ABSTRACT There is some controversy for the most valuable method of BP estimation in hypertensives... more ABSTRACT There is some controversy for the most valuable method of BP estimation in hypertensives to predict end-organ damage like LVMI. Therefore, we designed a study comparing casual (c-), self-recorded (s-), ambulatory (a-) and BP during bicycle (b-) stress testing in essential hypertensives.24 patients (pts.) (mean age 52±11 years, range 20-74, 7 males) were included after informed consent was obtained. After a 2-week placebo period pts were randomized either to carvedilol (C) 25-50mg or fosinopril (F) 10-20mg daily. Both groups did not differ with respect to age, body mass index (mean 28±4kg/m2), duration of hypertension and concomitant risk factors. BP readings were obtained by conventional sphygmomanometry (c-BP, b-BP), Spacelabs 90207 (a-BP) and an oscillometric device (Boso Medicus) (s-BP). An office visit was scheduled monthly, b-BP and a-BP were measured at entry and after 6 months, s-BP was measured twice each day. BP-values at baseline were comparable in both groups (C vs F) (mean c-BP 115±6 vs 115±9, mean a-BP 106±11 vs 110±9, mean s-BP morning 114±14 vs 111±15, mean s-BP evening 110±16 vs 107±11, mean b-BP at peak 139±12 vs 140±11mmHg).After the 6 month treatment-period BP decreased significantly in both groups regardless the type of BP-measurement. LVMI decreased in C (-16.7g; -10% compared to baseline,ns) and in F (-4.5g; -3% compared to baseline,ns). At baseline the highest correlation to LVMI was shown by ambulatory pulse pressure during nighttime (r=0.6, p=0.004) and s-BP (r=0.7, p
The cardiotonic steroid marinobufagenin (MBG) is increasingly suggested to be responsible for som... more The cardiotonic steroid marinobufagenin (MBG) is increasingly suggested to be responsible for some of the cardiovascular injury that has been previously attributed to aldosterone. We examined the clinical correlates of circulating MBG concentrations in hypertensive patients and tested the hypothesis that MBG serves as a reliable diagnostic tool for detecting primary aldosteronism (PA). Plasma MBG concentrations (mean: 0.51 ± 0.25 nmol/l) were measured in the morning fasting samples in 20 patients with PA and 20 essential hypertensive (EH) controls matched for age, sex, body mass index, renal function, urinary sodium and intake of antihypertensive medication (mean age: 51.6 years; 52.2% women). Overall, plasma MBG was directly correlated with plasma aldosterone, aldosterone to active renin ratio (AARR), diastolic blood pressure, mean carotid intima-media thickness, serum sodium, urinary protein to creatinine ratio and inversely with serum potassium levels. Plasma MBG levels were significantly higher in patients with PA compared to EH (mean: 0.68 ± 0.12 versus 0.35 ± 0.24 nmol/l; p < 0.001). ROC analysis yielded a greater AUC for plasma MBG compared to the AARR, PAC and serum potassium levels for detecting PA. Youden's Index analyses yielded the optimal plasma MBG cut-off score for diagnosing PA at > 0.49 nmol/l with specificity and sensitivity values of 0.85 and 0.95, respectively, which were higher than those at the optimum AARR cut-off at > 3.32 ng/dl/µU/ml. In a well-characterized cohort, values of plasma MBG were significantly related to clinical correlates of cardiovascular and renal disease. Plasma MBG emerged as a valuable alternative to the AARR for screening of PA.
