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Sample records for hypotensive newborn pigs

  1. Escherichia coli challenge in newborn pigs.

    Science.gov (United States)

    Jensen, M L; Cilieborg, M S; Østergaard, M V; Bering, S B; Jørgensen, C B; Sangild, P T

    2012-12-01

    Escherichia coli F18 is a common porcine enteric pathogen causing diarrhea and edema in weaned pigs. An essential step in the pathogenesis of this enteric colibacillosis is a fimbria-receptor interaction in the small intestine, involving the α(1,2)-fucosyltransferase gene (FUT1) enzyme for bacterial receptor binding to the epithelium. Enzyme expression is genetically determined and increases after weaning at 3 to5 wk, probably due to age- and/or diet-related intestinal maturation. We hypothesized that artificially reared piglets, deprived of sow's milk from birth, show susceptibility to F18 already in the neonatal period. First we verified the intestinal expression of FUT1 in preterm, term, and weaned pigs by quantitative real-time polymerase chain reaction. Then age-related F18 susceptibility (degree of diarrhea) was evaluated in 3-, 10-, and 20-d-old pigs after inoculation of 10(10) cfu E. coli F18 per day for 12 d. Finally, F18 susceptibility was evaluated in caesarean-delivered 0- to 7-d-old piglets inoculated daily with F18 as above. For all pigs, their sows were genotyped to ensure expression of the FUT1 enzyme. FUT1 expression was detected in the proximal and distal small intestine with no apparent differences in levels among preterm, term, and weaned pigs. No consistent F18-induced diarrhea was detected in any of the 3 groups of 3- to 20-d-old pigs. In contrast, 0- to 7-d-old caesarean-delivered pigs showed a higher score of diarrhea in pigs inoculated with F18 compared with controls (2.4 ± 0.1 vs. 1.8 ± 0.1 respectively; P sow milk are highly susceptible to diarrhea induced by E. coli F18. Lack of the protective effects of birth colonization and sow milk may contribute to high intestinal F18 sensitivity. The newborn pig may be a useful model to investigate factors in maternal milk that protect against F18 diarrhea.

  2. Transvenous retrograde nidus sclerotherapy under controlled hypotension (TRENSH): hemodynamic analysis and concept validation in a pig arteriovenous malformation model.

    Science.gov (United States)

    Massoud, Tarik F

    2013-08-01

    Transvenous retrograde nidus sclerotherapy under controlled hypotension (TRENSH) is a proposed novel concept for endovascular treatment of cerebral arteriovenous malformations (AVMs). To assess the experimental hemodynamic feasibility of TRENSH in a pig AVM model. We surgically constructed carotid-jugular fistula-type AVM models in 8 pigs. In 5 pigs (group 1) we hemodynamically assessed the AVM through the main arterial feeder (AF) and draining vein (DV) at systemic normotension (Syst(norm)). We then performed retrograde nidus angiography through the DV at progressively deeper levels of hemorrhagic systemic hypotension (Syst(hypo)), and graded and correlated these angiograms with the degree of Syst(hypo). In another 3 pigs (group 2) we correlated the effects of temporary balloon occlusion of the main AF with the angiographic extent of retrograde nidus filling. In group 1 pigs, the drop in AF pressure correlated strongly (r(2) = 0.93-0.99) with the drop in DV pressure at progressively deeper Syst(hypo). Minimal retrograde nidus filling occurred at Syst(norm). We observed progressively greater extents of retrograde nidus filling as the transnidal pressure gradients fell with deeper Syst(hypo). Near-complete retrograde permeation of the nidus was possible as the transnidal gradients approached 0 mm Hg. As more of the nidus filled, its concurrent emptying was documented through a greater number of DVs. Temporary AF occlusion resulted in improved retrograde nidus filling in all group 2 pigs. Endovascular TRENSH appears feasible in a pig AVM model. Further experimental investigations of TRENSH are necessary to assess its full potential before future clinical applications.

  3. Dopamine therapy does not affect cerebral autoregulation during hypotension in newborn piglets

    DEFF Research Database (Denmark)

    Eriksen, Vibeke Ramsgaard; Rasmussen, Martin Bo; Hahn, Gitte Holst

    2017-01-01

    BACKGROUND: Hypotensive neonates who have been treated with dopamine have poorer neurodevelopmental outcome than those who have not been treated with dopamine. We speculate that dopamine stimulates adrenoceptors on cerebral arteries causing cerebral vasoconstriction. This vasoconstriction might...... lead to a rightward shift of the cerebral autoregulatory curve; consequently, infants treated with dopamine would have a higher risk of low cerebral blood flow at a blood pressure that is otherwise considered "safe". METHODS: In anaesthetized piglets, perfusion of the brain, monitored with laser......-doppler flowmetry, and cerebral venous saturation was measured at different levels of hypotension. Each piglet was studied in two phases: a phase with stepwise decreases in MAP and a phase with stepwise increases in MAP. We randomized the order of the two phases, whether dopamine was given in the first or second...

  4. Citric Acid Cycle Metabolites Predict the Severity of Myocardial Stunning and Mortality in Newborn Pigs

    DEFF Research Database (Denmark)

    Hyldebrandt, Janus Adler; Støttrup, Nicolaj Brejnholt; Frederiksen, Christian Alcaraz

    2016-01-01

    the presence of myocardial stunning and predicts mortality in acute noninfarct right ventricular heart failure in newborn pigs. This phenomenon occurs independently of the type of inotrope, suggesting that citric acid cycle intermediates represent potential markers of acute noninfarct heart failure.......OBJECTIVES: Myocardial infarction and chronic heart failure induce specific metabolic changes in the neonatal myocardium that are closely correlated to outcome. The aim of this study was to examine the metabolic responses to noninfarct heart failure and inotropic treatments in the newborn heart......, which so far are undetermined. DESIGN: A total of 28 newborn pigs were instrumented with a microdialysis catheter in the right ventricle, and intercellular citric acid cycle intermediates and adenosine metabolite concentrations were determined at 20-minute intervals. Stunning was induced by 10 cycles...

  5. Management of hypotension in preterm infants (The HIP Trial): a randomised controlled trial of hypotension management in extremely low gestational age newborns.

    Science.gov (United States)

    Dempsey, E M; Barrington, K J; Marlow, N; O'Donnell, C P; Miletin, J; Naulaers, G; Cheung, P-Y; Corcoran, D; Pons, G; Stranak, Z; Van Laere, D

    2014-01-01

    Extremely preterm babies (delivered at hypotension and treated with inotropic and pressor drugs in the immediate postnatal period. Dopamine is the most commonly used first-line drug. Babies who are treated for hypotension more frequently sustain brain injury, have long-term disability or die compared to those who are not. Despite the widespread use of drugs to treat hypotension in such infants, evidence for efficacy is lacking, and the effect of these agents on long-term outcomes is unknown. In extremely preterm babies, restricting the use of dopamine when mean blood pressure (BP) values fall below a nominal threshold and using clinical criteria to determine escalation of support ('restricted' approach) will result in improved neonatal and longer-term developmental outcomes. RESEARCH PLAN: In an international multi-centre randomised trial, 830 infants born at <28 weeks of gestation, and within 72 h of birth, will be allocated to 1 of 2 alternative treatment options (dopamine vs. restricted approach) to determine the better strategy for the management of BP, using a conventional threshold to commence treatment. The first co-primary outcome of survival without brain injury will be determined at 36 weeks' postmenstrual age and the second co-primary outcome (survival without neurodevelopmental disability) will be assessed at 2 years of age, corrected for prematurity. It is essential that appropriately designed trials be performed to define the most appropriate management strategies for managing low BP in extremely preterm babies.

  6. Neither xenon nor fentanyl induces neuroapoptosis in the newborn pig brain.

    Science.gov (United States)

    Sabir, Hemmen; Bishop, Sarah; Cohen, Nicki; Maes, Elke; Liu, Xun; Dingley, John; Thoresen, Marianne

    2013-08-01

    Some inhalation anesthetics increase apoptotic cell death in the developing brain. Xenon, an inhalation anesthetic, increases neuroprotection when combined with therapeutic hypothermia after hypoxic-ischemic brain injury in newborn animals. The authors, therefore, examined whether there was any neuroapoptotic effect of breathing 50% xenon with continuous fentanyl sedation for 24 h at normothermia or hypothermia on newborn pigs. Twenty-six healthy pigs (inhaled xenon with fentanyl at hypothermia (Trec = 33.5 °C), (2) 24 h of 50% inhaled xenon with fentanyl at normothermia (Trec = 38.5 °C), (3) 24 h of fentanyl at normothermia, or (4) nonventilated juvenile controls at normothermia. Five additional nonrandomized pigs inhaled 2% isoflurane at normothermia for 24 h to verify any proapoptotic effect of inhalation anesthetics in our model. Pathological cells were morphologically assessed in cortex, putamen, hippocampus, thalamus, and white matter. To quantify the findings, immunostained cells (caspase-3 and terminal deoxynucleotidyl transferase-mediated deoxyuridine-triphosphate nick-end labeling) were counted in the same brain regions. For groups (1) to (4), the total number of apoptotic cells was less than 5 per brain region, representing normal developmental neuroapoptosis. After immunostaining and cell counting, regression analysis showed that neither 50% xenon with fentanyl nor fentanyl alone increased neuroapoptosis. Isoflurane caused on average a 5- to 10-fold increase of immunostained cells. At normothermia or hypothermia, neither 24 h of inhaled 50% xenon with fentanyl sedation nor fentanyl alone induces neuroapoptosis in the neonatal pig brain. Breathing 2% isoflurane increases neuroapoptosis in neonatal pigs.

  7. The influence of elevated testicular temperature and scrotal surgery on the number of gonocytes in the newborn pig.

    Science.gov (United States)

    Frankenhuis, M T; Wensing, C J; Kremer, J

    1981-02-01

    Morphological changes become apparent shortly after birth in the abdominally located testes of the pig. To test the influence of temperature on gonocyte multiplication, scrotal testes of newborn piglets were subjected to continuous artificial heating. It was found that in the young pig during the first 2 weeks of life when the mitotic activity of the gonocytes is high, they are very sensitive to a combination of elevated testicular temperature and scrotal surgery.

  8. Resolution of refractory hypotension and anuria in a premature newborn with loss-of-function of ACE.

    Science.gov (United States)

    Richer, Julie; Daoud, Hussein; Geier, Pavel; Jarinova, Olga; Carson, Nancy; Feberova, Jana; Ben Fadel, Nadya; Fadfel, Nadya Ben; Unrau, Jennifer; Bareke, Eric; Khatchadourian, Karine; Bulman, Dennis E; Majewski, Jacek; Boycott, Kym M; Dyment, David A

    2015-07-01

    We present the investigation and management of a premature, hypotensive neonate born after a pregnancy complicated by anhydramnios to highlight the impact of early and informed management for rare kidney disease. Vasopressin was used to successfully treat refractory hypotension and anuria in the neonate born at 27 weeks of gestation. Next generation sequencing of a targeted panel of genes was then performed in the neonate and parents. Subsequently, two compound heterozygous deletions leading to frameshift mutations were identified in the angiotensin 1-converting enzyme gene ACE; exon 5:c.820_821delAG (p.Arg274Glyfs*117) and exon24: c.3521delG (p.Gly1174Alafs*12), consistent with a diagnosis of renal tubular dysgenesis. In light of the molecular diagnosis, identification, and treatment of associated low aldosterone level resulted in further improvement in renal function and only mild residual chronic renal failure is present at 14 months of age. Truncating alterations in ACE most often result in fetal demise during gestation or in the first days of life and typically as a result of the Potter sequence. The premature delivery, and serendipitous early treatment with vasopressin, and then later fludrocortisone, resulted in an optimal outcome in an otherwise lethal condition. © 2015 Wiley Periodicals, Inc.

  9. Myelin Sheath Development in the Maxillary Nerve of the Newborn Pig.

    Science.gov (United States)

    Papageorgiou, K V; Grivas, I; Chiotelli, M; Panteris, E; Papaioannou, N; Nauwynck, H; Kritas, S K

    2017-02-01

    Myelination, the ensheathing of neuronal axons by myelin, is important for the proper function of both central and peripheral nervous systems. Various studies have investigated the quantitative parameters of myelination in certain species. Pigs are among the species of which their use as laboratory animals in neuroscience research increased the past few decades. However, there is limited data regarding the myelination process in the pig. Moreover, the maxillary nerve is crucial for Pseudorabies Virus (PrV) neuropathogenesis. In this context, a quantitative analysis of various myelination parameters of the maxillary nerve was performed, during the first 5 weeks of porcine post-natal development, the time period, which exhibits the highest interest for PrV neuropathogenesis. The evaluation was conducted in four groups of uninfected pigs, at the time of birth (group 0w), at the age of 1 week (group 1w), 3 weeks (group 3w) and 5 weeks (group 5w), using toluidine blue staining, immunofluorescence and electron microscopy. Axon and fibre diameter, perimeter and surface, myelin sheath thickness and g-ratio were measured on histological sections transverse to the longitudinal axis of the maxillary nerve. The thickness of myelin sheath was 0.76 μm for group 0w, 0.94 μm for group 1w, 0.98 μm for group 3w and 1.03 μm for group 5w. The g-ratio was 0.529, 0.540, 0.542 and 0.531 for the respective animal groups. The results of this study contribute to the understanding of the myelination process in the pig will be used for the study of PrV effects on the myelination development of newborn piglets' maxillary nerve and may shed new light to their vulnerability to the virus. © 2016 Blackwell Verlag GmbH.

  10. Distribution and fate of /sup 14/C-chloramphenicol in the new-born pig

    Energy Technology Data Exchange (ETDEWEB)

    Appelgren, L.E.; Eberhardson, B.; Martin, K. (Department of Pharmacology, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala); Slanina, P. (Toxicology Laboratory, National Food Administration, Uppsala, Sweden)

    1982-01-01

    The distribution of /sup 14/C-chloramphenicol has been studied in new-born pigs with the aid of whole-body autoradiography. In the lung, liver, adrenal cortex, kidney, myocardium, pancreas, thyroid, spleen and skeletal muscle the amounts of radioactivity were higher than that of the blood short time after injection and remained higher than the blood up to 8 hrs. After 4 and 8 hrs the brain concentration of /sup 14/C was also higher than that of the blood. In the bone marrow, however, the concentration did not reach that of the blood during the whole experiment. In the organs more than 90% of the radioactivity was represented by chloramphenicol; the excretory organs, thyroids, and adrenals being exceptions.

  11. Thoracoscopic interruption of patent ductus arteriosus compromises cardiopulmonary function in newborn pigs.

    Science.gov (United States)

    Sielenkämper, A W; Meyer, J; Loick, H M; Hachenberg, T

    1998-11-01

    Interruption of patent ductus arteriosus (PDA) using video-assisted thoracoscopic surgery (VATS) has recently been introduced into clinical practice. To study cardiovascular and pulmonary function during VATS, we treated 16 newborn pigs (weight 1421+/-44 g) with PDA with conventional surgical interruption (CSI; n = 7) or interruption via VATS (n = 9). Measurements of hemodynamics and gas exchange were performed before, during, and after surgery. Systemic perfusion was calculated using Fick's equation. Stress hormones (ACTH, epinephrine, and norepinephrine) were determined before and after surgery. The duration of the surgical procedure was 41+/-8 min for CSI and 49+/-9 min for VATS (mean+/-SEM). With VATS, PaO2 decreased during and after surgery (P < 0.05), whereas alveolar-arterial PO2 difference (PA-aO2) and PaCO2 were increased (P < 0.05). Compared with CSI after surgery, PaO2 with VATS was decreased (130+/-10 vs 171+/-12 mm Hg; P < 0.05). Systemic perfusion was lower during VATS (76.7% of baseline) than during CSI (107% of baseline; P < 0.05). Heart rate, mean arterial pressure, and right ventricular end-diastolic pressure remained unchanged with both treatments. Stress hormones were comparable between groups. We conclude that systemic perfusion and oxygenation were impaired during VATS compared with CSI. Therefore, VATS may be contraindicated in pediatric patients with minor cardiopulmonary reserve. We studied the cardiopulmonary effects of endoscopic interruption of the patent ductus arteriosus in an animal model of newborn pigs. Gas exchange and systemic perfusion were impaired compared with conventional interruption of the patent ductus arteriosus after thoracotomy.

  12. Iron dextran treatment does not induce serum protein carbonyls in the newborn pig.

    Science.gov (United States)

    Caperna, T J; Shannon, A E; Blomberg, L A; Garrett, W M; Ramsay, T G

    2012-01-01

    Oxidation of serum proteins can lead to carbonyl formation that alters their function and is often associated with stress-related diseases. As it is recommended that all pigs reared in modern production facilities be given supplemental iron at birth to prevent anemia, and metals can catalyze the carbonylation of proteins, the primary objective of this study was to determine whether standard iron dextran treatment was associated with enhanced serum protein oxidation in newborn piglets. Piglets were treated with 100 mg of iron dextran intramuscularly either on the day of birth, or on the third day after birth. Blood samples were collected from piglets 48 or 96 h after treatment and serum was harvested. For quantification, serum protein carbonyls were converted to hydrazones with dinitrophenyl hydrazine and analyzed spectrophotometrically. To identify and determine relative distribution of carbonylated proteins, serum protein carbonyls were derivatized with biotin hydrazide, separated by two-dimensional polyacrylamide gel electrophoresis, stained with avidin-fluorescein and identified by mass spectrometry. The standard iron dextran treatment was associated with no increase in total oxidized proteins if given either on the first or third day of life. In addition, with a few noted exceptions, the overall distribution and identification of oxidized proteins were similar between control and iron dextran-treated pigs. These results indicate that while iron dextran treatment is associated with a marked increase in circulating iron, it does not appear to specifically induce the oxidation of serum proteins.

  13. Xenon depresses aEEG background voltage activity whilst maintaining cardiovascular stability in sedated healthy newborn pigs

    OpenAIRE

    Thoresen, Marianne; Wood, Thomas Ragnar; Gill, Hannah; Hemmen, Sabir; Liu, Xun; Dingley, John

    2016-01-01

    Background Changes in electroencephalography (EEG) voltage range are used to monitor the depth of anaesthesia, as well as predict outcome after hypoxia-ischaemia in neonates. Xenon is being investigated as a potential neuroprotectant after hypoxic-ischaemic brain injury, but the effect of Xenon on EEG parameters in children or neonates is not known. This study aimed to examine the effect of 50% inhaled Xenon on background amplitude-integrated EEG (aEEG) activity in sedated healthy newborn pig...

  14. 1,2-Fucosyllactose Does Not Improve Intestinal Function or Prevent Escherichia coli F18 Diarrhea in Newborn Pigs

    DEFF Research Database (Denmark)

    Cilieborg, Malene Skovsted; Sangild, Per Torp; Jensen, Michael Ladegaard

    2017-01-01

     = 24) without (control) or with inoculation of enterotoxigenic Escherichia coli F18 (7.5 × 1010/day for 8 days) fed either no (F18) or 10 g/L 2′-FL (2FL-F18). Results: In vitro studies revealed decreased pathogen adhesion to intestinal epithelial cells with 2′-FL (5 g/L; P ... of mucosa and activities of some brush border enzymes in the proximal small intestine. In situ abundance of α-1,2-fucose and E coli was similar between groups, whereas sequencing showed higher abundance of Enterobacteriaceae in F18, Enterococcus in control and Lachnospiraceae in 2FL-F18 pigs. Conclusions: 2...... in the intestine and may in part explain the protective effects of human milk. We hypothesized that 2′-FL prevents diarrhea via competitive inhibition of pathogen adhesion in a pig model for sensitive newborn infants. Methods: Intestinal cell studies were coupled with studies on cesarean-delivered newborn pigs (n...

  15. Development of active immunity in newborn pigs with colostral antibodies by vaccination with gIII-deleted PRV.

    Science.gov (United States)

    Kit, S; Kit, M; McConnell, S; Lawhorn, B

    1994-01-01

    Maternal antibodies interfere with active immunization of swine by gI-deleted pseudorabies virus [(PRV); Aujeszky's disease virus] vaccines. To test the hypothesis that modified-live (MLV) vaccines retaining the PRV gI and with deletions in the PRV glycoprotein gIII and thymidine kinase (TK) genes might be efficacious in circumventing colostral antibody interference, the OMNI-MARK-PRV (gI+ gIII- TK-) vaccine was administered intramuscularly to 13 newborn pigs with colostral antibodies, while 10 pigs from the same litters served as nonvaccinated controls. At 49 days of age, when PRV virus neutralization (VN) antibodies were negative and all nonvaccinated pigs as well as 10 vaccinates were latex agglutination test (LAT)-negative, the pigs were challenged intranasally with the virulent PRV(SHOPE) strain. In support of the hypothesis, it was found that several central nervous system and respiratory disease signs developed in 6 of 10 nonvaccinates, with one fatality, while 2 of 13 vaccinates showed only very mild and transient disease signs. Nonvaccinates lost weight until post challenge day (PCD) 6, did not regain prechallenge weight until PCD 8, and at PCD 11 had gained only 4.9 pounds/pig. Vaccinates gained weight after challenge and at PCD 11 showed a 9.4 pounds/pig weight gain. On PCD 11, the geometric mean titer (GMT) for VN antibodies of the nonvaccinates was 9.3, while the GMT of the vaccinates for VN antibodies was 49.0, showing that vaccinated pigs had been immunologically primed.

  16. Pig-associated methicillin-resistant Staphylococcus aureus: Family transmission and severe pneumonia in a newborn

    DEFF Research Database (Denmark)

    Hartmeyer, Gitte Nyvang; Gahrn-Hansen, Bente; Skov, Robert L

    2010-01-01

    Abstract Carriage of pig-associated methicillin-resistant Staphylococcus aureus (MRSA) is known to occur in pig farmers. Zoonotic lineages of MRSA have been considered of low virulence and with limited capacity for inter-human spread. We present a case of family transmission of pig-associated MRSA...

  17. Intraoperative hypotension

    NARCIS (Netherlands)

    Bijker, J.B.|info:eu-repo/dai/nl/304822094

    2011-01-01

    Intraoperative hypotension is a frequent and common side effect of anesthesia. The incidence of intraoperative hypotension is however dependent on the chosen definition. A wide variety of definitions could be found in the recent anesthesia literature, and also self-reported definitions by anesthesia

  18. Orthostatic hypotension

    National Research Council Canada - National Science Library

    Bradley, John G; Davis, Kathy A

    2003-01-01

    Orthostatic hypotension is a physical finding defined by the American Autonomic Society and the American Academy of Neurology as a systolic blood pressure decrease of at least 20 mm Hg or a diastolic...

  19. Importance of neonatal immunoglobulin transfer for hippocampal development and behaviour in the newborn pig

    National Research Council Canada - National Science Library

    Kateryna Goncharova; Liudmyla Lozinska; Ester Arevalo Sureda; Jarosław Woliński; Björn Weström; Stefan Pierzynowski

    2017-01-01

    .... Thirty six, unsuckled newborn piglets were fed an infant formula or colostrum and supplemented orally or intravenously with either species-specific or foreign immunoglobulin and then compared to both...

  20. Age-dependent NOC/oFQ contribution to impaired hypotensive cerebral hemodynamics after brain injury.

    Science.gov (United States)

    Armstead, William M

    2002-10-01

    Previous studies have observed that the newly described opioid, nociceptin/orphanin FQ (NOC/oFQ), contributed to age dependent reductions in cerebral blood flow (CBF) and pial artery diameter after fluid percussion brain injury (FPI). Unrelated studies have noted a similar age dependency in impaired hypotensive cerebral autoregulation after FPI. This study was designed to compare the role of NOC/oFQ in impaired hypotensive cerebral autoregulation after FPI in newborn and juvenile pigs equipped with a closed cranial window. Ten minutes of hemorrhagic hypotension (10-15 mL blood/kg) decreased mean arterial blood pressure uniformly in both groups ( approximately 44%). In the newborn, hypotensive pial artery dilation was blunted within 1 h of FPI but partially protected by pretreatment with the NOC/oFQ antagonist, [F/G] NOC/oFQ (1-13) NH(2) (1 mg/kg, i.v.) (34 +/- 1 vs. 8 +/- 1 vs. 20 +/- 2% for sham control, FPI, and FPI-[F/G] NOC/oFQ (1-13) NH(2), respectively). CBF was reduced during normotension by FPI, further reduced by hypotension, but both were partially protected by this antagonist in the newborn (63 +/- 4, 34 +/- 2, and 20 +/- 2 vs. 65 +/- 4, 47 +/- 2, and 29 +/- 2 mL/min.100 g for normotension, normotension-FPI and hypotension-FPI in the absence and presence of [F/G] NOC/oFQ (1-13) NH(2), respectively). In contrast, blunted hypotensive pial artery dilation was protected significantly less by this NOC/oFQ antagonist in the juvenile (32 +/- 2 vs. 7 +/- 2 vs. 13 +/- 2% for sham control, FPI and FPI-NOC/oFQ antagonist, respectively). Similarly, [F/G] NOC/oFQ (1-13) NH(2) had less protective effect on normotensive and hypotensive CBF values post FPI in the juvenile. These data indicate that NOC/oFQ contributes to impaired hypotensive cerebral hemodynamics following brain injury in an age-dependent manner.

