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At least 19 recordsLinked to original sources

[Breast feeding, lactation disorders and inflammatory diseases of the female breast].

Approximately 98% of our female population are capable of breast-feeding. Optimal success in breast-feeding is achieved when the first suckling stimulus occurs no later than 2 h following delivery. Obstetrical surgery impairs breast-feeding. Lactation is considered to be optimal with 7 to 10 min of milk uptake and 7 to 10 min of suckling for galactopoesis and discontinuation. The individual pattern of suckling is critical for initiation and duration of lactation. Due to environmental contamination of the milk, a critical assessment of advantages and disadvantages of breast-feeding needs to be performed if it is considered for more than four months. Early diagnosis and immediate initiation of treatment of mastitis helps avoiding abscess formation with potential surgical sequelae. Medical--dopamine agonists--and physical therapy permit continuation of breast-feeding.

Breast Feeding↗

[Warning signals in acute abdominal disorders. Lactate is the best marker of mesenteric ischemia].

An increased plasma lactate concentration (PLC) is a recognized danger signal often found in cases of shock, septicaemia, hepatic and renal failure, and diabetic ketoacidosis. In 120 patients with abdominal complaints, we found the PLC to be above normal limits in 96 per cent (24/25) of the mesenteric ischaemia subgroup, in all 20 of the general bacterial peritonitis subgroup, in 30 per cent (6/20) of the acute pancreatitis subgroup, and in about half of the 25 cases of intestinal obstruction. In all other abdominal conditions represented (n = 30), comprising various inflammatory or infectious abdominal diseases, the PLC was within the normal range. In patients with abdominal complaints, an increased PLC usually indicates the needs of emergency surgery. In the present series, the PLC manifested a sensitivity of 96 per cent and a specificity of 38 per cent as a marker of mesenteric ischaemia, and was also found to be a useful aid in the diagnosis of bowel obstruction and general bacterial peritonitis.

Abdomen, Acute↗

The diagnostic utility of lactate sensitivity in panic disorder.

Lactate infusion is the most extensively studied of the pharmacological challenge tests in panic disorder. We assessed the value of this test in the diagnosis and subtyping of panic in clinical and research settings. Analysis of lactate infusion studies to date suggests that patients with panic attacks are significantly more sensitive to lactate than are healthy controls or patients with other psychiatric disorders without panic attacks. However, the usefulness of lactate infusion is limited by the lack of standardized, objective criteria for lactate-induced panic and uncertainty as to the sensitivity and specificity of the test for current, clinically significant panic attacks. Except in rare cases, the clinical history is likely to be of more value than lactate response in diagnosing panic disorder. Determination of the role of the test in subtyping patients with panic disorder awaits further study of the diagnostic, prognostic, genetic, and pathophysiologic significance of lactate sensitivity.

Anxiety Disorders↗

Specificity of lactate infusions in social phobia versus panic disorders.

Lactate infusions produced panic attacks in one of 15 patients with social phobia, four of nine with agoraphobia, and 10 of 20 with panic disorder in a blind study. The proportion of patients with social phobia who panicked in response to lactate was significantly lower than that of patients with agoraphobia or panic disorder. These findings lend validity to the DSM-III classification of anxiety states. They also suggest that the pathophysiology of social phobia differs from that of disorders characterized by spontaneous panic attacks.

Adult↗

Association of gestational diabetes with other lactation-related disorders: A 2-sample Mendelian randomization analysis of causal effects.

Gestational diabetes mellitus (GDM) is associated with adverse metabolic outcomes and may also be related to postpartum breast and lactation disorders. Observational studies are susceptible to confounding and reverse causation. We used a 2-sample Mendelian randomization design to examine the association between genetic liability to GDM and other disorders of the breast and lactation associated with childbirth. Genetic liability to GDM was associated with higher odds of a composite phenotype of breast and lactation disorders associated with childbirth. Replication using independent samples and more specific clinical outcomes is required. Summary statistics for GDM and the FinnGen outcome "other disorders of breast and lactation associated with childbirth" were obtained from the Integrative Epidemiology Unit open genome-wide association study resource. single nucleotide polymorphisms associated with GDM (P&#x2005;<&#x2005;5&#x2009;&#xd7;&#x2009;10-6) were clumped (R2&#x2005;<&#x2005;0.001) within 10,000&#x2009;kb. The inverse-variance weighted method was the primary analysis; Mendelian randomization-Egger, weighted median, simple mode, and weighted mode analyses were complementary methods. Heterogeneity, directional horizontal pleiotropy, leave-one-out, and Steiger directionality analyses were performed. Nineteen single nucleotide polymorphisms were retained; F statistics ranged from 21.08 to 288.04. Genetic liability to GDM was associated with higher odds of the outcome in the inverse-variance weighted analysis (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.08-2.09; P&#x2005;=&#x2005;.0165). The weighted median (OR, 1.76; 95% CI, 1.09-2.84; P&#x2005;=&#x2005;.0216) and weighted mode estimates (OR, 1.98; 95% CI, 1.21-3.26; P&#x2005;=&#x2005;.0148) were directionally consistent. There was no statistical evidence of heterogeneity or directional horizontal pleiotropy. The Steiger test supported the direction from GDM to the outcome (P&#x2005;=&#x2005;1.30&#x2005;&#xd7;&#x2005;10-11).

Diabetes, Gestational↗