1.  Peer Reviewed Title: Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring. A prospective, randomized, pilot study. Author: Battaglia C; Mancini F; Fabbri R; Persico N; Busacchi P; Facchinetti F; Venturoli S Source: Fertility and Sterility. 2009 Jul 8; Abstract: OBJECTIVE: To compare the effects of a pill containing drospirenone with those of a combined contraceptive vaginal ring on the lipid and carbohydrate metabolism and on the surrogate markers of arterial function. SETTING: Bologna University School of Medicine. PATIENT(S): Thirty-seven women with polycystic ovary syndrome (PCOS) were randomly submitted to drospirenone + ethinylestradiol (group I; n = 19) or combined contraceptive vaginal ring (group II; n = 18) therapy. The duration of the study was 6 months. INTERVENTION(S): The effect of treatments was assessed after 6 months of therapy. MAIN OUTCOME MEASURE(S): Utero-ovarian ultrasound analysis and color Doppler evaluation of uterine and stromal ovarian arteries. In addition, analysis of brachial artery flow-mediated vasodilatation and 24-hour ambulatory blood pressure monitoring were performed. Fasting blood samples were drawn for testing biochemical and hormonal parameters and nitrites/nitrates. RESULT(S): Both treatments improved hirsutism, hyperandrogenemia, and ultrasound and color Doppler ovarian parameters. Both drospirenone + ethinylestradiol or contraceptive vaginal ring induced a slight but significant increase of diurnal and 24-hour blood pressure. Although both therapies worsened the lipid profile, the oral pill administration was associated with a more evident increase of circulating triglycerides. The 6-month treatment with the vaginal ring significantly improved the area under the curve for glucose, insulin, and C-peptide, whereas the drospirenone + ethinylestradiol pill induced an increase in the insulinogenic index and homeostatic model assessment estimate for insulin resistance values. CONCLUSION(S): Vaginal hormonal contraception appears to be preferable to oral ethinylestradiol + drospirenone administration in hyperinsulinemic patients with PCOS. Language: English Keywords: ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | CLIENTS | OVARIAN CYSTS | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | LOW-DOSE PROGESTINS | VAGINAL RING | CARDIOVASCULAR EFFECTS | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | BLOOD PRESSURE | ULTRASONICS | Developed Countries | Europe, Southern | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Physiology | Biology | Metabolic Effects | Lipids | Hemic System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342128 |
| 2. Peer Reviewed Title: Both a combined oral contraceptive and depot medroxyprogesterone acetate impair endothelial function in young women. Author: Lizarelli PM; Martins WP; Vieira CS; Soares GM; Franceschini SA; Ferriani RA; Patta MC Source: Contraception. 2009 Jan;79(1):35-40. Abstract: BACKGROUND: The study was conducted to determine whether the use of a combined oral contraceptive (COC) or depot medroxyprogesterone acetate (DMPA) interferes with endothelial function. STUDY DESIGN: The study was conducted on 100 women between the ages of 18 and 30 years. Fifty women had not used hormonal contraception (control group) for at least 12 months, 25 were current users of a COC (ethinylestradiol 30 mcg+levonorgestrel 150 mcg) and 25 were current users of DMPA (150 mg) for at least a 6-month period. All women were evaluated for brachial flow-mediated dilation (FMD), intima-media thickness, carotid distensibility and stiffness index, arterial pressure, body mass index, waist circumference, heart rate and lipid profile. RESULTS: A significant difference in FMD was observed between the COC and control groups (6.4+/-2.2% vs. 8.7+/-3.4%, p<.01) and between the DMPA and control groups (6.2+/-2.1% vs. 8.7+/-3.4%, p<.01). The DMPA group had lower values of total cholesterol (TC) and low-densitylipoprotein (LDL-C) than COC users and the control group (TC: DMPA=139.9+/-21.5 mg/dL vs. controls=167.1+/-29.2 mg/dL vs. COC=168.2+/-37.5, p=.001; LDL-C: DMPA=85.3+/-20.1 mg/dL vs. controls=102+/-24.5 mg/dL vs. COC=106.7+/-33.3 mg/dL, p=.01). The control group had higher levels of high-density lipoprotein (HDL-C) than the DMPA and COC groups (controls=52.4+/-14.1 mg/dL vs. DMPA=42.2+/-7.2 mg/dL vs. COC=45.4+/-9.1 mg/dL, p=.001). No significant differences were observed regarding the other variables. CONCLUSIONS: FMD was lower among COC and DMPA users, suggesting that these hormonal contraceptives may promote endothelial dysfunction. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | EVALUATION INDEXES | WOMEN IN DEVELOPMENT | ORAL CONTRACEPTIVES, COMBINED | DEPO-PROVERA | SIDE EFFECTS | HEALTH STATUS INDEXES | CHOLESTEROL | ADMINISTRATION AND DOSAGE | BLOOD PRESSURE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Economic Development | Economic Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Lipids | Physiology | Biology | Drugs | Hemic System Document Number: 330537 |
| 3. Title: Metabolic and cardiovascular impact of oral contraceptives in polycystic ovary syndrome. Author: Soares GM; Vieira CS; de Paula Martins W; Dos Reis RM; de Sa MF; Ferriani RA Source: International Journal of Clinical Practice. 2009 Jan;63(1):160-9. Abstract: Chronic anovulation, polycystic ovarian morphology and hyperandrogenism are the diagnostic criteria for polycystic ovary syndrome (PCOS). Metabolic disturbances are more common in PCOS women who are prone to develop metabolic syndrome and to present higher levels of some cardiovascular disease risk marker. Oral contraceptives are widely used in PCOS, but conflicting data have been reported regarding their impact on carbohydrate and lipid metabolism on PCOS women. This paper presents a critical evaluation of combined oral contraceptives (COCs) metabolic effect - carbohydrate metabolism and insulin sensitivity, lipid metabolism, haemostasis, body weight, arterial pressure and cardiovascular impact - on PCOS women. Because of the paucity of data on the impact of COCs on cardiovascular and metabolic parameters in PCOS patients, most of there commendations are based on studies involving ovulatory women. The use of low-dose COCs is preferable in PCOS, especially among patients with glucose intolerance, insulin resistance and uncomplicated diabetes mellitus. Although reported as a side effect of COCs, marked weight gain has not been confirmed among users. However, when arterial hypertension or elevated risk for thromboembolism is present, progestogen-only hormonal contraceptives should be used instead of COCs. Regarding dyslipidaemia, COCs reduce low-density lipoprotein and total cholesterol and elevate high-density lipoprotein and triglycerides, and therefore are not recommended for women with high triglycerides levels. The choice of a COC, which alleviates the PCOS-induced hyperandrogenism without significant negative impact on cardiovascular risk, is one of the greatest challenges faced by gynaecologists nowadays. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | OVARIAN CYSTS | CARDIOVASCULAR EFFECTS | ORAL CONTRACEPTIVES, COMBINED | BODY WEIGHT | CARBOHYDRATE METABOLIC EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | LIPID METABOLIC EFFECTS | CONTRACEPTIVE SAFETY | BLOOD PRESSURE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Economic Development | Economic Factors | Diseases | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Metabolic Effects | Safety | Public Health | Health | Lipids | Hemic System Document Number: 341138 |
