bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urine albumin–creatinine ratio in women with gestational diabetes: Its link with glycaemic status
Authors: Wong Vincent W. , Chong Shanley , Jalaludin Bin , Russell Hamish , Depczynski Barbara 
Published: October 2014

BackgroundMicro‐albuminuria has been established as a marker for micro‐vascular disease. Spot urine albumin‐to‐creatinine ratio (UACR), even in the high normal range, predicts future cardiovascular events. The value of UACR in women with gestational diabetes mellitus (GDM) during pregnancy is uncertain.AimThe objectives of this study were to assess the associations between UACR (performed at the time of GDM diagnosis) and various maternal parameters and to evaluate its correlation with pregnancy outcomes.Materials and MethodsWe conducted a retrospective review of women with GDM who attended antenatal clinics at a single centre between March 2010 and September 2013.ResultsAmong 1015 women included in this study, high UACR levels were associated with advancing maternal age, maternal obesity, gestational hypertension, elevated glycosylated haemoglobin (HbA1c) and high fasting glucose level. After adjustments for various maternal factors, only advancing age, HbA1c and fasting glucose level were associated with UACR. In terms of pregnancy outcomes, elevated UACR was not associated with adverse events, but was a predictor for pre‐eclampsia.ConclusionsThe finding that UACR was associated with glycaemic status in women with GDM suggests early micro‐vascular disease may be present in women who had greater degree of hyperglycaemia. This raises the question of whether women with GDM and elevated UACR may be at higher risk of developing cardiovascular disease in the future. Long‐term follow‐up of this subgroup of women would be worthwhile.
Can we identify changes in fascial paravaginal supports after childbirth?
Authors: Cassadó‐Garriga Jordi , Wong Vivien , Shek Kalai , Dietz Hans Peter 
Published: October 2014

BackgroundDefects of anterior vaginal wall fascia are generally assumed to be factors in the aetiology of cystocele. However, to date, there is very little information on diagnosis by imaging.AimTo document the appearance of vaginal fornices before and after childbirth using 4D ultrasound volume data sets as an aid in diagnosing paravaginal defects of the anterior vaginal wall.Materials and MethodsThis study was performed by re‐analysing data sets obtained in a previously published study involving ante‐ and postpartum pelvic floor assessment by ultrasound. Two hundred and two nulliparous women had been seen at a mean gestation of 37.2 weeks at two tertiary hospitals. One hundred and sixty‐three returned 3 months postpartum. All the participants underwent an interview and 4D translabial ultrasound at both antepartum and postpartum appointments. The integrity of vaginal fornices and levator ani was assessed by tomographic ultrasound.ResultsVaginal fornices were assessed in both ante‐ and postnatal volumes, and loss of forniceal tenting was found in 85 patients (52%). On average, seven slices were affected (range, 1–16). On multivariate analysis, controlling for potential confounders, including partial/complete avulsion, loss of forniceal tenting remained independently associated with increased cystocele descent (P = 0.005).ConclusionsVaginal childbirth is associated with loss of tenting of the vaginal fornices, independent of levator trauma, and also with impaired anterior vaginal wall support. This evidence suggests the existence of paravaginal defects and may imply a role for such defects in the causation of anterior vaginal wall prolapse.
Using SMS to monitor adverse events following trivalent influenza vaccination in pregnant women
Authors: Regan Annette K. , Blyth Christopher C. , Mak Donna B. , Richmond Peter C. , Effler Paul V. 
Published: October 2014

BackgroundTrivalent influenza vaccine (TIV) has been recommended for pregnant women in Australia for more than a decade and funded since 2009, yet vaccination coverage remains low. Misperceptions of the safety of TIV in pregnancy have been identified as a major contributor to low vaccination rates. Ongoing safety monitoring with dissemination of results could help improve antenatal influenza vaccine uptake.AimTo implement a real‐time safety monitoring program for TIV administered to pregnant women.Materials and MethodsBetween March and July 2013, a cohort of 3,173 pregnant women who received the 2013 TIV agreed to follow‐up regarding possible adverse events following immunisation (AEFI); 3,047 (96%) provided a mobile telephone number and were sent a short message service (SMS) inquiring whether they had experienced an AEFI; attempts were made to contact the remaining 126 (4%) women by voice telephone call.ResultsResponses were obtained from 2,885 (90.9%) women, 413 (14.3%) of whom reported a suspected AEFI. Local reactions were the most frequently reported AEFI (4.9%), followed by headache (3.3%), fever (2.7%), fatigue (2.5%), diarrhoea (2.5%) and malaise (1.2%); 39 women (1.4%) sought medical advice and no serious vaccine‐related AEFIs were identified. Response rates were higher for SMS compared to telephone (84% vs 63%; P < 0.001).ConclusionsThese findings support the safety of TIV in pregnant women. Mobile phone technology proved an efficient method for timely surveillance of adverse events following vaccination. The low level of AEFI observed should be reassuring to antenatal patients and their providers and help promote TIV uptake.
A prospective audit of the adherence to a new magnesium sulphate guideline for the neuroprotection of infants born less than 30 weeks' gestation
Authors: Tan Yu Hwee , Groom Katie M. 
Published: October 2014

