Early Childhood Longitudinal Study-Birth Cohort, which has a nationally representative sample of children followed from birth in 2001 through age 4 (n = 6,450). Asthma was based on parental report of a medical professional's diagnosis. We used generalized estimating equation binomial models to compute adjusted odds ratios (ORs) of childhood asthma with maternal obesity and 4 measures of gestational weight gain. Compared with children of normal-weight mothers, children of obese mothers had increased risk of asthma (adjusted OR, 1.63; 95% confidence interval [CI], 1.26-2.12) by age 4, and children born to overweight mothers had similar risk (adjusted OR, 1.25; 95% CI, 0.99-1.59). Extreme-low weight gain (gain (≥25 kg) were associated with increased risk of asthma; however, the following measures were not significant predictors of asthma: meeting gestational weight gain recommendations of the Institute of Medicine, total gestational weight gain, and weekly rate of weight gain in the second and third trimesters. Extreme-low or extreme-high gestational weight gain and maternal obesity are risk factors for early childhood asthma, further evidence of the long-term impact of intrauterine exposure on children and the need to target preconception care to improve child health indicators.

Shielding Effect of Lead Glasses on Radiologists' Eye Lens Exposure in Interventional Procedures.

Science.gov (United States)

Hu, Panpan; Kong, Yan; Chen, Bo; Liu, Qianqian; Zhuo, Weihai; Liu, Haikuan

2017-04-20

To study the shielding effect of radiologists' eye lens with lead glasses of different equivalent thicknesses and sizes in interventional radiology procedures. Using the human voxel phantom with a more accurate model of the eye and MCNPX software, eye lens doses of the radiologists who wearing different kinds of lead glasses were simulated, different beam projections were taken into consideration during the simulation. Measurements were also performed with the physical model to verify simulation results. Simulation results showed that the eye lens doses were reduced by a factor from 3 to 9 when wearing a 20 cm2-sized lead glasses with the equivalent thickness ranging from 0.1 to 1.0 mm Pb. The increase of dose reduction factor (DRF) was not significant whenever increase the lead equivalent of glasses of which larger than 0.35 mm. Furthermore, the DRF was proportional to the size of glass lens from 6 to 30 cm2 with the same lead equivalent. The simulation results were in well agreements with the measured ones. For more reasonable and effective protection of the eye lens of interventional radiologists, a pair of glasses with a lead equivalent of 0.5 mm Pb and large-sized (at least 27 cm2 per glass) lens are recommended. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Gestational surrogacy: Viewpoint of Iranian infertile women

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Azad Rahmani

2011-01-01

Full Text Available Background: Surrogacy is a popular form of assisted reproductive technology of which only gestational form is approved by most of the religious scholars in Iran. Little evidence exists about the Iranian infertile women′s viewpoint regarding gestational surrogacy. Aim: To assess the viewpoint of Iranian infertile women toward gestational surrogacy. Setting and Design: This descriptive study was conducted at the infertility clinic of Tabriz University of Medical Sciences, Iran. Materials and Methods: The study sample consisted of 238 infertile women who were selected using the eligible sampling method. Data were collected by using a researcher developed questionnaire that included 25 items based on a five-point Likert scale. 0 Statistical Analysis: Data analysis was conducted by SPSS statistical software using descriptive statistics. 0 Results: Viewpoint of 214 women (89.9% was positive. 36 (15.1% women considered gestational surrogacy against their religious beliefs; 170 women (71.4% did not assume the commissioning couple as owners of the baby; 160 women (67.2% said that children who were born through surrogacy would better not know about it; and 174 women (73.1% believed that children born through surrogacy will face mental problems. Conclusion: Iranian infertile women have positive viewpoint regarding the surrogacy. However, to increase the acceptability of surrogacy among infertile women, further efforts are needed.

Auditory brainstem response in neonates: influence of gender and weight/gestational age ratio

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Rosanna M. Giaffredo Angrisani

2013-12-01

Full Text Available OBJECTIVE: To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR in preterm (PT and term (T newborns. METHODS: 176 newborns were evaluated by ABR; 88 were preterm infants - 44 females (22 small and 22 appropriate for gestational age and 44 males (22 small and 22 appropriate for gestational age. The preterm infants were compared to 88 term infants - 44 females (22 small and 22 appropriate for gestational age and 44 males (22 small and 22 appropriate for gestational age. All newborns had bilateral presence of transient otoacoustic emissions and type A tympanometry. RESULTS: No interaural differences were found. ABR response did not differentiate newborns regarding weight/gestational age in males and females. Term newborn females showed statistically shorter absolute latencies (except on wave I than males. This finding did not occur in preterm infants, who had longer latencies than term newborns, regardless of gender. CONCLUSIONS: Gender and gestational age influence term infants' ABR, with lower responses in females. The weight/gestational age ratio did not influence ABR response in either groups.

Differences in the utilization of gestational surrogacy between states in the U.S.

Science.gov (United States)

Perkins, Kiran M; Boulet, Sheree L; Levine, Aaron D; Jamieson, Denise J; Kissin, Dmitry M

2018-04-01

Gestational surrogacy policy in the USA varies by state, but information on state differences is lacking. This study used data from the National Assisted Reproductive Technology Surveillance System from 2010 to 2014 to calculate state differences in gestational carrier cycle characteristics. Of the 662,165 in-vitro fertilization cycles in the USA between 2010 and 2014, 16,148 (2.4%) used gestational carriers. Non-USA residents accounted for 18.3% of gestational carrier cycles, and 29.1% of gestational carrier cycles by USA residents were performed in a state other than the state of residence of the intended parent. USA gestational surrogacy practice varies by state, potentially impacting patients' access to surrogacy services.

Developmental immunotoxicology of lead

International Nuclear Information System (INIS)

Dietert, Rodney R.; Lee, Ji-Eun; Hussain, Irshad; Piepenbrink, Michael

2004-01-01

The heavy metal, lead, is a known developmental immunotoxicant that has been shown to produce immune alterations in humans as well as other species. Unlike many compounds that exert adverse immune effects, lead exposure at low to moderate levels does not produce widespread loss of immune cells. In contrast, changes resulting from lead exposure are subtle at the immune cell population level but, nevertheless, can be functionally dramatic. A hallmark of lead-induced immunotoxicity is a pronounced shift in the balance in T helper cell function toward T helper 2 responses at the expense of T helper 1 functions. This bias alters the nature and range of immune responses that can be produced thereby influencing host susceptibility to various diseases. Immunotoxic responses to lead appear to differ across life stages not only quantitatively with regard to dose response, but also qualitatively in terms of the spectrum of immune alterations. Experimental studies in several lab animal species suggest the latter stages of gestation are a period of considerable sensitivity for lead-induced immunotoxicity. This review describes the basic characteristics of lead-induced immunotoxicity emphasizing experimental animal results. It also provides a framework for the consideration of toxicant exposure effects across life stages. The existence of and probable basis for developmental windows of immune hyper-susceptibility are presented. Finally, the potential for lead to serve as a perinatal risk factor for childhood asthma as well as other diseases is considered

Global transport calculations with an equivalent barotropic system

Science.gov (United States)

Salby, Murry L.; O'Sullivan, Donal; Garcia, Rolando R.; Tribbia, Joseph

1990-01-01

Transport properties of the two-dimensional equations governing equivalent barotropic motion are investigated on the sphere. This system has ingredients such as forcing, equivalent depth, and thermal dissipation explicitly represented, and takes into account compression effects associated with vertical motion along isentropic surfaces. Horizontal transport properties of this system are investigated under adiabatic and diabatic conditions for different forms of dissipation, and over a range of resolutions. It is shown that forcing represetative of time-mean and amplified conditions at 10 mb leads to the behavior typical of observations at this level. The displacement of the polar night vortex and its distortion into a comma shape are evident, as is irreversible mixing under sufficiently strong forcing amplitude. It is shown that thermal dissipation influences the behavior significantly by inhibiting the amplification of unstable eddies and thereby the horizontal stirring of air.

Screening for gestational diabetes: examining a breakfast meal test ...

African Journals Online (AJOL)

Objective: This study was performed to analyse the carbohydrate quantity of the non-standardised breakfast meal test consumed as part of a screening test for gestational diabetes. Design: A prospective descriptive design was utilised. Setting: Screening for gestational diabetes was performed in the High-Risk Antenatal ...

CXC chemokine ligand 16 is increased in gestational diabetes mellitus and preeclampsia and associated with lipoproteins in gestational diabetes mellitus at 5 years follow-up.

Science.gov (United States)

Lekva, Tove; Michelsen, Annika E; Aukrust, Pål; Paasche Roland, Marie Cecilie; Henriksen, Tore; Bollerslev, Jens; Ueland, Thor

2017-11-01

Women with a history of gestational diabetes mellitus and preeclampsia are at increased risk of cardiovascular disease later in life, but the mechanism remains unclear. The aim of the study was to evaluate the association between CXC chemokine ligand 16 and indices of glucose metabolism, dyslipidemia and systemic inflammation in gestational diabetes mellitus and preeclampsia. This sub-study of the population-based prospective cohort included 310 women. Oral glucose tolerance test was performed during pregnancy and 5 years later along with lipid analysis. CXC chemokine ligand 16 was measured in plasma (protein) and peripheral blood mononuclear cells (messenger RNA) during pregnancy and at follow-up. Circulating CXC chemokine ligand 16 was higher in gestational diabetes mellitus women early in pregnancy and at follow-up, while higher in preeclampsia women late in pregnancy compared to control women. Messenger RNA of CXC chemokine ligand 16 in peripheral blood mononuclear cells were lower in gestational diabetes mellitus and preeclampsia women compared to control women. Increased circulating CXC chemokine ligand 16 level was associated with a higher apolipoprotein B and low-density lipoprotein cholesterol in gestational diabetes mellitus women but not in normal pregnancy at follow-up. Our study shows that women with gestational diabetes mellitus and preeclampsia had a dysregulated CXC chemokine ligand 16 during pregnancy, and in gestational diabetes mellitus, the increase in CXC chemokine ligand 16 early in pregnancy and after 5 years was strongly associated with their lipid profile.

Maternal outcomes and follow-up after gestational diabetes mellitus

Science.gov (United States)

Kim, C.

2014-01-01

Gestational diabetes mellitus reflects impaired maternal insulin secretion relative to demand prior to pregnancy, as well as temporary metabolic stressors imposed by the placenta and fetus. Thus, after delivery, women with gestational diabetes have increased risk of diabetes and recurrent gestational diabetes because of their underlying impairment, which may be further exacerbated by fat accretion during pregnancy and post-partum deterioration in lifestyle behaviours. This hypothetical model is discussed in greater detail, particularly the uncertainty regarding pregnancy as an accelerator of β-cell decline and the role of gestational weight gain. This report also presents risk estimates for future glucose intolerance and diabetes and reviews modifiable risk factors, particularly body mass and lifestyle alterations, including weight loss and breastfeeding. Non-modifiable risk factors such as race/ethnicity and insulin use during pregnancy are also discussed. The review concludes with current literature on lifestyle modification, recommendations for post-partum glucose screening, and future directions for research to prevent maternal disease. PMID:24341443

[Chinese neonatal birth weight curve for different gestational age].

Science.gov (United States)

Zhu, Li; Zhang, Rong; Zhang, Shulian; Shi, Wenjing; Yan, Weili; Wang, Xiaoli; Lyu, Qin; Liu, Ling; Zhou, Qin; Qiu, Quanfang; Li, Xiaoying; He, Haiying; Wang, Jimei; Li, Ruichun; Lu, Jiarong; Yin, Zhaoqing; Su, Ping; Lin, Xinzhu; Guo, Fang; Zhang, Hui; Li, Shujun; Xin, Hua; Han, Yanqing; Wang, Hongyun; Chen, Dongmei; Li, Zhankui; Wang, Huiqin; Qiu, Yinping; Liu, Huayan; Yang, Jie; Yang, Xiaoli; Li, Mingxia; Li, Wenjing; Han, Shuping; Cao, Bei; Yi, Bin; Zhang, Yihui; Chen, Chao

2015-02-01

Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve. A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system. the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1. A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method. Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes

DEFF Research Database (Denmark)

2017-01-01

were supplemented with study level data from studies that did not provide IPD, the overall effect was similar, with stronger evidence of benefit for gestational diabetes (0.76, 0.65 to 0.89, I2=36.8%; 59 studies, 16 885 women).Conclusion Diet and physical activity based interventions during pregnancy......Objective To synthesise the evidence on the overall and differential effects of interventions based on diet and physical activity during pregnancy, primarily on gestational weight gain and maternal and offspring composite outcomes, according to women's body mass index, age, parity, ethnicity...... Randomised trials on diet and physical activity based interventions in pregnancy.Data synthesis Statistical models accounted for clustering of participants within trials and heterogeneity across trials leading to summary mean differences or odds ratios with 95% confidence intervals for the effects overall...

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes

DEFF Research Database (Denmark)

2017-01-01

Randomised trials on diet and physical activity based interventions in pregnancy.Data synthesis Statistical models accounted for clustering of participants within trials and heterogeneity across trials leading to summary mean differences or odds ratios with 95% confidence intervals for the effects overall......Objective To synthesise the evidence on the overall and differential effects of interventions based on diet and physical activity during pregnancy, primarily on gestational weight gain and maternal and offspring composite outcomes, according to women's body mass index, age, parity, ethnicity...... were supplemented with study level data from studies that did not provide IPD, the overall effect was similar, with stronger evidence of benefit for gestational diabetes (0.76, 0.65 to 0.89, I2=36.8%; 59 studies, 16 885 women).Conclusion Diet and physical activity based interventions during pregnancy...

Doppler ultrasound scan during normal gestation: umbilical circulation

International Nuclear Information System (INIS)

Ruiz, T.; Sabate, J.; Martinez-Benavides, M. M.; Sanchez-Ramos, J.

2002-01-01

To determine normal umbilical circulation patterns by means of Doppler ultrasound scan in a healthy gestating population without risk factors and with normal perinatal results, and to evaluate any occurring modifications relative to gestational age by obtaining records kept during pregnancy. One hundred and sixteen pregnant women carrying a single fetus have been studied. These women had no risk factors, with both clinical and analytical controls, as well as ultrasound scans, all being normal. There were performed a total of 193 Doppler ultrasound scans between weeks 15 and 41 of gestation, with blood-flow analysis in the arteries and vein of the umbilical cord. The obtained information was correlated with parameters that evaluate fetal well-being (fetal monitoring and/or oxytocin test) and perinatal result (delivery type, birth weight, Apgar score). Statistical analysis was performed with the programs SPSS 6.0.1 for Windows and EPIINFO 6.0.4. With pulsed Doppler, the umbilical artery in all cases demonstrated a biphasic morphology with systolic and diastolic components and without retrograde blood flow. As the gestation period increased, there was observed a progressive decrease in resistance along with an increase in blood-flow velocity during the diastolic phase. The Doppler ultrasound scan is a non-invasive method that permits the hemodynamic study of umbilical blood circulation. A knowledge of normal blood-flow signal morphology, as well as of the normal values for Doppler indices in relation to gestational age would permit us to utilize this method in high-risk pregnancies. (Author) 30 refs

Secular trends in gestational age and birthweight in twins

NARCIS (Netherlands)

Gielen, M.; van Beijsterveldt, C.E.M.; Derom, C.A.; Vlietinck, R; Nijhuis, J.G.; Zeegers, M.P.A.; Boomsma, D.I.

2010-01-01

Background: In recent decades, the overall rate of preterm births has increased. The aim of the present study was to examine whether this trend is also seen for multiple gestations. More specifically, we examined if there has been a decrease in gestational age for live born monozygotic (MZ) and

Decreased plasma chemerin levels in women with gestational diabetes mellitus

DEFF Research Database (Denmark)

Hare, K J; Bonde, L; Svare, J A

2014-01-01

circulating chemerin levels, which may act to reduce pregnancy-induced insulin resistance and prevent glucose intolerance. Women with gestational diabetes, however, have severely reduced chemerin levels that remain low after delivery, which may contribute to the insulin resistance, glucose intolerance......AIMS: To evaluate fasting and post-prandial serum chemerin levels in pregnant women with and without gestational diabetes, and again following delivery when normal glucose homeostasis is re-established. METHODS: Chemerin levels were measured in serum from nine women with gestational diabetes......, and from eight age- and BMI-matched pregnant women with normal glucose tolerance during two meal tests: in the third trimester and 3-4 months post partum. All women with gestational diabetes re-established normal glucose tolerance after delivery. RESULTS: Meal intake did not affect serum chemerin levels...

The long gestation of the small naked mole-rat (Heterocephalus glaber Ruppell, 1842 studied with ultrasound biomicroscopy and 3D-ultrasonography.

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Kathleen Roellig

Full Text Available The naked mole-rat (Heterocephalus glaber is one of the two known mammalian species that live in a eusocial population structure. Here we investigate the exceptionally long gestation period of 70 days observed in the mole-rat queen. The course of seven successful pregnancies in two individuals was recorded in a colony of captive naked mole-rats using ultrasound biomicroscopy (UBM and 3D-ultrasonography. We establish a catalogue of basic reference ultrasound data for this species by describing the ultrasonographic appearance of reproductive organs, calculating growth curves to predict gestational age and defining ultrasonographic milestones to characterize pregnancy stages. Mean litter size was 10.9±2.7, of which 7.2±1.5 survived the weaning period. Mean interbirth interval was 128.8±63.0 days. The reproductive success in our colony did not differ from previously published data. In the queen the active corpora lutea had an anechoic, fluid filled centre. Using UBM, pregnancy could be detected 53 days before parturition. The period of embryonic development is assumed to last until 30 days before parturition. Embryonic resorptions were detected frequently in the queen, indicating that this might be an ordinary event in this species. We discuss the extraordinary long gestation period of this small rodent and postulate that the long gestation is beneficial to both the eusocial structure and longevity. An increased litter size, twice as large as for other rodents of similar size, seemingly compensates for the doubling of pregnancy length. We demonstrate that the lifetime reproductive effort of a naked mole-rat queen is equivalent to the mass of offspring that would be produced if all of the females of a colony would be reproducing.

Review of gestational diabetes mellitus effects on vascular structure and function.

Science.gov (United States)

Jensen, Louise A; Chik, Constance L; Ryan, Edmond A

2016-05-01

Vascular dysfunction has been described in women with a history of gestational diabetes mellitus. Furthermore, previous gestational diabetes mellitus increases the risk of developing Type 2 diabetes mellitus, a risk factor for cardiovascular disease. Factors contributing to vascular changes remain uncertain. The aim of this review was to summarize vascular structure and function changes found to occur in women with previous gestational diabetes mellitus and to identify factors that contribute to vascular dysfunction. A systematic search of electronic databases yielded 15 publications from 1998 to March 2014 that met the inclusion criteria. Our review confirmed that previous gestational diabetes mellitus contributes to vascular dysfunction, and the most consistent risk factor associated with previous gestational diabetes mellitus and vascular dysfunction was elevated body mass index. Heterogeneity existed across studies in determining the relationship of glycaemic levels and insulin resistance to vascular dysfunction. © The Author(s) 2016.

Gestational surrogacy in Australia 2004-2011: treatment, pregnancy and birth outcomes.

Science.gov (United States)

Wang, Alex Y; Dill, Sandra K; Bowman, Mark; Sullivan, Elizabeth A

2016-06-01

Information on gestational surrogacy arrangement and outcomes is limited in Australia. This national population study investigates the epidemiology of gestational surrogacy arrangement in Australia: treatment procedures, pregnancy and birth outcomes. A retrospective study was conducted of 169 intended parents cycles and 388 gestational carrier cycles in Australia in 2004-2011. Demographics were compared between intended parents and gestational carrier cycles. Pregnancy and birth outcomes were compared by number of embryos transferred. Over half (54%) intended parents cycles were in women aged surrogacy treatment, including 9 liveborn twins. Of these, 22% (16) were preterm and 14% (10) were low birthweight. Preterm birth was 13% for liveborn babies following SET, lower than the 31% or liveborn babies following DET. To avoid adverse outcomes for both carriers and babies, SET should be advocated in all gestational surrogacy arrangements. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Gestational Weight Gain and Pregnancy Outcomes in 481 Obese Glucose-Tolerant Women

DEFF Research Database (Denmark)

Jensen, Dorte Møller; Ovesen, Per; Beck-Nielsen, Henning

2005-01-01

OBJECTIVE: To investigate the effect of gestational weight gain in obese glucose-tolerant women. RESEARCH DESIGN AND METHODS: We performed a historical cohort study of 481 women with prepregnancy BMI > or = 30 kg/m2 and a normal 2-h 75-g oral glucose tolerance test (OGTT) during the third trimester......-weight women (3,478 g). In multivariate analyses, increasing weight gain was associated with significantly higher rates of hypertension (OR 4.8 [95% CI for group 4 vs. group 1: 1.7-13.1]), cesarean section (3.5 [1.6-7.8]), induction of labor (3.7 [1.7-8.0]), and large-for-gestational-age infants (4.7 [2.......0-11.0]). There was no difference in rates of small-for-gestational-age infants. Significant predictors for birth weight (determined by multiple linear regression) were gestational weight gain, 2-h OGTT result, pre-gestational BMI, maternal age, gestational age, and smoking. CONCLUSIONS: Increasing weight gain in obese women...

Metabolic disorders in adipocytokine imbalance and gestational complications

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Natalya B. Chabanova

2017-06-01

Full Text Available Adipose tissue as an endocrine organ synthesizes a large number of biologically active substances, adipocytokines, which have both local and systemic effects influencing the vascular wall, tissue sensitivity to insulin, glucose metabolism, and systemic inflammation. The data obtained from clinical and experimental studies demonstrate the close relationship between the imbalance of adipocytokines and pregnancy complications such as insulin resistance, gestational diabetes, and preeclampsia. In this connection, close attention of obstetrician-gynecologists and endocrinologists is focused on etiopathogenic aspects of the formation of gestational complications with metabolic disorders caused by an imbalance of adipocytokines with maternal obesity and to the search for markers of these disorders. The review presents the current literature data on adipose tissue hormones and their influence on the course of a gestational process.

Variations in resting energy expenditure: impact on gestational weight gain.

Science.gov (United States)

Berggren, E K; O'Tierney-Ginn, P; Lewis, S; Presley, L; De-Mouzon, S Hauguel; Catalano, P M

2017-10-01

There are significant variations in gestational weight gain, with many women gaining in excess of the Institute of Medicine guidelines. Unfortunately, efforts to improve appropriate gestational weight gain have had only limited success. To date, interventions have focused primarily on decreasing energy intake and/or increasing physical activity. Maternal resting energy expenditure, which comprises ∼60% of total energy expenditure compared with the ∼20% that comes from physical activity, may be an important consideration in understanding variations in gestational weight gain. Our objective was to quantify the changes in resting energy expenditure during pregnancy and their relationship to gestational weight gain and body composition changes among healthy women. We hypothesized that greater gestational weight gain, and fat mass accrual in particular, are inversely related to variations in resting energy expenditure. We conducted a secondary analysis of a prospective cohort studied before conception and late pregnancy (34-36 weeks). Body composition (estimated using hydrodensitometry) and resting energy expenditure (estimated using indirect calorimetry) were measured. The relationship between the changes in resting energy expenditure and gestational weight gain and the change in fat mass and fat-free mass were quantified. Resting energy expenditure was expressed as kilocalories per kilogram of fat-free mass per day (kilocalories per kilogram of fat-free mass -1 /day -1 ) and kilocalories per day. Correlations are reported as r. Among 51 women, preconception body mass index was 23.0 (4.7) kg/m 2 ; gestational weight gain was 12.8 (4.7) kg. Preconception and late pregnancy resting energy expenditure (kilocalories per day) correlated positively with the change in fat-free mass (r = 0.37, P = .008; r = 0.51, P = .001). Late-pregnancy resting energy expenditure (kilocalories per kilogram of fat-free mass -1 /day -1 ) was inversely associated with the change in fat

Sonographic monitoring of complications and anomalies in twin gestations

International Nuclear Information System (INIS)

Coleman, B.G.; Grumbach, K.; Arger, P.H.; Mintz, M.C.; Arenson, R.L.; Mennuti, M.T.; Gabbe, S.G.

1986-01-01

One hundred sixty-eight twin gestations were evaluated to assess the role of US in the diagnosis of obstetric complications and anomalies. US revealed the following complications: symptomatic polyhydramnios (eight cases), myomas (seven), placenta previa (three), and abruption (five). Fetal anomalies included twin-twin transfusion syndrome (two), acardiac anomaly (two), chromosomal abnormality (two), anencephaly (one), hydrocephaly (one), and conjoined twins (two). In 26 gestations intrauterine fetal demise or neonatal death involved one or both twins for a total of 42 deaths, constituting a mortality of 12.5%. No maternal deaths occurred. The impact of sonographic monitoring on the obstetric management of twin gestations is emphasized

EQUIVALENCE VERSUS NON-EQUIVALENCE IN ECONOMIC TRANSLATION

Directory of Open Access Journals (Sweden)

Cristina, Chifane

2012-01-01

Full Text Available This paper aims at highlighting the fact that “equivalence” represents a concept worth revisiting and detailing upon when tackling the translation process of economic texts both from English into Romanian and from Romanian into English. Far from being exhaustive, our analysis will focus upon the problems arising from the lack of equivalence at the word level. Consequently, relevant examples from the economic field will be provided to account for the following types of non-equivalence at word level: culturespecific concepts; the source language concept is not lexicalised in the target language; the source language word is semantically complex; differences in physical and interpersonal perspective; differences in expressive meaning; differences in form; differences in frequency and purpose of using specific forms and the use of loan words in the source text. Likewise, we shall illustrate a number of translation strategies necessary to deal with the afore-mentioned cases of non-equivalence: translation by a more general word (superordinate; translation by a more neutral/less expressive word; translation by cultural substitution; translation using a loan word or loan word plus explanation; translation by paraphrase using a related word; translation by paraphrase using unrelated words; translation by omission and translation by illustration.

Cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers.

Science.gov (United States)

Vela-Huerta, M; Aguilera-López, A; Alarcón-Santos, S; Amador, N; Aldana-Valenzuela, C; Heredia, A

2007-09-01

To compare cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers. Color Doppler echocardiography was performed in 113 (22 large for gestational age infants of diabetic mothers, 21 of nondiabetic mothers and 70 adequate for gestational age newborns) full-term infants. Pulmonary arterial pressure was significantly higher in infants of diabetic mothers than in those of nondiabetic mothers and normal infants at 24 h (38.5 vs. 32.5, and 35.5 mmHg, respectively). However, slow fall in this parameter was shown in all large for gestational age infants. Open ductus arteriosus was frequent in all large for gestational age infants, but its closure was significantly delayed in infants of diabetic mothers. Septal hypertrophy was higher in infants of diabetic mothers than in large for gestational age infants of nondiabetic mothers. Large for gestational age infants born from nondiabetic mothers showed delayed fall in pulmonary arterial pressure similar to those born from diabetic mothers but showed lower proportion of septal hypertrophy. Patent ductus arteriosus persisted for longer period of time in all large for gestational age infants than in normal infants, but its closure was significantly delayed in infants of diabetic mothers.

Equivalence principle and quantum mechanics: quantum simulation with entangled photons.

Science.gov (United States)

Longhi, S

2018-01-15

Einstein's equivalence principle (EP) states the complete physical equivalence of a gravitational field and corresponding inertial field in an accelerated reference frame. However, to what extent the EP remains valid in non-relativistic quantum mechanics is a controversial issue. To avoid violation of the EP, Bargmann's superselection rule forbids a coherent superposition of states with different masses. Here we suggest a quantum simulation of non-relativistic Schrödinger particle dynamics in non-inertial reference frames, which is based on the propagation of polarization-entangled photon pairs in curved and birefringent optical waveguides and Hong-Ou-Mandel quantum interference measurement. The photonic simulator can emulate superposition of mass states, which would lead to violation of the EP.

Association between healthy maternal dietary pattern and risk for gestational diabetes mellitus.

Science.gov (United States)

Tryggvadottir, E A; Medek, H; Birgisdottir, B E; Geirsson, R T; Gunnarsdottir, I

2016-02-01

Gestational diabetes mellitus (GDM) is associated with negative health effects for mother and child. The aim was to investigate the association between maternal dietary patterns and GDM. Prospective observational study including 168 pregnant women aged 18-40 years, recruited at routine 20-week ultrasound. All participants kept a 4-day weighed food record following recruitment (commencement: gestational weeks 19-24). Principal component analysis was used to extract dietary patterns from 29 food groups. A Healthy Eating Index (HEI) was constructed. All women underwent an oral glucose tolerance test in weeks 23-28. One clear dietary pattern (Eigenvalue 2.4) was extracted with positive factor loadings for seafood; eggs; vegetables; fruits and berries; vegetable oils; nuts and seeds; pasta; breakfast cereals; and coffee, tea and cocoa powder, and negative factor loadings for soft drinks and French fries. This pattern was labeled a prudent dietary pattern. Explained variance was 8.2%. The prevalence of GDM was 2.3% among women of normal weight before pregnancy (n=86) and 18.3% among overweight/obese women (n=82). The prudent dietary pattern was associated with lower risk of GDM (OR: 0.54; 95% CI: 0.30, 0.98). When adjusting for age, parity, prepregnancy weight, energy intake, weekly weight gain and total metabolic equivalent of task the association remained (OR: 0.36; 95% CI: 0.14, 0.94). Similar results were found when only including overweight or obese women (OR: 0.31; 95% CI: 0.13, 0.75). Adhering to a prudent dietary pattern in pregnancy was clearly associated with lower risk of GDM, especially among women already at higher risk because of overweight/obesity before pregnancy.

