Combined Effect of Microplastics and Cd Alters the Enzymatic Activity of Soil and the Productivity of Strawberry Plants.

The synergistic effect between heavy metals and microplastics can affect soil properties as well as plant performance and yield. The objective of this study was to evaluate the combined effect of microplastics and cadmium on a soil-plant system. Specifically, we proposed to explore changes in soil microbiological activity, the growth and yield parameters of strawberry plants, and to evaluate the accumulation of these pollutants in the soil and root system. Plants were planted in clay pots under greenhouse conditions. The experiment was set up as a completely randomized design, with four treatments (Control; MPs; Cd; and Cd + MPs) and five replicates. The results showed that MPs and/or Cd affected plant growth, plant biomass, the number of fruits, root characteristics, dehydrogenase activity, acid phosphatase, and microbial biomass, and increased the accumulation of Cd in the roots and soil. The increased bioavailability of Cd, due to the presence of microplastics, could explain the observed negative effects on soil properties and the performance of strawberry plants.

Basal Glucose on Tolerance Test During Pregnancy Predicts Impaired Fasting Glucose and Type 2 Diabetes Within 2 Months After Gestational Diabetes.

OBJECTIVES: Postpartum mothers with gestational diabetes may remain with either type 2 diabetes mellitus, impaired glucose tolerance or impaired fasting glucose. Our aim in this study was to identify maternal variables that could predict 1 or more of these conditions. METHODS: In 193 singleton pregnancies with gestational diabetes, we applied bivariate logistic regression and receiver-operating characteristic curves to data from the index glucose-challenge test that allowed the diagnosis of gestational diabetes. RESULTS: Receiver-operating characteristic curves of fasting glucose from the index glucose-challenge test predicted impaired fasting glucose and type 2 diabetes mellitus combined, with a sensitivity of 100%, false-positive rate of 40.5%, area under the curve of 0.849, p=0.004 and positive predictive value 45%, and with a cutoff point of 4.7 mmol/L. CONCLUSIONS: At the time of diagnosis of gestational diabetes during pregnancy, a basal glucose level of ≥4.7 mmol/L on index glucose-challenge test indicates a 45% probability of either type 2 diabetes mellitus or impending diabetes early postpartum.

Gestational Diabetes: Glycemic Control in the Last Two Weeks Before Delivery Contributes to Newborn Insulinemia.

INTRODUCTION: Fetal hyperinsulinemia in gestational diabetes mellitus (GDM) not only is important during intrauterine life, a time when it can result in macrosomia, but also at delivery, since it can result in neonatal hypoglycemia and hyperbilirubinemia. The question is, how long before delivery does maternal glycemic control contribute to newborn insulinemia in GDM? METHODS: In 72 women with GDM, we calculated Spearman's rank (rs) correlations between umbilical cord blood C-peptide at birth (a biomarker of insulin secretion), and both maternal glycosylated hemoglobin (HbA1c) and mean blood glucose (MBG) recorded in the last two visits prior to delivery. Iterative correlations were done between umbilical cord blood C-peptide at birth, and maternal glucose control, at 0, 1, 2, 3, 4, and 5 weeks before delivery. RESULTS: At an early visit (32.95 ± 1.8 weeks), rs = 0.353 (P = 0.07) between HbA1c and C-peptide, whereas rs = 0.244 (P = 0.186) between MBG and C-peptide. At the latest visit (35.04 ± 1.6 weeks), rs = 0.456 (P = 0.004) between HbA1c versus C-peptide, and rs = 0.359 (P = 0.023) between MBG versus C-peptide. Iterative correlations between MBG and C-peptide became significant at 2 weeks before delivery. CONCLUSION: To further reduce the risk of hypoglycemia and hyperbilirubinemia in infants born to women with GDM, besides applying a strict in-patient glucose control protocol at delivery, it is necessary to improve even more the quality of maternal glucose control during the last 2 weeks prior to delivery.

