Large-for-gestational-age infants of type 1 diabetic mothers: An effect of preprandial hyperglycemia?

Objective. To determine how the frequency, timing and magnitude of hyperglycemia are associated with large-for-gestational-age (LGA) infants in pregnancies complicated by type 1 diabetes.

Methods. Charts from pregnant women with type 1 diabetes (n = 70) were reviewed. Indices of maternal glycemic control were determined for seven gestational periods (weeks 7–10, 11–15, 16–19, 20–24, 25–28, 29–32 and 33–38) and compared between women who delivered LGA infants and appropriate-for-gestational-age (AGA) infants.

Results. Of the 70 pregnancies, 57% of the infants were LGA (4.3 ± 0.4 kg) and 43% were AGA (3.2 ± 0.4 kg). Total maternal weight gain and rate of weight gain were significantly higher in mothers with LGA infants. The glycemic variables associated with an LGA infant were percentage of preprandial values above target for weeks 11–15, 25–28 and 29–32, and percentage of all values above target for weeks 33–38. For the entire pregnancy, the strongest predictors of an LGA infant were percentage of preprandial blood glucose values above target during weeks 29–32 and maternal weight gain.

Conclusions. In pregnant women with type 1 diabetes, frequent episodes of preprandial hyperglycemia in the third trimester significantly impact the development of LGA infants.     

The effect of histological chorioamnionitis on the short-term outcome of preterm infants ≤32 weeks: a single-center study

Abstract

Background and objectives: Chorioamnionitis (CA) is an acute inflammation of the membranes and chorion of the placenta. The aim of this study was to determine the effect of histological CA on the short-term outcome of preterm infants.

Subjects and methods: The clinical characteristics and outcomes of the preterm infant including respiratory distress syndrome, duration of mechanical ventilation, patent ductus arteriosus (PDA) requiring medical treatment or ligation, necrotizing enterocolitis, bronchopulmonary dysplasia, death and intraventricular hemorrhage (IVH; grade III–IV) were analyzed.

Results: Two hundred and eighty-one infants born at ≤32 weeks gestational ages were included. Infants were divided into two groups: one with histological CA (n?=?145) and without histological CA (n?=?136). Mean gestational age was 28.8?±?2.6 weeks and 29.1?±?2.5 weeks, and mean birth weight was 1138?±?350?g and 1210?±?299?g, respectively. There were no differences in gestational age and birth weight among the groups. Compared with the group, histological CA was associated with early onset sepsis (p?=?0.007), PDA (p?=?0.003), IVH (p?=?0.03), and death (p?=?0.04).

Conclusion: Maternal histological CA is an important risk factor for preterm deliveries and associated with serious morbidities such as early onset sepsis, IVH, PDA and increased mortality.     

Prematurity stereotyping and perceived vulnerability at 5‐months: Relations with mothers and their premature and full‐term infants at 9‐months

Objective: To examine the relationship between mothers' prematurity stereotyping and perceptions of vulnerability at 5 months and mother–infant interactions at 9 months for mothers of premature (N = 56) and full‐term (N = 59) infants. Method: At 5 months, mothers rated videotapes of unfamiliar infants given either a full‐term label (FTL) or premature label (PL) and completed questionnaires. At 9 months, mothers were videotaped in interactions with their own infant. A subgroup of mothers completed questionnaires at 32 months. Results: Mothers who more positively rated infants labelled with the same birth status as their own infants chose a more mature toy for their own infant and exhibited more positive interactive behaviours with their own infant at 9 months. Mothers who viewed their infant as more vulnerable at 5 months demonstrated less positive interactions with their 9‐month old infants. Both mothers of premature and full‐term infants who rated FTL infants more positively at 5 months felt less self‐efficacious; however, the former group felt more overprotective whereas the latter group reported less overprotectiveness. Conclusions: Results show some support for a relationship between early maternal cognitions and later maternal behaviour, although present findings are not as consistent as in previous studies. Implications of these findings are discussed.     

The longitudinal effects of midwife‐led postnatal debriefing on the psychological health of mothers

Pain has been shown to be invested with a multiplicity of meanings. This applies to labour pain as much as to any other. The meanings of pain in general and of labour pain in particular are examined in terms of religion, philosophy, spirituality, biology and culture. The possibility of the existence of political meanings is considered. An attempt is made to distinguish the meaning of labour pain for the carers and for the woman. The possibility that searching for meaning serves as a coping mechanism is explored. The argument is advanced that an understanding of the meaning of labour pain to the woman in labour is a fundamental prerequisite if the midwife is to facilitate the woman's achievement of a satisfying birth experience.     