Radioactive waste equivalence

International Nuclear Information System (INIS)

Orlowski, S.; Schaller, K.H.

1990-01-01

The report reviews, for the Member States of the European Community, possible situations in which an equivalence concept for radioactive waste may be used, analyses the various factors involved, and suggests guidelines for the implementation of such a concept. Only safety and technical aspects are covered. Other aspects such as commercial ones are excluded. Situations where the need for an equivalence concept has been identified are processes where impurities are added as a consequence of the treatment and conditioning process, the substitution of wastes from similar waste streams due to the treatment process, and exchange of waste belonging to different waste categories. The analysis of factors involved and possible ways for equivalence evaluation, taking into account in particular the chemical, physical and radiological characteristics of the waste package, and the potential risks of the waste form, shows that no simple all-encompassing equivalence formula may be derived. Consequently, a step-by-step approach is suggested, which avoids complex evaluations in the case of simple exchanges

Equivalence principles and electromagnetism

Science.gov (United States)

Ni, W.-T.

1977-01-01

The implications of the weak equivalence principles are investigated in detail for electromagnetic systems in a general framework. In particular, it is shown that the universality of free-fall trajectories (Galileo weak equivalence principle) does not imply the validity of the Einstein equivalence principle. However, the Galileo principle plus the universality of free-fall rotation states does imply the Einstein principle.

Experimental modelling of the consequences of brief late gestation asphyxia on newborn lamb behaviour and brain structure.

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Margie Castillo-Melendez

Full Text Available Brief but severe asphyxia in late gestation or at the time of birth may lead to neonatal hypoxic ischemic encephalopathy and is associated with long-term neurodevelopmental impairment. We undertook this study to examine the consequences of transient in utero asphyxia in late gestation fetal sheep, on the newborn lamb after birth. Surgery was undertaken at 125 days gestation for implantation of fetal catheters and placement of a silastic cuff around the umbilical cord. At 132 days gestation (0.89 term, the cuff was inflated to induce umbilical cord occlusion (UCO, or sham (control. Fetal arterial blood samples were collected for assessment of fetal wellbeing and the pregnancy continued until birth. At birth, behavioral milestones for newborn lambs were recorded over 24 h, after which the lambs were euthanased for brain collection and histopathology assessments. After birth, UCO lambs displayed significant latencies to (i use all four legs, (ii attain a standing position, (iii find the udder, and (iv successfully suckle--compared to control lambs. Brains of UCO lambs showed widespread pathologies including cell death, white matter disruption, intra-parenchymal hemorrhage and inflammation, which were not observed in full term control brains. UCO resulted in some preterm births, but comparison with age-matched preterm non-UCO control lambs showed that prematurity per se was not responsible for the behavioral delays and brain structural abnormalities resulting from the in utero asphyxia. These results demonstrate that a single, brief fetal asphyxic episode in late gestation results in significant grey and white matter disruption in the developing brain, and causes significant behavioral delay in newborn lambs. These data are consistent with clinical observations that antenatal asphyxia is causal in the development of neonatal encephalopathy and provide an experimental model to advance our understanding of neuroprotective therapies.

New recommendations for dose equivalent

International Nuclear Information System (INIS)

Bengtsson, G.

1985-01-01

In its report 39, the International Commission on Radiation Units and Measurements (ICRU), has defined four new quantities for the determination of dose equivalents from external sources: the ambient dose equivalent, the directional dose equivalent, the individual dose equivalent, penetrating and the individual dose equivalent, superficial. The rationale behind these concepts and their practical application are discussed. Reference is made to numerical values of these quantities which will be the subject of a coming publication from the International Commission on Radiological Protection, ICRP. (Author)

Equivalent models of wind farms by using aggregated wind turbines and equivalent winds

International Nuclear Information System (INIS)

Fernandez, L.M.; Garcia, C.A.; Saenz, J.R.; Jurado, F.

2009-01-01

As a result of the increasing wind farms penetration on power systems, the wind farms begin to influence power system, and therefore the modeling of wind farms has become an interesting research topic. In this paper, new equivalent models of wind farms equipped with wind turbines based on squirrel-cage induction generators and doubly-fed induction generators are proposed to represent the collective behavior on large power systems simulations, instead of using a complete model of wind farms where all the wind turbines are modeled. The models proposed here are based on aggregating wind turbines into an equivalent wind turbine which receives an equivalent wind of the ones incident on the aggregated wind turbines. The equivalent wind turbine presents re-scaled power capacity and the same complete model as the individual wind turbines, which supposes the main feature of the present equivalent models. Two equivalent winds are evaluated in this work: (1) the average wind from the ones incident on the aggregated wind turbines with similar winds, and (2) an equivalent incoming wind derived from the power curve and the wind incident on each wind turbine. The effectiveness of the equivalent models to represent the collective response of the wind farm at the point of common coupling to grid is demonstrated by comparison with the wind farm response obtained from the detailed model during power system dynamic simulations, such as wind fluctuations and a grid disturbance. The present models can be used for grid integration studies of large power system with an important reduction of the model order and the computation time

Diagnostic value of newborn foot length to predict gestational age

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Mutia Farah Fawziah

2017-08-01

Full Text Available Background  Identification of gestational age, especially within 48 hours of birth, is crucial for newborns, as the earlier preterm status is detected, the earlier the child can receive optimal management. Newborn foot length is an anthropometric measurement which is easy to perform, inexpensive, and potentially efficient for predicting gestational age. Objective  To analyze the diagnostic value of newborn foot length in predicting gestational age. Methods  This diagnostic study was performed between October 2016 and February 2017 in the High Care Unit of Neonates at Dr. Moewardi General Hospital, Surakarta. A total of 152 newborns were consecutively selected and underwent right foot length measurements before 96 hours of age. The correlation between newborn foot length to classify as full term and gestational age was analyzed with Spearman’s correlation test because of non-normal data distribution. The cut-off point of newborn foot length was calculated by receiver operating characteristic (ROC curve and diagnostic values of newborn foot length were analyzed by 2 x 2 table with SPSS 21.0 software. Results There were no significant differences between male and female newborns in terms of gestational age, birth weight, choronological age, and newborn foot length (P>0.05. Newborn foot length and gestational age had a significant correlation (r=0.53; P=0.000. The optimal cut-off newborn foot length to predict full term status was 7.1 cm. Newborn foot length below 7.1 cm had sensitivity 75%, specificity 98%, positive predictive value 94.3%, negative predictive value 90.6%, positive likelihood ratio 40.5, negative likelihood ratio 0.25, and post-test probability 94.29%, to predict preterm status in newborns. Conclusion  Newborn foot length can be used to predict gestational age, especially for the purpose of differentiating between preterm and full term newborns.

Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

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Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

2017-05-01

The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Fetal eyeball volume: relationship to gestational age and biparietal diameter.

Science.gov (United States)

Odeh, Marwan; Feldman, Yulia; Degani, Shimon; Grinin, Vitali; Ophir, Ella; Bornstein, Jacob

2009-08-01

To measure and determine normal values of the fetal eyeball volume between 14 and 40 weeks of gestation. The volume of the fetal eyeball was measured with three-dimensional ultrasound between 14 and 40 weeks of gestation using the VOCAL software.Only singleton pregnancies without fetal growth restriction, diabetes mellitus, hypertension or major fetal malformation were included. Over all, 203 women were studied. In 125 both eyeballs were measured while in 78 only one eyeball was measured. The volume of the eyeball correlated strongly with gestational age (right: R = 0.946, P eyeball volume and the BPD were: square of right eyeball = -0.180 + 0.187 BPD, square of left eyeball = -0.182 + 0.187 BPD. The volume of the eyeball has strong positive correlations with gestational age and BPD. Our data may be helpful in fetuses suspected of having eye anomalies.

Improved homeothermy and hypothermia in African lions during gestation.

Science.gov (United States)

Trethowan, Paul D; Hart, Tom; Loveridge, Andrew J; Haw, Anna; Fuller, Andrea; Macdonald, David W

2016-11-01

Mammals use endogenously produced heat to maintain a high and relatively constant core body temperature (T b ). How they regulate their T b during reproduction might inform us as to what thermal conditions are necessary for optimal development of offspring. However, few studies have measured T b in free-ranging animals for sufficient periods of time to encounter reproductive events. We measured T b continuously in six free-ranging adult female African lions (Panthera leo) for approximately 1 year. Lions reduced the 24 h amplitude of T b by about 25% during gestation and decreased mean 24 h T b by 1.3 ± 0.1°C over the course of the gestation, reducing incidences of hyperthermia (T b > 39.5°C). The observation of improved homeothermy during reproduction may support the parental care model (PCM) for the evolution of endothermy, which postulates that endothermy arose in birds and mammals as a consequence of more general selection for parental care. According to the PCM, endothermy arose because it enabled parents to better control incubation temperature, leading to rapid growth and development of offspring and thus to fitness benefits for the parents. Whether the precision of T b regulation in pregnant lions, and consequently their reproductive success, will be influenced by changing environmental conditions, particularly hotter and drier periods associated with climate change, remains to be determined. © 2016 The Author(s).

Early detection of diabetes after pregnancy complicated by gestational diabetes

DEFF Research Database (Denmark)

Nielsen, Jane Hyldgård; Overgaard, Charlotte; Olesen, Christinna Rebecca

Title: Early detection of diabetes after pregnancy complicated by gestational diabetes Background: Women whose pregnancy was complicated by gestational diabetes have a 7-fold higher risk of developing diabetes, primarily type 2. 40% of women with a history gestational diabetes mellitus (GDM...... of health consequences for women. Aims: Examine the extent of participation in follow-up screening in the Danish Region of North Jutland, and the possible consequences of nonattendance. Methods: A register based study. In Danish national registers 2171 birthing women whose pregnancy was complicated by GDM...

Can quantum probes satisfy the weak equivalence principle?

International Nuclear Information System (INIS)

Seveso, Luigi; Paris, Matteo G.A.

2017-01-01

We address the question whether quantum probes in a gravitational field can be considered as test particles obeying the weak equivalence principle (WEP). A formulation of the WEP is proposed which applies also in the quantum regime, while maintaining the physical content of its classical counterpart. Such formulation requires the introduction of a gravitational field not to modify the Fisher information about the mass of a freely-falling probe, extractable through measurements of its position. We discover that, while in a uniform field quantum probes satisfy our formulation of the WEP exactly, gravity gradients can encode nontrivial information about the particle’s mass in its wavefunction, leading to violations of the WEP. - Highlights: • Can quantum probes under gravity be approximated as test-bodies? • A formulation of the weak equivalence principle for quantum probes is proposed. • Quantum probes are found to violate it as a matter of principle.

Can quantum probes satisfy the weak equivalence principle?

Energy Technology Data Exchange (ETDEWEB)

Seveso, Luigi, E-mail: luigi.seveso@unimi.it [Quantum Technology Lab, Dipartimento di Fisica, Università degli Studi di Milano, I-20133 Milano (Italy); Paris, Matteo G.A. [Quantum Technology Lab, Dipartimento di Fisica, Università degli Studi di Milano, I-20133 Milano (Italy); INFN, Sezione di Milano, I-20133 Milano (Italy)

2017-05-15

We address the question whether quantum probes in a gravitational field can be considered as test particles obeying the weak equivalence principle (WEP). A formulation of the WEP is proposed which applies also in the quantum regime, while maintaining the physical content of its classical counterpart. Such formulation requires the introduction of a gravitational field not to modify the Fisher information about the mass of a freely-falling probe, extractable through measurements of its position. We discover that, while in a uniform field quantum probes satisfy our formulation of the WEP exactly, gravity gradients can encode nontrivial information about the particle’s mass in its wavefunction, leading to violations of the WEP. - Highlights: • Can quantum probes under gravity be approximated as test-bodies? • A formulation of the weak equivalence principle for quantum probes is proposed. • Quantum probes are found to violate it as a matter of principle.

Gestational Age-Dependent Increase of Survival Motor Neuron Protein in Umbilical Cord-Derived Mesenchymal Stem Cells

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Sota Iwatani

2017-09-01

Full Text Available BackgroundSpinal muscular atrophy (SMA is the most common genetic neurological disease leading to infant death. It is caused by loss of survival motor neuron (SMN 1 gene and subsequent reduction of SMN protein in motor neurons. Because SMN is ubiquitously expressed and functionally linked to general RNA metabolism pathway, fibroblasts (FBs are most widely used for the assessment of SMN expression in SMA patients but usually isolated from skin biopsy samples after the onset of overt symptoms. Although recent translational studies of SMN-targeted therapies have revealed the very limited time window for effective SMA therapies during perinatal period, the exact time point when SMN shortage became evident is unknown in human samples. In this study, we analyzed SMN mRNA and protein expression during perinatal period by using umbilical cord-derived mesenchymal stem cells (UC-MSCs obtained from preterm and term infants.MethodsUC-MSCs were isolated from 16 control infants delivered at 22–40 weeks of gestation and SMA fetus aborted at 19 weeks of gestation (UC-MSC-Control and UC-MSC-SMA. FBs were isolated from control volunteer and SMA patient (FB-Control and FB-SMA. SMN mRNA and protein expression in UC-MSCs and FBs was determined by RT-qPCR and Western blot.ResultsUC-MSC-Control and UC-MSC-SMA expressed the comparable level of MSC markers on their cell surface and were able to differentiate into adipocytes, osteocytes, and chondrocytes. At steady state, SMN mRNA and protein expression was decreased in UC-MSC-SMA compared to UC-MSC-Control, as observed in FB-SMA and FB-Control. In response to histone deacetylase inhibitor valproic acid, SMN mRNA and protein expression in UC-MSC-SMA and FB-SMA was increased. During perinatal development from 22 to 40 weeks of gestation, SMN mRNA and protein expression in UC-MSC-Control was positively correlated with gestational age.ConclusionUC-MSCs isolated from 17 fetus/infant of 19–40 weeks of gestation

Gestational surrogacy: Psychosocial aspects

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Nicolás Ruiz-Robledillo

2016-12-01

Full Text Available Innovation in assisted reproductive technologies together with increased infertility and new family structures are increasing the use of gestational surrogacy as a means to have children. Before, during and after the process, it is necessary to study the psychosocial characteristics of triad members: the gestational surrogate, intended parents, and offspring. Research has indicated positive adaptation to the process and benefits for all members of the triad. Altruism is the main motivation of surrogates. Notably, psychological well-being has been found to be higher in individuals who have become parents through surrogacy than in those who have used egg donation or have followed a natural process of conception. Moreover, no differences in psychosocial characteristics have been observed in the offspring, compared with children born through natural conception or egg donation. Results highlight the positive aspects of surrogacy. Future research should investigate psychosocial factors that modulate the process, acting as risk and protective factors for well-being of the triad members, and identify the optimal profiles of surrogates for the process to be a success.

Maternal and fetal outcome of mothers with gestational diabetes mellitus attending BIRDEM Hospital.

Science.gov (United States)

Sajani, T T; Rahman, M T; Karim, M R

2014-04-01

Gestational diabetes mellitus, most of which progress to type-2 diabetes mellitus is increasing worldwide. Identification of gestational diabetes and control of glucose can reduce such complications and improve maternal and neonatal health. A hospital based cross sectional study was conducted to find out maternal and fetal outcome of gestational diabetes from January to July 2011. Data were collected from 109 gestational diabetes mothers attending Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital for delivery. Study revealed that gestational diabetes was more common among mothers aged >25 years old and multiparaous women. Mean gestational age of diagnosis was 16.82±9.54 weeks. Sixty eight (68%) mothers were diagnosed before 20 weeks of gestation and more than 90% mothers with gestational diabetes delivered by caesarean section. Mean pregnancy weight gain was 6.8±1.18kg. Adverse maternal outcome observed in 24% cases and adverse fetal outcome was present in 34% cases. In univariate analysis weeks of delivery and fasting blood sugar were statistically significantly associated with adverse pregnancy outcome. Babies born to mothers with only diet restriction had less birth weight than mothers with insulin therapy. Pregnancy thought to be the most vulnerable stage of women's life and protecting her health along with her fetus during this period yields a positive impact on the health of future generation. Particular attention should be given during antenatal period to initiate screening programme and treatment protocol for gestational diabetic mothers.

Pregnancy-specific stress, preterm birth, and gestational age among high-risk young women.

Science.gov (United States)

Cole-Lewis, Heather J; Kershaw, Trace S; Earnshaw, Valerie A; Yonkers, Kimberly Ann; Lin, Haiqun; Ickovics, Jeannette R

2014-09-01

There is evidence that pregnancy-specific stress is associated with preterm birth. The purpose of this study is to examine the association between change in pregnancy-specific stress over the course of pregnancy and birth outcomes (i.e., preterm birth and gestational age) in an understudied but vulnerable group using a theoretically derived model. Multivariate linear and logistic regression techniques were used to examine the association between pregnancy-specific stress (measured in second and third trimester) and length of gestation (i.e., preterm birth and gestational age) among a sample of 920 Black and/or Latina adolescent and young women. Second trimester pregnancy-specific stress was not associated with preterm birth or gestational age. Third trimester pregnancy-specific stress was associated with preterm birth but not with gestational age. Change in pregnancy-specific stress between second and third trimester was significantly associated with increased likelihood of preterm delivery and shortened gestational age, even after controlling for important biological, behavioral, psychological, interpersonal, and sociocultural risk factors. Findings emphasize the importance of measuring pregnancy-specific stress across pregnancy, as the longitudinal change from second to third trimester was significantly associated with length of gestation measured both as a dichotomous variable (preterm birth) and a continuous variable (gestational age). Furthermore, this is the first study to observe the association of pregnancy-specific stress with length of gestation in this understudied population-unique in age, race, and ethnicity. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Genetic Associations with Gestational Duration and Spontaneous Preterm Birth

DEFF Research Database (Denmark)

Zhang, G.; Feenstra, B.; Bacelis, J.

2017-01-01

. METHODS: We performed a genomewide association study in a discovery set of samples obtained from 43,568 women of European ancestry using gestational duration as a continuous trait and term or preterm (... of 8643 women) to test for replication of genomic loci that had significant genomewide association (Pdiscovery set. RESULTS: In the discovery and replication data sets, four loci (EBF1, EEFSEC, AGTR2, and WNT4) were...... significantly associated with gestational duration. Functional analysis showed that an implicated variant in WNT4 alters the binding of the estrogen receptor. The association between variants in ADCY5 and RAP2C and gestational duration had suggestive significance in the discovery set and significant evidence...

78 FR 11210 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

Science.gov (United States)

2013-02-15

... Development Conference: Diagnosing Gestational Diabetes Mellitus AGENCY: National Institutes of Health, HHS... ``Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus.'' The conference will be open to... http://prevention.nih.gov/cdp/ . SUPPLEMENTARY INFORMATION: Gestational diabetes mellitus (GDM) is a...

Conservative management of preterm premature rupture of membranes beyond 32 weeks' gestation: is it worthwhile?

Science.gov (United States)

Tsafrir, Z; Margolis, G; Cohen, Y; Cohen, A; Laskov, I; Levin, I; Mandel, D; Many, A

2015-01-01

We aimed to investigate whether conservative management of preterm premature rupture of membranes (PPROM) at 32-34 weeks' gestation improves outcome. In this retrospective analysis of singleton pregnancies, the study group included patients with PPROM at 28-34 weeks' gestation and the control group included patients presented with spontaneous preterm delivery at 28-34 weeks' gestation. Both groups were subdivided according to gestational age - early (28-31 weeks' gestation) versus late (32-34 weeks' gestation). Adverse neonatal outcome included neonatal death, intraventricular haemorrhage grade 3/4, respiratory distress syndrome, periventricular leucomalacia and neonatal sepsis. The study and control groups included 94 and 86 women, respectively. The study group had a lower incidence of adverse neonatal outcome at the earlier weeks (28-31), compared with the control group at the same gestational age. In contrast, at 32-34 weeks' gestation no difference in the risk for adverse neonatal outcome was noticed. Additionally, within the study group, chorioamnionitis rate was significantly higher among those who delivered at 32-34 weeks' gestation (p < 0.01). No advantage for conservative management of PPROM was demonstrated beyond 31 weeks' gestation. Moreover, conservative management of PPROM at 32-34 weeks' gestation may expose both mother and neonate to infectious morbidity.

Gestational diabetes: How risky are the mothers of rural Bengal, India

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Sonali Sain

2013-01-01

Full Text Available Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28 weeks were interviewed using a predesigned schedule adapted from American Diabetes Association and WHO guidelines and their clinical and obstetrical examination was done. Mothers identified with at least 1 risk factor were advised for screening by Glucose Challenge test (GCT. Those with a positive result were confirmed by Glucose Tolerance Test. Out of 625 antenatal mothers, majority i.e. 60.32% of the mothers were exposed to low risk for developing gestational diabetes. Among 248 (39.68% mothers who had at least one risk factor, 20.56% were GCT positive amounting to 8.16% of the total population. 11.69% of the mothers with positive risk factors were GTT positive amounting to 56.86% of GCT positive mothers. This accounted for 4.64% of the total study population. Thus this method of preliminary screening for risk factors of gestational diabetes undertaken in all antenatal mothers followed by confirmatory testing in those found to be risk factor positive can provide a feasible alternative in increasing the yield for detection of gestational diabetes articularly in a low resource setting.

Gestational diabetes mellitus screening, management and outcomes in the Cook Islands.

Science.gov (United States)

Aung, Yin Yin May; Sowter, Martin; Kenealy, Timothy; Herman, Josephine; Ekeroma, Alec

2015-04-17

To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies. Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glucose greater than or equal to 7.8 mmol/L) was followed by a 75 g oral glucose tolerance test (gestational diabetes mellitus diagnosed if fasting glucose greater than or equal to 5.2 mmol/L or 2-hour glucose greater than or equal to 8.0 mmol/L; pregnancy impaired glucose tolerance if positive screen and negative diagnostic test). Uptake of the screening programme rose from 49.0% to 99.6% by the end of the study period. 646 women had a glucose challenge; for 186/646 (28.8%) the challenge was positive; 183 had an oral glucose tolerance test; 89/646 (13.8%) had pregnancy impaired glucose tolerance; 94/646 (13.9%) had gestational diabetes mellitus. Median maternal weight gain was 6 kg (gestational diabetes mellitus) and 10 kg (normal glucose tolerance); caesarean section rates were 25% and 11% respectively; baby birthweights were not significantly different. 59 women with gestational diabetes mellitus had a post-natal glucose tolerance test at their 6-week check and 21 (35.6%) had diabetes confirmed. The gestational diabetes mellitus screening programme has a high uptake and current management appears effective in reducing maternal and fetal weight gain. A proposed new screening programme is outlined.

The long gestation of the small naked mole-rat (Heterocephalus glaber Rüppell, 1842) studied with ultrasound biomicroscopy and 3D-ultrasonography.

Science.gov (United States)

Roellig, Kathleen; Drews, Barbara; Goeritz, Frank; Hildebrandt, Thomas Bernd

2011-03-07

The naked mole-rat (Heterocephalus glaber) is one of the two known mammalian species that live in a eusocial population structure. Here we investigate the exceptionally long gestation period of 70 days observed in the mole-rat queen. The course of seven successful pregnancies in two individuals was recorded in a colony of captive naked mole-rats using ultrasound biomicroscopy (UBM) and 3D-ultrasonography. We establish a catalogue of basic reference ultrasound data for this species by describing the ultrasonographic appearance of reproductive organs, calculating growth curves to predict gestational age and defining ultrasonographic milestones to characterize pregnancy stages. Mean litter size was 10.9±2.7, of which 7.2±1.5 survived the weaning period. Mean interbirth interval was 128.8±63.0 days. The reproductive success in our colony did not differ from previously published data. In the queen the active corpora lutea had an anechoic, fluid filled centre. Using UBM, pregnancy could be detected 53 days before parturition. The period of embryonic development is assumed to last until 30 days before parturition. Embryonic resorptions were detected frequently in the queen, indicating that this might be an ordinary event in this species. We discuss the extraordinary long gestation period of this small rodent and postulate that the long gestation is beneficial to both the eusocial structure and longevity. An increased litter size, twice as large as for other rodents of similar size, seemingly compensates for the doubling of pregnancy length. We demonstrate that the lifetime reproductive effort of a naked mole-rat queen is equivalent to the mass of offspring that would be produced if all of the females of a colony would be reproducing.

Optimizing postpartum care for the patient with gestational diabetes mellitus.

Science.gov (United States)

Martinez, Noelle G; Niznik, Charlotte M; Yee, Lynn M

2017-09-01

Gestational diabetes mellitus poses well-established risks to both the mother and infant. As >50% of women with gestational diabetes mellitus will develop type 2 diabetes mellitus in their lifetime, performing postpartum oral glucose tolerance testing is paramount to initiation of appropriate lifestyle interventions and pharmacologic therapy. Nonetheless, test completion among women with gestational diabetes mellitus is estimated to be diabetes mellitus. Based on existing evidence, we propose best practices for the postpartum care of women with gestational diabetes mellitus: (1) enhanced patient support for identifying long-term health care providers, (2) patient-centered medical home utilization when possible, (3) patient and provider test reminders, and (4) formalized obstetrician-primary care provider hand offs using the Situation Background Assessment Recommendation (SBAR) mnemonic. These strategies deserve future investigation to solidify a multilevel approach for identifying and preventing the continuum of diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

Technical note: Equivalent genomic models with a residual polygenic effect.

Science.gov (United States)

Liu, Z; Goddard, M E; Hayes, B J; Reinhardt, F; Reents, R

2016-03-01

Routine genomic evaluations in animal breeding are usually based on either a BLUP with genomic relationship matrix (GBLUP) or single nucleotide polymorphism (SNP) BLUP model. For a multi-step genomic evaluation, these 2 alternative genomic models were proven to give equivalent predictions for genomic reference animals. The model equivalence was verified also for young genotyped animals without phenotypes. Due to incomplete linkage disequilibrium of SNP markers to genes or causal mutations responsible for genetic inheritance of quantitative traits, SNP markers cannot explain all the genetic variance. A residual polygenic effect is normally fitted in the genomic model to account for the incomplete linkage disequilibrium. In this study, we start by showing the proof that the multi-step GBLUP and SNP BLUP models are equivalent for the reference animals, when they have a residual polygenic effect included. Second, the equivalence of both multi-step genomic models with a residual polygenic effect was also verified for young genotyped animals without phenotypes. Additionally, we derived formulas to convert genomic estimated breeding values of the GBLUP model to its components, direct genomic values and residual polygenic effect. Third, we made a proof that the equivalence of these 2 genomic models with a residual polygenic effect holds also for single-step genomic evaluation. Both the single-step GBLUP and SNP BLUP models lead to equal prediction for genotyped animals with phenotypes (e.g., reference animals), as well as for (young) genotyped animals without phenotypes. Finally, these 2 single-step genomic models with a residual polygenic effect were proven to be equivalent for estimation of SNP effects, too. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Labour induction with gestational hypertension: A great obstetric challenge.

Science.gov (United States)

Khaskheli, Meharun-Nissa; Baloch, Shahla; Sheeba, Aneela; Baloch, Sarmad; Khan, Fahad

2017-01-01

To observe the fetomaternal morbidity and mortality with induction of labour in pregnant women with gestational hypertension. The subjected study population included was 138 pregnant women with gestational hypertension. These pregnant women were between 34-40 weeks of gestational period in whom labour was induced, while the pregnant women who had labour induction for other reasons were excluded. These women were registered on the predesigned proforma. The data was collected and analyzed on SPSS version 21. Out of the 138 cases, mean age of the women was 25.93±5.037, prim gravid women were 78(56.5%), gestational period in majority of these women 71(51.4%) varied between 35-38 weeks. The common presenting symptoms were oedema 119(86.23%), headache 90(65.21%). Labour induction in majority of the cases 81(58.7%) was carried with prosten pessary. The Caesarean section was needed in 39(28.3%) women in emergency due to maternal and fetal reasons or due to failed induction. Maternal complications were uncontrolled hypertension 23(16.7%), intensive care unit admission 21(15.2%), fits 15(10.9%), post partum haemorrhage 13(9.4%). Fetal complications were birth asphyxia 49(35.5%), neonatal intensive care unit admission 17(12.3%), neonatal death 14(10.1%). The emergency Caesarean section rate was quite high with induction of labour in pregnant women with gestational diabetes. The maternal morbidity as well as fetal morbidity and mortality rate was also high.

The Estimation of Gestational Age at Birth in Database Studies.

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Eberg, Maria; Platt, Robert W; Filion, Kristian B

2017-11-01

Studies on the safety of prenatal medication use require valid estimation of the pregnancy duration. However, gestational age is often incompletely recorded in administrative and clinical databases. Our objective was to compare different approaches to estimating the pregnancy duration. Using data from the Clinical Practice Research Datalink and Hospital Episode Statistics, we examined the following four approaches to estimating missing gestational age: (1) generalized estimating equations for longitudinal data; (2) multiple imputation; (3) estimation based on fetal birth weight and sex; and (4) conventional approaches that assigned a fixed value (39 weeks for all or 39 weeks for full term and 35 weeks for preterm). The gestational age recorded in Hospital Episode Statistics was considered the gold standard. We conducted a simulation study comparing the described approaches in terms of estimated bias and mean square error. A total of 25,929 infants from 22,774 mothers were included in our "gold standard" cohort. The smallest average absolute bias was observed for the generalized estimating equation that included birth weight, while the largest absolute bias occurred when assigning 39-week gestation to all those with missing values. The smallest mean square errors were detected with generalized estimating equations while multiple imputation had the highest mean square errors. The use of generalized estimating equations resulted in the most accurate estimation of missing gestational age when birth weight information was available. In the absence of birth weight, assignment of fixed gestational age based on term/preterm status may be the optimal approach.

