PubMed · 8147532
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R Burtles. 1994. Avoiding calculations for preparing continuous infusions.. https://doi.org/10.1111/j.1365-2044.1994.tb03446.x
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BACKGROUND: Pregnancy is associated with marked insulin resistance that seems to have little, if any, impact on the long-term risk of non-insulin-dependent diabetes mellitus (NIDDM) in the general population. The aim of this study was to test whether pregnancy would alter the risk of NIDDM among women with a high prevalence of pancreatic beta-cell dysfunction, as indicated by a history of gestational diabetes mellitus. METHODS: The cohort consisted of 666 Latino women with gestational diabetes attending a high-risk family planning clinic. They were followed up for up to 7.5 years, during which time they were weighed and underwent an oral glucose-tolerance test annually. The effect of an additional pregnancy, and of other risk factors for diabetes, was examined. FINDINGS: 87 (13%) of the women completed an additional pregnancy. 80 of those women did not have NIDDM immediately after the additional pregnancy and their subsequent annual incidence rate of NIDDM was 30.9% (95% CI 12.7-49.1), more than 2.5 times the annual incidence rate of NIDDM in the cohort overall (11.9%; 95% CI 10.0-13.8). Proportional hazards regression analysis using the presence or absence of an additional pregnancy as a time-dependent variable confirmed that an additional pregnancy increased the rate ratio of NIDDM to 3.34 (95% CI 1.80-6.19), compared with women without an additional pregnancy after adjustment for other potential diabetes risk factors during the index pregnancy (antepartum oral glucose tolerance, highest fasting glucose, gestational age at diagnosis of gestational diabetes) and during follow-up (postpartum body mass index [BMI], and glucose tolerance, weight change, breast feeding, and months of contraceptive use). Weight gain also was independently associated with an increased risk of NIDDM; the rate ratio was 1.95 (95% CI 1.63-2.33) for each 10 lb (4.5 kg) gained during follow-up after adjustment for the additional pregnancy and the other potential risk factors. INTERPRETATION: The study showed that a single pregnancy, independent of the well-known effect of weight gain, accelerated the development of NIDDM in a group of women with a high prevalence of pancreatic beta-cell dysfunction. This finding implies that episodes of insulin resistance may contribute to the decline in beta-cell function that leads to NIDDM in many high-risk individuals.
The purpose of this study was to determine the effect of oral sensorimotor treatment on oral-motor skills and measures of growth in moderately eating impaired children with cerebral palsy who were stratified by state of aspiration/nonaspiration. Twenty-seven children aged 2.5-10.0 years participated in this study (aspiration: n = 7, nonaspiration: n = 20). Weight and skinfold measures were taken. Children were observed at lunch time and six domains of feeding were examined: spoon feeding, biting, chewing, cup drinking, straw drinking, swallowing, and drooling. Children underwent 10 weeks of control and 10 weeks of sensorimotor treatment, 5-7 minutes/day, 5 days/week. Treatment compliance for the entire group was 67%. Children who aspirated had significantly poorer oral-motor skills in spoon feeding, biting, chewing, and swallowing than children who did not aspirate. There was significant improvement in eating: spoon feeding (fewer abnormal behaviors, p < 0.03), chewing (more normal behaviors, p < 0.003), and swallowing (more normal behaviors, p < 0.008). There were no significant changes in drinking skills. Children as a group maintained their pretreatment weight-age percentile but did not show any catch-up growth. Children showed adequate energy reserves as measured by skinfold thicknesses. Improvement in oral-motor skills may help these children to ingest food more competently (i.e., less spillage). However, their weight remains at the lowest level of age norms.
These findings suggest that PA banding may be suitable in children with congenital heart disease and excessive pulmonary flow, and that best results are obtained when the band circumference is < 90% of the standard pulmonary valve-ring circumference, as calculated from an equation derived from normal pulmonary valve dimensions. This guideline applies equally well to small infants weighing < 3 kg and to larger patients.