Glycemic profile assessment during betamethasone administration in women with twin pregnancies after IVF with or without gestational diabetes

BACKGROUND AND AIMS

Betamethasone's effect on glycemia in twin pregnancies, with or without gestational diabetes mellitus, has not been adequately investigated.

METHODS

We assessed the glycemic profile of 30 women with twin pregnancies after in-vitro-fertilization who were given betamethasone.

RESULTS

The majority of women were treated eventually with insulin to maintain glycemia. In insulin-treated women the increase in insulin dosage was of 61.1%. Insulin use/dosage was not associated with betamethasone dose, age, gestational age, weight gain in pregnancy, or duration of hyperglycemia.

CONCLUSION

Post-betamethasone, twin pregnancies seem to follow the same glycemia pattern as singleton pregnancies.

Study on the Interaction between Serum Thyrotropin and Semen Parameters in Men

The effect of thyroid function on semen parameters has been studied in pathological conditions in small studies. With this research work, we aimed to study thyroid hormone effects on semen parameters in 130 men who were evaluated for couple subfertility. Our study was cross-sectional. We noted semen volume, sperm concentration, total sperm count, testosterone levels and thyrotropin (TSH) levels. The analysis included ordinary least squares regression (OLS-R), quantile regression (QR) and segmented line regression (SR). Using OLS-R, a weak negative correlation was found between the logTSH levels and semen volume (r = −0.16, r² = 0.03, p = 0.05). In Q-R, each incremental unit increase in logTSH decreased the mean semen volume between −0.78 ± 0.44 and −1.33 ± 0.34 mL (40–60th response quantile) and between −1.19 ± 0.71 and −0.61 ± 0.31 mL (70–90th response quantile) (p = 0.049). With SR, a biphasic relationship of sperm concentration with TSH was noted (positive turning to negative, peaking at TSH = 1.22 μIU/mL). Thus, a weak negative association between the TSH levels and semen volume was noted, showing a trough within the usual normal range for TSH. Moreover, a biphasic relationship between the sperm concentration and TSH was also noted, peaking at approximately mid-normal TSH levels. Based on our results, TSH explained slightly less than 3% of the variation in semen volume and 7% of the sperm concentration (thus, other factors, which were not studied here, have a more important effect on it).

No aspect of structure should be left behind in relation to student autonomous motivation

BACKGROUND

Provision of structure in classroom settings constitutes one of the pillars of conducive learning environments. However, little is known whether the particular elements of provided structure-namely, contingency, clear expectations, help and support, and monitoring-are equally important for student learning and motivation.

AIMS

In this cross-sectional study, we aimed to investigate to what extent students' autonomous motivation is linearly and curvilinearly related to their perceptions of their teachers' contingency, clear expectations, help and support, and monitoring.

SAMPLE

Participants were 12,036 Turkish adolescent students (age range: 15-19 years; 54.4% males) from 446 classes, nested into 24 public schools.

METHODS

Cross-sectional, based on student ratings of their self-determined motivation and their teacher structure provision and autonomy support.

RESULTS

Multilevel and ordinary least-squares polynomial regression analyses showed all the four perceived structure elements to predict autonomous motivation, with expectations and contingency (especially when coupled with monitoring) being even more important predictors than the other elements. Response surface analyses also showed strong positive relation between autonomous motivation and all the possible pairs of the four elements of perceived structure along the line of congruence, suggesting an additive effect when teachers are thought to be contingent and helpful and supportive (or monitor their students, or clearly communicate their expectations).

CONCLUSIONS

These findings imply the key role that teachers could play in enhancing their students' autonomous motivation by providing all the elements of structure.

Alpha-Methyldopa May Attenuate Insulin Demand in Women with Gestational Diabetes Treated with Betamethasone

Gestational diabetes mellitus (GDM) is associated with hypertensive disorders in pregnancy. Alpha-methyl-DOPA (αMD) is a commonly used medication for hypertension in pregnant women. This medication may be associated with alteration in insulin resistance and glucose homeostasis. The aim of the present study was to investigate in 152 pregnant women whether the demands of exogenous insulin in glucocorticoid-treated women during pregnancy are different between those with GDM and hypertension treated with αMD and those without hypertension. In the group of women with GDM under insulin treatment, who received αMD for hypertension, the increase in insulin needs was relatively lower by at least 30% of the pre-admission insulin dose compared to all of the remaining women not receiving αMD in the same group (9 women vs. 50 women, p = 0.035). Our work raises the hypothesis that αMD can favorably modulate insulin sensitivity in the third trimester of pregnancy in previously insulin-treated women with gestational diabetes who receive glucocorticoids.

Insulin requirements during lactation in women with diabetes mellitus type 1 in comparison with pre-pregnancy levels: A 10-year retrospective study

The metabolic profile variability of women with diabetes mellitus type 1 (DM1) during breastfeeding, leads to a reassessment in managing glycemia, mainly to prevent hypoglycemia. In this retrospective study we assessed insulin needs, vis-à-vis breastfeeding in DM1. A 10.7% reduction of daily insulin dosage, compared to pre-pregnancy insulin needs, was noted in women who breastfed exclusively versus 10.8% in those who supplemented breastfeeding (p = NS). Women who experienced hypoglycemic episodes, tended (but not significantly) to be younger (p = 0.10), with longer duration of DM1 and more weight gain in pregnancy. Exclusive breastfeeding was associated with younger age (p = 0.04), regardless of hypoglycemia (p = 0.25).

