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Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus

OBJECTIVE

Preanalytical processing of blood samples can affect plasma glucose measurement because on-going glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined.

RESEARCH DESIGN AND METHODS

All pregnant women in the Australian Capital Territory (ACT) are recommended for GDM testing with a 75-g OGTT using the World Health Organization diagnostic criteria. From January 2015 to May 2017, OGTT samples were collected into sodium fluoride (NaF) tubes and kept at room temperature until completion of the test (delayed centrifugation). From June 2017 to October 2018, OGTT samples in NaF tubes were centrifuged within 10 min (early centrifugation).

RESULTS

A total of 7,509 women were tested with the delayed centrifugation protocol and 4,808 with the early centrifugation protocol. The mean glucose concentrations for the fasting, 1-h and 2-h OGTT samples were, respectively, 0.24 mmol/L (5.4%), 0.34 mmol/L (4.9%), and 0.16 mmol/L (2.3%) higher using the early centrifugation protocol (P < 0.0001 for all), increasing the GDM diagnosis rate from 11.6% (n = 869/7,509) to 20.6% (n = 1,007/4,887).

CONCLUSIONS

The findings of this study highlight the critical importance of the preanalytical processing protocol of OGTT blood samples used for diagnosing GDM. Delay in centrifuging of blood collected into NaF tubes will result in substantially lower rates of diagnosis than if blood is centrifuged early.




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A Randomized Controlled Trial Comparing Glargine U300 and Glargine U100 for the Inpatient Management of Medicine and Surgery Patients With Type 2 Diabetes: Glargine U300 Hospital Trial

OBJECTIVE

The role of U300 glargine insulin for the inpatient management of type 2 diabetes (T2D) has not been determined. We compared the safety and efficacy of glargine U300 versus glargine U100 in noncritically ill patients with T2D.

RESEARCH DESIGN AND METHODS

This prospective, open-label, randomized clinical trial included 176 patients with poorly controlled T2D (admission blood glucose [BG] 228 ± 82 mg/dL and HbA1c 9.5 ± 2.2%), treated with oral agents or insulin before admission. Patients were treated with a basal-bolus regimen with glargine U300 (n = 92) or glargine U100 (n = 84) and glulisine before meals. We adjusted insulin daily to a target BG of 70–180 mg/dL. The primary end point was noninferiority in the mean difference in daily BG between groups. The major safety outcome was the occurrence of hypoglycemia.

RESULTS

There were no differences between glargine U300 and U100 in mean daily BG (186 ± 40 vs. 184 ± 46 mg/dL, P = 0.62), percentage of readings within target BG of 70–180 mg/dL (50 ± 27% vs. 55 ± 29%, P = 0.3), length of stay (median [IQR] 6.0 [4.0, 8.0] vs. 4.0 [3.0, 7.0] days, P = 0.06), hospital complications (6.5% vs. 11%, P = 0.42), or insulin total daily dose (0.43 ± 0.21 vs. 0.42 ± 0.20 units/kg/day, P = 0.74). There were no differences in the proportion of patients with BG <70 mg/dL (8.7% vs. 9.5%, P > 0.99), but glargine U300 resulted in significantly lower rates of clinically significant hypoglycemia (<54 mg/dL) compared with glargine U100 (0% vs. 6.0%, P = 0.023).

CONCLUSIONS

Hospital treatment with glargine U300 resulted in similar glycemic control compared with glargine U100 and may be associated with a lower incidence of clinically significant hypoglycemia.




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Promising New Research on Early Intervention for Autism

CNN reports that a study confirms that early autism intervention in toddlers is effective. A study was completed with a program called the Early Start Denver Model (ESDM). This program involves about twenty hours a week in the child's own home. It involves play and parents can easily learn some of the skills that can be applied in other settings. The study compared a group of toddlers that were given ESDM intervention to a group of toddlers receiving typical community interventions. Both groups showed improvement, but the ESDM group improved IQ by 18 points compared to 8 points with traditional interventions. The study is reporting that some of the children "virtually caught up to the typical kids their age." However, they are not claiming it is a cure for autism. According to the article they are working on a replication study to determine if there are similar results. Personally, I'm looking forward to the results of the replication study and want to find out more about this method. From what I understand it is less of a time constraint than ABA therapy.

This study also demonstrated the need for early intervention, which also includes early identification. When children are diagnosed early, they can begin receiving interventions that are proven effective. The study showed that current methods are working, but there may be a new program that can be even more effective on the horizon.

I'd love to hear more from my readers if you have any experience with ESDM or more information about it.