47-Fold rise of diabetes in childbearing age Chilean women: Markov model and cost-effectiveness of prevention of birth defects.

AIM: Prevalence of type 2 diabetes mellitus (T2DM) during childbearing age in Chile had a 47-fold rise in 7 years, reaching 120 844 women, half of which are unaware of their condition. We aimed to project pregnancies and births among Chilean women of childbearing age (WCBA) with T2DM and report the incidence of birth defects and the associated years of life lost and lifetime costs. METHODS: Markov model of cohort of WCBA with T2DM (WCBA-DM) with a 20-year time horizon (2018-2037), using data from previous studies. Two scenarios were assessed: scenario A: no universal detection of T2DM and scenario B: universal screening of T2DM using glycosylated hemoglobin levels. Both lifetime costs and disability-adjusted life years (DALY) were calculated with a 5% discount rate (US$ of 2017). RESULTS: In scenario A, 12 163 infants with birth defects could be born among the analyzed cohort, resulting in 243 260 years of life lost, 296 652 DALY and in lifetime costs of US$ 1 957 657 966. In scenario B, the first three figures could be reduced by 70.4% to 3599 infants with birth defects, 71 980 years of life lost and 87 794 DALY. Due to the addition of diabetes screening and new patient costs to scenario B, there would be a lesser reduction (67.3%) in total lifetime costs, to US$ 640 669 296. CONCLUSION: Screening of diabetes in WCBA would yield a 20-year reduction of 70.4% in the number of infants with birth defects, years of life lost and DALY. Total lifetime costs could be reduced by 67.3%.

Near-optimal glycemic control in Chilean women with pregestational type-2 diabetes: persistent macrosomia relates to maternal pre-pregnancy overweight.

UNLABELLED: After a 10-year program intending to improve glycemic control in diabetic pregnancies, we evaluated whether factors underlying macrosomia are similar for type-1 and -2 pregestational diabetic women. PATIENTS AND METHODS: Twenty-three pregnancies in type-1 diabetics (PDM1, age 28.3+/-1.1 years) and 51 pregnancies in type-2 diabetics (PDM2, age 32.8+/-0.6 years) were followed and treated with intensified insulin therapy. Several factors potentially influencing macrosomia were evaluated. STATISTICS: chi-square, Fisher's exact, Student's "t" and Mann-Whitney "U" tests, and ROC analysis. RESULTS: In PDM1 and PDM2, respectively, large-for-gestational-age (LGA) frequencies were 26.08% and 37.25% (NS), antepartum HbA1c values were 6.5+/-0.32 and 6.1+/-0.16 (NS), and pre-pregnancy body mass indexes (BMI) were 23.03+/-0.66 and 30.01+/-0.89 (p<0.0001). In PDM1 the main predictor of LGA was an antepartum HbA1c> or =6.8% (p=0.046), whereas in PDM2 pregestational BMI> or =24 the variable associated (p=0.032) with LGA newborns. CONCLUSIONS: PDM1 and PDM2 differ in the underlying factors related to macrosomia. Whereas in PDM1 the antepartum HbA1c emerged as the most significant variable, suggesting that glycemic control largely determines macrosomia, in PDM2 with near-optimal glycemic control, macrosomia related to pregestational BMI.

Transfusión intravascular en el manejo de la enfermedad hemolítica perinatal: reevaluación de nuestra experiencia / Intravascular transfusion in the treatment of perinatal hemolytic disease: reevaluation of our experience

Presentamos la reevaluación de nuestra experiencia en transfusión intravascular, experiencia acumulada desde 1989 a la fecha. Los resultados alcanzados en 82 procedimientos en 26 pacientes, con sobrevida de 8 de 10 fetos hidrópicos y 13 de los 16 no hidrópicos, son comparables a los presentados pr otros centros cuyos datos están disponibles para su análisis en la literatura de la especialidad. Compartimos además, lo que hemos aprendido en la práctica de este procedimiento durante los últimos años