  1. NOC/oFQ and NMDA contribute to piglet hypoxic ischemic hypotensive cerebrovasodilation impairment.

    Science.gov (United States)

    Armstead, William M

    2002-05-01

    Previous studies have observed that hypotensive pial artery dilation was blunted after hypoxia-ischemia. In unrelated studies, the opioid nociceptin/orphanin FQ (NOC/oFQ) was observed to contribute to hypoxic ischemic impairment of N-methyl-D-aspartate (NMDA)-induced pial dilation. This study determined the contribution of NOC/oFQ and NMDA to hypoxic ischemic hypotensive cerebrovasodilation impairment in newborn pigs equipped with a closed cranial window. Global cerebral ischemia was produced via elevated intracranial pressure. Hypoxia decreased PO(2) to 33 +/- 3 mm Hg. Topical NOC/oFQ (10(-10) M), the cerebrospinal fluid concentration after hypoxia-ischemia, had no effect on pial artery diameter by itself but attenuated hypotension (mean arterial blood pressure decrease of 44 +/- 2%) -induced pial artery dilation (35 +/- 2% versus 22 +/- 3%). Hypotensive pial artery dilation was blunted by hypoxia-ischemia, but such dilation was partially protected by pretreatment with the putative NOC/oFQ receptor antagonist, [F/G] NOC/oFQ (1-13) NH(2) (10(-6) M; 29 +/- 2%, sham control; 7 +/- 2%, hypoxia-ischemia; and 13 +/- 2%, hypoxia-ischemia and [F/G] NOC/oFQ (1-13) NH(2)). Coadministration of the NMDA antagonist MK801 (10(-5) M) with NOC/oFQ(10(-10) M) partially prevented hypotensive pial dilation impairment. Similarly, pretreatment with MK801 partially protected hypoxic ischemia impairment of hypotensive pial dilation (35 +/- 2%, sham control; 7 +/- 1%, hypoxia-ischemia; 22 +/- 2%, hypoxia-ischemia + MK801). These data show that NOC/oFQ and NMDA contribute to hypoxic ischemic hypotensive cerebrovasodilation impairment. These data suggest that NOC/oFQ modulation of NMDA vascular activity also contributes to such hypotensive impairment.

  2. Xenon depresses aEEG background voltage activity whilst maintaining cardiovascular stability in sedated healthy newborn pigs.

    Science.gov (United States)

    Sabir, Hemmen; Wood, Thomas; Gill, Hannah; Liu, Xun; Dingley, John; Thoresen, Marianne

    2016-04-15

    Changes in electroencephalography (EEG) voltage range are used to monitor the depth of anaesthesia, as well as predict outcome after hypoxia-ischaemia in neonates. Xenon is being investigated as a potential neuroprotectant after hypoxic-ischaemic brain injury, but the effect of Xenon on EEG parameters in children or neonates is not known. This study aimed to examine the effect of 50% inhaled Xenon on background amplitude-integrated EEG (aEEG) activity in sedated healthy newborn pigs. Five healthy newborn pigs, receiving intravenous fentanyl sedation, were ventilated for 24 h with 50%Xenon, 30%O2 and 20%N2 at normothermia. The upper and lower voltage-range of the aEEG was continuously monitored together with cardiovascular parameters throughout a 1 h baseline period with fentanyl sedation only, followed by 24 h of Xenon administration. The median (IQR) upper and lower aEEG voltage during 1 h baseline was 48.0 μV (46.0-50.0) and 25.0 μV (23.0-26.0), respectively. The median (IQR) aEEG upper and lower voltage ranges were significantly depressed to 21.5 μV (20.0-26.5) and 12.0 μV (12.0-16.5) from 10 min after the onset of 50% Xenon administration (p=0.002). After the initial Xenon induced depression in background aEEG voltage, no further aEEG changes were seen over the following 24h of ventilation with 50% xenon under fentanyl sedation. Mean arterial blood pressure and heart rate remained stable. Mean arterial blood pressure and heart rate were not significantly influenced by 24h Xenon ventilation. 50% Xenon rapidly depresses background aEEG voltage to a steady ~50% lower level in sedated healthy newborn pigs. Therefore, care must be taken when interpreting the background voltage in neonates also receiving Xenon. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Effects of xenon and hypothermia on cerebrovascular pressure reactivity in newborn global hypoxic–ischemic pig model

    Science.gov (United States)

    Chakkarapani, Elavazhagan; Dingley, John; Aquilina, Kristian; Osredkar, Damjan; Liu, Xun; Thoresen, Marianne

    2013-01-01

    Autoregulation of cerebral perfusion is impaired in hypoxic–ischemic encephalopathy. We investigated whether cerebrovascular pressure reactivity (PRx), an element of cerebral autoregulation that is calculated as a moving correlation coefficient between averages of intracranial and mean arterial blood pressure (MABP) with values between −1 and +1, is impaired during and after a hypoxic–ischemic insult (HI) in newborn pigs. Associations between end-tidal CO2, seizures, neuropathology, and PRx were investigated. The effect of hypothermia (HT) and Xenon (Xe) on PRx was studied. Pigs were randomized to Sham, and after HI to normothermia (NT), HT, Xe or xenon hypothermia (XeHT). We defined PRx >0.2 as peak and negative PRx as preserved. Neuropathology scores after 72 hours of survival was grouped as ‘severe' or ‘mild.' Secondary PRx peak during recovery, predictive of severe neuropathology and associated with insult severity (P=0.05), was delayed in HT (11.5 hours) than in NT (6.5 hours) groups. Seizures were associated with impaired PRx in NT pigs (P=0.0002), but not in the HT/XeHT pigs. PRx was preserved during normocapnia and impaired during hypocapnia. Xenon abolished the secondary PRx peak, increased (mean (95% confidence interval (CI)) MABP (6.5 (3.8, 9.4) mm Hg) and cerebral perfusion pressure (5.9 (2.9, 8.9) mm Hg) and preserved the PRx (regression coefficient, −0.098 (95% CI (−0.18, −0.01)), independent of the insult severity. PMID:23899927

  4. [Use of dextrofer-100 and vitamin B12 on newborn pigs].

    Science.gov (United States)

    Petkov, P I; Khadzhistoev, V

    1984-01-01

    Studies were carried out with the iron dextran preparation-100 and vitamin B12 at 100 gamma, applied to 80 pigs of 10 sows of the Camborough hybrid on two swine breeding complexes of different raising technologies. The pigs were divided into 4 groups of animals each. The Ist group was treated with dextrofer, the IInd--with dextrofer + vit. B12, the IIIrd--with vit. B12, and the IVth was left as control. The hemoglobin rate, erythrocyte, count, iron, and live-weight were followed up. It was found that the hemoglobin values at birth with the Ist group on the two complexes were within the range of 8.89 +/- 1.3 to 10.24 +/- 1.36 g/100 cm-3, while with the IInd group they were higher at weaning--11.8 +/- 0.48 g/100 cm3. The IIIrd and IVth group showed very low values at weaning--7.47 +/- 0.46 g/100 cm3 and 6.35 +/- 1.05 cm3. The twofold injection at a 7-day interval did not alter essentially the hemoglobin values. The pigs of the IInd group, injected twice, had much higher values of the erythrocyte count--7.58 +/- 0.09 T/L. The liveweight of the pigs of all four groups from the 7th day on ranged from 2.15 to 2.4 +/- 0.2 kg. Following a twofold injection with the pigs of the IInd group it rose to 6.1 +/- 0.14 kg. Similar proved the data concerning the iron in the blood plasma. Its values were highest with the pigs of the IInd group which were injected twice--38.86 +/- 1.7 mol/l.

  5. Iron Dextran treatment does not induce serum protein carbonyls in the newborn pig

    Science.gov (United States)

    Oxidation of serum proteins can lead to carbonyl formation which alters their function and is often associated with stress-related diseases. Since it is recommended that all pigs reared in modern production facilities be given supplemental iron at birth to prevent anemia, and metals can catalyze th...

  6. In vitro induction and differentiation of newborn guinea pig hippocampus neural stem cells into cells resembling inner hair cells, using artificial perilymph.

    Science.gov (United States)

    Wang, Y; Dong, M-M

    2011-08-01

    To investigate whether artificial perilymph can induce neural stem cells, derived from the hippocampus of newborn guinea pigs, to differentiate into inner ear hair cells, in vitro. Primary neural stem cells derived from the hippocampus of newborn guinea pigs were incubated in medium containing either 10 per cent fetal bovine serum or 5, 10 or 15 per cent artificial perilymph, for three weeks. Differentiated cells were identified using immunofluorescence, Western blot and scanning electron microscopy. Both fetal bovine serum and artificial perilymph induced the neural stem cells to differentiate into cells with hair-cell-specific antibodies. Neural stem cells can survive in both fetal bovine serum and artificial perilymph, and within these media can differentiate into cells with hair-cell-specific antibodies. This provides an experimental basis for transplantation of neural stem cells into the inner ear.

  7. NOC/oFQ activates PKC and generates superoxide to impair hypotensive cerebrovasodilation after hypoxia/ischemia.

    Science.gov (United States)

    Armstead, William

    2002-01-01

    Previous studies have observed that hypotensive pial artery dilation was blunted following global cerebral ischemia in the piglet. In unrelated studies, superoxide (O-2) contributed to impaired hypotensive cerebrovasodilation following traumatic brain injury in the rat while the opioid nociceptin/orphanin FQ (NOC/oFQ) generated O-2 via activation of protein kinase C in the piglet. This study determined the contribution of NOC/oFQ, PKC activation and O-2 generation in hypoxic ischemic hypotensive cerebrovasodilation impairment. Anesthetized newborn pigs equipped with a closed cranial window were used. Global cerebral ischemia was produced via elevated intracranial pressure. Hypoxia, via inhalation of nitrogen, decreased PO2 to 34I3 mmHg. Topical NOC/oFQ (10-10M), the CSF concentration following hypoxia/ischemia, had no effect on pial artery diameter by itself but attenuated hypotension (mean arterial blood pressure decrease of 44I2%) induced pial artery dilation (33I1 vs 19I2%). Coadministration of the PKC inhibitor chelerythrine (10-7M) or the O-2 scavenger polyethylene glycol superoxide dismutase and catalase (SODCAT) with NOC/oFQ (10-10M) partially prevented hypotensive pial dilation impairment (34I2 vs 28I1% for SODCAT). Hypotensive pial artery dilation was blunted by hypoxia/ischemia but such dilation was partially protected by the NOC/oFQ receptor antagonist [F/G] NOC/oFQ (1-13) NH2 (10-6M), chelerythine or SODCAT (34I1 vs 7I2 vs 21I2% for sham, H/I and H/I + SODCAT, respectively). These data show that PKC activation and generation of O-2 contributes to hypoxia/ischemia impairment of hypotensive pial artery dilation. These data suggest that NOC/oFQ activates PKC and generates O-2 to impair hypotensive cerebrovasodilation after hypoxia/ischemia.

  8. Importance of neonatal immunoglobulin transfer for hippocampal development and behaviour in the newborn pig.

    Directory of Open Access Journals (Sweden)

    Kateryna Goncharova

    Full Text Available Neurological disorders are among the main clinical problems affecting preterm children and often result in the development of communication and learning disabilities later in life. Several factors are of importance for brain development, however the role of immunoglobulins (passive immunity transfer has not yet been investigated. Piglets are born agammaglobulinemic, as a result of the lack of transfer of maternal immunoglobulins in utero, thus, they serve as an ideal model to mimic the condition of immunoglobulin deficiency in preterm infants. Thirty six, unsuckled newborn piglets were fed an infant formula or colostrum and supplemented orally or intravenously with either species-specific or foreign immunoglobulin and then compared to both newborn and sow-reared piglets. Two days after the piglets were born behavioural tests (novel recognition and olfactory discrimination of conspecifics scent were performed, after which the piglets were sacrificed and blood, cerebrospinal fluid and hippocampi samples were collected for analyses. Both parameters of neuronal plasticity (neuronal maturation and synapse-associated proteins and behavioural test parameters appeared to be improved by the appearance of species-specific porcine immunoglulin in the circulation and cerebrospinal fluid of the piglets. In conclusion, we postulate possible positive clinical effects following intravenous infusion of human immunoglobulin in terms of neuronal plasticity and cognitive function in preterm infants born with low blood immunoglobulin levels.

  9. Utero-placental transfer of alternate energy substrates and glucose homeostasis in the newborn pig

    Energy Technology Data Exchange (ETDEWEB)

    Thulin, A.J.

    1985-01-01

    In the first experiment, three sows in late gestation were infused with (/sup 14/C)..beta..-hydroxybutyrate to evaluate utero-placental transfer of ketones. ..beta..-Hydroxy-butyrate (BOHB) concentrations were low in both the mother and fetus throughout the experiments (0.0189, 0.0197, 0.0054, and 0.0063 mmole/liter blood for UV, UA, FV, and FA, respectively). Radioactive BOHB was detected in fetal blood within two minutes post-injection. Lipid extracts of liver and adipose tissue exhibited the greatest relative incorporation of (/sup 14/C)..beta..-hydroxybutyrate followed by lung and heart tissues (3540, 3674, 1214, and 528 dpm/g wet weight, respectively). In a second study, five gravid gilts during late gestation were used to determine utero-placental transfer of maternal free fatty acids (FFA). Using similar techniques as Exp. 1, injections were given containing (/sup 14/C) linoleic acid and (/sup 3/H) palmitic acid or (/sup 14/C) octanoic acid. In a third experiment, gravid gilts were fed supplemental energy as starch (C), soybean oil (SO) or medium-chain triglycerides (MCT) during late gestation to determine the influence on colostrum composition and neonatal pig glucose homeostasis. Energy content of colostrum was increased (P = 0.05 by feeding SO and MCT. After a 36 h fast, mean piglet glucose concentrations were higher (P < 0.05) for MCT pigs. Glucose and creatinine levels showed quadratic effects, while FFA and blood urea nitrogen (BUN) exhibited cubic patterns during the fasting period. Although creatine levels were similar, BUN concentrations were higher (P < 0.01) for MCT progeny.

  10. Exogenous Fecal Microbiota Transplantation from Local Adult Pigs to Crossbred Newborn Piglets

    Directory of Open Access Journals (Sweden)

    Luansha Hu

    2018-01-01

    Full Text Available This study was conducted to investigate the effect of exogenous fecal microbiota transplantation on gut bacterial community structure, gut barrier and growth performance in recipient piglets. Twelve litters of Duroc × Landrace × Yorkshire piglets of the same birth and parity were weighed and divided into two groups. One group (recipient piglets was inoculated orally with fecal microbiota suspension of healthy adult Jinhua pigs daily from day 1 to day 11. The other (control was given orally the same volume of sterile physiological saline at the same time. The experiment lasted 27 days. The results showed that the relative abundance of Firmicutes, Prevotellaceae, Lachnospiraceae, Ruminococcus, Prevotella, and Oscillospira in the colon of recipient piglets was increased. Proteobacteria, Fusobacteriaceae, Clostridiaceae, Pasteuriaceae, Alcaligenaceae, Bacteroidaceae, Veillonellaceae, Sutterella, Escherichia, and Bacteroides in the colon of recipient piglets were decreased. An average daily weight gain of recipient piglets was increased, and diarrhea incidence of the recipient was decreased during the trial. Intestinal morphology and tight junction barrier of recipient piglets were improved. The optical density of sIgA+ cells, the number of goblet cells and relative expressions of MUC2 in the intestinal mucosa of recipient piglets were enhanced. Protein expressions of β-defensin 2 and mRNA expressions of TLR2 and TLR4 in the intestinal mucosa of recipient piglets were also increased. These findings supported that the exogenous fecal microbiota had significant effects on animal’s growth performance, intestinal barrier function, and innate immune via modulating the composition of the gut microbiota.

  11. Age-related changes in oxygen and nutrient uptake by hindquarters in newborn pigs during cold-induced shivering.

    Science.gov (United States)

    Lossec, G; Lebreton, Y; Hulin, J C; Fillaut, M; Herpin, P

    1998-11-01

    Newborn pigs rely essentially on shivering thermogenesis in the cold. In order to understand the rapid postnatal enhancement of thermogenic capacities in piglets, the oxygen and nutrient uptake of hindquarters was measured in vivo in 1- (n = 6) and 5-day-old (n = 6) animals at thermal neutrality and during cold exposure. The hindquarters were considered to represent a skeletal muscle compartment. Indirect calorimetry and arterio-venous techniques were used. The cold challenge (23 C at 1 day old and 15 C at 5 days old for 90 min) induced a similar increase (+90 %) in regulatory heat production at both ages. Hindquarters blood flow was higher at 5 days than 1 day old at thermal neutrality (26 +/- 3 vs. 17 +/- 1 ml min-1 (100 g hindquarters)-1) and its increase in the cold was much more marked (+65 % at 5 days old vs. +25 % at 1 day old). Oxygen extraction by the hindquarters rose from 30-35 % at thermal neutrality to 65-70 % in the cold at both ages. The calculated contribution of skeletal muscle to total oxygen consumption averaged 34-40 % at thermal neutrality and 50-64 % in the cold and skeletal muscle was the major contributor to regulatory thermogenesis. Based on hindquarters glucose uptake and lactate release, carbohydrate appeared to be an important fuel for shivering. However, net uptake of fatty acids increased progressively during cold exposure at 5 days old. The enhancement in muscular blood supply and fatty acid utilization during shivering is probably related to the postnatal improvement in the thermoregulatory response of the piglet.

  12. Hexapeptides from human milk prevent the induction of oxidative stress from parenteral nutrition in the newborn guinea pig

    Science.gov (United States)

    Miloudi, Khalil; Tsopmo, Apollinaire; Friel, James K.; Rouleau, Thérèse; Comte, Blandine; Lavoie, Jean-Claude

    2016-01-01

    INTRODUCTION In preterm neonates, peroxides contaminating total parenteral nutrition (TPN) contribute to oxidative stress, which is suspected to be a strong inducer of hepatic complications related to prematurity. Recently, others reported that hexapeptides derived from human milk (HM) exerted free radical–scavenging activities in vitro. Therefore, the aim of this study was to assess the capacity of these hexapeptides to limit the generation of peroxides in TPN and to prevent TPN-induced hepatic oxidative stress. METHODS At 3 d of life, guinea pigs were infused, through a catheter in jugular vein, with TPN containing or not peptide-A (YGYTGA) or peptide-B (ISELGW). Peroxide concentrations were measured in TPN solutions, whereas glutathione, glutathionyl-1,4-dihydroxynonenal (GS-HNE) and mRNA levels of interleukin-1 (IL-1) and tumor necrosis factor-α (TNFα) were determined in liver after 4 d of infusion. RESULTS The addition of peptide-A to TPN allowed a reduction in peroxide contamination by half. In vivo, peptide-A or peptide-B corrected the hepatic oxidative status induced by TPN. Indeed, both peptides lowered the hepatic redox potential of glutathione and the level of GS-HNE, a marker of lipid peroxidation. As compared with animals infused with TPN without peptide, the hepatic mRNA levels of IL-1 and TNFα were lower in animals infused with TPN containing peptide-A or peptide-B. DISCUSSION These results suggest that the addition of YGYTGA or ISELGW to TPN will reduce oxidative stress in newborns. The reduction in mRNA of two proinflammatory cytokines could be important for the incidence of hepatic complications related to TPN. PMID:22337230

  13. Impaired Cerebral Blood Flow Autoregulation During Postraumatic Arterial Hypotension After Fluid Percussion Brain Injury is Prevented by Phenylephrine in Female but Exacerbated in Male Piglets by ERK MAPK Upregulation

    Science.gov (United States)

    Armstead, William M.; Kiessling, J. Willis; Kofke, W. Andrew; Vavilala, Monica S.

    2012-01-01

    Objective Traumatic brain injury (TBI) contributes to morbidity and mortality in children and boys are disproportionately represented. Hypotension is common and worsens outcome after TBI. Extracellular signal-related kinase (ERK) mitogen activated protein kinase (MAPK) is upregulated and reduces CBF after fluid percussion brain injury (FPI) in piglets. We hypothesized that increased CPP via phenylephrine (PHE) sex dependently reduces impairment of cerebral autoregulation during hypotension after FPI through modulation of ERK MAPK. Design Prospective, randomized animal study. Setting University laboratory. Subjects Newborn (1–5 day old) pigs. Interventions CBF, pial artery diameter, ICP and autoregulatory index (ARI) were determined before and after FPI in untreated, pre- and post-injury PHE (1 μg/kg/min iv) treated male and female pigs during normotension and hemorrhagic hypotension. CSF ERK MAPK was determined by ELISA. Measurements and Main Results Reductions in pial artery diameter, CBF, CPP and elevated ICP after FPI were greater in males, which were blunted by PHE pre- or post-FPI. During hypotension and FPI, pial artery dilation was impaired more in males. PHE decreased impairment of hypotensive pial artery dilation after FPI in females, but paradoxically caused vasoconstriction after FPI in males. Papaverine induced pial artery vasodilation was unchanged by FPI and PHE. CBF, CPP, and ARI decreased markedly during hypotension and FPI in males but less in females. PHE prevented reductions in CBF, CPP, and ARI during hypotension in females but increased reductions in males. CSF ERK MAPK was increased more in males than females after FPI. PHE blunted ERK MAPK upregulation in females, but increased ERK MAPK upregulation in males after FPI. Conclusions These data indicate that elevation of CPP with PHE sex dependently prevents impairment of cerebral autoregulation during hypotension after FPI through modulation of ERK MAPK. These data suggest the potential role

  14. Enteral but not parenteral antibiotics enhance gut function and prevent necrotizing enterocolitis in formula-fed newborn preterm pigs

    DEFF Research Database (Denmark)

    Birck, Malene Muusfeldt; Nguyen, Duc Ninh; Cilieborg, Malene Skovsted

    2016-01-01

    Preterm infants are susceptible to infection and necrotizing enterocolitis (NEC) and are often treated with antibiotics. Simultaneous administration of enteral and parenteral antibiotics during the first days after preterm birth prevents formula-induced NEC lesions in pigs, but it is unknown which...... administration route is most effective. We hypothesized that only enteral antibiotics suppress gut bacterial colonization and NEC progression in formula-fed preterm pigs. Caesarean-delivered preterm pigs (90–92% of gestation) were fed increasing amounts of infant formula from birth to day 5 and given saline (CON...... of mild NEC lesions (59–63%) in CON and PAR pigs (P positive bacteria...

  15. The effects of amoxicillin treatment of newborn piglets on the prevalence of hernias and abscesses, growth and ampicillin resistance of intestinal coliform bacteria in weaned pigs.

    Science.gov (United States)

    Yun, Jinhyeon; Olkkola, Satu; Hänninen, Marja-Liisa; Oliviero, Claudio; Heinonen, Mari

    2017-01-01

    This study investigated the effects of a single amoxicillin treatment of newborn piglets on the prevalence of hernias and abscesses until the age of nine weeks. We also studied whether the treatment was associated with growth and mortality, the need for treatment of other diseases, the proportions of ampicillin resistant coliforms and antimicrobial resistance patterns of intestinal Escherichia coli (E. coli). A total of 7156 piglets, from approximately 480 litters, were divided into two treatment groups: ANT (N = 3661) and CON (N = 3495), where piglets were treated with or without a single intramuscular injection of 75 mg amoxicillin one day after birth, respectively. The umbilical and inguinal areas of weaned pigs were palpated at four and nine weeks of age. At the same time, altogether 124 pigs with hernias or abscesses and 820 non-defective pigs from three pens per batch were weighed individually. Mortality and the need to treat piglets for other diseases were recorded. Piglet faecal samples were collected from three areas of the floors of each pen at four weeks of age. The prevalence of umbilical hernias or abscesses did not differ between the groups at four weeks of age, but it was higher in the CON group than in the ANT group at nine weeks of age (2.3% vs. 0.7%, P antibiotic treatment. Further, continuous antimicrobial treatment of newborn piglets could negatively influence the development of the normal microbiota of the piglet and promote selection of antimicrobial resistance genes in herds. Therefore we suggest rejection of the use of routine administration of antimicrobial agents at birth.