Albumin is the major plasma protein with several important biological functions. Various disturba... more Albumin is the major plasma protein with several important biological functions. Various disturbances of albumin function have been demonstrated in end-stage liver disease. These functional disturbances may be related to oxidative modifications of albumin at cysteine-34, including the irreversibly oxidized human nonmercaptalbumin-2 (HNA2). The aim of the present study was to relate oxidative modification of albumin to short-term prognosis in chronic liver failure. Patients with advanced cirrhosis (N = 39), acute-on-chronic liver failure (N = 15), and healthy controls (N = 15) were investigated. Three fractions of albumin were separated by high performance liquid chromatography according to the redox state of cysteine-34. The HNA2 fraction was markedly increased in cirrhotic patients vs. controls and correlated with the degree of chronic liver failure as well as laboratory parameters of liver dysfunction. The HNA2 level tended to be a better predictor of short-term mortality than the model for end stage liver disease with respect to both 30-day mortality (area under the receiver operating characteristic curve [AUROC] 0.87 vs. 0.81, NS) and 90-day mortality (AUROC 0.87 vs. 0.82, NS). In multivariate analysis of prognostic variables, HNA2 was the only remaining predictor of 90-day mortality. Our results suggest that HNA2, a marker of chronic oxidative stress, is related to liver dysfunction and mortality in cirrhosis and may represent a novel biomarker of chronic liver failure.
Is there a correlation between cell cycle perturbations and cytotoxicity in ovarian cancer cells ... more Is there a correlation between cell cycle perturbations and cytotoxicity in ovarian cancer cells exposed to cytotoxic drugs in vitro? We tested the association between cytotoxicity and in vitro cell cycle perturbations after exposure of human ovarian cancer cells to seven cytotoxic agents. Three principal patterns of cell cycle alterations were observed; a sequential S-G/M block after exposure to the non phase-specific agents cis-platinum, 4-hydroperoxy-eyclophosphamide, and mitomycin C (Group I); an isolated G2/M block after exposure to the G2/M phase-specific drugs etoposide and vincristine (Group II); and an isolated S block following exposure to the S phase-specific agents 5-fluorouracil and cytosine arabinoside (Group III). Overall, there was no direct correlation between the degree of cell cycle perturbations and cytotoxicity. However, when the three subgroups of phase non-specific agents, S phase-specific agents, and G2/M specific agents were analyzed separately, positive cor...
The aim of the study was to assess the effect of a birth-chair on obstetric outcome. We reviewed ... more The aim of the study was to assess the effect of a birth-chair on obstetric outcome. We reviewed the hospital records of 220 consecutive pregnant women who gave birth on a birth-chair at our institution. The control group consisted of 440 pregnant women who preceded and followed the index cases and who had spontaneous vaginal deliveries in the conventional dorsal supine position. The controls were matched for parity and for the attending mid-wife. Patients who delivered in the birth-chair had significantly lower rates of episiotomy and manual separation of the placenta. The umbilical blood cord pH was significantly higher in neonates of the birth-chair group. The duration of labour, rate of perineal and vaginal injury, Apgar scores and rate of admission to a neonatal intermediate care unit were not influenced by the mode of delivery. Our data support previous studies that a birth-chair delivery may be a safe alternative to conventional delivery in the supine position.
To evaluate the outcome of singleton pregnancies after non-amniocentesis-induced premature ruptur... more To evaluate the outcome of singleton pregnancies after non-amniocentesis-induced premature rupture of membranes (PROM) at 14 to 23 weeks' gestation. We reviewed the hospital records of 53 consecutive pregnant women with PROM at 14 to 23 weeks' gestation at our institution from 1991 to 1996; the pregnancies were not associated with amniocentesis or multiple gestation. The median interval between PROM and delivery was 1 day (range 0-90; mean 5.2 days). Fifty-two (98%) of the 53 neonates were stillborn or died within 4 days. One neonate (2%), a 720-gram male delivered vaginally at 23 weeks' gestation, survived. The infant had Apgar scores of 6 at 1 minute and 2 at 5 minutes, and showed normal physical and neurological development at age 5 months. The outcome of pregnancies with non-amniocentesis-induced PROM at 14 to 23 weeks' gestation is almost uniformly poor.
Ovarian cancer continues to be the leading cause of death due to gynecologic malignancies and mos... more Ovarian cancer continues to be the leading cause of death due to gynecologic malignancies and most patients still present with advanced disease. In the present study we evaluated long-term survival and prognostic factors in patients with stage IV ovarian cancer. The charts of 62 consecutive women with FIGO stage IV epithelial ovarian cancer were reviewed. Chemotherapy was the only factor associated with longer survival. Three patients (5%) survived for longer than 5 years. One died of disease at 6.3 years and two are alive without evidence of disease at 12.4 and 14.9 years, respectively. Survival seemed to correlate with the possibility of administering chemotherapy. Patients with verified stage IV ovarian cancer, in whom due to the initial tumor load, operative extent and concomitant illness, the possibility of postoperative chemotherapy administration seems questionable, might be considered for primary chemotherapy followed by surgery.
