Search PubMed⌕ Search

Biomedical subjects

M W Carpenter

Publications and source records attributed to M W Carpenter.

41 records · Page 3Linked to original sources

Criteria for screening tests for gestational diabetes.

A 50 gm, 1-hour glucose screening test was given to 381 gravid women 25 years of age or older. All women with plasma glucose values greater than or equal to 130 mg/dl (119 mg/dl, whole blood) were given a 100 gm, 3-hour glucose tolerance test to diagnose gestational glucose intolerance using O'Sullivan's diagnostic criteria. On the basis of the distribution of screening test values, three diagnostic zones could be identified: a zone below 135 mg/dl plasma glucose, with less than 1% probability of diabetes; a zone above 182 mg/dl plasma glucose, with more than 95% probability of diabetes; and a central zone of uncertainty (135 to 182 mg/dl, plasma glucose), where further testing is required. These test results suggest that thresholds for further testing be lowered from 143 to 135 mg/dl of plasma glucose.

Adult↗

Exercise fails to improve postprandial glycemic excursion in women with gestational diabetes.

The effect of an acute period of moderate intensity exercise on maternal glycemic excursion following a mixed nutrient meal was studied. Five normal (NL) and six gestational diabetic (GDM) subjects were enrolled. A randomized crossover design was used to compare fasting glucose and insulin levels, peak glucose and insulin levels and incremental area of the glycemic and insulin curves following a mixed nutrient meal with or without an exercise stress that took place 14 h earlier. Exercise consisted of upright stationary cycling for 30 min at a heart rate consistent with 60% VO2max. The clinical characteristics of normal and gestational diabetic subjects were comparable. Mean values (+/-SEM) with, versus without, exercise for fasting glucose (NL: 78.9 +/- 2.6 vs. 80.0 +/- 2.6 mg/dl; GDM: 86.4 +/- 2.0 vs. 82.1 +/- 3.5 mg/ dl), peak glucose (NL: 132.3 +/- 10.4 vs. 139.1 +/- 15.6 mg/dl; GDM: 165.8 +/- 5.5 vs. 160.3 +/- 7.8 mg/dl), the area under the glycemic curve (NL: 5758 +/- 1038 vs. 6393 +/- 1281 mg/dl.min; GDM: 8,178 +/- 890 vs. 8,331 +/- 563 mg/dl.min) did not differ. Similarly, plasma insulin levels did not differ between protocols for either group of subjects. Exercise has been proposed as a treatment to reduce glycemia in gestational diabetes. Results from this study indicate a single bout of exercise did not blunt the glycemic response observed following a mixed nutrient meal.

Adult↗

Glucocorticoid-associated maternal hyperglycemia: a randomized trial of insulin prophylaxis.

OBJECTIVES: To study the degree and timing of maternal hyperglycemia following betamethasone therapy in nondiabetic patients and establish a prophylactic dose of insulin. METHODS: Forty-five patients receiving betamethasone 12 mg i.m. at 7 AM on two consecutive days were randomized to no insulin (n = 20), low-dose insulin (n = 18), and high-dose insulin (n = 7) protocols. Each treatment group received s.c. insulin at 7 AM on the 2 days of betamethasone therapy (20 units NPH/10 units regular, and 40 units NPH/20 units regular, respectively). Capillary plasma glucose measurements were obtained at fasting and 2 h after meals for 3 days. A multivariate normal regression model was used to estimate and compare mean glucose levels. RESULTS: Eighty-five percent of patients who did not receive insulin exhibited hyperglycemia at levels previously associated with fetal acidosis. Significant differences in mean postprandial plasma glucose levels were found between the no-treatment and insulin groups on days 1 and 2. No significant differences were noted between groups on day 3. CONCLUSIONS: Transient maternal hyperglycemia occurs in a consistent pattern in nondiabetic patients receiving betamethasone, which can be limited by the concurrent use of insulin. Further studies to assess fetal acidosis in this setting are warranted.

Adult↗

Fryns syndrome: a new definition.

Fryns syndrome is a lethal, autosomal recessive syndrome of multiple congenital anomalies described by Fitch et al. in 1978 and Fryns et al. in 1979. As originally described, the major diagnostic criteria included abnormal facies; small thorax with widely spaced, hypoplastic nipples; distal limb and nail hypoplasia; and diaphragmatic hernia with pulmonary hypoplasia. Malformations involving other systems occurred irregularly in published reports. We reviewed 41 published cases of Fryns syndrome and added 4 cases of our own. The major diagnostic criteria described by Fryns were consistent in all cases with the exception of two criteria. Narrow thorax with hypoplastic nipples and gastrointestinal anomalies were present in less than 50% of the cases. Although for 16 of the 41 published cases there was no information on central nervous system findings, 21 of the 29 remaining cases (72%) had CNS malformations. These lesions were absence of corpus callosum, arhinencephaly, and heterotopia of cerebral and cerebellar tissue. Similarly, for 12 of the 41 published cases there was no information on cardiovascular findings but 29 of the 33 remaining cases (88%) had congenital heart disease. These lesions were ventricular septal defects, arterial septal defects, and persistent left superior vena cava. We conclude that central nervous system anomalies and congenital heart disease should be added to the major diagnostic criteria of Fryns syndrome.

Abnormalities, Multiple↗

Rapid determination of cholesterol in single and multicomponent prepared foods.

A rapid method has been developed for cholesterol determination in single and multicomponent foods. The method involves alcoholic KOH saponification of the samples, extraction of the nonsaponifiable fraction with hexane, and injection of concentrated extract into the gas chromatograph without derivatizations. It has been applied to a wide variety of frozen and refrigerated foods. More than 300 samples were analyzed with a coefficient of variation (CV) ranging from 0.5 to 8.6%. The average recoveries of cholesterol from spiked oil and tomato vegetable soup samples were 100 +/- 1.5% and 99.7 +/- 1.6% and the CVs were 1.5 and 1.6%, respectively. This method reduces labor by > 70%, eliminates dangerous chemicals, and minimizes solvent use, compared to the AOAC method and other methods cited in the manuscript. The method was used successfully on a wide variety of multicomponent foods. We recommend this method for collaborative study under the AOAC guidelines for method approval.

Animals↗