Purpose
To investigate whether maternal cigarette smoking during pregnancy is a risk factor for developing GDM.
Methods
MEDLINE, Scopus, CENTRAL and Google Scholar databases were searched from ...inception to December 2022 to identify eligible original articles. A systematic review and meta-analysis (weighted data, random-effects model) were performed. The primary outcome was the development of GDM in pregnant women. The results were expressed as odds ratios (OR) with 95% confidence interval (CI) (inverse variance method). Subgroup analysis was planned according to the maternal smoking status and GDM diagnostic criteria. Statistical heterogeneity was checked with the Chi-squared (Chi
2
) test and the I
2
index was used to quantify it. The studies were evaluated for publication bias.
Results
Thirty-five studies, including 23,849,696 pregnant women, met the inclusion criteria. The pooled OR of smoking during pregnancy compared with non-smoking (never smokers and former smokers) was 1.06 (95% CI 0.95–1.19), p = 0.30; I
2
= 90%; Chi
2
= 344; df=34; p < 0.001. Subgroup analysis was performed according to the two-step Carpenter-Coustan diagnostic criteria, due to the high heterogeneity among the other applied methods. The pooled OR for the Carpenter-Coustan subgroup was 1.19 (95% CI 0.95–1.49), p = 0.12; I
2
= 63%; Chi
2
= 27; df=10; p < 0.002. Further subgroup analysis according to maternal smoking status was not performed due to missing data.
Conclusion
There is no evidence to support an association between maternal cigarette smoking during pregnancy and the risk for GDM. Universally accepted diagnostic criteria for GDM must be adopted to reduce heterogeneity and clarify the association between smoking and GDM.
This is the first study, that aimed: a) to compare immune response, namely the kinetics of neutralizing antibodies (Nabs), after vaccination with BNT162b2 mRNA vaccine (Comirnaty, Pfizer/BioNTech) ...between patients with autoimmune thyroiditis and controls, and b) to investigate changes in thyroid function in healthy subjects with no history of thyroid dysfunction before and after vaccination with BNT162b2 mRNA vaccine (Comirnaty, Pfizer/BioNTech).
The entire study consisted of two sub-studies. In the first sub-study, NAbs levels after BNT162b2 mRNA vaccination were compared between 56 patients with autoimmune thyroiditis and 56 age and gender-matched healthy controls from the day of the first dose until a period of up to three months after the second dose. In the second sub-study, thyroid hormones (T3, T4, TSH) and thyroid auto-antibodies levels (anti-TG, anti-TPO) of 72 healthy subjects with no history of thyroid disease were examined before (D1) and one month after completion of the second dose (D50).
Among patients with autoimmune thyroiditis, the median neutralizing inhibition on D22, immediately before second dose, was 62.5%. One month later (D50), values increased to 96.7%, while three months after the second dose NAbs titers remained almost the same (94.5%). In the healthy group, median NAbs levels at D22 were 53.6%. On D50 the median inhibition values increased to 95.1%, while after three months they were 89.2%. The statistical analysis did not show significant differences between two groups (p-values 0.164, 0.390, 0.105 for D22, D50 and three months). Regarding changes in thyroid function, the mean value for T4 before vaccination was 89.797 nmol/L and one month after the second dose was 89.11 nmol/L (p-value=0.649). On D1 the mean T3 value was 1.464 nmol/L, which dropped to 1.389 nmol/L on D50 (p-value = 0.004). For TSH, mean levels were 2.064 mIU/ml on D1 and fell to 1.840 mIU/ml one month after the second dose (p-value=0.037). Despite decrease, all thyroid hormone levels remained within the normal range. No changes were found for anti-TPO or anti-TG.
This study provided evidence that patients with autoimmune thyroiditis present similar immunological response to COVID-19 BNT162b2 mRNA vaccine (Comirnaty, Pfizer/BioNTech) with healthy subjects, while vaccination may affect thyroid function.
SARS-CoV-2 vaccination is the most powerful and promising tool against the COVID-19 pandemic. Millions of people have been vaccinated worldwide. Recently, few cases of subacute thyroiditis following ...SARS-CoV-2 vaccination with various types of vaccine have been reported. We describe here a 36-year-old woman who presented with subacute thyroiditis 10 days after she had received her first dose of the SARS-CoV-2 mRNA vaccine Comirnaty (Pfizer/BioNTech); the condition receded but then recurred 10 days after she received her second dose. As vaccination programmes proceed, clinicians' attention and vigilance for such cases will be increased. Physicians need to know that subacute thyroiditis is a mild and self-limiting condition in the majority of cases. Last but not least, the benefits of vaccination against COVID-19 outweigh the side-effects reported so far.