During the last decade, new software tools and the access to learning contents at any time via we... more During the last decade, new software tools and the access to learning contents at any time via web and internet has created new formats in transfer of knowledge, skills and comprehension. The learning effect and the efficiency of these new tools compared to traditional material and format of teaching and learning is the focus of controversies. During the initial hype of introducing the new technologies in general little attention was given on the need of human resources to produce the different types of learning material and on the individual efficiency of each of the methods compared to traditional material. We claim that poly-format teaching (we mean with it using as many types of material and teaching formats as possible, even if they seem sometimes redundant in content) would match best the diversity of learning types among students. This work describes an example of poly-format teaching fundamental biomechanics applied on the healing process of a bone fracture. A group of stude...
To compare the obstetric and neonatal outcome in pregnancies complicated by gestational diabetes ... more To compare the obstetric and neonatal outcome in pregnancies complicated by gestational diabetes mellitus after amniocentesis for amniotic fluid insulin measurement or maternal blood glucose monitoring or both as selection criterion for therapy. In a retrospective study, 408 diabetic pregnancies were analyzed; 307 were treated with diet alone (group 1) and 101 with diet and insulin (group 2). Pearson's chi2 or Fisher's exact test was used to assess obstetric and anthropometric data within these groups, and p values <0.05 were considered statistically significant. Group 1 - According to the method used, no significant differences were found for gestational age at birth (p = 0.396), mode of delivery (p = 0.79) and neonatal outcome parameters determined as mean birth weight (p = 0.348), birth weight above the 75th percentile (p = 0.473), mean ponderal index (PI; p = 0.434), pH of umbilical artery (p = 0.065) and of umbilical-vein blood (p = 0.052), mean Apgar scores at 1 (p ...
ABSTRACT There is some controversy for the most valuable method of BP estimation in hypertensives... more ABSTRACT There is some controversy for the most valuable method of BP estimation in hypertensives to predict end-organ damage like LVMI. Therefore, we designed a study comparing casual (c-), self-recorded (s-), ambulatory (a-) and BP during bicycle (b-) stress testing in essential hypertensives.24 patients (pts.) (mean age 52±11 years, range 20-74, 7 males) were included after informed consent was obtained. After a 2-week placebo period pts were randomized either to carvedilol (C) 25-50mg or fosinopril (F) 10-20mg daily. Both groups did not differ with respect to age, body mass index (mean 28±4kg/m2), duration of hypertension and concomitant risk factors. BP readings were obtained by conventional sphygmomanometry (c-BP, b-BP), Spacelabs 90207 (a-BP) and an oscillometric device (Boso Medicus) (s-BP). An office visit was scheduled monthly, b-BP and a-BP were measured at entry and after 6 months, s-BP was measured twice each day. BP-values at baseline were comparable in both groups (C vs F) (mean c-BP 115±6 vs 115±9, mean a-BP 106±11 vs 110±9, mean s-BP morning 114±14 vs 111±15, mean s-BP evening 110±16 vs 107±11, mean b-BP at peak 139±12 vs 140±11mmHg).After the 6 month treatment-period BP decreased significantly in both groups regardless the type of BP-measurement. LVMI decreased in C (-16.7g; -10% compared to baseline,ns) and in F (-4.5g; -3% compared to baseline,ns). At baseline the highest correlation to LVMI was shown by ambulatory pulse pressure during nighttime (r=0.6, p=0.004) and s-BP (r=0.7, p
