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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the work was to analyse the basic parameters of perinatal care of diabetic pregnant women, hospitalized in the Clinical Hospital in Bytom in years 1992-2001. The retrospective analysis of 405 diabetic pregnant patients who delivered their babies there was carried out. Diabetes types were following: GDM--44.9%, DM without vascular lesion--43%, DM with vascular lesion--12.1%. Mean age of pregnant women was 28.8 +/- 16 years. 42% patients were primipara, 58% patients were secundipara and multipara. The most often complications during pregnancy were following: threatening premature labour (36.5%), PIH (11.7%), urinary tract infection (9.65%) obesity (8.27%). Mean time of pregnancy was 38 +/- 2 Hbd. Prematurity was 25.9%. 199 patients had caesarean section (49.1%). 24 unsuccessful cases included fetal congenital defects, abortions, missed labour, perinatal fetal death. The authors suggest that such complications in diabetic pregnant patients can be prevented by early diabetes detection, intensive biophysical and biochemical control over fetus, achievement of normoglycaemic condition and a proper choice of delivery time. During last 10 years in our clinical hospital there was observed a decrease in infantile and perinatal mortality, better condition of infants and decrease in number of complications.
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PMID:[Evaluation of the health care of diabetic pregnant women and their newborns in 1992-2001 in the Obstetrics and Gynaecology Department in Bytom]. 1500 17

The prevalence of asthma in the United States is higher than in many other countries in the world. Asthma, the most common chronic disease of childhood in the United States, disproportionately burdens many socioeconomically disadvantaged urban communities. In this review we discuss hypotheses for between-country disparities in asthma prevalence, including differences in "hygiene" (e.g., family size, use of day care, early-life respiratory infection exposures, endotoxin and other farm-related exposures, microbial colonization of the infant bowel, exposure to parasites, and exposure to large domestic animal sources of allergen), diet, traffic pollution, and cigarette smoking. We present data on socioeconomic and ethnic disparities in asthma prevalence and morbidity in the United States and discuss environmental factors contributing to asthma disparities (e.g., housing conditions, indoor environmental exposures including allergens, traffic air pollution, disparities in treatment and access to care, and cigarette smoking). We discuss environmental influences on somatic growth (low birth weight, prematurity, and obesity) and their relevance to asthma disparities. The relevance of the hygiene hypothesis to the U.S. urban situation is reviewed. Finally, we discuss community-level factors contributing to asthma disparities.
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PMID:Population disparities in asthma. 1576 Feb 82

Evidence has accumulated that small for gestational age (SGA) children have long-term adult health consequences including obesity, Type 2 diabetes mellitus, hypertension, coronary artery disease and stroke. This increased risk of later adult disease is likely a consequence of an early, persistent reduction in insulin sensitivity. The SGA children and adults studied were predominantly at term gestation, and it appears that prematurity also leads to insulin resistance with possibly similar health consequences for later life. Both term SGA and premature children have an abnormal early environment: one in utero and one post-natally. Parallels are made among those born SGA at term or premature to show the potential importance of maternal factors, the intrauterine milieu, including nutrient supply and intake in fetal and early newborn life. It is possible that manipulation of these factors during early neonatal life in premature babies could lead to normalisation of insulin sensitivity. To confirm this hypothesis, further studies are needed to better understand the pathophysiological mechanisms leading to reduced insulin sensitivity and confirm that prematurity is linked with similar long-term health consequences as being born SGA.
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PMID:Insulin sensitivity in people born pre-term, with low or very low birth weight and small for gestational age. 1661 99

The success of liver transplantation essentially depends on the prevention and treatment of long term complications, which may be due to surgery, opportunistic infections, organ rejection and relapse of the initial liver disease. The side effects of immunosuppressive drugs--arterial hypertension, glucose intolerance and diabetes, dyslipidemia and obesity, renal failure, osteoporosis, malignancy, and anaemia--should be regularly screened and treated without delay. Surgical procedures in transplanted patients are safe and rarely followed by complications. Although pregnancy in this setting is considered at risk, because of prematurity and low birth weight, overall outcomes are favourable. The yearly influenza vaccination is strongly recommended. The survival and the quality of life of liver transplant patients also depend on a good communication between the general practitioner and the transplantation centre.
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PMID:[Management of patients after liver transplantation]. 1700 50

IR is hypothesized to be the important pathophysiologic link between adiposity and future development of type 2 diabetes and cardiovascular disease. A variety of methods for measuring IR have been validated in children, from the gold-standard hyperinsulinemic euglycemic clamp, to simple fasting measures based on fasting insulin and glucose levels. Studies have shown that there are a number of important risk factors for IR in children, including adiposity and visceral adiposity, race/ethnicity, puberty, a family history of type 2 diabetes, sex, and being small for gestational age or prematurity. However, obesity represents the critical risk factor for IR in children. Greater than 50% of obese adolescents in the US have IR. Formal assessment of IR in obese children may represent an important strategy for improving the efficacy of pharmacologic therapy for weight loss and chronic disease prevention.
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PMID:Insulin resistance in children and adolescents. 1716 45