| 4. Peer Reviewed Title: Maternal deaths due to eclampsia and HELLP syndrome. Author: Vigil-De Gracia P Source: International Journal of Gynecology and Obstetrics. 2009;104:90-94. Abstract: Objective: To evaluate maternal deaths associated with eclampsia, HELLP syndrome, and the concurrence of these conditions. Method: A review of Medline studies reporting maternal deaths associated with eclampsia or HELLP syndrome published in English, Spanish, and Portuguese between 1995 and June 2008. Results: A total of 304 deaths were identified: 100 due to eclampsia, 117 due to eclampsia/HELLP, and 87 associated with HELLP syndrome. Of the total deaths, 71.3% of women had seizures and 67.1% developed HELLP syndrome. In high-income countries 3.9% of deaths were due to eclampsia without HELLP syndrome, while in low-income countries this figure was 42.5% (Pb0.0001). The presence of HELLP syndrome in the women who died of eclampsia was 90.6% (29/32) in high-income countries compared with 47.6% (88/185) in low-income countries (Pb0.001). Conclusion: Concurrent eclampsia and HELLP syndrome was diagnosed in 5-6 out of 10 deaths associated with eclampsia or HELLP syndrome in this review. Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | MATERNAL MORTALITY | ECLAMPSIA | PREECLAMPSIA | CAUSES OF DEATH | HYPERTENSION | CEREBROVASCULAR EFFECTS | LIVER DYSFUNCTION | BLOOD PRESSURE | Mortality | Population Dynamics | Demographic Factors | Population | Pregnancy Complications | Diseases | Vascular Diseases | Physiology | Biology | Hemic System Document Number: 340212 |
| 5. Peer Reviewed Title: Clinical and biochemical characteristics of polycystic ovary syndrome in Korean women. Author: Chae SJ; Kim JJ; Choi YM; Hwang KR; Jee BC Source: Human Reproduction. 2008;23(8):1924-1931. Abstract: BACKGROUND: We investigated the differences in anthropometrical, hormonal and insulin resistance parameters according to the subtype of polycystic ovary syndrome (PCOS) in Korean women. METHODS: We recruited 166 women with PCOS and retrospectively recruited 277 controls. PCOS was diagnosed by irregular menstruation (IM), polycystic ovary (PCO) and hyperandrogenism (HA). Subjects were divided into four subgroups: the IM/HA/PCO group (n = 87, 52.4%), the IM/PCO group (n = 52, 31.3%), the IM/HA group (n = 23, 13.9%) and the HA/PCO group (n = 4, 2.4%). Clinical and biochemical variables were compared among the PCOS subgroups. RESULTS: The IM/HA/PCO and IM/HA groups showed higher body mass index (P < 0.001) and waist-to-hip ratio (P < 0.001) than the IM/PCO group. The IM/HA group had higher triglyceride levels than the other groups (P < 0.001). Higher fasting insulin (P < 0.001) and postprandial 2 h insulin (P < 0.01) were noted in the IM/HA/PCO group and the IM/HA group, compared with the IM/PCO group. Women with PCOS showed lower sex hormone-binding globulin (P < 0.001) and higher systolic blood pressure (BP) (P = 0.004), diastolic BP (P = 0.001), fasting insulin (P < 0.001), postprandial 2 h insulin (P < 0.001), homeostatic model for insulin resistance (P < 0.001) and clinical and biochemical parameters of metabolic syndrome (P < 0.05) compared with subjects without PCOS. CONCLUSIONS: Women with PCOS without HA are common in Korea and are less likely to have metabolic dysfunction, insulin resistance and elevated BP. PCOS without HA may be a mild phenotype of PCOS. Therefore, women with PCOS in Korea could have a reduced likelihood of having metabolic syndrome compared with women of other ethnicities. Language: English Keywords: KOREA | RESEARCH REPORT | RETROSPECTIVE STUDIES | OVARIAN EFFECTS | BLOOD PRESSURE | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | MENSTRUATION DISORDERS | METABOLIC EFFECTS | Studies | Research Methodology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Hemic System | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Diseases Document Number: 327760 |
| 6. Peer Reviewed Title: Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: Systematic review and meta-analysis. Author: Cnossen JS; Vollebregt KC; de Vrieze N; ter Riet G; Mol BW Source: BMJ. British Medical Journal. 2008;336(7653):1117-1120. Abstract: The objective was to determine the accuracy of using systolic and diastolic blood pressure, mean arterial pressure, and increase of blood pressure to predict pre-eclampsia. The design used was a systematic review with meta-analysis of data on test accuracy. The data sources used were Medline, Embase, Cochrane Library, Medion, checking reference lists of included articles and reviews, contact with authors. Without language restrictions, two reviewers independently selected the articles in which the accuracy of blood pressure measurement during pregnancy was evaluated to predict pre-eclampsia. Data were extracted on study characteristics, quality, and results to construct 2×2 tables. Summary receiver operating characteristic curves and likelihood ratios were generated for the various levels and their thresholds. 34 studies, testing 60 599 women (3341 cases of pre-eclampsia), were included. In women at low risk for pre-eclampsia, the areas under the summary receiver operating characteristic curves for blood pressure measurement in the second trimester were 0.68 (95% confidence interval 0.64 to 0.72) for systolic blood pressure, 0.66 (0.59 to 0.72) for diastolic blood pressure, and 0.76 (0.70 to 0.82) for mean arterial pressure. Findings for the first trimester showed a similar pattern. Second trimester mean arterial pressure of 90 mm Hg or more showed a positive likelihood ratio of 3.5 (95% confidence interval 2.0 to 5.0) and a negative likelihood ratio of 0.46 (0.16 to 0.75). In women deemed to be at high risk, a diastolic blood pressure of 75 mm Hg or more at 13 to 20 weeks' gestation best predicted pre-eclampsia: positive likelihood ratio 2.8 (1.8 to 3.6), negative likelihood ratio 0.39 (0.18 to 0.71). Additional subgroup analyses did not show improved predictive accuracy. When blood pressure is measured in the first or second trimester of pregnancy, the mean arterial pressure is a better predictor for pre-eclampsia than systolic blood pressure, diastolic blood pressure, or an increase of blood pressure. (author's) Language: English Keywords: NETHERLANDS | LITERATURE REVIEW | PREGNANT WOMEN | TESTING | PREGNANCY, FIRST TRIMESTER | PREGNANCY, SECOND TRIMESTER | PREECLAMPSIA | BLOOD PRESSURE | MEASUREMENT | RELIABILITY | Developed Countries | Europe, Western | Europe | Population Characteristics | Demographic Factors | Population | Research Methodology | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Hemic System | Physiology | Biology Document Number: 326845 |
