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Biomedical subjects

M Maresh

Publications and source records attributed to M Maresh.

At least 37 records · Page 2Linked to original sources
PubMed1991

The effects of diabetes on placental lipase activity in the rat and human.

Lipase activities were measured at pH 4 and pH 8 in the placentas of rats made diabetic by streptozotocin treatment and also in the placentas of women classified as having 1) impaired glucose tolerance or type 2 diabetes, 2) type 1 diabetes with no associated vascular complication, and 3) type 1 diabetes with associated vascular disease. In both sets of experiments, the placentas were compared with normal control groups. The placental lipase activity measured at pH 8 was not significantly different in either streptozotocin-treated rats or impaired glucose tolerance/diabetic women as compared with controls, whereas the lipase activity measured at pH 4 increased significantly as compared with controls in both species. Furthermore, in the women there was a significant correlation between placental lipase activity at pH 4 and birth weight in impaired glucose tolerance/type 2 diabetes. It is suggested that the increased placental lipase activity may contribute to the increased fetal weight in human diabetic pregnancy, by contributing to the increased fat transfer across the placenta from mother to fetus.

Animals↗
PubMed1990

Data collection for an obstetric department.

A well-designed computerized data collection system allows an accurate, complete data-set to be compiled for all pregnant women. It should be able to produce all the documentation necessary for pregnancy care, with minimum delay, and avoid repetitive data entry. Data is stored on computer on the back of operational tasks so that it may be subsequently used for audit. In addition it may be used for research purposes. Patient care can be improved if the computer is programmed to react to certain items being entered by requesting further relevant data-items. This therefore acts as a teaching method. A further extension of this is to use the data to help reach a diagnosis and thus suggest a logical management. A computerized data collection system cannot bring order out of chaos. Before introducing one there must be well-stated objectives of what is required from it. It must be clearly stated what is to be collected by whom and for what purpose. Apart from the capital outlay there may be a need to set money aside for revenue purposes for additional staff involved in maintaining the system. If a large system is being introduced then this will have considerable implications with regard to the work done by some staff, and job descriptions may need renegotiation--an aspect usually overlooked.

Data Collection↗
PubMed1990

Absent maternofetal potassium gradient at term.

Mean (SE) umbilical venous plasma potassium concentrations at 5.5, 10, 20, and 30 minutes after the start of laparotomy at term were 4.75 (0.15), 5.95 (0.26), 6.81 (0.23), and 7.59 (0.81) mmol/kg plasma water. Maternal peripheral venous plasma concentrations were 4.30 (0.13) before and 4.26 (0.23) mmol/kg plasma water after laparotomy. Plasma calcium concentration in maternal and cord blood did not change significantly.

Cesarean Section↗
PubMed1989

Factors predisposing to and outcome of gestational diabetes.

Two hundred thirteen women with abnormal glucose tolerance tests (GTTs) were diagnosed over 9 years by a screening program involving the total antenatal population. Each subject was matched for age, parity, and ethnic group with a control. The gestational diabetics were subdivided into classes A1 or A2 based on the fasting plasma glucose value of their GTT: A1 when below 6.0 mmol/L (108 mg/dL) and A2 when 6.0 mmol/L (108 mg/dL) or higher. All received treatment with dietary advice and some with insulin. Birth weight was not related to maternal age or severity of diabetes, but was related to maternal obesity. However, neonatal morbidity indices such as admission to the special care baby unit for longer than 48 hours and polycythemia (hematocrit above 65%) were related significantly to the severity of the diabetes and not to maternal age or obesity.

Adult↗
PubMed1986

Assessment of an on-line computerized perinatal data collection and information system.

An on-line maternity data collection system has been designed to provide the information required for perinatal audit and to allow many of the letters and forms required for effective communication in pregnancy to be produced automatically. The system meets the requirements of the Korner Committee on Health Services Information and has been approved by the Computer Policy Committee. Pregnancy is followed prospectively from the first antenatal clinic visit until the file is closed 28 days after delivery. Data are entered by midwives and secretaries onto a network of microcomputers placed at convenient points in the maternity unit. The system has been fully operational with no significant problems since the beginning of 1984 and has led to improved communication between hospital and the community. Analysis of 253 consecutive case notes showed a high level of accuracy of the data recorded on computer. Reports and clinical audit are readily available both from the system locally, from standard programmes on the regional mainframe computer and via a mainframe computer at London University.

Computer Systems↗
PubMed1986

Low energy diets in the treatment of gestational diabetes.

