Search

Aims: This study aims to estimate the incidence of adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) in Germany.Methods: Pregnant women were identified from a health claims database for the year of 2016. Three groups were defined: general population without GDM, women with GDM without treatment and women with GDM and insulin treatment. Operationalisation of outcomes was aligned with the hyperglycaemia and adverse pregnancy outcomes (HAPO) study.Results: The cohort consisted of 58,297 mother-child pairs. Of those, 7245 had a GDM diagnosis and 1407 had a GDM diagnosis with a prescription of insulin. Adverse pregnancy outcomes were higher in both GDM groups compared to the control group. Birthweight (OR 2.08 [95% CI 1.50-2.90]), primary caesarean section (OR 1.70 [95% CI 1.48-1.95]), intensive neonatal care (OR 1.25 [95% CI 1.04-1.50]), preeclampsia (OR 1.51 [95% CI 1.23-1.85]), and clinical neonatal hypoglycaemia (OR 5.32 [95% CI 4.27-6.62]) were higher in the GDM+insulin group in comparison to a control group after adjustment for potential confounders.Conclusion: Most of the adverse pregnancy outcomes were moderately higher in both identified GDM groups in comparison to women without GDM. Women receiving insulin treatment are at an increased risk of most of the defined adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Background: MicroRNAs (miRNAs) are small single-stranded RNA molecules working as post-transcriptional modulators of gene expression. Trophoblast cells are a heterogenous group of fetal cells forming the feto–maternal interface and displaying a wide spectrum of functions. The regulation of their behavior may partly underly the control through miRNAs. Therefore, we aimed to compare the miRNA profile of primary first and third trimester trophoblast cells with that of different trophoblastic cell lines. Material and methods: Total RNA was obtained from isolated cytotrophoblast cells from healthy term and first trimester placentae and the cell lines HTR-8/SVneo (immortalized trophoblast cells), JEG-3 (choriocarcinoma), ACH-3P and AC1-M59, which are choriocarcinoma cells fused with first and third trimester trophoblast cells, respectively. The expression level of 762 different miRNAs was quantitatively analyzed by using a TaqMan Human MicroRNA Array. For testing the reproducibility of the array technique, the expression of 9 selected miRNAs has been re-analyzed by individual qPCR. Results: The analyzed cell types share many similar patterns of miRNAs, but are significantly distinct in the expression of three miRNA clusters: chromosome 19 miRNA cluster (C19MC; containing 54 different miRNAs), C14MC (34 miRNAs) and a minor cluster (miRNA-371 to miRNA-373 cluster), also located on chromosome 19. Expression of miRNAs within C19MC increases significantly from first to third trimester trophoblast while that of C14MC members decreases. MiRNAs within the miR-371-3 cluster augment slightly. C19MC and the miR-371-3 cluster are not expressed by HTR-8/SVneo cells whilst C14MC is almost not detectable in the choriocarcinoma-derived cell lines complete array data available at NCBI Gene Expression Omnibus accession number GSE32346: http://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE32346). Beside the miRNAs within the mentioned clusters, further 27 miRNAs are differentially expressed (>100 fold) between term and first trimester trophoblast cells. The placenta-specific miRNAs miR-141 and miR-21 as well as let-7g are expressed in all tested cells with the highest expression in primary trophoblast cells. Conclusion: Primary first trimester and term trophoblast cells and trophoblastic cell lines display major differences in their miRNA fingerprints which may be involved in their different behavior and characteristics. [Copyright &y& Elsevier]

Abstract: The behavior of ordinary concrete and high strength concrete under a combinative effect of stress and chemical corrosion was studied in the present work. The concrete specimens were immersed in a variety of chemical solutions including 10%, 5%, 1% and 0.1% ammonium nitrate and simultaneously subjected to different flexural loads with load levels of 30%, 40% and 50% of their initial flexure strengths. The influences of the concentration of solutions, quality class of the concretes and load level of applied flexural stress on the strength of concretes were investigated. The relationships between life-time of the concrete and concentration of the solution, relative strength of the concrete and penetration depth of the ammonium nitrate solutions were determined. The mechanisms of stress corrosion of concrete exposed to ammonium nitrate solution and superimposed to a flexural stress was also discussed. [Copyright &y& Elsevier]

Abstract: Aims: The extent of lymph node dissection in gastric cancer remains controversial. The Maruyama computer model and the sentinel lymph node biopsy (SLNB) are compared for their value to predict the nodal status and lead to stage-adapted surgery. Methods: Thirty four patients with stage I–IV gastric cancer underwent both staging procedures. For SLNB, 15 patients underwent endoscopic, peri-tumoural injection of 99mTc-colloid, and 19 patients were injected of Patent blue V®. All ‘hot’ or blue sentinel lymph nodes (SLNs) were separately excised and histopathologically assessed. If the SLN was negative after routine staining by H&E, it was processed completely and reanalysed after immunohistochemistry. Results: At least, one SLN was detected by means of SLNB in 33/34 of the patients. The sensitivity to identify a positive nodal status was 22/33 and the specificity/positive predictive value was 10/10 and 22/22. Additional micrometastases or isolated tumour cells in the SLN led to ‘upstaging’ of 5/15, initially classified as nodal negative by H&E-staining. Using the Maruyama computer model, a sensitivity of 22/23 for the correct prediction of the lymph node involvement was associated with a specificity of 2/10 and a positive predictive value of 22/30. Conclusions: The clinical impact of the Maruyama computer model is limited due to low specificity and a low positive predictive value, rendering the method less useful as an indicator for individualised surgery. [Copyright &y& Elsevier]

During fetal development, different control systems mediated by the autonomic nervous system form functional connections over a wide range of time scales. Using multiscale multifractal analysis (MMA) of fetal heart rate variability (HRV), we describe fundamental relationships in the developing scale-wide adjustments within fetal behavior states as well as across state changes. MMA yields the local Hurst exponent surface h(q,s) with q as the multifractal parameter and s as the scale. In 30-minute recordings of healthy fetuses between 24 and 36 weeks of gestation (n = 25 in quiet sleep, n = 29 in active sleep, n = 30 changing sleep state) we investigated the dependency of h(q,s) on gestation age. In univariate models, we found a decreasing persistence for short scales and small amplitudes in the quiet (s 1 = 39, q 1 = − 0.7, R 2 = 0.52) and in the active (s 1 = 69, q 1 = − 1.4, R 2 = 0.23) sleep in contrast to an increasing persistency for long scales and large amplitudes (s 1 = 147, q 1 = 2.4, R 2 = 0.29) in the mixed state. Bivariate models (additional scales considered) presented increased coefficients of determination R 2 = 0.56, 0.4, and 0.43, respectively. Persistency increasing with age in connection with the sleep state changes (independent of the age related short range dependencies within the separate homogeneous sleep states) is reported here for the first time. The MMA indices obtained for the fetal HRV represent characteristics of the maturating scale-wide cardiovascular control in the context of the evolving sleep state dynamics, which have so far not been considered. They should be incorporated in the search for HRV indices for prenatal diagnosis of developmental disorders and risk assessment. [ABSTRACT FROM AUTHOR]