| 7. Peer Reviewed Title: Nicotine in breast milk influences heart rate variability in the infant. Author: Dahlstrom A; Ebersjo C; Lundell B Source: Acta Paediatrica. 2008;:[5] p. Abstract: The aim was to study the effects of postnatal exposure to nicotine on the regulation of heart rate and blood pressure in infants. Thirty-eight mother-infant pairs were studied. Twenty nonsmoking and 18 smoking (2-20 cigarettes per day) mothers were included. All infants were healthy, exclusively breastfed and their postnatal age was 6 weeks. During a home visit infant's urine and mothers' milk were sampled and concentrations of nicotine and cotinine were analyzed. Infants' electrocardiogram (ECG) were recorded, sleep state documented and blood pressure during sleep was measured. Heart rate variability (HRV) was calculated with spectral analysis of R-R intervals. The smoking mothers exposed their infants to nicotine in milk with a median nicotine concentration of 47 (8-192) microg/L. Analysis of infants' urine showed that the nonsmoking group had 0.8 (0-5.2) and the smoke group 60 (17-139) microg cotinine/L (p less than 0.01). The frequency domain low-to-high frequency (LF/HF) ratio, was correlatedto milk nicotine concentrations in the milk sample, from smoking mothers. HRV decreased, with increasing milk nicotine, ingested by the boys (r = -0.74, p = 0.02) but not the girls (r = -0.13, p = 0.76). The differences of mean arterial pressure between sleep states in the infants, were significantly lower in the smoke group 5.8(6.8) compared to the nonsmoke group 11.5(7.2) mmHg (p = 0.03). Postnatal exposure to nicotine influences autonomic cardiovascular control in infants. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | INFANT | MOTHERS | BREASTFEEDING, EXCLUSIVE | TOBACCO USE | EXAMINATIONS AND DIAGNOSES | BLOOD PRESSURE | MOTHER-TO-CHILD TRANSMISSION | EXPOSURE | CARDIOVASCULAR EFFECTS | Europe, Northern | Europe | Developed Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Hemic System | Physiology | Biology | Transmission | Infections | Diseases | Risk Factors Document Number: 327168 |
| 8. Peer Reviewed Title: Accuracy of self-screening for contraindications to combined oral contraceptive use. Author: Grossman D; Fernandez L; Hopkins K; Amastae J; Garcia SG Source: Obstetrics and Gynecology. 2008 Sep;112(3):572-8. Abstract: OBJECTIVE: To estimate how well a convenience sample of women from the general population could self-screen for contraindications to combined oral contraceptives using a medical checklist. METHODS: Women 18-49 years old (N=1,271) were recruited at two shopping malls and a flea market in El Paso, Texas, and asked first whether they thought birth control pills were medically safe for them. They then used a checklist to determine the presence of level 3 or 4 contraindications to combined oral contraceptives according to the World Health Organization Medical Eligibility Criteria. The women then were interviewed by a blinded nurse practitioner, who also measured blood pressure. RESULTS: The sensitivity of the unaided self-screen to detect true contraindications was 56.2% (95% confidence interval [CI] 51.7-60.6%), and specificity was 57.6% (95% CI 54.0-61.1%). The sensitivity of the checklist to detect true contraindications was 83.2% (95% CI 79.5-86.3%), and specificity was 88.8% (95% CI 86.3-90.9%). Using the checklist, 6.6% (95% CI 5.2-8.0%) of women incorrectly thought they were eligible for use when, in fact, they were contraindicated, largely because of unrecognized hypertension. Seven percent (95% CI 5.4-8.2%) of women incorrectly thought they were contraindicated when they truly were not, primarily because of misclassification of migraine headaches. In regression analysis, younger women, more educated women, and Spanish speakers were significantly more likely to correctly self-screen (P<.05). CONCLUSION: Self-screening for contraindications to oral contraceptives using a medical checklist is relatively accurate. Unaided screening is inaccurate and reflects common misperceptions about the safety of oral contraceptives. Over-the-counter provision of this method likely would be safe, especially for younger women and if independent blood pressure screening were encouraged. Language: English Keywords: TEXAS | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | KNOWLEDGE | WHO | BLOOD PRESSURE | SELF CARE | SCREENING | HYPERTENSION | MIGRAINE | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Sociocultural Factors | UN | International Agencies | Organizations | Political Factors | Hemic System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Examinations and Diagnoses | Vascular Diseases | Diseases Document Number: 329053 |
| 9. Title: [Early determinants of blood pressure among adults of the 1982 birth cohort, Pelotas, Southern Brazil] Author: Horta BL; Gigante DP; Victora CG; Barros FC Source: Revista De Saude Publica. 2008 Dec;42 Suppl 2:86-92. Abstract: OBJECTIVE: To evaluate the effects of exposure occurring during pregnancy or the first years of life on blood pressure. METHODS: Cohort study on all children born in 1982 in maternity hospitals in the city of Pelotas, Southern Brazil. The mothers living in the urban area were interviewed and the children were followed up on different occasions. In 2004-5, all the individuals in the cohort were sought for monitoring. Their blood pressure was measured twice, at the start and end of the interview, using a digital wrist sphygmomanometer. Associations between blood pressure and the following variables were evaluated: skin color; maternal schooling level; family income at birth; change in income between birth and 23 years of age; birth weight; and duration of breastfeeding. Analysis of variance was used to compare the means and a generalized linear model was used in the adjusted analysis. RESULTS: Blood pressure measurements were obtained from 4,291 individuals: 2,208 males and 2,083 females. The mean systolic blood pressure was 117.5 +/- 15.0 mmHg and the mean diastolic was 73.6 +/- 11.5 mmHg. Among the men, systolic blood pressure was higher among those of black or brown skin color and among those who were never considered poor. Diastolic pressure was only associated with birth weight. Among the women, systolic blood pressure was greater among those of black or brown skin color whose mothers' schooling level was greater than or equal to 12 years or whose birth weight was less than 4,000 g. CONCLUSIONS: For both sexes, only skin color was associated with blood pressure. Breastfeeding did not have any long-term effect on blood pressure and the associations for birth weight and socioeconomic level were inconsistent. Language: EnglishPortuguese Keywords: BRAZIL | RESEARCH REPORT | COHORT ANALYSIS | ADULTS | ETHNIC GROUPS | BLOOD PRESSURE | HYPERTENSION | SOCIOECONOMIC STATUS | BIRTH WEIGHT | BREASTFEEDING | INEQUALITIES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Hemic System | Physiology | Biology | Vascular Diseases | Diseases | Socioeconomic Factors | Economic Factors | Body Weight | Infant Nutrition | Nutrition | Health Document Number: 342192 |
| 10. Title: The bradykinin-degrading aminopeptidase P is increased in women taking the oral contraceptive pill. Author: La Corte AL; Carter AM; Turner AJ; Grant PJ; Hooper NM Source: Journal of the Renin - Angiotensin-aldosterone System. 2008 Dec;9(4):221-5. Abstract: INTRODUCTION: The renin-angiotensin and kininogen-kinin hormonal systems are critically involved in regulating blood pressure and are candidates in contributing to oral contraceptive pill (OCP)-induced hypertension.Angiotensin-converting enzyme (ACE) and aminopeptidase P (AP-P) are key enzymes in these systems and are both involved in the degradation of the vasodilator bradykinin. METHODS: Circulating ACE and AP-P levels were measured by activity assay using selective fluorogenic peptide substrates in plasma samples from the Leeds Family Study. In addition, the effect of progesterone on the expression of AP-P and ACE was examined in cells. RESULTS: Women on the OCP had higher age-adjusted plasma AP-P (mean [95% confidence interval]) (0.27 [0.23-0.32] nmol/min/ml (n = 53)) compared with women not on the OCP (0.17 [0.16-0.19] nmol/min/ml (n = 133), p < 0.001) or males (0.19 [0.17-0.20] nmol/min/ml (n = 209), p<0.001).There were no differences in the age-adjusted plasma ACE levels among the three groups. In HepG2 cells, progesterone treatment increased the AP-P protein and mRNA expression, whereas no effect of progesterone treatment was observed for ACE. CONCLUSION: Increased AP-P may result in increased breakdown of bradykinin.These data suggest that progesterone-induced increases in AP-P may contribute to the development of OCP-induced hypertension in susceptible Women. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | PROGESTERONE | TREATMENT | HYPERTENSION | ORAL CONTRACEPTIVES | BLOOD PRESSURE | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vascular Diseases | Diseases | Contraceptive Methods | Contraception | Family Planning | Hemic System Document Number: 329634 |
