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  • 1
    Online Resource
    Online Resource
    Weight retention and glucose intolerance in early postpartum after gestational diabetes
    Oxford University Press (OUP) ; 2023
    In:  European Journal of Endocrinology Vol. 188, No. 5 ( 2023-05-10), p. 438-447
    Details
    In: European Journal of Endocrinology, Oxford University Press (OUP), Vol. 188, No. 5 ( 2023-05-10), p. 438-447
    Abstract: To determine risk factors for early postpartum weight retention (PPWR) and glucose intolerance (GI) in women with gestational diabetes (GDM). Design and Methods Prospective, multicentre (n = 8) cohort study in 1201 women with a recent history of GDM. Pregnancy and postpartum characteristics, and data from self-administered questionnaires were collected at the 6-16 weeks postpartum 75 g oral glucose tolerance test. Results Of all participants, 38.6% (463) had moderate ( & gt;0 and ≤5 kg) and 15.6% (187) had high ( & gt;5 kg) PPWR. Independent predictors for early PPWR were excessive gestational weight gain (GWG), lack of breastfeeding, higher dietary fat intake, insulin use during pregnancy, multiparity, lower prepregnancy body mass index (BMI), and lower education degree. Compared to PPWR & lt;5 kg, women with high PPWR had a more impaired postpartum metabolic profile, breastfed less often, had higher depression rates (23.1% [43] vs 16.0% [74] , P = .035) and anxiety levels, and lower quality of life. Of all participants, 28.0% (336) had GI (26.1% [313] prediabetes and 1.9% [23] diabetes). Women with high PPWR had more often GI compared to women without PPWR (33.7% [63] vs 24.9% [137] , P = .020). Only 12.9% (24) of women with high PPWR perceived themselves at high risk for diabetes but they were more often willing to change their lifestyle than women with moderate PPWR. Conclusions Modifiable risk factors such as lifestyle, prepregnancy BMI, GWG, and mental health can be used to identify a subgroup of women with GDM at the highest risk of developing early PPWR, allowing for a more personalized follow-up.
    Type of Medium: Online Resource
    ISSN: 0804-4643 , 1479-683X
    URL: Article
    DOI: 10.1093/ejendo/lvad053
    RVK:
    WA 15000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1485160-X
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  • 2
    Online Resource
    Online Resource
    Risk factor screening for gestational diabetes mellitus based on the 2013 WHO criteria
    Oxford University Press (OUP) ; 2019
    In:  European Journal of Endocrinology Vol. 180, No. 6 ( 2019-06), p. 353-363
    Details
    In: European Journal of Endocrinology, Oxford University Press (OUP), Vol. 180, No. 6 ( 2019-06), p. 353-363
    Abstract: Since many European countries use risk factor screening for gestational diabetes mellitus (GDM), we aimed to determine the performance of selective screening for GDM based on the 2013 WHO criteria. Design and methods Overall, 1811 women received universal screening with a 75 g oral glucose tolerance test (OGTT) with GDM in 12.5% ( n  = 231) women based on the 2013 WHO criteria. We retrospectively applied different European selective screening guidelines to this cohort and evaluated the performance of different clinical risk factors to screen for GDM. Results By retrospectively applying the English, Irish, French and Dutch guidelines for selective screening, respectively 28.5% ( n  = 526), 49.7% ( n  = 916), 48.5% ( n  = 894) and 50.7% ( n  = 935) had at least one risk factor, with GDM prevalence of respectively 6.5% ( n  = 120), 7.9% ( n  = 146), 8.0% ( n  = 147) and 8.4% ( n  = 154). Using maternal age ≥30 and/or BMI ≥25 for screening, positive rate was 69.9% ( n  = 1288), GDM prevalence 10.2% ( n  = 188), sensitivity 81.4% (CI: 75.8–86.2%) and specificity 31.8% (CI: 29.5–34.1%). Adding other clinical risk factors did not improve detection. GDM women without risk factors had more neonatal hypoglycemia (14.4 vs 4.0%, P  = 0.001) and labor inductions (39.7 vs 25.9%, P  = 0.020) than normal-glucose tolerant women, and less cesarean sections than GDM women with risk factors (13.8 vs 31.0%, P  = 0.010). Conclusions By applying selective screening by European guidelines, about 50% of women would need an OGTT with the lowest number of missed cases (33%) by the Dutch guidelines. Screening with age ≥30 years and/or BMI ≥25, reduced the number of missed cases to 18.6% but 70% would need an OGTT.