  16. Pathophysiology of the Cardiovascular System and Neonatal Hypotension.

    Science.gov (United States)

    Shead, Sandra L

    2015-01-01

    Hypotension is common in low birth weight neonates and less common in term newborns and is associated with significant morbidity and mortality. Determining an adequate blood pressure in neonates remains challenging for the neonatal nurse because of the lack of agreed-upon norms. Values for determining norms for blood pressure at varying gestational and postnatal ages are based on empirical data. Understanding cardiovascular pathophysiology, potential causes of hypotension, and assessment of adequate perfusion in the neonatal population is important and can assist the neonatal nurse in the evaluation of effective blood pressure. This article reviews cardiovascular pathophysiology as it relates to blood pressure and discusses potential causes of hypotension in the term and preterm neonate. Variation in management of hypotension across centers is discussed. Underlying causes and pathophysiology of hypotension in the neonate are described.

  17. An mRNA Vaccine Encoding Rabies Virus Glycoprotein Induces Protection against Lethal Infection in Mice and Correlates of Protection in Adult and Newborn Pigs.

    Science.gov (United States)

    Schnee, Margit; Vogel, Annette B; Voss, Daniel; Petsch, Benjamin; Baumhof, Patrick; Kramps, Thomas; Stitz, Lothar

    2016-06-01

    Rabies is a zoonotic infectious disease of the central nervous system (CNS). In unvaccinated or untreated subjects, rabies virus infection causes severe neurological symptoms and is invariably fatal. Despite the long-standing existence of effective vaccines, vaccine availability remains insufficient, with high numbers of fatal infections mostly in developing countries. Nucleic acid based vaccines have proven convincingly as a new technology for the fast development of vaccines against newly emerging pathogens, diseases where no vaccine exists or for replacing already existing vaccines. We used an optimized non-replicating rabies virus glycoprotein (RABV-G) encoding messenger RNA (mRNA) to induce potent neutralizing antibodies (VN titers) in mice and domestic pigs. Functional antibody titers were followed in mice for up to one year and titers remained stable for the entire observation period in all dose groups. T cell analysis revealed the induction of both, specific CD4+ as well as CD8+ T cells by RABV-G mRNA, with the induced CD4+ T cells being higher than those induced by a licensed vaccine. Notably, RABV-G mRNA vaccinated mice were protected against lethal intracerebral challenge infection. Inhibition of viral replication by vaccination was verified by qRT-PCR. Furthermore, we demonstrate that CD4+ T cells are crucial for the generation of neutralizing antibodies. In domestic pigs we were able to induce VN titers that correlate with protection in adult and newborn pigs. This study demonstrates the feasibility of a non-replicating mRNA rabies vaccine in small and large animals and highlights the promises of mRNA vaccines for the prevention of infectious diseases.

  18. An mRNA Vaccine Encoding Rabies Virus Glycoprotein Induces Protection against Lethal Infection in Mice and Correlates of Protection in Adult and Newborn Pigs.

    Directory of Open Access Journals (Sweden)

    Margit Schnee

    2016-06-01

    Full Text Available Rabies is a zoonotic infectious disease of the central nervous system (CNS. In unvaccinated or untreated subjects, rabies virus infection causes severe neurological symptoms and is invariably fatal. Despite the long-standing existence of effective vaccines, vaccine availability remains insufficient, with high numbers of fatal infections mostly in developing countries. Nucleic acid based vaccines have proven convincingly as a new technology for the fast development of vaccines against newly emerging pathogens, diseases where no vaccine exists or for replacing already existing vaccines. We used an optimized non-replicating rabies virus glycoprotein (RABV-G encoding messenger RNA (mRNA to induce potent neutralizing antibodies (VN titers in mice and domestic pigs. Functional antibody titers were followed in mice for up to one year and titers remained stable for the entire observation period in all dose groups. T cell analysis revealed the induction of both, specific CD4+ as well as CD8+ T cells by RABV-G mRNA, with the induced CD4+ T cells being higher than those induced by a licensed vaccine. Notably, RABV-G mRNA vaccinated mice were protected against lethal intracerebral challenge infection. Inhibition of viral replication by vaccination was verified by qRT-PCR. Furthermore, we demonstrate that CD4+ T cells are crucial for the generation of neutralizing antibodies. In domestic pigs we were able to induce VN titers that correlate with protection in adult and newborn pigs. This study demonstrates the feasibility of a non-replicating mRNA rabies vaccine in small and large animals and highlights the promises of mRNA vaccines for the prevention of infectious diseases.

  19. Aerosolized KL4 surfactant improves short-term survival and gas exchange in spontaneously breathing newborn pigs with hydrochloric acid-induced acute lung injury.

    Science.gov (United States)

    Lampland, Andrea L; Wolfson, Marla R; Mazela, Jan; Henderson, Christopher; Gregory, Timothy J; Meyers, Patricia; Plumm, Brenda; Worwa, Cathy; Mammel, Mark C

    2014-05-01

    Surfactant therapy may be beneficial in acute lung injury (ALI). In spontaneously breathing newborn pigs with ALI supported with continuous positive airway pressure (CPAP), we evaluated the hypothesis that aerosolized KL4 surfactant (AERO KL4 S) would provide a similar therapeutic effect as intratracheal KL4 surfactant (ETT KL4 S) when compared to controls. We randomized pigs with HCl-induced ALI to: (1) 175 mg/kg KL4 surfactant via endotracheal tube (ETT); (2) AERO KL4 S (22.5 mg/min phospholipid) for 60 min via continuous positive airway pressure (CPAP); or (3) sham procedure on CPAP. We obtained physiologic data and arterial blood gases throughout the 3-hr study. At study end, lungs were excised for analysis of interleukin-8 (IL-8), myeloperoxidase (MPO) levels and histomorphometric data. Pigs treated with ETT KL4 S and AERO KL4 S had improved survival and sustained pO2 compared to controls. The AERO KL4 S group had higher pH compared to controls. Lung IL-8 levels were lower in the AERO KL4 S group compared to controls. Histomorphometric analysis showed less hemorrhage in the ETT and AERO KL4 S groups compared to controls. The AERO KL4 S group had more open lung units per fixed-field than the ETT KL4 S or controls. AERO KL4 S produced similar improvements in survival, physiology, inflammatory markers, and morphology as ETT KL4 S in an ALI model. © 2013 Wiley Periodicals, Inc.

  20. Characterization of virulence of the Streptococcus suis serotype 2 reference strain Henrichsen S 735 in newborn gnotobiotic pigs

    NARCIS (Netherlands)

    Vecht, U.; Wisselink, H.J.; Stockhofe-Zurwieden, N.; Smith, H.E.

    1996-01-01

    Strain Henrichsen S 735 (NCTC 10234) of Streptococcus suis serotype 2 reference and three other such strains (strains S 4005, S 3921 and T 141) were tested for virulence by inoculating pigs intranasally and intravenously. The taxonomical properties of each strain were determined. Phenotypes were

  1. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  2. Adenosine and dialysis hypotension

    NARCIS (Netherlands)

    Franssen, CMF

    In this issue, Imai et al. report the results of a double-blind placebo-controlled study on the effect of an adenosine A1 receptor antagonist, FK352, on the incidence of dialysis hypotension in hypotension-prone patients. This Commentary discusses the use of selective adenosine A1 receptor

  3. A sandwich ELISA for porcine alpha-1 acid glycoprotein (pAGP, ORM-1) and further demonstration of its use to evaluate growth potential in newborn pigs.

    Science.gov (United States)

    Caperna, T J; Shannon, A E; Stoll, M; Kahl, S; Blomberg, L A; Vallet, J L; Ramsay, T G

    2017-07-01

    A simple, reproducible sandwich, ELISA was developed to measure porcine alpha-1 acid glycoprotein (pAGP, ORM-1) in pig plasma. Porcine AGP isolated from serum was purchased and a polyclonal antisera was prepared in rabbits using the whole pAGP molecule as immunogen. The antiserum was affinity purified, and a portion of the purified antibody fraction was labeled with horseradish peroxidase. Porcine AGP protein was used as a standard, whereas commercially available buffers and reagents were utilized throughout the assay. The assay was specific for pAGP, had a lower limit of detection of 3.2 ng/mL, and could be used to quantify pAGP in plasma or serum. Using this ELISA, we corroborated our previous findings obtained by RID assay, which demonstrated that the AGP concentration in newborn piglets is negatively associated with preweaning growth rate. The current data were obtained using piglets from a different geographical location and genetic background and showed that elevated AGP at birth was associated with reduced preweaning growth rate (P < 0.001, r = 0.433, n = 19 litters). In addition, litters with a greater average AGP at birth were at a growth disadvantage compared with litters with reduced average AGP plasma concentrations (P < 0.001, r = 0.708, n = 19 litters). Litter average plasma AGP was a better predictor of litter preweaning growth rate than average litter birth weight. The data represent further support for using perinatal AGP concentrations as a tool to identify potential slower growing pigs and as a plasma biomarker for predicting litter growth rate. Published by Elsevier Inc.

  4. Mechanism of cold-induced increase in susceptibility to enterotoxigenic Escherichia coli-induced diarrhea of the newborn pig

    Energy Technology Data Exchange (ETDEWEB)

    Sarmiento Mendoza, J.I.

    1986-01-01

    These experiments studied the susceptibility to enterotoxigenic Escherichia coli (ETEC) in piglets kept at 25/sup 0/C (cold) or 35/sup 0/C (warm) from birth and infected at 18 h of age. When infected with ETEC strain M431 cold piglets had greater incidence and severity of diarrhea, fluid secretion, dehydration and intestinal colonization than warm littermates. In contrast, when piglets were challenged with ETEC strain O926-B-9C, which lacks the pilus antigens K99, K88, 987P but is able to produce heat stable enterotoxin (ST), increases influidity of feces and colonic and fecal contents in cold piglets were not consistent and there was no significant difference in bacterial counts between temperature groups. Cold piglets given /sup 14/C-polyethylene glycol had the bulk of radiolabelled contents in the cranial small intestinal segments indicating prolonged retention or decreased propulsion in comparison to warm littermates. No difference, however, was found in xylose absorption between temperature groups. It was investigated if insulin administration reduces the net propulsion of contents in newborn piglets as cold stress does. The segments containing the greater percentages of radioactivity were always more cranial in insulin injected piglets than in control piglets. There was, however, no differences in severity of disease or bacterial numbers between insulin injected and control piglets infected with M431 ETEC.

  5. Quantitative determination of fentanyl in newborn pig plasma and cerebrospinal fluid samples by HPLC-MS/MS.

    Science.gov (United States)

    Blanco, M E; Encinas, E; González, O; Rico, E; Vozmediano, V; Suárez, E; Alonso, R M

    2015-09-01

    In this study, a selective and sensitive high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method requiring low sample volume (≤100 μL) was developed and validated for the quantitative determination of the opioid drug fentanyl in plasma and cerebrospinal fluid (CSF). A protein precipitation extraction with acetonitrile was used for plasma samples whereas CSF samples were injected directly on the HPLC column. Fentanyl and (13) C6 -fentanyl (Internal Standard) were analyzed in an electrospray ionization source in positive mode, with multiple reaction monitoring (MRM) of the transitions m/z 337.0/188.0 and m/z 337.0/105.0 for quantification and confirmation of fentanyl, and m/z 343.0/188.0 for (13) C6 -fentanyl. The respective lowest limits of quantification for plasma and CSF were 0.2 and 0.25 ng/mL. Intra- and inter-assay precision and accuracy did not exceed 15%, in accordance with bioanalytical validation guidelines. The described analytical method was proven to be robust and was successfully applied to the determination of fentanyl in plasma and CSF samples from a pharmacokinetic and pharmacodynamic study in newborn piglets receiving intravenous fentanyl (5 µg/kg bolus immediately followed by a 90-min infusion of 3 µg/kg/h). Copyright © 2015 John Wiley & Sons, Ltd.

  6. Diagnosis and management of hypotension in neonates.

    Science.gov (United States)

    Farrugia, Ryan; Rojas, Hector; Rabe, Heike

    2013-09-01

    The diagnosis and management of hypotension in neonates is a frequently encountered issue in the intensive care setting. There is an ongoing debate as to the appropriateness of blood pressure monitoring as an indicator of organ perfusion and tissue hypoxia. These ultimately determine morbidity and mortality in the sick newborn. This article explores the methods available for the assessment of organ perfusion and speculates on other means that may become available in the future. Different modalities of treatment currently in use are discussed, with the aim of using information gained from perfusion monitoring techniques to determine the optimal choice of therapy.

  7. EFFECTS OF CANNABIDIOL PLUS HYPOTHERMIA ON SHORT-TERM NEWBORN PIG BRAIN DAMAGE AFTER ACUTE HYPOXIA-ISCHEMIA

    Directory of Open Access Journals (Sweden)

    Hector Lafuente

    2016-07-01

    Full Text Available Background: Hypothermia is standard treatment for neonatal encephalopathy, but near 50% of treated infants have adverse outcomes. Pharmacological therapies can act through complementary mechanisms to hypothermia and would improve neuroprotection. Cannabidiol could be a good candidate.Objective: To test whether immediate treatment with cannabidiol and hypothermia act through complementary brain pathways in hypoxic-ischemic newborn piglets.Methods: Hypoxic-ischemic animals were randomized to receive 30 min after the insult: 1 normothermia- and vehicle-treated group; 2 normothermia- and cannabidiol-treated group; 3 hypothermia- and vehicle-treated group; and 4 hypothermia- and cannabidiol-treated group. Six hours after treatment, brains were processed to qualify the number of neurons by Nissl staining. Proton nuclear magnetic resonance spectra were obtained and analyzed for lactate, N-acetyl-aspartate and glutamate. Metabolite ratios were calculated to assess neuronal damage (lactate/N-acetyl-aspartate and excitotoxicity (glutamate/Nacetyl-aspartate. Western blot studies were performed to quantify protein nitrosylation (oxidative stress and expression of caspase-3 (apoptosis and TNFα (inflammation.Results: Individually, the hypothermia and the cannabidiol treatments reduced the glutamate/Nacetyl-aspartate ratio, as well as TNFα and oxidized protein levels. Also, both therapies reduced the number of necrotic neurons and prevented an increase in lactate/N-acetyl-aspartate ratio. The combined effect of hypothermia and cannabidiol on excitotoxicity, inflammation and oxidative stress, and on histological damage, was greater than either hypothermia or cannabidiol alone.Conclusion: Cannabidiol and hypothermia act complementarily and show additive effects on the main factors leading to hypoxic-ischemic brain damage.

  8. Dynamic FDG PET for assessing early effects of cerebral hypoxia and resuscitation in new-born pigs

    Energy Technology Data Exchange (ETDEWEB)

    Lange, Charlotte de [Oslo University Hospital, Rikshospitalet, Department of Paediatric Research, P.O. Box 4950, Oslo (Norway); Oslo University Hospital, Rikshospitalet, Department of Radiology and Nuclear Medicine, P.O. Box 4950, Oslo (Norway); Malinen, Eirik [Oslo University Hospital, Department of Medical Physics, P.O. Box 4953, Oslo (Norway); University of Oslo, Department of Physics, P.O. Box 1048, Oslo (Norway); Qu, Hong [University of Oslo, Centre for Molecular Biology and Neuroscience, Department of Anatomy, Institute of Basic Medical Sciences, P.O. Box 1105, Oslo (Norway); Johnsrud, Kjersti [Oslo University Hospital, Rikshospitalet, Department of Radiology and Nuclear Medicine, P.O. Box 4950, Oslo (Norway); Skretting, Arne [Oslo University Hospital, The Intervention Centre, P.O. Box 4950, Oslo (Norway); Saugstad, Ola Didrik [Oslo University Hospital, Rikshospitalet, Department of Paediatric Research, P.O. Box 4950, Oslo (Norway); University of Oslo, Department of Medicine, P.O. Box 1078, Oslo (Norway); Munkeby, Berit H. [Oslo University Hospital, Rikshospitalet, Department of Paediatric Research, P.O. Box 4950, Oslo (Norway)

    2012-05-15

    Changes in cerebral glucose metabolism may be an early prognostic indicator of perinatal hypoxic-ischaemic injury. In this study dynamic {sup 18}F-FDG PET was used to evaluate cerebral glucose metabolism in piglets after global perinatal hypoxia and the impact of the resuscitation strategy using room air or hyperoxia. New-born piglets (n = 16) underwent 60 min of global hypoxia followed by 30 min of resuscitation with a fraction of inspired oxygen (FiO{sub 2}) of 0.21 or 1.0. Dynamic FDG PET, using a microPET system, was performed at baseline and repeated at the end of resuscitation under stabilized haemodynamic conditions. MRI at 3 T was performed for anatomic correlation. Global and regional cerebral metabolic rates of glucose (CMR{sub gl}) were assessed by Patlak analysis for the two time-points and resuscitation groups. Global hypoxia was found to cause an immediate decrease in cerebral glucose metabolism from a baseline level (mean {+-} SD) of 21.2 {+-} 7.9 to 12.6 {+-} 4.7 {mu}mol/min/100 g (p <0.01). The basal ganglia, cerebellum and cortex showed the greatest decrease in CMR{sub gl} but no significant differences in global or regional CMR{sub gl} between the resuscitation groups were found. Dynamic FDG PET detected decreased cerebral glucose metabolism early after perinatal hypoxia in piglets. The decrease in CMR{sub gl} may indicate early changes of mild cerebral hypoxia-ischaemia. No significant effect of hyperoxic resuscitation on the degree of hypometabolism was found in this early phase after hypoxia. Cerebral FDG PET can provide new insights into mechanisms of perinatal hypoxic-ischaemic injury where early detection plays an important role in instituting therapy. (orig.)

  9. Newborn jaundice

    Science.gov (United States)

    Jaundice of the newborn; Neonatal hyperbilirubinemia; Bili lights - jaundice; Infant - yellow skin; Newborn - yellow skin ... to be able to do this efficiently. Most newborns have some yellowing of the skin, or jaundice. ...

  10. Enflurane for controlled hypotension.

    OpenAIRE

    Firn, S.

    1983-01-01

    Enflurane was substituted for halothane in an established technique of controlled hypotension, involving beta-blockade and sympathetic ganglion blockade, for 2 groups of patients. One group was undergoing major plastic surgery and/or major maxillo-facial surgery and these patients breathed spontaneously. The other group was undergoing major neurosurgery and received intermittent positive pressure ventilation (IPPV). All patients were carefully monitored during anaesthesia and for 24 hours pos...

  11. A sandwich ELISA for porcine alpha-1acid glycoprotein (pAGP, ORM-1) and further demonstration of its use to evaluate growth potential in newborn pigs

    Science.gov (United States)

    A simple, reproducible sandwich ELISA was developed to measure porcine alpha-1 acid glycoprotein (pAGP, ORM-1) in pig plasma. Pig AGP isolated from serum was purchased and a polyclonal antisera was prepared in rabbits using the whole pAGP molecule as immunogen. The antiserum was affinity-purified...

  12. Hypotension begins at 110 mm Hg: redefining "hypotension" with data.

    Science.gov (United States)

    Eastridge, Brian J; Salinas, Jose; McManus, John G; Blackburn, Lorne; Bugler, Eileen M; Cooke, William H; Convertino, Victor A; Concertino, Victor A; Wade, Charles E; Holcomb, John B

    2007-08-01

    Clinicians routinely refer to hypotension as a systolic blood pressure (SBP) Data Bank with emergency department SBP and mortality data were analyzed. Patients (140,898) with severe head injuries, a Glasgow Coma Score definition of hypotension and hypoperfusion than is 90 mm Hg. This analysis will also be useful for developing appropriately powered studies of hemorrhagic shock.

  13. Controlled hypotension for spinal surgery

    OpenAIRE

    Dutton, Richard P.

    2004-01-01

    Controlled, deliberate hypotension during anesthesia for major spinal surgery reduces intraoperative blood loss and transfusion requirement. Hypotension may be achieved with increased doses of volatile anesthetic agents or by continuous infusion of vasodilating drugs. Safe application of this technique requires knowledge of the physiology of hemorrhagic shock and close intraoperative monitoring to avoid vasoconstriction and end-organ ischemia.

  14. A single bolus meal elicits different regulation of protein synthesis and mTOR signaling in visceral tissues and skeletal muscle of newborn pigs

    Science.gov (United States)

    Neonates, a highly anabolic population, use dietary amino acids efficiently for growth because they can increase protein synthesis in response to feeding to a greater extent than mature animals. The enhancement of protein synthesis after a meal in neonatal pigs is well known, but the time course of ...

  15. [Orthostatic hypotension; that great unknown].

    Science.gov (United States)

    Velilla-Zancada, S M; Prieto-Díaz, M A; Escobar-Cervantes, C; Manzano-Espinosa, L

    2016-11-16

    Orthostatic hypotension is an anomaly of growing interest in scientific research. Although certain neurogenic diseases are associated with this phenomenon, it can also be associated with non-neurological causes. Although orthostatic hypotension is defined by consensus as a decrease in the systolic blood pressure of at least 20mmHg, or a decrease in diastolic blood pressure of at least 10mmHg, within 3min of standing, the studies differ on how to diagnose it. Orthostatic hypotension is associated with certain cardiovascular risk factors and with drug treatment, but the results are contradictory. The purpose of this review is to update the knowledge about orthostatic hypotension and its treatment, as well as to propose a method to standardise its diagnosis. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Spontaneous intracranial hypotension

    Energy Technology Data Exchange (ETDEWEB)

    Haritanti, A. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Karacostas, D. [Department of Neurology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)], E-mail: bneurol@med.auth.gr; Drevelengas, A. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Kanellopoulos, V. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)], E-mail: vasikanel@hotmail.com; Paraskevopoulou, E. [Department of Neurology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Lefkopoulos, A.; Economou, I.; Dimitriadis, A.S. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)

    2009-02-15

    Spontaneous intracranial hypotension (SIH) is an uncommon but increasingly recognized syndrome. Orthostatic headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delayed diagnosis of this condition may subject patients to unnecessary procedures and prolong morbidity. We describe six patients with SIH and outline the important clinical and neuroimaging findings. They were all relatively young, 20-54 years old, with clearly orthostatic headache, minimal neurological signs (only abducent nerve paresis in two) and diffuse pachymeningeal gadolinium enhancement on brain MRI, while two of them presented subdural hygromas. Spinal MRI was helpful in detecting a cervical cerebrospinal fluid leak in three patients and dilatation of the vertebral venous plexus with extradural fluid collection in another. Conservative management resulted in rapid resolution of symptoms in five patients (10 days-3 weeks) and in one who developed cerebral venous sinus thrombosis, the condition resolved in 2 months. However, this rapid clinical improvement was not accompanied by an analogous regression of the brain MR findings that persisted on a longer follow-up. Along with recent literature data, our patients further point out that SIH, to be correctly diagnosed, necessitates increased alertness by the attending physician, in the evaluation of headaches.

  17. Hemodynamics in diabetic orthostatic hypotension

    DEFF Research Database (Denmark)

    Hilsted, J; Parving, H H; Christensen, N J

    1981-01-01

    in normal subjects (n = 7) and in juvenile-onset diabetic patients without neuropathy (n = 8), with slight neuropathy (decreased beat-to-beat variation in heart rate during hyperventilation) (n = 8), and with severe neuropathy including orthostatic hypotension (n = 7). Blood pressure decreased precipitously...... in the standing position in the diabetics with orthostatic hypotension, whereas moderate decreases were found in the other three groups. Upon standing, heart rate rose and cardiac output and plasma volume decreased similarly in the four groups. The increases in total peripheral resistance, splanchnic vascular...... than 0.025) than in the patients without neuropathy, whereas plasma renin responses to standing were similar in the four groups. We conclude that in diabetic hypoadrenergic orthostatic hypotension the basic pathophysiological defect is lack of ability to increase vascular resistance, probably due...

  18. Pseudoarachnoiditis in Spontaneous Intracranial Hypotension

    Directory of Open Access Journals (Sweden)

    Özlem Alkan

    2011-03-01

    Full Text Available Spontaneous intracranial hypotension is an important cause of new daily persistent headaches in young and middle-aged individuals. The diagnosis is made based on low cerebrospinal fluid pressure with characteristic findings upon brain and spinal magnetic resonance imaging (MRI. We present the case of a 15-year-old boy with spontaneous intracranial hypotension. Although his brain MRI was normal, his lumbar spinal MRI showed clustering of the nerve roots characteristic of arachnoiditis. Radionuclide cisternography revealed an epidural leak, which was treated with an epidural blood patch. The patient reached a near-full recovery within 24 h, and the lumbar spinal MRI findings mimicking arachnoiditis disappeared.