| 11. Title: Diurnal blood pressure variation in the evaluation of early onset severe pre-eclampsia. Author: Steyn DW; Odendaal HJ; Hall DR Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2008 Jun;138(2):141-146. Abstract: The objective was to study the association between diurnal variation in blood pressure, the mean daily blood pressure and various complications of pregnancy in patients presenting with severe pre-eclampsia before 34 weeks' gestation. Forty-four women presenting to a tertiary hospital in South Africa with severe pre-eclampsia between 28 and 34 weeks' gestation were managed expectantly for at least 8 days. We measured maternal blood pressure every 30 min with the pregnancy validated Spacelabs 90209 automated blood pressure monitor for 24 h periods on alternative days. The mean 24-h diastolic blood pressure measurement, the mean diastolic blood pressure for daytime and nighttime, the day-night blood pressure difference and the night-day ratio were compared with the occurrence of abruptio placentae, gestational age at delivery, neonatal intensive care unit admission, birth weight, abnormal umbilical artery Doppler FVW and reason for delivery. One hundred and seventy-six 24-h studies were analyzed. Theday-night blood pressure difference decreased with increasing mean diastolic blood pressure (r = -0.323, p less than 0.0001). A combination of normal mean diastolic blood pressure and normal day-night blood pressure difference was associated with increased gestational age and lower caesarean section rates. The combination of mean diastolic blood pressure and day-night blood pressure difference may be a supplementary measurement of disease severity in early onset severe pre-eclampsia and seems to be of prognostic value. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | ECLAMPSIA | BLOOD PRESSURE | PREGNANCY COMPLICATIONS | EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Diseases | Hemic System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 327006 |
12.  Title: Changes in blood pressure, BMI and ECG patterns in women using low-dose contraceptives. Author: Syed S; Rahim M; Javed M; Qureshi MA Source: Journal of the College of Physicians and Surgeons, Pakistan. 2008 Jan;18(1):31-36. Abstract: The objective was to determine the cardiovascular risk factors in users of second generation contraceptives by recording changes in body mass index, blood pressure and electrocardiogram. The design of the study was cross-sectional study. The setting for the study was The National Institute of Fertility Research Centers at Jinnah Postgraduate Medical Center and PIB Maternity Home Karachi, from July 1997 to 1999. Sixty four women volunteered for this study (age range 20-35 years), belonging to low-income group with similar socio-cultural background. The Body Mass Index (BMI) was calculated by measuring height and weight of the subjects; systolic and diastolic blood pressure and ECG recording by standard method. The group means, standard deviations and coefficient correlation for interrelationship among variables in respective groups of subjects were calculated using relevant statistical method and software program. There was no significant difference between BMI of two types of contraceptive users as compared to non users; but BMI was significantly correlated with both systolic and diastolic blood pressures in injectable users as compared to controls. ECG alterations frequently observed in contraceptive users (40%) as compared to controls were normal findings. It was observed that women aged less than 30 years and using contraceptives for more than three years had a tendency to gain weight and developed a mild increase in systolic and diastolic blood pressures. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | ORAL CONTRACEPTIVES, LOW-DOSE | INJECTABLES | CARDIOVASCULAR EFFECTS | BODY WEIGHT | BLOOD PRESSURE | Developing Countries | Asia, Southern | Asia | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Hemic System Document Number: 324371 |
| 13. Peer Reviewed Title: Three new oral contraceptives. Source: Obstetrics and Gynecology. 2007 Jan 1;109(1):193-195. Abstract: Three new combination oral contraceptives (COCs) with shortened hormone-free intervals, Seasonique, Loestrin 24 Fe and Yaz, have recently been approved by the FDA. All 3 are derivatives of older products. Theoretically, shortened hormone-free intervals would reduce hormone withdrawal symptoms, particularly withdrawal bleeding, and decrease the risk of ovulation and pregnancy. One study found that contraceptive regimens with shorter hormone-free intervals suppressed ovarian hormone production more effectively than those with the traditional 7-day interval. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | PROGRESS REPORT | CLINICAL RESEARCH | CLINICAL TRIALS | WOMEN | ORAL CONTRACEPTIVES, COMBINED | PRODUCT APPROVAL | USFDA | ADMINISTRATION AND DOSAGE | MENSTRUATION DISORDERS | ORAL CONTRACEPTIVES, SIDE EFFECTS | BLOOD PRESSURE | DYSMENORRHEA | North America | Americas | Developed Countries | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Legislation | Political Factors | Sociocultural Factors | USPHS | Government Agencies | Organizations | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Contraceptive Safety | Safety | Public Health | Hemic System | Physiology | Biology Document Number: 310757 |
| 14. Title: The impact of hormonal contraceptives on blood pressure, urinary albumin excretion and glomerular filtration rate. Author: Atthobari J; Gansevoort RT; Visser ST; de Jong PE; de Jog-van den Berg LT Source: British Journal of Clinical Pharmacology. 2007 Feb;63(2):224-231. Abstract: In short-term studies, hormonal contraceptives (HC) have been suggested to induce a rise in blood pressure (BP) and urinary albumin excretion (UAE), while the effect of HC in renal function (GFR) is still under debate. Data on long-term and withdrawal effects of HC use on these outcomes are, however, not available. We therefore studied whether the start and cessation of HC induce changes in BP, UAE and GFR. We used data from the PREVEND Study, a prospective cohort of subjects aged 28-75 years. Eligible were women aged = 45 years with complete clinical and pharmacy data on baseline and follow-up screening (4 years later). Multivariate regression analysis was used to estimate the effects of HC on BP, UAE and GFR in those who started (n = 73), stopped (n = 117) or continued (n = 183) with those who never used HC (n = 286) as the reference group. BP increased among starters and fell in stoppers. These changes compared with never-users were statistically significant, even after adjustment for relevant variables. UAE increased by 14.2% in starters (P = 0.074) and fell by 10.6% in stoppers (P = 0.021), while GFR fell by 6.3% in starters ( P < 0.001) and did not change in stoppers. The effects of stopping HC on UAE and GFR were significantly different compared with changes among never-users, even after adjustment for other variables (P = 0.023 and 0.036, respectively). The start of HC was independently associated with worsening of BP, UAE and GFR, while stopping HC use resulted in an improvement. These data suggest that long-term HC use (aged 28-45 years) may be deleterious from the cardiovascular and renal point of view, but stopping may result in correction of these effects. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | COHORT ANALYSIS | WOMEN | CONTRACEPTION | HORMONES | IMPACT | BLOOD PRESSURE | RENAL EFFECTS | CARDIOVASCULAR EFFECTS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Family Planning | Endocrine System | Physiology | Biology | Communication | Hemic System | Urogenital Effects | Urogenital System Document Number: 314443 |
