#16
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Íè ïðîøëî è ãîäà ñ ìîìåíòà âûõîäà â ñâåò.
Ìåíÿ, êñòàòè, åùå è âîïðîñ íàçíà÷åíèÿ ïðàêòè÷åñêè âñåì áåðåìåííûì ïðåïàðàòîâ Éîäà èíòåðåñóåò? Õîòåëîñü áû óçíàòü ìíåíèå ýíäîêðèíîëîãîâ. Ñïàñèáî. |
#17
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2 Acusher
Âòîðîé ðàç óæå ïðåäóïðåæäàþ, åñëè õîòèòå ÷òî-òî îáñóäèòü ñ êîëëåãàìè, ìèëîñòè ïðîñèì íà ôîðóì äëÿ âðà÷åé, â êîíñóëüòàòèâíûõ òîïèêàõ íåæåëàòåëüíû ïðîôåññèîíàëüíûå äèñêóññèè. Òåìà ðàçäåëåíà. |
#18
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Öèòàòà:
__________________________________________________ ______________________________________ Recommendations and ‘take home’ messages. Iodine deficiency (ID) occurs during pregnancy when gestation takes place in areas with even only a mild iodine restriction. Since this occurs at a time when thyroid hormone requirements are increased, ID induces a vicious circle leading to enhanced thyroidal stimulation, relative hypothyroxinemia and gestational goitrogenesis, that affects both the mother and the fetus. Women in the childbearing period should have an average daily iodine intake of 150 μg. During pregnancy and breastfeeding, the recommended nutrient intake (RNI) for iodine ought to be increased to 200-300 μg per day (250 μg/d on the average). To avoid the risk potentially associated with iodine excess, the iodine intake of pregnant women and breastfeeding mothers should not exceed twice the daily RNI for iodine (i.e. 500 μg iodine/d). To assess the adequacy of iodine intake during pregnancy at the level of a population, urinary iodine concentration (UIC) should be measured in a cohort of the population. UIC should ideally range between 150-250 μg/L. Measuring UIC is not a valid tool to assess the adequacy of iodine nutrition at the level of individuals. For this purpose, only the pattern of changes in thyroid function parameters can provide the required evaluation. In order to reach the daily RNI, multiple means must be considered, tailored to the characteristics of iodine intake levels in a given population. Different situations must therefore be distinguished: In countries with iodine sufficiency or well-established universal salt iodization (USI) programs, pregnancies are not at risk of having iodine deficiency. No systematic dietary fortification needs to be organized in the population, but women can individually be recommended to use multivitamin tablets containing iodine supplements during pregnancy. In countries without USI programs or established USI programs where the coverage is known to be only partial, iodine supplements should be given to all pregnant women, in the form of KI (100-200 μg/d) or iodine-containing multivitamin pills especially designed for pregnancy purposes. Finally, in remote areas with no accessible USI programs, difficult socio-economic conditions, and frequently with severe iodine deficiency, prophylactic & therapeutic iodine fortification of pregnant women becomes an emergency to avoid endemic cretinism. It is recommended to administer iodized oil orally (400 mg of iodine) once, as early as possible during gestation. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#19
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Íåêîòîðûå ó÷åáíèêè óæå óñòàðåâàþò ê ìîìåíòó ñâîåãî âûõîäà â ñâåò. Òàê ÷òî âûáîð - òåñò ñ 75 ã ãëþêîçû.
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#20
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Öèòàòà:
Åñëè íèêòî íå ñîìíåâàåòñÿ â íåîáõîäèìîñòè ñêðèíèíãà äèàáåòà áåðåìåííûõ â ãðóïïàõ ðèñêà è ïî ýòîìó âîïðîñó ñóùåñòâóåò ,ïî÷òè ÷òî îáùèé, êîíñåíñóñ, òî â âîïðîñå òåõíè÷åñêîãî èñïîëíåíèÿ öàðèò ïîëíàÿ íåðàçáåðèõà. Ê ñîæàëåíèþ, óíèôèöèðîâàííîãî òåñòà íå ñóùåñòâóåò. Ðàçíÿòñÿ íå òîëüêî äîçû ãëþêîçû, ìîìåíòû âçÿòèÿ êðîâè è òä, íî äàæå èíòåðïðåòèðîâàíèå ïîëó÷åííûõ ðåçóëüòàòîâ. |
#21
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Âîîáùå-òî äâà âàðèàíòà äëÿ äèàãíîçà (òðåõ÷àñîâîé òåñò ñî 100 ã èëè äâóõ÷àñîâîé ñ 75 ã). Íèêàêèõ ðàçíîãëàñèé ïî ïîâîäó èíòåðïðåòàöèè òåñòà ñ 75 ã íåò - êðèòåðèè òå æå, òîëüêî îòñóòñòâóåò ïîíÿòèå "ÍÒÃ" - ñðàçó óñòàíàâëèâàåòñÿ äèàãíîç ÑÄ.
Diagnosis The 3-hour 100 g OGTT has been the standard diagnostic test in the United States since O'Sullivan and Mahan proposed criteria for the diagnosis of GDM more than 40 years ago.4,5 A 75 g OGTT is used outside of pregnancy and is preferred for use in pregnancy by some physicians in the United States and by many physicians in other countries. Participants in the Fourth International Workshop Conference on GDM accepted the use of a 75 g 2-hour OGTT as an alternative to the 100 g OGTT, although evidence supporting this approach is limited. The diagnosis of GDM can also be made by finding either a fasting plasma glucose level above 126 mg/dl (7.0 mmol/L) or a random plasma glucose level above 200 mg/dl (11.1 mmol/L) and confirming that result with a second test.6 âîò, íàïðèìåð, ññûëî÷êà: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#22
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Óâàæàåìàÿ Àííà Øâåäîâà!
Äàéòå, ïîæàëóéñòà, óòâåðæäåííûé â Ðîññèè ïðîòîêîë ïðîâåäåíèÿ òåñòà ñ 75 ã ãëþêîçû. âû âåäü ïîíèìàåòå, êàêîâà áþðîêðàòèÿ. Ñïàñèáî. Ï.Ìàðòûíåíêî. |
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#23
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À âîò: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
Ðàçäåë 16.
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#24
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Áëàãîäàðñòâóþ!
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