•A 36-year-old woman presented subacute thyroiditis after the SARS-CoV-2 mRNA vaccine.•It receded but recurred after the 2nd dose.•It is usually a mild and self-limiting condition .•Benefits of vaccination against COVID-19 outweigh side effects.
Type 2 diabetes mellitus (T2DM) is often complicated by steatotic liver disease, cardiovascular disease (CVD), and extrahepatic cancer. We investigated whether FIB-4, an indicator of liver fibrosis, ...is associated with a higher risk of CVD and extrahepatic cancer history in T2DM.
Two hundred and nine of 244 diabetics admitted to our center in one year were included and retrospectively evaluated.
One hundred and fifty-two (72.7%) were males and 57 (27.3%) females. The mean age and FIB-4 were 64.3 ± 11 years, and 1.15 ± 0.5, respectively. One hundred and fifty patients (71.8%) had FIB-4 ≤ 1.3, and 59 (28.2%) had FIB-4 > 1.3. A history of CVD was presented in 76 (36.4%) patients, and of extrahepatic cancer in 39 (18.7%). Patients with CVD were significantly older than those without (68.4 ± 8.5 vs. 63.2 ± 11.5 years;
= 0.002), with significantly higher FIB-4 (1.26 ± 0.5 vs. 1.08 ± 0.5;
= 0.012). Patients with cancer were older, with higher FIB-4 compared to those without (68.2 ± 9.5 vs. 64.4 ± 10.9 years;
= 0.098 and 1.37 ± 0.6 vs. 1.1 ± 0.5;
= 0.004, respectively). FIB-4 > 1.3 was associated with a 2.1-fold probability for CVD (χ
= 5.810;
= 0.025) and 2.7-fold probability for cancer history (χ
= 7.603;
= 0.01).
FIB-4 ≥ 1.3 is associated with a higher probability of CVD or extrahepatic cancer history. FIB-4 could potentially discriminate patients at risk, justifying stricter surveillance.
Objective: Smokers with diabetes show higher risk for serious microvascular and macrovascular complications, leading them to greater mortality risk. Moreover because of insulin resistance that ...nicotine is causing diabetes parameters become worse in smokers. The objective was to identify the characteristics of diabetic smokers that could help increase smoking cessation rates. Methods: We recruited diabetic type II, smokers (searching for diabetic you smoke in the medical files) and motivated them using WHO/ISH risk prediction charts. We assessed nicotine addiction (FNDT), metabolic rate at rest, psychometric parameters (SCL-90), Confidence, motivation, Body weight, glycosylated hemoglobin, BMI, Blood pressure, exhaled CO, CRP, Blood lipids, eating and exercise questionnaires (FFQ, IPAQ 2002). All parameters were measured at the beginning, at the end of the first month at after 3 months. The smoking cessation program is administered by a multidisciplinary team (respiratory physician, endocrinologist, dietician, behavioural psychologist) once a week for the first month and then once a month for the first trimester. All smokers are administered varenicline (free of charge) at the approved dose for 3 months. Results: From the 20 first diabetic patients that were recruited, 17 (85%-13 men and 4 women) accepted following our smoking cessation program and understood that they would benefit a lot from smoking cessation. At the end of the 3m. 12 (70,5%) had quit smoking without adding weight, all of them had comorbidities (asthma, depression and coronary heart disease). The group was very addicted (Fangerstrom scale:7,8), was smoking more than one pack of cigarette (24.8cig/d) and were motivated to quit (Average motivation scale 1-10:8.6) but not confident (Average confidence scale 1-10: 5.5). These are the first results of a clinical trial of diabetic smokers (total number will be 250smokers) that will be helped to quit using intense behavioural support and varenicline for three months. Conclusions: We conclude that diabetic smokers can effectively quit using an intense multidisciplinary approach, close follow-up plus varenicline for three months, without adding weight. The specific characteristics of this population will be taken into account in order to ameliorate the program. A web-based approach will be added to smokers that cannot follow the program on site. Table: Average age (years) 57.6 Average cigarettes/day (before/after) 24.8/3 Average kg (before/after) 82.35/82.85 Average Fangerstrom scale before 7.8 Average motivation (scale 1 to 10) 8.6 Average confidence (scale 1 to 10) 5.5 Average SCL-90 score 77 Average BP Systolic/ Diastolic (mmHg) 124/73 Average HbA1c % 6.5 Average CO ppm (before/after) 18.6/7.17 Table I: Diabetic Type II smokers that took part at an intense smoking cessation program
The concomitant presentation of thyroid-associated ophthalmopathy (TAO) and ocular myasthenia gravis is well documented. In the course of Graves disease (GD), symptomatic transient neuromuscular ...junction disorder may occur due to the effect of thyroid hormones at the neuromuscular synapse. Diagnostic clues are the clinical and electrophysiologic remission synchronous with restoration of euthyroidism. Furthermore, the occurrence of thymic hyperplasia in GD poses further diagnostic and therapeutic considerations. These points are discussed in the case report of a 43-year-old male patient suffering from TAO and transient neuromuscular junction disorder due to GD.
