PREVALENCE OF GESTATIONAL DIABETES MELLITUS AND PERINATAL OUTCOMES ACCORDING TO THE OLD WHO CRITERIA AND IADPSG CRITERIA

Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy. Pregnancies with GDM have worse outcomes compared to pregnancies with normal glucose tolerance. The objectives of the study were to determine the prevalence of GDM and perinatal outcomes according to the old WHO criteria and IADPSG criteria. Subjects and methods: A retrospective study included 2,405 pregnant women who delivered between January 2009 and December 2010. According to the OGTT results, pregnant women were divided into 4 groups. We analyzed the prevalence of GDM, characteristics of pregnant women and their newborns and perinatal outcomes. Results: We found significantly higher prevalence of GDM according to the IADPSG criteria compared to the WHO criteria. Pregnant women with GDM were significantly older, had higher pre-pregnancy BMI, fasting and 2-h plasma glucose. Pregnant women with GDM had worse pregnancy outcomes compared to control group. The overall proportion of overweight and obese pregnant women was the highest in the group of untreated pregnant women with GDM according to the IADPSG criteria. In this group we found significantly higher rate of fetal macrosomia and LGA. The rate of caesarean section was significantly higher in comparison to control group. Pre-eclampsia was significantly more common in groups of pregnant women with GDM compared to control group. Conclusion: IADPSG diagnostic criteria reveals more women with hyperglycemic disorders in pregnancy. A group of pregnant women who were normoglycemic according to the WHO criteria, but according to the IADPSG were diagnosed GDM, had adverse pregnancy outcomes. Lower values of glycemia, than those defined for diabetes in pregnancy, are associated with adverse pregnancy outcomes

Procalcitonin in systemic and localized bacterial infection

Introduction: Procalcitonin (PCT) has been proposed as a marker of infection in critically ill patients. The aim of the study was to evaluate and compare the possible discriminative use of PCT together with other standard inflammatory parameters, such as C-reactive protein (CRP), platelets (PLT), white blood cell count (WBC) and immature granulocytes (IG) in differentiating systemic and localized bacterial infection in critically ill patients. Materials and methods: According to clinical sings and microbiologic findings, 25 patients were divided into two groups: group A - patients with systemic bacterial infection and group B - patients with localized bacterial infection. Concentration of PCT and CRP; PLT, WBC and IG count were determined in all patients. Results: The median concentration of PCT was 1.3 (range: 0.1-7.4) μg/L in group A and 0.2 (range: 0.1-9.1) μg/L in group B with differences between groups being statistically significant (P = 0.038). A significantly higher median PLT count (P = 0.012) was found in group B (327, range: 91-647 x 109/L) as compared to group A (140, range: 40-325 x 109/L). In contrast, there were no statistically significant differences in median values of CRP, WBC and IG between groups (P = 0.071; 0.189 and 0.239, respectively). According to ROC (receiver operating characteristic) analysis, the obtained cut-off value for PCT as the marker of systemic bacterial infection was 0.3 μg/L (sensitivity 91%, specificity 64%). Conclusion: According to our results, PCT concentrations and PLT counts showed better discrimination than other investigated standard inflammatory parameters for differentiating systemic from localized bacterial infection in critically ill patients

PREVALENCE OF GESTATIONAL DIABETES MELLITUS AND PERINATAL OUTCOMES ACCORDING TO THE OLD WHO CRITERIA AND IADPSG CRITERIA

Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy. Pregnancies with GDM have worse outcomes compared to pregnancies with normal glucose tolerance. The objectives of the study were to determine the prevalence of GDM and perinatal outcomes according to the old WHO criteria and IADPSG criteria. Subjects and methods: A retrospective study included 2,405 pregnant women who delivered between January 2009 and December 2010. According to the OGTT results, pregnant women were divided into 4 groups. We analyzed the prevalence of GDM, characteristics of pregnant women and their newborns and perinatal outcomes. Results: We found significantly higher prevalence of GDM according to the IADPSG criteria compared to the WHO criteria. Pregnant women with GDM were significantly older, had higher pre-pregnancy BMI, fasting and 2-h plasma glucose. Pregnant women with GDM had worse pregnancy outcomes compared to control group. The overall proportion of overweight and obese pregnant women was the highest in the group of untreated pregnant women with GDM according to the IADPSG criteria. In this group we found significantly higher rate of fetal macrosomia and LGA. The rate of caesarean section was significantly higher in comparison to control group. Pre-eclampsia was significantly more common in groups of pregnant women with GDM compared to control group. Conclusion: IADPSG diagnostic criteria reveals more women with hyperglycemic disorders in pregnancy. A group of pregnant women who were normoglycemic according to the WHO criteria, but according to the IADPSG were diagnosed GDM, had adverse pregnancy outcomes. Lower values of glycemia, than those defined for diabetes in pregnancy, are associated with adverse pregnancy outcomes

