Pregnancy and lactation associated osteoporosis: unrecognized cause of musculoskeletal pain syndrome during the peri-pregnancy period

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare disorder, usually occurring in late pregnancy and the early post-partum period. The prevalence, etiology, pathogenesis and therapy remains unclear. Three clinical cases of PLO present patients with multiple severe osteoporotic fractures during the peri-pregnancy period and different treatment strategies

Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

Vitamin D deficiency has a high worldwide prevalence, but actions to improve this public health problem are challenged by the heterogeneity of nutritional and clinical vitamin D guidelines, with respect to the diagnosis and treatment of vitamin D deficiency. We aimed to address this issue by providing respective recommendations for adults, developed by a European expert panel, using the Delphi method to reach consensus. Increasing the awareness of vitamin D deficiency and efforts to harmonize vitamin D guidelines should be pursued. We argue against a general screening for vitamin D deficiency but suggest 25-hydroxyvitamin D (25(OH)D) testing in certain risk groups. We recommend a vitamin D supplementation dose of 800 to 2000 international units (IU) per day for adults who want to ensure a sufficient vitamin D status. These doses are also recommended for the treatment of vitamin D deficiency, but higher vitamin D doses (e.g., 6000 IU per day) may be used for the first 4 to 12 weeks of treatment if a rapid correction of vitamin D deficiency is clinically indicated before continuing, with a maintenance dose of 800 to 2000 IU per day. Treatment success may be evaluated after at least 6 to 12 weeks in certain risk groups (e.g., patients with malabsorption syndromes) by measurement of serum 25(OH)D, with the aim to target concentrations of 30 to 50 ng/mL (75 to 125 nmol/L)

Diagnostic Criteria and Classification of Hyperglycaemia First Detected in Pregnancy

The high prevalence of diabetes globally and its increasing frequency in women of gestational age have generated new research data on the relationship between glycaemia and pregnancy outcomes. The diagnostic criteria for hyperglycaemia in pregnancy recommended by the World Health Organization (WHO) in 1999 were not evidence-based and needed to be updated in the light of previously unavailable data. The update follows the WHO procedures for guidelines development. Systematic reviews were conducted for key questions, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was applied to assess the quality of the evidence and to determine the strength of the recommendation on the diagnostic cut-off values for gestational diabetes. Where evidence was absent (diagnosis of diabetes in pregnancy) or GRADE was not deemed suitable (classification), recommendations were based on consensus

Strategies for implementing the WHO diagnostic criteria and classification of hyperglycaemia first detected in pregnancy

The World Health Organization (WHO) has recently released updated recommendations on Diagnostic Criteria and Classification of Hyperglycaemia First Detected in Pregnancy which are likely to increase the prevalence of gestational diabetes mellitus (GDM). Any increase in the number of women with GDM has implications for health services since these women will require treatment and regular surveillance during the pregnancy. Some health services throughout the world may have difficulty meeting these demands since country resources for addressing the diabetes burden are finite and resource allocation must be prioritised by balancing the need to improve care of people with diabetes and finding those with undiagnosed diabetes, including GDM. Consequently each health service will need to assess their burden of hyperglycaemia in pregnancy and decide if and how it will implement programmes to test for and treat such women. This paper discusses some considerations and options to assist countries, health services and health professionals in these deliberations. (C) 2014 Elsevier Ireland Ltd. All rights reserved.World Diabetes Foundation for a study on the screening for gestational diabetes in Tamil NaduUniv Sydney, Boden Inst Obes Nutr & Exercise, Sydney, NSW 2006, AustraliaUniv Fed Rio Grande do Sul, Post Grad Program Epidemiol, Porto Alegre, RS, BrazilUAE Univ, Fac Med, Al Ain, U Arab EmiratesUniv Geneva, Fac Med, Serv Obstet Matern HUG, Geneva, SwitzerlandUniv Cape Town, Groote Schuur Hosp, Dept Obstet & Gynaecol, ZA-7925 Cape Town, South AfricaTel Aviv Univ, Sackler Fac Med, Rabin Med Ctr, Helen Schneider Hosp Women, IL-69978 Tel Aviv, IsraelMcGill Univ, Dept Med, Montreal, PQ, CanadaMcGill Univ, Dept Obstet & Gynaecol, Montreal, PQ, CanadaNorthwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USATokyo Womens Med Univ, Ctr Diabet, Ebina Gen Hosp, Tokyo, JapanRiga Stradins Univ, Riga East Clin Univ Hosp, Riga, LatviaDr Balaji Diabet Care Ctr, Diabet Res Inst, Chennai, Tamil Nadu, IndiaNatl Hlth Serv Fdn Trust, Cambridge Univ Hosp, Inst Metab Sci, Cambridge, EnglandUniv Yaounde I, Fac Med & Biomed Sci, Yaounde, CameroonNewcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne, Tyne & Wear, EnglandUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilPeking Univ, Hosp 1, Beijing 100871, Peoples R ChinaUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilWeb of Scienc

Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: A World Health Organization Guideline

UAE Univ, Fac Med, Al Ain, U Arab EmiratesUniv Geneva, Fac Med, Serv Obstet Matern HUG, CH-1211 Geneva 4, SwitzerlandUniv Cape Town, Groote Schuur Hosp, Dept Obstet & Gynaecol, ZA-7700 Rondebosch, South AfricaUniv Sydney, Boden Inst Obes Nutr & Exercise, Sydney, NSW 2006, AustraliaUniv Fed Rio Grande do Sul, Post Grad Program Epidemiol, Porto Alegre, RS, BrazilTel Aviv Univ, Sackler Fac Med, Rabin Med Ctr, Helen Schneider Hosp Women, IL-49100 Petah Tiqwa, IsraelMcGill Univ, Dept Med, Montreal, PQ, CanadaMcGill Univ, Dept Obstet & Gynaecol, Montreal, PQ, CanadaNorthwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USATokyo Womens Med Univ, Ctr Diabet, Ebina Gen Hosp, Tokyo, JapanRiga Stradins Univ, Riga East Clin Univ Hosp, Riga, LatviaUniv Rio Grande do Sul, Porto Alegre, RS, BrazilDiabet Res Inst, Madras, Tamil Nadu, IndiaDr Balaji Diabet Care Ctr, Madras, Tamil Nadu, IndiaCambridge Univ Hosp Natl Hlth Serv Fdn Trust, Inst Metab Sci, Cambridge, EnglandRural Hlth Acad Ctr, Shepperton, Vic, AustraliaUniv Yaounde I, Fac Med & Biomed Sci, Yaounde, CameroonNewcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, EnglandUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilPeking Univ, Hosp 1, Beijing 100871, Peoples R ChinaUniv Oslo, Inst Hlth & Soc, Fac Med, N-0316 Oslo, NorwayChinese Univ Hong Kong, Prince Wales Hosp, Dept Obstet & Gynaecol, Hong Kong, Hong Kong, Peoples R ChinaUniv Chile, Hosp Clin, Santiago, ChileNW State Med Univ, Matern Hosp 17, St Petersburg, RussiaIllawarra Diabet Serv, Wollongong, NSW, AustraliaSamad Clin, Karachi, PakistanUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilWeb of Scienc