Prevalence of gestational diabetes mellitus in Europe: A meta-analysis.

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Eades, Claire E; Cameron, Dawn M; Evans, Josie M M

2017-07-01

Estimates of the prevalence of gestational diabetes vary widely. It is important to have a clear understanding of the prevalence of this condition to be able to plan interventions and health care provision. This paper describes a meta-analysis of primary research data reporting the prevalence of gestational diabetes mellitus in the general pregnant population of developed countries in Europe. Four electronic databases were systematically searched in May 2016. English language articles reporting gestational diabetes mellitus prevalence using universal screening in general pregnant population samples from developed countries in Europe were included. All papers identified by the search were screened by one author, and then half screened independently by a second author and half by a third author. Data were extracted by one author. Values for the measures of interest were combined using a random effects model and analysis of the effects of moderator variables was carried out. A total of 3258 abstracts were screened, with 40 studies included in the review. Overall prevalence of gestational diabetes mellitus was 5.4% (3.8-7.8). Maternal age, year of data collection, country, area of Europe, week of gestation at testing, and diagnostic criteria were found to have a significant univariate effect on GDM prevalence, and area, week of gestation at testing and year of data collection remained statistically significant in multivariate analysis. Quality category was significant in multivariate but not univariate analysis. This meta-analysis shows prevalence of GDM that is at the upper end of previous estimates in Europe. Copyright © 2017 Elsevier B.V. All rights reserved.

Pregnancy outcome following gestational exposure to azithromycin

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Woodland C Cindy

2006-05-01

Full Text Available Abstract Background Azithromycin is an azalide antibiotic with an extensive range of indications and has become a common treatment option due to its convenient dosing regimen and therapeutic advantages. Human studies addressing gestational use of azithromycin have primarily focused on antibiotic efficacy rather than fetal safety. Our primary objective was to evaluate the possibility of teratogenic risk following gestational exposure to azithromycin. Methods There were 3 groups of pregnant women enrolled in our study: 1 women who took azithromycin. 2 women exposed to non-teratogenic antibiotics for similar indications, and 3 women exposed to non-teratogenic agents. They were matched for gestational age at time of call, maternal age, cigarette and alcohol consumption. Rates of major malformations and other endpoints of interest were compared among the three groups. Results Pregnancy outcome of 123 women in each group was ascertained. There were no statistically significant differences among the three groups in the rates of major malformations; 3.4% (exposed versus 2.3% (disease matched and 3.4% (non teratogen or any other endpoints that were examined. In the azithromycin group, 88 (71.6% women took the drug during the first trimester Conclusion Results suggest that gestational exposure to azithromycin is not associated with an increase in the rate of major malformations above the baseline of 1–3%. Our data adds to previous research showing that macrolide antibiotics, as a group, are generally safe in pregnancy and provides an evidence-based option for health professionals caring for populations with chlamydia.

Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis.

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Gong, Li-Li; Liu, He; Liu, Li-Hong

2016-04-01

Hypothyroidism disorders and gestational diabetes are among the most common endocrinopathies during pregnancy. We conducted a meta-analysis to investigate whether hypothyroidism in pregnancy is associated with gestational diabetes risk. Published literature from PubMed and EMBASE were searched for eligible publications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a fixed- or random-effects model. Seven articles described the relationship between hypothyroidism and risk of gestational diabetes. This meta-analysis revealed that overt hypothyroidism was associated with an increased risk of gestational diabetes (OR 1.892, 95% CI 1.679-2.132, p hypothyroidism, with the OR of 1.558 (95% CI 1.292-1.877, p hypothyroidism was 1.749 (95% CI 1.586-1.928, p hypothyroidism may be a risk factor for gestational diabetes. Copyright © 2016. Published by Elsevier B.V.

Large for Gestational Age (LGA)

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... mother Other risk factors for having large-for-gestational-age newborns include Maternal obesity Having had previous LGA babies Genetic abnormalities or syndromes (for example, Beckwith-Wiedemann syndrome or Sotos syndrome) Excessive weight gain during pregnancy (the fetus gets more calories as ...

Correspondences. Equivalence relations

International Nuclear Information System (INIS)

Bouligand, G.M.

1978-03-01

We comment on sections paragraph 3 'Correspondences' and paragraph 6 'Equivalence Relations' in chapter II of 'Elements de mathematique' by N. Bourbaki in order to simplify their comprehension. Paragraph 3 exposes the ideas of a graph, correspondence and map or of function, and their composition laws. We draw attention to the following points: 1) Adopting the convention of writting from left to right, the composition law for two correspondences (A,F,B), (U,G,V) of graphs F, G is written in full generality (A,F,B)o(U,G,V) = (A,FoG,V). It is not therefore assumed that the co-domain B of the first correspondence is identical to the domain U of the second (EII.13 D.7), (1970). 2) The axiom of choice consists of creating the Hilbert terms from the only relations admitting a graph. 3) The statement of the existence theorem of a function h such that f = goh, where f and g are two given maps having the same domain (of definition), is completed if h is more precisely an injection. Paragraph 6 considers the generalisation of equality: First, by 'the equivalence relation associated with a map f of a set E identical to (x is a member of the set E and y is a member of the set E and x:f = y:f). Consequently, every relation R(x,y) which is equivalent to this is an equivalence relation in E (symmetrical, transitive, reflexive); then R admits a graph included in E x E, etc. Secondly, by means of the Hilbert term of a relation R submitted to the equivalence. In this last case, if R(x,y) is separately collectivizing in x and y, theta(x) is not the class of objects equivalent to x for R (EII.47.9), (1970). The interest of bringing together these two subjects, apart from this logical order, resides also in the fact that the theorem mentioned in 3) can be expressed by means of the equivalence relations associated with the functions f and g. The solutions of the examples proposed reveal their simplicity [fr

Association between placentome size, measured using transrectal ultrasonography, and gestational age in cattle.

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Adeyinka, F D; Laven, R A; Lawrence, K E; van Den Bosch, M; Blankenvoorde, G; Parkinson, T J

2014-03-01

The aim of this study was to estimate whether fetal age could be accurately estimated using placentome size. Fifty-eight cows with confirmed conception dates in two herds were used for the study. The length of the long axis and cross-sectional area of placentomes close to the cervix were measured once every 10 days between approximately 60-130 days of gestation and once every 15 days between 130-160 days of gestation. Four to six placentomes were measured using transrectal ultrasonography in each uterine horn. A linear mixed model was used to establish the factors that were significantly associated with log mean placentome length and to create an equation to predict gestational age from mean placentome length. Limits of agreement analysis was then used to evaluate whether the predictions were sufficiently accurate for mean placentome length to be used, in practice, as a method of determining gestational age. Only age of gestation (puterine horn (p=0.048) were found to have a significant effect on log mean placentome length. From the three models used to predict gestational age the one that used log mean placentome length of all placentomes, adjusting for the effect of horn, had the smallest 95% limits of agreement; ±33 days. That is, predicted gestational age had a 95% chance of being between 33 days greater and 33.7 days less than actual age. This is approximately twice that reported in studies using measurement of fetal size. Measurement of placentomes near to the cervix using transrectal ultrasonography was easily achieved. There was a significant association between placentome size and gestational age, but between-cow variation in placentome size and growth resulted in poor agreement between placentome size and gestational age. Although placentomes can be easily visualised during diagnosis of pregnancy using transrectal ultrasonography, mean placentome size should not be used to estimate gestational age.

Placental transfer of 60Co as a function of gestation age

International Nuclear Information System (INIS)

Zylicz, E.; Zablotna, R.; Szot, Z.

1976-01-01

The transfer of 60 Co from mother to foetus in relation to the time of gestation was examined 24 hrs after injecting 5 μCi of 60 CoCl 2 to the pregnant rat on 15th - 21st day of gestation. The radioactivity of foetuses, placentae as well as liver, kidney and femur of mother was determined. It was found that activity of 60 Co transferred to the foetus body increased with the time of gestation. (author)

Amino acid profiling in the gestational diabetes mellitus

OpenAIRE

Rahimi, Najmeh; Razi, Farideh; Nasli-Esfahani, Ensieh; Qorbani, Mostafa; Shirzad, Nooshin; Larijani, Bagher

2017-01-01

Background The prevalence of gestational diabetes mellitus (GDM) is increasing globally which is associated with various side effects for mothers and fetus. It seems that metabolomic profiling of the amino acids may be useful in early diagnosis of metabolic diseases. This study aimed to explore the association of the amino acids profiles with GDM. Methods Eighty three pregnant women with gestational age ?25?weeks were randomly selected among pregnant women referred to prenatal care clinic in ...

Depression during gestation in adolescent mothers interferes with neonatal neurobehavior

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Marina Carvalho de Moraes Barros

2013-12-01

Full Text Available Objective: To compare the neurobehavior of neonates born to adolescent mothers with and without depression during gestation. Methods: This prospective cross-sectional study included healthy term neonates born to adolescent mothers with untreated depression during gestation, without exposure to legal or illicit drugs, and compared them with infants born to adolescent mothers without psychiatric disorders. Maternal psychiatric diagnoses were assessed by the Composite International Diagnostic Interview (CIDI 2.1 and neonatal neurobehavior by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS at 24 to 72 hours of life. Neurobehavioral outcomes were analyzed by ANOVA adjusted for confounders. Results: 37 infants born to mothers with depression during gestation were compared to 332 infants born to mothers without psychiatric disorders. Infants of mothers with depression had smaller head circumferences. Significant interactions of maternal depression and male gender, gestational age > 40 weeks, regional anesthesia during delivery, vaginal delivery, and infant head circumference ≥ 34 cm were found. Worse performance was noted in the following neonatal neurobehavioral parameters: arousal, excitability, lethargy, hypotonicity, and signs of stress and abstinence. Conclusion: Infants born to adolescent mothers with depression exhibit some behavioral changes in the first days of life. These changes are associated with infant sex, gestational age, type of anesthesia, mode of delivery, and head circumference.

Gestational Protein Restriction Impairs Insulin-Regulated Glucose Transport Mechanisms in Gastrocnemius Muscles of Adult Male Offspring

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Blesson, Chellakkan S.; Sathishkumar, Kunju; Chinnathambi, Vijayakumar

2014-01-01

Type II diabetes originates from various genetic and environmental factors. Recent studies showed that an adverse uterine environment such as that caused by a gestational low-protein (LP) diet can cause insulin resistance in adult offspring. The mechanism of insulin resistance induced by gestational protein restriction is not clearly understood. Our aim was to investigate the role of insulin signaling molecules in gastrocnemius muscles of gestational LP diet–exposed male offspring to understand their role in LP-induced insulin resistance. Pregnant Wistar rats were fed a control (20% protein) or isocaloric LP (6%) diet from gestational day 4 until delivery and a normal diet after weaning. Only male offspring were used in this study. Glucose and insulin responses were assessed after a glucose tolerance test. mRNA and protein levels of molecules involved in insulin signaling were assessed at 4 months in gastrocnemius muscles. Muscles were incubated ex vivo with insulin to evaluate insulin-induced phosphorylation of insulin receptor (IR), Insulin receptor substrate-1, Akt, and AS160. LP diet-fed rats gained less weight than controls during pregnancy. Male pups from LP diet–fed mothers were smaller but exhibited catch-up growth. Plasma glucose and insulin levels were elevated in LP offspring when subjected to a glucose tolerance test; however, fasting levels were comparable. LP offspring showed increased expression of IR and AS160 in gastrocnemius muscles. Ex vivo treatment of muscles with insulin showed increased phosphorylation of IR (Tyr972) in controls, but LP rats showed higher basal phosphorylation. Phosphorylation of Insulin receptor substrate-1 (Tyr608, Tyr895, Ser307, and Ser318) and AS160 (Thr642) were defective in LP offspring. Further, glucose transporter type 4 translocation in LP offspring was also impaired. A gestational LP diet leads to insulin resistance in adult offspring by a mechanism involving inefficient insulin-induced IR, Insulin receptor

Cost-effectiveness of an exercise program during pregnancy to prevent gestational diabetes: Results of an economic evaluation alongside a randomised controlled trial

NARCIS (Netherlands)

Oostdam, E.W.M.; Bosmans, J.E.; Wouters, M.G.A.J.; Eekhoff, E.M.W.; van Mechelen, W.; van Poppel, M.N.M.

2012-01-01

Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM and the risks associated with GDM lead to increased health care costs and losses in productivity. The objective of this study is to evaluate whether the FitFor2 exercise program during pregnancy is

Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort

DEFF Research Database (Denmark)

Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta

2017-01-01

evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. RESULTS: The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792...

Dose equivalent distribution during occupational exposure in oncology

International Nuclear Information System (INIS)

Marco H, J.

1996-01-01

In this work are presented the results of the radiological surveillance of occupationally exposed workers at the National Institute of Oncology and Radiology during 26 years. The incidence of the equivalent dose in the personal working with radiant sources and radioactive substances in areas of x rays diagnostic, teletherapy, brachytherapy, nuclear medicine and biomedical research was showed. The employed dosimetric system makes use of ORWO RD3/RD4 monitoring film with copper and lead filters inside a plastic cassette manufactured in Cuba. The experimental method is supported by the optical densitometric analysis of films together with a set of standard film calibrated in standard X and gamma photon beams by means of a secondary standard dosimeter, type NPL. Statistics show that except those workings with radium-226, manual brachytherapy or Mo-99/Tc-99 generator elution, the equivalent dose distribution in our workers has been kept in regions well down the annual permissible limit. (authors). 6 refs., 3 tabs

Calculation methods for determining dose equivalent

International Nuclear Information System (INIS)

Endres, G.W.R.; Tanner, J.E.; Scherpelz, R.I.; Hadlock, D.E.

1987-11-01

A series of calculations of neutron fluence as a function of energy in an anthropomorphic phantom was performed to develop a system for determining effective dose equivalent for external radiation sources. Critical organ dose equivalents are calculated and effective dose equivalents are determined using ICRP-26 [1] methods. Quality factors based on both present definitions and ICRP-40 definitions are used in the analysis. The results of these calculations are presented and discussed. The effective dose equivalent determined using ICRP-26 methods is significantly smaller than the dose equivalent determined by traditional methods. No existing personnel dosimeter or health physics instrument can determine effective dose equivalent. At the present time, the conversion of dosimeter response to dose equivalent is based on calculations for maximal or ''cap'' values using homogeneous spherical or cylindrical phantoms. The evaluated dose equivalent is, therefore, a poor approximation of the effective dose equivalent as defined by ICRP Publication 26. 3 refs., 2 figs., 1 tab

Declines in Birth weight and Fetal Growth Independent of Gestational Length

Science.gov (United States)

Morisaki, Naho; Esplin, M. Sean; Varner, Michael W.; Henry, Erick; Oken, Emily

2014-01-01

Objective Birth weight is decreasing in the US and elsewhere, even among term singletons, although trends in most maternal characteristics should contribute to increased birth weight. Some studies have attributed this decline to the simultaneous decrease in gestational length. Methods Using data from Intermountain Healthcare, where a successful initiative reduced the number of early term (37–38 week) elective deliveries, we examined trends in birth weight, small-for-gestational-age (SGA), and large-for-gestational-age (LGA) among 219,694 singleton infants born July 2000 to December 2008 at 37–41 weeks gestation. Results Over the 8.5 years, births through scheduled deliveries at 37–38 weeks decreased (9.4% to 4.4%), but overall scheduled deliveries increased (29% to 34%) and mean gestational age at birth (39.1 weeks) did not change. Mean birth weight (3410g to 3383g) and LGA (9.0% to 7.4%) both decreased, whereas SGA increased (7.5% to 8.2%). In multivariable analyses adjusting for maternal and infant characteristics, birth weight decreased (36g; 95% CI: 31, 42), especially among infants born at 37–38 weeks (40g; 30, 49) or that had medical indications for urgent deliveries (48g; 34, 63). Odds of LGA decreased (0.84; 0.80, 0.88) and odds of SGA increased (1.14; 1.08, 1.20). Conclusion Even in a population where gestation length did not change, birth weight and fetal growth declined. Decrease in not only gestational length but in fetal growth as well is likely to be contributing to the widely observed recent decrease in birth weight. PMID:23262927

Self-management of gestational diabetes among Chinese migrants: A qualitative study.

Science.gov (United States)

Wah, Yat Yin Eric; McGill, Margaret; Wong, Jencia; Ross, Glynis P; Harding, Anna-Jane; Krass, Ines

2018-04-21

Gestational diabetes mellitus is one of the most common complications of pregnancy. Women with Gestational diabetes are at increased risk of serious health outcomes, such as pre-eclampsia, obstructed labor, and the development of Type 2 diabetes later in life. Chinese migrants, the third largest cultural group in Australia, are more likely to develop Gestational diabetes than Australian-born women. However, to date, Gestational diabetes self-management has not been investigated in this population. To explore the understanding and self-management experiences of Gestational diabetes among Chinese migrants. Data were collected through individual semi-structured face-to-face interviews. Participants were recruited from the antenatal clinic at the Royal Prince Alfred Hospital. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. Although the majority of participants demonstrated a good understanding of Gestational diabetes, some did not understand the principles behind healthcare advice and faced challenges in self-management. Confusion about self-monitoring of blood glucose and fear of insulin were also evident. Participants relied on both formal and informal sources of information. Some had difficulty obtaining adequate support. Cultural influences on self-management included meeting family needs, Chinese diet and use of Chinese medicines. To assist Chinese women with Gestational diabetes to better self-manage their condition, there is a need for clinicians to: (1) provide more effective diabetes education to ensure clear understanding of self-management principles; (2) actively elicit and respond to women's confusion and concerns; (3) provide women with adequate practical support; and (4) develop greater cultural awareness. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Gestational diabetes mellitus in Greenland

DEFF Research Database (Denmark)

Pedersen, Michael Lynge; Olesen, Jesper; Jørgensen, M. E.

2016-01-01

Background. Within the last 20 years, the prevalence of gestational diabetes mellitus (GDM) has been reported to be increasing worldwide in correlation with ethnic and geographic variations. The actual prevalence of GDM throughout all of Greenland remains unknown. Objective. The aim of this study...

Effective dose equivalent

International Nuclear Information System (INIS)

Huyskens, C.J.; Passchier, W.F.

1988-01-01

The effective dose equivalent is a quantity which is used in the daily practice of radiation protection as well as in the radiation hygienic rules as measure for the health risks. In this contribution it is worked out upon which assumptions this quantity is based and in which cases the effective dose equivalent can be used more or less well. (H.W.)

Acculturation and gestational weight gain in a predominantly puerto rican population

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Tovar Alison

2012-11-01

Full Text Available Abstract Background Identifying risk factors that affect excess weight gain during pregnancy is critical, especially among women who are at a higher risk for obesity. The goal of this study was to determine if acculturation, a possible risk factor, was associated with gestational weight gain in a predominantly Puerto Rican population. Methods We utilized data from Proyecto Buena Salud, a prospective cohort study of Hispanic women in Western Massachusetts, United States. Height, weight and gestational age were abstracted from medical records among participants with full-term pregnancies (n=952. Gestational weight gain was calculated as the difference between delivery and prepregnancy weight. Acculturation (measured via a psychological acculturation scale, generation in the US, place of birth and spoken language preference was assessed in early pregnancy. Results Adjusting for age, parity, perceived stress, gestational age, and prepregnancy weight, women who had at least one parent born in Puerto Rico/Dominican Republic (PR/DR and both grandparents born in PR/DR had a significantly higher mean total gestational weight gain (0.9 kg for at least one parent born in PR/DR and 2.2kg for grandparents born in PR/DR and rate of weight gain (0.03 kg/wk for at least one parent born in PR/DR and 0.06 kg/wk for grandparents born in PR/DR vs. women who were of PR/DR born. Similarly, women born in the US had significantly higher mean total gestational weight gain (1.0 kg and rate of weight gain (0.03 kg/wk vs. women who were PR/ DR born. Spoken language preference and psychological acculturation were not significantly associated with total or rate of pregnancy weight gain. Conclusion We found that psychological acculturation was not associated with gestational weight gain while place of birth and higher generation in the US were significantly associated with higher gestational weight gain. We interpret these findings to suggest the potential importance of the

Acculturation and gestational weight gain in a predominantly Puerto Rican population.

Science.gov (United States)

Tovar, Alison; Chasan-Taber, Lisa; Bermudez, Odilia I; Hyatt, Raymond R; Must, Aviva

2012-11-21

Identifying risk factors that affect excess weight gain during pregnancy is critical, especially among women who are at a higher risk for obesity. The goal of this study was to determine if acculturation, a possible risk factor, was associated with gestational weight gain in a predominantly Puerto Rican population. We utilized data from Proyecto Buena Salud, a prospective cohort study of Hispanic women in Western Massachusetts, United States. Height, weight and gestational age were abstracted from medical records among participants with full-term pregnancies (n=952). Gestational weight gain was calculated as the difference between delivery and prepregnancy weight. Acculturation (measured via a psychological acculturation scale, generation in the US, place of birth and spoken language preference) was assessed in early pregnancy. Adjusting for age, parity, perceived stress, gestational age, and prepregnancy weight, women who had at least one parent born in Puerto Rico/Dominican Republic (PR/DR) and both grandparents born in PR/DR had a significantly higher mean total gestational weight gain (0.9 kg for at least one parent born in PR/DR and 2.2 kg for grandparents born in PR/DR) and rate of weight gain (0.03 kg/wk for at least one parent born in PR/DR and 0.06 kg/wk for grandparents born in PR/DR) vs. women who were of PR/DR born. Similarly, women born in the US had significantly higher mean total gestational weight gain (1.0 kg) and rate of weight gain (0.03 kg/wk) vs. women who were PR/ DR born. Spoken language preference and psychological acculturation were not significantly associated with total or rate of pregnancy weight gain. We found that psychological acculturation was not associated with gestational weight gain while place of birth and higher generation in the US were significantly associated with higher gestational weight gain. We interpret these findings to suggest the potential importance of the US "obesogenic" environment in influencing unhealthy

High dietary fiber during late gestation reduces the rate of stillborn piglets

DEFF Research Database (Denmark)

Feyera, Takele; Højgaard, Camilla Kaae; Vinther, Jens

2017-01-01

The beneficial effects of dietary fiber in the diet of gestating sows have been thoroughly investigated from behavioral and welfare prospective. However, there is limited information whether dietary fiber is beneficial from a reproductive point of view. Therefore, the present study aimed to inves......The beneficial effects of dietary fiber in the diet of gestating sows have been thoroughly investigated from behavioral and welfare prospective. However, there is limited information whether dietary fiber is beneficial from a reproductive point of view. Therefore, the present study aimed...... assigned to the control and treatment group, respectively. Sows in the control group were fed according to normal feeding strategy of the herd, fed a standard gestation diet until 1 week before expected parturition, fed a transition diet until day 5 of lactation and a standard lactation diet until weaning....... Sows in the treatment group were fed as the control group but part of the gestation diet (from day 102 to 108 of gestation) and part of the transition diet (from day 109 of gestation until farrowing) was replaced by a fiber rich supplement. Thus, 350 and 700 g/d of the supplement replaced part...

Efficacy of probiotic supplement for gestational diabetes mellitus: a systematic review and meta-analysis.

Science.gov (United States)

Pan, Jiajia; Pan, Qiangwei; Chen, Yumei; Zhang, Hongping; Zheng, Xiaodong

2017-09-19

Probiotic supplement might be beneficial for gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of probiotic supplement in gestational diabetes mellitus. PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of probiotic supplement in gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome were fasting serum insulin and fasting plasma glucose. Meta-analysis was performed using the fixed-effect or random-effect model. Six RCTs involving 830 patients were included in the meta-analysis. Overall, compared with control intervention in gestational diabetes mellitus, probiotic supplementation intervention was found to significantly reduce fasting serum insulin (Std. mean difference = -0.95; 95% CI = -1.73 to -0.17; p gestational age (Std. mean difference = 0.07; 95% CI = -0.20-0.34; p = .63), and gestational weight (Std. mean difference = -0.11; 95% CI = -0.38-0.16; p = .43). Compared with control intervention in gestational diabetes mellitus, probiotic supplementation was found to significantly reduce insulin resistance (HOMA-IR) and fasting serum insulin, but had no substantial influence on fasting plasma glucose, gestational age and gestational weight.

Gestational Age at First Antenatal Care Visit in Malawi.

Science.gov (United States)

Mkandawire, Paul

2015-11-01

This paper examines the gestational age at first antenatal care (ANC) visit and factors associated with timely initiation of ANC in Malawi in a context where maternal and child health services are generally provided for free. Lognormal survival models are applied to Demographic and Health Survey data from a nationally representative sample of women (n = 13,588) of child-bearing age. The findings of this study show that less than 30 % of pregnant women initiate ANC within the World Health Organization recommended gestational timeframe of 16 weeks or earlier. The hazard analysis shows a gradient in the initiation of ANC by maternal education level, with least educated mothers most likely to delay their first ANC visit. However, after adjusting for variables capturing intimate partner violence in the multivariate models, the effect of maternal education attenuated and lost statistical significance. Other significant predictors of gestational age at first ANC include media exposure, perceived distance from health facility, age, and birth order. The findings of the study link domestic violence directly with the gestational age at which mothers initiate ANC, suggesting that gender-based violence may operate through delayed initiation of ANC to undermine maternal and child health outcomes.

Association between maternal nutritional status of pre pregnancy, gestational weight gain and preterm birth.

Science.gov (United States)

Xinxo, Sonela; Bimbashi, Astrit; Z Kakarriqi, Eduard; Zaimi, Edmond

2013-01-01

Maternal nutritional status of pre pregnancy and gestational weight gain affects the preterm birth. The association between maternal nutritional status of pre pregnancy and preterm birth appears to be complex and varied by studies from different countries, thus this association between the gestational weight gain and preterm birth is more consolidated. The study aims to determine any association between the pre pregnancy maternal nutritional status, gestational weight gain and the preterm birth rate in the Albanian context. In case control study, we analyzed women who have delivered in obstetric institutions in Tirana during the year 2012. Body mass index and gestational weight gain of 150 women who had a preterm delivery were compared with those of 150 matched control women who had a normal delivery regarding the gestation age. The self-reported pre pregnancy weight, height, gestational weight gain, age, education and parity are collected through a structured questioner. The body mass index and gestational weight gain are categorized based on the Institute of Medicine recommendation. The multiple logistic regression is used to measure the association between the nutritional status of pre pregnancy and gestational weight gain and the preterm birth rate. The women which have a underweight status or obese of pre pregnancy are more likely to have a preterm birth compared to the women of a normal pre-pregnancy nutritional status (respectively OR =2.7 and 4.3 pnutritional status and gestational weight gain affects the risk for preterm birth. Pre-pregnancy and gestation nutritional assessments should be part of routine prenatal visits.

Changing Survival Rate of Infants Born Before 26 Gestational Weeks

Science.gov (United States)

Rahman, Asad; Abdellatif, Mohamed; Sharef, Sharef W.; Fazalullah, Muhammad; Al-Senaidi, Khalfan; Khan, Ashfaq A.; Ahmad, Masood; Kripail, Mathew; Abuanza, Mazen; Bataclan, Flordeliza

2015-01-01

Objectives: This study aimed to evaluate the changing survival rate and morbidities among infants born before 26 gestational weeks at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective study assessed the mortality and morbidities of all premature infants born alive at 23–26 gestational weeks at SQUH between June 2006 and May 2013. Infants referred to SQUH within 72 hours of birth during this period were also included. Electronic records were reviewed for gestational age, gender, birth weight, maternal age, mode and place of delivery, antenatal steroid administration, morbidity and outcome. The survival rate was calculated and findings were then compared with those of a previous study conducted in the same hospital from 1991 to 1998. Rates of major morbidities were also calculated. Results: A total of 81 infants between 23–26 gestational weeks were admitted to the neonatal unit during the study period. Of these, 58.0% were male and 42.0% were female. Median gestational age was 25 weeks and mean birth weight was 770 ± 150 g. Of the 81 infants, 49 survived. The overall survival rate was 60.5% compared to 41% reported in the previous study. Respiratory distress syndrome (100.0%), retinopathy of prematurity (51.9%), bronchopulmonary dysplasia (34.6%), intraventricular haemorrhage (30.9%) and patent ductus arteriosus (28.4%) were the most common morbidities. Conclusion: The overall survival rate of infants between 23–26 gestational weeks during the study period had significantly improved in comparison to that found at the same hospital from 1991 to 1998. There is a need for the long-term neurodevelopmental follow-up of premature infants. PMID:26357555

Equivalence relations of AF-algebra extensions

Indian Academy of Sciences (India)

In this paper, we consider equivalence relations of *-algebra extensions and describe the relationship between the isomorphism equivalence and the unitary equivalence. We also show that a certain group homomorphism is the obstruction for these equivalence relations to be the same.

