329 research outputs found
Diabetes:Therapy for gestational diabetes mellitus--time for a change?
No full textFor >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women with gestational diabetes mellitus is highly relevant
Pregnancy outcomes in women with diabetesd lessons learned from clinical research:The 2015 Norbert Freinkel award lecture
No full textAmongwomen with diabetes, theworst pregnancy outcome is seen in the subgroup of women with diabetic nephropathy. Development of severe preeclampsia that leads to early preterm delivery is frequent. Predictors and pathophysiological mechanisms for the development of preeclampsia among women with diabetes and observational studies that support antihypertension treatment for pregnant women with microalbuminuria or diabetic nephropathy preventing preeclampsia and early preterm delivery are presented here.Obtaining andmaintaining strict glycemic control before and during pregnancy is paramount to prevent pretermdelivery. The cornerstones of diabetes management are appropriate diet and insulin, although the risk of severe hypoglycemia always needs to be taken into account when tailoring a diabetes treatment plan. Pathophysiological mechanisms of the increased risk of hypoglycemia during pregnancy are explored, and studies evaluating the use of insulin analogs, insulin pumps, and continuous glucose monitoring to improve pregnancy outcomes and to reduce the risk of severe hypoglycemia in pregnant women with type 1 diabetes are reported. In addition to strict glycemic control, other factors involved in fetal overgrowth are explored, and restricting maternal gestationalweight gain is a promising treatment area. The optimal carbohydrate content of the diet is discussed. In summary, the lessons learned from this clinical research are that glycemic control, gestational weight gain, and antihypertension treatment all are of importance for improving pregnancy outcomes in pregnant women with preexisting diabetes. An example of how to use app technology to share the recent evidence-based clinical recommendations for women with diabetes who are pregnant or planning pregnancy is given.</p
Comparing the harmful effects of nontuberculous mycobacteria and Gram negative bacteria on lung function in patients with cystic fibrosis
No full textBACKGROUND: To better understand the relative effects of infection with nontuberculous mycobacteria and Gram negative bacteria on lung function decline in cystic fibrosis, we assessed the impact of each infection in a Danish setting. METHODS: Longitudinal registry study of 432 patients with cystic fibrosis contributing 53,771 lung function measures between 1974 and 2014. We used a mixed effects model with longitudinally structured correlation, while adjusting for clinically important covariates. RESULTS: Infections with a significant impact on rate of decline in %FEV1 were Mycobacterium abscessus complex with -2.22% points per year (95% CI -3.21 to -1.23), Burkholderia cepacia complex -1.95% (95% CI -2.51 to -1.39), Achromobacterxylosoxidans -1.55% (95% CI -2.21 to -0.90), and Pseudomonas aeruginosa -0.95% (95% CI -1.24 to -0.66). Clearing M. abscessus complex was associated with a change to a slower decline, similar in magnitude to the pre-infection slope. CONCLUSIONS: In a national population we have demonstrated the impact on lung function of each chronic CF pathogen. M. abscessus complex was associated with the worst impact on lung function. Eradication of M. abscessus complex may significantly improve lung function
In the Footsteps of an Observer – Looking at Edvard Munch in Åsgårdstrand
No full textThis article presents an arts based approach to some of the motifs that Edvard Munch painted during his many stays in the Norwegian town of Åsgårdstrand. The author examines the relationship between Munch’s and her own observations made from the very same vantage points in the landscapes. The theoretical thrust of the article is informed by arts based research as promoted by art education theorists Barone and Eisner (2012) and art therapy researcher McNiff (2013). It is also inspired by Pink’s text “Doing sensory ethnography” (2009), which highlights the multisensory experience and recognises the significance of the researcher’s own presence in the data collection process. A key tool in the research project was a tablet device (iPad), used both as a camera in the field and as a tool for creative artistic exploration in practice. The method involved digitally painting Munch’s figures onto photos taken from the same places as the artist must have stood when inspired to paint his famous pictures. The author argues that a tablet with artistic software applications can serve as a versatile and handy “portable studio”, facilitating immediate first-hand experience and understanding. The concluding discussion focuses on how this practical arts based approach to the work of a famous artist can be implemented in an art education setting.publishedVersio
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