Glycemia after Betamethasone in Pregnant Women without Diabetes-Impact of Marginal Values in the 75-g OGTT

Betamethasone (BM) administration in pregnancy has been shown to reduce the incidence and severity of neonatal respiratory distress syndrome. Its known diabetogenic impact, combined with placental insulin resistance, leads to a transient increase in glycemia. However, its effect on glucose homeostasis in pregnancy has not been adequately investigated. We closely monitored and assessed the glycemic profile of 83 pregnant women, with normal glucose metabolism, who were given BM during their hospitalization due to threatened premature labor. A significant change in the glycemic profile in most patients was noted, lasting 1.34 ± 1.05 days. Sixty-six of eighty-three women were eventually treated with insulin to maintain glycemia within acceptable limits. The mean ± SD insulin dosage was 12.25 ± 11.28 units/day. The need for insulin therapy was associated with higher BM doses and the presence of marginal values in the 75-g oral glucose tolerance test (OGTT) at 60 min. Our study demonstrates, following BM administration, the need for increased awareness and individualized monitoring/treatment of pregnant women with normal—yet marginal—values in the 75-g OGTT.

Self-determined motivation and academic buoyancy as predictors of achievement in normative settings

BACKGROUND

Academic buoyancy (Martin & Marsh, 2006, Oxford Review of Education, 35, 353; 2008, Journal of School Psychology, 46, 53) is students' competence to respond effectively to academic daily setbacks and is considered an optimal characteristic of students' functioning related to achievement. From the self-determination theory perspective (Ryan & Deci, 2017, American Psychologist, 55, 68), satisfaction of the need for autonomy, competence, and relatedness and autonomous forms of motivation relate to students' optimal functioning in schooling.

AIMS

We investigated (1) whether students' end-of-course (T2) academic buoyancy in the normative environment of English preparatory programmes (EPP) is predicted by their beginning-of-course (T1) need satisfaction or frustration and autonomous or controlled motivation (i.e., high or low self-determined motivation), and (2) whether students' T2 academic buoyancy mediates the relation between students' T1 self-determined motivation and final (T3) academic achievement.

SAMPLE

In T1 and T2, 267 students (M_age  = 19.11, SD = 1.28) attending three EPPs in Ankara, Turkey, participated in the study.

METHOD

A prospective design was used, data were collected through self-reports, and SEM was conducted to test the hypotheses.

RESULTS

Students' T1 need frustration negatively predicted T1 autonomous motivation and positively predicted T1 controlled motivation, which (respectively) positively and negatively predicted T2 academic buoyancy. T1 need satisfaction related positively to T2 academic buoyancy. Finally, T2 academic buoyancy mediated the relation between students' need satisfaction and final achievement while controlled motivation was also negatively related to final achievement.

CONCLUSION

Students' high need satisfaction and low need frustration as well as high autonomous and low controlled motivation could support students' buoyancy and achievement in the normative settings of EPP.

Glycemic profile assessment during betamethasone administration in women with gestational diabetes mellitus

AIM

Betamethasone's effect on glucose homeostasis in the presence of gestational diabetes has not been adequately investigated.

MATERIALS-METHODS

We assessed the glycemic profile of 99 women with gestational diabetes (52 on insulin, 47 on medical nutrition therapy) who were given betamethasone during hospitalization for at risk pregnancies.

RESULTS

In insulin-treated women the increase in total daily insulin dose significantly linked to betamethasone dose (p = 0.014). In women on diet, the need for insulin was positively related to betamethasone dose, age and gestational age >34th week (all p < 0.05).

CONCLUSION

Parsimonious betamethasone use might still be beneficial with a milder effect on glycemia.

A contemporary therapeutic approach to bone disease in beta-thalassemia - a review

Homozygous beta-thalassemia represents a serious hemoglobinopathy, in which an amazing prolongation in the survival rate of patients has been achieved over recent decades. A result of this otherwise positive evolution is the fact that bone problems have become a major issue in this group of patients. Through an in-depth review of the related literature, the purpose of this study is to present and comment on the totality of the data that have been published to date pertaining to the prevention and treatment of thalassemia bone-disease, focusing on: the contribution of diet and lifestyle, the treatment of hematologic disease and its complications, the management of hypercalciuria, the role of vitamins and minerals and the implementation of anti-osteoporosis medical regimen. In order to comprehensively gather the above information, we mainly reviewed the international literature through the PubMed database, searching for the preventive and therapeutic data that have been published pertaining to thalassemia bone-disease over the last twenty-nine years. There is no doubt that thalassemia bone-disease is a complication of a multi-factorial etiopathology, which does not follow the rules of classical postmenopausal osteoporosis. Bisphosphonates have been the first line of treatment for many years now, with varied and usually satisfactory results. In addition, over the last few years, more data have arisen for the use of denosumab, teriparatide, and other molecules that are in the clinical trial phase, in beta-thalassemia.