Equivalent physical models and formulation of equivalent source layer in high-resolution EEG imaging

International Nuclear Information System (INIS)

Yao Dezhong; He Bin

2003-01-01

In high-resolution EEG imaging, both equivalent dipole layer (EDL) and equivalent charge layer (ECL) assumed to be located just above the cortical surface have been proposed as high-resolution imaging modalities or as intermediate steps to estimate the epicortical potential. Presented here are the equivalent physical models of these two equivalent source layers (ESL) which show that the strength of EDL is proportional to the surface potential of the layer when the outside of the layer is filled with an insulator, and that the strength of ECL is the normal current of the layer when the outside is filled with a perfect conductor. Based on these equivalent physical models, closed solutions of ECL and EDL corresponding to a dipole enclosed by a spherical layer are given. These results provide the theoretical basis of ESL applications in high-resolution EEG mapping

Equivalent physical models and formulation of equivalent source layer in high-resolution EEG imaging

Energy Technology Data Exchange (ETDEWEB)

Yao Dezhong [School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu City, 610054, Sichuan Province (China); He Bin [The University of Illinois at Chicago, IL (United States)

2003-11-07

In high-resolution EEG imaging, both equivalent dipole layer (EDL) and equivalent charge layer (ECL) assumed to be located just above the cortical surface have been proposed as high-resolution imaging modalities or as intermediate steps to estimate the epicortical potential. Presented here are the equivalent physical models of these two equivalent source layers (ESL) which show that the strength of EDL is proportional to the surface potential of the layer when the outside of the layer is filled with an insulator, and that the strength of ECL is the normal current of the layer when the outside is filled with a perfect conductor. Based on these equivalent physical models, closed solutions of ECL and EDL corresponding to a dipole enclosed by a spherical layer are given. These results provide the theoretical basis of ESL applications in high-resolution EEG mapping.

Birth weight centiles by gestational age for twins born in south India.

Science.gov (United States)

Premkumar, Prasanna; Antonisamy, Belavendra; Mathews, Jiji; Benjamin, Santhosh; Regi, Annie; Jose, Ruby; Kuruvilla, Anil; Mathai, Mathews

2016-03-24

Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India. The study was conducted at the Christian Medical College, Vellore, south India. The birth records of all consecutive pregnancies resulting in twin births between 1991 and 2005 were reviewed. Only live twin births between 24 and 42 weeks of gestation were included. Birth weight centiles for gestational age were obtained using the methodology of generalized additive models for location, scale and shape (GAMLSS). Centiles curves were obtained separately for monochorionic and dichorionic twins. Of 1530 twin pregnancies delivered during the study period (1991-2005), 1304 were included in the analysis. The median gestational age at birth was 36 weeks (1st quartile 34, 3rd quartile 38 weeks). Smoothed percentile curves for birth weight by gestational age increased progressively till 38 weeks and levels off thereafter. Compared with dichorionic twins, monochorionic twins had lower birth weight for gestational age from after 27 weeks. We provide centile values of birth weight at 24 to 42 completed weeks of gestation for twins born in south India. These charts could be used both in routine clinical assessments and epidemiological studies.

Serum YKL-40 and gestational diabetes - an observational cohort study

DEFF Research Database (Denmark)

Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J

2016-01-01

To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical...... records. Sixty-eight women (5.8%) developed GDM. Serum YKL-40 increased from gestational age (GA) 12 weeks and the following weeks in the women who developed GDM and was independent of BMI, parity, and maternal age (OR = 2.69, 95% CI: 1.45-5.00, p = 0.002). No association was found between serum YKL-40...

Predictive factors for birth weight of newborns of mothers with gestational diabetes mellitus.

Science.gov (United States)

Silva, Sara de Oliveira Corrêa da; Saunders, Cláudia; Zajdenverg, Lenita; Moreira, Luciana Novaes; Heidelmann, Sonaly Petronilho; Pereira, Ariane Cristine Dos Santos; Padilha, Patricia de Carvalho

2018-04-01

To evaluate the predictive factors of birth weight (BW) of newborns of women with gestational diabetes mellitus (GDM). A cross-sectional study was performed among pregnant women with GDM treated in a public maternity unit, Brazil. We selected 283 pregnant women, with nutritional follow-up initiated till the 28th gestational week, singleton pregnancy, without chronic diseases and with birth weight information of the newborns. The predictive factors of BW were identified by multivariate linear regression. Mean maternal age was 31.2 ± 5.8 years; 64.4% were non-white; 70.1% were pre-gestational overweight or obese. Mean BW was 3234.3 ± 478.8 g. An increase of 1 kg of weight in the first and third trimesters increased BW by 21 g (p = 0.01) and 27 g (p = 0.03), respectively. Similarly, the other predictive factors of BW were pre-gestational body mass index (β = 17.16, p = 0.02) and postprandial plasma glucose in the third trimester (β = 4.14, p = 0.008), in the model adjusted by gestational age at delivery (β = 194.68, p gestational age at birth, and maternal pre-gestational and gestational anthropometric characteristics. Maternal glycaemic levels may also influence BW. The results may contribute to a review of prenatal routines for pregnant women with GDM. Copyright © 2018 Elsevier B.V. All rights reserved.

Transnational gestational surrogacy: does it have to be exploitative?

Science.gov (United States)

Kirby, Jeffrey

2014-01-01

This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings (such as rural, western India), is exploitative of surrogate women. Arising out of consideration of the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative.

Serum adiponectin levels in gestational diabetes mellitus

Directory of Open Access Journals (Sweden)

Abhijit Bhograj

2016-01-01

Full Text Available Introduction: Gestational diabetes mellitus (GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.[1] Pregnancy is a unique situation in which there is a physiological temporary increase in insulin resistance (IR. The mechanisms responsible for the gestational-induced IR are not completely understood. The current study was undertaken to compare adiponectin levels during 24–28 weeks period of gestation in drug-naive newly diagnosed GDM women with a cohort of normoglycemic pregnant women. Subjects and Methods: A total of 47 pregnant women in the age group of 18–40 years were included in this cross-sectional study, of which 13 were GDM cases and 34 were normoglycemic controls. Serum adiponectin level was analyzed by enzyme-linked immunosorbent assay. Results: The mean adiponectin level was 16.92 ng/ml (standard deviation [SD] = 2.78 and 19.38 ng/ml (SD = 2.71 in case and control groups, respectively, and the difference was found to be statistically significant (P = 0.008. Conclusion: Our study demonstrated decreased serum adiponectin levels in women with GDM when compared with age- and body mass index-matched euglycemic pregnant women.

Testing statistical hypotheses of equivalence

CERN Document Server

Wellek, Stefan

2010-01-01

Equivalence testing has grown significantly in importance over the last two decades, especially as its relevance to a variety of applications has become understood. Yet published work on the general methodology remains scattered in specialists' journals, and for the most part, it focuses on the relatively narrow topic of bioequivalence assessment.With a far broader perspective, Testing Statistical Hypotheses of Equivalence provides the first comprehensive treatment of statistical equivalence testing. The author addresses a spectrum of specific, two-sided equivalence testing problems, from the

Birth Weight, Gestational Age, and Infantile Colic

DEFF Research Database (Denmark)

Milidou, Ioanna; Søndregaard, Charlotte; Jensen, Morten Søndergaard

Background Infantile colic is a condition of unknown origin characterized by paroxysms of crying during the first months of life. A few studies have identified low birth weight (BW) as a risk factor among infants born at term, while the association between gestational age (GA) and infantile colic...... interviews of the mother during pregnancy and post partum. Adjusted odds ratios (OR) with 95% confidence intervals (in brackets) are presented. Infantile colic was defined as crying for more than three hours per day and for more than three days per week (modified Wessel’s criteria). Results A total of 4...... with GA gestational weeks 32-40. Finally, after adjusting for GA...

Analysis of national representative opinion surveys concerning gestational surrogacy in Japan.

Science.gov (United States)

Suzuki, Kohta; Hoshi, Kazuhiko; Minai, Junko; Yanaihara, Takumi; Takeda, Yasuhisa; Yamagata, Zentaro

2006-05-01

Although gestational surrogacy offers several advantages, this procedure has given rise to some ethical and legal issues. We aimed to clarify the factors affecting the attitude of the Japanese toward gestational surrogacy. Cross-sectional study. Nationwide opinion surveys concerning assisted reproductive technologies (ART) were carried out in 1999 and 2003. Participants included 2568 and 3647 people from the general public surveyed in 1999 and 2003, respectively (1564 people received only the questionnaire, and 2083 people received a questionnaire and brochure about ART). Multivariate-adjusted odds ratio and 95% confidence interval from logistic regression models for factors affecting the attitude toward gestational surrogacy. In both surveys, approximately half of respondents approved of gestational surrogacy; 20-30% disapproved of the procedure. People with high socioeconomic status clearly expressed their opinion on this issue. A liberal attitude toward gender role promoted approval of gestational surrogacy; a liberal attitude toward family had the opposite effect. Our findings suggest that socioeconomic status affects people's expression of their opinion regarding this issue, while attitudes toward this procedure were influenced by individual belief. Considering socioeconomic status and diversity of individual belief is required for further discussion on this topic.

Hidden from view: Canadian gestational surrogacy practices and outcomes, 2001-2012.

Science.gov (United States)

White, Pamela M

2016-05-01

This paper raises some troubling questions about the fertility treatments provided to Canadian gestational surrogates, women not genetically related to the child that they carry. Using information published between 2003 and 2012 by Canada's Assisted Reproduction Registry, the paper traces the growing incidence of births to gestational surrogates. The transfer of more than one embryo increases the chance of pregnancy and the incidence of multiple births, and while the incidence of multiple births has declined overall since 2010, gestational surrogates consistently experience a higher proportion of multiple births and experienced higher levels of multiple embryo transfers. In 2012, just 26% of gestational surrogates received a single embryo transfer compared to 47% of other in vitro fertilisation (IVF) patients. The paper suggests that renewed attention needs to be paid to the counselling provided to gestational surrogates and treatment consenting mechanisms used by IVF clinics and that review of the 2007 Canadian Medical Association surrogate treatment guidelines is warranted. Finally, the paper describes the difficulties in obtaining accurate data about Canadian assisted reproductive medicine. Without good data, it becomes far more difficult to identify the possibility of potentially harmful practices. Copyright © 2016 Elsevier Inc. All rights reserved.

21 CFR 26.9 - Equivalence determination.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Equivalence determination. 26.9 Section 26.9 Food... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.9 Equivalence determination... document insufficient evidence of equivalence, lack of opportunity to assess equivalence or a determination...

Inflammatory markers in umbilical cord blood from small-for-gestational-age newborns

DEFF Research Database (Denmark)

Lausten-Thomsen, Ulrik; Olsen, Marianne; Greisen, Gorm

2014-01-01

This study investigates the role of inflammation in intrauterine growth retardation by exploring the levels of inflammatory markers in umbilical cord blood from neonates who were born small-for-gestational-age (SGA) and comparing them to neonates who were born appropriate-for-gestational-age (AGA...... of elevated inflammatory markers in the cord blood from SGA infants compared to AGA infants, and consequently the results suggest an inflammatory component in intrauterine growth restriction (IUGR).......This study investigates the role of inflammation in intrauterine growth retardation by exploring the levels of inflammatory markers in umbilical cord blood from neonates who were born small-for-gestational-age (SGA) and comparing them to neonates who were born appropriate-for-gestational-age (AGA...

[Multiple gestation epidemiology--15 years survey].

Science.gov (United States)

Rodrigues, Carla T; Branco, Miguel R; Ferreira, Isabel D; Nordeste, Ana; Fonseca, Margarida; Taborda, Adelaide; Silva, Isabel S; Almeida, Maria do Céu

2005-01-01

Between January of 1987 and December of 2001 were born 1243 twins related to 609 multiple pregnancies, in Maternidade Bissaya-Barreto. Data were grouped in periods of three years and several parameters were studied. The rate of multiple gestation has increased probably due to the contribution of the assisted conception techniques, and to the increase of the number of multiple fetal pregnancies (two or more) and to the increase of the mother age. These more frequent obstetric problems were preterm birth, gestational hypertension and abnormal sonographic data of fetal growth. The average age of delivery was 34 weeks and the birth weight has decreased. The most important factors for neonatal morbidity were hyaline membranous disease, intraventricular haemorrhage and the twin-twin transfusion syndrome. The neonatal mortality decreased in the last studied period.

Drugs Approved for Gestational Trophoblastic Disease

Science.gov (United States)

This page lists cancer drugs approved by the Food and Drug Administration (FDA) for gestational trophoblastic disease. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

Hysteroscopic Differences in the Gestational Sac in Asymptomatic Blighted Ovum and Viable Pregnancy at Early Gestation

Directory of Open Access Journals (Sweden)

Fu-Tsai Kung

2005-12-01

Conclusions: The anatomic alterations of the gestational sac reflect impending sac necrosis and abortion in early-stage pregnancy loss. There were no morphologic differences between the two groups in the pattern of capillary distribution on the endometrium or the implantation base.

Editorial: New operational dose equivalent quantities

International Nuclear Information System (INIS)

Harvey, J.R.

1985-01-01

The ICRU Report 39 entitled ''Determination of Dose Equivalents Resulting from External Radiation Sources'' is briefly discussed. Four new operational dose equivalent quantities have been recommended in ICRU 39. The 'ambient dose equivalent' and the 'directional dose equivalent' are applicable to environmental monitoring and the 'individual dose equivalent, penetrating' and the 'individual dose equivalent, superficial' are applicable to individual monitoring. The quantities should meet the needs of day-to-day operational practice, while being acceptable to those concerned with metrological precision, and at the same time be used to give effective control consistent with current perceptions of the risks associated with exposure to ionizing radiations. (U.K.)

Pregnancy to postpartum transition of serum metabolites in women with gestational diabetes

OpenAIRE

Chorell, Elin; Hall, Ulrika Andersson; Gustavsson, Carolina; Berntorp, Kerstin; Puhkala, Jatta; Luoto, Riitta; Olsson, Tommy; Holmäng, Agneta

2017-01-01

Context Gestational diabetes is commonly linked to development of type 2 diabetes mellitus (T2DM). There is a need to characterize metabolic changes associated with gestational diabetes in order to find novel biomarkers for T2DM. Objective To find potential pathophysiological mechanisms and markers for progression from gestational diabetes mellitus to T2DM by studying the metabolic transition from pregnancy to postpartum. Design The metabolic transition profile from pregnancy to postpartum wa...

Effect of radiation on gestation periods in dams of Segment III beagles

International Nuclear Information System (INIS)

Angleton, G.M.; Lee, A.C.

1981-01-01

The lengths of the gestation periods for bitches whose offspring were potentially assignable to Segment III of the Long-Term Study were not affected by radiation exposure (P = .998). Other factors were found to significantly correlate with the duration of the gestation periods, including the length of the first gestation period (P < .001), size of first litter (P = .175), the average environmental temperature during pregnancy (P = .055) and the size of the second litter

Reduction of Salmonella Shedding by Sows during Gestation in Relation to Its Fecal Microbiome

Directory of Open Access Journals (Sweden)

Guillaume Larivière-Gauthier

2017-11-01

Full Text Available Pork meat is estimated to be responsible for 10–20% of human salmonellosis cases in Europe. Control strategies at the farm could reduce contamination at the slaughterhouse. One of the targeted sectors of production is maternity, where sows could be Salmonella reservoirs. The aim of this study was to assess the dynamics of shedding of Salmonella in terms of variation in both shedding prevalence and strains excreted during gestation in Quebec’s maternity sector. The evolution of the fecal microbiota of these sows during gestation was also assessed to detect bacterial populations associated with these variations. A total of 73 sows both at the beginning and the end of the gestation were randomly selected and their fecal matter was analyzed. Salmonella detection was conducted using a method that includes two selective enrichment media (MSRV and TBG. Nine isolates per positive samples were collected. Among the 73 sows tested, 27 were shedding Salmonella. Sows in the first third of their gestation shed Salmonella significantly more frequently (21/27 than those in the last third (6/46 (χ2P < 0.05. The shedding status of 19 of the sows that were previously sampled in the first third of their gestation was followed, this time in the last third of their gestation, which confirmed reduction of shedding. Using 16S rRNA gene sequencing and qPCR, significant differences between the fecal flora of sows at the beginning and the end of the gestation, shedding Salmonella or not and with different parity number were detected. Using MaAsLin, multiple OTUs were found to be associated with the time of gestation, the status of Salmonella excretion and parity number. Some of the identified taxa could be linked to the reduction of the shedding of Salmonella at the end of gestation. In this study, we showed that the level of Salmonella shedding was variable during gestation with significantly higher shedding at the beginning rather than at the end of gestation. We

Ovine placental steroid synthesis and metabolism in late gestation.

Science.gov (United States)

Reynolds, Lawrence P; Legacki, Erin L; Corbin, C Jo; Caton, Joel S; Vonnahme, Kimberly A; Stanley, Scott; Conley, Alan J

2018-04-14

Steroid synthesis is required for pregnancy maintenance and for parturition but comparatively little is known about the major metabolic routes that influence circulating concentrations. Dietary intake changes progesterone and estradiol concentrations in pregnant ewes but whether this reflects placental synthesis is unknown. Progesterone metabolism by 5alpha-reduction is a major metabolic route in other species and can influence the onset of parturition. Therefore, studies were conducted to 1) determine placental enzyme activity, progesterone and estradiol measured by immuno-assay in late gestation ewes on low, moderate and high nutritional planes, 2) to assess the significance of 5alpha-reduction of progesterone in determining progesterone concentrations in late gestation ewes (gestation day 145) given finasteride to inhibit 5alpha-reductase metabolism. In the second experiment, steroid profiles were examined comprehensively in blood and tissues by liquid chromatography tandem mass spectrometry for the first time in this species. Dietary intake altered progesterone and estradiol serum concentrations but without correlated changes in placental 3beta-hydroxysteroid dehydrogenase, 17alpha-hydroxylase/17,20-lyase cytochrome P450 or aromatase activity. 5alpha-reduced pregnane metabolites were identified in ewes at 145 days of gestation, but concentrations were lower than those of progesterone. Finasteride inhibited 5alpha-reduced progesterone metabolism but did not impact serum progesterone concentrations in these ewes. We conclude 1) that diet-induced changes in serum progesterone and estradiol concentrations are not likely a result of altered placental synthesis of sex steroid but most likely by their metabolism, and 2) metabolism by 5α-reduction is not a major determinant of systemic progesterone concentrations in late gestation ewes.

Mixed field dose equivalent measuring instruments

International Nuclear Information System (INIS)

Brackenbush, L.W.; McDonald, J.C.; Endres, G.W.R.; Quam, W.

1985-01-01

In the past, separate instruments have been used to monitor dose equivalent from neutrons and gamma rays. It has been demonstrated that it is now possible to measure simultaneously neutron and gamma dose with a single instrument, the tissue equivalent proportional counter (TEPC). With appropriate algorithms dose equivalent can also be determined from the TEPC. A simple ''pocket rem meter'' for measuring neutron dose equivalent has already been developed. Improved algorithms for determining dose equivalent for mixed fields are presented. (author)

The FL/AC ratio for prediction of shoulder dystocia in women with gestational diabetes.

Science.gov (United States)

Duryea, Elaine L; Casey, Brian M; McIntire, Donald D; Twickler, Diane M

2017-10-01

To determine if sonographic variables, including fetal femur length to abdominal circumference (FL/AC) ratio, are associated with shoulder dystocia in women with gestational diabetes. This was a retrospective cohort study of women with gestational diabetes who delivered singleton infants at Parkland Hospital from 1997 to 2015. Diagnosis and treatment of gestational diabetes were uniform including sonography at 32-36 weeks. Biometric calculations were evaluated for correlation with shoulder dystocia. During the study period, 6952 women with gestational diabetes underwent a sonogram at a mean gestation of 34.8 ± 1.8 weeks. Of 4183 vaginal deliveries, 66 experienced shoulder dystocia (16/1000). The FL/AC was associated with shoulder dystocia (p dystocia in women with gestational diabetes. Additionally, it is a simple ratio that is independent of the reference used and remains stable, unlike age-adjusted AC and HC/AC ratio.

Evaluation of serum profile during various stages of gestation in crossbred deoni cows

Directory of Open Access Journals (Sweden)

Mahesh S. Dodamani

Full Text Available The research was conducted on 36 (Deoni and Deoni X H.F. cross-bred cows between 2nd to 5th lactation. Cows were divided as early, mid and late gestation period comprising 12 cows in each group. Results of the present study indicated that there is no variation in serum Ca, Mg, Na and K level but serum P level declines significantly from early to late gestation, where as serum Cl level decreases from early to mid gestation and again increases from mid to late gestation. [Vet World 2009; 2(10.000: 398-399

Characterization of revenue equivalence

NARCIS (Netherlands)

Heydenreich, B.; Müller, R.; Uetz, Marc Jochen; Vohra, R.

2009-01-01

The property of an allocation rule to be implementable in dominant strategies by a unique payment scheme is called revenue equivalence. We give a characterization of revenue equivalence based on a graph theoretic interpretation of the incentive compatibility constraints. The characterization holds

[Growth patterns of appropriate for gestational age infants of gestational diabetic mothers during the first year].

Science.gov (United States)

Zhao, Y L; Ma, R M; Zhang, Y; Mo, Y X; Chen, Z; Sun, Y H; Ding, Z B

2016-08-02

To explore the growth pattern of appropriate for gestational age (AGA) infants of mother with gestational diabetes mellitus (GDM). The objects of this study were offspring of women who delivered in our hospital from January to December 2011. The GDM group included 70 AGA infants (36 male cases and 34 female cases) of mother with GDM. The control group included 154 AGA infants (66 male cases and 88 female cases) of women with normal glucose tolerance. The data of demographic characteristics of mothers of two groups were collected. Body weight and length of infants in two groups were measured at 3, 6 and 12 months age respectively. Body mass index (BMI), weight and height gain during infancy (0-3 months, 3-6 months and 6-12 months) of infants in two groups were also calculated. Body weight, length and BMI of male AGA infants in GDM group were less than that of control group at 3 months and 6 months age, but more than that of control group at 12 months age, however, there were no significant differences between two group(P>0.05). The weight and height gain during infancy (0-3 months, 3-6 months) of male AGA infants in GDM group were lower than that of control group, but the difference was statistically significant only at 3-6 months[(1.1±0.4) vs (1.4±0.4) kg, P=0.040; (4.9±2.3) vs (6.3±1.2) cm, P=0.026]. The weight and height gain during infancy (6-12 months) of male AGA infants of gestational diabetic mothers were higher than that of control group, but the difference was not statistically significant[(2.1±0.5) vs (1.8±0.5) kg, P=0.361; (8.4±1.3) vs (7.8±1.4) cm, P=0.464]. Male infants of gestational diabetic mothers grew slowly during their infancy of 0-6 months, and then their growth became increasingly fast, which suggested that the influence of intrauterine hyperglycemia environment of GDM mothers on fetal growth might continue after birth.

Inflammatory Response of Human Gestational Membranes to Ureaplasma parvum Using a Novel Dual-Chamber Tissue Explant System.

Science.gov (United States)

Potts, Lauren C; Feng, Liping; Seed, Patrick C; Jayes, Friederike L; Kuchibhatla, Maragatha; Antczak, Brian; Nazzal, Matthew K; Murtha, Amy P

2016-05-01

Preterm premature rupture of membranes (PPROM) is often associated with intra-amniotic inflammation and infection. Current understanding of the pathogenesis of PPROM includes activation of pro-inflammatory cytokines and proteolytic enzymes leading to compromise of membrane integrity. The impact of exposure to bacterial pathogens, including Ureaplasma parvum, on gestational membranes is poorly understood. Our objective was to develop a dual-chamber system to characterize the inflammatory response of gestational membranes to U. parvum in a directional nature. Full-thickness human gestational membrane explants, with either choriodecidua or amnion oriented superiorly, were suspended between two washers in a cylindrical device, creating two distinct compartments. Brilliant green dye was introduced into the top chamber to assess the integrity of the system. Tissue viability was evaluated after 72 h using a colorimetric cell proliferation assay. Choriodecidua or amnion was exposed to three doses of U. parvum and incubated for 24 h. Following treatment, media from each compartment were used for quantification of U. parvum (quantitative PCR), interleukin (IL)-8 (enzyme-linked immunosorbent assay), and matrix metalloproteinase (MMP)-2 and MMP-9 activity (zymography). We observed that system integrity and explant viability were maintained over 72 h. Dose-dependent increases in recovered U. parvum, IL-8 concentration, and MMP-2 activity were detected in both compartments. Significant differences in IL-8 concentration and MMP-9 activity were found between the choriodecidua and amnion. This tissue explant system can be used to investigate the inflammatory consequences of directional bacterial exposure for gestational membranes and provides insight into the pathogenesis of PPROM and infectious complications of pregnancy. © 2016 by the Society for the Study of Reproduction, Inc.

A reformulation of the transport-transport SPH equivalence technique

International Nuclear Information System (INIS)

Hebert, A.

2015-01-01

The superhomogeneisation (SPH) equivalence technique is a correction procedure based on equivalence factors. These equivalence factors are computed in such a way that a macro calculation made over a macro region and a coarse energy group with a simplified transport operator leads to the same leakage and reaction rates as a reference calculation performed without homogenization and with a fine group discretization. The situation where the macro calculation is performed with diffusion theory is a well understood and a common application of the technique. However, the case where the macro calculation is performed in transport theory is more complex and the SPH technique was reformulated in order to take into account the angular parity of the flux moments and cross sections. We found that the general rule to multiply all cross sections by a SPH factor and to divide all flux moment by the same factor is not valid. A new correction strategy is proposed to deal with transport-theory macro calculations. The strategy is slightly different whether or not the macro calculation is performed with a spherical harmonics (PN or SPN) discretization. The new approach was implemented in the DRAGON lattice code. Numerical results are comparing the classical and reformulated techniques. (author)

A reformulation of the transport-transport SPH equivalence technique

Energy Technology Data Exchange (ETDEWEB)

Hebert, A., E-mail: alain.hebert@polymtl.ca [Ecole Polytechnique de Montreal, Montreal, QC (Canada)

2015-07-01

The superhomogeneisation (SPH) equivalence technique is a correction procedure based on equivalence factors. These equivalence factors are computed in such a way that a macro calculation made over a macro region and a coarse energy group with a simplified transport operator leads to the same leakage and reaction rates as a reference calculation performed without homogenization and with a fine group discretization. The situation where the macro calculation is performed with diffusion theory is a well understood and a common application of the technique. However, the case where the macro calculation is performed in transport theory is more complex and the SPH technique was reformulated in order to take into account the angular parity of the flux moments and cross sections. We found that the general rule to multiply all cross sections by a SPH factor and to divide all flux moment by the same factor is not valid. A new correction strategy is proposed to deal with transport-theory macro calculations. The strategy is slightly different whether or not the macro calculation is performed with a spherical harmonics (PN or SPN) discretization. The new approach was implemented in the DRAGON lattice code. Numerical results are comparing the classical and reformulated techniques. (author)

Neuropsychological Impairment in School-Aged Children Born to Mothers With Gestational Diabetes.

Science.gov (United States)

Bolaños, Lourdes; Matute, Esmeralda; Ramírez-Dueñas, María de Lourdes; Zarabozo, Daniel

2015-10-01

The aim of this study was to determine whether school-aged children born to mothers with gestational diabetes show delays in their neuropsychological development. Several key neuropsychological characteristics of 32 children aged 7 to 9 years born to mothers with gestational diabetes were examined by comparing their performance on cognitive tasks to that of 28 children aged 8 to 10 years whose mothers had glucose levels within normal limits during pregnancy. The gestational diabetes group showed low performance on graphic, spatial, and bimanual skills and a higher presence of soft neurologic signs. Lower scores for general intellectual level and the working memory index were also evident. Our results suggest that gestational diabetes is associated with mild cognitive impairment. © The Author(s) 2015.

The Infant Born to a Woman with Gestational Diabetes.

Science.gov (United States)

Povinelli, Theresa; Lim, Caitlin; Raines, Deborah A

2017-07-01

Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. During pregnancy, women with GDM develop insulin resistance, which results in altered glucose tolerance. As a result, there are frequent episodes of hyperglycemia and high levels of circulating amino acids, increasing the transfer of nutrients to the fetus. This article discusses the role of the mother-baby nursing in the care of neonates born to women with gestational diabetes.

Equivalence of two alternative approaches to Schroedinger equations

International Nuclear Information System (INIS)

Goenuel, B; Koeksal, K

2006-01-01

A recently developed simple approach for the exact/approximate solution of Schroedinger equations with constant/position-dependent mass, in which the potential is considered as in the perturbation theory, is shown to be equivalent to the one leading to the construction of exactly solvable potentials via the solution of second-order differential equations in terms of known special functions. The formalism in the former solves difficulties encountered in the latter in revealing the corrections explicitly to the unperturbed piece of the solutions whereas the other obviates cumbersome procedures used in the calculations of the former

Characterization of Revenue Equivalence

NARCIS (Netherlands)

Heydenreich, Birgit; Müller, Rudolf; Uetz, Marc Jochen; Vohra, Rakesh

2008-01-01

The property of an allocation rule to be implementable in dominant strategies by a unique payment scheme is called \\emph{revenue equivalence}. In this paper we give a characterization of revenue equivalence based on a graph theoretic interpretation of the incentive compatibility constraints. The

Gestational weight gain and nutritional state of the newborn: a descriptive study

Directory of Open Access Journals (Sweden)

Kelen Cristina Ramos dos SANTOS

Full Text Available The objective was to characterize puerperal women in relation to gestational weight gain and their newborns in accordance with the nutritional state at birth. This is a descriptive, quantitative and retrospective study approved by the Ethics Committee at the institution responsible. The collection of data was from December 2012 to May 2013. The sample was composed of 24 puerperal women and their children. The participants presented an average age of 26.5 (DP=5.4 years, 79.2% white; 91.7% married; 58.3% multiparous; 75% with a level of education between secondary school and higher education; 58.3% with a low family income; 54.1% presented an altered pre-gestational nutritional state and 75% obtained an inadequate gestational weight gain. 79.2% of the newborns were classified as Adequate for Gestational Age (AIG. The newborns classified as Large for Gestational Age (GIG were from pregnant women that had excessive weight gain or were overweight. It was concluded that health professionals should be attentive to nutritional deviations with the intention of avoiding complications for maternal/fetal health.