  19. Communication and Your Newborn

    Science.gov (United States)

    ... Your Newborn Medical Care and Your Newborn Learning, Play, and Your Newborn Your Newborn's Hearing, Vision, and Other Senses Your Newborn's Growth A Guide for First-Time Parents Sleep and Newborns Jaundice in Healthy Newborns Your Child’s Development: 3-5 Days View more Partner Message About ...

  20. Intracranial hypotension and intracranial hypertension.

    Science.gov (United States)

    Yuh, Esther L; Dillon, William P

    2010-11-01

    Intracranial pressure (ICP) is the pressure within the intracranial space. Intracranial hypotension is a clinical syndrome in which low cerebrospinal fluid volume (CSF) results in orthostatic headache. Severe cases can result in nausea, vomiting, photophobia, and, rarely, decreased level of consciousness and coma. CSF opening pressure can be within the normal range in spontaneous intracranial hypotension. Imaging tests therefore play a key and decisive role in the diagnosis, as well as treatment, of intracranial hypotension. Intracranial hypertension occurs in a chronic form known as idiopathic intracranial hypertension, as well as in a large variety of neurologic and systemic disorders. Symptoms include headache, nausea and vomiting, blurred vision, and in severe cases, altered level of consciousness that can progress to coma and death. Direct measurements of CSF pressure through lumbar puncture (in idiopathic intracranial hypotension) or invasive ICP monitoring (in acute intracranial hypertension) are the key diagnostic tests. Imaging is used primarily to determine treatable causes of increased ICP, to assess for impending brain herniation, and to evaluate ventricular size. Copyright © 2010 Elsevier Inc. All rights reserved.

  1. Droxidopa for Symptomatic Neurogenic Hypotension.

    Science.gov (United States)

    Ferguson-Myrthil, Nadia

    Droxidopa is a first-in-class, orally available, synthetic amino acid precursor of norepinephrine that received accelerated Food and Drug Administration approval in February 2014 after Orphan Drug status for a debilitating condition known as symptomatic neurogenic orthostatic hypotension. Neurogenic disorders often lead to postural hypotension as a result of poor norepinephrine release from its storage sites. Clinical data suggest increases in standing systolic blood pressure and improvements in many other markers for subjective relief in patients with symptomatic neurogenic hypotension who received droxidopa therapy over 1-2 weeks. Studies evaluating the sustained effects of droxidopa are ongoing. With minimal drug interactions (even with carbidopa use) or adverse effects, droxidopa therapy can be used safely in patients with a variety of neurologic conditions; however, more data are needed to determine its appropriate pharmacotherapeutic role. In all, droxidopa is a safe and effective medication for the treatment of orthostatic dizziness/lightheadedness, or the "feeling that you are about to black out" in adult patients with symptomatic neurogenic orthostatic hypotension secondary to primary autonomic failure (Parkinson's disease, multiple system atrophy, and pure autonomic failure), dopamine beta-hydroxylase deficiency, and nondiabetic autonomic neuropathy.

  2. A randomized comparative trial of combinational methods for preventing post-spinal hypotension at elective cesarean delivery

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2011-01-01

    Conclusions: Among the three studied methods, administration of ephedrine plus bandage of the lower extremities was the most effective one in reducing the incidence of post-spinal hypotension. The groups were not clinically different concerning the effect of treatment on newborn health.

  3. Sleep and Newborns

    Science.gov (United States)

    ... of Braces Eating Disorders Mitral Valve Prolapse Arrhythmias Sleep and Newborns KidsHealth > For Parents > Sleep and Newborns ... night it is. How Long Will My Newborn Sleep? Newborns should get 14 to 17 hours of ...

  4. Growth and Your Newborn

    Science.gov (United States)

    ... Your Newborn Medical Care and Your Newborn Learning, Play, and Your Newborn A Guide for First-Time Parents Your Child's Growth Breastfeeding vs. Formula Feeding Your Child's Development: Newborn View more Partner Message About Us Contact ...

  5. Maternal Methyl Donor Supplementation during Gestation Counteracts the Bisphenol A-Induced Impairment of Intestinal Morphology, Disaccharidase Activity, and Nutrient Transporters Gene Expression in Newborn and Weaning Pigs

    Directory of Open Access Journals (Sweden)

    Hong Liu

    2017-04-01

    Full Text Available This study was conducted to explore whether exposure to bisphenol A (BPA during pregnancy could change intestinal digestion and absorption function in offspring using pigs as a model, and whether methyl donor (MET could counteract the BPA-induced impacts. Fifty Landrace × Yorkshire sows were divided into four dietary groups throughout gestation: control diet (CON; control diet supplemented with BPA (50 mg/kg; control diet supplemented with MET (3 g/kg betaine, 400 mg/kg choline, 150 μg/kg vitamin B12, and 15 mg/kg folic acid; and control diet with BPA and MET supplementation (BPA + MET. Intestine samples were collected from pigs’ offspring at birth and weaning. Maternal BPA exposure during pregnancy significantly reduced the ratio of jejunum villus height to crypt depth, decreased the jejunum sucrase activity, down-regulated the mRNA expression of jejunum peptide transporter 1 (Pept1 and DNA methyl transferase 3a (DNMT3a, and decreased the DNA methylation level of jejunum Pept1 in offspring (p < 0.05. Maternal MET supplementation significantly raised the ratio of villus height to crypt depth in jejunum and ileum, improved the jejunum lactase activity, up-regulated the mRNA expression of jejunum Pept1, lactase (LCT, DNMT1, DNMT3a, and methylenetetrahydrofolate reductase (MTHFR, and increased the DNA methylation level of jejunum Pept1 in offspring (p < 0.05. However, the ratio of jejunum villus height to crypt depth was higher in BPA + MET treatment compared with CON and BPA treatment (p < 0.05. Meanwhile, there was no difference in the jejunum sucrase activity, the mRNA expression of jejunum Pept1 and DNMT3a, and the DNA methylation level of jejunum Pept1 between CON and BPA + MET treatment. These results indicated that maternal exposure to BPA during gestation might suppress offspring’s intestinal digestion and absorption function, whereas supplementation of MET could counteract these damages, which might be associated with DNA methylation.

  6. [Efficiency of hydroxyethyl starch use for arterial hypotension and shock in early postoperative period].

    Science.gov (United States)

    Kriuchko, D S; Ionov, O V; Balashova, E N; Kirtbaia, A R; Nikitina, I V; Krasnova, L A; Sharipova, L V; Terliakova, O Iu; Milaia, O V

    2013-01-01

    It is common knowledge that arterial hypotension is a one of most prevalent pathology of early neonatal period and it causes severe neurological complications. Purpose of the prospective randomized open study was to assess the efficacy of HES 130/0.4 (6% Voluven) as a start medicine for arterial hypotension in early neonatal period in comparison with normal saline solution (0.9% NaCl). the study was held from January 2010 to September 2011. Newborns of the ICU with arterial hypotension on the first day of life were included into the study. Acute haemorrhage was an exclusion criterion. Routine monitoring of arterial pressure, heart rate and diuresis was carried out in all newborns. pH, pCO2, pO2 blood glucose, lactate and BE levels were measured before and after the treatment. Echocardiography, examination of regional blood flow in anterior cerebral artery, renal artery and mesenteric artery was held HES 130/0.4 (6% Voluven) and saline solution (0.9% NaCl) were used Parameters of haemostasis, biochemical and haematological analysis monitored after the solutions use. Time of arterial pressure normalization and duration of the treatment positive effect were recorded Episodes of hypotension, amount of cardiotonics per day and per 7 days and duration of cardiotonics administration were recorded as well. 6% Voluven infusion both to 0.9% NaCl infusion normalizes the regional circulation. Furthermore it increases the blood pH and diuresis. Lactate level normalization occurred only after 6% Voluven infusion. There was not change of serum sodium level. Liver enzymes, C-protein, prothrombin index were same in both groups of patients. 6% Voluven use in newborns with extremely low birth weight was accompanied with increasing of creatinine level, prolongation of activated partial thromboplastin time and increasing of intraventricular hemorrhage rate. Newborns with weight over 1000 gram did not have these complications. Voluven advantage in comparison with saline solution is a

  7. Predicting spinal hypotension during Caesarean section

    African Journals Online (AJOL)

    Hypotension under spinal anaesthesia for Caesarean section is a common and important problem, with significant maternal and foetal implications. The ability to predict which patients are at particular risk for severe hypotension would enable anaesthetists not only to prepare appropriately but potentially also to individualise ...

  8. Orthostatic hypotension: epidemiology, pathophysiology and management

    Science.gov (United States)

    Jacob, G.; Robertson, D.

    1995-01-01

    Orthostatic hypotension is characterized by low upright blood pressure levels and symptoms of cerebral hypoperfusion. Whereas orthostatic hypotension is heterogeneous, correct pathophysiologic diagnosis is important because of therapeutic and prognostic considerations. Although therapy is not usually curative, it can be extraordinarily beneficial if it is individually tailored. Management of the Shy-Drager syndrome (multiple-system atrophy) remains a formidable challenge.

  9. Prevention of Spinal Hypotension During Caesarean Section ...

    African Journals Online (AJOL)

    Background: Volume preload with intravenous fluid is a method used in preventing spinal anaesthesia induced hypotension during caesarean section. We compared the efficacy of preloading with 1000ml Ringer's Lactate (RL) solution versus 500ml 6% Hydroxyethyl starch (HES) in preventing hypotension in two groups of ...

  10. Newborn head molding

    Science.gov (United States)

    Newborn cranial deformation; Molding of the newborn's head; Neonatal care - head molding ... The bones of a newborn baby's skull are soft and flexible, with gaps between the plates of bone. The spaces between the bony plates of ...

  11. Spontaneous intracranial hypotension: diagnosis to management.

    Science.gov (United States)

    Limaye, Kaustubh; Samant, Rohan; Lee, Ricky W

    2016-06-01

    Spontaneous Intracranial Hypotension typically occurs from spontaneous CSF leak. CSF volume depletion rather than decrease in CSF pressure is thought to be the main causative feature for intracranial hypotension. More and more cases of intracranial hypotension are getting diagnosed with the advances in the imaging. The advances in the imaging have also led to the better understanding of the dynamic changes that occur with intracranial hypotension. The old theories of CSF overproduction or CSF underproduction have not been substantially associated with intracranial hypotension. It has also led to the fore different atypical clinical features and presentations. Although, it has been known for a long time, the diagnosis is still challenging and dilemma persists over one diagnostic modality over other and the subsequent management. Spontaneous CSF leaks occur at the spinal level and the skull base and other locations are rare. The anatomy of spontaneous intracranial hypotension is a very complex process with significant overlap in connective tissue disorders, previous dural weakness or meningeal diverticula. To localize the location of the CSF leak-CT myelography is the modality of choice. CSF cysternography may provide additional confirmation in uncertain cases and also MRI spine imaging may be of significant help in some cases. Spontaneous intracranial hypotension continues to be a diagnostic dilemma and our effort was to consolidate available information on the clinical features, diagnostics, and management for a practicing neurologist for a "15-20 min quick update of the topic".

  12. The commonly missed diagnosis of intracranial hypotension

    Directory of Open Access Journals (Sweden)

    Ashlee N. Ruggeri-McKinley, BSN, RN

    2016-06-01

    Full Text Available We report a 28 year old female who presented with a subacute onset of a severe throbbing and stabbing headache after a morning spin class 9 months ago. We confirmed the diagnosis of spontaneous intracranial hypotension cause by a cerebrospinal fluid leak. The headache finally resolved after a 55 ml blood patch. Affecting an estimated 5/100,000 patients, spontaneous intracranial hypotension is considered rare in medical literature. Many patients with spontaneous intracranial hypotension are incapacitated for years and even decades. The misdiagnosis of intracranial hypotension can have serious consequences and lead to unnecessary testing and treatment. Healthcare professionals need to be aware of this diagnosis when evaluating a patient with acute head pain. Considering that physical exams are usually normal, clinicians must focus on the patient history and physical. Clues in the patient interviewing process can lead to an immediate and accurate diagnosis.

  13. Maternal hypotension and neonatal acidemia during Caeserean ...

    African Journals Online (AJOL)

    Objectives: To determine the incidence of neonatal acidaemia following delivery through caesarean section under spinal anaesthesia and determine the prevalence of maternal hypotension during Caesarean section under spinal anaesthesia and its correlation with neonatal acidaemia. Design: Prospective observational ...

  14. Corticosteroids for treating hypotension in preterm infants.

    Science.gov (United States)

    Ibrahim, Hafis; Sinha, Ian P; Subhedar, Nimish V

    2011-12-07

    Systemic hypotension is a relatively common complication of preterm birth and is associated with periventricular haemorrhage, periventricular white matter injury and adverse neurodevelopmental outcome. Corticosteroid treatment has been used as an alternative or an adjunct to conventional treatment with volume expansion and vasopressor/inotropic therapy. To determine the effectiveness and safety of corticosteroids used either as primary treatment of hypotension or for the treatment of refractory hypotension in preterm infants. Randomized or quasi-randomised controlled trials were identified by searching the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2011), MEDLINE (1996 to Jan 2011), EMBASE (1974 to Jan 2011), CINAHL (1981 to 2011), reference lists of published papers and abstracts from the Pediatric Academic Societies and the European Society for Pediatric Research meetings published in Pediatric Research (1995 to 2011). We included all randomised or quasi-randomised controlled trials investigating the effect of corticosteroid therapy in the treatment of hypotension in preterm infants (hypotension resistant to inotropes/pressors and volume therapy. We included studies comparing oral/intravenous corticosteroids with placebo, other drugs used for providing cardiovascular support or no therapy in this review. Methodological quality of eligible studies was assessed according to the methods used for minimising selection bias, performance bias, attrition bias and detection bias. Studies that evaluated corticosteroids (1) as primary treatment for hypotension or (2) for refractory hypotension unresponsive to prior use of inotropes/pressors and volume therapy, were analysed using separate comparisons. Data were analysed using the standard methods of the Neonatal Review Group using Rev Man 5.1.2. Treatment effect was analysed using relative risk, risk reduction, number needed to treat for categorical outcomes and weighted mean

  15. Controlled hypotension: a guide to drug choice.

    Science.gov (United States)

    Degoute, Christian-Serge

    2007-01-01

    For half a century, controlled hypotension has been used to reduce bleeding and the need for blood transfusions, and provide a satisfactory bloodless surgical field. It has been indicated in oromaxillofacial surgery (mandibular osteotomy, facial repair), endoscopic sinus or middle ear microsurgery, spinal surgery and other neurosurgery (aneurysm), major orthopaedic surgery (hip or knee replacement, spinal), prostatectomy, cardiovascular surgery and liver transplant surgery. Controlled hypotension is defined as a reduction of the systolic blood pressure to 80-90 mm Hg, a reduction of mean arterial pressure (MAP) to 50-65 mm Hg or a 30% reduction of baseline MAP. Pharmacological agents used for controlled hypotension include those agents that can be used successfully alone and those that are used adjunctively to limit dosage requirements and, therefore, the adverse effects of the other agents. Agents used successfully alone include inhalation anaesthetics, sodium nitroprusside, nitroglycerin, trimethaphan camsilate, alprostadil (prostaglandin E1), adenosine, remifentanil, and agents used in spinal anaesthesia. Agents that can be used alone or in combination include calcium channel antagonists (e.g. nicardipine), beta-adrenoceptor antagonists (beta-blockers) [e.g. propranolol, esmolol] and fenoldopam. Agents that are mainly used adjunctively include ACE inhibitors and clonidine. New agents and techniques have been recently evaluated for their ability to induce effective hypotension without impairing the perfusion of vital organs. This development has been aided by new knowledge on the physiology of peripheral microcirculatory regulation. Apart from the adverse effects of major hypotension on the perfusion of vital organs, potent hypotensive agents have their own adverse effects depending on their concentration, which can be reduced by adjuvant treatment. Care with use limits the major risks of these agents in controlled hypotension; risks that are generally less

  16. How do pediatric anesthesiologists define intraoperative hypotension?

    Science.gov (United States)

    Nafiu, Olubukola O; Voepel-Lewis, Terri; Morris, Michelle; Chimbira, Wilson T; Malviya, Shobha; Reynolds, Paul I; Tremper, Kevin K

    2009-11-01

    Although blood pressure (BP) monitoring is a recommended standard of care by the ASA, and pediatric anesthesiologists routinely monitor the BP of their patients and when appropriate treat deviations from 'normal', there is no robust definition of hypotension in any of the pediatric anesthesia texts or journals. Consequently, what constitutes hypotension in pediatric anesthesia is currently unknown. We designed a questionnaire-based survey of pediatric anesthesiologists to determine the BP ranges and thresholds used to define intraoperative hypotension (IOH). Members of the Society of Pediatric Anesthesia (SPA) and the Association of Paediatric Anaesthetists (APA) of Great Britain and Ireland were contacted through e-mail to participate in this survey. We asked a few demographic questions and five questions about specific definitions of hypotension for different age groups of patients undergoing inguinal herniorraphy, a common pediatric surgical procedure. The overall response rate was 56% (483/860), of which 76% were SPA members. Majority of the respondents (72%) work in academic institutions, while 8.9% work in institutions with fewer than 1000 annual pediatric surgical caseload. About 76% of respondents indicated that a 20-30% reduction in baseline systolic blood pressure (SBP) indicates significant hypotension in children under anesthesia. Most responders (86.7%) indicated that they use mean arterial pressure or SBP (72%) to define IOH. The mean SBP values for hypotension quoted by SPA members was about 5-7% lower across all pediatric age groups compared to values quoted by APA members (P = 0.001 for all age groups). There is great variability in the BP parameters used and the threshold used for defining and treating IOH among pediatric anesthesiologists. The majority of respondents considered a 20-30% reduction from baseline in SBP as indicative of significant hypotension. Lack of a consensus definition for a common clinical condition like IOH could have

  17. Programming Pig

    CERN Document Server

    Gates, Alan

    2011-01-01

    This guide is an ideal learning tool and reference for Apache Pig, the open source engine for executing parallel data flows on Hadoop. With Pig, you can batch-process data without having to create a full-fledged application-making it easy for you to experiment with new datasets. Programming Pig introduces new users to Pig, and provides experienced users with comprehensive coverage on key features such as the Pig Latin scripting language, the Grunt shell, and User Defined Functions (UDFs) for extending Pig. If you need to analyze terabytes of data, this book shows you how to do it efficiently

  18. Hearing Loss: Screening Newborns

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Hearing Loss Screening Newborns Past Issues / Spring 2015 Table ... deafness, which account for most cases. Screening Newborns' Hearing Now Standard In 1993, children born in the ...

  19. Low blood sugar - newborns

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007306.htm Low blood sugar - newborns To use the sharing features on this page, please enable JavaScript. A low blood sugar level in newborn babies is also called neonatal ...

  20. Newborn test (image)

    Science.gov (United States)

    The newborn is commonly assessed with the APGAR score, a quick test performed at 1 and 5 minutes after birth to determine the physical condition of the newborn. The five categories assessed are heart rate, respiratory ...

  1. Transient tachypnea - newborn

    Science.gov (United States)

    TTN; Wet lungs - newborns; Retained fetal lung fluid; Transient RDS; Prolonged transition; Neonatal - transient tachypnea ... Newborns with transient tachypnea have breathing problems soon after birth, most often within 1 to 2 hours. ...

  2. Nail care for newborns

    Science.gov (United States)

    ... Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Nail care for newborns URL of this page: //medlineplus.gov/ency/article/001914.htm Nail care for newborns To use ...

  3. [Hypotension and bradycardia before spinal anesthesia].

    Science.gov (United States)

    Shiraishi Zapata, Carlos Javier

    I report a case of hypotension and bradycardia before spinal anesthesia in a pregnant woman with mild to moderate hypertension treated with nifedipine and methyldopa, scheduled for an elective cesarean delivery. She had the history of neurally-mediated syncopes. Two main factors (increased vagal tone and adverse effects of antihypertensive drugs) could explain the hypotension and bradycardia before spinal anesthesia. Monitoring allowed recognizing the problem and corrected it. Thus, it was avoided a disaster in anesthesia, as hemodynamic changes after spinal anesthesia, they would have joined to previous hypotension and bradycardia, which would have caused even a cardiac arrest. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Orthognathic surgery with or without induced hypotension.

    Science.gov (United States)

    Carlos, E; Monnazzi, M S; Castiglia, Y M M; Gabrielli, M F R; Passeri, L A; Guimarães, N C

    2014-05-01

    This study involved a retrospective evaluation of patients subjected to surgery for dentofacial deformities treated without induced controlled hypotension (group I, n=50) and a prospective evaluation of patients who were subjected to surgery under hypotensive general anaesthesia (group II, n=50). No statistical differences were found between the study groups with regard to the duration of surgery. However, there were statistically significant differences in the need for blood transfusion and the occurrence of bradycardia during the maxillary down-fracture. Hypotensive anaesthesia decreased the need for a blood transfusion and the occurrence of bradycardia, and is therefore considered highly beneficial for patients undergoing orthognathic surgery. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Simulating pigs

    NARCIS (Netherlands)

    Boumans, Iris

    2017-01-01

    The transition towards sustainable pig production systems is receiving increasing attention nowadays. Pig behaviour plays a central role in sustainability, as it is an important indicator for pig welfare and can also affect other sustainability issues. Understanding behaviour and related welfare

  6. Genetics and molecular biology of hypotension

    Science.gov (United States)

    Robertson, D.

    1994-01-01

    Major strides in the molecular biology of essential hypertension are currently underway. This has tended to obscure the fact that a number of inherited disorders associated with low blood pressure exist and that these diseases may have milder and underrecognized phenotypes that contribute importantly to blood pressure variation in the general population. This review highlights some of the gene products that, if abnormal, could cause hypotension in some individuals. Diseases due to abnormalities in the catecholamine enzymes are discussed in detail. It is likely that genetic abnormalities with hypotensive phenotypes will be as interesting and diverse as those that give rise to hypertensive disorders.

  7. Obstetric spinal hypotension: Preoperative risk factors and the ...

    African Journals Online (AJOL)

    Background. Obstetric spinal hypotension is a common and important problem during caesarean delivery. Identifying patients at risk for hypotension may guide clinical decision-making and allow timeous referral. Objective. Using preoperative risk factors, to develop a simple scoring system to predict systolic hypotension.

  8. Pharmacological Evidence of Hypotensive Activity of Somina ...

    African Journals Online (AJOL)

    (root pulp and bark). Pak J Pharmacol 2009; 26(2):. 41-47. 10. Adeboye JO, Fajonyomi MO, Makinde JM, Taiwo OB. A preliminary study on the hypotensive activity of. Persea Americana leaf extracts in anaesthetized normotensive rats. Fitoterapia 1999; 70: 15-20. 11. Sleight P, La Rovere MT, Mortara A, Pinna G, Maestri R.

  9. Acute renal failure in the newborn.

    Science.gov (United States)

    Andreoli, Sharon Phillips

    2004-04-01

    , intermittent hemodialysis, or hemofiltration with or without a dialysis circuit. The preferential use of hemofiltration by pediatric nephrologists is increasing while the use of peritoneal dialysis is decreasing except for neonates and small infants. Peritoneal dialysis has been a major modality of therapy for acute renal failure in the neonate when vascular access may be difficult to maintain. In the newborn, the prognosis and recovery from acute renal failure is highly dependent upon the underlying etiology of the acute renal failure. Factors that are associated with mortality include multiorgan failure, hypotension, need for pressors, hemodynamic instability, and need for mechanical ventilation and dialysis. The mortality and morbidity of newborns with acute renal failure is much worse in neonates with multiorgan failure. Newborns who have suffered substantial loss of nephrons as may occur in cortical necrosis are at risk for late development of renal failure after apparent recovery from the initial insult. Similarly, hypoxic/ischemic and nephrotoxic injury to the developing kidney can result is decreased nephron number. Newborns with acute renal failure need life-long monitoring of their renal function, blood pressure, and urinalysis. Typically, the late development of chronic renal failure will first becomes apparent with the development of hypertension, proteinuria, and eventually an elevated blood urea nitrogen and creatinine.

