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Intrapartum application of the continuous glucose monitoring system in pregnancies complicated with diabetes: A review and feasibility study

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World Journal of Obstetrics and Gynecology 2013年第3期2卷 42-46页

作者： Vicentia C Harizopoulou Panagiotis Tsiartas Dimitrios G Goulis Dimitrios Vavilis Grigorios Grimbizis theodoros D Theodoridis Basil C Tarlatzis Unit for Human Reproduction First Department of Obstetrics and Gynaecology Papageorgiou General HospitalRing Road Nea Efkarpia 54603 Thessaloniki Greece Department of Obstetrics and Gynecology Sahlgrenska University Hospital 41685 G?teborg Sweden

Intrapartum maternal normoglycemia seems to play an important role in the prevention of adverse perinatal, maternal and neonatal outcomes. Several glucose monitoring protocols have been developed, aiming to achieve a tight glucose monitoring and control. Depending on the type of diabetes and the optimal or suboptimal glycemic control, the treatment options include fasting status of the parturient, frequent monitoring of capillary blood glucose, intravenous dextrose infusion and subcutaneous or intravenous use of insulin. Continuous glucose monitoring system(CGMS) is a relatively new technology that measures interstitial glucose at very short time intervals over a specifi c period of time. The resulting profi le provides a more comprehensive measure of glycemic excursions than intermittent home blood glucose monitoring. Results of studies applying the CGMS technology in patients with or without diabetes mellitus(DM) have revealed new insights in glucose metabolism. Moreover, CGMS have a potential role in the improvement of glycemic control during pregnancy and labor, which may lead to a decrease in perinatal morbidity and mortality. In conclusion, the use of CGMS, with its important technical advantages compared to the conventional way of monitoring, may lead into a more etiological intrapartum management of both the mother and her fetus/infant in pregnancies complicated with DM.

关键词：产妇血糖妇科治疗方法

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Histopathology of renal asphyxia in newborn piglets: Individual susceptibility to tubular changes

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World Journal of Nephrology 2015年第2期4卷 313-318页

作者： Clara Gerosa Nicoletta Iacovidou Ioanna Argyri Daniela Fanni Apostolos Papalois Filippia Aroni Gavino Faa theodoros Xanthos Vassilios Fanos Department of Pathology University of Cagliari National and Kapodistrian University of Athens ELPEN Research-Experimental Center Laboratory of Experimental Surgery and Surgical Research University of Athens Department of Neonatology University of Cagliari

OBJECTIVE:To analyze the effects on the kidney of hypoxia-reoxygenation in an experimental model of normocapnic asphyxia.;METHODS:To this end, 40 newborn Landrace/Large-White piglets aged 1-4 d were studied in this work. Hypoxia was induced by decreasing the inspired fiO2 to 0.06-0.08. Animals were resuscitated with different fiO2 and subdivided into 4 groups: group 1, 2, 3 and 4 received 18%, 21%, 40% and 100% O2 respectively. Macroscopic examination was carried out to evidence possible pathological features. Tissue sample were obtained from both kidneys. Four or five micron paraffin sections were stained with H-E and PAS stain and examined under an optical microscope.;RESULTS:Pathological changes, mainly affecting tubular cells, were observed in the vast majority of kidneys of asphyxiated piglets. The most frequent tubular changes were: tubular casts (95%), tubular dilatation (87.5%), tubular vacuolization (70%), tubular eosinophilia (52.5%), sloughing (50%), fragmentation of the brush border (50%), oedema (32.5%), apoptosis (15%) and glomerular changes (meningeal cell proliferation, capsular adhesion between the flocculus and Bowman's capsule, glomerulosclerosis and fibrous or cellular crescents associated with collapse of the glomerular tuft). Statistical analysis was carried out on changes observed when the animals were allocated in the 4 groups (χ(2)-test 0.05). The statistical analysis showed no evidence of differences regarding kidney lesions among the animals groups.;CONCLUSIONS:Our data show that renal pathology in newborn piglets is characterized by interindividual variability to hypoxia and is not associated with oxygen concentration.

关键词：窒息模型肾脏肾病治疗方法

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