Quantification of the equivalence principle

International Nuclear Information System (INIS)

Epstein, K.J.

1978-01-01

Quantitative relationships illustrate Einstein's equivalence principle, relating it to Newton's ''fictitious'' forces arising from the use of noninertial frames, and to the form of the relativistic time dilatation in local Lorentz frames. The equivalence principle can be interpreted as the equivalence of general covariance to local Lorentz covariance, in a manner which is characteristic of Riemannian and pseudo-Riemannian geometries

Hormone patterns in early human gestation

International Nuclear Information System (INIS)

Mishell, D.R. Jr.; Thorneycroft, I.H.; Nagata, Y.; Murata, T.; Nakamura, R.M.

1974-01-01

Accurate measurement of the low concentration of gonadotropins and steroid hormones present in human serum has been made possible by the development of sensitive radioimmunoassay (RIA) techniques. With the use of RIA FSH and LH, progesterone and 17OH-progesterone have been previously measured in early normal pregnancy. In order to determine the daily pattern of hormone levels in early normal pregnancy, gonadotropins as well as steroid hormone levels were measured in serum samples obtained daily from three women from the time of the last menstrual period prior to conception throughout the first few months of gestation. To further identify the steroid hormone pattern in early normal pregnancy, concentrations of estradiol, progesterone, and 17OH-progesterone were measured in individual serum samples obtained from a group of 158 women with apparently normal gestations who subsequently had therapeutic abortions. (auth)

Determination of gestational age by ultrasonography - wrong, wrong and wrong again?

International Nuclear Information System (INIS)

Bratlid, D.

1991-01-01

The article is a critical review of principal weaknesses in the current use of ultrasonography for determination of gestational age and discusses the fact that the method in its practical use disregards any biological variation in biparietal diameter. It is concluded that second trimester determination of gestational age by ultrasonography has an accuracy no greater than ±1.5 weeks. This is comparable to the accuracy of the clinical assessment of maturation in the newborn baby. Ultrasonography as the main indicator of gestational age should be used only when the pregnant woman's own menstrual history is obviously incorrect. 6 refs., 1 fig

Aquaporin expression in the fetal porcine urinary tract changes during gestation

DEFF Research Database (Denmark)

Jakobsen, L K; Trelborg, K; Kingo, P S

2018-01-01

The expression of aquaporins (AQPs) in the fetal porcine urinary tract and its relation to gestational age has not been established. Tissue samples from the renal pelvis, ureter, bladder and urethra were obtained from porcine fetuses. Samples were examined by RT-PCR (AQPs 1-11), QPCR (AQPs positive....... Immunohistochemistry showed AQP1 staining in sub-urothelial vessels at all locations. Western blotting analysis confirmed increased AQP1 protein levels in bladder samples during gestation. Expression levels of AQP1, 3, 5, 9 and 11 in the urinary tract change during gestation, and further studies are needed to provide...

Delivery of a baby with severe combined immunodeficiency at 31 weeks gestation following an extreme preterm prelabour spontaneous rupture of the membranes: a case report

Directory of Open Access Journals (Sweden)

Watkinson Sally J

2009-11-01

Full Text Available Abstract Introduction If left untreated, severe combined immunodeficiency can lead to an acute susceptibility to infection. The intrauterine environment is sterile until the amniotic membranes rupture. The vaginal flora then ascends into the genital tract, thus increasing the risk of chorioamnionitis. An extremely premature and prolonged membrane rupture is associated with a dismal prognosis for an immunocompetent preterm fetus. There are no case reports to date that detail the outcome of an immunocompromised preterm baby following prolonged rupture of membranes. Case presentation We present the case of a 32-year-old Indian woman who delivered a 31-week gestational baby who had a severe combined immunodeficiency following premature prelabour prolonged rupture of the membranes at the 14th week of gestation. Conclusion Extreme preterm prelabour spontaneous rupture of membranes in an underlying condition of severe combined immunodeficiency does not necessarily lead to an unfavourable outcome.

Predictors of Size for Gestational Age in St. Louis City and County

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Pamela K. Xaverius

2014-01-01

Full Text Available Objective. To identify social, behavioral, and physiological risk factors associated with small for gestational age (SGA by gestational age category in St. Louis City and County. Methods. A retrospective cohort study was conducted using birth certificate and fetal death records from 2000 to 2009 (n = 142,017. Adjusted associations of risk factors with SGA were explored using bivariate logistic regression. Four separate multivariable logistic regression analyses, stratified by gestational age, were conducted to estimate adjusted odds ratios. Results. Preeclampsia and inadequate weight gain contributed significantly to increased odds for SGA across all gestational age categories. The point estimates ranged from a 3.41 increased odds among women with preeclampsia and 1.76 for women with inadequate weight gain at 24–28 weeks’ gestational age to 2.19 and 2.11 for full-term infants, respectively. Among full-term infants, smoking (aOR = 2.08, chronic hypertension (aOR = 1.46, and inadequate prenatal care (aOR = 1.25 had the next most robust and significant impact on SGA. Conclusion. Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age. Education on the importance of nutrition and adequate weight gain during pregnancy is vital. In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes.

Perinatal outcomes after gestational surrogacy versus autologous IVF: analysis of national data.

Science.gov (United States)

Sunkara, Sesh Kamal; Antonisamy, Belavendra; Selliah, Hepsy Y; Kamath, Mohan S

2017-12-01

Anonymized data were obtained from the Human Fertilization and Embryology Authority to determine whether gestational surrogacy influences perinatal outcomes compared with pregnancies after autologous IVF. A total of 103,160 singleton live births, including 244 after gestational surrogacy, 87,571 after autologous fresh IVF and intractyoplasmic sperm injection (ICSI) and 15,345 after autologous frozen embryo transfers were analysed. Perinatal outcomes of pretern birth (PTB), low birth weight (LBW) and high birth weight (HBW) were compared. No difference was found in the risk of PTB and LBW after gestational surrogacy compared with autologous fresh IVF-ICSI: PTB (adjusted OR 0.90, 95% CI 0.56 to 1.42), LBW (adjusted OR 0.90, 95% CI 0.57 to 1.43) and gestational surrogacy compared with autologous frozen embryo transfers: PTB (adjusted OR 0.96, 95% CI 0.58 to 1.60), LBW (adjusted OR 1.16, 95% CI 0.69 to 1.96). The incidence of HBW was significantly higher after gestational surrogacy compared with fresh IVF-ICSI (adjusted OR 1.94, 95% CI 1.38 to 2.75); no difference was found in HBW between gestational surrogacy and autologous frozen embryo transfers. The dataset is limited by lack of information on confounders, i.e. ethnicity, body mass index, underlying medical history, which could result in residual confounding. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

RESEARCHES REGARDING THE MAIN REPRODUCTION INDICATORS DETERMINATED IN SOWS, STAND GESTATION PEN TIPE

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RAMONA UNTARU

2007-05-01

Full Text Available Current researches were carried out with the goal to quantisize the lost from the weaning to early gestation at the sows housed in open pen gestation. In this trail we tested two pen types, different not only by size, but also by feeders’ emplacement. The main reproduction indicators that we calculated until the 28 gestation day were the proportion of sows in heat after weaning, the weaning to estrus interval and the gestation rates. The weaning to estrus interval was about 4 to 7 days, most sows were in heat in the day 5 and 6 days after weaning. The percent of heat detection after weaning was 71.42% for the small pens and 70.71% for the big pens (differences statistically non significant, chi test value was 0.983. The gestation rate at 28 days after insemination was 91.62% for the small pens and 94.72% for the large pens (chi test value 0,959, statistically non significant differences. The overpopulation for heat induction and after that chipping animals together in those pens, show that the lost are up to 40.47%, between weaning – day 28 of gestation.

Gestational Weight Gain and its Relation with Birth Weight of the Newborn.

Science.gov (United States)

Thapa, Meena; Paneru, Rupa

2017-01-01

Gestational weight gain is an important predictor of the health of the newborn. It is affected by body mass index of the women. This study was conducted to find out gestational weight gain according to Institute of Medicine 2009 recommendation and relationship of newborn birth weight to body mass index and gestational weight gain of the women. It was cross sectional, hospital based study. The women, who attended at term pregnancy for delivery and having recorded first trimester body weight, were included in the study. Their body mass index was calculated and they were stratified into 4 groups according to body mass index. The gestational weight gain was calculated by subtracting first trimester body weight from body weight at the time of admission for delivery. All the women were followed till delivery. The newborn birth weight was taken immediately after delivery. A total of 227 women were enrolled in the study. More than half of the women had normal body mass index. There were 84 (37%) overweight and obese women. Mean gestational weight gain was 10.21 kg, and mean weight of the newborn was 3.05 kg. There were equal number of women who had adequate weight gain and less weight gain according to recommendation. Excess weight gain was seen in 34 (15%) women. Women of higher body mass index and women who had gain more weight during pregnancy had larger newborns. Body mass index and gestational weight gain of the women were important predictors of birth weight of the newborn. There is a positive correlation between gestational weight gain of the women and birth weight of the newborn.

The principle of equivalence reconsidered: assessing the relevance of the principle of equivalence in prison medicine.

Science.gov (United States)

Jotterand, Fabrice; Wangmo, Tenzin

2014-01-01

In this article we critically examine the principle of equivalence of care in prison medicine. First, we provide an overview of how the principle of equivalence is utilized in various national and international guidelines on health care provision to prisoners. Second, we outline some of the problems associated with its applications, and argue that the principle of equivalence should go beyond equivalence to access and include equivalence of outcomes. However, because of the particular context of the prison environment, third, we contend that the concept of "health" in equivalence of health outcomes needs conceptual clarity; otherwise, it fails to provide a threshold for healthy states among inmates. We accomplish this by examining common understandings of the concepts of health and disease. We conclude our article by showing why the conceptualization of diseases as clinical problems provides a helpful approach in the delivery of health care in prison.

Animal models for clinical and gestational diabetes: maternal and fetal outcomes.

Science.gov (United States)

Kiss, Ana Ci; Lima, Paula Ho; Sinzato, Yuri K; Takaku, Mariana; Takeno, Marisa A; Rudge, Marilza Vc; Damasceno, Débora C

2009-10-19

Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl) and mild diabetes (glycemia between 120 and 300 mg/dl) on glycemia and maternal reproductive and fetal outcomes of Wistar rats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans. On day 5 of life, 96 female Wistar rats were assigned to three experimental groups: control (n = 16), severe (n = 50) and mild diabetes (n = 30). At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight. Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses. Experimental models of severe diabetes during pregnancy reproduced maternal and fetal outcomes of pregnant women

Animal models for clinical and gestational diabetes: maternal and fetal outcomes

Directory of Open Access Journals (Sweden)

Kiss Ana CI

2009-10-01

Full Text Available Abstract Background Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl and mild diabetes (glycemia between 120 and 300 mg/dl on glycemia and maternal reproductive and fetal outcomes of Wistar rats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans. Methods On day 5 of life, 96 female Wistar rats were assigned to three experimental groups: control (n = 16, severe (n = 50 and mild diabetes (n = 30. At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight. Results Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses. Conclusion Experimental models of severe diabetes during pregnancy

Management of Gestational Diabetes Mellitus: Selfefficacy and Perinatal Outcomes

OpenAIRE

Emine Gerçek; Hakan Şen

2015-01-01

The purpose of this review is to give knowledge about effects on perinatal outcomes of self-efficacy in management of gestational diabetes. Gestational diabetes mellitus (GDM) is a significant health concern due to the potentially adverse outcomes for the mother and the fetus/infant. Close monitoring and treatment of GDM are important to the long-term health of a pregnant woman and her baby. More over, maternal metabolic control during pregnancy may positively impact women’s...

On the operator equivalents

International Nuclear Information System (INIS)

Grenet, G.; Kibler, M.

1978-06-01

A closed polynomial formula for the qth component of the diagonal operator equivalent of order k is derived in terms of angular momentum operators. The interest in various fields of molecular and solid state physics of using such a formula in connection with symmetry adapted operator equivalents is outlined

[Spatial analysis of gestational anemia in Peru, 2015].

Science.gov (United States)

Hernández-Vásquez, Akram; Azañedo, Diego; Antiporta, Daniel A; Cortés, Sandra

2017-01-01

To establish regional prevalences of anemia in pregnant women receiving care at public clinics in Peru in 2015 and identify high-prevalence district conglomerates. An ecological study was carried out on data from pregnant women with anemia registered on the Nutritional Status Information System (SIEN) who received care in 7703 public clinics in 2015. Regional and district prevalences of gestational anemia were calculated. District conglomerates with a high prevalence of gestational anemia were identified using the Moran Index. Information was gathered from 311,521 pregnant women distributed in 1638 districts in Peru. The national prevalence of anemia was 24.2% (95% confidence interval [95% CI]: 24.0-24.3%), the rural prevalence was 30.5%, and the urban prevalence was 22.0%. The regions of Huancavelica (45.5%; 95% CI: 44.2-46.7%), Puno (42.8%; 95% CI: 41.9-43.7%), Pasco (38.5%; 95% CI: 36.9-40.0%), Cusco (36.0%; 95% CI: 35.3-36.8%), and Apurímac (32.0%; 95% CI: 30.8-33.1%) had the highest prevalences of anemia. The local Moran Index identified 202 high-priority districts (hot spots) (12.3% of total; 44 urban and 158 rural) located in Ancash, Apurímac, Arequipa, Ayacucho, Cajamarca, Cusco, Huancavelica, Huánuco, Junín, La Libertad, Lima, Pasco, and Puno containing high-prevalence district conglomerates. Gestational anemia in Peru has its highest prevalence rates in rural and southern mountainous areas. The district conglomerates with high prevalence rates of gestational anemia coincide with the areas of high regional prevalence.

Motor equivalence and structure of variance: multi-muscle postural synergies in Parkinson's disease.

Science.gov (United States)

Falaki, Ali; Huang, Xuemei; Lewis, Mechelle M; Latash, Mark L

2017-07-01

We explored posture-stabilizing multi-muscle synergies with two methods of analysis of multi-element, abundant systems: (1) Analysis of inter-cycle variance; and (2) Analysis of motor equivalence, both quantified within the framework of the uncontrolled manifold (UCM) hypothesis. Data collected in two earlier studies of patients with Parkinson's disease (PD) were re-analyzed. One study compared synergies in the space of muscle modes (muscle groups with parallel scaling of activation) during tasks performed by early-stage PD patients and controls. The other study explored the effects of dopaminergic medication on multi-muscle-mode synergies. Inter-cycle variance and absolute magnitude of the center of pressure displacement across consecutive cycles were quantified during voluntary whole-body sway within the UCM and orthogonal to the UCM space. The patients showed smaller indices of variance within the UCM and motor equivalence compared to controls. The indices were also smaller in the off-drug compared to on-drug condition. There were strong across-subject correlations between the inter-cycle variance within/orthogonal to the UCM and motor equivalent/non-motor equivalent displacements. This study has shown that, at least for cyclical tasks, analysis of variance and analysis of motor equivalence lead to metrics of stability that correlate with each other and show similar effects of disease and medication. These results show, for the first time, intimate links between indices of variance and motor equivalence. They suggest that analysis of motor equivalence, which requires only a handful of trials, could be used broadly in the field of motor disorders to analyze problems with action stability.

78 FR 67360 - Ambient Air Monitoring Reference and Equivalent Methods: Designation of Five New Equivalent Methods

Science.gov (United States)

2013-11-12

... Methods: Designation of Five New Equivalent Methods AGENCY: Office of Research and Development; Environmental Protection Agency (EPA). ACTION: Notice of the designation of five new equivalent methods for...) has designated, in accordance with 40 CFR Part 53, five new equivalent methods, one for measuring...

77 FR 60985 - Ambient Air Monitoring Reference and Equivalent Methods: Designation of Three New Equivalent Methods

Science.gov (United States)

2012-10-05

... Methods: Designation of Three New Equivalent Methods AGENCY: Environmental Protection Agency. ACTION: Notice of the designation of three new equivalent methods for monitoring ambient air quality. SUMMARY... equivalent methods, one for measuring concentrations of PM 2.5 , one for measuring concentrations of PM 10...

Clusters of week-specific maternal gestational weight gain pattern and their association with birthweight: an observational cohort study.

Science.gov (United States)

Liang, Huan; Yin, Chuanmin; Dong, Xinran; Acharya, Ganesh; Li, Xiaotian

2017-10-01

Gestational weight gain varies widely among different populations, and an inappropriate gestational weight gain is associated with adverse pregnancy outcomes. We aimed to investigate week-specific serial changes in gestational weight gain in an urban Chinese population to derive clusters of gestational weight gain patterns and explore the impact of gestational weight gain patterns on birthweight. This was an observational cohort study of 6130 women delivered at a university hospital in Shanghai, China. Pre-pregnancy bodyweight, height, week-specific and total gestational weight gain, pregnancy outcome and birthweight were extracted using electronic medical records. The association between gestational weight gain and gestational age was tested using linear regression, and week-specific reference percentiles for gestational weight gain were calculated. Hierarchical clustering was used to derive gestational weight gain clusters. Mean birthweight among the clusters was compared using Dunnet's test. We found a significant linear association between gestational weight gain and gestational age (r = 0.56; p gain pattern were identified. The birthweight significantly correlated with gestational weight gain (r = 0.28; p gain throughout the pregnancy, the mean birthweight among the clusters that had abnormal gestational weight gain (inadequate or excessive) in the third trimester was significantly different (p gain (between 5 and 95 percentile) in the third-trimester had similar mean birthweight. Women with abnormal gestational weight gain before the third-trimester still had a fair chance of delivering a normal birthweight baby if their gestational weight gain was normal in the third-trimester, suggesting that interventions started even late in pregnancy may have a positive effect on fetal growth. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Macrosomia Predictors in Infants Born to Cuban Mothers with Gestational Diabetes.

Science.gov (United States)

Cruz, Jeddú; Grandía, Raiden; Padilla, Liset; Rodríguez, Suilbert; Hernández García, Pilar; Lang Prieto, Jacinto; Márquez-Guillén, Antonio

2015-07-01

INTRODUCTION Fetal macrosomia is the most important complication in infants of women with diabetes, whether preconceptional or gestational. Its occurrence is related to certain maternal and fetal conditions and negatively affects maternal and perinatal outcomes. The definitive diagnosis is made at birth if a newborn weighs >4000 g. OBJECTIVE Identify which maternal and fetal conditions could be macrosomia predictors in infants born to Cuban mothers with gestational diabetes. METHODS A case-control study comprising 236 women with gestational diabetes who bore live infants (118 with macrosomia and 118 without) was conducted in the América Arias University Maternity Hospital, Havana, Cuba, during 2002-2012. The dependent variable was macrosomia (birth weight >4000 g). Independent maternal variables included body mass index at pregnancy onset, overweight or obesity at pregnancy onset, gestational age at diabetes diagnosis, pregnancy weight gain, glycemic control, triglycerides and cholesterol. Fetal variables examined included third-semester fetal abdominal circumference, estimated fetal weight at ≥28 weeks (absolute and percentilized by Campbell and Wilkin, and Usher and McLean curves). Chi square was used to compare continuous variables (proportions) and the student t test (X ± SD) for categorical variables, with significance threshold set at p gestational diabetes diagnosis, total fasting cholesterol and hypercholesterolemia. The highest OR for macrosomia were for maternal hypertriglyceridemia (OR 4.80, CI 2.34-9.84), third-trimester fetal abdominal circumference >75th percentile (OR 7.54, CI 4.04-14.06), and estimated fetal weight >90th percentile by Campbell and Wilkin curves (OR 4.75, CI 1.42-15.84) and by Usher and McLean curves (OR 8.81, CI 4.25-18.26). CONCLUSIONS Most variables assessed were predictors of macrosomia in infants of mothers with gestational diabetes. They should therefore be taken into account for future studies and for patient management

Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus.

Science.gov (United States)

Liu, Chaoqun; Zhong, Chunrong; Zhou, Xuezhen; Chen, Renjuan; Wu, Jiangyue; Wang, Weiye; Li, Xiating; Ding, Huisi; Guo, Yanfang; Gao, Qin; Hu, Xingwen; Xiong, Guoping; Yang, Xuefeng; Hao, Liping; Xiao, Mei; Yang, Nianhong

2017-01-01

Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.

Effectiveness of lead aprons in positron emission tomography

International Nuclear Information System (INIS)

Bezerra Fonseca, R.; Amaral, A.

2008-01-01

Full text: In the last two decades, Positron Emission Tomography (PET) has emerged as clinical diagnostic technique, becoming one of the fastest growing imaging tools in modern nuclear medicine. Because 511 keV annihilation photon energy is much higher than the photon with mean energy of 140 keV emitted in Single Photon Computed Tomography (SPECT), medical staff working in PET studies receive a higher dose than those working only with SPECT tracers do. As a result, special attention must be paid to keep radiation exposure as low as reasonably achievable (ALARA principle). Lead equivalent apron is the principal personal protective equipment for technologists occupationally exposed to ionizing radiation in medical procedures and may be an important component in the ALARA program. However, in practices involving PET, 0.5 mm lead equivalent aprons have been used regardless of photon's energy. In this context, this work was designed for evaluating radioprotective effectiveness of such aprons in PET procedures. For this, the operational quantities personal dose equivalent H p (0.07) and H p (10) have been assessed by using MCNP4C code in a model of individual exposure to small source of 511 keV photons, representing the situation of injection of the radiopharmaceutical, in two situations: technologists wearing and not wearing 0.5 mm lead aprons. To represent the technologist a mathematical anthropomorphic phantom was employed, and the simulated source to subject distances varied between 40 to 100 cm, in steps of 10 cm. The results showed no significant differences between the values obtained for H p (10) in the two situations, pointing out that that there is no radioprotective influence of wearing such aprons on PET practices. Compared to simulations without such device, H p (0.07) increased up about 26% when technologist is wearing radioprotective aprons, depending on the source to subject distance. On the basis of this work, 0.5 mm lead equivalent aprons should not be

Gestational surrogacy in India

OpenAIRE

Rozée , Virginie; Unisa , Sayeed; De La Rochebrochard , Elise

2016-01-01

International audience; While gestational surrogacy is illegal in France, it is authorized in other countries, such as India. Drawing upon a study of Indian surrogates, Indian and foreign intended parents pursuing surro­gacy, as well as physicians, lawyers and Indian clinic and agency managers, Virginie Rozée, Sayeed Unisa and Elise de La Rochebrochard describe how surrogacy services are organized in India and examine the expectations and rationales of the protagonists.

Placental effects of lead in mice.

Science.gov (United States)

Fuentes, M; Torregrosa, A; Mora, R; Götzens, V; Corbellla, J; Domingo, J L

1996-01-01

Although a number of studies in animal models have shown embryolethal and teratogenic lead effects when this element is administered by a parenteral route, the mechanism of the embryonary changes is well not established. In this study, the embryonic effects of parenteral lead exposure on day 9 of gestation were assessed in the Swiss mouse. Lead acetate trihydrate was injected intraperitoneally at 14, 28, 56 and 112 mg/kg. There was no maternal toxicity evidenced by death, reduced body weight gain or reduced food consumption. However, absolute placental weight at 112 mg/kg and relative placental weight at 14, 56 and 112 mg/kg were diminished significantly. The number of total implants, live and dead fetuses, sex ratio and fetal body weight were unaffected by lead exposure. Most sections of placenta showed vascular congestion, an increase of intracellular spaces and deposits of hyaline material of perivascular predominance. Trophoblast hyperplasia was also observed, whereas there was a reinforcement of the fibrovascular network in the labyrinth. It is concluded that the trophoblast hyperplasia observed in the placenta of pregnant mice after parenteral lead exposure at doses that are not toxic for the dam could act as a repairing mechanism of the extraembryonary tissues.

Evolution of diagnostic criteria for gestational diabetes mellitus

DEFF Research Database (Denmark)

Houshmand, Azadeh; Jensen, Dorte Møller; Mathiesen, Elisabeth R

2013-01-01

The establishment of universal diagnostic guidelines for gestational diabetes mellitus has been a long time coming. The lack of consensus and uniformity in procedures for diagnosing this disease has been a problem ever since its existence was recognized. The USA, European countries, and Australia...... criteria for gestational diabetes mellitus, based for the first time on perinatal outcome....... have each developed their own guidelines through the years, all based either on the maternal risk of subsequent diabetes, on arbitrary statistics, or on studies conducted on non-pregnant women. None of these guidelines have been based on risk for perinatal complications. Recently, the Hyperglycemia...

Investigation of Equivalent Circuit for PEMFC Assessment

International Nuclear Information System (INIS)

Myong, Kwang Jae

2011-01-01

Chemical reactions occurring in a PEMFC are dominated by the physical conditions and interface properties, and the reactions are expressed in terms of impedance. The performance of a PEMFC can be simply diagnosed by examining the impedance because impedance characteristics can be expressed by an equivalent electrical circuit. In this study, the characteristics of a PEMFC are assessed using the AC impedance and various equivalent circuits such as a simple equivalent circuit, equivalent circuit with a CPE, equivalent circuit with two RCs, and equivalent circuit with two CPEs. It was found in this study that the characteristics of a PEMFC could be assessed using impedance and an equivalent circuit, and the accuracy was highest for an equivalent circuit with two CPEs

Fast food consumption and gestational diabetes incidence in the SUN project.

Directory of Open Access Journals (Sweden)

Ligia J Dominguez

Full Text Available BACKGROUND: Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. METHODS: The prospective dynamic "Seguimiento Universidad de Navarra" (SUN cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0-3 servings/month, intermediate (>3 servings/month and ≤2 servings/week and high (>2 servings/week. Non-conditional logistic regression models were used to adjust for potential confounders. RESULTS: We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81-2.13 and 1.86 (95% CI: 1.13-3.06 for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007. CONCLUSION: Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes.

Hypertension Risk Subsequent to Gestational Dysglycemia Is Modified by Race/Ethnicity.

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Bentley-Lewis, Rhonda; Huynh, Jennifer; Li, Sylvia; Wenger, Julia; Thadhani, Ravi

2016-01-01

Gestational diabetes mellitus is associated with an increased risk of type 2 diabetes mellitus and hypertension. Additionally, gestational dysglycemia has been associated with an increased risk of type 2 diabetes mellitus but not yet associated with hypertension subsequent to pregnancy in long-term follow-up. Therefore, we set out to examine this relationship as well as the role of race/ethnicity in modifying this relationship. We analyzed a prospective observational cohort followed between 1998 and 2007. There were 17 655 women with self-reported race/ethnicity and full-term, live births. A 1-hour 50 g oral glucose-load test and a 3-hour 100 g oral glucose-tolerance test enabled third trimester stratification of women into 1 of 4 glucose-tolerance groups: (1) normal (n=15 056); (2) abnormal glucose-load test (n=1558); (3) abnormal glucose-load and -tolerance tests (n=520); and (4) gestational diabetes mellitus (n=521). Women were then followed for a mean±standard deviation of 4.1±2.9 years after delivery for the development of hypertension. Although gestational diabetes mellitus was associated with an increased risk of hypertension after pregnancy (odds ratio [95% confidence interval]: 1.58 [1.02, 2.45]; P=0.04), dysglycemia defined by an abnormal glucose-load test predicted hypertension only among black women (4.52 [1.24, 16.52]; P=0.02). The risk of hypertension after pregnancy among dysglycemia groups not meeting criteria for gestational diabetes mellitus varied based on the race/ethnicity of the population. Further research on the implications of the intersection of race/ethnicity and gestational dysglycemia on subsequent hypertension is warranted. © 2015 American Heart Association, Inc.

Neck circumference might predict gestational diabetes mellitus in Han Chinese women: A nested case-control study.

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He, Fang; He, Hua; Liu, Wenqi; Lin, Junyu; Chen, Bingjun; Lin, Yucong; Zhao, Yitao; Tao, Wen; Xia, Xuefeng

2017-03-01

A large neck circumference might be an indicator of metabolic syndrome and its components, and for certain patients is more practical as an index than waist circumference. The demarcation value for neck circumference that suggests metabolic syndrome appears to vary by ethnic group. Gestational diabetes mellitus is considered a component of metabolic syndrome in pregnant women. We investigated whether neck circumference in Han Chinese women is associated with gestational diabetes mellitus in early pregnancy, and determined a predictive demarcation value. A nested case-control study was carried out with 255 women aged 18-35 years. Gestational diabetes mellitus was diagnosed according to the criteria of the American Diabetes Association through a 2-h, 75-g oral glucose tolerance test. Of the total population, 41 (16%) women developed gestational diabetes mellitus by 24-28 weeks of gestation. Neck circumference at gestational week 16 positively correlated with pre-pregnancy waist circumference, bodyweight and body mass index, and maternal age (P = 0.029) and hemoglobin A1c at gestational week 24 (P ≤ 0.001). By binary logistic regression, neck circumference was an independent predictor of gestational diabetes mellitus (odds ratio 1.840, 95% confidence interval 1.040-3.254; P = 0.036). According to the receiver operating characteristic curve, for predicting gestational diabetes mellitus the optimal demarcation for neck circumference at gestational week 16 was 35.15 cm. Neck circumference is a viable tool to screen for gestational diabetes mellitus. In this population of pregnant Han Chinese women, a neck circumference of ≥35.15 cm was a predictor of gestational diabetes mellitus. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Incidence of respiratory disorders in neonates born between 34 and 36 weeks of gestation following exposure to antenatal corticosteroids between 24 and 34 weeks of gestation.

