The association between adipocytokines and glycemic control in women with gestational diabetes mellitus

<p><b>Objective:</b> To evaluate the relationship between adipocytokines and glycemic control.</p> <p><b>Study design:</b> Prospective observational trial of gestations with gestational diabetes mellitus (GDM). Fasting glucose (FG), insulin, adiponectin, leptin, chemerin, retinol-binding protein 4 (RBP-4), osteocalcin, and resistin were measured. HomeOstasis model assessment of insulin resistance (HOMA-IR) and QUantitative insulin sensitivity ChecK Index (QUICKI) were calculated. Women who required medications for glycemic control were compared to women using nutritional therapy only.</p> <p><b>Results:</b> Overall, 75 women were included −26 (34.7%) required medications to achieve good glycemic control. Factors associated with poor control are as follows: low resistin (aOR 0.84), HOMA-IR (aOR 1.96), QUICKI (aOR 0.62), first trimester FG (aOR 1.43), and maternal age (aOR 1.26). HOMA-IR and QUICKI performed highest for prediction. Resistin, first trimester FG, maternal age, and QUICKI had an AUC of 0.878, sensitivity and specificity of 87.5% for the prediction of the need for medications.</p> <p><b>Conclusions:</b> Low resistin is associated with poor control. A model utilizing maternal age, first trimester fasting glucose, and first visit QUICKI yields good predictability.</p

Outcome of vaginal mesh reconstructive surgery in multiparous compared with grand multiparous women: Retrospective long-term follow-up

<div><p>We aimed to compare the long-term surgical outcome and complications of multiparous and grand multiparous women undergoing reconstructive surgery with vaginal mesh implants for repair of pelvic organ prolapse. This retrospective, long-term follow-up (28.17±20.7 months) comprised 113 women who underwent surgical reconstructive surgery with vaginal polypropylene mesh in a high parity rate population medical center. The women were divided into 2 groups (multiparous and grand multiparous) and each group was evaluated for objective and subjective surgical outcome. Patient demographics and surgical data were retrieved from electronic medical records. Outcome measure included POP-Q exam as objective outcome and validated Pelvic Floor Distress Inventory questionnaire (PFDI) to assess subjective outcome. Average age of patients was 62±7.9 (range 42–83) years. Average parity was 5.6±3.1 (range 1–14). There were 54 (47.7%) multiparous women and 59 (52.3%) grand multiparous women. The grand multiparous women were younger than the multiparous women and had a significantly higher degree of prolapse. At the last follow-up, the only significant difference was related to symptoms of an overactive bladder. In conclusion, long-term follow-up demonstrates that vaginal mesh surgery in grand multiparous women offers anatomical and subjective cure rates comparable to multiparous women.</p></div

Patient's characteristics.

<p>Patient's characteristics.</p

POP Q^* for multiparous women before and after the procedure.

<p>POP Q^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176666#t005fn001" target="_blank">*</a>} for multiparous women before and after the procedure.</p

POP-Q^* for the whole group before and after the procedure and by group prior to surgery.

<p>POP-Q^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176666#t001fn001" target="_blank">*</a>} for the whole group before and after the procedure and by group prior to surgery.</p

Surgical procedures.

<p>Surgical procedures.</p

POP Q^* for grand multiparous women, before and after the procedure.

<p>POP Q^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176666#t006fn001" target="_blank">*</a>} for grand multiparous women, before and after the procedure.</p