| 15. Title: Morbidity and mortality associated with pre-eclampsia at two tertiary care hospitals in Sri Lanka. Author: Dissanayake VH; Samarasinghe HD; Morgan L; Jayasekara RW; Seneviratne HR Source: Journal of Obstetrics and Gynaecology Research. 2007 Feb;33(1):56-62. Abstract: The aim was to report the occurrence of morbidity and mortality associated with carefully phenotyped pre-eclampsia in a sample of nulliparous Sinhalese women with strictly defined disease. A phenotyping database of 180 nulliparous women with pre-eclampsia and 180 nulliparous normotensive pregnant women who were recruited for a study into genetics of pre-eclampsia was analyzed. Women who developed pre-eclampsia had significantly higher systolic blood pressure (SBP; P = 0.002) and diastolic blood pressure (DBP; P = 0.002) at booking (at approximately 13 weeks of gestation). 38.3%, 28.3% and 33.3% of women delivered at < 34 weeks, at 34--36 weeks, and at term, respectively. 78% required a cesarean section. Complications included SBP = 160 mmHg (75.5%); DBP = 110 mmHg (83.8%); proteinuria = 3 + (150 mg/dL) in the urine protein heat coagulation test (87%); renal failure requiring dialysis (2%); platelet counts < 100 x 10/9/L (13%); = 70 U/L in aspartate and/or alanine aminotransaminase (15%); placentalabruption (4%); eclampsia (9%); and one maternal death. Maternal complications indicative of severe disease, apart from the incidence of SBP = 160 mmHg and DBP = 110 mmHg, were not significantly different in early and late-onset pre-eclampsia; fetal outcome was better with late-onset disease. 48% of babies were small for gestational age. Only 80 of 135 babies of women with pre-eclampsia whose condition could be confirmed at 6 weeks post-partum were alive. Pre-eclampsia in Sinhalese women is associated with severe maternal morbidity and fetal morbidity and mortality, suggesting that modification of the Western diagnostic criteria and/or guidelines for medical care may be necessary. There is an urgent need to improve neonatal intensive care services in Sri Lanka. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | HOSPITALS | MORTALITY | NULLIPARITY | GESTATIONAL AGE | PREECLAMPSIA | TREATMENT | BLOOD PRESSURE | MORBIDITY | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Facilities | Delivery of Health Care | Health | Population Dynamics | Parity | Fertility Measurements | Fertility | Fetus | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Medical Procedures | Medicine | Health Services | Hemic System | Physiology | Biology Document Number: 314471 |
| 16. Peer Reviewed Title: The oral contraceptive containing 30 micrograms of ethinylestradiol plus 3 mg of drospirenone is able to antagonize the increase of extracellular water occurring in healthy young women during the luteal phase of the menstrual cycle: an observational study. Author: Fruzzetti F; Lello S; Lazzarini V; Fratta S; Orru M Source: Contraception. 2007 Mar;75(3):199-203. Abstract: This nonrandomized study aimed to evaluate body weight and composition during the menstrual cycle and during oral contraception with 30 µg of ethinylestradiol plus 3 mg of drospirenone (EE+DRSP). Multifrequency bioelectrical impedance analysis was carried out in 38 normally cycling women (mean age, 25.5 years) at baseline during the follicular phase (FP) and the luteal phase (LP) of the menstrual cycle and after three and six cycles of EE+DRSP to evaluate total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass and fat-free mass. Body weight, waist-to-hip ratio, blood pressure and the plasma concentrations of electrolytes were also determined at each visit. TBW and ECW increased in the LP. During EE+DRSP, TBW and ECW were significantly lower than in the LP but similar to the values measured in the FP. No significant variations in ICW or in the other parameters were observed. EE+DRSP maintains the same concentrations in TBW and ECW observed in the FP. This effect is likely due to the antimineralocorticoid activity of DRSP, which counteracts the water retention elicited by estrogen. (author's) Language: English Keywords: ITALY | RESEARCH REPORT | WOMEN | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | BODY WEIGHT | WATER | BLOOD PRESSURE | EVALUATION | Developed Countries | Europe, Southern | Europe | Demographic Factors | Population | Menstruation | Reproduction | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Natural Resources | Environment | Hemic System Document Number: 313011 |
| 17. Peer Reviewed Title: Monthly injectable contraceptive use by adolescents in Brazil: Evaluation of clinical aspects. Author: Guazzelli CA; Jacobucci MS; Barbieri M; Araujo FF; Moron AF Source: Contraception. 2007 Jul;76(1):45-48. Abstract: This prospective noncomparative observational study evaluated the clinical symptoms, body weight and blood pressure of 38 adolescents receiving a monthly injectable contraceptive containing estradiol valerate 5 mg and norethisterone 50 mg. The volunteers, aged 16-19 years, were examined monthly during 1 year and asked about the following symptoms at baseline: dysmenorrhea, headache, breast tenderness, leg pain and irritability. There was a constant and gradual decline in each of the above symptoms over time, and there was a statistically significant difference between symptoms reported at the first visit and subsequent appointments. Body weight and blood pressure did not change significantly during the 1-year period. No pregnancies were observed. These findings suggest that monthly injectable contraception with estradiol valerate 5 mg/norethisterone 50 mg represents a highly effective and well-tolerated contraceptive for teens. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | PROSPECTIVE STUDIES | ADOLESCENTS, FEMALE | PREMENSTRUAL TENSION | EXAMINATIONS AND DIAGNOSES | INJECTABLES | ESTRADIOL | NORETHINDRONE | ADMINISTRATION AND DOSAGE | BODY WEIGHT | BLOOD PRESSURE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Menstruation Disorders | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Estrogens | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Hemic System Document Number: 317957 |