  10. Hypotension and Environmental Noise: A Replication Study

    Directory of Open Access Journals (Sweden)

    Peter Lercher

    2014-08-01

    Full Text Available Up to now, traffic noise effect studies focused on hypertension as health outcome. Hypotension has not been considered as a potential health outcome although in experiments some people also responded to noise with decreases of blood pressure. Currently, the characteristics of these persons are not known and whether this down regulation of blood pressure is an experimental artifact, selection, or can also be observed in population studies is unanswered. In a cross-sectional replication study, we randomly sampled participants (age 20–75, N = 807 from circular areas (radius = 500 m around 31 noise measurement sites from four noise exposure strata (35–44, 45–54, 55–64, >64 Leq, dBA. Repeated blood pressure measurements were available for a smaller sample (N = 570. Standardized information on socio-demographics, housing, life style and health was obtained by door to door visits including anthropometric measurements. Noise and air pollution exposure was assigned by GIS based on both calculation and measurements. Reported hypotension or hypotension medication past year was the main outcome studied. Exposure-effect relationships were modeled with multiple non-linear logistic regression techniques using separate noise estimations for total, highway and rail exposure. Reported hypotension was significantly associated with rail and total noise exposure and strongly modified by weather sensitivity. Reported hypotension medication showed associations of similar size with rail and total noise exposure without effect modification by weather sensitivity. The size of the associations in the smaller sample with BMI as additional covariate was similar. Other important cofactors (sex, age, BMI, health and moderators (weather sensitivity, adjacent main roads and associated annoyance need to be considered as indispensible part of the observed relationship. This study confirms a potential new noise effect pathway and discusses potential patho

  11. Follow-up of 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn

    DEFF Research Database (Denmark)

    Eriksen, Vibeke; Nielsen, Lars Holme; Klokker, Mads

    2009-01-01

    AIM: Determine the prevalence of sensorineural hearing loss (SNHL) and relate this to cumulative exposure to hypoxia, hypocapnia and hypotension. Describe chronic health problems among 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn (PPHN). METHODS: The index...

  12. Aconite poisoning presenting as hypotension and bradycardia.

    Science.gov (United States)

    Chan, Thomas Y K

    2009-12-01

    The principal toxic ingredients of aconite roots include aconitine, mesaconitine and hypaconitine, which are known cardiotoxins and neurotoxins. A 58-year-old man took a decoction of 11 g each of processed 'chuanwu' (the main root of Aconitum carmichaeli) and processed 'caowu' (the root of A. kusnezoffii) as treatment for his neck pain. One hour later, he experienced numbness of tongue and the four limbs, generalized weakness, nausea, vomiting, diarrhoea and dizziness. Three hours after ingestion, he was admitted to hospital. His blood pressure was 106/53 mmHg and heart rate 65 beats/min. Six hours after ingestion, he became hypotensive (systolic blood pressure aconite poisoning, prolonged hypotension and sinus bradycardia may occur and supportive therapy with close monitoring of blood pressure and cardiac rhythm are essential.

  13. Spontaneous intracranial hypotension: use of unenhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Quinones Tapia, D.; Lopez-Ibor, L. [Dept. of Neuroradiology, Clinica de La Zarzuela, Aravaca, Madrid (Spain); Pardo, J.; Anciones, V. [Dept. of Neurology, Clinica de La Zarzuela, Aravaca, Madrid (Spain); Serrano, J.M. [Dept. of Ophthalmology, Fundacion Jimenez Diaz, Madrid (Spain)

    2000-07-01

    We report a case of spontaneous intracranial hypotension diagnosed with unenhanced cranial MRI, showing laminar subdural fluid and engorgement of the hypophysis and perisellar sinuses. Cerebrospinal fluid pressure was low. MRI was normal after resolution of symptoms. Prior reports emphasise the enhancing pachymeninges seen in this syndrome. We maintain that, when subdural collections and perisellar engorgement are detected on unenhanced MRI in the proper clinical setting, contrast enhancement may not be necessary for the diagnosis. (orig.)

  14. Hypotension in Severe Dimethoate Self-Poisoning

    OpenAIRE

    Davies, James; Roberts, Darren; Eyer, Peter; Buckley, Nick; Eddleston, Michael

    2008-01-01

    Introduction Acute self-poisoning with the organophosphorus (OP) pesticide dimethoate has a human case fatality three-fold higher than poisoning with chlorpyrifos despite similar animal toxicity. The typical clinical presentation of severe dimethoate poisoning is quite distinct from that of chlorpyrifos and other OP pesticides: many patients present with hypotension that progresses to shock and death within 12?48 h post-ingestion. The pathophysiology of this syndrome is not clear. Case report...

  15. Jaundice in Healthy Newborns

    Science.gov (United States)

    ... that hasn't responded to other treatments, a blood transfusion may be done. Reviewed by: Rupal Christine Gupta, MD Date reviewed: January 2015 previous 1 • 2 For Teens For Kids For Parents MORE ON THIS TOPIC Pregnancy & Newborn Center Looking at Your Newborn: What's ...

  16. Use of plasma orosomucoid in newborn piglets to predict preweaning growth performance and its mechanism of action

    Science.gov (United States)

    Orosomucoid (ORM) is the most prevalent serum protein in the newborn pig. The present study was designed to determine if plasma ORM at birth can be used to predict the relative performance of piglets within a litter between birth and weaning using a highly sensitive ELISA specific for pig ORM. Sec...

  17. Levocarnitine Decreases Intradialytic Hypotension Episodes: A Randomized Controlled Trial.

    Science.gov (United States)

    Ibarra-Sifuentes, Héctor Raúl; Del Cueto-Aguilera, Ángel; Gallegos-Arguijo, Daniel Alberto; Castillo-Torres, Sergio Andres; Vera-Pineda, Raymundo; Martínez-Granados, Rolando Jacob; Atilano-Díaz, Alexandro; Cuellar-Monterrubio, Jesus Eduardo; Pezina-Cantú, Cesar Octaviano; Martínez-Guevara, Edgar de Jesús; Ortiz-Treviño, Juan Francisco; Delgado-García, Guillermo Rubén; Martínez-Jiménez, José Guadalupe; Cruz-Valdez, Jesús; Sánchez-Martínez, Concepción

    2017-10-01

    Intradialytic hypotension is common complication in stage 5 chronic kidney disease patients on hemodialysis. Incidence ranges from 15 to 30%. These patients have levocarnitine deficiency. A randomized, placebo-controlled quadruple-blinded trial was designed to demonstrate the levocarnitine efficiency on intradialytic hypotension prevention. Patients were randomized into four groups, to receive levocarnitine or placebo. During the intervention period, levocarnitine and placebo was administered 0 and 30 min before each hemodialysis session, respectively. During the trial, 33 patients received 1188 hemodialysis sessions. We identified 239 (21.3%) intradialytic hypotension episodes. The intradialytic hypotension episodes were less frequent in the levocarnitine group (9.3%, 60 IH events) (P hypotension episodes. Levocarnitine supplementation before each hemodialysis session efficiently diminishes the intradialytic hypotension episodes. This is a new application method that must be considered and explored. © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  18. Epidural anesthesia, hypotension, and changes in intravascular volume

    DEFF Research Database (Denmark)

    Holte, Kathrine; Foss, Nicolai B; Svensén, Christer

    2004-01-01

    hypotension is present, which may have implications for the choice of treatment of hypotension. However, no long-term information or measurements of plasma volumes with or without hypotension after epidural anesthesia are available. METHODS: In 12 healthy volunteers, the authors assessed plasma (125I...... and ephedrine has similar hemodynamic effects, the latter may be preferred in patients with cardiopulmonary diseases in which perioperative fluid overload is undesirable....

  19. The management of orthostatic hypotension in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Alvaro eSanchez-Ferro

    2013-06-01

    Full Text Available Orthostatic hypotension is a common and disabling symptom affecting Parkinson’s disease (PD patients. We present the effect of the different therapies commonly used to manage Parkinson’s disease on this clinical manifestation. For this purpose, we describe the relationship between orthostatic hypotension and the current treatments employed in PD, such as L-Dopa, dopaminergic agonists, and continuous dopaminergic stimulation therapies. Additionally, we review the therapeutic measures that could be used to ameliorate orthostatic hypotension. There are different approaches to deal with this manifestation, including pharmacological and non-pharmacological treatments, although none of them is specifically aimed for treating orthostatic hypotension in PD.

  20. PigGIS: Pig Genomic Informatics System

    DEFF Research Database (Denmark)

    Ruan, Jue; Guo, Yiran; Li, Heng

    2007-01-01

    Pig Genomic Information System (PigGIS) is a web-based depository of pig (Sus scrofa) genomic learning mainly engineered for biomedical research to locate pig genes from their human homologs and position single nucleotide polymorphisms (SNPs) in different pig populations. It utilizes a variety of...... human exons. We have also recovered 18 700 SNPs and 20 800 unique 60mer oligonucleotide probes for future pig genome analyses. PigGIS can be freely accessed via the web at http://www.piggis.org/ and http://pig.genomics.org.cn/ .......Pig Genomic Information System (PigGIS) is a web-based depository of pig (Sus scrofa) genomic learning mainly engineered for biomedical research to locate pig genes from their human homologs and position single nucleotide polymorphisms (SNPs) in different pig populations. It utilizes a variety...

  1. Lethal effect of a single dose of rasburicase in a preterm newborn infant.

    Science.gov (United States)

    Zaramella, Patrizia; De Salvia, Alessandra; Zaninotto, Martina; Baraldi, Maura; Capovilla, Giovanni; De Leo, Domenico; Chiandetti, Lino

    2013-01-01

    This case report describes a preterm newborn infant who was treated with a single dose of rasburicase for an increase in uric acid level. He died on the third day as a result of complications of hemolysis, which appeared to be precipitated by rasburicase. The patient's death was preceded by progressive respiratory insufficiency, lactic acidosis, and hyperbilirubinemia, culminating in refractory hypoxia and hypotension. A postmortem assay for glucose-6-phosphate dehydrogenase showed deficiency and the glucose-6-phosphate dehydrogenase Mediterranean genotype.

  2. Secondary Intracranial Hypotension: A Case Report

    Directory of Open Access Journals (Sweden)

    Pinar Gundogan Bozdag

    2014-04-01

    Full Text Available Intracranial hypotension is a clinical condition that characterized by postural (orthostatic headache and low pressure. It apperas with cerebrospinal fluid leak which occurs spontaneous or depending on the secondary attempts. 31 years old female patient which has diagnosis of acute appendicitis and underwent appendectomy under spinal anesthesia. postoperative 5.day she admitted with a postural headache, diplopia. Patient was treated with conservative methods after diagnosed with magnetic resonance imaging. We aim to asses an encountered complication after spinal anesthesia which widely applied for surgical procedures with imaging findings and literature.

  3. Infant - newborn development

    Science.gov (United States)

    ... appear normal. Your infant seems to be "losing" developmental milestones. For example, if your 9-month-old was ... time. Images Skull of a newborn Infantile reflexes Developmental milestones Moro reflex References Feigelman S. The first year. In: ...

  4. Feeding Your Newborn

    Science.gov (United States)

    ... than usual. Continue to nurse or feed on demand. Nursing mothers need not worry — breastfeeding stimulates milk production and your supply of breast milk will adjust to your baby's demand for it. Is My Newborn Getting Enough to ...

  5. In vivo and in vitro hypotensive effect of aqueous extract of Moringa stenopetala.

    Science.gov (United States)

    Mengistu, M; Abebe, Y; Mekonnen, Y; Tolessa, T

    2012-12-01

    Moringa stenopetala, Baker f. (Moringaceae) is used for food and medicine in Southern Ethiopia. To substantiate the hypotensive effect of M. stenopetala in vivo and in vitro. An in vivo experiment was carried out on male guinea pigs anaesthetized with pentobarbital. The arterial blood pressure was recorded from a carotid artery filled with heparinized saline via an arterial cannula connected to a pressure transducer. For the in vitro experiment the descending thoracic aorta was removed and kept moistened in Krebs-Henseleit solution and then mounted in a 20ml tissue bath maintained at 37°C and bubbled with a mixture of 95% oxygen and 5% carbon dioxide. Crude aqueous leaf extract of M. stenopetala caused significant fall in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MABP) at doses of 10, 20, 30 and 40 mg/kg in normotensive anaesthetized guinea pigs (n = 12). The effect might have been mediated by non-autonomic nervous system as the effect is not altered by atropine and propranolol. The extract also caused significant dose and time dependent inhibition of K(+) induced contraction on guinea pig aorta. M.stenopetala has blood pressure lowering effect substantiating the use of the plant in traditional medicine.

  6. Ontogenic increase in PGE2 and PGF2 alpha receptor density in brain microvessels of pigs.

    OpenAIRE

    Li, D. Y.; Varma, D. R.; Chemtob, S.

    1994-01-01

    1. The hypothesis that the relative vasoconstrictor ineffectiveness of prostaglandin E2 (PGE2) and PGF2 alpha on cerebral vessels of newborn pigs might be due to fewer receptors for these prostanoids was tested by comparing receptors for PGE2 (EP) and PGF2 alpha (FP) in cerebral microvessels from newborn and adult pigs. 2. Specific binding of [3H]-PGE2 and [3H]-PGF2 alpha to membranes prepared from brain microvessels showed that EP and FP receptor density (Bmax) in tissues from newborn animal...

  7. Indigo carmine-induced hypotension in patients undergoing general anaesthesia.

    Science.gov (United States)

    Jeon, H J; Yoon, J S; Cho, S S; Kang, K O

    2012-03-01

    Indigo carmine is a blue dye that is widely applied to localise ureteral orifices. It is generally believed to be a safe, biologically inert substance, and hypotensive reactions are extremely rare. However, we experienced three cases of indigo carmine-induced hypotension within a period of two weeks.

  8. The Prevalence of Orthostatic Hypotension in Type 2 Diabetes ...

    African Journals Online (AJOL)

    BACKGROUND: Orthostatic Hypotension is a serious and common complication of diabetes mellitus. AIMS: To determine the prevalence and risk factors of Orthostatic Hypotension in type 2 diabetic patients in a diabetes mellitus clinic in Enugu South-East Nigeria. METHOD AND MATERIALS: A structured questionnaire ...

  9. Association of mortality risk with various definitions of intradialytic hypotension.

    Science.gov (United States)

    Flythe, Jennifer E; Xue, Hui; Lynch, Katherine E; Curhan, Gary C; Brunelli, Steven M

    2015-03-01

    Intradialytic hypotension is a serious and frequent complication of hemodialysis; however, there is no evidence-based consensus definition of intradialytic hypotension. As a result, coherent evaluation of the effects of intradialytic hypotension is difficult. We analyzed data from 1409 patients in the HEMO Study and 10,392 patients from a single large dialysis organization to investigate the associations of commonly used intradialytic hypotension definitions and mortality. Intradialytic hypotension definitions were selected a priori on the basis of literature review. For each definition, patients were characterized as having intradialytic hypotension if they met the corresponding definition in at least 30% of baseline exposure period treatments or characterized as control otherwise. Overall and within subgroups of patients with predialysis systolic BPhypotension definitions that considered symptoms, interventions, and decreases in BP during dialysis were not associated with outcome, and when added to nadir BP, symptom and intervention criteria did not accentuate associations with mortality. Our results suggest that nadir-based definitions best capture the association between intradialytic hypotension and mortality. Copyright © 2015 by the American Society of Nephrology.

  10. Purpose of Newborn Hearing Screening

    Science.gov (United States)

    ... Español Text Size Email Print Share Purpose of Newborn Hearing Screening Page Content Article Body Before you ... they go home from the hospital. Why do newborns need hearing screening? Babies learn from the time ...

  11. Umbilical cord care in newborns

    Science.gov (United States)

    ... Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Umbilical cord care in newborns URL of this page: //medlineplus.gov/ency/article/001926.htm Umbilical cord care in newborns To ...

  12. GALACTOSEMIA IN NEWBORN CHILDREN

    Directory of Open Access Journals (Sweden)

    G.V. Yatsyk

    2007-01-01

    Full Text Available Galactosemia is a hereditary disease, the pathogenetic treatment of which is based on dietotherapy. Early diagnosing and the adequate choice of the diet improve the development forecasts for the ill child. The article describes a classical galactosemia case in a newborn. It is shown that despite diagnosing the disease on the second month of life, the adequate selection of etiopathogenetic dietotherapy and etiotropic therapy of the concurrent diseases helped compensate the inborn galactose metabolism defect and optimize the long-term forecast for the child.Key words: inborn metabolism dysfunctions, alactosemia, dietotherapy, newborn children.

  13. Epidural anesthesia, hypotension, and changes in intravascular volume

    DEFF Research Database (Denmark)

    Holte, Kathrine; Foss, Nicolai B; Svensén, Christer

    2004-01-01

    hypotension is present, which may have implications for the choice of treatment of hypotension. However, no long-term information or measurements of plasma volumes with or without hypotension after epidural anesthesia are available. METHODS: In 12 healthy volunteers, the authors assessed plasma (125I...... constant was 56 ml/min. CONCLUSIONS: Thoracic epidural anesthesia per se does not lead to changes in blood volumes despite a reduction in blood pressure. When fluid is infused, there is a dilution, and the fluid initially seems to be located centrally. Because administration of hydroxyethyl starch...

  14. Medical Care and Your Newborn

    Science.gov (United States)

    ... Healthy Drinks for Kids Medical Care and Your Newborn KidsHealth > For Parents > Medical Care and Your Newborn Print A A A What's in this article? ... as when he or she will see your newborn for the first time, office hours and on- ...

  15. Urine Blockage in Newborns

    Science.gov (United States)

    ... bladder, and a urethra. The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below ... the kidney swells. The ureter remains a normal size. UPJ obstruction usually occurs ... (PUV), the most common form of BOO seen in newborns and during prenatal ...

  16. Intradialytic Hypotension and Cardiac Remodeling: A Vicious Cycle

    Directory of Open Access Journals (Sweden)

    Chia-Ter Chao

    2015-01-01

    Full Text Available Hemodynamic instability during hemodialysis is a common but often underestimated issue in the nephrologist practice. Intradialytic hypotension, namely, a decrease of systolic or mean blood pressure to a certain level, prohibits the safe and smooth achievement of ultrafiltration and solute removal goal in chronic dialysis patients. Studies have elucidated the potential mechanisms involved in the development of Intradialytic hypotension, including excessive ultrafiltration and loss of compensatory mechanisms for blood pressure maintenance. Cardiac remodeling could also be one important piece of the puzzle. In this review, we intend to discuss the role of cardiac remodeling, including left ventricular hypertrophy, in the development of Intradialytic hypotension. In addition, we will also provide evidence that a bidirectional relationship might exist between Intradialytic hypotension and left ventricular hypertrophy in chronic dialysis patients. A more complete understanding of the complex interactions in between could assist the readers in formulating potential solutions for the reduction of both phenomena.

  17. Unexpected hypotension in catecholamine reversal: a case report

    OpenAIRE

    Okada, Yohei; Ishi, Wataru; Narumiya, Hiromichi; Liduka, Ryoji

    2017-01-01

    Background Catecholamine agents are commonly used to support circulation; however, they may cause unexpected hypotension in a special situation. Here we describe the first unexpected case of hypotension in response to catecholamine agents. Case presentation A 29-year-old Japanese man with schizophrenia was transferred to our emergency department. He was in shock and in coma. After fluid resuscitation, we induced catecholamine agents; however, his blood pressure decreased to 59/40 mmHg in resp...

  18. Orthostatic hypotension as a manifestation of vitamin B12 deficiency.

    Science.gov (United States)

    Ganjehei, Leila; Massumi, Ali; Razavi, Mehdi; Wilson, James M

    2012-01-01

    A 90-year-old woman with orthostatic hypotension and near-syncope was found to have a low-normal level of vitamin B(12) and no other medical findings that could explain her orthostasis. Her symptoms responded to vitamin B(12) replacement therapy. This case shows that vitamin B(12) deficiency can induce orthostatic hypotension and syncope that are correctable by vitamin B(12) replacement.

  19. Update on intracranial hypertension and hypotension.

    Science.gov (United States)

    Hoffmann, Jan; Goadsby, Peter J

    2013-06-01

    The aim of this article is to review recent findings on the pathophysiology of idiopathic changes in intracranial pressure. The review will focus on idiopathic intracranial hypertension (IIH) and spontaneous intracranial hypotension (SIH). Substantial evidence indicates that IIH is associated with delayed absorption of cerebrospinal fluid (CSF). Stenoses of the transverse sinus are common in IIH, but their clinical significance has not been entirely clarified. Despite the observed efficacy of endovascular treatment in some IIH patients, a correlation between the extent of observed stenoses and the clinical course of the disease could not be demonstrated. The underlying cause of SIH is a spontaneous CSF leakage into the epidural space. Conservative treatment and the epidural blood patch remain the treatment of choice for this rare syndrome. Recent clinical evidence indicates that IIH is probably a result of CSF outflow abnormality rather than of CSF production. Further research is needed to elucidate the causes of elevated intracranial pressure and the mechanism leading to visual loss. Prospective randomized clinical trials are needed to clarify a possible therapeutic potential of endovascular treatment. Research efforts on SIH should focus further on associated connective tissue disorders predisposing to CSF leaks.

  20. A rare cause of postoperative hypotension.

    Science.gov (United States)

    Salinas, Pedro D; Toth, Laura N; Manning, Harold L

    2015-05-01

    A 62-year-old woman presented with a 3-month history of abdominal distension and decreased exercise tolerance. A chest radiograph showed a probable left pleural effusion (Fig 1). A CT scan of the abdomen revealed a solid ovarian mass with omental caking and a large volume of ascites; there was also confirmation of a left pleural effusion. Three days before surgery a CT pulmonary angiogram (CTPA) showed no evidence of pulmonary thromboembolism (PTE). The patient had some improvement in her symptoms after paracentesis and thoracentesis with drainage of 2,000 mL and 250 mL of fluid, respectively. She underwent total abdominal hysterectomy, bilateral oophorectomy, and partial sigmoid resection with an estimated blood loss of 850 mL. During the operation, she received 5 L of crystalloid and required phenylephrine at 40 to 80 μg/min to maintain a mean arterial pressure > 65 mm Hg. She was extubated after surgery, but immediately after extubation, she became markedly hypotensive and hypoxemic with a BP of 50/20 mm Hg and an oxygen saturation of 70%. An ECG showed T-wave inversions from V1 to V5 and an S1Q3T3 pattern (Fig 2). A bedside echocardiogram showed an enlarged right ventricle (RV), septal dyskinesia, and obliteration of the left ventricle, all consistent with systolic and diastolic RV overload (Fig 3).

  1. Intravenous fluid to prevent hypotension in patients undergoing elective colonoscopy.

    Science.gov (United States)

    Leslie, K; Tay, T; Neo, E

    2006-06-01

    Colonoscopy may be associated with hypotension during sedation leading to postoperative morbidity. However, no treatment is proven to ameliorate intraoperative hypotension for this procedure. We therefore conducted a randomized trial to determine the effect of intravenous fluid infusion on the incidence of hypotension during sedation for colonoscopy. With institutional approval, 160 patients presenting for elective colonoscopy were randomized to 1.5 ml/kg or 15 ml/kg Hartmann's solution before colonoscopy. All observers were blind to group allocation. The incidence of hypotension during sedation (29% vs 25%; P=0.59) and postoperative morbidity (nausea, vomiting, headache, drowsiness and dizziness) (41% vs 39%; P= 0.75) did not differ between the two groups. Hypotensive patients were older, had a higher baseline systolic blood pressure, and were thirstier after fluid infusion than normotensive patients. This study does not support the use of 15 ml/kg Hartmann's solution to reduce the incidence of hypotension or postoperative morbidity in patients undergoing elective colonoscopy.

  2. Advancing newborn health: The Saving Newborn Lives initiative

    Science.gov (United States)

    Tinker, A.; Parker, R.; Lord, D.; Grear, K.

    2009-01-01

    Until recently, newborn health was virtually absent from the global health agenda. Now, assistance agencies, national governments and non-governmental organisations are increasingly addressing this previously neglected issue of close to four million newborns dying every year. The experience of the Saving Newborn Lives initiative documents some of the progress that has been made and the challenges and opportunities that lie ahead. Since the start of the initiative in 2000, targeted research, focused on overcoming the key barriers to improved newborn survival, has demonstrated low-cost, community-based interventions and strategies that can significantly reduce newborn mortality. Building on what has been learned from this and other efforts to date, the challenge now is to reach the millions of newborns still at risk. PMID:19851911

  3. Gingival Cyst of Newborn.

    Science.gov (United States)

    Moda, Aman

    2011-01-01

    Gingival cyst of newborn is an oral mucosal lesion of transient nature. Although it is very common lesion within 3 to 6 weeks of birth, it is very rare to visualize the lesion thereafter. Presented here is a case report of gingival cyst, which was visible just after 15 days of birth. Clinical diagnoses of these conditions are important in order to avoid unnecessary therapeutic procedure and provide suitable information to parents about the nature of the lesion.

