Cigarette smoking and risk of gestational diabetes: a systematic review of observational studies

<p>Abstract</p> <p>Background</p> <p>Gestational diabetes is a prevalent disease associated with adverse outcomes of pregnancy. Smoking as been associated with glucose intolerance during pregnancy in some but not all studies. Therefore, we aimed to systematically review all epidemiological evidence to examine the association between cigarette smoking during pregnancy and risk of developing gestational diabetes mellitus.</p> <p>Methods</p> <p>We conducted a systematic review of articles published up to 2007, using PubMed, Embase, LILACS e CINAHL to identify the articles. Because this review focuses on studies of smoking during pregnancy, we excluded studies evaluating smoking outside pregnancy. Two investigators independently abstracted information on participant's characteristics, assessment of exposure and outcome, and estimates for the association under study. We evaluated the studies for publication bias and performed heterogeneity analyses. We also assessed the effect of each study individually through sensitivity analysis.</p> <p>Results</p> <p>We found and critically reviewed 32 studies, of which 12 met the criteria for inclusion in the review. Most of the studies provided only unadjusted measurements. Combining the results of the individual studies, we obtained a crude odds ratio of 1.03 (99% CI 0.85–1.25). Only 4 studies presented adjusted measurements of association, and no association was found when these alone were analyzed (OR 0.95; 99% CI 0.85–1.07). Subgroup analysis could not be done due to small sample size.</p> <p>Conclusion</p> <p>The number of studies is small, with major heterogeneity in research design and findings. Taken together, current data do not support an association between cigarette smoking during pregnancy and the risk of gestational diabetes.</p

A fast and accurate method to measure both oxidative stress and vitality in a single organ slice.

Increased oxidative stress does not necessarily cause an organ to suffer from oxidative damage, since antioxidant systems to protect organs are present. However, when a decrease in the vitality of an organ coincides with an increase in oxidative stress, increased oxidative damage is likely. A sequential method for the measurement of both energy status and oxidative stress in the same sample has been developed. The novelty of this method lies in the combination of efficiency and accuracy. Nucleotides and malondialdehyde (MDA) of 80 different samples can be released in a perchloric environment with ultrasonic treatment instead of homogenization. Malondialdehyde concentration can be measured after complexing with 2,4-dinitrophenylhydrazine without any homogenization, solvent phase extraction, and centrifugation steps. Yields of both malondialdehyde and nucleotides were similar to those of the homogenization procedure. Detection limit was 141 fmol for MDA and 22.5 pmol for the nucleotides. Furthermore, the stability of the malondialdehyde-2,4-dinitrophenylhydrazine complex after 3 weeks at -20 degrees C is excellent 99.7% (+/-5.6). Nucleotides are stable for the same time period. Spiking of samples with MDA and nucleotides showed good recoveries (102.5% (+/-5.0) and 99.8% (+/-7.9), respectively). The present data show an accurate method to measure both the energy status and the oxidative stress in a single organ slice with a minimum of effort and time

Ingestão pré-operatória de carboidratos diminui a ocorrência de sintomas gastrointestinais pós-operatórios em pacientes submetidos à colecistectomia Preoperative ingestion of carbohydrates diminishes the occurence of postoperative gastrointestinal symptoms in patients submitted to cholecystectomy

RACIONAL: Estudos recentes mostram que a abreviação do jejum pré-operatório, ao contrário do jejum de 6-8 h apresenta vários benefícios. Pacientes que recebem carboidratos apresentam menos fome e menos ansiedade do que os que permaneceram em jejum noturno. A ingestão pré-operatória de carboidratos por via oral no dia da operação diminui a resposta orgânica ao trauma. OBJETIVO: Avaliar o efeito da ingestão de bebida com carboidratos 6 e 2 horas antes da operação na ocorrência de sintomas gastrointestinais pós-operatórios em pacientes colecistectomizadas. MÉTODOS: Estudo prospectivo e randomizado com 54 pacientes do sexo feminino (42[19-69] anos) candidatas à colecistectomia eletiva foram randomizadas para receber uma bebida contendo 12.5% de carboidratos, 6 (400 mL) e 2 horas (200 mL) antes da operação (grupo carboidrato n = 28) ou jejum de 6-8 horas (grupo convencional n= 26). As variáveis investigadas foram a ocorrência de vômitos, náuseas, distensão abdominal, eliminação de flatos e fezes, e o tempo de internação no pós-operatório. RESULTADOS: A ocorrência de distensão abdominal (42.3% vs 17.8%; P = 0,04), vômitos (53.8% vs 21.4%; P = 0,01) a associação de dois ou mais sintomas gastrointestinais (73.1% vs 39.3%; P = 0,01) e o tempo de internação pós-operatória (2 [1-3] vs 1 [1-3] dias; P = 0,04) foram significativamente menores no grupo carboidrato. CONCLUSÃO: A ingestão carboidratos no pré-operatório diminui a ocorrência de manifestações gastrointestinais pós-operatórias e o tempo de internação em colecistectomia.<br>BACKGROUND: Earlier reports have shown that performing operations in fed, opposed to overnight-fasted patients, has several benefits. Preoperative patients receiving carbohydrates were found to be less hungry and less anxious than those receiving placebo or those fasting overnight. Preoperative oral carbohydrate loading on the day of operation may diminish the organic response to trauma. AIM: To investigate the effects of preoperative carbohydrate-rich drinks regarding gastrointestinal symptoms after cholecystectomy. METHODS: Randomized prospective trial. A total of 54 female patients (average age = 42[19-69] years-old) scheduled for elective cholecystectomy were randomized to receive either a beverage containing 12.5% carbohydrate, 6 (400 mL) and 2 hours (200 mL) before surgery (group carbohydrate n=28) or fasting for 6-8 hours (control group n=26). Parameters investigated included the occurrence of vomit, nausea, abdominal distention, passage of flatus and feces, and the length of postoperative hospital stay. RESULTS: Abdominal distension (42.3 vs 17.8%; P = 0,04), episodes of vomiting (53.8% vs 21.4%; P = 0,01), the presence of two or more associated gastrointestinal symptoms (73.1% vs 39.3%; P = 0,01), and the length of postoperative hospital stay (2 [1-3] vs 1 [1-3] days; P = 0,04) was significantly smaller in the carbohydrate control group. CONCLUSION: Preoperative oral carbohydrate administration reduces both postoperative gastrointestinal discomfort and postoperative hospital stay after cholecystectomy