| 18. Title: Elevated serum levels of interleukin-15 and interleukin-16 in preeclampsia. Author: Hu W; Wang H; Wang Z; Huang H; Dong M Source: Journal of Reproductive Immunology. 2007 Apr;73(2):166-171. Abstract: A generalized inflammatory response has been considered to be the main pathology and has an important role in the pathogenesis of preeclampsia. The immune aberrations per se and immunomodulatory milieu present in serum need to be elucidated. The purpose of the current investigation was to characterize changes in serum levels of interleukin (IL)-15 and IL-16 in preeclampsia. Thirty-seven women with preeclampsia were recruited and 36 age- and gestational age-matched women with normal pregnancy served as control. Levels of IL-15 and IL-16 were detected with immune assays in all serum samples. We found that serum levels of IL-15 and IL-16 were significantly higher in preeclampsia than in normal pregnancy (p < 0.001 for both). There were significant differences in serum IL-15 and IL-16 between mild and severe preeclampsia (p < 0.01 for both). Our data corroborate the hypothesis of an increased inflammatory response in preeclampsia, as illustrated by the elevated serum levels of IL-15 and IL-16, suggesting their possible role in the pathogenesis of preeclampsia. These associations may offer insight into the pathophysiology of preeclampsia. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | CONTROL GROUPS | PREGNANT WOMEN | PREECLAMPSIA | PROTEINS | IMMUNOLOGICAL EFFECTS | BLOOD PRESSURE | LABORATORY PROCEDURES | Developing Countries | Asia, Eastern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Physiology | Biology | Immunity | Immune System | Hemic System | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 317924 |
| 19. Title: Effect of oxytocics on the blood pressure of normotensive Nigerian parturients. Author: Jago AA; Ezechi OC; Achinge GI; Okunlola MA Source: Journal of Maternal-Fetal and Neonatal Medicine. 2007 Sep;20(9):703-705. Abstract: The single most common direct obstetric disorder accounting for 25% of all maternal deaths globally is severe hemorrhage, generally occurring postpartum. Nearly all these deaths occur in the developing world. The role of oxytocic drugs in the management of the third stage of labor as a strategy to reduce maternal mortality has been emphasized. However, the adverse effects of these oxytocic agents, in particular ergometrine, have not been properly evaluated in our environment. The objectives were to evaluate the effect of ergometrine and oxytocin on the cardiovascular system when used for active management of the third stage of labor. A double-blind, randomized controlled study was carried out at the Federal Medical Centre, Makurdi over 24 months. Five hundred and ten patients were randomized to treatment with either 0.5 mg of intramuscular ergometrine or 10 I of intravenous oxytocin, respectively, as single injections. Their effects on the cardiovascular system were observed using blood pressure as a marker. Ergometrine unlike oxytocin was observed to cause a significant rise in blood pressure, and this effect was most marked in the first 24 hours of the puerperium. These results suggest that ergometrine may be safe in normotensive parturients but hazardous in hypertensive parturients in whom oxytocin would be a safer option. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | DOUBLE-BLIND STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | OXYTOCIN | BLOOD PRESSURE | BLEEDING | CHILDBIRTH | PREGNANCY COMPLICATIONS | ERGOT ALKALOIDS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Pituitary Hormones | Hormones | Endocrine System | Physiology | Biology | Hemic System | Signs and Symptoms | Diseases | Pregnancy Outcomes | Pregnancy | Reproduction | Alkaloids | Organic Chemicals | Ingredients and Chemicals Document Number: 319653 |
| 20. Title: Morbidity and mortality associated with pre-eclampsia at two tertiary care hospitals in Sri Lanka [letter] Author: Marasinghe JP; Amarasinghe AA Source: Journal of Obstetrics and Gynaecology Research. 2007 Dec;33(6):888. Abstract: The exercise by Dissanayake et al. made an interesting read. Their conclusion that pre-eclampsia in Sinhalese women is associated with increased maternal morbidity, and fetal morbidity and mortality is an eye opener to the local health-care providers, policy makers and program managers. It also invites further studies on blood pressure variation during pregnancy in Sinhalese women and the postulation of a different cut-off level for diagnosing elevated blood pressure in pregnancy. It may be prudent to educate local obstetricians and other care providers of pregnant women of the detrimental effects of delaying intervention until blood pressure reaches 140/90 mmHg, and the likelihood of developing more severe disease by the time the blood pressure reaches the cut-off level, which seems to be more suitable for Caucasian women. The study re-evaluates the importance of pre-pregnancy counseling and assessment, including blood pressure in fertile women, in assessing the rise in blood pressure. As the authors correctly suggest, there is an urgent need to invest in specialized maternal care services managing women with pre-eclampsia and neonatal intensive care services in Sri Lanka. In the meantime, there are a few drawbacks to the study which need to be considered. The two hospitals utilized to recruit the study samples were teaching hospitals in metropolitan Colombo. These institutions represented only a prescreened and referred group of women from local hospitals and antenatal clinics. So, the applicability of the results generated to a larger population is questionable. There may be a type II error accounting for the statistically non-significant result obtained with the booking blood pressures of early onset and late onset groups of pre-eclampsia. This is in contrast to our day-to-day experience in which we often see fluctuating blood pressure values with on-and-off higher readings in early onset preeclamptic patients. The value of uterine artery Doppler in detecting such a subtle change may need to be considered with its reasonable sensitivity, specificity, rapidity and non-invasiveness in detecting pregnancies destined to develop pre-eclampsia. Though Sri Lanka is not yet ready to supplement all pregnant mothers with a Doppler analysis, the future is promising. Moreover it is well-known that blood pressure is poorly measured in clinical practice, with digit preference (rounding the final digit of blood pressure to 0). We failed to find a note on this regard in the study. The study does however add some valuable tips to our existing knowledge on gestational hypertension in Sri Lankan women. It opens the door for further studies to generate a novel diagnostic criterion for preeclampsia for Sri Lankan women. (full text) Language: English Keywords: SRI LANKA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREECLAMPSIA | PREGNANCY COMPLICATIONS | FETAL DEATH | BLOOD PRESSURE | MONITORING | ULTRASONICS | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Mortality | Population Dynamics | Hemic System | Physiology | Biology | Evaluation | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 322697 |