  4. Transport of the newborn.

    Science.gov (United States)

    Srikasibhandha, S; Cats, B P

    1977-12-01

    Analysis of facilities used in the transfer of neonates with respiratory distress syndrome (RDS) to the Newborn Intensive Care Unit (N.I.C.U.) of the Free University Amsterdam during the period 1969-1976 revealed many deficiencies. Most of the sick newborn infants were accompanied by inadequately trained personnel. In a number of cases they were in incubators which could hardly guarantee the neutral thermal temperature for the infant concerned. In the most cases there were no facilities either for resuscitation or for ventilatory assistance during transport. It was found that infants born in the referring hospitals more often required artificial ventilation than infants born in the University Hospital. Since the former were--on an average--more severely ill than the latter, the duration of ventilatory assistance was usually longer and their survival rate was lower. Retrospectively, in many instances referred infants were on admission already in such a condition that artificial ventilation should have been started long before. General aspects of newborn transport, viz. way of transport, incubator with facilities for emergency care i.e. artificial ventilation and intravascular therapy, accompanying personnel, stabilization of the infant, role of education and evaluation of the transport are discussed.

  5. Redefining hypotension in the elderly: normotension is not reassuring.

    Science.gov (United States)

    Oyetunji, Tolulope A; Chang, David C; Crompton, Joseph G; Greene, Wendy R; Efron, David T; Haut, Elliott R; Cornwell, Edward E; Haider, Adil H

    2011-07-01

    Recent debate concerns the most appropriate definition of hypotension. Some have advocated raising the systolic blood pressure (BP) threshold to 110 mm Hg while others favor 80 mm Hg. The optimal definition of hypotension differs by age group. An analysis was performed of trauma victims 18 years and older in the National Trauma Data Bank, excluding burn injury patients and those with incomplete data. Injured patients who were hospitalized in various trauma centers across the continental United States. Three age groups were identified for analysis as follows: 18 to 35 years, 36 to 64 years, and 65 years and older. One hundred one multiple logistic regression analyses were performed for each population. Hypotension was sequentially defined as an emergency department systolic BP (SBP) of 50 to 150 mm Hg to see which model best predicted mortality, adjusting for demographic and injury covariates. The discriminatory power of each model was measured using the area under the receiver operating characteristic (AUROC) curve. Optimally defined hypotension was identified as the model with the highest AUROC curve. In-hospital mortality. A total of 902,852 patients (median age, 44 years; 66.2% men) were analyzed. Overall mortality was 4.1%. Optimal emergency department SBP cutoff values for hypotension were 85 mm Hg for patients aged 18 to 35 years, 96 mm Hg for patients aged 36 to 64 years, and 117 mm Hg for elderly patients. For patients younger than 65 years, the classic definition of hypotension as an emergency department SBP less than 90 mm Hg remains optimal. With increasing involvement of elderly individuals in trauma and their peculiarity as a comorbid state, there is a need to redefine what is presently defined as a cutoff value for hypotension in elderly patients.

  6. Orthostatic hypotension predicts motor decline in early Parkinson disease.

    Science.gov (United States)

    Kotagal, Vikas; Lineback, Christina; Bohnen, Nicolaas I; Albin, Roger L

    2016-11-01

    Orthostatic hypotension is increasingly reported as a risk factor for development of late-stage disease features in Parkinson disease (PD). Less is known about its significance in individuals with early PD who are often targeted for neuroprotective trials. Using data from the CALM-PD trial (n = 275), we explored whether early orthostatic hypotension predicts a decline in the Unified Parkinson's Disease Rating Scale (UPDRS) II (activities of daily living) or UDPRS III (motor) score after 102 weeks. We also explored risk factors for worsening orthostatic hypotension over a nearly 2-year period. After controlling for age, disease duration, gender, study drug, change in mini-mental status exam score, levodopa equivalent dose, and baseline UPDRS II or III score respectively, the degree of orthostatic hypotension at enrollment associated with a worsening in UPDRS motor score (t = 2.40, p = 0.017) at week 102 but not with UPDRS ADL score (t = 0.83, p = 0.409). Worsening in orthostatic hypotension during the study associated with longer disease duration (t = 2.37, p = 0.019) and lower body mass index (BMI) (t = -2.96, p = 0.003). Baseline orthostatic hypotension is a predictor of UPDRS motor decline in individuals with early PD and should be accounted for in clinical trial design. Low BMI may predict orthostatic hypotension in PD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Treating pigs

    DEFF Research Database (Denmark)

    Dam, Mie S.; Svendsen, Mette N.

    2017-01-01

    This paper explores how animal modelling is negotiated and practised in the field of translational neonatology research in Denmark. Based on ethnography from a biomedical research centre, NEOMUNE, in which veterinary and medical scientists worked on developing a ‘preterm pig brain model’, we...... of prematurity, but also the suffering of the human patient entitled to individual care. Based on this ethnographic fieldwork we argue that the demand for clinical relevance in translational research highlights the animal laboratory as also being a “moral laboratory” (Mattingly, 2014). In seeking to align...

  8. Newborn screening for MCAD deficiency

    DEFF Research Database (Denmark)

    Horvath, Gabriella A; Davidson, A G F; Stockler-Ipsiroglu, Sylvia G

    2008-01-01

    BACKGROUND: Medium Chain Acyl-CoA Dehydrogenase (MCAD) Deficiency is an autosomal recessive disorder of fatty acid oxidation, with potential fatal outcome. MCAD deficiency is diagnosed by acylcarnitine analysis on newborn screening blood spot cards by tandem mass spectrometry. Early diagnosis...... length acylcarnitines, octanoylcarnitine (C8) and decanoylcarnitine (C10), were measured on newborn screening blood spot cards. Out of 121,000 live births, 17 newborns had C8 values above the screening cut-off of 0.38 umol/L. Ten newborns had elevated C8 on repeat cards and were investigated further...

  9. Changes in the newborn at birth

    Science.gov (United States)

    Birth - changes in the newborn ... This breath sounds like a gasp, as the newborn's central nervous system reacts to the sudden change ... fluid, and the uterine wall. After delivery, the newborn begins to lose heat. Receptors on the baby's ...

  10. Newborn Screening Tests for your Baby

    Science.gov (United States)

    ... your baby > Newborn screening tests for your baby Newborn screening tests for your baby E-mail to ... can be treated if found early. What is newborn screening? Before your baby leaves the hospital, he ...

  11. Newborn jaundice - what to ask your doctor

    Science.gov (United States)

    ... your doctor; What to ask your doctor about newborn jaundice ... What causes jaundice in a newborn child? How common is newborn jaundice? Will the jaundice harm my child? What are the treatments for jaundice? How long does ...

  12. Evaluation and treatment of hypotension in the preterm infant.

    LENUS (Irish Health Repository)

    Dempsey, E M

    2012-01-31

    A large proportion of very preterm infants receive treatment for hypotension. The definition of hypotension is unclear, and, currently, there is no evidence that treating it improves outcomes or, indeed, which treatment to choose among the available alternatives. Assessment of circulatory adequacy of the preterm infant requires a careful clinical assessment and may also require ancillary investigations. The most commonly used interventions, fluid boluses and dopamine, are problematic: fluid boluses are statistically associated with worse clinical outcomes and may not even increase blood pressure, whereas dopamine increases blood pressure mostly by causing vasoconstriction and may decrease perfusion. For neither intervention is there any reliable data showing clinical benefit. Prospective trials of intervention for hypotension and circulatory compromise are urgently required.

  13. Increasing incidence of hypotension in the emergency department

    DEFF Research Database (Denmark)

    Holler, Jon G; Henriksen, Daniel P; Mikkelsen, Søren

    2016-01-01

    BACKGROUND: The epidemiology of hypotension as presenting symptom among patients in the Emergency Department (ED) is not clarified. The aim of this study was to describe the incidence, etiology, and overall mortality of hypotensive patients in the ED. METHODS: Population-based cohort study......: 121-130). The IR increased 28 % during the period (from 113 to 152 cases per 100,000 pyar). Patients ≥65 years had the highest IR compared to age ... %) and cardiovascular diseases (15 %) as the most common. The overall 7-day, 30-day and 90-day mortality rates were 15 % (95 % CI: 14-16), 22 % (95 % CI: 21-24) and 28 % (95 % CI: 27-30) respectively. CONCLUSION: During 2000-2011 the overall incidence of ED hypotension increased and remained highest among the elderly...

  14. Ontogenic increase in PGE2 and PGF2 alpha receptor density in brain microvessels of pigs.

    Science.gov (United States)

    Li, D. Y.; Varma, D. R.; Chemtob, S.

    1994-01-01

    1. The hypothesis that the relative vasoconstrictor ineffectiveness of prostaglandin E2 (PGE2) and PGF2 alpha on cerebral vessels of newborn pigs might be due to fewer receptors for these prostanoids was tested by comparing receptors for PGE2 (EP) and PGF2 alpha (FP) in cerebral microvessels from newborn and adult pigs. 2. Specific binding of [3H]-PGE2 and [3H]-PGF2 alpha to membranes prepared from brain microvessels showed that EP and FP receptor density (Bmax) in tissues from newborn animals was less than 50% of that determined in tissues from adults. By contrast, estimates of affinity (KD) were unchanged. 3. Specifically bound [3H]-PGE2 to brain microvessels from both the newborn and adult was displaced by AH 6809 (EP1-selective antagonist) by 80-90%, and only by approximately 30-35% by both 11-deoxy PGE1 (EP2/EP3 agonist) and M&B 28,767 (EP3 agonist); butaprost (EP2 agonist) was completely ineffective. 4. PGE2, 17-phenyl trinor PGE2 (EP1 agonist), PGF2 alpha and fenprostalene (PGF2 alpha analogue) caused significantly less increase in inositol 1,4,5-triphosphate (IP3) in brain microvessels from the newborn than in those from adult pigs. The stimulation of IP3 by PGE2 and 17-phenyl trinor PGE2 was almost completely inhibited by the EP1 antagonist, AH 6809. 5. PGE2, 11-deoxy PGE1 and M&B 28,767 produced small reduction of adenosine 3':5'-cyclic monophosphate (cyclic AMP) production in adult vessels but no effect in newborn tissues. 6. The lower density of EP and FP receptors in microvessels of newborn pigs compared to adults may explain the reduced ability of PGE2 and PGF2 alpha to stimulate production of IP3 in tissues from newborn animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8032662

  15. Orthostatic hypotension after delta 9-tetrahydrocannabinol marihuana inhalation.

    Science.gov (United States)

    Merritt, J C; Cook, C E; Davis, K H

    1982-01-01

    3 male glaucoma subjects experienced orthostatic hypotension within 10 min after completing 2% delta 9-THC ranging from 57 to 233 ng/ml were found 5 min after smoking. Peripheral venodilation appeared responsible for the precipitous decrease in systolic blood pressure in all 3 subjects. These orthostatic episodes which clinically simulated the typical 'faint' were characterized by the absence of tachycardia and their relief by assuming a reclining position. The postural hypotension occurred despite differences in inhalation technique, level of delta (9)-THC present in plasma, previous marihuana experience of body habitus.

  16. Amiodarone-Induced Life-Threatening Refractory Hypotension.

    Science.gov (United States)

    Doshi, Deepak; Jayawardana, Ravi

    2015-09-14

    Amiodarone is frequently used in emergency departments for treatment of arrhythmias. Incidence of several amiodarone-related adverse events is unknown. The literature is sparse for potentially life-threatening adverse effects of amiodarone. We present a case of a male patient who presented with chest discomfort and rapid atrial fibrillation. He was known to have paroxysmal atrial fibrillation, which did not respond to initial beta-blocker treatment. The second-line drug amiodarone was given to the patient for rate control. He developed severe hypotension related to amiodarone and required inotropic support along with rapid-sequence intubation. Intravenous amiodarone can cause severe and refractory hypotension.

  17. Refractory hypotension due to intraoperative hypothermia during spinal instrumentation

    Directory of Open Access Journals (Sweden)

    Ponniah Vanamoorthy

    2010-01-01

    Full Text Available We report a case of inadvertent hypothermia leading to severe hypotension resistant to high dose vasopressors, which responded to temperature correction in a patient undergoing spinal instrumentation surgery. A 60-year-old female developed severe hypotension during spinal instrumentation surgery. After review of all factors it was found to be secondary to hypothermia. The patient did not respond to high dose vasopressors. However, when normothermia was restored she recovered uneventfully. Patients undergoing lengthy spinal procedures in prone position are vulnerable to develop hypothermia and consequent cardiovascular depression so adequate measures should be taken to prevent hypothermia.

  18. congenital epulis in a newborn

    African Journals Online (AJOL)

    GB

    BACKGROUND: Congenital epulis is a rare lesion of the newborn, presenting as mass in the oral cavity which can interfere with respiration and feeding. It should be distinguished from other lesions which can occur in newborns, both clinically and histopathologically. CASE DETAILS: Here, we report a case of congenital ...

  19. Miniature pigs.

    Science.gov (United States)

    Van Metre, D C; Angelos, S M

    1999-09-01

    Miniature pigs have become popular pets in North America, and veterinarians of a variety of clinical specialties may be called on for their care. Successful collection of blood from these animals requires familiarity with the location of sites for venipuncture and knowledge of adequate methods of restraint. In this article, restraint and techniques for venipuncture are described, as well as techniques for cerebrospinal fluid collection, semen collection, and vaginal cytologic examination. Interpretation of hematologic, serum biochemical, and urinalysis data are also discussed. Methods for diagnosis of skin diseases, gastrointestinal parasitism, and enteric infectious diseases are included in order to provide the practitioner with the essential knowledge and skills for a variety of clinical pathologic studies of this unique pet.

  20. Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?

    NARCIS (Netherlands)

    Fedorowski, A.; Hamrefors, V.; Sutton, R.; Dijk, J.G. van; Freeman, R.; Lenders, J.W.M.; Wieling, W.

    2017-01-01

    PURPOSE: The contribution of diastolic blood pressure measurement to the diagnosis of classical orthostatic hypotension is not known. We aimed to explore the prevalence of isolated systolic and diastolic orthostatic hypotension components in patients with syncope and orthostatic intolerance.

  1. Influence of controlled hypotension versus normotension on amount of blood loss during breast reduction.

    NARCIS (Netherlands)

    Kop, E.C.; Spauwen, P.H.M.; Kouwenberg, P.P.G.M.; Heymans, F.J.; Beem, H.B. van

    2009-01-01

    SUMMARY: Controlled hypotension employed during surgical procedures results in a beneficial reduction in blood loss during the operation. Breast reduction is a common cosmetic surgical procedure. Yet, in the Netherlands, controlled hypotension is not standard during breast reduction procedures, and

  2. Geriatric hypotensive syndromes are not explained by cardiovascular autonomic dysfunction alone

    NARCIS (Netherlands)

    Lagro, J.; Meel-van den Abeelen, A.S.; Jong, D.L. de; Schalk, B.W.M; Olde Rikkert, M.G.M.; Claassen, J.A.H.R.

    2013-01-01

    BACKGROUND: Though highly prevalent, the pathophysiology of orthostatic hypotension (OH), postprandial hypotension (PPH), and carotid sinus hypersensitivity (CSH) are rarely studied together. Therefore, we conducted such a comprehensive study focusing on the common role of the cardiovascular

  3. Dynamic right ventricular outflow obstruction: A rare cause of hypotension during anestesia induction

    Directory of Open Access Journals (Sweden)

    Maria Enrica Antoniucci

    2017-01-01

    Conclusions: RVOTO is an unusual, but possible cause of severe arterial hypotension during general anesthesia induction. TEE is useful for the evaluation of severely hypotensive patients who do not respond to routine treatment with fluids and vasoconstrictors.

  4. Refined localization of the Escherichia coli F4ab/F4ac receptor locus on pig chromosome 13

    DEFF Research Database (Denmark)

    Joller, D.; Jørgensen, Claus Bøttcher; Bertschinger, H.U.

    2009-01-01

    Diarrhoea in newborn and weaned pigs caused by enterotoxigenic Escherichia coli (ETEC) expressing F4 fimbriae leads to considerable losses in pig production. In this study, we refined the mapping of the receptor locus for ETEC F4ab/F4ac adhesion (F4bcR) by joint analysis of Nordic and Swiss data....

  5. Identification of alpha-1 acid glycoprotein (AGP) as a potential marker of impaired growth in the newborn piglet

    Science.gov (United States)

    Two studies were conducted to investigate the relationship between the circulating levels of the acute phase proteins haptoglobin (HP) and alpha 1 acid glycoprotein (AGP) and growth potential in neonatal pigs. In runts, the circulating level of AGP, but not HP in serum of newborn piglets was higher...

  6. Hypotensive Activity of Moringa oleifera Lam (Moringaceae) Root ...

    African Journals Online (AJOL)

    Purpose: To explore the hypotensive activity and chemical composition of Moringa oleifera Lam (Moringaceae) roots. Methods: The fresh roots of M. oleifera was cut into small pieces and successively extracted with petroleum ether (PE) and dichloromethane (DC). PE extract was further divided into MRP and MRP -1.

  7. aging hypotension and intra-operative cardiac arres

    African Journals Online (AJOL)

    The development of a scoring tool for the measurement of performance in man- aging hypotension and intra-operative cardiac arrest during spinal anaesthesia ..... clinical evidence, likelihood of negative consequences, current standards of care or simply their own practice. No specific approach was prescribed and this may ...

  8. Postural hypotension in type 1 diabetes: The influence of glycemic ...

    African Journals Online (AJOL)

    Background: Postural hypotension (PH) indicates the presence of cardiac autonomic neuropathy and in diabetes mellitus (DM) is associated with adverse outcome. Nonetheless, PH has been rarely characterized in young persons in Sub‑saharan Africa where suboptimal care of DM is prevalent. Aims: The aim of the study ...

  9. [Clinical experimental studies in patients with asympathicotonic hypotension].

    Science.gov (United States)

    Anlauf, M; Werner, U; Merguet, P; Nitzs, T; Graben, N; Bock, K D

    1975-04-25

    Three patients with postural hypotension (two of the idiopathic type, one possibly due to familial dysautonomia) were found to have not only the pathognomonic postural hypotension, without rise in heart rate, cardiac output and peripheral vascular resistance, but also a similarly abnormal regulatory mechanism on ergometric stress when recumbent. There was a delayed-response to the bloodpressure fall on Valsalva a manoeuvre, and the blood volume was reduced. A combined effect of these factors explains that these patients have a more marked impairment of physical capcity than might be expected merely from the orthostatic hypotension. The actions of noradrenaline, adrenaline, phenylephrine, isoproterenol, angiotensin and tyramine on blood pressure and heart rate were different from normal. Plasma-renin activity was reduced in all three patients and could not be raised. Urinary excretion of adrenaline and noradrenaline was markedly diminished. Reactions to noradrenaline and tyramine, as well as the excretion pattern of the catecholamine metabolites suggest a disorder of active adrenaline liberation. Furthermore, different disorders of catecholamine metabolism underlie idiopathic orthostatic hypotension and familial autonomia. Therapeutic trials with fludrocortisone, beta-receptor blockers and levodopa brought improvement, but long-term results are not yet available.

  10. Physical Manoeuvres to Prevent Vasovagal Syncope and Initial Orthostatic Hypotension

    NARCIS (Netherlands)

    Krediet, Paul

    2007-01-01

    Vasovagal syncope ("the common faint") and near syncope from initial orthostatic hypotension are huge medical problems given the number of patients and their impact on quality of life. The treatment options are often unsatisfactory. The studies in this thesis set out to investigate the potential

  11. Intraoperative hypotension and delirium after on-pump cardiac surgery

    NARCIS (Netherlands)

    Wesselink, E M; Kappen, T H; van Klei, W A; Dieleman, J M; van Dijk, D; Slooter, A J C

    BACKGROUND: Delirium is a common complication after cardiac surgery and may be as a result of inadequate cerebral perfusion. We studied delirium after cardiac surgery in relation to intraoperative hypotension (IOH). METHODS: This observational single-centre, cohort study was nested in a randomized

  12. Hypotensive Activity of Moringa oleifera Lam (Moringaceae) Root ...

    African Journals Online (AJOL)

    Purpose: To explore the hypotensive activity and chemical composition of Moringa oleifera Lam. (Moringaceae) roots. Methods: The fresh roots of M. oleifera was cut into small pieces and successively extracted with petroleum ether (PE) and dichloromethane (DC). PE extract was further divided into MRP and MRP -1.

  13. Postural hypotension in type 1 diabetes: The influence of glycemic ...

    African Journals Online (AJOL)

    2013-06-04

    Jun 4, 2013 ... other hand, noted that PH as detected by BP response to standing had the best positive predictive value of cardiac autonomic neuropathy (CAN) in the cohort of type 2 diabetics studied in Enugu. Postural hypotension in type 1 diabetes: The influence of glycemic control and duration of illness. OA Oduwole1 ...

  14. Orthostatic hypotension in older persons: a diagnostic algorithm

    NARCIS (Netherlands)

    Krecinic, T.; Mattace-Raso, F.; van der Velde, N.; Pereira, G.; van der Cammen, T.

    2009-01-01

    Orthostatic hypotension (OH) is a frequent phenomenon in older persons and usually has a multifactorial origin. When the diagnosis is suspected, the work-up should initially be directed at the most prevalent causes. This clinical algorithm may be a useful tool in the diagnostic process

  15. Bionic baroreceptor corrects postural hypotension in rats with impaired baroreceptor.

    Science.gov (United States)

    Hosokawa, Kazuya; Ide, Tomomi; Tobushi, Tomoyuki; Sakamoto, Kazuo; Onitsuka, Ken; Sakamoto, Takafumi; Fujino, Takeo; Saku, Keita; Sunagawa, Kenji

    2012-09-04

    Impairment of the arterial baroreflex causes orthostatic hypotension. Arterial baroreceptor sensitivity degrades with age. Thus, an impaired baroreceptor plays a pivotal role in orthostatic hypotension in most elderly patients. There is no effective treatment for orthostatic hypotension. The aims of this investigation were to develop a bionic baroreceptor (BBR) and to verify whether it corrects postural hypotension. The BBR consists of a pressure sensor, a regulator, and a neurostimulator. In 35 Sprague-Dawley rats, we vascularly and neurally isolated the baroreceptor regions and attached electrodes to the aortic depressor nerve for stimulation. To mimic impaired baroreceptors, we maintained intracarotid sinus pressure at 60 mm Hg during activation of the BBR. Native baroreflex was reproduced by matching intracarotid sinus pressure to the instantaneous pulsatile aortic pressure. The encoding rule for translating intracarotid sinus pressure into stimulation of the aortic depressor nerve was identified by a white noise technique and applied to the regulator. The open-loop arterial pressure response to intracarotid sinus pressure (n=7) and upright tilt-induced changes in arterial pressure (n=7) were compared between native baroreceptor and BBR conditions. The intracarotid sinus pressure-arterial pressure relationships were comparable. Compared with the absence of baroreflex, the BBR corrected tilt-induced hypotension as effectively as under native baroreceptor conditions (native, -39±5 mm Hg; BBR, -41±5 mm Hg; absence, -63±5 mm Hg; P<0.05). The BBR restores the pressure buffering function. Although this research demonstrated feasibility of the BBR, further research is needed to verify its long-term effect and safety in larger animal models and humans.

  16. Healthy Start, Grow Smart: Your Newborn.

    Science.gov (United States)

    Department of Education, Washington, DC.

    This booklet offers guidance to parents in caring for their newborn babies. Advice is given on the following topics: (1) newborn health screening; (2) what a healthy newborn looks like; (3) newborn reflexes; (4) baby checkups; (5) fathers' role; (6) the baby blues; (7) sleeping position; (8) breast milk; (9) breast feeding; (10) bottle feeding;…

  17. Intra-uterine growth retardation affects birthweight and postnatal development in pigs, impairing muscle accretion, duodenal mucosa morphology and carcass traits.

    Science.gov (United States)

    Alvarenga, A L N; Chiarini-Garcia, H; Cardeal, P C; Moreira, L P; Foxcroft, G R; Fontes, D O; Almeida, F R C L

    2013-01-01

    The present study investigated the occurrence of intra-uterine growth retardation (IUGR) in newborn (n=40) and 150-day-old (n=240) pigs of different birthweight ranges (high, HW: 1.8-2.2kg; low, LW: 0.8-1.2kg) from higher-parity commercial sows and its impact on their subsequent development and carcass traits in a Brazilian commercial production system. HW newborn pigs had heavier organs than LW pigs (Pmuscle fibres and a higher percentage of connective tissue in the semitendinosus muscle, greater fibre number per mm(2) and a lower height of the duodenal mucosa (Pgrowth performance, muscle accretion, duodenal mucosa morphology and carcass traits.

