Factors associated with early cessation of breastfeeding in women with gestational diabetes mellitus.

AIM: To determine factors associated with early cessation of breastfeeding (≤ 3 months) in women with recent gestational diabetes mellitus (GDM). METHODS: A cross-sectional online survey of women aged ≥ 18 years, diagnosed with GDM in 2010 and registered with the National Diabetes Services Scheme in Australia. The 59 questions examined breastfeeding duration, intention, attitudes, exclusivity and support. RESULTS: 738 women completed the survey (15% response rate). Data was analysed for 729 eligible respondents. Of these 97% reported 'ever' breastfeeding and 19% had breastfed for ≤ 3 months. Cessation of breastfeeding at or before 3 months was associated with breastfeeding problems at home [adjusted odds ratio 8.01, 95% confidence interval (4.57, 14.05)], return to work prior to three months [OR 3.39 (95% CI 1.53, 7.55)], inadequate breastfeeding support [OR 1.88 (95% CI 1.10, 3.22)], caesarean delivery [OR 1.70 (95% CI 1.04, 2.76)], low socioeconomic status (SEIFA 1 unit increase) [OR 0.89 (95% CI 0.81, 0.97)] and BMI (2 unit increase) [OR 1.08 (95% CI 1.01, 1.57)]. Being married or de facto [OR 0.14 (95% CI 0.03, 0.62)] was a protective against early cessation of breastfeeding. CONCLUSION: Strategies to improve breastfeeding duration in women with GDM need to address those most at risk of early cessation and provide appropriate postpartum breastfeeding support in this group.

Postpartum diet quality in Australian women following a gestational diabetes pregnancy.

BACKGROUND/OBJECTIVES: To describe the diet quality of a national sample of Australian women with a recent history of gestational diabetes mellitus (GDM) and determine factors associated with adherence to national dietary recommendations. SUBJECTS/METHODS: A postpartum lifestyle survey with 1499 Australian women diagnosed with GDM ≤3 years previously. Diet quality was measured using the Australian recommended food score (ARFS) and weighted by demographic and diabetes management characteristics. Multinominal logistic regression analysis was used to determine the association between diet quality and demographic characteristics, health seeking behaviours and diabetes-related risk factors. RESULTS: Mean (±s.d.) ARFS was 30.9±8.1 from a possible maximum score of 74. Subscale component scores demonstrated that the nuts/legumes, grains and fruits were the most poorly scored. Factors associated with being in the highest compared with the lowest ARFS quintile included age (odds ratio (OR) 5-year increase=1.40; 95% (confidence interval) CI:1.16-1.68), tertiary education (OR=2.19; 95% CI:1.52-3.17), speaking only English (OR=1.92; 95% CI:1.19-3.08), being sufficiently physically active (OR=2.11; 95% CI:1.46-3.05), returning for postpartum blood glucose testing (OR=1.75; 95% CI:1.23-2.50) and receiving risk reduction advice from a health professional (OR=1.80; 95% CI:1.24-2.60). CONCLUSIONS: Despite an increased risk of type 2 diabetes, women in this study had an overall poor diet quality as measured by the ARFS. Women with GDM should be targeted for interventions aimed at achieving a postpartum diet consistent with the guidelines for chronic disease prevention. Encouraging women to return for follow-up and providing risk reduction advice may be positive initial steps to improve diet quality, but additional strategies need to be identified.

Perceived risk of Type 2 diabetes in Australian women with a recent history of gestational diabetes mellitus.

AIMS: To describe the risk perceptions and factors associated with a high level of perceived risk for the development of Type 2 diabetes in a sample of Australian women with a recent history of gestational diabetes mellitus. METHODS: Participants were women aged 18 years and over, diagnosed with gestational diabetes between 2003 and 2005, registered with the National Diabetes Services Scheme. Cross-sectional data were collected via written postal survey and included a self-reported risk perception scale. RESULTS: Of 4098 invited, eligible women, 1372 consented to participate (response rate 36%). Respondents currently pregnant or subsequently diagnosed with Type 2 diabetes were excluded (n = 196). Up to 3 years post-gestational diabetes, 32% of women perceived that they were at a low or very low risk for developing Type 2 diabetes, 42% at moderate risk and 26% high or very high risk. Using logistic regression analysis, factors associated with high level of perceived risk were body mass index > 25 kg/m(2) [odds ratio (OR) 4.50, 95% confidence interval (CI) (3.12, 6.51)], a family history of diabetes [OR 3.80, 95% CI (2.67, 5.33)] and use of insulin during pregnancy [OR 1.92, 95% CI (1.31, 2.61)]. CONCLUSIONS: Although women with known risk factors for Type 2 diabetes were more likely to perceive their risk as high, we found that one third still considered themselves to be at low or very low risk for the development of diabetes. These results suggest a need for increased awareness of gestational diabetes as a strong predictor of Type 2 diabetes risk.

Natural killer cell activity of prostatic cancer patients.

Natural killer (NK) cell activity of prostatic cancer patients was compared with that of control groups by the radioactive indium (111In) release assay using the K562 and H494 cells as targets. Patients suffering from advanced prostatic cancer (clinical stages C and D) exhibited significantly lower NK activity against K562 cells (28 +/- 18%) than did the normal group (41 +/- 19%). The lower NK activity of these patients is not related to their age, since patients in the same age range with localized cancer (stage B) or benign prostatic hyperplasia did not show low NK activity (37% +/- 19%). This lower NK activity is not due to a depletion of the NK cell precursor population, since the NK activity of advanced cancer patients improves significantly after in vitro incubation with interferon. The NK activity of normal subjects or patient groups showed wide fluctuations during the 18-month observation period. Because of these interassay variations, it is necessary to use standard control subjects during long-term monitoring of the NK activity of the patients.