Procalcitonin in systemic and localized bacterial infection

Introduction: Procalcitonin (PCT) has been proposed as a marker of infection in critically ill patients. The aim of the study was to evaluate and compare the possible discriminative use of PCT together with other standard inflammatory parameters, such as C-reactive protein (CRP), platelets (PLT), white blood cell count (WBC) and immature granulocytes (IG) in differentiating systemic and localized bacterial infection in critically ill patients. Materials and methods: According to clinical sings and microbiologic findings, 25 patients were divided into two groups: group A - patients with systemic bacterial infection and group B - patients with localized bacterial infection. Concentration of PCT and CRP; PLT, WBC and IG count were determined in all patients. Results: The median concentration of PCT was 1.3 (range: 0.1-7.4) μg/L in group A and 0.2 (range: 0.1-9.1) μg/L in group B with differences between groups being statistically significant (P = 0.038). A significantly higher median PLT count (P = 0.012) was found in group B (327, range: 91-647 x 109/L) as compared to group A (140, range: 40-325 x 109/L). In contrast, there were no statistically significant differences in median values of CRP, WBC and IG between groups (P = 0.071; 0.189 and 0.239, respectively). According to ROC (receiver operating characteristic) analysis, the obtained cut-off value for PCT as the marker of systemic bacterial infection was 0.3 μg/L (sensitivity 91%, specificity 64%). Conclusion: According to our results, PCT concentrations and PLT counts showed better discrimination than other investigated standard inflammatory parameters for differentiating systemic from localized bacterial infection in critically ill patients

Baclofen-induced dyshidrosiform bullous pemphigoid in a paraplegic patient complicated with methicillin-resistant Staphylococcus aureus (mrsa) and urinary infection

Bullous pemphigoid (BP) is an autoimmune disorder which is usually chronic, with blistering that predominantly affects the skin and occasionally the mucosa, and which includes several different types. One of them is a very rare dyshidrosiform type which is localized on the hands and feet with small or large blisters on the palmoplantar surfaces. BP resulting from a drug reaction is a relatively rare occurrence, and so far more than 50 different medications have been identified as triggers. The aim of this article was to present the case of a paraplegic patient who developed this rare dyshidrosiform type of BP while he was being neurologically treated with baclofen. In spite of therapy with systemic and topical corticosteroids and other measures, successful treatment was achieved only after eliminating baclofen from the patient’s regimen. His general state of health was seriously endangered due to nasal and skin methicillin-resistant Staphylococcus aureus (MRSA), urinary infection, and oral mycosis (soor), and he was at high risk of sepsis and a fatal outcome. Through our efforts, however, we managed to achieve an excellent outcome. According to our knowledge, this was the first case of baclofen-induced dyshidrosiform BP. </p

Baclofen-induced dyshidrosiform bullous pemphigoid in a paraplegic patient complicated with methicillin-resistant Staphylococcus aureus (mrsa) and urinary infection

Bullous pemphigoid (BP) is an autoimmune disorder which is usually chronic, with blistering that predominantly affects the skin and occasionally the mucosa, and which includes several different types. One of them is a very rare dyshidrosiform type which is localized on the hands and feet with small or large blisters on the palmoplantar surfaces. BP resulting from a drug reaction is a relatively rare occurrence, and so far more than 50 different medications have been identified as triggers. The aim of this article was to present the case of a paraplegic patient who developed this rare dyshidrosiform type of BP while he was being neurologically treated with baclofen. In spite of therapy with systemic and topical corticosteroids and other measures, successful treatment was achieved only after eliminating baclofen from the patient’s regimen. His general state of health was seriously endangered due to nasal and skin methicillin-resistant Staphylococcus aureus (MRSA), urinary infection, and oral mycosis (soor), and he was at high risk of sepsis and a fatal outcome. Through our efforts, however, we managed to achieve an excellent outcome. According to our knowledge, this was the first case of baclofen-induced dyshidrosiform BP. </p