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Angela's Tips for Handling Your Child's Special Education Needs

This guest post is written by Angela Peterson who writes on the topic of Online Psychology Degrees and can be emailed at angela_peterson@rediffmail.com

It’s not easy raising a child, and when he or she is affected by a severe disorder or disease, you have a greater challenge ahead of you. You have to put in extra effort, energy and thought into your child’s development and progress, one aspect of which includes their education. Some parents of children with special needs may be tempted to overprotect by keeping them in cloistered environments and limiting their interaction with the outside world. This usually only hampers the child instead of helping them. If you’re a parent with a child who has special needs, here’s some strategies:

* Understand your child: Some children may be able to express themselves while others are limited because of their disability. Whatever the case, understand your child and know that they have a mind of their own even if they are unable to speak it. Instead of forcing your will on them, get to know what they wish to do and cater to their needs as much as possible as long as it does not cause them any harm.

* Be patient: It’s a tough task, but you need to have an enormous amount of patience with your child. You need to condition yourself to be patient through practice and experience, otherwise you and your child will be subject to a great deal of stress.

* Decide on their education: There are many options for providing education to your special needs child, so look for what is available in your area. If you plan to homeschool, you will need to do some research before you’re up to the task. Many feel that it’s better to let the professionals handle this task who are trained and more experienced. Also, your child gets to mingle with other children and interact with them on a regular basis, which is very important to his or her social development.

*Think about inclusive classrooms: Parents often want their special needs children to attend regular schools. Learn about inclusive classrooms and determine if it is a good fit for your child. Consider if your child is up to the task of being educated with general education children and if he/she can cope with the curriculum in such classrooms. Although teachers in inclusive classrooms are trained to deal with children with special needs, there may be times when your child could be bullied or teased by the other kids for not being like them. Take all these facts into consideration before you decide on an inclusive classroom for your child.


Children with special needs need all the help and support they can get from parents and teachers, and it’s up to you to decide on the best form of education for them.




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Support for ADHD in the Schools

Penny Williams from A Mom's view of ADHD and I decided to join forces this month in an attempt to reach more people through our blogs. I believe that many of my readers would find her blog helpful and I also felt that I could offer some insight into the school perspective to her readers. Penny wrote Make Homework Routine a few weeks ago. If you found that helpful, check out her blog full of more strategies! A Mom's View of ADHD is an excellent resource for parents of children with ADHD. It's written from by a parent going through it and provides excellent insight and strategies. I highly recommend it as a place for parents to go to connect and gain support.

Be sure to check out my article, Support for ADHD in the Schools. I discussed the options available for receiving support in the schools for ADHD such as an IEP or a 504 Plan.





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Protecting the DREAM: The Potential Impact of Different Legislative Scenarios for Unauthorized Youth

With the Trump administration having announced the end of the DACA program, Congress is facing growing calls to protect unauthorized immigrants who came to the U.S. as children. This fact sheet examines DREAM Act bills introduced in Congress as of mid-2017, offering estimates of who might earn conditional legal status—and ultimately legal permanent residence—based on educational, professional, and other requirements in the legislation.




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The Diversity Visa Program Holds Lessons for Future Legal Immigration Reform

On paper, the Diversity Visa Program is not set up to bring in the highly skilled; applicants need only a high school diploma (or equivalent) or two years of mid-level work experience. Yet as this commentary explains, the green-card lottery has become a channel for entry of the highly skilled—with half of recipients coming to the United States in recent years having a college degree.




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Preparing Newcomers for the Jobs of Today and the Labor Markets of Tomorrow

This Migration Policy Institute Europe webinar examines possible scenarios for how social, economic, and technological trends could affect jobs, labor market policy, education and social policies, and migrant integration. Speakers also explored the potential of coding schools for refugees to help alleviate skills shortages and provide a pathway to work.




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House probe: Trump admin failed to adequately screen travelers from South Korea, Italy for COVID-19

The Trump administration failed to conduct effective screening of passengers from South Korea and Italy for the coronavirus when those countries were experiencing rapid expansion in COVID-19 cases.




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Pennsylvania, Texas, California among states lifting coronavirus restrictions Friday

California, Iowa, Pennsylvania and Rhode Island are among states that are loosening coronavirus restrictions Friday to gradually revive their economies.




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Gujarat university, second MBBS examination, forensic medicine question papers, January 2015

Gujarat university, second MBBS examination, forensic medicine question papers, January 2015




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Resources for Medical Students and Professionals

The mission of Medip Academy Resources site is to provide teaching and learning materials to medical students (UG and PG) and medical professionals. Medip Academy Resources is a platform for sharing University Examination Papers, Medical Educational Materials, Practical Guides, MCQs, Problem solving etc. The resources available on this site are easily searchable and free to download. URL: http://www.medipacademy.com/resources Email: resources@medipacademy.com How to add a resource? Please share your useful resource by email to resources@medipacademy.com Happy Sharing! Dr. Bhaven Kataria Department of Pharmacology, GMERS Medical College, Sola Ahmedabad, Gujarat, India




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Climate change is influencing where tropical cyclones are formed

Over the last 40 years, climate change has been influencing where tropical cyclones form, according to a new study.