Immune regression of visceral metastases in athymic mice. Correlation of "low-level" in vitro cell-mediated cytotoxic reactions with allograft rejection in vivo.

The MDAY-D2 tumor of DBA/2 origin metastasizes widely and predictably in syngeneic DBA/2 mice, as well as in allogeneic athymic mice. BALB/c mice, which are H-2 compatible with MDAY-D2, reject the tumor based on non-H2 histocompatibility antigens. This rejection corresponds directly with the generation of a "low-level," in vitro, cell-mediated cytotoxic response in ipsilateral peripheral lymph nodes and spleen. Production of cytotoxic antibody also occurs during tumor rejection. Previous work has demonstrated the effectiveness of adoptively transferred, sensitized BALB/c lymphocytes in eliminating preexisting visceral metastases in BALB/c athymic mice. The present study shows that in this model the complete regression of H-2-compatible allografts, in the form of preexisting metastases, correlates directly with the ability of adoptively transferred cells to mediate low-level, cell-mediated cytotoxicity in vitro. Both graft rejection in vivo and cell-mediated cytotoxicity in vitro are mediated by T cells. Enriched sensitized B cells and anti-MDAY-D2 serum are both incapable of mediating this graft rejection in vivo. Based on these findings, we conclude that relatively weak in vitro cell-mediated cytotoxic responses should not be dismissed as biologically insignificant, for they may be indicative of considerable immune potential in vivo.

Biological effects of short course radiation in transitional cell carcinoma of the bladder.

We evaluated the biologic effects of short course radiation therapy (1800 to 2000 rads) administered before cystectomy by placing tumors in tissue culture and observing their growth. No differences in growth were observed between irradiated and nonirradiated tumors. The minimal sublethal dose of radiation that effectively suppresses the growth of transitional cell carcinoma needs to be determined.

Immune-mediated arrest and reversal of established visceral metastases in athymic mice.

The metastasizing MDAY-D2 tumor of DBA/2 mice disseminates in BALB/c allogeneic athymic nude (nu/nu) mice in a manner identical to that observed in the syngeneic host. Both the kinetics and organ distribution pattern of metastases from s.c. implants of MDAY-D2 are routinely predictable at any given tumor dose. BALB/c heterozygote (nu/+) litter-mates reject MDAY-D2 grafts on the basis of the multiple minor histocompatibility differences that exist between DBA/2 and BALB/c mice. The in vitro cell-mediated cytotoxic response detected in tumor-bearing BALB/c nu/+ mice is "low grade" (isotope release is approximately 40 to 50% by 24-hr 111-indium-8-hydroxyquinoline assay and approximately 6 to 8% by 6-hr 51Cr assay) and yet correlates directly with tumor rejection. BALB/c nu/nu mice can be protected against MDAY-D2 by previous reconstitution with lymphoid cells from normal or MDAY-D2-sensitized BALB/c nu/+ mice. In addition, surgically documented, established visceral metastases in BALB/c nu/nu mice can be arrested and regressed by the adoptive transfer of MDAY-D2-sensitized BALB/c nu/+ spleen cells. This represents one of the few models where established metastases have been immunotherapeutically regressed. As such, the MDAY-D2 BALB/c nu/nu mouse model offers unique advantages for studying the role of the immune system in regulating the metastatic process.

An in vivo assessment of in vitro sensitized human lymphocytes using athymic, "nude" mice.

Cytotoxic lymphocytes were generated in vitro by co-cultivation of human peripheral blood lymphocytes with cultured human tumor cells. Their cytotoxic action was demonstrated in vivo in immunologically deficient "nude" mice.

Human prostatic acid phosphatases: II. A double--antibody radioimmunoassay.

A double-antibody radioimmunoassay method for prostate-specific acid phosphatase (PAP) is presented. Experimental details are outlined to assess the reproducibility and reliability of the method under assay conditions. The upper limit of the serum PAP levels in the present assay was set at 2.4 ng/100 microliter by 162 determinations of normal serum samples. The serum PAP levels of patients with nonprostatic malignant tumors fell in the normal range, whereas the levels higher than 4.0 ng/100 microliter were found in patients with prostatic carcinoma.

Fc receptor-bearing lymphoid cells in the chicken. I. Characterization of the Fc(IgG) receptor.

The receptor for FC(IgG) on chicken lymphoid cells was investigated by EA rosette techniques using sheep erythrocytes sensitized with a sub-agglutinating dose of anti-sheep erythrocyte (SRBC) chicken serum. Chicken lymphocytes did not form rosettes with SRBC coated with rabbit antibody, and human and mouse lymphocytes did not bind SRBC sensitized with chicken antibody. Only avian sera were effective in blocking the Fc receptor. Similarities between chicken and mammalian Fc receptors were demonstrated as both are pronase sensitive, trypsin resistant, and are distinct from surface immunoglobulin. Fc receptors were also distinguished from avian bursa- and thymus-specific antigens. Additional Fc receptor-bearing cells were revealed in bursa, spleen and bone marrow lymphocytes after neuraminidase treatment.