  18. Screening Newborns' Hearing Now Standard

    Science.gov (United States)

    ... Other Communication Disorders Click to enlarge image Newborn Hearing Infographic Illustration: NIH, National Institute on Deafness and Other Communication Disorders In 1993, children born in the U.S. were screened for hearing ...

  19. Learning, Play, and Your Newborn

    Science.gov (United States)

    ... and weeks of life, newborns can recognize their mother's voice. Your infant will respond to your voice ( ... particularly during fussy times. Smile, stick out your tongue, and make other expressions for your infant to ...

  20. Pain Management in Newborns

    Science.gov (United States)

    Hall, Richard W.; Anand, Kanwaljeet J. S.

    2014-01-01

    Effective pain management is a desirable standard of care for preterm and term newborns and may potentially improve their clinical and neurodevelopmental outcomes. Neonatal pain should be assessed routinely using context-specific, validated and objective pain methods, despite the limitations of currently available tools. Reducing invasive procedures, and using pharmacological, behavioral or environmental measures can be used to manage neonatal pain. Non-pharmacologic approaches include kangaroo care, facilitated tucking, non-nutritive sucking, sucrose and other sweeteners, massage and acupuncture therapy. They are used for procedures causing acute, transient, or mild pain, or as adjunctive therapy for moderate or severe pain. Local and topical anesthetics can reduce the acute pain caused by skin-breaking or mucosa-injuring procedures. Opioids form the mainstay for treatment of severe pain; morphine and fentanyl are the most commonly used drugs, although other opioids are also available. Non-opioid drugs include various sedatives and anesthetic agents, mostly used as adjunctive therapy in ventilated neonates. Acetaminophen, ibuprofen and other drugs are used for neonates, although their efficacy and safety remains unproven. Approaches for implementing an effective pain management program in the Neonatal ICU are summarized, together with practical protocols for procedural, postoperative, and mechanical ventilation-associated neonatal pain and stress. PMID:25459780

  1. Studies on vertical transmission of Trichinella spiralis in experimentally infected guinea pigs (Cavia porcellus).

    Science.gov (United States)

    Riva, Eliana; Fiel, Cesar; Bernat, Gisele; Muchiut, Sebastián; Steffan, Pedro

    2017-08-01

    An experimental study to enhance knowledge on the capability of Trichenella spiralis to pass from guinea pigs to progeny at different periods of pregnancy or lactation was performed. For this purpose, 18 female adult guinea pigs were inoculated with 100 or 1000 T. spiralis muscle larvae (ML) during early, late gestation and during lactation period. The presence of T. spiralis (ML) in mothers and newborns was studied through enzymatic digestion from muscle samples. ML were observed in 9 of 42 newborn guinea pigs and levels of infection were significantly higher when infections of mothers were done during late gestation (p = 0.0046) with the high infective dose (p = 0.0043). T. spiralis ML were not recovered from any of the newborns from mothers infected in the lactation period. Ten out of 18 infected mothers presented larvae 1 in their mammary glands. Muscle samples from the tongue and the masseter showed the highest larval burdens. These observations confirm previous reports on that ML of T. spiralis are capable to pass through placental tissues to reach and encyst in striated muscle groups of newborn guinea pigs. This study may also reinforce the importance of preventive programs to control trichinellosis in those endemic areas where pregnant women would have high risk of infection.

  2. Prematurity does not markedly affect intestinal sensitivity to endotoxins and feeding in pigs.

    Science.gov (United States)

    Bering, Stine B; Bai, Shiping; Zhang, Keying; Sangild, Per T

    2012-08-01

    Preterm neonates show enhanced sensitivity to nutrient maldigestion and bacteria-mediated gut inflammatory disorders, such as necrotising enterocolitis (NEC). We hypothesised that preterm birth increases the sensitivity of intestinal nutrient absorption to endotoxins and that feeding after birth reduces this response. Hence, we investigated the postnatal development of nutrient digestive and absorptive capacity in the preterm and term pig intestine, and its responsiveness to endotoxins. Pigs were delivered by caesarean section at preterm (n 20) or term (n 17) gestation, and the small intestine was collected at birth or after 2 d of colostrum feeding, followed by ex vivo stimulation with lipopolysaccharide endotoxins and mixed gut contents collected from pigs with NEC. Brush border enzyme activities were reduced in newborn preterm v. term pigs (39-45 % reduction, P endotoxins could be less important, at least in pigs.

  3. Evaluation of spontaneous intracranial hypotension using radionuclide cisternography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Zy; Park, Chan H.; Pai, Moon Sun; Yoon, Seok Nam; Oh, Yun Min; Kim, Jang Sung [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1999-02-01

    We report four cases of spontaneous intracranial hypotension that were investigated by radionuclide cisternography. {sup 99m}Tc-diethylenetriamine pentaacetic acid radionuclide cisternography of all our patients showed direct sign of cerebrospinal fluid leakage as well as indirect signs of less activity than expected over the cerebral convexities and rapid appearance of bladder activity. The headache of all patients was eventually controlled with bed rest and hydration.

  4. Rabbit model of uncontrolled hemorrhagic shock and hypotensive resuscitation

    Directory of Open Access Journals (Sweden)

    J.B. Rezende-Neto

    2010-12-01

    Full Text Available Clinically relevant animal models capable of simulating traumatic hemorrhagic shock are needed. We developed a hemorrhagic shock model with male New Zealand rabbits (2200-2800 g, 60-70 days old that simulates the pre-hospital and acute care of a penetrating trauma victim in an urban scenario using current resuscitation strategies. A laparotomy was performed to reproduce tissue trauma and an aortic injury was created using a standardized single puncture to the left side of the infrarenal aorta to induce hemorrhagic shock similar to a penetrating mechanism. A 15-min interval was used to simulate the arrival of pre-hospital care. Fluid resuscitation was then applied using two regimens: normotensive resuscitation to achieve baseline mean arterial blood pressure (MAP, 10 animals and hypotensive resuscitation at 60% of baseline MAP (10 animals. Another 10 animals were sham operated. The total time of the experiment was 85 min, reproducing scene, transport and emergency room times. Intra-abdominal blood loss was significantly greater in animals that underwent normotensive resuscitation compared to hypotensive resuscitation (17.1 ± 2.0 vs 8.0 ± 1.5 mL/kg. Antithrombin levels decreased significantly in normotensive resuscitated animals compared to baseline (102 ± 2.0 vs 59 ± 4.1%, sham (95 ± 2.8 vs 59 ± 4.1%, and hypotensive resuscitated animals (98 ± 7.8 vs 59 ± 4.1%. Evidence of re-bleeding was also noted in the normotensive resuscitation group. A hypotensive resuscitation regimen resulted in decreased blood loss in a clinically relevant small animal model capable of reproducing hemorrhagic shock caused by a penetrating mechanism.

  5. Hemofiltration and Hemodiafiltration Reduce Intradialytic Hypotension in ESRD

    Science.gov (United States)

    Altieri, Paolo; Andrulli, Simeone; Bolasco, Piergiorgio; Sau, Giovanna; Pedrini, Luciano A.; Basile, Carlo; David, Salvatore; Feriani, Mariano; Montagna, Giovanni; Di Iorio, Biagio Raffaele; Memoli, Bruno; Cravero, Raffaella; Battaglia, Giovanni; Zoccali, Carmine

    2010-01-01

    Symptomatic intradialytic hypotension is a common complication of hemodialysis (HD). The application of convective therapies to the outpatient setting may improve outcomes, including intradialytic hypotension. In this multicenter, open-label, randomized controlled study, we randomly assigned 146 long-term dialysis patients to HD (n = 70), online predilution hemofiltration (HF; n = 36), or online predilution hemodiafiltration (HDF; n = 40). The primary end point was the frequency of intradialytic symptomatic hypotension (ISH). Compared with the run-in period, the frequency of sessions with ISH during the evaluation period increased for HD (7.1 to 7.9%) and decreased for both HF (9.8 to 8.0%) and HDF (10.6 to 5.2%) (P < 0.001). Mean predialysis systolic BP increased by 4.2 mmHg among those who were assigned to HDF compared with decreases of 0.6 and 1.8 mmHg among those who were assigned to HD and HF, respectively (P = 0.038). Multivariate logistic regression demonstrated significant risk reductions in ISH for both HF (odds ratio 0.69; 95% confidence interval 0.51 to 0.92) and HDF (odds ratio 0.46, 95% confidence interval 0.33 to 0.63). There was a trend toward higher dropout for those who were assigned to HF (P = 0.107). In conclusion, compared with conventional HD, convective therapies (HDF and HF) reduce ISH in long-term dialysis patients. PMID:20813866

  6. Syringomyelia Caused by Traumatic Intracranial Hypotension: Case Report and Literature Review.

    Science.gov (United States)

    Richard, Sébastien; Humbertjean, Lisa; Mione, Gioia; Braun, Marc; Schmitt, Emmanuelle; Colnat-Coulbois, Sophie

    2016-07-01

    Syringomyelia due to intracranial hypotension is rarely described. As a consequence, intracranial hypotension is less recognized as a potential cause of syringomyelia or mistaken with Chiari type 1 malformation. The pathogeny is poorly understood, and we lack diagnostic and therapeutic strategies for this particular setting. We describe a 45-year-old patient who developed syringomyelia after about 10 years of undiagnosed intracranial hypotension caused by traumatic C6 cerebrospinal fluid (CSF) leak. Surgical closing of the leak was required to treat intracranial hypotension after failure of conservative measures and blind epidural patches. It led to a marked improvement of cerebral and spinal signs. We discuss the pathogeny of syringomyelia caused by intracranial hypotension and highlight a mechanical theory of hyperpressure against the cervical spine due to blockage of CSF flow by descent of cerebellar tonsils at the foramen magnum level. We describe discriminating clinical and radiologic signs to differentiate intracranial hypotension from Chiari type 1 malformation and discuss mechanisms and causality relating trauma and intracranial hypotension. Syringomyelia can be a consequence of long-term progression of intracranial hypotension, which must be differentiated from Chiari type 1 malformation. In our case, resolution was achieved by detecting and closing the CSF leak causing the intracranial hypotension. Reports of similar cases are necessary to understand the origin of CSF leak in traumatic intracranial hypotension and assess the best therapeutic strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Impact of Controlled Induced Hypotension on Cognitive Functions of Patients Undergoing Functional Endoscopic Sinus Surgery.

    Science.gov (United States)

    Nowak, Stanislaw; Ołdak, Anna; Kluzik, Anna; Drobnik, Leon

    2016-03-18

    Controlled induced hypotension guarantees less blood loss and better visibility of the surgical site. The impact of hypotension on post-operative cognitive functions is still being discussed. The objective of this study was to evaluate the effects of controlled induced hypotension on the cognitive functions of patients undergoing functional endoscopic sinus surgery (FESS). We allocated 47 patients with a good grade of preoperative cognitive functions evaluated with the Mini-Mental State Examination to 3 groups (1 - mild hypotension, 2 - intermediate hypotension, 3 - severe hypotension) according to the degree of mean intraoperative arterial pressure compared with preoperative blood pressure. Cognitive functions were evaluated preoperatively, 6 h, and 30 h postoperatively with standardized tests: the Stroop Test, Trail Making Test (TMT), and Verbal Fluency Test (VFT). A decrease in the test results and increase in the number of mistakes made were considered an impairment of cognitive functions. A total of 47 patients (group 1 - mild hypotension - 15, group 2 - intermediate hypotension - 19, group 3 - severe hypotension - 13) were included in the study. A significant decrease was observed in all the 3 groups after Stroop A test 6h postoperatively but it improved 30h postoperatively, without differences between the groups. Neither a significant decrease in the test results nor an increase in the number of mistakes was noted for Stroop B tests, TMT A&B tests and VFT. The degree of controlled intraoperative hypotension during FESS did not influence the results of psychometric tests.

  8. Introduction of enteral food increases plasma GLP-2 and decreases GLP-2 receptor mRNA abundance during pig development

    DEFF Research Database (Denmark)

    Petersen, Yvette M; Hartmann, Bolette; Holst, Jens Juul

    2003-01-01

    Glucagon-like peptide 2 (GLP-2) may mediate in part the rapid growth effects of luminal nutrients in the small intestine of newborns. The objectives of this study were to determine plasma GLP-2 concentrations and small intestinal GLP-2 receptor (GLP-2R) mRNA abundance (measured by reverse...... of the response was delayed in premature newborn pigs. Small intestinal GLP-2R mRNA abundance was highest at birth and decreased with enteral food intake in fetal, suckling and weaned pigs (P

  9. The Pig Farm Manager for modelling pig production systems

    OpenAIRE

    Zonderland, J.J.; Enting, I.

    2003-01-01

    Before setting up or changing a pig farm operation, the consequences of the farm set up must be explored and changes planned. To calculate technical and economic consequences a farm manager model for pig production systems, the Pig Farm Manager, has been developed. The Pig Farm Manager estimates the effects of various farm designs as well as farm management on production, environmental and economical parameters. The Pig Farm Manager includes simulations for sow farms and finisher pig farms. I...

  10. Antibody-Secreting Cell Responses and Protective Immunity Assessed in Gnotobiotic Pigs Inoculated Orally or Intramuscularly with Inactivated Human Rotavirus†

    OpenAIRE

    Yuan, Lijuan; Kang, S.-Y.; Ward, Lucy A.; To, Thanh L.; Saif, Linda J.

    1998-01-01

    Newborn gnotobiotic pigs were inoculated twice perorally (p.o.) (group 1) or intramuscularly (i.m.) (group 2) or three times i.m. (group 3) with inactivated Wa strain human rotavirus and challenged with virulent Wa human rotavirus 20 to 24 days later. To assess correlates of protection, antibody-secreting cells (ASC) were enumerated in intestinal and systemic lymphoid tissues from pigs in each group at selected postinoculation days (PID) or postchallenge days. Few virus-specific ASC were dete...

  11. Lack of a hypotensive effect with rapid administration of a new aqueous formulation of intravenous amiodarone.

    Science.gov (United States)

    Somberg, John C; Timar, Sandor; Bailin, Steven J; Lakatos, Ferenc; Haffajee, Charles I; Tarjan, Jeno; Paladino, Walter P; Sarosi, Istvan; Kerin, Nicholas Z; Borbola, Jozsef; Bridges, Duane E; Molnar, Janos

    2004-03-01

    Hypotension is the most frequent adverse event reported with intravenous amiodarone. Hypotension has been attributed to the vasoactive solvents of the standard formulation (Cordarone IV) and is not dose related, but related to the rate of infusion. Drug labeling calls for intravenous amiodarone to be administered over 10 minutes. A new aqueous formulation of amiodarone (Amio-Aqueous) does not contain vasoactive excipients and may be administered safely by rapid administration without hypotension. This hypothesis was tested using combined data of 4 clinical trials; each assessed the development of hypotension prospectively. Hypotension was defined as a 25% decrease in systolic blood pressure (BP), with the development of a systolic BP of amiodarone formulation, because Cordarone cannot be administered by rapid bolus owing to excipient-related hypotension.

  12. Pig model for diabetes

    DEFF Research Database (Denmark)

    2016-01-01

    The present invention relates to a transgenic pig comprising a mutated IAPP gene and displaying a phenotype associated with diabetes. The invention also relates to a transgenic blastocyst, embryo, fetus, donor cell and/or cell nucleusderived from said transgenic pig. The invention further relates...... to use of the transgenic pig as a model system for studying therapy, treatment and/or prevention of diabetes....

  13. Vitamin K deficiency bleeding of the newborn

    Science.gov (United States)

    Vitamin K deficiency bleeding of the newborn (VKDB) is a bleeding disorder in babies. It most often ... A lack of vitamin K may cause severe bleeding in newborn babies. Vitamin K plays an important role in blood clotting. Babies often ...

  14. Det arterielle blodtryks afhaengighed af hjertets fyldning ved svaer ortostatisk hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Haedersdal, C; Stokholm, K H

    1995-01-01

    The present study aimed at an investigation of the relation between arterial blood pressure and cardiac filling in patients with severe postural hypotension. Seven patients aged 49 to 84 years were studied during head-up tilt at three different tilt angles (median values: 0, 25, and 45 degrees...... is strongly dependent upon cardiac filling in severe postural hypotension, and has underlined the importance of intravascular volume expansion as a measure against postural hypotension....

  15. Hypotensive Response Magnitude and Duration in Hypertensives: Continuous and Interval Exercise

    OpenAIRE

    Raphael Santos Teodoro de Carvalho; Cássio Mascarenhas Robert Pires; Gustavo Cardoso Junqueira; Dayana Freitas; Leila Maria Marchi-Alves

    2015-01-01

    Background: Although exercise training is known to promote post-exercise hypotension, there is currently no consistent argument about the effects of manipulating its various components (intensity, duration, rest periods, types of exercise, training methods) on the magnitude and duration of hypotensive response. Objective: To compare the effect of continuous and interval exercises on hypotensive response magnitude and duration in hypertensive patients by using ambulatory blood pressure monitor...

  16. Use of remifentanil in comparison with sodium nitroprusside for controlled hypotension during rhinoplasty: Randomized controlled trail

    OpenAIRE

    Aboseif, Eman Mohammed Kamal; Osman, Sameh Mohammed

    2015-01-01

    Objective: To evaluate the clinical efficacy of remifentanil infusion in comparison with sodium nitroprusside regarding controlled hypotension during rhinoplasty. Background: Controlled hypotension is a well-known technique used in many operations to reduce blood loss and need for blood transfusion and to provide satisfactory bloodless surgical field. Many pharmacological agents are used to perform controlled hypotension intraoperatively. Patients and methods: A total of 130 adult conse...

  17. Impact of Controlled Induced Hypotension on Cognitive Functions of Patients Undergoing Functional Endoscopic Sinus Surgery

    OpenAIRE

    Nowak, Stanis?aw; O?dak, Anna; Kluzik, Anna; Drobnik, Leon

    2016-01-01

    Background Controlled induced hypotension guarantees less blood loss and better visibility of the surgical site. The impact of hypotension on post-operative cognitive functions is still being discussed. The objective of this study was to evaluate the effects of controlled induced hypotension on the cognitive functions of patients undergoing functional endoscopic sinus surgery (FESS). Material/Methods We allocated 47 patients with a good grade of preoperative cognitive functions evaluated with...

  18. Efficacy and acceptability of an "App on sick newborn care" in physicians from newborn units

    National Research Council Canada - National Science Library

    Prakash, V; Thukral, Anu; Sankar, M Jeeva; Agarwal, Ramesh K; Paul, Vinod K; Deorari, Ashok K

    2016-01-01

    ... in this direction has been the emphasis on institutional deliveries and strengthening of "Facility based newborn care" in the public health system, which envisages a nationwide creation of special newborn care units (SNCUs) at district hospitals in addition to newborn Care Corners (NBCC) at every point of child birth, and newborn stabil...

  19. Hypotension induced by activation of the transient receptor potential vanilloid 4 channels: role of Ca2+-activated K+ channels and sensory nerves.

    Science.gov (United States)

    Gao, Feng; Wang, Donna H

    2010-01-01

    To examine the mechanisms involved in hypotension induced by transient receptor potential vanilloid 4 (TRPV4) activation. Wistar rats were given 50 mg/kg capsaicin subcutaneously 1-2 days postnatally to cause degeneration of capsaicin-sensitive sensory nerves. Vehicle was given to the corresponding newborn rats that formed the control group. After being weaned, male rats were picked for further investigation. At the age of 8 weeks, mean arterial pressure and its response to 4alpha-phorbol 12,13-didecanoate [4alpha-PDD, a selective TRPV4 activator, 2.5 mg/kg, intravenous(ly) or i.v.] with or without CGRP8-37 (1 mg/kg per min, i.v.), an antagonist of calcitonin gene-related peptide (CGRP, a potent vasodilator released from sensory nerves), in vehicle or capsaicin-pretreated rats anesthetized with sodium pentobarbital [50 mg/kg, intraperitoneal(ly)] were monitored to observe the contributions of neuropeptides released from sensory nerves to the 4alpha-PDD-induced hypotension. To detect the roles of various vasodilating factors released by vascular endothelium in the hypotensive effect induced by TRPV4 activation, the corresponding inhibitors/blockers, including indomethacin (a cyclooxygenase inhibitor, 10 mg/kg, i.v.), Nomega-nitro-L-arginine (L-NA, a nitric oxide synthase inhibitor, 20 mg/kg, i.v.), apamin [a blocker of small conductance Ca2+-activated K+ (MaxiK) channels, 50 microg/kg, i.v.] combined with charybdotoxin (a blocker of intermediate and large conductance MaxiK channels, 50 microg/kg, i.v.), were used at various time before 4alpha-PDD injection. Plasma CGRP and substance P levels of rats before or after administration were measured using the corresponding radioimmunoassays. At last, immunohistochemistry stainings were performed to observe expression of TRPV4/CGRP/MaxiK in mesenteric resistance arteries and sensory neurons/nerve fibers. Intravenous administration of 4alpha-PDD produced remarkable hypotension in vehicle-pretreated rats. The depressor

  20. Rebound intracranial hypertension: a complication of epidural blood patching for intracranial hypotension.

    Science.gov (United States)

    Kranz, P G; Amrhein, T J; Gray, L

    2014-06-01

    Rebound intracranial hypertension is a complication of epidural blood patching for treatment of intracranial hypotension characterized by increased intracranial pressure, resulting in potentially severe headache, nausea, and vomiting. Because the symptoms of rebound intracranial hypertension may bear some similarity to those of intracranial hypotension and literature reports of rebound intracranial hypertension are limited, it may be mistaken for refractory intracranial hypotension, leading to inappropriate management. This clinical report of 9 patients with confirmed rebound intracranial hypertension reviews the clinical characteristics of patients with this condition, emphasizing factors that can be helpful in discriminating rebound intracranial hypertension from refractory spontaneous intracranial hypotension, and discusses treatment. © 2014 by American Journal of Neuroradiology.

  1. 42 CFR 435.117 - Newborn children.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Newborn children. 435.117 Section 435.117 Public..., Children Under 8, and Newborn Children § 435.117 Newborn children. (a) The agency must provide Medicaid eligibility to a child born to a woman who has applied for, has been determined eligible and is receiving...

  2. Comparison of the efficiency of Banna miniature inbred pig somatic cell nuclear transfer among different donor cells.

    Directory of Open Access Journals (Sweden)

    Hongjiang Wei

    Full Text Available Somatic cell nuclear transfer (SCNT is an important method of breeding quality varieties, expanding groups, and preserving endangered species. However, the viability of SCNT embryos is poor, and the cloned rate of animal production is low in pig. This study aims to investigate the gene function and establish a disease model of Banna miniature inbred pig. SCNT with donor cells derived from fetal, newborn, and adult fibroblasts was performed, and the cloning efficiencies among the donor cells were compared. The results showed that the cleavage and blastocyst formation rates did not significantly differ between the reconstructed embryos derived from the fetal (74.3% and 27.4% and newborn (76.4% and 21.8% fibroblasts of the Banna miniature inbred pig (P>0.05. However, both fetal and newborn fibroblast groups showed significantly higher rates than the adult fibroblast group (61.9% and 13.0%; P<0.05. The pregnancy rates of the recipients in the fetal and newborn fibroblast groups (60% and 80%, respectively were higher than those in the adult fibroblast group. Eight, three, and one cloned piglet were obtained from reconstructed embryos of the fetal, newborn, and adult fibroblasts, respectively. Microsatellite analyses results indicated that the genotypes of all cloning piglets were identical to their donor cells and that the genetic homozygosity of the Banna miniature inbred pig was higher than those of the recipients. Therefore, the offspring was successfully cloned using the fetal, newborn, and adult fibroblasts of Banna miniature inbred pig as donor cells.