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Tests show heating is the best way to disinfect N95 masks for reuse

Test results suggest N95 masks can be safely disinfected through heating 50 times before their filtration efficiency begins to decline.




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Neanderthals preferred bovine bones for leather-making tools

When it came to selecting bones for leather-making tools, Neanderthals were surprisingly choosy. New archaeological analysis shows Neanderthals preferentially selected bovine rib bones to make a tool called a lissoir.




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Immigration Enforcement in the United States: The Rise of a Formidable Machinery

MPI has released a major study that describes and analyzes today’s immigration enforcement programs, as they have developed and grown in the 25 years since IRCA launched the current enforcement era.




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Immigration Enforcement in the United States: The Rise of a Formidable Machinery

Release of a major report that describes and analyzes the immigration enforcement system in the United States as it has developed and grown in the quarter century since the Immigration Reform and Control Act of 1986 launched the current era of enforcement.




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A House Divided: Divergent Views in Congress Over Immigration Reform - A Video Chat

MPI experts participate in a video chat shortly after the Migration Policy Institute released an analysis comparing the major provisions of the Senate bill to those of the individual House bills considered to date in House committees. 




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A Strategic Framework for Creating Legality and Order in Immigration

This report analyzes how governments ought to best allocate their resources to address the risks associated with migration—the "immigration harms" that undermine the positive economic and social benefits of immigration—including choosing which threats to tackle and where to prioritize enforcement efforts. Immigration policymakers can learn from other public policy regulation efforts to ensure that regulatory actions advance the public interest.




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IRCA in Retrospect: Guideposts for Today’s Immigration Reform

This policy brief traces the successes and failures of the 1986 Immigration Reform and Control Act, which represented the first and most comprehensive legislation to take on the issue of illegal immigration to the United States. The brief makes the case that IRCA's major flaws were rooted in statutory design more than regulatory challenges and implementation by the administrative agencies.




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Business as Usual? Regularizing Foreign Labor in Costa Rica

With the growing urbanization and consolidation of Nicaraguan immigrants in sectors such as construction and domestic service, Costa Rica has shifted its focus from immigration enforcement to integration. Tension has emerged between the government and private sector as a new mechanism for regularizing unauthorized immigrant workers has failed to gain traction.




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Leadership Visions: A Discussion with Mexican Foreign Minister Claudia Ruiz-Massieu

An MPI Leadership Visions discussion with the Foreign Minister of Mexico, Claudia Ruiz-Massieu, for her first public appearance in Washington, DC. 




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Shifting Gears, Trump Administration Launches High-Profile Worksite Enforcement Operations

An unannounced sweep of 98 convenience stores by U.S. immigration authorities—resulting in the arrest of 21 unauthorized workers—may signal a new approach to worksite enforcement under the Trump administration, moving away from a strategy of paper-based audits that resulted in higher employer fines and fewer worker arrests. This article explores worksite enforcement over recent decades.




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Will Immigration Reform Ever Succeed Again? The Legacy of IRCA &amp; Its Enduring Lessons

This provocative discussion showcases Charles Kamasaki's book, Immigration Reform: The Corpse That Will Not Die, and explores the lessons that can be learned from the Immigration Reform and Control Act of 1986, its intended and unintended consequences, and how the law’s legacy has shaped contemporary politics surrounding immigration.




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Navy adapts maintenance procedures, strategies for containing COVID-19

The Navy has been particularly hard hit by the coronavirus pandemic and is working to adapt its strategies for maintenance as well as containing outbreaks on ships.




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California to send mail-in ballots to all voters

California Gov. Gavin Newsom on Friday signed an executive order requiring mail-in ballots be sent to all eligible voters for the November election.




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AAI Corp., a division of Textron, nabs $20.7M contract modification for Navy drone program

Textron was awarded a $20.7 million contract modification Friday for work on the Navy's Unmanned Influence Sweep System and Unmanned Surface Vehicle program.




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AccuWeather increases number of hurricanes predicted for 'very active' 2020 Atlantic season

Based on the newest forecasting models, AccuWeather forecasters have extended the upper range of hurricanes predicted for the Atlantic hurricane season.




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New Jersey nursing home with overwhelmed morgue fined for violations

Federal health officials fined a New Jersey nursing home where last month authorities discovered 17 bodies piled in a small morgue.