The cardiotonic steroid marinobufagenin (MBG) is increasingly suggested to be responsible for som... more The cardiotonic steroid marinobufagenin (MBG) is increasingly suggested to be responsible for some of the cardiovascular injury that has been previously attributed to aldosterone. We examined the clinical correlates of circulating MBG concentrations in hypertensive patients and tested the hypothesis that MBG serves as a reliable diagnostic tool for detecting primary aldosteronism (PA). Plasma MBG concentrations (mean: 0.51 ± 0.25 nmol/l) were measured in the morning fasting samples in 20 patients with PA and 20 essential hypertensive (EH) controls matched for age, sex, body mass index, renal function, urinary sodium and intake of antihypertensive medication (mean age: 51.6 years; 52.2% women). Overall, plasma MBG was directly correlated with plasma aldosterone, aldosterone to active renin ratio (AARR), diastolic blood pressure, mean carotid intima-media thickness, serum sodium, urinary protein to creatinine ratio and inversely with serum potassium levels. Plasma MBG levels were significantly higher in patients with PA compared to EH (mean: 0.68 ± 0.12 versus 0.35 ± 0.24 nmol/l; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). ROC analysis yielded a greater AUC for plasma MBG compared to the AARR, PAC and serum potassium levels for detecting PA. Youden&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Index analyses yielded the optimal plasma MBG cut-off score for diagnosing PA at &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.49 nmol/l with specificity and sensitivity values of 0.85 and 0.95, respectively, which were higher than those at the optimum AARR cut-off at &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 3.32 ng/dl/µU/ml. In a well-characterized cohort, values of plasma MBG were significantly related to clinical correlates of cardiovascular and renal disease. Plasma MBG emerged as a valuable alternative to the AARR for screening of PA.
Albumin is the major plasma protein with several important biological functions. Various disturba... more Albumin is the major plasma protein with several important biological functions. Various disturbances of albumin function have been demonstrated in end-stage liver disease. These functional disturbances may be related to oxidative modifications of albumin at cysteine-34, including the irreversibly oxidized human nonmercaptalbumin-2 (HNA2). The aim of the present study was to relate oxidative modification of albumin to short-term prognosis in chronic liver failure. Patients with advanced cirrhosis (N = 39), acute-on-chronic liver failure (N = 15), and healthy controls (N = 15) were investigated. Three fractions of albumin were separated by high performance liquid chromatography according to the redox state of cysteine-34. The HNA2 fraction was markedly increased in cirrhotic patients vs. controls and correlated with the degree of chronic liver failure as well as laboratory parameters of liver dysfunction. The HNA2 level tended to be a better predictor of short-term mortality than the model for end stage liver disease with respect to both 30-day mortality (area under the receiver operating characteristic curve [AUROC] 0.87 vs. 0.81, NS) and 90-day mortality (AUROC 0.87 vs. 0.82, NS). In multivariate analysis of prognostic variables, HNA2 was the only remaining predictor of 90-day mortality. Our results suggest that HNA2, a marker of chronic oxidative stress, is related to liver dysfunction and mortality in cirrhosis and may represent a novel biomarker of chronic liver failure.
Is there a correlation between cell cycle perturbations and cytotoxicity in ovarian cancer cells ... more Is there a correlation between cell cycle perturbations and cytotoxicity in ovarian cancer cells exposed to cytotoxic drugs in vitro? We tested the association between cytotoxicity and in vitro cell cycle perturbations after exposure of human ovarian cancer cells to seven cytotoxic agents. Three principal patterns of cell cycle alterations were observed; a sequential S-G/M block after exposure to the non phase-specific agents cis-platinum, 4-hydroperoxy-eyclophosphamide, and mitomycin C (Group I); an isolated G2/M block after exposure to the G2/M phase-specific drugs etoposide and vincristine (Group II); and an isolated S block following exposure to the S phase-specific agents 5-fluorouracil and cytosine arabinoside (Group III). Overall, there was no direct correlation between the degree of cell cycle perturbations and cytotoxicity. However, when the three subgroups of phase non-specific agents, S phase-specific agents, and G2/M specific agents were analyzed separately, positive cor...