A randomised prospective study of treatment with dietary restriction alone or insulin therapy with dietary advice was performed in 15 women with glucose intolerance diagnosed early in the third trimester of pregnancy. Twenty-four hour profiles of plasma glucose and 3-hydroxybutyrate were performed before and four weeks after commencing treatment. The effect on neonatal outcome was assessed. The case history of one of the patients in the study was sent to British physicians with a special interest in diabetes to obtain their opinion about the appropriate initial treatment of women with gestational diabetes.

3-Hydroxybutyric Acid↗
PubMed1985

An obstetric microcomputer information system.

A systems analysis has been done to determine how computer technology can provide an information system to improve the care of the mother and her baby. A minimum data base was established complying with the recommendations of the Körner Committee and designed to meet the needs of the health personnel looking after the mother and baby. An ICL DRS 20/50 network of four microcomputers has been installed in the obstetric unit of a district teaching hospital with a link to the regional mainframe. There have been no significant software or hardware faults since the system became fully operational in January 1984. All women are registered on the system at their first visit allowing the pregnancy to be followed prospectively. Subsequently midwives enter data on line at delivery and at discharge. The on line validation and range checks improves the accuracy of the data allowing a reliable perinatal audit to be obtained routinely. The system has been accepted by the staff since much of the routine pregnancy documentation is produced automatically. This includes booking letters and summaries for general practitioners, admission slips, birth notification forms, registers and forms for the community midwives and health visitors. Immediate production of reports for community health staff allows better communication and improved patient care. No additional staff are needed in the obstetric unit and one job which was mainly of a clerical nature has been saved and the salary transferred to provide one more midwife for the postnatal wards.(ABSTRACT TRUNCATED AT 250 WORDS)

Computers↗
PubMed1985

The effect of diet and insulin on metabolic profiles of women with gestational diabetes mellitus.

Twenty women with abnormal glucose tolerance, detected from a routine program of antenatal screening for gestational diabetes mellitus (GDM) at 28 wk, were admitted for 24-h metabolic profiles. They were then alternately allocated to either insulin and dietary restriction or dietary restriction alone and then retested 4 wk later while on therapy. Ten normal controls were assessed twice at similar gestations to the study group. Before treatment, the 20 gestational diabetic subjects had higher mean concentrations of plasma glucose and 3-hydroxybutyrate than the controls for most of the profile, but mean insulin values were similar. Insulin therapy was associated with a reduction in mean glucose concentrations so that the profile was similar to the controls, while in the diet-alone group the reduction was less. The 3-hydroxybutyrate concentrations rose between profiles in the normal group and also rose in those treated by diet alone, but still remained within the upper range of normal even at night. Insulin therapy resulted in a similar 3-hydroxybutyrate profile to the controls. The C-peptide response to breakfast was reduced in both groups to levels below that of the controls. Neonatal outcome indices were similar in the two treatment groups, despite the differences in maternal metabolites, but because of the size of this study, conclusions about the neonate must be tentative.

3-Hydroxybutyric Acid↗
PubMed1983

Selection of an obstetric data base for a microcomputer and its use for on-line production of birth notification forms, discharge summaries and perinatal audit.

A microcomputer system is described which stores data for perinatal audit and produces 'on-line' the statutory birth notification form and mother and baby discharge summary. The derivation of a minimum data-base and the methods used to obtain reliable data are outlined. The results of a trial of the production of the birth notification form for 195 deliveries are reported together with those of a further trial of 86 deliveries in which the system was used to produce both the notification form and the discharge summary. A study of the accuracy of the handwritten birth notification forms revealed a high error rate which was markedly reduced by the use of the microcomputer system. The system is now in routine use and further developments are outlined.

Computers↗
PubMed1983

Delayed pushing with lumbar epidural analgesia in labour.

Seventy-six primigravidae with epidural analgesia were randomly assigned to one of two groups for management in the second stage. In one group the women delayed pushing and in the other they were managed conventionally. The two groups were well matched for maternal and infant characteristics, including position and level of the presenting part at full dilatation and fetal scalp blood pH. The mean waiting time in the second stage before pushing was increased from 27 min in the conventional group to 123 min in the delayed group. This delay was not associated with an increase in abnormal fetal heart rate abnormalities or any decrease in umbilical cord pH or Apgar scores. In contrast, the delay was associated with an increase in spontaneous deliveries and a decrease in forceps deliveries (P = 0.06). These findings suggest a need for redefining the management of the second stage of labour with epidural analgesia.

Adult↗