The effect of α-amylase on the acrosomal membrane of human sperm

Purpose Sperm capacitation and the acrosome reaction are prerequisites to accomplishing fertilization. The object of this research was to induce capacitation and the acrosome reaction of human sperm, comparing the acrosome status of fertile and infertile men, using -amylase.Methods Acrosome status was measured using indirect immunofluorescence (IIF; monoclonal antibody GB24, Thèramex), hemizona assay (HZA), and transmission electron microscopy (TEM).Results Acrosome-reacted sperm without -amylase treatment was significantly more abundant in the fertile versus the infertile group utilizing IIF, HZA, and TEM. -Amylase-treated spermatozoa from the fertile and infertile groups showed a significant increase in the number of sperm bound to the hemizona (P <0.05).Conclusions The percentage of acrosome-reacted sperm in the infertile group was significantly enhanced by a-amylase, utilizing IIF and TEM.     

The effect of progressive muscle relaxation on cancer patients’ self-efficacy

Background and purposeSelf-efficacy is considered as one of the influential parameters affecting the health of patients. This study aimed to investigate the effect of relaxation techniques on self-efficacy of patients suffering from cancer.Materials and methodsThis study was a clinical trial in which 80 patients suffering from cancer were randomly assigned to two groups of experimental and control. Data collection instruments consisted of demographic information and Strategies Used by People to Promote Health questionnaires. In the experimental group, the patients performed relaxation techniques once a day for 30 min over two months. In the control group, the patients received the routine care.ResultsA statistically significant difference was observed between the mean self-efficacy indices in the experimental group (p = 0.001). There was no significant difference in the control group (p = 0.3).ConclusionMuscle relaxation can enhance self-efficacy of cancer patients. Therefore, it can be used as an alternative method for patients who are willing to use this technique.     

The effect of vacuum operator’s experience on Apgar scores

Objective

To determine the effect of a vacuum operator’s experience on Apgar scores.

Methods

A historical cohort study was conducted. All women who delivered by vacuum extraction between January 2003 and December 2007 at Songklanagarind Hospital were recruited. Vacuum operators were divided into two groups: staff doctors and residents. Comparisons of Apgar scores and rates of low Apgar scores (≤7) between the two groups were studied. A multivariate logistic regression analysis was used to control confounding variables for low Apgar scores.

Results

The percentages for the procedure performed by the staff doctors and residents were 76.9 and 23.1?%. At 1?min, the rates of low Apgar scores in the staff and resident groups were 6.7 and 24.1?% (p?<?0.001), and at 5?min, the rates of low Apgar scores were 0.6 and 5.2?% (p?<?0.001). Multivariate logistic regression analysis showed that the operator’s experience was an independent risk factor for low Apgar scores. The residents had a 2.9-fold increased risk of low Apgar scores at 1?min compared with the staff doctors (adjusted odds ratio 2.9; 95?% confidence interval 1.7–6.8). In the resident group, the third year residents had the lowest risk of low Apgar scores.

Conclusions

The vacuum operator’s experience was an independent risk factor for low Apgar scores. Improvement of the residency training program is mandatory.     

The effect of hesperetin on ischemia–reperfusion injury in rat ovary

Purpose

Hesperidin (HES), a citrus fruit extract, has beneficial effects on various ischemia/reperfusion (I/R) models. We aimed to evaluate the possible positive effects of hesperetin (HPT), an active metabolite of HES, on a rat ovarian I/R model.

Methods

We divided 24 Wistar Albino rats into four groups. Group I (n = 6) was sham operated, Group II (n = 6) was the I/R group, Group III (n = 6) was the I/R + solvent group and Group IV (n = 6) was the I/R + HPT group. Three hours of ischemia and 3 h of reperfusion were performed on each rat in Groups II, III, and IV. Dimethyl sulfoxide (DMSO) was given intraperitoneally to the rats in the III. Group, and 50 mg/kg of HPT dissolved in DMSO was given intraperitoneally to the rats in the IV. Group 30 min before reperfusion. After 3 h of reperfusion, the ipsilateral ovaries of the rats were examined immunohistochemically to detect apoptosis.

Results

Hematoxylin and eosin (H and E) staining demonstrated less edema and hemorrhage in the group where HPT was applied. Caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining showed significantly lower apoptosis in the group where HPT was used when compared to either the I/R or solvent group.

Conclusions

To the best of our knowledge, this is the first study that shows the beneficial effects of HPT in an ovarian I/R injury. HPT improved tissue damage and apoptosis caused by I/R injury. To identify the possible positive effects of HPT in ovarian torsion of humans and use in clinical practice, more studies must be performed.     

The effect of intraventricularly administered GnRH on plasma β-endorphin levels of the rat

This study investigates the effects of intraventricularly administered gonadotropin-releasing hormone (GnRH) on plasma β-endorphin levels in female proestrous rats.