The aim of the study was to assess the effect of a birth-chair on obstetric outcome. We reviewed ... more The aim of the study was to assess the effect of a birth-chair on obstetric outcome. We reviewed the hospital records of 220 consecutive pregnant women who gave birth on a birth-chair at our institution. The control group consisted of 440 pregnant women who preceded and followed the index cases and who had spontaneous vaginal deliveries in the conventional dorsal supine position. The controls were matched for parity and for the attending mid-wife. Patients who delivered in the birth-chair had significantly lower rates of episiotomy and manual separation of the placenta. The umbilical blood cord pH was significantly higher in neonates of the birth-chair group. The duration of labour, rate of perineal and vaginal injury, Apgar scores and rate of admission to a neonatal intermediate care unit were not influenced by the mode of delivery. Our data support previous studies that a birth-chair delivery may be a safe alternative to conventional delivery in the supine position.
To evaluate the outcome of singleton pregnancies after non-amniocentesis-induced premature ruptur... more To evaluate the outcome of singleton pregnancies after non-amniocentesis-induced premature rupture of membranes (PROM) at 14 to 23 weeks' gestation. We reviewed the hospital records of 53 consecutive pregnant women with PROM at 14 to 23 weeks' gestation at our institution from 1991 to 1996; the pregnancies were not associated with amniocentesis or multiple gestation. The median interval between PROM and delivery was 1 day (range 0-90; mean 5.2 days). Fifty-two (98%) of the 53 neonates were stillborn or died within 4 days. One neonate (2%), a 720-gram male delivered vaginally at 23 weeks' gestation, survived. The infant had Apgar scores of 6 at 1 minute and 2 at 5 minutes, and showed normal physical and neurological development at age 5 months. The outcome of pregnancies with non-amniocentesis-induced PROM at 14 to 23 weeks' gestation is almost uniformly poor.
Ovarian cancer continues to be the leading cause of death due to gynecologic malignancies and mos... more Ovarian cancer continues to be the leading cause of death due to gynecologic malignancies and most patients still present with advanced disease. In the present study we evaluated long-term survival and prognostic factors in patients with stage IV ovarian cancer. The charts of 62 consecutive women with FIGO stage IV epithelial ovarian cancer were reviewed. Chemotherapy was the only factor associated with longer survival. Three patients (5%) survived for longer than 5 years. One died of disease at 6.3 years and two are alive without evidence of disease at 12.4 and 14.9 years, respectively. Survival seemed to correlate with the possibility of administering chemotherapy. Patients with verified stage IV ovarian cancer, in whom due to the initial tumor load, operative extent and concomitant illness, the possibility of postoperative chemotherapy administration seems questionable, might be considered for primary chemotherapy followed by surgery.
During the last decade, new software tools and the access to learning contents at any time via we... more During the last decade, new software tools and the access to learning contents at any time via web and internet has created new formats in transfer of knowledge, skills and comprehension. The learning effect and the efficiency of these new tools compared to traditional material and format of teaching and learning is the focus of controversies. During the initial hype of introducing the new technologies in general little attention was given on the need of human resources to produce the different types of learning material and on the individual efficiency of each of the methods compared to traditional material. We claim that poly-format teaching (we mean with it using as many types of material and teaching formats as possible, even if they seem sometimes redundant in content) would match best the diversity of learning types among students. This work describes an example of poly-format teaching fundamental biomechanics applied on the healing process of a bone fracture. A group of stude...
To compare the obstetric and neonatal outcome in pregnancies complicated by gestational diabetes ... more To compare the obstetric and neonatal outcome in pregnancies complicated by gestational diabetes mellitus after amniocentesis for amniotic fluid insulin measurement or maternal blood glucose monitoring or both as selection criterion for therapy. In a retrospective study, 408 diabetic pregnancies were analyzed; 307 were treated with diet alone (group 1) and 101 with diet and insulin (group 2). Pearson's chi2 or Fisher's exact test was used to assess obstetric and anthropometric data within these groups, and p values <0.05 were considered statistically significant. Group 1 - According to the method used, no significant differences were found for gestational age at birth (p = 0.396), mode of delivery (p = 0.79) and neonatal outcome parameters determined as mean birth weight (p = 0.348), birth weight above the 75th percentile (p = 0.473), mean ponderal index (PI; p = 0.434), pH of umbilical artery (p = 0.065) and of umbilical-vein blood (p = 0.052), mean Apgar scores at 1 (p ...
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