Nowadays, the interaction between humans and robots is constantly expanding, requiring more and more human motion recognition applications to operate in real time. However, most works on temporal ...action detection and recognition perform these tasks in offline manner, i.e. temporally segmented videos are classified as a whole. In this paper, based on the recently proposed framework of Temporal Recurrent Networks, we explore how temporal context and human movement dynamics can be effectively employed for online action detection. Our approach uses various state-of-the-art architectures and appropriately combines the extracted features in order to improve action detection. We evaluate our method on a challenging but widely used dataset for temporal action localization, THUMOS'14. Our experiments show significant improvement over the baseline method, achieving state-of-the art results on THUMOS'14.
Objective To investigate a probable impact of seasons on the diagnosis of GDM, as well as the specific effect of the environmental temperature on the diagnosis of this clinical entity. Patients and ...methods Two observational studies, one retrospective and one prospective, were conducted in a referral center. Study A included retrospectively 7618 pregnant women who underwent a 3-h 100 g OGTT during the 3rd trimester of gestation. Study B prospectively included 768 pregnant women tested in the 3rd trimester of gestation with a 75 g OGTT. Temperature was recorded every day at 09:00 h. Results Retrospective Study A: GDM prevalence differed significantly by season: winter = 28.1%, summer = 39.2%, spring = 32.4% and autumn = 32.4% (P < 0.0001). The odds ratio for being diagnosed with GDM was much higher during summer 1.65 (95% CI: 1.43–1.90), with spring and autumn following with 1.23 (95% CI: 1.08–1.39) compared to winter. Glucose levels during OGTT were measured: significantly increased blood glucose values were observed at 60, 120 and 180 min in summer, which remained significant after adjustment for age, gestational age, BMI, weight gain during pregnancy and blood pressure. Prospective Study B: At temperatures above 25°C, the average glucose 60-min and 120-min levels were increased. The relative risk for abnormal glucose values at 60 min, when the environmental temperature increased over 25°C, was 2.2 (1.5–3.3). Conclusions GDM prevalence in Greece presents seasonal variation, with higher risk during summer due to post glucose load level variations. These variations could be attributed to differences in environmental temperature.
Purpose
The objective of this retrospective study was to compare glycemic control, pregnancy outcomes, and neonatal outcomes in women with gestational diabetes mellitus (GDM) treated with (a) insulin ...detemir and (b) insulin neutral protamine Hagedorn (NPH).
Methods
A total of 192 women with GDM were included in the analysis. Ninety-eight women received detemir, while 94 women received NPH. Data regarding medical history, glycemic control, and time and mode of delivery, as well as neonatal outcomes, were recorded.
Results
Baseline characteristics were comparable between the two groups. There were no differences with respect to the week of insulin initiation, total insulin dose, duration of insulin therapy, daily insulin dose/weight in early and late pregnancy, or the number of insulin injections per day
.
Maternal overall weight gain during pregnancy and weight gain per week did not differ either. The detemir group had slightly lower HbA1c levels at the end of gestation median: det 5.2% (33 mmol/mol) vs NPH 5.4% (36 mmol/mol),
p
=0.035). There were no cases of hypoglycemia or allergic reactions in the two groups. There were also no differences regarding neonatal outcomes according to the available data, given that data in some cases were missing.
Conclusion
The use of insulin detemir was found to be equally effective and safe compared to NPH in women with GDM.
PDF