    Type of Medium: Online Resource
    ISSN: 0804-4643 , 1479-683X
    URL: Article
    DOI: 10.1530/EJE-19-0117
    RVK:
    WA 15000
    Language: Unknown
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 1485160-X
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  • 3
    Online Resource
    Online Resource
    ENDOCRINE TUMOURS: Thyrotropin-secreting pituitary adenoma: a structured review of 535 adult cases
    Oxford University Press (OUP) ; 2021
    In:  European Journal of Endocrinology Vol. 185, No. 2 ( 2021-08-01), p. R65-R74
    Details
    In: European Journal of Endocrinology, Oxford University Press (OUP), Vol. 185, No. 2 ( 2021-08-01), p. R65-R74
    Abstract: Thyrotropin-secreting pituitary adenomas (TSHomas) are a rare entity, occurring in one per million people. We performed a systematic review of 535 adult cases summarizing the clinical, biochemical, hormonal and radiological characteristics of TSHoma. Furthermore, we discussed the current guidelines for diagnosis and treatment. Methods A structured research was conducted using Pubmed and Web of Science with the following MeSH terms: 'thyrotropin secreting pituitary adenoma' OR 'TSHoma' OR 'thyrotropinoma.' Results Our analysis included 535 cases originating from 18 case series, 5 cohort studies and 91 case reports. The mean age at diagnosis was 46 years. At presentation, 75% had symptoms of hyperthyroidism, 55.5% presented with a goitre and 24.9% had visual field defects. The median TSH at diagnosis was 5.16 (3.20–7.43) mU/L with a mean FT4 of 41.5 ± 15.3 pmol/L. The majority (76.9%) of the TSHomas were macroadenoma. Plurihormonality was seen in 37.4% of the adenoma with a higher incidence in macroadenoma. Surgical resection of the adenoma was performed in 87.7% of patients of which 33.5% had residual pituitary adenoma. Post-operative treatment with a somatostatin analogue (SSA) led to a stable disease in 81.3% of the cases with residual tumour. We noticed a significant correlation between the diameter of the adenoma and residual pituitary adenoma ( r  = 0.490, P   〈 0.001). However, in patients preoperatively treated with an SSA, this correlation was absent. Conclusion TSHomas are a rare cause of hyperthyroidism and are frequently misdiagnosed. Based on our structured analysis of case series, cohort studies and case reports, we conclude that the majority of TSHomas are macroadenoma being diagnosed in the fifth to sixth decade of life and presenting with symptoms of hyperthyroidism. Plurihormonalitiy is observed in one-third of TSHomas. Treatment consists of neurosurgical resection and SSA in case of surgical failure.
    Type of Medium: Online Resource
    ISSN: 0804-4643 , 1479-683X
    URL: Article
    DOI: 10.1530/EJE-21-0162
    RVK:
    WA 15000
    Language: Unknown
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1485160-X
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  • 4
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    Online Resource
    CTLA4 , SH2B3 , and CLEC16A diversely affect the progression of early islet autoimmunity in relatives of Type 1 diabetes patients
    Oxford University Press (OUP) ; 2023
    In:  Clinical and Experimental Immunology Vol. 211, No. 3 ( 2023-03-24), p. 224-232
    Details
    In: Clinical and Experimental Immunology, Oxford University Press (OUP), Vol. 211, No. 3 ( 2023-03-24), p. 224-232
    Abstract: The HLA region is the major genetic risk determinant of Type 1 diabetes. How non-HLA loci contribute to the genetic risk is incompletely understood, but there are indications that at least some impact progression of asymptomatic autoimmunity. We examined whether SNPs in 7 susceptibility loci (INS, SH2B3, PTPN2, PTPN22, CTLA4, CLEC16A, and IL2RA) could improve prediction of the progression from single to multiple autoantibody positivity, and from there on to diagnosis. SNPs were genotyped in persistently autoantibody positive relatives by allelic discrimination qPCR and disease progression was studied by multivariate Cox regression analysis. In our cohort, only the CTLA4 GA genotype (rs3087243, P = 0.002) and the CLEC16A AA genotype (rs12708716, P = 0.021) were associated with accelerated progression from single to multiple autoantibody positivity, but their effects were restricted to presence of HLA-DQ2/DQ8, and IAA as first autoantibody, respectively. The interaction of CTLA4 and HLA-DQ2/DQ8 overruled the effect of DQ2/DQ8 alone. The HLA-DQ2/DQ8-mediated risk of progression to multiple autoantibodies nearly entirely depended on heterozygosity for CTLA4. The SH2B3 TT genotype (rs3184504) was protective for HLA-DQ8 positive subjects (P = 0.003). At the stage of multiple autoantibodies, only the CTLA4 GA genotype was a minor independent risk factor for progression towards clinical diabetes (P = 0.034). Our study shows that non-HLA polymorphisms impact progression of islet autoimmunity in a subgroup-, stage- and SNP-specific way, suggesting distinct mechanisms. If confirmed, these findings may help refine risk assessment, follow-up, and prevention trials in risk groups.