Developmental origins of health and disease (DOHaD) focuses on the earliest stages of human development, and provides a novel paradigm to complement other strategies for lifelong prevention of common chronic health conditions. The 3 International Congress on DOHaD, held in 2005, retained the most popular features from the first two biannual Congresses, while adding a number of innovations, including increased emphasis on implications of DOHaD for the developing world; programs for trainees and young investigators; and new perspectives, including developmental plasticity, influences of social hierarchies, effects of prematurity, and populations in transition. Emerging areas of science included, first, the controversial role of infant weight gain in predicting adult obesity, diabetes, and cardiovascular disease. Second, in the era of epidemic obesity, paying attention to the over-nourished fetus is as important as investigating the growth retarded one. Third, environmental toxins appear to have abroad range of long-lasting effects on the developing human. Fourth, epigenetic mechanisms could unite several strands of human and animal observations, and explain how genetically identical individuals raised in similar postnatal environments can nonetheless develop widely differing phenotypes. Improving the environment to which an individual is exposed during development may be as important as any other public health effort to enhance population health world wide.
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PMID:Meeting report on the 3rd International Congress on Developmental Origins of Health and Disease (DOHaD). 1741 66

Cholelithiasis is a rare finding in children, even though recent series show increased detection of this disease. A retrospective study was performed in children with a diagnosis of cholelithiasis between 1993 and 2005 in the Reina Sofia Hospital in Tudela (Spain). Eighteen patients with cholelithiasis and three with biliary sludge were detected. Predisposing factors for cholelithiasis were prematurity and parenteral nutrition (one patient), sepsis (two patients), obesity (one patient), and a family history of the disease (one patient). The disease was idiopathic in 11 patients. Gallstones were detected in two patients presenting with appendicular symptoms. One child with biliary sludge had received treatment with ceftriaxone as a predisposing factor. All patients were diagnosed by ultrasound. Plain abdominal X-ray detected lithiasis in 12 of the 15 patients (80 %) with cholelithiasis who underwent this procedure. The most frequent symptoms were abdominal pain (seven patients), abdominal pain and vomiting (five patients), and diarrhea (one patient). Two patients presented with appendicular symptoms. Fourteen patients underwent surgery (open cholecystectomy in two and laparoscopic cholecystectomy in 12). None of the patients required emergency surgery. Cholelithiasis in children is an unusual finding, but is not exceptional and is associated with nonspecific symptoms. Plain abdominal X-ray is useful in diagnosis but the main diagnostic technique is ultrasonography.
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PMID:[Childhood cholelithiasis in a district hospital]. 1758 24

Recent trends of increasing infant morbidity and mortality are inconsistent with this nation's vision of advances in adult quality of life and longevity. Infant mortality and weight at birth are important predictors of the health of a society, making these findings all the more disturbing. Infant morbidity could be a reflection or alternatively, a harbinger of increasing national rates of obesity, diabetes mellitus, community violence and widening economic disparities. This paper presents the linkage between perinatal health and adult health using infant morbidities (infant mortality, low birthweight, prematurity) as examples. Infant morbidities/mortalities are social problems with health-care consequences. All social classes suffer the results of poor infant health. Improving perinatal health can improve the health of a community in a cyclic fashion. We propose that improving the health of reproductive age women and infants; will result in a reduction in the incidence of severe/chronic and costly adult health outcomes.
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PMID:Improving perinatal health: a novel approach to improve community and adult health. 1823 8

Several studies have reported data supporting the idea that an impaired intrauterine environment that deprives the fetus of optimal nutrient delivery results in the predisposition of the fetus to experience cardiovascular and metabolic dysfunction in later life. However, contradictory data still exist. Our purpose was to investigate the effects of both birth weight and weight gain on the risk for high blood pressure levels in 6- to 10-year-old children. This cross-sectional study included 739 children divided into quartiles of birth weight. The mean values of both systolic and diastolic pressure were significantly different between quartiles of birth weight, with increasing blood pressure values as the birth weight decreased (P<0.001). Covariance analysis adjusting for gender, prematurity, and body mass index (BMI) showed that both systolic and diastolic pressure remained greater in the lowest than in the highest birth weight quartile. Separating those with low and normal birth weight demonstrated that the risk of childhood hypertension was significantly higher among children with low birth weight and current obesity (odds ratio [OR]: 5.0, confidence interval [CI]: 3.3 to 16.1; P=0.023). The inverse association between birth weight and blood pressure levels appears to be programmed during fetal life, while weight gain during childhood adds to this risk.
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PMID:Blood pressure levels in childhood: probing the relative importance of birth weight and current size. 1883 Jul 9

Genetic and environmental factors influence insulin sensitivity (IS) during one's lifetime. Actually, uterine environment may affect IS at birth and later in life. In particular, various exogenous toxic substances, coupled to a genetic predisposition, may remarkably influence the regulation of the hypothalamus-hypophysis-adrenal gland axis, and the production or the activity of insulin, cerebral incretins, pro-inflammatory cytokines, and placental hormones. Owing to this reaction against environmental injuries, fetal growth and endocrine system development may be impaired, leading to low or large birth weight, or prematurity. Reduced growth in early life has been related to insulin resistance, which can be silent for years and evident in predisposed adults. The incidence of type 2 diabetes mellitus and obesity associated with sedentary lifestyle patterns and inadequate dieting behaviors in children and adolescents has rapidly increased during the last decade. Recent evidences suggest that the Pro12Ala polymorphism of the peroxisome proliferator-activated receptor- (PPAR-) gene and the angiotensin converting enzyme (ACE) I/D gene polymorphism combined with environmental factors, such as phthalates interfering with the post receptorial action of insulin, alter insulin-sensible tissues. Therefore, IS, deriving from a complex interaction between genotype and environment, may change during life and depends on previous metabolic control, which is a sort of metabolicmemory. The goal for the future is preventing the complications associated with impaired IS through the control of exogenous factors and the use of drugs selectively effective on its pathogenesis.
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PMID:Influence of environment on insulin sensitivity. 1939 33


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