| 21. Title: Blood pressure and kidney size in term newborns with intrauterine growth restriction. Author: Matsuoka OT; Shibao S; Leone CR Source: Sao Paulo Medical Journal. 2007 Mar;125(2):85-90. Abstract: Low birth weight is associated with higher blood pressure in childhood and adulthood. The aim of this study was to investigate the influence of intrauterine growth restriction (IUGR) on newborn systolic blood pressure (SBP). The prospective comparative study took place at the Neonatal and Intensive in Clinical Pediatrics Division, Maternity Hospital in Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. 35 newborns with IUGR and 35 without IUGR were compared. Healthy term newborns without malformations, with Apgar score at fifth minute > 6 were included. Birth weight, kidney weight/birth weight ratio, kidney weight (ultrasound scan), plasma renin activity (PRA) and SBP evolution were analyzed during the first month of life (on 1st, 3rd, 7th and 30th days). SBP evolution, kidney weight/birth weight ratio and PRA did not differ between the two groups. In newborns with IUGR, SBP presented positive correlations with birth weight (r = 0.387 p = 0.026) and BMI (r = 0.412 p = 0.017) on the 7th day of life. Positive correlations with birth weight (r = 0.440 p = 0.01) and birth length (r = 0.386 p = 0.026) were also seen on the 30th day. There was an inverse correlation on the 7th day between SBP and kidney weight/ birth weight ratio (r = -0.420 p = 0.014), but this did not persist to the end of the month. IUGR seems not to have any influence on SBP, PRA or kidney weight among term newborns during their first month of life. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | PROSPECTIVE STUDIES | CLINICAL RESEARCH | CASE CONTROL STUDIES | INFANT | BLOOD PRESSURE | RENAL EFFECTS | INTRAUTERINE GROWTH RETARDATION | LOW BIRTH WEIGHT | ANTHROPOMETRY | BIRTH WEIGHT | ULTRASONICS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Hemic System | Physiology | Biology | Urogenital Effects | Urogenital System | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Body Weight | Measurement | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 319768 |
| 22. Title: Epidural anaesthesia during labour for a patient with congenital complete heart block: A Case Report. Author: Monem A; Chohan U; Ali M Source: JPMA. Journal of the Pakistan Medical Association. 2007 Nov;57(11) Abstract: We report labour pain management in a full term pregnant patient with Congenital Complete Heart Block. She delivered uneventfully under routine monitoring with facilities for pacing at hand. She previously had an uneventful normal delivery and a D&E, both outside our hospital. Only findings were a low heart rate of 45-50 beats per minute. She never had syncopal attacks. She had a good effort tolerance on ETT. Her ejection fraction was 60% on Echocardiogram. She was given a single shot low dose spinal with fentanyl followed by epidural insertion. She successfully delivered through mid-cavity forceps in about 2.5 hours. The only problem encountered was a transient bradycardia of 40 per minute with a systolic blood pressure of 70 mmHg, which settled with ephedrine. Pace maker insertion is recommended early in case the patient is symptomatic or has a prolonged Q-T interval or left atrial enlargement on ECG. Regional anaesthesia is recommended to prevent valsalva induced bradycardia or cardiac arrest during expulsive efforts by the patient. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | PREGNANT WOMEN | CONGENITAL ABNORMALITIES | HEART DISEASES | CHILDBIRTH | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | ANESTHESIA | BLOOD PRESSURE | FORCEPS | Developing Countries | Asia, Southern | Asia | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Pregnancy Outcomes | Pregnancy | Reproduction | Signs and Symptoms | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hemic System | Physiology | Biology | Surgical Equipment | Equipment and Supplies Document Number: 321969 |
| 23. Title: Iatrogenic Cushing's syndrome in a adolescent with AIDS on ritonavir and inhaled fluticasone [letter] Author: Pessanha TM; Campos JM; Barros AC; Pone MV; Garrido JR Source: AIDS. 2007 Feb 19;21(4):529-532. Abstract: The authors describe an adolescent with AIDS receiving ritonavir and inhaled fluticasone who developed Cushing's syndrome, and review similar cases described in the literature. The patient was a female adolescent, 16 years of age, with AIDS grade C3 classified by the Centers for Disease Control and Prevention, vertically transmitted, followed at the Pediatric Infectious Diseases Department since 1994. Her previous medical history was characterized by interstitial lymphocytic pneumonia, repeated pneumonias, chronic otitis media and bronchospasm. She has been on antiretroviral therapy since July 1996 with zidovudine and didanosine, being switched to zidovudine and estavudine after one year. She had been treated with stavudine, lamivudine and ritonavir since October 1998. (excerpt) Language: English Keywords: BRAZIL | LITERATURE REVIEW | RESEARCH REPORT | CASE STUDIES | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | PERSONS LIVING WITH HIV/AIDS | BLOOD PRESSURE | ANTIRETROVIRAL THERAPY | AIDS | COMPLICATIONS | PITUITARY HORMONES | SIDE EFFECTS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Hemic System | Physiology | Biology | HIV | Hormones | Endocrine System | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 312195 |
| 24. Title: Comparison of antiphospholipid antibodies in hypertensive with normotensive pregnant women. Author: Salehi R; Asl AA; Alizadeh M; Sayyahmelli M; Azarfarin R Source: JPMA. Journal of the Pakistan Medical Association. 2007 Jul-Dec;32(2):1-6. Abstract: The aim of this study was to assess the association between the occurrence of hypertension (HTN) in pregnancy and antiphospholipid antibodies. We conducted a cross-sectional study of 100 pregnant women with their first pregnancy induced HTN and no history of thrombosis, renal disease or systemic autoimmune diseases. HTN was defined as blood pressure (BP) of 140/90 mmHg or higher on two measurements with 6 hours apart. Control group comprised of pregnant women without hypertension or proteinuria and without history of thrombosis or systemic autoimmune disease. Antiphospholipid Antibodies (Antiphospholipid IgG and IgM and anticardiolipin IgG and IgM) levels were measured in both groups. There were significantly higher titer of Antiphospholipid IgG and anticardiolipin IgG and IgM in case group (p<0.05). Antiphospholipid IgM had no difference between two groups (p=0.14). There were moderate but statistically significant correlation between blood pressure and parity (r=0.3; p=0.0001), gestational age and antiphospholipid IgM antibody level (r=0.3; p=0.02), and between gestational age and anticardiolipin IgM antibody level (r=0.28; p=0.002). We found elevated levels of IgG and IgM anticardiolipin and IgG antiphospholipid antibodies in pregnancy induced HTN, but level of antiphospholipid IgM antibody was not different in hypertensive and normotensive women. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | HYPERTENSION | BLOOD PRESSURE | PARITY | GESTATIONAL AGE | AUTOIMMUNE RESPONSE | ANTIBODIES | Developing Countries | Middle East | Research Methodology | Population Characteristics | Demographic Factors | Population | Vascular Diseases | Diseases | Hemic System | Physiology | Biology | Fertility Measurements | Fertility | Population Dynamics | Fetus | Pregnancy | Reproduction | Immunologic Factors | Immunity | Immune System Document Number: 323596 |
