ABSTRACT
BACKGROUND: Although diabetic ketoacidosis (DKA) in pregnancy can result in significant adverse consequences for both mother and fetus, the response to treatment, time course of recovery, and perinatal outcomes have not been well studied in pregnancy. OBJECTIVE: We examined the precipitating factors, laboratory abnormalities, treatment strategies, and clinical recovery in pregnancies complicated by DKA. STUDY DESIGN: This is a retrospective cohort study of pregnancies complicated by DKA between October 1999 and June 2015. The diagnosis was verified by hyperglycemia; anion gap >12âmEq/L, pH <7.3, HCO3 <15âmEq/L; and the presence of ketones. Each episode of DKA was reviewed and subsequent perinatal outcomes analyzed. RESULTS: During this period, we identified 33 women with 40 admissions (incidence: 0.2%). The majority of women had type 1 diabetes (67%), and almost all presented with nausea and vomiting (97%). Over half had poor compliance with prescribed insulin. The initial mean blood glucose was 380âmg/dL, within 6 hours, it was <200âmg/dL. By 12 hours, the acidosis had resolved in 90% of patients. CONCLUSION: Nausea and vomiting is a prominent presenting feature of DKA in pregnancy. With aggressive insulin and resuscitation, hyperglycemia and acidosis improve rapidly. With current treatment, good perinatal outcomes can be expected.
Subject(s)
Diabetes Mellitus, Type 1/therapy , Diabetic Ketoacidosis/therapy , Fluid Therapy/methods , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Pregnancy in Diabetics/therapy , Abortion, Spontaneous/epidemiology , Adult , Birth Weight , Cesarean Section , Congenital Abnormalities/epidemiology , Crystalloid Solutions , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/metabolism , Diabetic Ketoacidosis/epidemiology , Diabetic Ketoacidosis/metabolism , Disease Progression , Female , Fetal Death , Gestational Age , Glycated Hemoglobin/metabolism , Humans , Hyperbilirubinemia, Neonatal/epidemiology , Hypoglycemia/epidemiology , Infant, Newborn , Infant, Newborn, Diseases/epidemiology , Intensive Care Units, Neonatal/statistics & numerical data , Isotonic Solutions/therapeutic use , Pre-Eclampsia/epidemiology , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/metabolism , Pregnancy Complications/therapy , Pregnancy in Diabetics/epidemiology , Pregnancy in Diabetics/metabolism , Premature Birth/epidemiology , Retrospective Studies , Texas/epidemiology , Young AdultABSTRACT
PURPOSE: The purpose of the present study was to analyze the neuromuscular responses during the performance of a sit to stand [STS] task in water and on dry land. SCOPE: 10 healthy subjects, five males and five females were recruited for study. Surface electromyography sEMG was used for lower limb and trunk muscles maximal voluntarty contraction [MVC] and during the STS task. RESULTS: Muscle activity was significantly higher on dry land than in water normalized signals by MVC from the quadriceps-vastus medialis [17.3%], the quadriceps - rectus femoris [5.3%], the long head of the biceps femoris [5.5%], the tibialis anterior [13.9%], the gastrocnemius medialis [3.4%], the soleus [6.2%]. However, the muscle activity was higher in water for the rectus abdominis [-26.6%] and the erector spinae [-22.6%]. CONCLUSIONS: This study for the first time describes the neuromuscular responses in healthy subjects during the performance of the STS task in water. The differences in lower limb and trunk muscle activity should be considered when using the STS movement in aquatic rehabilitation.
Subject(s)
Immersion/physiopathology , Movement/physiology , Muscle Contraction/physiology , Muscle, Skeletal/physiology , Task Performance and Analysis , Adult , Electromyography , Female , Healthy Volunteers , Humans , Hydrotherapy , Leg/physiology , Male , Neuromuscular Monitoring , Posture/physiology , Thigh/physiology , Young AdultABSTRACT
We assessed the bond strength of a glass ionomer cement to dentin that had been in contact with different materials. Flat dentin surfaces in freshly extracted human teeth were covered for 48 h with a 1 mm layer of a variety of materials that are used for temporary filling or root canal sealing. The products were mechanically removed and a glass ionomer cement cylindrical specimen bonded to the dentin surface. After 7-days immersion in 37 degrees C water the tensile bond strength was tested. The results were compared with those on dentin surfaces not in contact with any endodontic material. The statistical analysis showed that none of the materials used interfered with the bonding of the glass ionomer to dentin.
Subject(s)
Dental Bonding , Dentin , Glass Ionomer Cements/chemistry , Root Canal Filling Materials/chemistry , Analysis of Variance , Calcium Hydroxide/chemistry , Calcium Sulfate/chemistry , Camphor/chemistry , Chlorophenols/chemistry , Dental Cements , Drug Combinations , Humans , Hydrocarbons, Iodinated/chemistry , Methylmethacrylates/chemistry , Minerals/chemistry , Polyvinyls/chemistry , Thymol/chemistry , Zinc Oxide/chemistry , Zinc Oxide-Eugenol Cement/chemistryABSTRACT
We assessed the bond strength of a composite resin to dentin that had been in contact with different materials. Flat dentin surfaces in freshly extracted human teeth were covered for 15 min or 48 h with a 1-mm layer of a variety of materials. The products were mechanically removed and a composite resin cylindrical specimen bonded to the dentin surface using the Prisma universal bond system. After 7 days immersion at 37 degrees C in water, the tensile bond strength was tested. The results were compared with those on dentin surfaces not in contact with any endodontic material. Statistical analysis showed that some materials (Grossmans Cement, IRM, Maisto's slowly resorbable paste) reduced the strength of the bond or even precluded bonding. It is necessary to develop techniques that will eliminate this when restoring endodontically treated teeth.
