[Screening for gestational diabetes mellitus based on blood glucose 2hrs value after a 75g oral glucose load].

We examined the relationship between the time of blood collection and the blood glucose value by analyzing blood glucose values around one hour and two hours after a 75g oral glucose load in 50 women who were at 24 to 28 weeks of gestation. We performed a 75g, 2hrs screening test at 16 to 33 weeks of gestation on all 2,570 pregnant women who visited our out patient clinic between May, 1986 and August, 1991. 1. During the 50-70 minutes after glucose loading, the blood glucose level changed 15-20mg/dl every 10 minutes. During the 110-130 minutes after glucose loading, the change was smaller (10-15mg/dl). These results suggest that the blood glucose level is more stable at 120 minutes than at 60 minutes. 2. When the cut-off point was set at 130mg/dl, the screening test for GDM with a 75g, 2hrs value had a sensitivity of 100%, and a specificity of 85.5% and the incidence of GDM was 3.1%. A 75g, 2hrs screening test therefore seems to be as useful in detecting GDM as a 50g, 1-hour test and to be more suited to crowded out patient clinics because its ability to detect GDM is not seriously affected by small variations in the blood sampling time.

[Clinical evaluation of pivmecillinam in the maintenance therapy of chronic urinary tract infection (author's transl)].

In order to evaluate the efficacy and safety of pivmecillinam (melysin tablet, PMPC), PMPC was administered to 78 chronic UTI cases in the field of obstetrics and gynecology (posthysterectomy infection, chronic cystitis, chronic pyelonephritis and etc.). In principle, daily 400 mg of PMPC was administered for 2 weeks. (1) Overall clinical efficacy judged by doctor was evaluated in 78 cases and the result was; excellent in 17, good in 37, fair in 10, poor in 13 and unknown in 1 case with the effectiveness rate of 69.2%. (2) Overall clinical efficacy judged by 'criteria for clinical evaluation in complicated UTI' recommended by UTI study member was evaluated in 54 cases and the result was; excellent in 15, good in 20 and poor in 19 cases with the overall efficacy rate of 64.8%, the result of which was similar to that of doctor's judgement. (3) Efficacy on pyuria was evaluated in 72 cases and it was cleared in 27, decreased in 25, unchanged in 20 and unknown in 6 cases. Efficacy on bacteriuria was evaluated in 72 cases and it was eliminated in 44, decreased in 9, replaced in 8, unchanged in 8 and unknown in 9 cases. (4) Side effect, considered by doctors to be caused by PMPC administration, was noticed in 3 out of 78 cases (3.8%), all of which was mild gastrointestinal disturbance and the administration of PMPC was continued. Abnormal change of laboratory finding considered by doctors to be caused by PMPC administration was noticed in 1 out of 78 cases, which was slight elevation of GOT and GPT values. It is therefore considered that PMPC appear to be useful drug for the maintenance therapy of chronic UTI in the field of obstetrics and gynecology.