Antenatal magnesium sulphate reduces the risk of cerebral palsy in babies born <30 weeks’ gestation. A guideline for its use in women at imminent risk of preterm birth was implemented at National Women's Health, Auckland City Hospital in 2012. This prospective audit assessed adherence to the guideline in women delivering at <30 weeks in the first year after its implementation. Magnesium sulphate was safely administered to 58 of 71 (82%) eligible women and 58 of 61 (95%) of women where it was clinically appropriate and practically achievable.
A possible link between dysmenorrhoea and the development of chronic pelvic pain
Authors: Hardi Gemma , Evans Susan , Craigie Meredith 
Published: October 2014

Anecdotally, severe dysmenorrhoea can pre‐date the development of chronic pelvic pain (CPP). This study describes the timeline for the transition from dysmenorrhoea to CPP in a cohort of new patients attending a private gynaecology clinic. In 16.4% of cases, transition occurred within one year, and within 12 years in over 50%. Our study suggests clinicians need to observe women with severe dysmenorrhoea for signs of chronic pain. Further research is needed into the transition from dysmenorrhoea to CPP, and effective early interventions.
Simulation‐based teaching versus point‐of‐care teaching for identification of basic transoesophageal echocardiography views: a prospective randomised study
Authors: Ogilvie E. , Vlachou A. , Edsell M. , Fletcher S. N. , Valencia O. , Meineri M. , Sharma V. 
Published: October 2014

SummaryIn recent years, the use of transoesophageal echocardiography has increased in anaesthesia and intensive care. We explored the impact of two different teaching methods on the ability of echocardiography‐naïve subjects to identify cardiac anatomy associated with the 20 standard transoesophageal echocardiography imaging planes, and assessed trainees' satisfaction with these methods of training. Fifty‐two subjects were randomly assigned to one of two groups: a simulation‐based and a theatre‐based teaching group. Subjects undertook video‐based tests comprised of 20 multiple choice questions on echocardiography views before and after receiving echocardiography teaching. Subjects in simulation‐ and theatre‐based teaching groups scored 40% (30–40 [20–50])% and 35% (30–40 [15–55])% in the pre‐test, respectively (p = 0.52). Following echocardiography teaching, subjects within both groups improved upon their pre‐test knowledge (p < 0.001). Subjects in the simulation‐based teaching group significantly outperformed their theatre‐based group counterparts in the post‐intervention test (p = 0.0002).
Metalloproteinase Inhibition Protects against Reductions in Circulating Adrenomedullin during Lead‐induced Acute Hypertension
Authors: Nascimento Regina A. , Mendes Gabryella , Possomato‐Vieira Jose S. , Gonçalves‐Rizzi Victor Hugo , Kushima Hélio , Delella Flavia K. , Dias‐Junior Carlos A. 
Published: October 2014

