Longitudinal analysis of changes in energy intake and macronutrient composition during pregnancy and 6 weeks post-partum.

Purpose: This prospective study was carried out in order to investigate changes in nutritional intake during pregnancy with regard to caloric intake and macronutrient composition in normal-weight pregnant women.

Methods: Using food scales, 32 healthy pregnant women estimated their food intake over a period of 2 days at gestational week 16, 22, 30, 36 and, in addition, 6 weeks after delivery. The recorded food logs were analyzed with respect to caloric intake and macronutrient composition.

Adiponectin during pregnancy: correlation with fat metabolism, but not with carbohydrate metabolism.

Background: Several studies show an association of adiponectin deficiency with obesity, insulin resistance and dysfunctional fat metabolism. This study investigates to what extent the correlations described occurs in pregnant women.

Method: Metabolism parameters and adiponectin serum levels were measured in 32 pregnant women at various times during their pregnancies and during the first six postpartum weeks.

Longitudinal changes in the continuous glucose profile measured by the CGMS in healthy pregnant women and determination of cut-off values.

Objective: This longitudinal study performed continuous evaluation of daily blood glucose level profiles in healthy normal-weight pregnant patients during various gestational age and determined normal levels.

Study Design: Thirty-two healthy normal-weight pregnant women received a continuous glucose monitoring system (CGMS) device for periods of 72h in the 16th, 22nd, 30th and 36th weeks of gestational age and at 6 weeks after delivery. All observations took place in the outpatient clinic of the Charité hospital.

Molecular epidemiology of oral treponemes in patients with periodontitis and in periodontitis-resistant subjects.

The etiologic role of oral treponemes in human periodontitis is still under debate. Although seen by dark-field microscopy in large numbers, their possible role is still unclear since they comprise some 60 different phylotypes, most of which are still uncultured. To determine their status as mere commensals or opportunistic pathogens, molecular epidemiological studies are required that include both cultured and as-yet-uncultured organisms.

Rate of dyspareunia after delivery in primiparae according to mode of delivery.

Objectives: The purpose of this study was to evaluate the influence of mode of delivery on sexual function.

Design: One thousand six hundred and thirteen questionnaires containing 16 questions about sexual behavior and dyspareunia before, during and after pregnancy were sent out to primiparous, ethnically homogeneous (fluent in German) patients who delivered in a large tertiary referral center between 6 months and 2(1/2) year before. The returned questionnaires were merged to clinical data from our obstetric database in an anonymous fashion.

Gender differences in the performance of a computerized version of the alcohol use disorders identification test in subcritically injured patients who are admitted to the emergency department.

Objective: The Alcohol Use Disorder Identification Test (AUDIT) has been recommended as a screening tool to detect patients who are appropriate candidates for brief, preventive alcohol interventions. Lower AUDIT cutoff scores have been proposed for women; however, the appropriate value remains unknown. The primary purpose of this study was to determine the optimal AUDIT cutpoint for detecting alcohol problems in subcritically injured male and female patients who are treated in the emergency department (ED).

Intermittent hirudin versus continuous heparin for anticoagulation in continuous renal replacement therapy.

Background: Besides possible bleeding complications a further problem in anticoagulation during continuous renal replacement therapy (CRRT) is the development of heparin-induced thrombocytopenia type II (HIT II) where further anticoagulation with heparin is contraindicated. The application of continuous hirudin as alternative for heparin caused bleeding complications by comparable filter efficacy. Aim of this prospective-controlled pilot study was to compare the efficacy and safety of intermittent hirudin and continuous heparin for anticoagulation during CRRT in critically ill patients.

The usefulness of glycosuria and the influence of maternal blood pressure in screening for gestational diabetes.

Objective: Although gestational diabetes is among the most common diseases arising during pregnancy, glucose stix is the only screening test to date in Germany. Our goal was to evaluate the sensitivity of the glucose-stix for diabetes screening and the possible influence of other parameters.

Methods: 1001 patients who underwent the 50 g glucose screening test between June 1, 1997 and January 5, 2000 as part of prenatal care were asked to participate.

No influence of high- and low-carbohydrate diet on the oral glucose tolerance test in pregnancy.

Objective: Our objective was to determine the influence of the carbohydrate content of the diet preceding the oral glucose tolerance test (OGTT) in pregnancy on the test results and to evaluate the necessity of the recommended preparatory high-carbohydrate diet.

Study Design: Thirty-four women from our outpatient clinic were enrolled in this prospective study. After giving informed consent, each women underwent a 90-min lesson (supervised by a dietary assistant) covering the carbohydrate, protein and fat content of different foods.

A randomized trial evaluating a predominantly fetal growth-based strategy to guide management of gestational diabetes in Caucasian women.

Objective: To compare the management of Caucasian women with gestational diabetes (GDM) based predominantly on monthly fetal growth ultrasound examinations with an approach based solely on maternal glycemia.

Research Design And Methods: Women with GDM who attained fasting capillary glucose (FCG) <120 mg/dl and 2-h postprandial capillary glucose (2h-CG) <200 mg/dl after 1 week of diet were randomized to management based on maternal glycemia alone (standard) or glycemia plus ultrasound. In the standard group, insulin was initiated if FCG was repeatedly >90 mg/dl or 2h-CG was >120 mg/dl.

Comparison of point-of-care-testing glucose meters with standard laboratory measurement of the 50g-glucose-challenge test (GCT) during pregnancy.

Objectives: Although glucose meters are well-established instruments for self-monitoring blood glucose levels, diagnostic and screening procedures should be performed using standard laboratory methods. In addition to standard laboratory methods, HemoCue is authorized for screening and diagnostic purposes in Germany. The rapid development of other glucose meters makes it necessary to re-evaluate this recommendation.

Risk for gestational diabetes and hypertension for women with twin pregnancy compared to singleton pregnancy.

Objectives: This study was undertaken to determine the incidence of pregnancy induced hypertension (PIH) and gestational diabetes (GDM) in twin pregnancies (TP) in comparison with singleton pregnancies (SP), and to test whether TP with GDM have a higher risk than TP without GDM, as is known to be the case in SP.

Materials And Methods: Eighty-nine patients with TP who sought prenatal care between 1 September 1994 and 30 October 1997, were asked to participate. One hundred and seventy-eight of the 1,416 patients were matched in a 1:2 ratio by age, body-mass-index, parity, gestational age at screening, and ethnicity with a singleton pregnancy from our database dating from the same period.

Rate and risk factors of hypoglycemia in large-for-gestational-age newborn infants of nondiabetic mothers.

Objective: The purpose of this study was to investigate the rate of hypoglycemia in large-for-gestational-age infants of nondiabetic mothers in relation to maternal or neonatal risk factors.

Study Design: Hospital charts of all term large-for-gestational-age infants born between 1994 and 1998 (n = 1136) were analyzed for the rate of neonatal hypoglycemia (capillary glucose level, < or =30 mg/dL) during the first 24 hours of life. Infants of women with preexisting or gestational diabetes mellitus were excluded (n = 180).

Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies.

Background: Limited health care budgets have raised the issue of how much therapy should be dedicated to critically ill patients with multiorgan and acute renal failure (ARF). No data are available on patients with ARF after hospital discharge.

Methods: We assessed long-term survival and quality of life after discharge.