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Ventolini, Gary; Neiger, Ran; Mathews, Lindsey; Adragna, Norma; Belcastro, Marc

2008-02-01

We studied the effect of antenatal corticosteroids on the incidence of respiratory disorders in singleton neonates born between 34 and 36 weeks of gestation. Retrospective analysis was conducted of the incidence of respiratory distress syndrome (RDS) and other respiratory disorders (need for mechanical ventilation, continuous positive airway pressure, and prolonged oxygen therapy) among singleton neonates delivered between 34 and 36 weeks of gestation who were exposed to antenatal corticosteroids, compared with neonates who were not exposed. Statistical analyses included two-tailed T tests, two-way analysis of variance for continuous data, and chi-square analysis for ratios. A probability of 0.05 was considered significant. Between January 1, 2000, and December 31, 2004, 1078 neonates were born between 34 and 36 weeks of gestation. Information regarding antenatal corticosteroids was available in 1044: 574 neonates (53.2%) were exposed to antenatal corticosteroids and 470 (43.6%) were not. One thousand and eighteen neonates were admitted to the neonatal intensive care unit. Respiratory disorders were diagnosed in 140 of those exposed to antenatal steroids (24.4%) and in 382 of the nonexposed (81.3%) ( P < 0.0001). Two hundred and ten neonates (20.6%) developed RDS: Of those, 43 were exposed to antenatal corticosteroids and 167 were not (incidence of RDS was 7.5% and 35.5%, respectively; P = 0.0001). The beneficial effects of corticosteroids were similar in both genders. It appears that the exposure of singleton pregnancies to antenatal corticosteroids between 24 and 34 weeks of gestation is associated with a significantly lower incidence of respiratory disorders among neonates born at 34 to 36 weeks of gestation. Further studies are needed to determine whether administering antenatal steroids to women experiencing preterm labor after 34 weeks of gestation would be associated with a similar beneficial effect.

The potential role of biomarkers in predicting gestational diabetes

Directory of Open Access Journals (Sweden)

Huguette S Brink

2016-08-01

Full Text Available Gestational diabetes (GD is a frequent complication during pregnancy and is associated with maternal and neonatal complications. It is suggested that a disturbing environment for the foetus, such as impaired glucose metabolism during intrauterine life, may result in enduring epigenetic changes leading to increased disease risk in adult life. Hence, early prediction of GD is vital. Current risk prediction models are based on maternal and clinical parameters, lacking a strong predictive value. Adipokines are mainly produced by adipocytes and suggested to be a link between obesity and its cardiovascular complications. Various adipokines, including adiponectin, leptin and TNFα, have shown to be dysregulated in GD. This review aims to outline biomarkers potentially associated with the pathophysiology of GD and discuss the role of integrating predictive biomarkers in current clinical risk prediction models, in order to enhance the identification of those at risk.

[Gestational syphilis and associated factors in public hospitals of Peru during 2000-2010].

Science.gov (United States)

Gonzales, Gustavo F; Tapia, Vilma; Serruya, Suzanne J

2014-04-01

To determine the epidemiological profile of gestational syphilis and associated factors in a Peruvian population. The study is a secondary analysis of data obtained from public hospitals in Peru for the 2000-2010 period. 652,636 pregnant women were included from 37 cities and 45 health centers in Peru. The prevalence of gestational syphilis was 0.7%, while 80.7% reported screening for gestational syphilis. The highest prevalence of maternal syphilis is found in the lowland rainforest followed by the highland rainforest. In the three regions of Peru decreased prevalence of gestational syphilis has been seen throughout the years. The prevalence for 2010 are 0.2% on the coast, in the highlands 0.23% and 0.47% in the jungle. The lack of education and prenatal care, high parity, cohabiting or single, and living in the jungle, are associated with having a positive syphilis test. The results suggests that prevalence of gestational syphilis has declined over the decade 2000-2010.

Distinguishing pathological from constitutional small for gestational age births in population-based studies.

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Ananth, Cande V; Vintzileos, Anthony M

2009-10-01

Small for gestational age (SGA) can occur following a pathological process or may represent constitutionally small fetuses. However, distinguishing these processes is often difficult, especially in large studies, where the term SGA is often used as a proxy for restricted fetal growth. Since biologic variation in fetal size is largely a third trimester phenomenon, we hypothesized that the definition of SGA at term may include a sizeable proportion of constitutionally small fetuses. In contrast, since biologic variation in fetal size is not fully expressed in (early) preterm gestations, it is plausible that SGA in early preterm gestations would comprise a large proportion of growth restricted fetuses. We compared mortality and morbidity rates between SGA and appropriate for gestational age (AGA) babies. A population-based study of over 19million non-malformed, singleton births (1995-04) in the United States was performed. Gestational age (24-44weeks) was based on a clinical estimate. SGA and AGA were defined as sex-specific birthweight constitutionally small.

Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study.

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Zhang, Cuilin; Tobias, Deirdre K; Chavarro, Jorge E; Bao, Wei; Wang, Dong; Ley, Sylvia H; Hu, Frank B

2014-09-30

To quantify the association between a combination of healthy lifestyle factors before pregnancy (healthy body weight, healthy diet, regular exercise, and not smoking) and the risk of gestational diabetes. Prospective cohort study. Nurses' Health Study II, United States. 20,136 singleton live births in 14,437 women without chronic disease. Self reported incident gestational diabetes diagnosed by a physician, validated by medical records in a previous study. Incident first time gestational diabetes was reported in 823 pregnancies. Each lifestyle factor measured was independently and significantly associated with risk of gestational diabetes. The combination of three low risk factors (non-smoker, ≥ 150 minutes a week of moderate to vigorous physical activity, and healthy eating (top two fifths of Alternate Healthy Eating Index-2010 adherence score)) was associated with a 41% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.59, 95% confidence interval 0.48 to 0.71). Addition of body mass index (BMI) diabetes compared with all other pregnancies (relative risk 0.48, 0.38 to 0.61). Compared with pregnancies in women who did not meet any of the low risk lifestyle factors, those meeting all four criteria had an 83% lower risk of gestational diabetes (relative risk 0.17, 0.12 to 0.25). The population attributable risk percentage of the four risk factors in combination (smoking, inactivity, overweight, and poor diet) was 47.5% (95% confidence interval 35.6% to 56.6%). A similar population attributable risk percentage (49.2%) was observed when the distributions of the four low risk factors from the US National Health and Nutrition Examination Survey (2007-10) data were applied to the calculation. Adherence to a low risk lifestyle before pregnancy is associated with a low risk of gestational diabetes and could be an effective strategy for the prevention of gestational diabetes. © Zhang et al 2014.

PLACENTAL INSUFFICIENCY IN PREGNANCY AFTER 40th WEEK OF GESTATION

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Vladimir Antic

2007-12-01

Full Text Available Pregnancy after the 40th week of gestation is often a great dilemma for obstetrician in diagnostic, therapeutic and in psychological terms as well. The aim of this study was to confirm the phenomenon of placental insufficiency in pregnancy after the 40th gestation week, the modality of delivery and perinatal outcome.The study comprised 3405 deliveries in a period of one year, 391 of which were terminated after the end of the 40th gestation week, including healthy pregnant women with singleton pregnancies. Control group included healthy pregnant women delivered between the 37th and 40th gestation week.The incidence of deliveries after the 40th week of gestation is 11.48%. Non-stress test was reactive in 99.65% of women in the study group. At the same time, CST (constriction– stress test was assessed as negative in 78.67% of cases. The pathological CST was found in only 1.33% of cases. Doppler ultrasound measurements showed the increased resistance in umbilical artery flow in 3% of cases. Vacuum extraction was used for 16.62%of deliveries in the study group, and 8.73% of deliveries in the control group (χ2=23.24;p<0.001. In the study group, Caesarean section was performed in 14.58% of cases, and in control group in 9.07% (χ2=11.09; p<0.001.Placental insufficiency induced by duration of pregnancy is a rear phenomenon in uncompromised pregnancy. There was no significant difference in the morbidity and mortality rates between the study and control group.

Obstetricians' rising liability insurance premiums and inductions at late preterm gestations.

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Murthy, Karna; Grobman, William A; Lee, Todd A; Holl, Jane L

2009-04-01

To estimate the association between professional liability insurance premiums for obstetricians and late preterm induction (LPI) rates. Data from the National Center for Health Statistics were used to identify all Illinois women pregnant with singletons at 34 weeks' gestation from 1991 to 2003. The independent association between LPI (induction between 34 and 37 weeks' gestation) rates and the previous year's obstetric malpractice insurance premiums was evaluated using linear regression. The mean annual LPI rate (5.4/1000 in 1991 to 15.2/1000 in 2003, P insurance premiums ($55,480 to $110,613, P insurance premium. Rising premiums are associated with increased frequency of LPI among women with singleton gestations.

The use of Am-241 as Equivalence Thickness Measurement for Irradiation Room at National institute for Cancer and Malacca Hospital: A Review

International Nuclear Information System (INIS)

Mohd Khalid Matori; Azuhar Ripin; Husaini Salleh

2013-01-01

Lead equivalent thickness measurement of a shielding material in diagnostic radiology is very important to ensure that requirements for the purpose of radiation protection of patients, employees and the public are met. The Malaysian Ministry of Health (MOH) has established that the irradiation room must have sufficient shielding thickness, for example for general radiography it must be at least equal to 2.0 mm of Pb, for panoramic dental radiography at least equal to 1.5 mm of Pb and for mammography should be a minimum of 1.0 mm of Pb. This paper presents a technique using americium-241 source to test and verify the integrity of the shielding thickness in term of lead equivalent for irradiation room at National Institute for Cancer (IKN) and General Malacca Hospital. Results of measurement of 10 irradiation rooms conducted in 2012 were analyzed for this presentation. Technical comparison of the attenuation of gamma rays from Am-241 source through the walls of the irradiation room and pieces of lead were used to assess the lead equivalent thickness of the walls. Results showed that almost all the irradiation rooms tested meet the requirements of the Ministry of Health and is suitable for the installation of the intended diagnostic X-ray apparatus. Some specific positions such as door knobs and locks, electrical plug sockets were identified with potential to not met the required lead equivalent thickness hence may contribute to higher radiation exposure to workers and the public. (author)

Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus

DEFF Research Database (Denmark)

Damm, P.; Kühl, C.; Bertelsen, Aksel

1992-01-01

OBJECTIVES: The purpose of this study was to determine the incidence of diabetes in women with previous dietary-treated gestational diabetes mellitus and to identify predictive factors for development of diabetes. STUDY DESIGN: Two to 11 years post partum, glucose tolerance was investigated in 241...... women with previous dietary-treated gestational diabetes mellitus and 57 women without previous gestational diabetes mellitus (control group). RESULTS: Diabetes developed in 42 (17.4%) women with previous gestational diabetes mellitus (3.7% insulin-dependent diabetes mellitus and 13.7% non...... of previous patients with gestational diabetes mellitus in whom plasma insulin was measured during an oral glucose tolerance test in late pregnancy a low insulin response at diagnosis was found to be an independent predictive factor for diabetes development. CONCLUSIONS: Women with previous dietary...

Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program.

Science.gov (United States)

Petrella, E; Malavolti, M; Bertarini, V; Pignatti, L; Neri, I; Battistini, N C; Facchinetti, F

2014-09-01

To determine whether changes in lifestyle in women with BMI > 25 could decrease gestational weight gain and unfavorable pregnancy outcomes. Women with BMI > 25 were randomized at 1st trimester to no intervention or a Therapeutic Lifestyle Changes (TLC) Program including diet (overweight: 1700 kcal/day, obese: 1800 kcal/day) and mild physical activity (30 min/day, 3 times/week). At baseline and at the 36th week women filled-in a Food Frequency Questionnaire. gestational weight gain, gestational diabetes mellitus, gestational hypertension, preterm delivery. Data stratified by BMI categories. Socio-demographic features were similar between groups (TLC: 33 cases, 28 cases). At term, gestational weight gain in obese women randomized to TLC group was lower (6.7 ± 4.3 kg) versus controls (10.1 ± 5.6 kg, p = 0.047). Gestational diabetes mellitus, gestational hypertension and preterm delivery were also significantly lower. TLC was an independent factor in preventing gestational weight gain, gestational diabetes mellitus, gestational hypertension. Significant changes in eating habits occurred in the TLC group, which increased the number of snacks, the intake of fruits-vegetables and decreased the consumption of sugar. A caloric restriction associated to changes in eating behavior and constant physical activity, is able to reduce gestational weight gain and related pregnancy complications in obese women.

Influence of exercise intervention on gestational diabetes mellitus: a systematic review and meta-analysis.

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Zheng, J; Wang, H; Ren, M

2017-10-01

Exercise intervention might be a promising approach to prevent gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of exercise intervention on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of exercise intervention on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus, preterm birth, and gestational age at birth. Meta-analysis was performed using random-effect model. Five RCTs involving 1872 patients were included in the meta-analysis. Overall, compared with control intervention, exercise intervention was found to significantly reduce the risk of gestational diabetes mellitus (std. mean difference 0.62; 95% CI 0.43-0.89; P = 0.01), but demonstrated no influence on preterm birth (OR 0.93; 95% CI 0.44-1.99; P = 0.86), gestational age at birth (std. mean difference -0.03; 95% CI -0.12 to 0.07; P = 0.60), glucose 2-h post-OGTT (std. mean difference -1.02; 95% CI -2.75 to 0.71; P = 0.25), birth weight (std. mean difference -0.10; 95% CI -0.25 to 0.04; P = 0.16), Apgar score less than 7 (OR 0.78; 95% CI 0.21-2.91; P = 0.71), and preeclampsia (OR 1.05; 95% CI 0.53-2.07; P = 0.88). Compared to control intervention, exercise intervention was found to significantly reduce the incidence of gestational diabetes mellitus, but had no significant influence on preterm birth, gestational age at birth, glucose 2-h post-OGTT, birth weight, Apgar score less than 7, and preeclampsia.

Tissue localization of some teratogens at early and late gestation related to fetal effects

Energy Technology Data Exchange (ETDEWEB)

Dencker, L [Uppsala Univ. (Sweden)

1976-01-01

A number of teratogens have been studied with regard to their distribution and tissue localization in pregnant rodents. The period from the presomite or early somite stages and up to the last days of gestation has been studied by means of whole body autoradiography. The fetal concentrations have been quantitatively measured from day 12 to day 18 of gestation for some of the teratogens by impulse counting. Cadmium (/sup 109/CdCl/sub 2/), mercury (/sup 203/HgCl/sub 2/), and trypan blue (detected by its colour) accumulated in the visceral yolk sac endoderm and in the embryonic endoderm. After duct closure time none of the substances were detected in the embryo except mercury in late gestation. The herbicide 2,4,5-T (/sup 14/C-2,4,5-T) did not pass to the embryonic tissues up to day 10-11 of gestation. The results obtained with 2,4,5-T show that the visceral yolk sac and chorioallantoic placenta have different characteristics concerning the transport of comparatively small organic molecules. /sup 14/C-salicylic acid reached relatively high concentrations during the entire embryonic-fetal period, proving salicylates fetotoxicity throughout gestation. Mercury, 2,4,5-T and salicylic acid showed an increasing fetal concentration with advancing stage of gestation. Extraembryonic mechanisms must too be considered of importance in inducing fetal damage. Cadmium mercury and trypan blue all accumulated in the placental structures throughout gestation. Zinc (/sup 65/ZnCl/sub 2/), which has been shown to be essential for fetal development probably because of its involvment in DNA synthesis, accumulated in the most rapidly growing embryonic structures. Zinc injected prior to gestation was transported to the embryos and placental structures while only a minor amount of the cadmium injected before gestation was mobilized from the maternal organs.

SU-E-P-09: Radiation Transmission Measurements and Evaluation of Diagnostic Lead-Based and Lead-Free Aprons

Energy Technology Data Exchange (ETDEWEB)

Syh, J [Willis-Knighton Medical Center, Shreveport, LA (United States)

2014-06-01

Purpose: This study was conducted to ensure that various lead shield apron manufacturers provided accurate attenuation factors regardless of whether the apron was made of lead-based or lead-free equivalent material. Methods: A calibrated ionization survey meter was placed at chest height and 36 cm horizontally away from a solid water phantom on a simulator couch. Measurements were done with or without apron. Radiation field was set to 24cmx24cm with the phantom at 100cm source-to-surface distance. Irradiation time was set for 1 minute at voltages of 60, 80, 100 and 120 kVp. Current was set at 6mA. Results: Between 60 kVp and 120 kVp, the transmission through 0.50 mm of lead-based apron was between 1.0% and 6.5% with a mean value of 3.2% and a standard deviation (s.d.) of 1.4%. The transmissions through the 0.50 mm lead-free aprons were 1.0 % to 12.0% with a mean value of 6.1% and s.d. of 2.6%. At 120 kVp, the transmission value was 6.5% for 0.50 mm lead-based apron and 11.1% to 12.0% for 0.50 mm lead-free aprons. The radiation transmissions at 80 kVp, measured in two different 0.5 mm lead-free aprons, were 4.3% each. However, only 1.4% transmission was found through the lead-based apron. Overall, the radiation transmitted through the lead-based apron was 1/3 transmission of lead-free at 80kVp, and half value of lead-free aprons at 100 and 120 kVp. Conclusion: Even though lead-based and lead-free aprons all claimed to have the same lead equivalent thickness, the transmission might not be the same. The precaution was needed to exercise diligence in quality assurance program to assure adequate protection to staff who wear it during diagnostic procedures. The requirement for aprons not only should be in certain thickness to meet state regulation but also to keep reasonably achievable low exposure with the accurate labeling from manufacturers.

SU-E-P-09: Radiation Transmission Measurements and Evaluation of Diagnostic Lead-Based and Lead-Free Aprons

International Nuclear Information System (INIS)

Syh, J

2014-01-01

Purpose: This study was conducted to ensure that various lead shield apron manufacturers provided accurate attenuation factors regardless of whether the apron was made of lead-based or lead-free equivalent material. Methods: A calibrated ionization survey meter was placed at chest height and 36 cm horizontally away from a solid water phantom on a simulator couch. Measurements were done with or without apron. Radiation field was set to 24cmx24cm with the phantom at 100cm source-to-surface distance. Irradiation time was set for 1 minute at voltages of 60, 80, 100 and 120 kVp. Current was set at 6mA. Results: Between 60 kVp and 120 kVp, the transmission through 0.50 mm of lead-based apron was between 1.0% and 6.5% with a mean value of 3.2% and a standard deviation (s.d.) of 1.4%. The transmissions through the 0.50 mm lead-free aprons were 1.0 % to 12.0% with a mean value of 6.1% and s.d. of 2.6%. At 120 kVp, the transmission value was 6.5% for 0.50 mm lead-based apron and 11.1% to 12.0% for 0.50 mm lead-free aprons. The radiation transmissions at 80 kVp, measured in two different 0.5 mm lead-free aprons, were 4.3% each. However, only 1.4% transmission was found through the lead-based apron. Overall, the radiation transmitted through the lead-based apron was 1/3 transmission of lead-free at 80kVp, and half value of lead-free aprons at 100 and 120 kVp. Conclusion: Even though lead-based and lead-free aprons all claimed to have the same lead equivalent thickness, the transmission might not be the same. The precaution was needed to exercise diligence in quality assurance program to assure adequate protection to staff who wear it during diagnostic procedures. The requirement for aprons not only should be in certain thickness to meet state regulation but also to keep reasonably achievable low exposure with the accurate labeling from manufacturers

Chronic Exposure to Uranium from Gestation: Effects on Behavior and Neurogenesis in Adulthood.

Science.gov (United States)

Dinocourt, Céline; Culeux, Cécile; Legrand, Marie; Elie, Christelle; Lestaevel, Philippe

2017-05-17

Uranium exposure leads to cerebral dysfunction involving for instance biochemical, neurochemical and neurobehavioral effects. Most studies have focused on mechanisms in uranium-exposed adult animals. However, recent data on developing animals have shown that the developing brain is also sensitive to uranium. Models of uranium exposure during brain development highlight the need to improve our understanding of the effects of uranium. In a model in which uranium exposure began from the first day of gestation, we studied the neurobehavioral consequences as well as the progression of hippocampal neurogenesis in animals from dams exposed to uranium. Our results show that 2-month-old rats exposed to uranium from gestational day 1 displayed deficits in special memory and a prominent depressive-like phenotype. Cell proliferation was not disturbed in these animals, as shown by 5-bromo-2'deoxyuridine (BrdU)/neuronal specific nuclear protein (NeuN) immunostaining in the dentate gyrus. However, in some animals, the pyramidal cell layer was dispersed in the CA3 region. From our previous results with the same model, the hypothesis of alterations of neurogenesis at prior stages of development is worth considering, but is probably not the only one. Therefore, further investigations are needed to correlate cerebral dysfunction and its underlying mechanistic pathways.

Lead transfer in maternal milk, and the absorption, retention, distribution and excretion of lead in suckling mice

Energy Technology Data Exchange (ETDEWEB)

Keller, Charles Arthur [Univ. of Rochester, NY (United States). Dept. of Radiation Biology and Biophysics

1980-01-01

Suckling mice were found to absorb and retain a greater fraction of an oral lead dose than did adult mice. Pinocytotic activity and lead uptake (in vivo) were found to be greatest in the distal small intestinal tissue. Cortisone pretreatment results in precocious cessation of pinocytotic activity in the intestine of suckling mice. Cortisone pretreatment of adult mice had no effect on whole body lead retention or intestinal tissue content of lead following an oral dose. The data indicate that the distal small intestine is the site of active pinocytosis of lead, and that pinocytosis is the major mechanism involved in lead absorption in suckling mice. Developmental differences were also observed in the percentage of lead retained in the whole body. Both groups exhibited dose-independent lead retention, indicating a first-order absorption process for each age group. Lead distribution and elimination from organs also differed between suckling and adult mice. Developmental differences were observed in organ lead concentration for kidneys and brain following oral doses. Relative distribution of lead to the brains of suckling mice were greater than to adult brains. Whole body and bone lead elimination rates were reduced in suckling compared to adult mice. Brain lead elimination rates did not differ in suckling and adult mice. A lactating mouse model was developed to study lead transfer to suckling offspring. Lead was transferred in milk to suckling offspring from mothers which had previously ingested lead in the drinking water. Relative lead transfer to suckled offspring during lactation greatly exceeded transfer to fetuses during gestation. Lactation resulted in an increased rate of maternal lead elimination. Lead concentration in milk exceeded plasma concentration by a factor of approximately 25. (ERB)

Immediate versus delayed insertion of an etonogestrel releasing implant at medical abortion-a randomized controlled equivalence trial.

Science.gov (United States)

Hognert, Helena; Kopp Kallner, Helena; Cameron, Sharon; Nyrelli, Christina; Jawad, Izabella; Heller, Rebecca; Aronsson, Annette; Lindh, Ingela; Benson, Lina; Gemzell-Danielsson, Kristina

2016-11-01

Does a progestin releasing subdermal contraceptive implant affect the efficacy of medical abortion if inserted at the same visit as the progesterone receptor modulator, mifepristone, at medical abortion? A etonogestrel releasing subdermal implant inserted on the day of mifepristone did not impair the efficacy of the medical abortion compared with routine insertion at 2-4 weeks after the abortion. The etonogestrel releasing subdermal implant is one of the most effective long acting reversible contraceptive methods. The effect of timing of placement on the efficacy of mifepristone and impact on prevention of subsequent unintended pregnancy is not known. This multicentre, randomized controlled, equivalence trial with recruitment between 13 October 2013 and 17 October 2015 included a total of 551 women with pregnancies below 64 days gestation opting for the etonogestrel releasing subdermal implant as postabortion contraception. Women were randomized to either insertion at 1 hour after mifepristone intake (immediate) or at follow-up 2-4 weeks later (delayed insertion). An equivalence design was used due to advantages for women such as fewer visits to the clinic with immediate insertion. The primary outcome was the percentage of women with complete abortion not requiring surgical intervention within 1 month. Secondary outcomes included insertion rates, pregnancy and repeat abortion rates during 6 months follow-up. Analysis was per protocol and by intention to treat. Women aged 18 years and older who had requested medical termination of a pregnancy up to 63 days of gestation and opted for an etonogestrel releasing contraceptive implant were recruited in outpatient family planning clinics in six hospitals in Sweden and Scotland. Efficacy of medical abortion was 259/275 (94.2%) in the immediate insertion group and 239/249 (96%) in the routine insertion group with a risk difference of 1.8% (95% CI -0.4 to 4.1%), which was within the ±5% margin of equivalence. The insertion

Revealing the equivalence of two clonal survival models by principal component analysis

International Nuclear Information System (INIS)

Lachet, Bernard; Dufour, Jacques

1976-01-01

The principal component analysis of 21 chlorella cell survival curves, adjusted by one-hit and two-hit target models, lead to quite similar projections on the principal plan: the homologous parameters of these models are linearly correlated; the reason for the statistical equivalence of these two models, in the present state of experimental inaccuracy, is revealed [fr

Gestation Related Gene Expression of the Endocannabinoid Pathway in Rat Placenta

Directory of Open Access Journals (Sweden)

Kanchan Vaswani

2015-01-01

Full Text Available Mammalian placentation is a vital facet of the development of a healthy and viable offspring. Throughout gestation the placenta changes to accommodate, provide for, and meet the demands of a growing fetus. Gestational gene expression is a crucial part of placenta development. The endocannabinoid pathway is activated in the placenta and decidual tissues throughout pregnancy and aberrant endocannabinoid signaling during the period of placental development has been associated with pregnancy disorders. In this study, the gene expression of eight endocannabinoid system enzymes was investigated throughout gestation. Rat placentae were obtained at E14.25, E15.25, E17.25, and E20, RNA was extracted, and microarray was performed. Gene expression of enzymes Faah, Mgll, Plcd4, Pld1, Nat1, Daglα, and Ptgs2 was studied (cohort 1, microarray. Biological replication of the results was performed by qPCR (cohort 2. Four genes showed differential expression (Mgll, Plcd4, Ptgs2, and Pld1, from mid to late gestation. Genes positively associated with gestational age were Ptgs2, Mgll, and Pld1, while Plcd4 was downregulated. This is the first comprehensive study that has investigated endocannabinoid pathway gene expression during rat pregnancy. This study provides the framework for future studies that investigate the role of endocannabinoid system during pregnancy.

Logically automorphically equivalent knowledge bases

OpenAIRE

Aladova, Elena; Plotkin, Tatjana

2017-01-01

Knowledge bases theory provide an important example of the field where applications of universal algebra and algebraic logic look very natural, and their interaction with practical problems arising in computer science might be very productive. In this paper we study the equivalence problem for knowledge bases. Our interest is to find out how the informational equivalence is related to the logical description of knowledge. Studying various equivalences of knowledge bases allows us to compare d...

Use of magnesium sulfate before 32 weeks of gestation

DEFF Research Database (Denmark)

Wolf, H. T.; Weber, T.; Piedvache, A.

2017-01-01

Objectives: The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. Methods: We used data from the European Perinatal Intensive Care in Europe (EPICE......) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires. The study population comprised 720 women with severe preeclampsia, eclampsia or HELLP and 3658 without...... preeclampsia delivering from 24 to 31 weeks of gestation in 119 maternity units with 20 or more very preterm deliveries per year. Results: Among women with severe pre-eclampsia, eclampsia or HELLP, 255 (35.4%) received MgSO4 before delivery. 41% of units reported use of MgSO4 whenever possible for pre...

Prevalence of gestational diabetes mellitus among women born in Greenland

DEFF Research Database (Denmark)

Jacobsen, Jytte Lindskov; Jørgensen, Marit Eika

2010-01-01

OBJECTIVES: To estimate the prevalence of gestational diabetes mellitus (GDM) among Greenlanders and to evaluate the quality of the current screening procedure for gestational diabetes. STUDY DESIGN: Observational retrospective study of consecutive birth-log data and medical records on pregnant....... However, only 54% of those women were screened. The prevalence of gestational diabetes was calculated to be 4.3% among high-risk Greenlandic pregnant women (2/46) (95% CI 0-10.0%). CONCLUSIONS: Despite a suboptimal screening rate, the prevalence of GDM among Greenlanders seems to be relatively low...... women who had given birth in Nuuk during 2008. METHODS: Information about maternal weight, weight gain in pregnancy, height, blood pressure, result of oral glucose tolerance test, family history of diabetes, smoking and alcohol habits, ethnicity, delivery and birth weight and length was collected...

Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners.

Science.gov (United States)

Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

2018-05-04

The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up. Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care. Purposive sampling and convergent interviews explored participants' communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory. Clinicians who provided maternity care at a tertiary referral hospital (n=13) in Queensland, Australia, and general practitioners (n=16) who provided maternity shared care with that hospital between December 2012 and July 2013. Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared. Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights

Screening for gestational diabetes in Europe

DEFF Research Database (Denmark)

Benhalima, Katrien; Damm, Peter; van Assche, Andre

2016-01-01

The incidence of gestational diabetes (GDM) is rising globally and it represents an important modifiable risk factor for adverse pregnancy outcomes. GDM is also associated with negative long-term health outcomes for both mothers and offspring. Acceptance and implementation of the 2013 World Health...

Gestational trophoblastic disease following complete hydatidiform ...

African Journals Online (AJOL)

Gestational trophoblastic disease following complete hydatidiform mole in Mulago Hospital, Kampala, Uganda. ... The main outcome measures were pre- and post-evacuation serum hCG levels and complications associated with oral methotrexate use. Results : The prevalence of CHM was 3.42 per 1,000 deliveries.