AbstractIntoxication with lead (Pb) results in increased blood pressure by mechanisms involving matrix metalloproteinases (MMPs). Recent findings have revealed that MMP type two (MMP‐2) seems to cleave vasoactive peptides. This study examined whether MMP‐2 and MMP‐9 levels/activities increase after acute intoxication with low lead concentrations and whether these changes were associated with increases in blood pressure and circulating endothelin‐1 or with reductions in circulating adrenomedullin and calcitonin gene‐related peptide (CGRP). Here, we expand previous findings and examine whether doxycycline (a MMPs inhibitor) affects these alterations. Wistar rats received intraperitoneally (i.p.) 1st dose 8 μg/100 g of lead (or sodium) acetate, a subsequent dose of 0.1 μg/100 g to cover daily loss and treatment with doxycycline (30 mg/kg/day) or water by gavage for 7 days. Similar whole‐blood lead levels (9 μg/dL) were found in lead‐exposed rats treated with either doxycycline or water. Lead‐induced increases in systolic blood pressure (from 143 ± 2 to 167 ± 3 mmHg) and gelatin zymography of plasma samples showed that lead increased MMP‐9 (but not MMP‐2) levels. Both lead‐induced increased MMP‐9 activity and hypertension were blunted by doxycycline. Doxycycline also prevented lead‐induced reductions in circulating adrenomedullin. No significant changes in plasma levels of endothelin‐1 or CGRP were found. Lead‐induced decreases in nitric oxide markers and antioxidant status were not prevented by doxycycline. In conclusion, acute lead exposure increases blood pressure and MMP‐9 activity, which were blunted by doxycycline. These findings suggest that MMP‐9 may contribute with lead‐induced hypertension by cleaving the vasodilatory peptide adrenomedullin, thereby inhibiting adrenomedullin‐dependent lowering of blood pressure.
Risk‐tailored CNS prophylaxis in a mono‐institutional series of 200 patients with diffuse large B‐cell lymphoma treated in the rituximab era
Authors: Ferreri Andrés J. M. , Bruno‐Ventre Marta , Donadoni Giovanni , Ponzoni Maurilio , Citterio Giovanni , Foppoli Marco , Vignati Alessandro , Scarfò Lydia , Sassone Marianna , Govi Silvia , Caligaris‐Cappio Federico 
Published: October 2014

SummaryThe most effective strategy to prevent central nervous system (CNS) dissemination in diffuse large B‐cell lymphoma (DLBCL) remains an important, unmet clinical need. Herein, we report a retrospective analysis of risk‐tailored CNS prophylaxis in 200 human immunodeficiency virus‐negative adults with DLBCL treated with rituximab‐CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or similar. High risk of CNS relapse was defined by involvement of specific extranodal organs, or simultaneous presence of advanced stage and high serum lactate dehydrogenase level; CNS prophylaxis with high‐dose methotrexate ± intrathecal chemotherapy (IT) was routinely used in high‐risk patients diagnosed after 2007. CNS relapse risk was low in 93 patients and high in 107; 40 high‐risk patients received prophylaxis, which consisted of IT alone in 7. At a median follow‐up of 60 months, one low‐risk and nine high‐risk patients (1% vs. 8%; P = 0·01) experienced CNS relapse. In the high‐risk group, CNS relapses occurred in 8/67 (12%) patients who did not receive prophylaxis and in 1/40 (2·5%) patients who did; the latter occurred in a patient managed with IT alone. CNS relapse rate was 12% (9/74) for patients treated with “inadequate” prophylaxis (none or IT only) and 0% (0/33) for patients managed with intravenous prophylaxis (P = 0·03). In conclusion, high‐dose methotrexate‐based prophylaxis significantly reduces CNS failures in high‐risk patients stratified by involvement of specific extranodal sites and International Prognostic Index.
Self‐monitoring of blood glucose versus self‐monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes receiving structured education: a cluster randomized controlled trial
Authors: Dallosso H. M. , Bodicoat D. H. , Campbell M. , Carey M. E. , Davies M. J. , Eborall H. C. , Hadjiconstantinou M. , Khunti K. , Speight J. , Heller S. 
Published: October 2014

AbstractAimsTo compare the effectiveness and acceptability of self‐monitoring of blood glucose with self‐monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes.MethodsWe conducted a multi‐site cluster randomized controlled trial with practice‐level randomization. Participants attended a structured group education programme, which included a module on self‐monitoring using blood glucose or urine glucose monitoring. HbA1c and other biomedical measures as well as psychosocial data were collected at 6, 12 and 18 months. A total of 292 participants with Type 2 diabetes were recruited from 75 practices.ResultsHbA1c levels were significantly lower at 18 months than at baseline in both the blood monitoring group [mean (se) −12 (2) mmol/mol; −1.1 (0.2) %] and the urine monitoring group [mean (se) −13 (2) mmol/mol; −1.2 (0.2)%], with no difference between groups [mean difference adjusted for cluster effect and baseline value = −1 mmol/mol (95% CI −3, 2); −0.1% (95% CI −0.3, 0.2)]. Similar improvements were observed for the other biomedical outcomes, with no differences between groups. Both groups showed improvements in total treatment satisfaction, generic well‐being, and diabetes‐specific well‐being, and had a less threatening view of diabetes, with no differences between groups at 18 months. Approximately one in five participants in the urine monitoring arm switched to blood monitoring, while those in the blood monitoring arm rarely switched (18 vs 1% at 18 months; P < 0.001).ConclusionsParticipants with newly diagnosed Type 2 diabetes who attended structured education showed similar improvements in HbA1c levels at 18 months, regardless of whether they were assigned to blood or urine self‐monitoring.
Prevalence and awareness of diabetes mellitus among a rural population in China: results from Liaoning Province
Authors: Zhou X. , Guan H. , Zheng L. , Li Z. , Guo X. , Yang H. , Yu S. , Sun G. , Li W. , Hu W. , Guo L. , Pan G. , Xing L. , Zhang Y. , Sun Y. 
Published: October 2014