    Type of Medium: Online Resource
    ISSN: 0009-9104 , 1365-2249
    URL: Article
    DOI: 10.1093/cei/uxad002
    RVK:
    XA 36770
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2020024-9
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  • 5
    Online Resource
    Online Resource
    Treatment effectiveness of pasireotide on health-related quality of life in patients with Cushing's disease
    Oxford University Press (OUP) ; 2014
    In:  European Journal of Endocrinology Vol. 171, No. 1 ( 2014-07), p. 89-98
    Details
    In: European Journal of Endocrinology, Oxford University Press (OUP), Vol. 171, No. 1 ( 2014-07), p. 89-98
    Abstract: Cushing's disease (CD) can significantly impair patients' health-related quality of life (HRQOL). This study investigated the treatment effectiveness of pasireotide on HRQOL of CD patients, and assessed the relationships between HRQOL and urinary free cortisol (UFC) and CD-related signs and symptoms. Design In this phase III, randomized, double-blind study, patients with UFC ≥1.5×upper limit of normal (ULN) received s.c. pasireotide 600 or 900 μg twice daily. The trial primary endpoint was UFC at or below ULN at month 6 without dose titration. Open-label treatment continued through month 12. HRQOL was measured using the Cushing's Quality of Life Questionnaire (CushingQoL) instrument at baseline and follow-up visits until month 12 during which clinical signs and features of CD, and the Beck Depression Inventory II (BDI-II), were also collected. Methods Pearson's/Spearman's correlations between changes in CushingQoL and changes in clinical signs and symptoms were assessed. Changes in CushingQoL and the proportion of patients achieving a clinically meaningful improvement in CushingQoL were also compared among patients stratified by mean UFC (mUFC) control status (controlled, partially controlled, and uncontrolled) at month 6. Analyses were also conducted at month 12, with multivariable adjustment for baseline characteristics and CushingQoL. Results Change in CushingQoL was significantly correlated with changes in mUFC ( r =−0.40), BMI ( r =−0.39), weight ( r =−0.41), and BDI-II ( r =−0.54) at month 12 but not at month 6. The percentage of CushingQoL responders at month 12 based on month 6 mUFC control status were as follows: 63, 58.8, and 37.9% in the controlled, partially controlled, and uncontrolled groups respectively. Adjusted CushingQoL scores at month 12 were 58.3 for controlled patients (Δ=11.5 vs uncontrolled, P =0.012) and 54.5 for partially controlled patients (Δ=7.7 vs uncontrolled, P =0.170). Conclusions Pasireotide treatment can result in a meaningful HRQOL improvement among those who complete a 12-month treatment period, most often among patients achieving biochemical control.
    Type of Medium: Online Resource
    ISSN: 0804-4643 , 1479-683X
    URL: Article
    DOI: 10.1530/EJE-13-1013
    RVK:
    WA 15000
    Language: Unknown
    Publisher: Oxford University Press (OUP)
    Publication Date: 2014
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  • 6
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    Online Resource
    Can early, tight glycaemic control prevent post-transplant diabetes mellitus?
    Oxford University Press (OUP) ; 2023
    In:  Nephrology Dialysis Transplantation Vol. 38, No. 2 ( 2023-02-13), p. 309-310
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. 2 ( 2023-02-13), p. 309-310
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfac129
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1465709-0
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  • 7
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    Online Resource
    Effect on the resistome of dual- vs monotherapy for the treatment of Neisseria gonorrhoeae : results from a randomized controlled trial (ResistAZM Trial)
    Oxford University Press (OUP) ; 2023
    In:  Open Forum Infectious Diseases
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP)
    Abstract: No randomized controlled trial (RCT) has compared the impact on the resistome of ceftriaxone (CRO) plus azithromycin (AZM) versus CRO for the treatment of Neisseria gonorrhoea (NG). Methods Open-label, single center, RCT comparing the effect on the resistome of CRO plus AZM versus CRO for the treatment of NG. Men who have sex with men (MSM) with genital, anorectal or pharyngeal NG infection were randomized into the CRO/AZM and CRO arms. Oral rinse and anorectal samples were taken for culture and resistome profiling at two visits (baseline and day 14). The primary outcome was the ratio of mean macrolide resistance determinants in anorectal samples from day 14 between arms. Results Twenty individuals were randomized in the CRO/AZM arm and 22 in the CRO arm. We found no significant difference in the mean macrolide resistance determinants in the day 14 anorectal samples between arms (ratio = 1.05, 95%CI 0.55-1.83, p-value = 0.102). The prevalence of baseline macrolide resistance was high (CRO/AZM arm = 95.00%, CRO arm = 90.91%). Conclusion We could not demonstrate a significant effect of dual CRO/AZM therapy on the resistome compared to CRO alone, likely due to a high baseline resistance to AZM. Interventions to prevent the emergence of antimicrobial resistance in MSM are needed.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofad462
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2757767-3
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