Effects of Gestational Housing on Reproductive Performance and Behavior of Sows with Different Backfat Thickness

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K. H. Kim

2016-01-01

Full Text Available The present study investigated the effects of back-fat thickness at d 107 of gestation and housing types during gestation on reproductive performance and behavior of sows. A total of 64 crossbred sows (Landrace×Yorkshire in their 3 to 4 parities were allotted to one of four treatments (n = 16 over two consecutive parities. During each parity, sows were assigned to two gestational housing types (stall or group housing and two level of back-fat thickness (<20 or ≥20 at d 107 of gestation. Gestating sows were transferred from gestational crates to stalls or pens (group housing 5 weeks before farrowing. All sows were moved to farrowing crates on d 109 of gestation. At weaning, back-fat thickness changes were lesser (p<0.05 in sows having back-fat thickness <20 mm than that of sows with ≥20 mm back-fat thickness at 107 d of gestation. Group housed sows had greater (p<0.05 feed intake and shorter (p<0.05 weaning-to-estrus interval than that of sows in stalls. At weaning, back-fat thickness changes were lesser (p<0.05 in group housed sows than that of sows in stalls. The number of piglets at weaning, growth rate and average daily gain were greater (p<0.05 in group housed sows than that of sows in stalls. During gestation, walking duration was more (p<0.05 in group housed sows. Group housed sows had lesser (p<0.05 farrowing duration and greater (p<0.05 eating time than that of sows in stalls. Result obtained in present study indicated that sows with ≥20 mm back-fat thickness at 107 days had better reproductive performance. Additionally, group housing of sows during last five week of gestation improved the performance and behavior and reproductive efficiency of sows.

The effects of ethanol and silymarin treatment during gestation on spatial working memory.

Directory of Open Access Journals (Sweden)

Romero David

2004-02-01

Full Text Available Abstract Background Using a rat model we have found that the bioflavonoid silymarin (SY ameliorates some of the negative consequences of in utero exposure to ethanol (EtOH. In the current study our aim was to determine if spatial working memory (SWM was impaired in offspring whose mothers were maintained on a liquid diet containing EtOH during different gestational weeks. We also determined if SWM was altered with a concomitant administration of SY with EtOH during specific gestational weeks. Methods We provided pregnant Fischer/344 rats with liquid diets containing 35% EtOH derived calories (EDC during specific weeks of the gestational period. A silymarin/phospholipid compound containing 29.8% silybin co-administered with EtOH was also administered during specific weeks of the gestational period. We tested SWM of the offspring with a radial arm maze on postnatal day (PND 60. After testing the rats were sacrificed and their brains perfused for later analysis. Results We observed SWM deficits, as well as a significantly lower brain weight in female offspring born of mothers treated with EtOH during the third week of gestation in comparison to mothers treated during either the first or second weeks of gestation. Rats from any group receiving EtOH in co-administration with SY showed no significant deficits in SWM. Conclusion EtOH treatment during the last week of gestation had the greatest impact on SWM. The addition of SY to the EtOH liquid diet appeared to ameliorate the EtOH-induced learning deficits.

A method to obtain new cross-sections transport equivalent

International Nuclear Information System (INIS)

Palmiotti, G.

1988-01-01

We present a method, that allows the calculation, by the mean of variational principle, of equivalent cross-sections in order to take into account the transport and mesh size effects on reactivity variation calculations. The method validation has been made in two and three dimensions geometries. The reactivity variations calculated in three dimensional hexagonal geometry with seven points by subassembly using two sets of equivalent cross-sections for control rods are in a very good agreement with the ones of a transport, extrapolated to zero mesh size, calculation. The difficulty encountered in obtaining a good flux distribution has lead to the utilisation of a single set of equivalent cross-sections calculated by starting from an appropriated R-Z model that allows to take into account also the axial transport effects for the control rod followers. The global results in reactivity variations are still satisfactory with a good performance for the flux distribution. The main interest of the proposed method is the possibility to simulate a full 3D transport calculation, with fine mesh size, using a 3D diffusion code, with a larger mesh size. The results obtained should be affected by uncertainties, which do not exceed ± 4% for a large LMFBR control rod worth and for very different rod configurations. This uncertainty is by far smaller than the experimental uncertainties. (author). 5 refs, 8 figs, 9 tabs

Personality type influence the gestational weight gain.

Science.gov (United States)

Franik, Grzegorz; Lipka, Nela; Kopyto, Katarzyna; Kopocińska, Joanna; Owczarek, Aleksander; Sikora, Jerzy; Madej, Paweł; Chudek, Jerzy; Olszanecka-Glinianowicz, Magdalena

2017-08-01

Pregnancy is frequently followed by the development of obesity. Aside from psychological factors, hormonal changes influence weight gain in pregnant women. We attempted to assess the potential association between personality type and the extent of gestational weight gain. The study group involved 773 women after term delivery (age 26.3 ± 3.9 years, body mass before pregnancy 61.2 ± 11.1 kg). Weight gain during pregnancy was calculated by using self-reported body mass prior to and during the 38th week of pregnancy. Personality type was assessed using the Polish version of the Framingham Type A Behavior Patterns Questionnaire (adapted by Juczynski). Two hundred forty-six (31.8%) study subjects represented type A personalities, 272 (35.2%) type B and 255 (33.0%) an indirect type. Gestational weight gain was related to the behavior patterns questionnaire score and age. In women gain was higher than in women with type B behavior of the same age. In women >30, the gestational weight gain was larger for type B personalities. Type A personality and increased urgency in younger pregnant women increases the risk of developing obesity during pregnancy in women below 30 years old. A higher level of competitiveness demonstrates a risk factor of excessive weight gain during pregnancy regardless of age.

Corticosterone response to gestational stress and postpartum memory function in mice.

Science.gov (United States)

Jafari, Zahra; Mehla, Jogender; Afrashteh, Navvab; Kolb, Bryan E; Mohajerani, Majid H

2017-01-01

Maternal stress is a common adversity during pregnancy. Gestational corticosterone alternations are thought to contribute to the etiology of postpartum behavioral disturbances. However, the impact of stress during pregnancy, in particular noise exposure, on gestational corticosterone fluctuations and spatial cognition in postpartum mice has not been fully understood yet. We hypothesized that noise exposure during pregnancy negatively affects gestational corticosterone levels and postpartum memory function in the dams similar to the physical stressors. Pregnant C57BL/6 mice were randomly assigned to either one of two stress conditions or a control condition. The noise stress (NS) was induced by presenting a loud intermittent 3000 Hz frequency on gestational days (GDs) 12, 14, and 16 for 24 hours, whereas the physical stress (PS) consisted of restraint and exposure to an elevated platform on GDs 12-16. Plasma corticosterone level was collected on GDs 11 and 17, and Morris water task (MWT) was carried out 30 days after parturition. Compared to the control group, the level of corticosterone in the stressed groups was significantly increased on GD17 relative to GD11. Significantly longer swim time and lower swim speed were observed in both stressed groups relative to the control group. Probe time was significantly shorter in the NS group than the other groups. The delta corticosterone level was significantly correlated with the swim time as well as the probe time in the three groups. Given the results, the adverse effects of gestational noise exposure on the hypothalamic pituitary-adrenal (HPA) axis activation and postpartum spatial learning and memory function were as large as/ or a bit stronger than the physical stresses. The findings suggest the significance of conservation against loud noise exposure in daily living, as well as need to further notice to the different aspects of gestational stress in mothers' behavior like offspring.

Assessment of structural cardiac abnormalities and diastolic function in women with gestational diabetes mellitus.

Science.gov (United States)

Oliveira, Alexandra P; Calderon, Iracema M P; Costa, Roberto A A; Roscani, Meliza G; Magalhães, Claudia G; Borges, Vera T M

2015-05-01

The main manifestation of hyperglycaemia during pregnancy is gestational diabetes mellitus. It can herald diabetes mellitus type 2 and its deleterious long-term effects, such as hypertension and cardiovascular disease. The aim of this study was to assess diastolic function in women with gestational diabetes mellitus, one of the first signs of future cardiovascular disease. A total of 21 women with gestational diabetes mellitus and 23 healthy pregnant women (control group) between 34 and 37 weeks of gestation underwent echocardiographic assessment. The diagnosis of gestational diabetes mellitus was made in agreement with the American Diabetes Association criteria. Echocardiographic images obtained were analysed according to the criteria of the American Society of Echocardiography. Data were analysed using Pearson correlation coefficient, analysis of variance and Student's t-test. Women with gestational diabetes mellitus had higher posterior wall and interventricular septum thickness, increased left ventricular mass and left ventricular mass index, lower early diastolic annular velocity and early diastolic annular velocity/late diastolic annular velocity ratio. There was a positive correlation between left ventricular mass index and fasting glucose and pregnancy body mass index. Patients with gestational diabetes mellitus seem to have a different diastolic profile as well as a mildly dysfunctional pattern on echocardiogram, which may show a need for greater glycaemic control. © The Author(s) 2015.

Effect of antenatal growth and prematurity on brain white matter: diffusion tensor study

International Nuclear Information System (INIS)

Lepomaeki, V.; Paavilainen, T.; Komu, M.; Matomaeki, J.; Lapinleimu, H.; Liisa Lehtonen, L.; Hurme, S.; Haataja, L.; Parkkola, R.

2012-01-01

White matter maturation is characterised by increasing fractional anisotropy (FA) and decreasing mean diffusivity (MD). Contradictory results have been published on the effect of premature birth on white matter maturation at term-equivalent age. To assess the association of gestational age and low birth-weight-for-gestational-age (z-score) with white matter maturation. Infants (n = 76, 53 males) born at different gestational ages were imaged at term-equivalent age. Gestational age and birth weight z-score were used as continuous variables and the effect on diffusion parameters was assessed. Brain maturation was studied using regions-of-interest analysis in several white matter areas. Gestational age showed no significant effect on white matter maturation at term-equivalent age. Children with low birth weight z-score had lower FA in the genu and splenium of the corpus callosum (regression, P = 0.012 and P = 0.032; correlation, P = 0.009 and P = 0.006, respectively), and higher MD in the splenium of the corpus callosum (regression, P = 0.002; correlation, P = 0.0004) compared to children whose birth weight was appropriate for gestational age. Children with low birth weight relative to gestational age show delay and/or anomaly in white matter maturation at term-equivalent age. (orig.)

Effect of antenatal growth and prematurity on brain white matter: diffusion tensor study

Energy Technology Data Exchange (ETDEWEB)

Lepomaeki, V. [Turku University Central Hospital, Medical Imaging Centre of Southwest Finland, Turku (Finland); Turku University Central Hospital, Turku PET-Centre, PO Box 52, Turku (Finland); Paavilainen, T.; Komu, M. [Turku University Central Hospital, Medical Imaging Centre of Southwest Finland, Turku (Finland); Matomaeki, J.; Lapinleimu, H.; Liisa Lehtonen, L. [Turku University Central Hospital and University of Turku, Department of Pediatrics, Turku (Finland); Hurme, S. [University of Turku, Department of Biostatistics, Turku (Finland); Haataja, L. [Turku University Central Hospital and University of Turku, Department of Pediatric Neurology, Turku (Finland); Parkkola, R. [Turku University Central Hospital, Medical Imaging Centre of Southwest Finland, Turku (Finland); Turku University Central Hospital, Turku PET-Centre, PO Box 52, Turku (Finland); University of Turku, Department of Diagnostic Radiology, Turku (Finland)

2012-06-15

White matter maturation is characterised by increasing fractional anisotropy (FA) and decreasing mean diffusivity (MD). Contradictory results have been published on the effect of premature birth on white matter maturation at term-equivalent age. To assess the association of gestational age and low birth-weight-for-gestational-age (z-score) with white matter maturation. Infants (n = 76, 53 males) born at different gestational ages were imaged at term-equivalent age. Gestational age and birth weight z-score were used as continuous variables and the effect on diffusion parameters was assessed. Brain maturation was studied using regions-of-interest analysis in several white matter areas. Gestational age showed no significant effect on white matter maturation at term-equivalent age. Children with low birth weight z-score had lower FA in the genu and splenium of the corpus callosum (regression, P = 0.012 and P = 0.032; correlation, P = 0.009 and P = 0.006, respectively), and higher MD in the splenium of the corpus callosum (regression, P = 0.002; correlation, P = 0.0004) compared to children whose birth weight was appropriate for gestational age. Children with low birth weight relative to gestational age show delay and/or anomaly in white matter maturation at term-equivalent age. (orig.)

Evaluation of thyroid dysfunction and autoimmunity in gestational diabetes mellitus and its relationship with postpartum thyroiditis.

Science.gov (United States)

Maleki, N; Tavosi, Z

2015-02-01

To evaluate thyroid dysfunction and autoimmunity in women with gestational diabetes and to investigate the frequency of postpartum thyroiditis in women with gestational diabetes. A total of 350 women with gestational diabetes and 350 healthy pregnant women were enrolled in the study. We studied the thyroid hormone profiles of the women in each group during pregnancy (at 24-28 weeks' gestation) and after delivery (at 6 weeks, 3, 6 and 9 months, and 1 year postpartum). A total of 342 women with gestational diabetes and 313 healthy pregnant women completed the follow-up during pregnancy and 1 year after delivery. Of the women with gestational diabetes, 16.6% had thyroid dysfunction, while of the healthy pregnant women, 6.1% had thyroid dysfunction. The prevalence of postpartum thyroiditis was higher in the women with a history of gestational diabetes (19.6%) than in the healthy pregnant women (10.2%), and this difference was statistically significant. According to the results of the present study, the prevalence of postpartum thyroiditis was higher in women with a history of gestational diabetes than in healthy women. We recommend that all women with gestational diabetes and women who have previous thyroid dysfunction should be screened for thyroid hormonal abnormalities during pregnancy and for 1 year after pregnancy. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening

DEFF Research Database (Denmark)

Buckley, B S; Harreiter, J; Damm, P

2012-01-01

Background: Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects...... of its diagnosis. Methods: The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide...... an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices...

Gelatinase (MMP-2 and -9 expression profiles during gestation in the bovine endometrium

Directory of Open Access Journals (Sweden)

Sato Takashi

2008-12-01

Full Text Available Abstract Background Various molecules participate in implantation and maintaining endometrial function during gestation. The remodeling of endometrial matrices is a necessary process in the coordination of gestational progress. Matrix-metalloproteinases (MMPs like gelatinases (MMP-2 and -9 and collagenase (MMP-1 are considered to play important roles in this process. We examined MMP-2 and -9 expression using zymography, in situ hybridization, real-time PCR, and microarray analysis to clarify their roles in the bovine endometrium during gestation. Methods Endometria, placentomes, and fetal membranes were collected from Japanese black cows that were killed on day 15 to 252 of gestation or during their estrous cycle. The gene expression of MMP-related molecules (mainly MMP-2 and -9 was examined using a custom-made microarray, real-time RT-PCR, and in-situ hybridization. Gelatinase activity was detected by zymography and film in situ zymography. Results Both gelatinases were expressed in the endometrium and fetal tissues throughout gestation. MMP-2 gene expression declined with the progress of gestation, but its intensity was maintained at a high level during the peri-implantation period and increased in late gestation. The expression level of MMP-9 was stably maintained, but was relatively low compared to that of MMP-2. These gene expression patterns matched those detected by zymography for the proteins. Microarray analysis suggested that the functions of MMP-2 during implantation and the last part of gestation are closely related with those of other molecules such as tissue inhibitors of metalloproteinase (TIMP-2, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS 1, membrane type 1 (MT1-MMP, and extracellular matrix metalloproteinase inducer (EMMPRIN. Conclusion We detected MMP-2 and -9 gene expression in the bovine endometrium and placentome throughout gestation. These data suggest that MMP-2 is one of the main endometrial

Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996-2011

Science.gov (United States)

... delivered by cesarean per 100 multiple births. Gestational age categories Early preterm : Births prior to 34 completed weeks of ... delivery among multiple births compared with singletons. The primary measure used to determine gestational age is the interval between the first day of ...

Gestational Age and Autism Spectrum Disorder

DEFF Research Database (Denmark)

Atladóttir, H Ó; Schendel, D.E.; Henriksen, T B

2016-01-01

Autism Spectrum Disorder (ASD) is a serious neurodevelopmental disorder. Several previous studies have identified pre-term birth as a risk factor for ASD but none has studied whether the association between gestational age and ASD has changed over time. This is a Danish population-based follow...

46 CFR 175.540 - Equivalents.

Science.gov (United States)

2010-10-01

... Safety Management (ISM) Code (IMO Resolution A.741(18)) for the purpose of determining that an equivalent... Organization (IMO) “Code of Safety for High Speed Craft” as an equivalent to compliance with applicable...

Equivalence of massive propagator distance and mathematical distance on graphs

International Nuclear Information System (INIS)

Filk, T.

1992-01-01

It is shown in this paper that the assignment of distance according to the massive propagator method and according to the mathematical definition (length of minimal path) on arbitrary graphs with a bound on the degree leads to equivalent large scale properties of the graph. Especially, the internal scaling dimension is the same for both definitions. This result holds for any fixed, non-vanishing mass, so that a really inequivalent definition of distance requires the limit m → 0

Association between gestational weight gain and perinatal outcomes in women with chronic hypertension.

Science.gov (United States)

Yee, Lynn M; Caughey, Aaron B; Cheng, Yvonne W

2017-09-01

Gestational weight gain above or below the 2009 National Academy of Medicine guidelines has been associated with adverse maternal and neonatal outcomes. Although it has been well established that excess gestational weight gain is associated with the development of gestational hypertension and preeclampsia, the relationship between gestational weight gain and adverse perinatal outcomes among women with pregestational (chronic) hypertension is less clear. The objective of this study was to examine the relationship between gestational weight gain above and below National Academy of Medicine guidelines and perinatal outcomes in a large, population-based cohort of women with chronic hypertension. This is a population-based retrospective cohort study of women with chronic hypertension who had term, singleton, vertex births in the United States from 2012 through 2014. Prepregnancy body mass index was calculated using self-reported prepregnancy weight and height. Women were categorized into 4 groups based on gestational weight gain and prepregnancy body mass index: (1) weight gain less than, (2) weight gain within, (3) weight gain 1-19 lb in excess of, and (4) weight gain ≥20 lb in excess of the National Academy of Medicine guidelines. The χ 2 tests and multivariable logistic regression analysis were used for statistical comparisons. Stratified analyses by body mass index category were additionally performed. In this large birth cohort, 101,259 women met criteria for inclusion. Compared to hypertensive women who had gestational weight gain within guidelines, hypertensive women with weight gain ≥20 lb over National Academy of Medicine guidelines were more likely to have eclampsia (adjusted odds ratio, 1.93; 95% confidence interval, 1.54-2.42) and cesarean delivery (adjusted odds ratio, 1.60; 95% confidence interval, 1.50-1.70). Excess weight gain ≥20 lb over National Academy of Medicine guidelines was also associated with increased odds of 5-minute Apgar gain 1-19 lb

Wijsman Orlicz Asymptotically Ideal -Statistical Equivalent Sequences

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Bipan Hazarika

2013-01-01

in Wijsman sense and present some definitions which are the natural combination of the definition of asymptotic equivalence, statistical equivalent, -statistical equivalent sequences in Wijsman sense. Finally, we introduce the notion of Cesaro Orlicz asymptotically -equivalent sequences in Wijsman sense and establish their relationship with other classes.

The performance of low pressure tissue-equivalent chambers and a new method for parameterising the dose equivalent

International Nuclear Information System (INIS)

Eisen, Y.

1986-01-01

The performance of Rossi-type spherical tissue-equivalent chambers with equivalent diameters between 0.5 μm and 2 μm was tested experimentally using monoenergetic and polyenergetic neutron sources in the energy region of 10 keV to 14.5 MeV. In agreement with theoretical predictions both chambers failed to provide LET information at low neutron energies. A dose equivalent algorithm was derived that utilises the event distribution but does not attempt to correlate event size with LET. The algorithm was predicted theoretically and confirmed by experiment. The algorithm that was developed determines the neutron dose equivalent, from the data of the 0.5 μm chamber, to better than +-20% over the energy range of 30 keV to 14.5 MeV. The same algorithm also determines the dose equivalent from the data of the 2 μm chamber to better than +-20% over the energy range of 60 keV to 14.5 MeV. The efficiency of the chambers is 33 counts per μSv, or equivalently about 10 counts s -1 per mSv.h -1 . This efficiency enables the measurement of dose equivalent rates above 1 mSv.h -1 for an integration period of 3 s. Integrated dose equivalents can be measured as low as 1 μSv. (author)

Gestational Exposure to a Viral Mimetic Poly(I:C Results in Long-Lasting Changes in Mitochondrial Function by Leucocytes in the Adult Offspring

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Cecilia Giulivi

2013-01-01

Full Text Available Maternal immune activation (MIA is a potential risk factor for autism spectrum disorder (ASD and schizophrenia (SZ. In rodents, MIA results in changes in cytokine profiles and abnormal behaviors in the offspring that model these neuropsychiatric conditions. Given the central role that mitochondria have in immunity and other metabolic pathways, we hypothesized that MIA will result in a fetal imprinting that leads to postnatal deficits in the bioenergetics of immune cells. To this end, splenocytes from adult offspring exposed gestationally to the viral mimic poly(I:C were evaluated for mitochondrial outcomes. A significant decrease in mitochondrial ATP production was observed in poly(I:C-treated mice (45% of controls mainly attributed to a lower complex I activity. No differences were observed between the two groups in the coupling of electron transport to ATP synthesis, or the oxygen uptake under uncoupling conditions. Concanavalin A- (ConA- stimulated splenocytes from poly(I:C animals showed no statistically significant changes in cytokine levels compared to controls. The present study reports for the first time that MIA activation by poly(I:C at early gestation, which can lead to behavioral impairments in the offspring similar to SZ and ASD, leads to long-lasting effects in the bioenergetics of splenocytes of adult offspring.

Mild gestational diabetes as a risk factor for congenital cryptorchidism

DEFF Research Database (Denmark)

Virtanen, Helena E; Tapanainen, Anna E; Kaleva, Marko M

2006-01-01

of cryptorchidism, e.g. prematurity and weight for gestational age, abnormal maternal glucose metabolism was significantly more common in the group of cryptorchid boys [diet-treated gestational diabetes, P = 0.0001; odds ratio, 3.98 (95% confidence interval, 1.97-8.05); diet-treated gestational diabetes or only......CONTEXT: Cryptorchidism is the most common malformation in newborn boys. Maternal diabetes has previously been suggested to be a risk factor for this disorder in one epidemiological study. OBJECTIVE: Evaluation of the prevalence of maternal glucose metabolism disorders during pregnancy in newborn...... diabetes diagnosis and abnormality of the result of a 2-h 75-g oral glucose tolerance test during pregnancy were obtained from the hospital records after delivery. RESULTS: After adjustment for possible confounding factors, i.e. maternal smoking during pregnancy, maternal age at delivery, and risk factors...

Ethical and Legal Issues in Gestational Surrogacy.

Science.gov (United States)

Casella, Claudia; Capasso, Emanuele; Terracciano, Lucia; Delbon, Paola; Fedeli, Piergiorgio; Salzano, Francesco Antonio; Policino, Fabio; Niola, Massimo

2018-01-01

This study originated from events that occurred in 2014 in an Italian hospital, where the embryos of a couple, obtained by means of homologous insemination, were mistakenly implanted into the uterus of another woman who, along with her husband, underwent the same treatment. Faced with this serious adverse circumstance, that gives rise to ethical and legal issues, the authors conducted a comparative examination of how to consider the division of maternity (between biological mother and uterine mother) and the related division of paternity (between genetic father and legal father, husband or partner of the gestational mother). Some preliminary observations are made concerning parenthood and filiation within the context of currently applicable Italian law. The following is a detailed analysis of the arguments in favour of the parental figures involved (gestational mother/genetic mother).

T-helper cytokine patterns and related antibodies in patients with gestational diabetes mellitus

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Etaati Z

2012-04-01

Conclusion: The changes in T-helper 1 and 2 associated antibodies and cytokines are not associated with gestational diabetes mellitus and could not be considered as a predictor for gestational diabetes mellitus.

Equivalence in Bilingual Lexicography: Criticism and Suggestions*

Directory of Open Access Journals (Sweden)

Herbert Ernst Wiegand

2011-10-01

Full Text Available

Abstract: A reminder of general problems in the formation of terminology, as illustrated by theGerman Äquivalence (Eng. equivalence and äquivalent (Eng. equivalent, is followed by a critical discussionof the concept of equivalence in contrastive lexicology. It is shown that especially the conceptof partial equivalence is contradictory in its different manifestations. Consequently attemptsare made to give a more precise indication of the concept of equivalence in the metalexicography,with regard to the domain of the nominal lexicon. The problems of especially the metalexicographicconcept of partial equivalence as well as that of divergence are fundamentally expounded.In conclusion the direction is indicated to find more appropriate metalexicographic versions of theconcept of equivalence.

Keywords: EQUIVALENCE, LEXICOGRAPHIC EQUIVALENT, PARTIAL EQUIVALENCE,CONGRUENCE, DIVERGENCE, CONVERGENCE, POLYDIVERGENCE, SYNTAGM-EQUIVALENCE,ZERO EQUIVALENCE, CORRESPONDENCE

Abstrakt: Äquivalenz in der zweisprachigen Lexikographie: Kritik und Vorschläge.Nachdem an allgemeine Probleme der Begriffsbildung am Beispiel von dt. Äquivalenzund dt. äquivalent erinnert wurde, wird zunächst auf Äquivalenzbegriffe in der kontrastiven Lexikologiekritisch eingegangen. Es wird gezeigt, dass insbesondere der Begriff der partiellen Äquivalenzin seinen verschiedenen Ausprägungen widersprüchlich ist. Sodann werden Präzisierungenzu den Äquivalenzbegriffen in der Metalexikographie versucht, die sich auf den Bereich der Nennlexikbeziehen. Insbesondere der metalexikographische Begriff der partiellen Äquivalenz sowie derder Divergenz werden grundsätzlich problematisiert. In welche Richtung man gehen kann, umangemessenere metalexikographische Fassungen des Äquivalenzbegriffs zu finden, wird abschließendangedeutet.

Stichwörter: ÄQUIVALENZ, LEXIKOGRAPHISCHES ÄQUIVALENT, PARTIELLE ÄQUIVALENZ,KONGRUENZ, DIVERGENZ, KONVERGENZ, POLYDIVERGENZ

A Combined Metabolomic and Proteomic Analysis of Gestational Diabetes Mellitus

OpenAIRE

Hajduk, Joanna; Klupczynska, Agnieszka; Dereziński, Paweł; Matysiak, Jan; Kokot, Piotr; Nowak, Dorota; Gajęcka, Marzena; Nowak-Markwitz, Ewa; Kokot, Zenon

2015-01-01

The aim of this pilot study was to apply a novel combined metabolomic and proteomic approach in analysis of gestational diabetes mellitus. The investigation was performed with plasma samples derived from pregnant women with diagnosed gestational diabetes mellitus (n = 18) and a matched control group (n = 13). The mass spectrometry-based analyses allowed to determine 42 free amino acids and low molecular-weight peptide profiles. Different expressions of several peptides and altered amino acid ...

Radiation protection clothing in X-ray diagnostics. Comparison of attenuation equivalents in narrow beam and inverse broad-beam geometry

International Nuclear Information System (INIS)

Pichler, Thomas; Schoepf, T.; Ennemoser, O.

2011-01-01

Purpose: Standard DIN EN 61 331-1 for attenuation measurements in the narrow and broad beam as well as DIN 6857-1 for the determination of shielding properties in the inverse broad-beam geometry are available for testing the attenuation of protection clothing. The attenuation measurements in the narrow beam don't consider scattered radiation and fluorescence due to the arrangement. This leads to the fact that the protective effect of lead-free materials will be misestimated when compared to lead. Therefore, the differences in attenuation equivalents, determined by both test methods for topical radiation protection aprons, were examined. Materials and Methods: The attenuations in inverse broad-beam geometry according to DIN 6857-1 and in the narrow beam according to DIN EN 61 331-1 were measured using commercially available aprons. They were made of lead, lead-reduced and lead-free materials. For determination of the attenuation equivalents, certificated lead-foils with high purity and a precise thickness of 0.1 to 1.25 mm were used. Results: The measurements in the narrow beam according to DIN EN 61 331-1 showed that nearly all aprons reach the required lead equivalent at mid-range tube voltages of 100 kV. At higher and lower tube voltages, the requirements of DIN EN 61 331-3 were largely not met. In contrast, the testing of the same aprons in inverse broad-beam geometry according to DIN 6857-1 showed that only a few aprons meet the requirements for being classified in the nominal protection class. Conclusion: The measurements suggest that testing method DIN 6857-1 has yet to prevail and that manufacturers are just beginning to develop the appropriate protective materials. (orig.)

Evaluating the Agreement of Risk Categorization for Fetal Down Syndrome Screening between Ultrasound-Based Gestational Age and Menstrual-Based Gestational Age by Maternal Serum Markers.

Science.gov (United States)

Chaksuwat, Pakorn; Sirichotiyakul, Supatra; Luewan, Suchaya; Tongsong, Theera

2018-01-01

To evaluate the agreement of risk categorization for Down syndrome screening between ultrasound scan-based gestational age (GA) and last menstrual period-based gestational age in both first and second trimesters by maternal serum markers. Data comprising 4,055 and 4,016 cases of first and second trimester screening were used. The maternal serum markers were analyzed using the ultrasound-based GA and menstrual age. The subjects whose menstrual age and ultrasound-based GA fell in different trimesters were excluded because the risk could not be calculated due to the different serum markers used in each trimester. The agreement of risk categorization for fetal Down syndrome was evaluated. The agreement of Down syndrome screening in the first and the second trimesters were 92.7% and 89%, respectively. The study found a good agreement of risk categorization by Kappa index, which was 0.615 for the overall screening. The menstrual age had a slight decrease in the detection rate and a lower false-positive rate. Menstrual age is acceptable in cases of accurate last menstrual period. However, in places where ultrasonography is not readily available, gestational age estimation by menstrual age along with clinical examination that corresponds to the gestational age can be reliable.