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IRS sets deadline to enter direct deposit information for stimulus checks

The Internal Revenue Service said Wednesday is the last day for Americans to provide their direct deposit information to receive their stimulus checks directly to their bank accounts.




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Watch: Ariana Grande, Justin Bieber release at-home video for 'Stuck with U'

Ariana Grande and Justin Bieber released their music video for "Stuck With U."




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Princess Love files for divorce from Ray J

Princess Love filed for divorce from Ray J, her husband and "Love & Hip Hop: Hollywood" co-star, after nearly four years of marriage.




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Watch: Pete Davidson says Bill Hader recommended him for 'SNL'

Pete Davidson discussed on "The Tonight Show" how Bill Hader helped him land a spot on "Saturday Night Live."




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Michael Buble shares rescheduled dates for 'An Evening with' tour

Michael Bublé postponed his "An Evening With" tour to 2021 due to the coronavirus pandemic.




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Look: Netflix shares teaser for 'Baby-Sitters Club' revival

Netflix shared a premiere date and teaser trailer for its "Baby-Sitters Club" series, based on the Ann M. Martin book series.




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'Community' cast reuniting for COVID-19 benefit live read

"Community" creator Dan Harmon and cast members Joel McHale, Donald Glover, Alison Brie, Yvette Nicole Brown, Gillian Jacobs, Danny Pudi, Jim Rash and Ken Jeong will perform a table read and Q&A for charity.




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Famous birthdays for May 9: Ghostface Killah, Noah Centineo

Rapper Ghostface Killah turns 50 and actor Noah Centineo 24, among the famous birthdays for May 9.




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CBS orders first seasons of 'Clarice,' 'Equalizer,' 'B Positive' for 2020-21

CBS said it has ordered first seasons of three new shows -- "Clarice," "The Equalizer" and "B Positive" for the 2020-21 television season.




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The Canadian Express Entry System for Selecting Economic Immigrants: Progress and Persistent Challenges

Since its launch in 2015, the Express Entry system has changed how economic immigration to Canada happens and how it fits into public and political debates. And while it has proven successful in cutting through application backlogs, some challenges remain. This report looks at how and why this points-based system was introduced, what its impact has been, and how it could be further finetuned.




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Rethinking U.S. Immigration Policy: New Realities Call for New Answers

The U.S. immigration system is in desperate need of an overhaul. What has been missing is an alternate vision for a path forward that treats immigration as a strategic resource while also accounting for heightened security and rule-of-law imperatives, which together can further U.S. interests, values, and democratic principles as a society. This concept note outlines a new MPI initiative, Rethinking U.S. Immigration Policy, that seeks to fill this gap.




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How to Stop Waiting for ‘When Coronavirus Ends’

How many times have you thought, “When coronavirus ends, I will ______” — as if you’re putting off everything (or at least the things you most love) until then? They...




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[ Other - Vietnam ] Open Question : What is HIV and how is it related to covid19? Any cure soon for both?




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[ Religion & Spirituality ] Open Question : Christians, why do some people keep lying by saying trans been using other Gender's room for long time but that lie?

i even got this from pro trans page that say they have laws banning men from women's room & trans aka GD was put into mad house, & even then there been alot of time where rapists &perverted freaks been using other Gender's bath room too doesn't make it right, they go to prison if they find out




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[ Singles & Dating ] Open Question : Muslim man looking for relief?

I know it's Ramadan, but I've been feeling urges for a few years now and it's just getting more and more now. I always imagine about sex and loving my to-be wife. Right now, I'm studying medicine, so my parents told me it's too early to get married (24 years old). I just don't know really what to do. I prone masturbate to get some relief. What should I do?




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[ Investing ] Open Question : What does an investor do when his stock notifies him...the company confirms a record date for a forward two for one stock split?




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[ Other - Holidays ] Open Question : What should I give my mom for Mother’s Day ?

No pets no electronics so maybe something that is nice and simple but homemade




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[ Politics ] Open Question : Why do people in Chicago kill themselves for nothing?




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[ Royalty ] Open Question : Why do males often name their male kids the same name, and a number, but females do not do the same for their daughters?

(I am in the USA). There was 8 Henry s https://en.wikipedia.org/wiki/Henry_VIII_of_England




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[ Politics ] Open Question : Is Camp David going to be the new Trump “White House“ since Melania’s White House is at the top of the avoidance list for germaphobes?




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[ Politics ] Open Question : Is Trump going to have to invade California?

The state leads the nation in poverty and homelessness while it's socialist elites live in absolute luxury. It's like some third world nation the US is obligated to invade on the basis of humanitarianism.