AbstractAimTo clarify the diabetes prevalence trends among the rural population in northern China.MethodsAll eligible permanent residents aged ≥ 35 years in selected rural villages of Liaoning province were invited to participate in the study. A total of 11 600 people completed all questionnaires and were included in the study. The response rate was 85.3%. Fasting plasma glucose levels were measured after at least 12 h of fasting and diabetes was diagnosed according to WHO criteria, i.e. fasting plasma glucose ≥ 7 mmol/l and/or being on treatment for diabetes. Impaired fasting glucose was defined according to the 1997 and the 2010 American Diabetes Association (ADA) criteria (6.1–6.9 and 5.6–6.9 mmol/l, respectively). Previous diagnoses of diabetes were assessed on the basis of self‐reports.ResultsThe prevalence of diabetes among adults in the rural population was 10.6% (10.0% in men and 11.1% in women). The prevalence of impaired fasting glucose was 13.0 and 36.1% according to the 1997 and the 2010 ADA criteria, respectively. The prevalence of previously diagnosed diabetes was 4.3% among the whole population (3.3% in men and 5.1% in women). The prevalence of previously diagnosed diabetes was 34.8% in men and 50.2% in women. Only 29.6% of men and 42% of women with diabetes had taken oral hypoglycaemic agents or insulin to lower their blood sugar. In multivariate analysis, age, drinking habits, BMI, dyslipidaemia and family history of diabetes were identified as independent risk factors for diabetes, and occupational physical activity, smoking and lean meat intake were identified as independent protective factors for diabetes.ConclusionsThe prevalence of diabetes and impaired fasting glucose were found to be high in this rural population. Although the rate of treatment of people with diabetes has increased, the glycaemic control rate was still at a low level.
Perioperative diabetes care: room for improving the person centredness
Authors: Hommel I. , van Gurp P. J. , Tack C. J. , Liefers J. , Mulder J. , Wollersheim H. , Hulscher M. E. J. L. 
Published: October 2014

AbstractAimsPerson centredness is an important principle for delivering high‐quality diabetes care. In this study, we assess the level of person centredness of current perioperative diabetes care.MethodsWe conducted a survey in six Dutch hospitals, among 690 participants with diabetes who underwent major abdominal, cardiac or large‐joint orthopaedic surgery. The survey included questions regarding seven dimensions of person‐centred perioperative diabetes care.ResultsComplete data were obtained from 298 participants. The survey scores were low for many of the dimensions of person centredness. The dimensions ‘information’, ‘patient involvement’ and ‘coordination and integration of care’ had the lowest scores. Only half the participants had received information about perioperative diabetes treatment, and approximately one‐third had received information about the effect of surgery on blood glucose values, target glucose values and glucose measurement times. Similarly, half the participants had an opportunity to ask questions preoperatively, and only one‐third of the participants felt involved in the decision‐making regarding diabetes treatment. Most participants knew neither the caregiver in charge of perioperative diabetes treatment nor whom to contact in case of diabetes‐related problems during their hospital stay.ConclusionsCurrent perioperative diabetes care is characterized by a lack of patient information and limited patient involvement. These results indicate that there is ample room for improving the person centredness of perioperative diabetes care.
Adolescent testosterone, muscle mass and glucose metabolism: evidence from the ‘Children of 1997’ birth cohort in Hong Kong
Authors: Hou W. W. , Tse M. A. , Lam T. H. , Leung G. M. , Schooling C. M. 
Published: October 2014