Some studies of maternal and infant lead exposure in Glasgow

Energy Technology Data Exchange (ETDEWEB)

Moore, M.R.; Goldberg, A.; Pocock, S.J.; Meredith, A.; Stewart, I.M.; MacAnespie, H.; Lees, R.; Low, A.

1982-04-01

In two studies in the city of Glasgow, 236 mothers and their newly born infants and 117 mothers and their 6-weeks old children's environmental lead exposure were examined. In both studies blood lead concentrations were found to correlate significantly with the cube root of the domestic water lead concentrations. In the first study, multiple regression analyses of maternal blood lead and cord blood lead concentrations on other variables showed a significant negative correlation with gestational age. It was also noted that there was an annual fluctuation in maternal blood lead concentration with highest values in the autumn. In the second study, similar relationships were found. Although there was no association between blood lead and sex, age, place of birth or feeding method, as in the previous study, a significant association between social class and blood lead was found. This could be explained on the basis of the significant correlation between water lead and social class. In those mothers who breast fed, breast milk lead concentrations were found to correlate significantly with blood lead concentrations where breast milk lead was around one tenth of blood lead concentration. These studies emphasise the importance of water lead in the economy of environmental lead exposure to mothers and their unborn and newly born infants.

Mars seasonal polar caps as a test of the equivalence principle

International Nuclear Information System (INIS)

Rubincam, David Parry

2011-01-01

The seasonal polar caps of Mars can be used to test the equivalence principle in general relativity. The north and south caps, which are composed of carbon dioxide, wax and wane with the seasons. If the ratio of the inertial (passive) to gravitational (active) masses of the caps differs from the same ratio for the rest of Mars, then the equivalence principle fails, Newton's third law fails, and the caps will pull Mars one way and then the other with a force aligned with the planet's spin axis. This leads to a secular change in Mars's along-track position in its orbit about the Sun, and to a secular change in the orbit's semimajor axis. The caps are a poor Eoetvoes test of the equivalence principle, being 4 orders-of-magnitude weaker than laboratory tests and 7 orders-of-magnitude weaker than that found by lunar laser ranging; the reason is the small mass of the caps compared to Mars as a whole. The principal virtue of using Mars is that the caps contain carbon, an element not normally considered in such experiments. The Earth with its seasonal snow cover can also be used for a similar test.

Diabetes and Pregnancy: Gestational Diabetes

Centers for Disease Control (CDC) Podcasts

2007-11-14

Gestational diabetes happens in a woman who develops diabetes during pregnancy. This podcast discusses its potential effects and action steps to avoid complications.  Created: 11/14/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT) and National Center on Birth Defects and Developmental Disabilities (NCBDDD), Prevention Research Branch.   Date Released: 11/27/2007.

Absorption of methylmercury by the fetal guinea pig during mid to late gestation

International Nuclear Information System (INIS)

Kelman, B.J.; Steinmetz, S.E.; Walter, B.K.; Sasser, L.B.

1980-01-01

Pregnant guinea pigs were injected with CH 3 203 HgCl at 22, 40, 47, 59, and 66 days of gestation, and fetal tissues were obtained 24 hours later. Autologous fetal erythrocytes were labeled with 51 Cr and used to label the fetal blood pool at each gestational age except 22 days so that tissue-bound Hg could be calculated. In general, Hg absorbed by the whole fetus increased during gestation, in parallel with increasing tissue mass, while Hg found in whole placentas remained the same. Liver, kidney, blood, and brain contained the highest Hg concentration early in gestation. While it is difficult to interpret the potential effects of the increased Hg concentrations, particular attention should be paid to the brain, since it is considered a target tissue in MeHg toxicity

Gestational diabetes mellitus: risk factors development, occurrence, diagnostics and treatment (review

Directory of Open Access Journals (Sweden)

Kostenko I.V.

2011-06-01

Full Text Available Gestational diabetes is defined as a violation of carbohydrate metabolism resulting in hyperglycemia of varying severity, firstly revealed or developed during the pregnancy. The article presents current data on the occurrence, etiology and pathogenesis of gestational diabetes, as well as methods for screening and diagnostics of disorders of carbohydrate metabolism during pregnancy. It explains the basic principles of diet therapy

Salinity in drinking water and the risk of (preeclampsia and gestational hypertension in coastal Bangladesh: a case-control study.

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Aneire Ehmar Khan

Full Text Available BACKGROUND: Hypertensive disorders in pregnancy are among the leading causes of maternal and perinatal death in low-income countries, but the aetiology remains unclear. We investigated the relationship between salinity in drinking water and the risk of (preeclampsia and gestational hypertension in a coastal community. METHODS: A population-based case-control study was conducted in Dacope, Bangladesh among 202 pregnant women with (preeclampsia or gestational hypertension, enrolled from the community served by the Upazilla Health Complex, Dacope and 1,006 matched controls from the same area. Epidemiological and clinical data were obtained from all participants. Urinary sodium and sodium levels in drinking water were measured. Logistic regression was used to calculate odds ratios, and 95% confidence intervals. FINDINGS: Drinking water sources had exceptionally high sodium levels (mean 516.6 mg/L, S.D 524.2. Women consuming tube-well (groundwater were at a higher disease risk than rainwater users (p900.01 mg/L, compared to <300 mg/L in drinking water (ORs 3.30 [95% CI 2.00-5.51], 4.40 [2.70-7.25] and 5.48 [3.30-9.11] (p-trend<0.001. Significant associations were seen for both (preeclampsia and gestational hypertension separately. INTERPRETATION: Salinity in drinking water is associated with increased risk of (preeclampsia and gestational hypertension in this population. Given that coastal populations in countries such as Bangladesh are confronted with high salinity exposure, which is predicted to further increase as a result of sea level rise and other environmental influences, it is imperative to develop and evaluate affordable approaches to providing water with low salt content.

Plasma cross-gestational sphingolipidomic analyses reveal potential first trimester biomarkers of preeclampsia.

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Aneta Dobierzewska

Full Text Available Preeclampsia (PE is a gestational disorder, manifested in the second half of pregnancy by maternal hypertension, proteinuria and generalized edema. PE is a major cause of maternal and fetal morbidity and mortality, accounting for nearly 40% of all premature births worldwide. Bioactive sphingolipids are emerging as key molecules involved in etiopathogenesis of PE, characterized by maternal angiogenic imbalance and symptoms of metabolic syndrome. The aim of this study was to compare the cross-gestational profile of circulating bioactive sphingolipids in maternal plasma from preeclamptic (PE versus normotensive control (CTL subjects with the goal of identifying sphingolipids as candidate first trimester biomarkers of PE for early prediction of the disease.A prospective cohort of patients was sampled at the first, second and third trimester of pregnancy for each patient (11-14, 22-24, and 32-36 weeks´ gestation. A retrospective stratified study design was used to quantify different classes of sphingolipids in maternal plasma. We used a reverse-phase high-performance liquid chromatography-tandem mass spectrometry (HPLC-ESI-MS/MS approach for determining different sphingolipid molecular species (sphingosine-1-phosphate (S1P, dihydro-sphingosine-1-phosphate (DH-S1P, sphingomyelins (SM and ceramides (Cer in cross-gestational samples of human plasma from PE (n = 7, 21 plasma samples across pregnancy and CTL (n = 7, 21 plasma samples across pregnancy patients.Plasma levels of angiogenic S1P did not change significantly in control and in preeclamptic patients´ group across gestation. DH-S1P was significantly decreased in second trimester plasma of PE patients in comparison to their first trimester, which could contribute to reduced endothelial barrier observed in PE. The major ceramide species (Cer 16:0 and Cer 24:0 tended to be up-regulated in plasma of control and PE subjects across gestation. The levels of a less abundant plasma ceramide species (Cer

Confinement, solitons and the equivalence between the sine-Gordon and massive Thirring models

International Nuclear Information System (INIS)

Blas Achic, H.S.; Ferreira, L.A.

2000-01-01

We consider a two-dimensional integrable and conformally invariant field theory possessing two Dirac spinors and three scalar fields. The interaction couples bilinear terms in the spinors to exponentials of the scalars. Its integrability properties are based on the sl(2) affine Kac-Moody algebra, and it is a simple example of the so-called conformal affine Toda theories coupled to matter fields. We show, using bosonization techniques, that the classical equivalence between a U(1) Noether current and the topological current holds true at the quantum level, and then leads to a bag model like mechanism for the confinement of the spinor fields inside the solitons. By bosonizing the spinors we show that the theory decouples into a sine-Gordon model and free scalars. We construct the two-soliton solutions and show that their interactions lead to the same time delays as those for the sine-Gordon solitons. The model provides a good laboratory to test duality ideas in the context of the equivalence between the sine-Gordon and Thirring theories

SAPONIFICATION EQUIVALENT OF DASAMULA TAILA

OpenAIRE

Saxena, R. B.

1994-01-01

Saponification equivalent values of Dasamula taila are very useful for the technical and analytical work. It gives the mean molecular weight of the glycerides and acids present in Dasamula Taila. Saponification equivalent values of Dasamula taila are reported in different packings.

Saponification equivalent of dasamula taila.

Science.gov (United States)

Saxena, R B

1994-07-01

Saponification equivalent values of Dasamula taila are very useful for the technical and analytical work. It gives the mean molecular weight of the glycerides and acids present in Dasamula Taila. Saponification equivalent values of Dasamula taila are reported in different packings.

Lysine supplementation in late gestation of gilts: effects on piglet birth weight, and gestational and lactational performance

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Diogo Magnabosco

2013-08-01

Full Text Available Lysine requirements for gain in maternal body reserves and piglet birth weight, during pregnancy, in contemporary prolific genotypes, are not well established. This study aimed to evaluate the effect of dietary lysine in late pregnancy on piglet birth weight, and on the gestational and lactational performance of gilts. Pregnant gilts were uniformly distributed into two groups and received, from 85 to 110 days of gestation, either of two lysine levels in their diet: Control group - 28g lysine/day (n=136, and Lysine group - 35g lysine/day (n=141. There were no effects (P>0.10 of supplemental lysine on body weight and backfat (BF gain of females or on piglet birth weight. Gilts supplemented with lysine tended to have a lower percentage of stillbirths (P=0.077, reduced within-litter birth weight variation (P=0.094 and a lower percentage of piglets weighing less than 1100g (P=0.082 than in the Control group. During lactation, the performance of sows and litters was also evaluated in a subgroup of sows (n=26/group. There were no differences between the Control and Lysine groups (P>0.10 in voluntary feed intake, body reserve losses (weight and BF, weaning-to-estrus interval of the sows, and litter weaning weight. In conclusion, an increase in lysine (from 28 to 35g/day in late gestation of gilts (85 to 110 days tends to reduce the rate of stillbirths and to improve the uniformity of litter weight at birth, but does not affect the performance of females until farrowing or during subsequent lactation.

Gauge equivalence of the Gross Pitaevskii equation and the equivalent Heisenberg spin chain

Science.gov (United States)

Radha, R.; Kumar, V. Ramesh

2007-11-01

In this paper, we construct an equivalent spin chain for the Gross-Pitaevskii equation with quadratic potential and exponentially varying scattering lengths using gauge equivalence. We have then generated the soliton solutions for the spin components S3 and S-. We find that the spin solitons for S3 and S- can be compressed for exponentially growing eigenvalues while they broaden out for decaying eigenvalues.

Vaeksthormonbehandling af korte børn født small for gestational age

DEFF Research Database (Denmark)

Christesen, Henrik B Thybo; Jensen, Rikke Bodin Beck; Birkebæk, Niels

2006-01-01

Short children born small for gestational age (SGA) are defined as having a birth weight below -2 SD for gestational age and a reduced height at four years of age (height gain 12 centimetres) in such children...

Gestational trophoblastic neoplasia: A 6 year retrospective study

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Sushruta Shrivastava

2014-01-01

Full Text Available Aims and Objectives: To study the clinical presentations of gestational trophoblastic neoplasia and its response to chemotherapy. Materials and Methods: This is a retrospective study of 28 women of gestational trophoblastic neoplasia evaluated over a period of 6 years from January 2004 to December 2009. Patients were evaluated on the basis of their age, number of deliveries, history of abortion or molar pregnancy, and the treatment received. All patients were scored on the basis of WHO scoring system. Patients with low risk (score /=7 received multiple agent chemotherapy with EMACO regimen. After completion of chemotherapy patients were followed for a minimum of 2 years. The response to treatment was evaluated during follow-up by clinical examination, beta hCG levels and imaging as and when required. Results: Out of 28 women only 27 could be evaluated, because 1 patient was lost to follow-up. Out of 27 patients, 18 patients (66.67% achieved complete remission with the first-line chemotherapy and additional 25.92% (7/27 achieved complete remission with second line chemotherapy resulting in complete remission of 92.5% (25/27. Conclusion: Gestational trophoblastic neoplasia is curable if patient is properly evaluated and scored. It shows good response to chemotherapy.

Ethical and Legal Issues in Gestational Surrogacy

Science.gov (United States)

Casella, Claudia; Capasso, Emanuele; Terracciano, Lucia; Delbon, Paola; Fedeli, Piergiorgio; Salzano, Francesco Antonio; Policino, Fabio; Niola, Massimo

2018-01-01

Abstract This study originated from events that occurred in 2014 in an Italian hospital, where the embryos of a couple, obtained by means of homologous insemination, were mistakenly implanted into the uterus of another woman who, along with her husband, underwent the same treatment. Faced with this serious adverse circumstance, that gives rise to ethical and legal issues, the authors conducted a comparative examination of how to consider the division of maternity (between biological mother and uterine mother) and the related division of paternity (between genetic father and legal father, husband or partner of the gestational mother). Some preliminary observations are made concerning parenthood and filiation within the context of currently applicable Italian law. The following is a detailed analysis of the arguments in favour of the parental figures involved (gestational mother/genetic mother). PMID:29675478

Glazed clay pottery and lead exposure in Mexico: Current experimental evidence.

Science.gov (United States)

Diaz-Ruiz, Araceli; Tristán-López, Luis Antonio; Medrano-Gómez, Karen Itzel; Torres-Domínguez, Juan Alejandro; Ríos, Camilo; Montes, Sergio

2017-11-01

Lead exposure remains a significant environmental problem; lead is neurotoxic, especially in developing humans. In Mexico, lead in human blood is still a concern. Historically, much of the lead exposure is attributed to the use of handcrafted clay pottery for cooking, storing and serving food. However, experimental cause-and-effect demonstration is lacking. The present study explores this issue with a prospective experimental approach. We used handcrafted clay containers to prepare and store lemonade, which was supplied as drinking water to pregnant rats throughout the gestational period. We found that clay pots, jars, and mugs leached on average 200 µg/l lead, and exposure to the lemonade resulted in 2.5 µg/dl of lead in the pregnant rats' blood. Neonates also showed increased lead content in the hippocampus and cerebellum. Caspase-3 activity was found to be statistically increased in the hippocampus in prenatally exposed neonates, suggesting increased apoptosis in that brain region. Glazed ceramics are still an important source of lead exposure in Mexico, and our results confirm that pregnancy is a vulnerable period for brain development.

Umbilical cord length in singleton gestations: a Finnish population-based retrospective register study.

Science.gov (United States)

Georgiadis, L; Keski-Nisula, L; Harju, M; Räisänen, S; Georgiadis, S; Hannila, M-L; Heinonen, S

2014-04-01

Many complications of pregnancy and delivery are associated with umbilical cord length. It is important to examine the variation in length, in order to identify normal and abnormal conditions. Moreover, the factors influencing cord growth and development are not precisely known. The main objectives were to provide updated reference charts for umbilical cord length in singleton pregnancies and to evaluate potential factors affecting cord length. Birth register data of 47,284 singleton pregnant women delivering in Kuopio University Hospital, Finland was collected prospectively. Gender-specific centile charts for cord length from 22 to 44 gestational weeks were obtained using generalized additive models for location, scale, and shape (GAMLSS). Gestational, fetal, and maternal factors were studied for their potential influence on cord length with single variable analysis and stepwise multiple linear regression analysis. Cord length increased according to gestational age, while the growth decelerated post-term. Birth weight, placental weight, pregravid maternal body mass index, parity, and maternal age correlated to cord length. Gestational diabetes and previous miscarriages were associated with longer cords, while female gender and placental abruption were associated with shorter cords. Girls had shorter cords throughout gestation although there was substantial variation in length in both genders. Cord length associated significantly with birth weight, placental weight, and gestational age. Significantly shorter cords were found in women with placental abruption. This important finding requires further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association of GSTs polymorphisms with risk of gestational diabetes mellitus.

Science.gov (United States)

Li, Yan; Li, Shaoru; Zhai, Qianqian; Hai, Jie; Wang, Di; Cao, Meng; Zhang, Qinggui

2015-01-01

We conducted a case-control study to investigate the association between GSTM1, GSTT1 and GSTP1 IIe105Val polymorphisms and development of gestational diabetes mellitus in a Chinese population. A total of 320 patients with gestational diabetes mellitus and 358 pregnancy subjects were consecutively collected between January 2013 and December 2014. Genotyping for detection of GSTM1, GSTT1 and GSTP1 IIe105Val was conducted by using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphisms) method. By Fisher's exact test, we found that the genotype distributions of GSTP1 IIe105Val were in line with the Hardy-Weinberg equilibrium in control subjects (P=0.57). By Chi-square test, we found significant differences in the genotype distributions of GSTM1 (χ(2)=11.49, P=0.001) and GSTT1 (χ(2)=18.50, Pgestational diabetes mellitus when compared with the present genotype, and the adjusted Ors (95% CI) were 1.71 (1.24-2.36) and 2.00 (1.44-2.79), respectively. However, the GSTP1 IIe105Val polymorphism was not associated with an elevated risk of gestational diabetes mellitus. In conclusion, we suggest that the GSTM1 null genotype and GSTT1 null genotype are correlated with an increased risk of gestational diabetes mellitus in a Chinese population.

The shifting trajectory of growth in femur length during gestation.

Science.gov (United States)

Bjørnerem, Ashild; Johnsen, Synnøve L; Nguyen, Tuan V; Kiserud, Torvid; Seeman, Ego

2010-05-01

Bone size is a determinant of bone strength and tracks in its percentile of origin during childhood and adolescence. We hypothesized that the ranking of an individual's femur length (FL) is established in early gestation and tracks thereafter. Fetal FL was measured serially using 2D ultrasound in 625 Norwegian fetuses. Tracking was assessed using Pearson correlation, a generalized estimating equation model, and by calculating the proportion of fetuses whose FL remained within the same quartile. Baseline FL Z-score (weeks 10 to 19) and later measurements correlated, but more weakly as gestation advanced: r = 0.59 (weeks 20 to 26); r = 0.45 (weeks 27 to 33); and r = 0.32 (weeks 34 to 39) (p baseline FL Z-score, placental weight (150 g), maternal height (5 cm), and weight (10 kg), was associated with a 0.25, 0.15, 0.10, and 0.05 SD higher FL Z-score at the end of gestation, respectively (p ranging from <0.001 to 0.02). Tracking within the same percentile throughout the whole of gestation, as suggest by growth charts, is uncommon. Deviation from tracking is more common and is the result of changes in growth velocity within and between fetuses and is partly influenced by maternal, fetal, and placental factors. (c) 2010 American Society for Bone and Mineral Research.

RISK FACTORS FOR GESTATIONAL TROPHOBLASTIC NEOPLASIA: A CASE CONTROL STUDY IN A TERTIARY HOSPITAL

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Hema Sreedharan Nair

2016-10-01

Full Text Available BACKGROUND Gestational trophoblastic disease is a spectrum of proliferative abnormalities of the trophoblast. GTD represents a benign form of the disease while GTN is the malignant often metastatic lesion. 75-80 per cent of patients initially diagnosed as GTD will follow a benign course after dilatation and curettage. 15-20 per cent develop locally invasive disease and 3-5 per cent develop metastatic lesions. The study aims to assess the proportion of gestational trophoblastic neoplasia among women with gestational trophoblastic disease and identify the risk factors for chemotherapy in gestational trophoblastic neoplasia. MATERIALS AND METHODS This is a case-control study conducted in a tertiary hospital during a 5-year period. Cases are gestational trophoblastic neoplasia diagnosed by either rising beta-HCG levels or plateauing beta-HCG levels or by histological evidence of choriocarcinoma. Controls are cases of gestational trophoblastic disease post evacuation with normal HCG regression at 8 weeks. There were 306 controls and 57 cases. RESULTS Tabulated and analysed using SPSS package. Of the 363 patients of gestational trophoblastic disease, 57 (15.7% needed chemotherapy. 98.2% belonged to the age group of 20-35 years. 63% had gestational age of more than 12 weeks, 56.1% had pre-evacuation HCG of more than 40,000. 15.7% needed combination therapy. CONCLUSION 1. 83.1% of patients belonged to age group of 20-30 years. 2. Blood group distribution of patients with gestational trophoblastic disease did not show any significance. 3. 15.7% of total patients were diagnosed to have gestational trophoblastic neoplasia that necessitated chemotherapy. 4. When uterine size was more than 12 weeks, a statistically significant number of patients needed chemotherapy compared to non-chemotherapy group. 5. When BHCG values were more than 40,000, a statistically significant number of patients needed chemotherapy. 6. A risk score of seven or more was found to

Establishing Substantial Equivalence: Transcriptomics

Science.gov (United States)

Baudo, María Marcela; Powers, Stephen J.; Mitchell, Rowan A. C.; Shewry, Peter R.

Regulatory authorities in Western Europe require transgenic crops to be substantially equivalent to conventionally bred forms if they are to be approved for commercial production. One way to establish substantial equivalence is to compare the transcript profiles of developing grain and other tissues of transgenic and conventionally bred lines, in order to identify any unintended effects of the transformation process. We present detailed protocols for transcriptomic comparisons of developing wheat grain and leaf material, and illustrate their use by reference to our own studies of lines transformed to express additional gluten protein genes controlled by their own endosperm-specific promoters. The results show that the transgenes present in these lines (which included those encoding marker genes) did not have any significant unpredicted effects on the expression of endogenous genes and that the transgenic plants were therefore substantially equivalent to the corresponding parental lines.

Maternal circulating leukocytes display early chemotactic responsiveness during late gestation

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Gomez-Lopez Nardhy

2013-01-01

Full Text Available Abstract Background Parturition has been widely described as an immunological response; however, it is unknown how this is triggered. We hypothesized that an early event in parturition is an increased responsiveness of peripheral leukocytes to chemotactic stimuli expressed by reproductive tissues, and this precedes expression of tissue chemotactic activity, uterine activation and the systemic progesterone/estradiol shift. Methods Tissues and blood were collected from pregnant Long-Evans rats on gestational days (GD 17, 20 and 22 (term gestation. We employed a validated Boyden chamber assay, flow cytometry, quantitative real time-polymerase chain reaction, and enzyme-linked immunosorbent assays. Results We found that GD20 maternal peripheral leukocytes migrated more than those from GD17 when these were tested with GD22 uterus and cervix extracts. Leukocytes on GD20 also displayed a significant increase in chemokine (C-C motif ligand 2 (Ccl2 gene expression and this correlated with an increase in peripheral granulocyte proportions and a decrease in B cell and monocyte proportions. Tissue chemotactic activity and specific chemokines (CCL2, chemokine (C-X-C motif ligand 1/CXCL1, and CXCL10 were mostly unchanged from GD17 to GD20 and increased only on GD22. CXCL10 peaked on GD20 in cervical tissues. As expected, prostaglandin F2α receptor and oxytocin receptor gene expression increased dramatically between GD20 and 22. Progesterone concentrations fell and estradiol-17β concentrations increased in peripheral serum, cervical and uterine tissue extracts between GD20 and 22. Conclusion Maternal circulating leukocytes display early chemotactic responsiveness, which leads to their infiltration into the uterus where they may participate in the process of parturition.

Gestational Weight Gain: Results from the Delta Healthy Sprouts Comparative Impact Trial

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Jessica L. Thomson

2016-01-01

Full Text Available Introduction. Delta Healthy Sprouts trial was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of Southern African American women and their infants. Results pertaining to the primary outcome, gestational weight gain, are reported. Methods. Participants (n=82, enrolled early in their second trimester of pregnancy, were randomly assigned to one of two treatment arms. Gestational weight gain, measured at six monthly home visits, was calculated by subtracting measured weight at each visit from self-reported prepregnancy weight. Weight gain was classified as under, within, or exceeding the Institute of Medicine recommendations based on prepregnancy body mass index. Chi-square tests and generalized linear mixed models were used to test for significant differences in percentages of participants within recommended weight gain ranges. Results. Differences in percentages of participants within the gestational weight gain guidelines were not significant between treatment arms across all visits. Conclusions. Enhancing the gestational nutrition and physical activity components of an existing home visiting program is feasible in a high risk population of primarily low income African American women. The impact of these enhancements on appropriate gestational weight gain is questionable given the more basic living needs of such women. This trial is registered with ClinicalTrials.gov NCT01746394, registered 4 December 2012.

Psychosocial Characteristics and Gestational Weight Change among Overweight, African American Pregnant Women

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Kelly C. Allison

2012-01-01

Full Text Available Objectives. To describe psychosocial factors identified as contributors of weight gain in the general population and to examine the relationship between these factors and gestational weight gain among low socioeconomic status, African American, overweight pregnant women. Methods. African American women (n=120 with a pregravid body mass index ≥25 kg/m2 completed measures of eating, sleep, and depressed mood between 14 and 24 weeks of gestation. Weight was tracked. Descriptive statistics, correlations, and linear regression modeling were used to characterize the sample and examine predictors of gestational weight gain. Results. Four percent screened positive for night eating syndrome, with 32% consuming at least 25% of their daily caloric intake after dinner (evening hyperphagia. None met criteria for binge eating disorder; 4% reported occasional binge episodes. Cognitive restraint over eating was low. Participants slept 7.1 (SD=1.9 h per night and reported 4.3 (SD=3.6 awakenings per week; 18% reported some level of depressed mood. Night and binge eating were related to each other, sleep quality, and depressed mood. Eating due to cravings was the only psychosocial variable to predict gestational weight gain. Conclusions. Depressed mood, night eating, and nighttime awakenings were common in this cohort, while cognitive restraint over eating was low. Most psychosocial variables were not predictive of excess gestational weight gain.

Prenatal exposure to gestational diabetes mellitus as an independent risk factor for long-term neuropsychiatric morbidity of the offspring.

Science.gov (United States)

Nahum Sacks, Kira; Friger, Michael; Shoham-Vardi, Ilana; Abokaf, Hanaa; Spiegel, Efrat; Sergienko, Ruslan; Landau, Daniella; Sheiner, Eyal

2016-09-01

The reported rates of gestational diabetes mellitus are constantly escalating and little is known about long-term complications in the offspring. Evidence from the field of epigenetics strongly advocates the need for research on the neuropsychiatric complications in offspring prenatally exposed to gestational diabetes mellitus. We sought to assess whether in utero exposure to gestational diabetes mellitus increases the risk of long-term neuropsychiatric morbidity in the offspring. A population-based cohort study compared the incidence of hospitalizations due to neuropsychiatric disease between singletons exposed and unexposed to gestational diabetes mellitus. Deliveries occurred in the years 1991 through 2014 in a regional tertiary medical center. Perinatal deaths, multiple gestations, mothers with pregestational diabetes or lack of prenatal care, and children with congenital malformations were excluded from the study. A multivariate generalized estimating equation logistic regression model analysis was used to control for confounders and for maternal clusters. During the study period 231,271 deliveries met the inclusion criteria; 5.4% of the births were to mothers diagnosed with gestational diabetes mellitus (n = 12,642), of these 4.3% had gestational diabetes type A1 (n = 10,076) and 1.1% had gestational diabetes type A2 (n = 2566). During the follow-up period, a significant linear association was noted between the severity of the gestational diabetes (no gestational diabetes, gestational diabetes mellitus A1, gestational diabetes mellitus A2) and neuropsychiatric disease of the offspring (1.02% vs 1.36% vs 1.68%, respectively, P gestational diabetes mellitus had higher cumulative incidence of neuropsychiatric morbidity. Using a generalized estimating equation multivariable logistic regression model, controlling for time-to-event, maternal age, gestational age at delivery, maternal obesity, maternal preeclampsia and fertility treatments, maternal gestational

On uncertainties in definition of dose equivalent

International Nuclear Information System (INIS)

Oda, Keiji

1995-01-01

The author has entertained always the doubt that in a neutron field, if the measured value of the absorbed dose with a tissue equivalent ionization chamber is 1.02±0.01 mGy, may the dose equivalent be taken as 10.2±0.1 mSv. Should it be 10.2 or 11, but the author considers it is 10 or 20. Even if effort is exerted for the precision measurement of absorbed dose, if the coefficient being multiplied to it is not precise, it is meaningless. [Absorbed dose] x [Radiation quality fctor] = [Dose equivalent] seems peculiar. How accurately can dose equivalent be evaluated ? The descriptions related to uncertainties in the publications of ICRU and ICRP are introduced, which are related to radiation quality factor, the accuracy of measuring dose equivalent and so on. Dose equivalent shows the criterion for the degree of risk, or it is considered only as a controlling quantity. The description in the ICRU report 1973 related to dose equivalent and its unit is cited. It was concluded that dose equivalent can be considered only as the absorbed dose being multiplied by a dimensionless factor. The author presented the questions. (K.I.)