Adult female Wistar rats (220-250 g) were implanted with an indwelling cannula in the third ventricle. Approximately 20 days later, the animals which had established a regular 4-day cycle were implanted with two indwelling catheters, one intracarotid and one intra-jugular, on the morning of proestrus. A single injection of 100 ng GnRH dissolved in 5 μl distilled water or 5 μl of saline (control) was infused slowly through the cannula in the third ventricle. Blood was withdrawn via the intracarotid catheter just before the infusion (12.30 h) andat 14.00, 15.30, 16.30 and 17.30 h for the determination of plasma β-endorphin levels.

The results indicated that intracerebroventricular infusion of GnRH causes a significant decline of plasma β-endorphin levels at all time points. It is postulated that GnRH possibly causes desensitization of GnRH receptors, due to the continuous GnRH supply to the pituitary via the blood circulation.     

The effect of weight loss program on serum anti-Müllerian hormone level in obese and overweight infertile women with polycystic ovary syndrome

We evaluated the predictive value of serum anti-Müllerian hormone (AMH) levels for improved menstrual cycles in response to dietary management in women with polycystic ovary syndrome (PCOS). In addition, we assessed the effect of a restricted calorie diet for 12 weeks on serum AMH levels. This intervention study was carried out at Rohan Institute, Tehran, Iran from 2013 to 2015. A total of 105 overweight and obese women with PCOS and reproductive impairment participated in a 12-week weight loss program (WLP). The serum AMH levels, weight, and menstrual cyclicity were assessed at baseline and post-intervention for all of the participants. A total of 90 patients completed the 12-week WLP. Of the 90 patients, 65 (72.2%) responded to the intervention with improvements in menstrual cyclicity. There were no significant differences in terms of age, baseline AMH levels, and other hormone profiles between responders and nonresponders. Responders had a significantly lower baseline body mass index (BMI) and waist circumference compared with nonresponders. These factors were the clinical predictors for a menstrual response after the intervention. The AMH levels did not significantly change after 12-week WLP despite the overall reduced weight; however, women who responded with improved reproductive function had a greater reduction in AMH levels.     

The enigma of low bilirubin kernicterus in premature infants: Why does it still occur,and is it preventable?

Low bilirubin kernicterus in preterm neonates, though rare, remains an unpredictable and refractory form of brain injury. Hypoalbuminemia, co-morbid CNS insult(s), infection, and inflammation are contributing causes that, in many cases, appear to interact in potentiating bilirubin neurotoxicity. Despite compulsive attention to serum bilirubin levels, and clinical and laboratory indices of neurotoxicity risk, low bilirubin kernicterus continues to be seen in contemporary NICUs. While efforts to refine and improve current treatment guidelines are certainly needed, such revision(s) will also have to take into account the risks and benefits of any intervention, including phototherapy.     

The effect of a group programme on women with the Mayer-Rokitansky-Küster-Hauser syndrome

Objective To evaluate the effect of a group programme on psychological distress in women with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
Setting Gynaecologic outpatient clinic.
Sample Seventeen women with MRKH syndrome participated in this study.
Method A semi-structured programme of seven sessions was offered dealing with themes of the MRKH syndrome. Psychological distress was measured at the first visit 3–6 month before the group programme was started (pre-test-0), at the first (pre-test) and then at the last group session (post-test).
Main outcome measure The Symptom Check List-90 was used to assess feelings of psychological distress.
Results The post-test subscale scores for anxiety, depression, interpersonal sensitivity and the total score for psychological distress were significantly lower than the pre-test-0 and pre-test scores (   P < 0.05  ). No significant differences were found between the pre-test-0 and pre-test subscale scores and total score.
Conclusion A semi-structured group programme seems valuable in helping women with the MRKH syndrome to deal with their psychological stress.     

The effect of the modes of delivery on the maternal and neonatal dynamic thiol–disulfide homeostasis

Abstract

Background: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol–disulfide homeostasis. The shift towards disulfide indicates the presence of oxidative environment. The thiol–disulfide homeostasis has not been studied in different mode of delivery before.

Aims: To investigate the effects of mode of parturition on the thiol–disulfide homeostasis in mothers and term infants.

Study design: The participants were grouped according to the mode of their delivery: group vaginal delivery (VD, n?=?40) and group cesarean section (C/S, n?=?40). Three serum samples were collected: from mothers at the beginning of labor, from the cord blood (CB), and from the infants at the 24th hour after birth. The dynamic thiol–disulfide homeostasis in both groups were compared.

Results: The levels of native-thiol and total-thiol in CB were significantly higher in VD group than those with C/S group. The levels of disulfide were higher in infants born by C/S compared with those born by VD. The disulfide-to-native thiol ratio, disulfide-to-total thiol ratio, and native thiol-to-total thiol ratio were similar between two groups.

Conclusion: Our results showed that the dynamic thiol–disulfide homeostasis of the neonate was greatly influenced by the way of delivery and supported that vaginally delivered infants have less oxidative stress.