AbstractAimsDiabetes rates are high in Asia despite relatively low rates of obesity, which might be related to lower muscle mass. Muscle mass plays an important role in glucose metabolism. Peak muscle mass is obtained in late adolescence. We tested the hypothesis that pubertal testosterone is negatively associated with glucose metabolism mediated by muscle mass.MethodsParticipants aged 15 years (278 boys and 223 girls) were recruited from the Hong Kong's ‘Children of 1997’ birth cohort in 2012. Multivariable linear regression with multiple imputation and inverse probability weighting was used to examine the adjusted associations of pubertal testosterone with skeletal muscle index, body fat percentage, fasting glucose, insulin and homeostasis model of assessment – insulin resistance.ResultsTotal testosterone was negatively associated with fasting glucose (−0.008, 95% confidence interval −0.015 to −0.002), insulin (−0.43, 95% confidence interval −0.56 to −0.30) and insulin and homeostasis model of assessment – insulin resistance (−0.09, 95% confidence interval −0.12 to −0.06) adjusted for sex, birth weight, highest parental education, mother's place of birth and physical activity. These associations were attenuated by additional adjustment for skeletal mass index or body fat percentage.ConclusionsAdolescent glucose metabolism may be influenced by testosterone, perhaps partially via skeletal muscle mass.
Utility of ketone measurement in the prevention, diagnosis and management of diabetic ketoacidosis
Authors: Misra S. , Oliver N. S. 
Published: October 2014

AbstractKetone measurement is advocated for the diagnosis of diabetic ketoacidosis and assessment of its severity. Assessing the evidence base for ketone measurement in clinical practice is challenging because multiple methods are available but there is a lack of consensus about which is preferable. Evaluating the utility of ketone measurement is additionally problematic because of variability in the biochemical definition of ketoacidosis internationally and in the proposed thresholds for ketone measures. This has led to conflicting guidance from expert bodies on how ketone measurement should be used in the management of ketoacidosis. The development of point‐of‐care devices that can reliably measure the capillary blood ketone β‐hydroxybutyrate (BOHB) has widened the spectrum of applications of ketone measurement, but whether the evidence base supporting these applications is robust enough to warrant their incorporation into routine clinical practice remains unclear. The imprecision of capillary blood ketone measures at higher values, the lack of availability of routine laboratory‐based assays for BOHB and the continued cost‐effectiveness of urine ketone assessment prompt further discussion on the role of capillary blood ketone assessment in ketoacidosis. In the present article, we review the various existing methods of ketone measurement, the precision of capillary blood ketone as compared with other measures, its diagnostic accuracy in predicting ketoacidosis and other clinical applications including prevention, assessment of severity and resolution of ketoacidosis.
Diabetes‐related quality of life is enhanced by glycaemic improvement in older people
Authors: Abbatecola A. M. , Spazzafumo L. , Fabbietti P. , Testa R. , Rabini R. A. , Bonfigli A. R. , Corsonello A. , Lattanzio F. , Paolisso G. 
Published: October 2014

AbstractAimsTo investigate the validity and reliability of the Audit of Diabetes‐Dependent Quality of Life instrument in older Italians with diabetes and to test the association of diabetes‐related quality of life with glycaemic control over time.MethodsA total of 558 outpatients with Type 2 diabetes from the Diabetic Unit of the Italian National Research Centre on Aging Hospital in Ancona were enrolled to complete questionnaires (Audit of Diabetes‐Dependent Quality of Life‐19 and the Short‐Form‐12), and to undergo clinical and biochemical testing at baseline and at 12 months of follow‐up. The overall impact of diabetes using the average weighted impact score from the Audit of Diabetes‐Dependent Quality of Life questionnaire was calculated. Participants were categorized according to this score as having either less or more negative diabetes‐related quality of life.ResultsParticipants had a mean ± sd age of 67.7 ± 9.2 years and 51.8% were male. Factor analysis and Cronbach's coefficient of internal consistency (Cronbach's α = 0.931) confirmed that the 19 domain‐specific Audit of Diabetes‐Dependent Quality of Life items could be combined into a single scale in this Italian population. The impact score correlated with the physical (r = 0.275; P < 0.001) and mental components (r = 0.291; P < 0.001) of the Short‐Form‐12 questionnaire. Significant differences were found according to diabetic complications in specific Audit of Diabetes‐Dependent Quality of Life items and impact scores. Insulin use had a greater association with a more negative quality of life compared with other antidiabetic agents. A multivariate linear regression model with restricted linear spline application showed that the relationship between HbA1c and impact score was not linear and that the change in the impact score was associated with improved glycaemic control in those with a less negative diabetes‐related quality of life at 12 months.ConclusionsThe Audit of Diabetes‐Dependent Quality of Life‐19 is a valid tool for measuring the impact of diabetes on quality of life in older Italians. Perception of diabetes‐related quality of life is associated with glycaemic control over time.