Gestational diabetes mellitus prevalence: Effect of the laboratory analytical variation.

Aims: To highlight the effect of laboratory analytic variation, assessed by glucose (a) total analytic laboratory error (TAEL) present in one index laboratory and (b) total recommended allowable error (TAEa) universally applicable to all laboratories, on the prevalence of gestational diabetes mellitus (GDM).

Methods: 2337 pregnant women underwent a 75-g oral glucose tolerance test (OGTT) for universal GDM screening. Since the true value of every laboratory result fluctuates within a range, the glucose TAEL and TAEa were used to define a lower and an upper diagnostic threshold (95% confidence interval, CI) for the three glucose OGTT cut-offs of the criteria of the American Diabetes Association, ADA (2003); the Canadian Diabetes Association, CDA (2013) and the International Association of Diabetes and Pregnancy Study Groups, IADPSG (2010).

Gestational diabetes: differences between the current international diagnostic criteria and implications of switching to IADPSG.

Aims: To highlight the differences between eight international expert panel diagnostic criteria (either current or outdated but in use) for the diagnosis of gestational diabetes mellitus (GDM) and implications of switching to the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criterion.

Methods: 2337 pregnant women underwent a 75-g oral glucose tolerance test as part of a universal screening protocol. The GDM prevalence and number of women classified differently were compared between the criteria of the American Diabetes Association (2003); Australasian Diabetes in Pregnancy Society (1998); the Canadian Diabetes Association, CDA (2003 & 2013); the European Association for the Study of Diabetes (1996); IADPSG (2010); the New Zealand Society for the Study of Diabetes (2004) and the World Health Organization (1999).

Dynamics of brain natriuretic peptide in critically ill patients with severe sepsis and septic shock.

Purpose: Changes of B-type natriuretic peptide (BNP) in sepsis and its utility in predicting intensive care unit outcomes remains a conflicting issue. To investigate the changes in plasma levels of BNP in patients with severe sepsis/septic shock and to study the association of BNP levels with the severity of the disease and prognosis of those patients.

Methods: Thirty patients with severe sepsis or septic shock were enrolled in our study.

Lowering serum uric acid to prevent acute kidney injury.

Epidemiological, experimental and clinical studies support a role for uric acid in acute kidney injury (AKI). We discuss how the conventional role of uric acid in AKI has now evolved from intratubular crystal deposition to pro-inflammatory, anti-angiogenic and immunological function. Data from recent studies are presented to support the hypothesis that uric acid may have a role in AKI via a crystal-independent process in addition to its traditionally accepted role to induce injury via crystal-dependent pathways.

Gestational diabetes in a tertiary care hospital: implications of applying the IADPSG criteria.

Background: The American Diabetes Association has endorsed the International Association of Diabetes and Pregnancy Groups (IADPSG) recommendation that every pregnant woman should undergo the 75 g oral glucose tolerance test (OGTT) to screen for gestational diabetes mellitus (GDM).

Purpose: To find the cost and workload implications of switching from the current two-step screening of GDM to the one-step IADPSG approach.

Methods: The cost (US $) and laboratory workload units (WLU) were calculated for three possible strategies: (1) 50 g glucose screen, if positive, followed by the 100 g OGTT; (2) universal 75 g OGTT; and (3) screening with the initial fasting plasma glucose of the OGTT.

Performance of the Roche Accu-Chek active glucose meter to screen for gestational diabetes mellitus using fasting capillary blood.

Background: Point-of-care (POC) blood glucose measurement using glucose meters is used by diabetes patients to mange their disease. POC glucose testing also is also used in tight glycemic control protocols and as a screening tool for diabetes. We report the performance and effectiveness of the Accu-Chek® Active (Roche Diagnostics GmbH, Mannheim, Germany) glucose meter to screen for gestational diabetes mellitus (GDM) using blood fasting capillary glucose (FCG).

Gestational diabetes: an evaluation of serum fructosamine as a screening test in a high-risk population.

Aim: To evaluate the value of serum fructosamine as a screening test for gestational diabetes mellitus (GDM).

Methods: 849 pregnant women underwent the one-step 75 g oral glucose tolerance test (OGTT) for universal screening of GDM. The fasting serum fructosamine (cFruc) was assessed using the area under the receiver operating characteristic curve (AUC).

Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose.

Objective: To determine the impact of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria on 1) gestational diabetes mellitus (GDM) diagnosis compared with the American Diabetes Association (ADA) criteria and 2) the fasting plasma glucose (FPG) to predict GDM.

Research Design And Methods: In 10,283 pregnant women undergoing a 75-g oral glucose tolerance test (OGTT) for universal screening of GDM, two FPG thresholds (of the OGTT) were used to rule in and to rule out GDM.

Results: The IADPSG and ADA criteria identified GDM in 3,875 (37.

Practice implications of recent clinical trials for the prevention of acute kidney injury in cardiovascular surgery.

Acute kidney injury in patients undergoing cardiovascular surgery is a complex problem with associated increased risks for dialysis, short- and long-term mortality, and progression to end-stage renal disease. Interventions to prevent and treat renal complications in this cohort have seldom been uniformly satisfactory due to the differences in strategies for intervention, drug doses and duration of treatment, baseline renal functions, and population studied. Nonetheless, significant advances have been made and include recognition of the effect of preexisting organ dysfunction on renal outcomes, reassessment of existing therapeutic interventions, and exploration of the feasibility of newer agents to prevent and treat acute kidney injury in cardiovascular surgery patients.

Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population.

Aims: In populations at high risk of gestational diabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM.

Methods: FCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g OGTT for universal screening of GDM.

Impact of a satellite laboratory on turnaround times for the emergency department.

Background: Prolonged laboratory turnaround time (TAT) contributes to prolonged length of stay in emergency departments (EDs). The TAT of laboratory test results is a common key performance indicator by which clinicians and regulatory bodies evaluate laboratory performance. Establishing satellite laboratories in EDs staffed by laboratory technologists is one approach towards reducing TAT.

Gestational diabetes: using a portable glucometer to simplify the approach to screening.

Background: In populations at a high-risk for gestational diabetes (GDM), the recommendation of screening every pregnant woman with the oral glucose tolerance test (OGTT) is very demanding.

Aim: To assess the usefulness of the portable, plasma optimized glucometer in simplifying the approach to screening of GDM.

Methods: 1,662 pregnant women underwent the one-step 75 g OGTT for routine screening of GDM, as defined by the criteria of the American Diabetes Association.

Cord blood thyroxine and thyroid stimulating hormone screening for congenital hypothyroidism: how useful are they?

Aim: To determine and compare the usefulness of cord blood screening for free thyroxine (FT4) and thyroid stimulating hormone (TSH).

Background: There is a vast amount of literature on capillary heel prick screening tests, but relatively little on cord blood testing particularly FT4. For a decade all infants born at Tawam Hospital had cord blood FT4 and at Oasis Hospital cord TSH measured through the hospital-based screening programme.

Gestational diabetes: fasting and postprandial glucose as first prenatal screening tests in a high-risk population.

Objective: To evaluate the value of fasting (FPG) and 2-hour postprandial (PPG) plasma glucose as screening tests for gestational diabetes mellitus (GDM) in a high-risk population during early pregnancy.

Study Design: At their first prenatal visit, 708 women underwent FPG and PPG for universal screening for GDM, with the diagnosis confirmed by the 75-g oral glucose tolerance test (World Health Organization criteria). The area under the receiver operating characteristic curve (AUC) was used to analyze the performance of the 2 screening tests.

Implementing the Stockholm Conference hierarchy of objective quality criteria in a routine laboratory.

Background: Analytical performance of clinical laboratory testing should be evaluated against objective quality specifications. The Stockholm Conference consensus recommendation states that from a hierarchy of quality models, the highest-ranking model should be used. This study reports the performance of a routine clinical laboratory using these quality recommendations.

Gestational diabetes: relevance of diagnostic criteria and preventive strategies for Type 2 diabetes mellitus.

Objective: Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus (DM(2)). The aim of this study was to compare the effect of three international diagnostic criteria on the prevalence of GDM with its implications for prevention of DM(2 )in the population.

Materials And Methods: One thousand one hundred and seventy-two pregnant women, who underwent the 75-g oral glucose tolerance test for routine, antenatal GDM screening, were classified using the criteria of the American Diabetes Association (ADA), the World Health Organization (WHO) and Australasian Diabetes in Pregnancy Society (ADIPS).

Gestational diabetes: utility of fasting plasma glucose as a screening test depends on the diagnostic criteria.

Aims: To demonstrate the effect of diagnostic criteria, as defined by four international expert panels, on the usefulness of fasting plasma glucose (FPG) as a screening test for gestational diabetes mellitus (GDM).

Methods: We tested 4602 pregnant women using a 75-g oral glucose tolerance test (OGTT) for universal GDM screening. The area under the receiver operating characteristic curve (AUC) was used to determine the FPG performance to detect GDM by the criteria of the American Diabetes Association (ADA), the Australasian Diabetes in Pregnancy Society, the European Association for the Study of Diabetes, and the World Health Organization (WHO).

Fasting plasma glucose as a screening test for gestational diabetes mellitus.

Although debated, most preeminent expert panels recommend routine screening for gestational diabetes mellitus (GDM). Among the many tests that have been used and evaluated for the screening of GDM, the fasting plasma glucose (FPG) remains very appealing. It is easy to administer, well tolerated, inexpensive, reproducible and patient friendly.

Hepatogastric fistula in a pediatric patient.

Hepatogastric fistula secondary to amebic liver abscess is extremely rare. Only three pediatric cases have been reported in the English literature. Percutaneous drainage of abscess along with parenteral metronidazole can prevent the need for extensive surgical intervention.

Thyroid function abnormalities and antithyroid antibody prevalence in pregnant women at high risk for gestational diabetes mellitus.

Both gestational diabetes mellitus (GDM) and thyroid dysfunction in pregnancy compromise maternal and fetal health. The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during early pregnancy in a population at high risk for GDM. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured in 301 pregnant women who underwent routine 'universal screening' for GDM.

Thyrotrophin and free thyroxine trimester-specific reference intervals in a mixed ethnic pregnant population in the United Arab Emirates.

Background: Physiological alterations in the homeostatic control of thyroid hormones cause changes in thyroid function tests in pregnant women. A lack of method, trimester and population-specific reference intervals for free thyroxine (FT4) and thyrotrophin (TSH) makes interpretation of FT4 and TSH levels in pregnancy difficult. We established trimester-specific reference intervals for TSH and FT4 in a mixed ethnic population of pregnant women attending two antenatal clinics in the United Arab Emirates.