| 25. Peer Reviewed Title: The effect of small dose bupivacaine-fentanyl in spinal anesthesia on hemodynamic nausea and vomiting in cesarean section. Author: Seyedhejazi M; Madarek E Source: Pakistan Journal of Medical Sciences. 2007 Oct-Dec;23(5):747-750. Abstract: The objective was to compare the hemodynamic, nausea and vomiting with small dose bupivacaine-fentanyl spinal anesthetic versus a conventional dose of spinal bupivacaine in parturients undergoing cesarean section. Forty patients aged 17-35 years old which underwent cesarean section were randomized into two groups. Group-A received spinal anesthesia with 8mg of bupivacaine and 10microg fentanyl, group B received 12mg bupivacaine. The mean dose of ephedrine needed was 4mg in group A and 11.75mg in group B (P=0.006). The mean ratio of lowest systolic pressure to baseline systolic pressure was 0.75 for group A and 0.65 for group B (P=0.04). Nausea and vomiting was observed in 10% of group A versus 20% in group B. Small dose of bupivacaine and Fentanyl provides good spinal anesthesia for cesarean section with less hypotension, nausea and vomiting. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | ADMINISTRATION AND DOSAGE | ANESTHESIA | CENTRAL NERVOUS SYSTEM EFFECTS | CESAREAN SECTION | DRUGS | NAUSEA | VOMITING | BLOOD PRESSURE | HYPOTENSION | Developing Countries | Middle East | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Central Nervous System | Physiology | Biology | Obstetrical Surgery | Surgery | Signs and Symptoms | Diseases | Hemic System | Vascular Diseases Document Number: 323565 |
| 26. Title: Total salpingectomy during abdominal hysterectomy: Effects on ovarian reserve and ovarian stromal blood flow. Author: Sezik M; Ozkaya O; Demir F; Sezik HT; Kaya H Source: Journal of Obstetrics and Gynaecology Research. 2007 Dec;33(6):863-869. Abstract: The aim was to investigate the short- and medium-term consequences of performing total salpingectomy during abdominal hysterectomy (without oophorectomy) on certain ovarian reserve parameters and blood flow velocity measurements through the ovarian stroma. Twenty-four patients were recruited and randomized into two groups. Group 1 patients (n = 12) underwent total hysterectomy and complete excision of the fallopian tubes bilaterally. In group 2 (classical approach), fallopian tubes were removed partially leaving behind the neighboring paraovarian tissue. Pre- and postoperative (at 1 and 6 months) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol values, ovarian volume estimation by transvaginal ultrasound, and ovarian stromal blood flow Doppler velocimetry were assessed during the early follicular phase. Mann-Whitney U-test, Student's t-test and Freidman's test were used for comparisons. Baseline data were similar across the groups (P > 0.05). Mean FSH, LH, estradiol values, and ovarian volume were unchanged after both of the techniques. However, mean pulsatility index, resistance index, and systole/diastole (S/D) ratio were significantly decreased in both groups compared to baseline values (group 1, P = 0.027, P = 0.018, and P = 0.013, respectively; group 2, P = 0.01, P = 0.002, and P = 0.0001, respectively). Postoperative decline in the mean pulsatility index was more pronounced (P = 0.02) in group 2 (partial removal). It appears that complete removal of fallopian tubes during hysterectomy has no advantageous effect on ovarian blood supply. It might be important to protect the ovarian blood supply as much as possible while performing hysterectomy in the reproductive period. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | HYSTERECTOMY | OVARIAN EFFECTS | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | ESTRADIOL | ULTRASONICS | BLOOD PRESSURE | TUBAL EXCISION | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Estrogens | Hemic System | Tubal Occlusion | Female Sterilization | Sterilization, Sexual | Family Planning Document Number: 322693 |
| 27. Peer Reviewed Title: Abortion and clostridial toxic shock syndrome. Author: Soper DE Source: Obstetrics and Gynecology. 2007 Nov;110(5):970-971. Abstract: More than 600,000 women in the United States have undergone mifepristone-misoprostol abortion since the U.S. Food and Drug Administration approved mifepristone (Mifeprex, Danco Laboratories, New York, NY) for use on September 28, 2000. Nearly 2 million women in Europe have used mifepristone. The frequency of diagnosed or treated infection after medical abortion is very low (0.92%, N = 46,421), and there is little difference in the frequency of infection among the regimens reviewed. In 2005, the Centers for Disease Control and Prevention published a case series of four deaths due to the toxic shock syndrome associated with Clostridium sordellii after medical abortion. To better understand this risk, Cohen et al continued to investigate toxic shock in women who had a recent abortion. They performed both active and passive surveillance for cases of toxic shock associated with medical or spontaneous abortion. They considered the cause of such cases by extracting DNA from the available pelvic tissues and performing Clostridium species-specific polymerase chain reaction assays and sequenced amplified products for confirmation of a Clostridium species. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PREGNANT WOMEN | TOXIC SHOCK SYNDROME | ABORTION | RU-486 | MISOPROSTOL | CYTOCHEMICAL EFFECTS | POSTABORTION | BLOOD PRESSURE | BACTERIAL AND FUNGAL DISEASES | REPRODUCTIVE TRACT INFECTIONS | Developed Countries | North America | Americas | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins, Synthetic | Prostaglandins | Cytologic Effects | Reproduction | Hemic System Document Number: 321981 Notification |
| 28. Title: Effect of a new oral contraceptive with drospirenone on vital signs, complete blood count, glucose, electrolytes, renal, and liver function. Author: Taneepanichskul S; Jaisamrarn U; Phupong V Source: Journal of the Medical Association of Thailand. 2007 Mar;90(3):426-431. Abstract: The objective was to evaluate the effect of a new oral contraception formulation with drospirenone (Yasmin) on vital signs, complete blood count, glucose, electrolytes, and renal and liver function. An open-label non-comparative clinical trial was conducted. One hundred women who were planning to use oral contraception for at least six months were recruited. The subjects received a blister pack which contained 21 tablets of 3 mg drospirenone/30 µg ethinyl estradiol for the first four cycles (1 cycle = 28 days). Cycle 5 and 6 blister packs were dispensed during the visit in cycle 4. Heart rate and blood pressure of each subject were checked at baseline and each visit. Serum from each subject was collected and sent for complete blood count, glucose, electrolytes, and renal and liver function tests at baseline and at cycle 6. Mean differences in these tests at cycle 6 compared to baseline were assessed. Ninety-two of the 100 subjects (92%) completed the present study. There was no significant change in heart rate, blood pressure, complete blood count, glucose, electrolytes, and renal and liver function tests at cycle 6 when compared to baseline. Oral contraception formulation with drospirenone (Yasmin) is well tolerated and has good contraceptive efficacy. It is safe, as it has no effect on heart rate, blood pressure, complete blood count, glucose, electrolytes, and renal and liver function. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | CARDIOVASCULAR EFFECTS | BLOOD PRESSURE | GLUCOSE METABOLISM EFFECTS | HEPATIC EFFECTS | RENAL EFFECTS | Developing Countries | Asia, Southeastern | Asia | Clinical Research | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Hemic System | Carbohydrate Metabolic Effects | Metabolic Effects | Urogenital Effects | Urogenital System Document Number: 313208 |
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