Binding of EphrinA5 to RET receptor tyrosine kinase : An in vitro study

Eph/Ephrin signaling pathways are crucial in regulating a large variety of physiological processes during development, such as cell morphology, proliferation, migration and axonal guidance. EphrinA (efn-A) ligands, in particular, can be activated by EphA receptors at cellcell interfaces and have been proposed to cause reverse signaling via RET receptor tyrosine kinase. Such association has been reported to mediate spinal motor axon navigation, but conservation of the interactive signaling pathway and the molecular mechanism of the interaction are unclear. Here, we found Danio rerio efn-A5b bound to Mus musculus EphA4 with high affinity, revealing structurally and functionally conserved EphA/efn-A signaling. Interestingly, we observed no interaction between efn-A5b and RET from zebrafish, unlike earlier cell-based assays. Their lack of association indicates how complex efn-A signaling is and suggests that there may be other molecules involved in efn-A5-induced RET signaling.Peer reviewe

Exploring critical factors affecting sign language knowledge and motivation for sign language learning in nurses: A cross-sectional study

Introduction: In times when the term inclusion, rights of patients, and the patient as a subject in health care are used more often, the limited availability of written material or sign language interpreters at health services is still a key barrier to health services for people who are hearing-impaired. The aim of this study is to examine nurses’ knowledge of communication skills with hearing-impaired patients, their preferred methods, and the possibility of using translation services. Methods: The study was cross-sectional, and data were collected in September–October 2019. The study included 407 nursing students. A demographic data form and questions divided into three parts, namely, communication skills (six questions), communication methods (three questions), and interpretation services (five questions), were used to collect data. Data were analyzed with descriptive statistics. Results: The questionnaire was administered among 424 students, and total of 407 students completed the questionnaire. Most of the respondents were female (320 [78.6%]) with 0–5 years of work experience (227 [55.8%]) in the tertiary level of healthcare (184 [45.3%]). The results showed that 326 (80.1%) of the respondents encountered a person with some form of hearing impairment during their work. Sign language was used by 56 (13.8%) of the respondents, but 74 (18.14%) nurses did not communicate when meeting with hearing-impaired patients. Two-thirds of the respondents never had the opportunity to learn sign language, and 43 (10.54%) respondents would choose an official interpreter as support. Male respondents were aware of the importance of communication with hearing-impaired patients and the use of an application for pain assessment (p &lt; 0.05). No statistically significant difference was observed regarding the department in which the respondents work (p &gt; 0.05). Conclusion: The results of the study showed insufficient knowledge and skills of nurses to communicate with hearing-impaired people

Effect of cold agglutinins on red blood cell parameters in a trauma patient: a case report

The presence of cold agglutinins (CAs) in samples intended for complete blood count (CBC) using automated haematology analysers might cause serious preanalytical errors. In this report we describe the case of a 90-year old female patient admitted to the Emergency department following trauma injuries. A blood testing on admission revealed surprisingly low red blood cell count (0.99 x 1012/L), low haematocrit (0.102 L/L) which did not correlate with haemoglobin concentration (100 g/L), and high erythrocytes indices (mean corpuscular haemoglobin, 101 pg; mean corpuscular haemoglobin concentration, 980 g/L). In the second sample, after repeated collection, almost equal results were observed. Blood smear examination under the microscope revealed clusters of erythrocytes. Cold agglutinins presence was suspected and, in order to get valid results, sample was warmed to 37 °C. Correction of CBC was observed. Furthermore, we performed some additional analysis to confirm the presence of CAs in this patient. The aim of this report was to present the laboratory findings in a case of CAs and propose a laboratory procedure for whole blood samples with suspected CAs

Membrane Protein Production and Purification from Escherichia coli and Sf9 Insect Cells

A major obstacle to studying membrane proteins by biophysical techniques is the difficulty in producing sufficient amounts of materials for functional and structural studies. To overexpress the target membrane protein heterologously, especially an eukaryotic protein, a key step is to find the optimal host expression system and perform subsequent expression optimization. In this chapter, we describe protocols for screening membrane protein production using bacterial and insect cells, solubilization screening, large-scale production, and commonly used affinity chromatography purification methods. We discuss general optimization conditions, such as promoters and tags, and describe current techniques that can be used in any laboratory without specialized expensive equipment. Especially for insect cells, GFP fusions are particularly useful for localization and in-gel fluorescence detection of the proteins on SDS-PAGE. We give detailed protocols that can be used to screen the best expression and purification conditions for membrane protein study.Peer reviewe