  3. Hypotensive and vasorelaxant effect of Diapocynin in normotensive rats.

    Science.gov (United States)

    Potje, Simone R; Troiano, Jéssica A; Graton, Murilo E; Ximenes, Valdecir F; Nakamune, Ana Claúdia M S; Antoniali, Cristina

    2017-05-01

    Nicotinamide adenine dinucleotide phosphate oxidase (NAD(P)H-oxidase) is a multicomponent enzyme system that generates superoxide anion by one-electron reduction of molecular oxygen and represents the major source of reactive oxygen species (ROS) in the vascular cells. Apocynin has been extensively used as an inhibitor of NADPH oxidase (NOX) in phagocytic cells and as an antioxidant in non-phagocytic cells. In phagocytes cells, due to the presence of myeloperoxidase, apocynin can be the converted to diapocynin, which is supposed to be the active form of this phytochemical. Moreover, apocynin was shown to induce hypotension and vasodilatation in many experimental animal models. However, there are no studies showing the effects of diapocynin on blood pressure or in vascular cells. In this present study, we used chemically synthesized diapocynin and analyzed its antioxidant capacity, effect on blood pressure and vascular reactivity. Moreover, it was evaluated the levels of nitric oxide (NO), ROS and calcium in aortic endothelial cells stimulated by diapocynin. All results were compared to apocynin. We found that diapocynin showed higher antioxidant capacity than apocynin. Apocynin and diapocynin, promoted hypotensive effects without changing the heart rate, however the effects of diapocynin were reversed faster than the effects of apocynin, which was long lasting. Diapocynin and apocynin induced endothelium dependent and independent vasodilatation, but diapocynin was less potent than apocynin regarding the capacity of induction of vasodilatation in mesenteric resistance arteries and aorta from Wistar rats. The relaxation induced by apocynin or diapocynin involves sGC and potassium channels in vascular smooth muscle cells and NOS participates of relaxation induced by apocynin or diapocynin in intact mesenteric rings. Apocynin and diapocynin increased NO and decreased ROS levels in endothelial cells, however diapocynin did not alter calcium levels in these cells. In

  4. Mechanism of exercise-induced hypotension in coronary artery disease.

    Science.gov (United States)

    Iskandrian, A S; Kegel, J G; Lemlek, J; Heo, J; Cave, V; Iskandrian, B

    1992-06-15

    Hypotension during exercise testing has been considered a marker of extensive coronary artery disease (CAD) and poor prognosis. The mechanism of hypotension was examined in 25 CAD patients who developed hypotension during treadmill exercise testing (mean decrease in systolic blood pressure [BP] 33 +/- 13 mm Hg) (group 1) and was compared with the results of 25 CAD patients who had a normal systolic BP response to exercise (mean increase 53 +/- 15 mm Hg) (group 2). The 2 groups were comparable in age, sex, extent of CAD, previous myocardial infarction, left ventricular ejection fraction, history of hypertension and cardiac medications. Exercise heart rate (121 +/- 23 vs 133 +/- 25 beats/min; p = not significant [NS]) and duration (6 +/- 2 vs 7 +/- 3 minutes; p = NS) were comparable. ST-segment depression occurred in 44% of patients in group 1 and in 52% in group 2 (p = NS), and angina during exercise occurred in 60% of both groups. Single-photon emission computed tomographic thallium images were abnormal in 24 patients (96%) in group 1 and in 20 patients (80%) in group 2 (p = NS). Percent thallium abnormality was 19 +/- 12% in group 1, and 18 +/- 14% in group 2 (p = NS), and the severity of thallium abnormality was 710 +/- 510 in group 1, and 510 +/- 500 in group 2 (p = NS). Ischemia involving the inferior/posterior segments was seen in 68% of patients in group 1 and in 60% in group 2 (p = NS). Increased lung thallium uptake was seen in 48% of both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. A Reversible Cause of Skin Hyperpigmentation and Postural Hypotension

    Directory of Open Access Journals (Sweden)

    Rabia Cherqaoui

    2013-01-01

    Full Text Available Vitamin B12 deficiency results in neuropsychiatric, hematologic, gynecologic, cardiovascular, and cutaneous manifestations. It is seen most commonly in the elderly, malabsorption diseases  (>60% of all cases, vegans, and vegetarians. Manifestations of pernicious anemia may be similar to Addison disease and may lead to a misdiagnosis. Herein, we report two cases of vitamin B12 deficiency in which clinical features shared many similarities with Addison disease. Both patients presented with progressive darkening of hands and postural hypotension that reversed with replenishment of vitamin B12. Vitamin B12 deficiency should be considered in patients presenting with skin lesions especially with other coexisting autoimmune diseases.

  6. Newborn with severe epidermolysis bullosa

    DEFF Research Database (Denmark)

    Boesen, Martin Lehmann; Bygum, Anette; Hertz, Jens Michael

    2016-01-01

    Epidermolysis bullosa (EB) is an inherited skin disease with four main subtypes that cannot be distinguished clinically at birth. All subtypes may present with widespread life-threatening blisters and fragile skin, making treatment and handling of the newborn with EB challenging. The prognosis...

  7. Kluyvera meningitis in a newborn.

    Science.gov (United States)

    Rosso, Marisa; Rojas, Pilar; Garcia, Elisa; Marquez, Javier; Losada, Antonio; Muñoz, Miguel

    2007-11-01

    Kluyvera is described infrequently in association with clinically significant infections in humans. It can produce a wide range of clinically significant manifestations. We describe a newborn with ventriculoperitoneal shunt, who was successfully treated for Kluyvera meningitis. We believe that this is the first case of Kluyvera central nervous system infection reported in a child.

  8. Newborns' Mooney-Face Perception

    Science.gov (United States)

    Leo, Irene; Simion, Francesca

    2009-01-01

    The aim of this study is to investigate whether newborns detect a face on the basis of a Gestalt representation based on first-order relational information (i.e., the basic arrangement of face features) by using Mooney stimuli. The incomplete 2-tone Mooney stimuli were used because they preclude focusing both on the local features (i.e., the fine…

  9. Congenital syphilis in the newborn.

    OpenAIRE

    V; Chawla; Pandit, P B; Nkrumah, F K

    1988-01-01

    We studied 53 newborn babies with congenital syphilis. The common clinical features seen were low birth weight, hepatosplenomegaly, anaemia, jaundice, and symmetrical superficial desquamation of the skin affecting palms and soles. The presence of these clinical signs is highly suggestive of early congenital syphilis. Hydrops fetalis without rhesus or ABO isoimmunisation should always arouse the suspicion of congenital syphilis.

  10. Newborn Screening for Pompe Disease.

    Science.gov (United States)

    Bodamer, Olaf A; Scott, C Ronald; Giugliani, Roberto

    2017-07-01

    Started in 1963 by Robert Guthrie, newborn screening (NBS) is considered to be one of the great public health achievements. Its original goal was to screen newborns for conditions that could benefit from presymptomatic treatment, thereby reducing associated morbidity and mortality. With advances in technology, the number of disorders included in NBS programs increased. Pompe disease is a good candidate for NBS. Because decisions regarding which diseases should be included in NBS panels are made regionally and locally, programs and efforts for NBS for Pompe disease have been inconsistent both in the United States and globally. In this article, published in the "Newborn Screening, Diagnosis, and Treatment for Pompe Disease" guidance supplement, the Pompe Disease Newborn Screening Working Group, an international group of experts in both NBS and Pompe disease, review the methods used for NBS for Pompe disease and summarize results of current and ongoing NBS programs in the United States and other countries. Challenges and potential drawbacks associated with NBS also are discussed. Copyright © 2017 by the American Academy of Pediatrics.

  11. Platelet indices in SGA newborns.

    Science.gov (United States)

    Wasiluk, A; Dabrowska, M; Osada, J; Jasinska, E; Laudanski, T; Redzko, S

    2011-01-01

    The current study objective was to compare blood platelet indices in full-term small-for-gestational-age newborns (SGA) and full-term appropriate-for-gestational-age newborns (AGA). We introduced to our study 61 SGA newborns (31 females and 30 males) and 70 eutrophic infants (32 females and 38 males). The SGA newborns were divided into two groups: those weighing less than the 5th centile: 35 infants (16 females and 19 males) and those between the 5th and 10th centiles: 26 infants (15 females and 11 males). Platelet indices were estimated in blood samples collected from the umbilical artery. SGA demonstrated a decreased count of blood platelets (238×103/μ) as compared with AGA (286×103/μL), p=0.0001. Platelet hematocrit (PTC) also showed differences in both groups (SGA=0.19% vs. AGA=0.22%; p=0.0005). Mean platelet volume (MPV) was higher in SGA (8.25fl) as compared with AGA (7.84fl); p=0.008. Large platelet count (LPLT) was higher in AGA 6.26% vs. SGA=4.75%; p=0.01. Platelet distribution width (PDW) was found to be nearly the same (SGA=47%, AGA=46%). PDW was higher in SGA newborns SGA infants between the 5th and 10th centiles (52%); p=0.008. A decreased blood platelet count, platelet hematocrit and large metabolically active platelet count, which in addition to reduced synthesis and excessive consumption of coagulation factors in states of hiperclotting is characteristic of IUGR, enhances the possibility of bleeding complications and increases the risk of infections. From a clinical point of view, it is important to take into consideration the degree of intrauterine hypotrophy during the evaluation of hemostatic disorders.

  12. Neurogenic orthostatic hypotension – management update and role of droxidopa

    Directory of Open Access Journals (Sweden)

    Vijayan J

    2015-06-01

    Full Text Available Joy Vijayan,1 Vijay K Sharma1,21Department of Medicine, Division of Neurology, National University Health System, 2Yong Loo Lin School of Medicine, National University of Singapore, SingaporeAbstract: Orthostatic hypotension (OH is defined as a significant decrease in blood pressure (BP during the first 3 minutes of standing or a head up on a tilt table. Symptoms of OH are highly variable, ranging from mild light-headedness to recurrent syncope. OH occurs due to dysfunction of one or more components of various complex mechanisms that interplay closely to maintain BP in a normal range during various physiological and associated disease states. Various biochemical and electrophysiological studies are often undertaken to assess the severity and etiology of OH. In addition to the lifestyle modifications, various medications that stimulate the adrenergic receptors or increase central blood volume are used in patients with OH. Droxidopa is a newer agent that increases the levels of norepinephrine in postganglionic sympathetic neurons. Management strategies for OH are presented, including the mechanism of action of droxidopa and various studies performed to assess its efficacy.Keywords: orthostatic hypotension, systemic blood pressure, midodrine, fludrocortisone, droxidopa

  13. Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation.

    LENUS (Irish Health Repository)

    Noori, S

    2014-08-14

    Objective:We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation.Study Design:A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg(-1)min(-1). Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension).Result:Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration.Conclusion:We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.Journal of Perinatology advance online publication, 14 August 2014; doi:10.1038\\/jp.2014.151.

  14. Nontraumatic Hypotension and Shock in the Emergency Department and the Prehospital setting, Prevalence, Etiology, and Mortality

    DEFF Research Database (Denmark)

    Holler, Jon Gitz; Bech, Camilla Louise Nørgaard; Henriksen, Daniel Pilsgaard

    2015-01-01

    of hypotensive shock was 9.5-19/1000 EMS contacts with an inhospital mortality of shock between 33 to 52%. ED prevalence of hypotension was 4-13/1000 contacts with a mortality of 12%. Information on mortality, prevalence and etiology of shock in the ED was limited. A meta-analysis was not feasible due...

  15. Haemodynamics in postural hypotension--effects of the beta-adrenoceptor partial agonist xamoterol, and pindolol

    DEFF Research Database (Denmark)

    Mehlsen, J; Trap-Jensen, J

    1990-01-01

    Beta-andrenoceptor agents have been used in the treatment of postural hypotension and agonist activity found to be important. The effects of xamoterol and pindolol on standing haemodynamics were compared in this study. Xamoterol was found to be of significant benefit, but pindolol was ineffective....... Xamoterol may therefore be useful in the treatment of postural hypotension....

  16. Orthostatic hypotension does not predict recurrent falling in a nursing home population

    NARCIS (Netherlands)

    Hartog, L. C.; Cimzar-Sweelssen, M.; Knipscheer, A.; Groenier, K. H.; Kleefstra, N.; Bilo, H. J. G.; Van Hateren, Kornelis J. J.

    2017-01-01

    Objective: Most studies regard orthostatic hypotension (OH) as a causal factor for falls. However, the evidence is lacking for this assumption. We aimed to investigate the relationship between orthostatic hypotension and fall incidents in nursing home residents. Methods: A total of 249 patients was

  17. Safety of labetalol-induced controlled hypotension during middle ear microsurgery

    NARCIS (Netherlands)

    de Hert, S.; Boeckx, E.; Vercauteren, M.; Claes, J.; van den Heyning, P.; Adriaensen, H.

    1989-01-01

    In order to study the influence of labetalol on the peroperative oxygenation during deliberate hypotension, 50 patients undergoing middle ear microsurgery were randomly divided in two groups of 25 patients; one group receiving labetalol to induce hypotension, the other group receiving placebo in a

  18. Postprandial and Orthostatic Hypotension Treated by Sitagliptin in a Patient with Dementia with Lewy Bodies.

    Science.gov (United States)

    Saito, Yoshihiro; Ishikawa, Joji; Harada, Kazumasa

    2016-11-25

    BACKGROUND Postprandial hypotension, induced by an absorption of glucose from intestine, could be treated by acarbose; however, it was unclear whether dipeptidyl peptidase-4 inhibitor reduced postprandial hypotension. CASE REPORT A 78-year-old woman who had experienced episodes of dizziness and hypotension after eating was admitted to our hospital. During 24-hour ambulatory blood pressure monitoring, there were repeated episodes of marked postprandial hypotension; i.e., a significant systolic blood pressure reduction within two hours after eating (from -58 to -64 mm Hg after meals). The patient was diagnosed with dementia with Lewy bodies. The patient exhibited postprandial hyperglycemia and hypotension after a 75 g oral glucose tolerance test. After the administration of 25 mg sitagliptin, the patient's postprandial and orthostatic hypotension was reduced remarkably. Moreover, her Mini-Mental State Examination score subsequently increased (from 22 to 25 points). CONCLUSIONS The dipeptidyl peptidase-4 inhibitor sitagliptin can delay postprandial increases in glucose levels and hypotensive episodes, as well as sympathetic nervous system abnormalities and orthostatic hypotension.

  19. Unexplained and prolonged perioperative hypotension after orthotopic liver transplantation: undiagnosed systemic mastocytosis.

    Science.gov (United States)

    Willingham, Darrin L; Peiris, Prith; Canabal, Juan M; Krishna, Murli; Hewitt, Winston R; Shine, Timothy S J; Arasi, Lisa C; Aranda-Michel, Jaime; Hughes, Christopher B; Kramer, David J

    2009-07-01

    Arterial vasodilation is common in end-stage liver disease, and systemic hypotension often may develop, despite an increase in cardiac output. During the preparation for and the performance of orthotopic liver transplantation, expected and transient hypotension may be caused by induction agents, anesthetic agents, liver mobilization, or venous clamping. A mild decrease of the already low systemic vascular resistance is often observed, and intermittent use of short-acting agents for vasopressor support is not uncommon. In this report, we describe a patient with unexpected and prolonged hypotension due to vasodilation during and after orthotopic liver transplantation. The preoperative end-stage liver disease evaluation, intraoperative events, and intensive care unit course were reviewed, and no cause for the vasodilation and prolonged hypotension was evident. The explant pathology report was later available and showed systemic mastocytosis. We hypothesize that the unexpected hypotension and vasodilation were caused by mast cell degranulation and its systemic effects on arterial tone.

  20. Granulomatosis With Polyangiitis-Associated Hypertrophic Pachymeningitis Mimicking Spontaneous Intracranial Hypotension: A Case Report.

    Science.gov (United States)

    Jung, Young Hee; Lee, Mi Ji; Lee, Chungbin; Cha, Jihoon; Chung, Chin-Sang

    2017-03-01

    Dural enhancement is a characteristic finding in both spontaneous intracranial hypotension and hypertrophic pachymeningitis. Positional headache is the most important feature that distinguishes the two diseases. We report a patient with granulomatosis with polyangiitis (formerly Wegener's granulomatosis) who initially manifested like spontaneous intracranial hypotension. We report here the case of a 63-year old man who presented with severe positional headache. The patient had typical symptoms, symmetric dural enhancement, and a recent history of nontraumatic subdural hygroma which led to the diagnosis of spontaneous intracranial hypotension, but was finally diagnosed as granulomatosis with polyangiitis-associated secondary hypertrophic pachymeningitis. Cyclophosphamide therapy was effective for the maintenance of remission. Hypertrophic pachymeningitis associated with granulomatosis with polyangiitis can present with positional headache and subdural hygroma, mimicking spontaneous intracranial hypotension. Granulomatosis with polyangiitis should be suspected when patients with spontaneous intracranial hypotension or hypertrophic pachymeningitis show atypical features. © 2016 American Headache Society.

  1. Emergency care for potbellied pigs.

    Science.gov (United States)

    Tynes, V V

    1998-09-01

    Because of the limited number of veterinarians treating potbellied pigs, many pet pigs do not receive proper preventative health care. The potbellied pig's continued popularity among urban dwellers ensures that veterinarians who treat small and exotic animals will be contacted by owners of pet pigs with real or perceived emergencies. Regardless of their knowledge of swine, the information contained in this article should enable any veterinarian to provide basic emergency care for pet pigs.

  2. A newborn with neck mass.

    Science.gov (United States)

    Pereira, Rita Calado; Barroso, Laura Martins; Mendes, Maria José; Joaquim, Isabel Fernandes; Ornelas, Helder

    2011-03-01

    Congenital goiter is a rare cause of neonatal neck mass and may result from a fetal defectin synthesis of thyroxine, or administration of antithyroid drugs or iodides during pregnancy. The thyroid dysfunction often accompanies it. This report describes a case of a male term newborn with congenital goiter and primary hypothyroidism. Hormonal replacement treatment was started leading to normal levels of free thyroxine and triiodothyronine. In face of a maternal negative investigation, dyshormonogenesis was considered to be the most probable cause of hypothyroidism.

  3. [Congenital syphilis: incidence among newborns

    Science.gov (United States)

    Araújo, E C; Moura, E F; Ramos, F L; Holanda, V G

    1999-01-01

    OBJECTIVE: To determine the incidence of congenital syphilis among newborns at the maternity of a public hospital. METHODS: The study was conducted at the maternity of Fundação Santa Casa de Misericórdia do Pará, from May to September 1996; 361 mothers were interviewed, and physical examination was performed in their newborns. Serum samples from both, mothers and neonates, were tested using three methods: VDRL, FTA - Abs, ELISA IgM. The diagnosis of congenital syphilis was established according to the criteria defined by Ministério da Saúde in 1993. RESULTS: The rate of congenital syphilis was of 9.1% (33); in 14 cases, there were one or more signs of the disease: prematurity, hepatomegaly, stillbirth, splenomegaly, perinatal death, abdominal distention, nasal stuffiness, jaundice, newborn small for gestational age. The majority of the infected mothers belonged to the age group of 20-35 years (81.8%); 60.6% were married; 63.6% received prenatal care; 48.5% reported previous spontaneous abortion, and 12.1% previous stillbirth. The rate of bisexuality among fathers was of 9.1%. CONCLUSION: The syphilis control measures and the prenatal care, have not been sufficient to prevent the high rate of the disease.

  4. Prevention of postoperative hypotension following spinal anesthesia for TURP: a double-blind randomized controlled trial comparing ephedrine with placebo.

    Science.gov (United States)

    Verdeyen, J; Ory, J P; Wyckmans, W; Vandermeersch, E; Jamaer, L; Van Assche, A

    2008-01-01

    Spinal hypotension (SH) is a common side effect of spinal anesthesia and may also occur after the surgical procedure. In this double-blinded, placebo-controlled, randomised clinical trial fifty patients undergoing transurethral prostatectomy under spinal anesthesia received 10 mg of ephedrine IV before being transferred from the operating table into their bed after the procedure, whereas fifty controls received saline IV. The number of per- and postoperative hypotensive episodes and vasopressor use, time delay between the administration of the study medication and the first hypotensive episode, level of spinal blockade at the start of surgery, pre- and postoperative hemoglobine and sodium concentration, cardiovascular co-morbidity and chronic medication were registered. There was no statistically significant difference in the incidence of postoperative hypotension between the two groups, but Poisson regression of the expected number of postoperative hypotensive episodes per patient showed a protective effect of ephedrine (p hypotension was a risk factor for developing postoperative hypotension (p hypotension, except for a correlation between preoperative alpha-receptor blocking drugs and peroperative hypotension (p hypotension (recorded incidence 31%) was almost as common as peroperative hypotension (recorded incidence 37%) and occurred as late as 190 minutes after the end of surgery. Ephedrine IV at the end of surgery reduced the number of postoperative hypotensive episodes per patient but did not reduce the overall incidence of postoperative SH.

  5. The Impact of Combined Prehospital Hypotension and Hypoxia on Mortality in Major Traumatic Brain Injury

    Science.gov (United States)

    Spaite, Daniel W.; Hu, Chengcheng; Bobrow, Bentley J.; Chikani, Vatsal; Barnhart, Bruce; Gaither, Joshua B.; Denninghoff, Kurt R.; Adelson, P. David; Keim, Samuel M.; Viscusi, Chad; Mullins, Terry; Sherrill, Duane

    2016-01-01

    BACKGROUND Survival is significantly reduced by either hypotension or hypoxia during the prehospital management of major traumatic brain injury (TBI). However, only a handful of small studies have investigated the influence of the combination of both hypotension and hypoxia occurring together. Objective: In patients with major TBI, we evaluated the associations between mortality and prehospital hypotension and hypoxia, both separately and in combination. METHODS All moderate/severe TBI cases in the pre-implementation cohort of the Excellence in Prehospital Injury Care (EPIC) Study (a statewide, before/after, controlled study of the impact of implementing the prehospital TBI treatment guidelines) from 1/1/07–3/31/14 were evaluated [exclusions: age200mmHg]. The relationship between mortality and hypotension (SBP controlling for Injury Severity Score, head region severity, injury type (blunt versus penetrating), age, sex, race, ethnicity, payer, inter-hospital transfer, and trauma center. RESULTS Among the 13,151 cases that met inclusion criteria [Median age: 45; Male: 68.6%], 11,545 (87.8%) had neither hypotension nor hypoxia, 604 (4.6%) had hypotension only, 790 (6.0%) had hypoxia only, and 212 (1.6%) had both hypotension and hypoxia. Mortality for the four study cohorts was 5.6%, 20.7%, 28.1%, and 43.9%, respectively. The crude and adjusted odds ratios (cOR/aOR) for death within the cohorts, utilizing the patients with neither hypotension nor hypoxia as the reference, were 4.4/2.5, 6.6/3.0, and 13.2/6.1, respectively. Evaluation for an interaction between hypotension and hypoxia revealed that the effects are additive on the log odds of death. CONCLUSION In this statewide analysis of major TBI, combined prehospital hypotension/hypoxia were associated with dramatically increased mortality. This effect on survival persisted even after controlling for multiple potential confounders. In fact, the adjusted odds of death in patients with both hypotension and hypoxia was

  6. Lymphomatosis cerebri presenting with orthostatic hypotension, anorexia, and paraparesis.

    Science.gov (United States)

    Keswani, Anjeni; Bigio, Eileen; Grimm, Sean

    2012-09-01

    To increase awareness about lymphomatosis cerebri by describing a patient with a unique presentation Case report a 58 year old woman presented with progressive lower extremity weakness, postural hypotension, and 90 pound weight loss over 3 months a brain magnetic resonance image revealed multiple non-enhancing foci of T2 hyperintensity in the periventricular white matter despite treatment with corticosteroids, she expired autopsy demonstrated normal gross appearance of the brain and spinal cord microscopic inspection revealed diffuse infiltration of the central nervous system (CNS) parenchyma and white matter by large atypical B cells, consistent with a diagnosis of lymphomatosis cerebri lymphomatosis cerebri is a primary CNS lymphoma variant that is poorly recognized and often misdiagnosed it commonly presents as a rapidly progressive dementia, although patients may present with neurologic dysfunction without dementia diagnosis requires a pathological examination treatment with intravenous high-dose methotrexate based chemotherapy should be considered in appropriate patients.

  7. [Propranolol treatment of effort angina in patients with arterial hypotension].

    Science.gov (United States)

    Idrisova, E M; Boshchenko, A A; Borovkova, N V; Demochko, A V; Chernov, V I; Karpov, R S

    2004-01-01

    To compare antianginal efficacy and tolerability of propranolol therapy in patients with stable angina pectoris and chronic hypotension (Hpts) and normotensive patients with angina of effort (Npts). A randomized, single-blind, placebo-controlled study was made in 35 Hpts and 38 Npts was made using bicycle exercise tests, echocardiography, stress myocardial scintigraphy with 77-199. Acute bicycle exercise tests showed high anti-ischemic activity of propranolol in 86% Hpts and 65% Npts. Stable antianginal propranolol effect in 57% Hpts was accompanied with a decrease of myocardial perfusion defect. Secondary resistance or pseudotolerance to an antianginal effect of propranolol was observed in 43% Hpts in 4-12 weeks (vs 0 of Npts; p bradicardia (p < 0.05), more anginal attacks (p < 0.001). Hpts had rapidly developing secondary resistance and pseudotolerance to propranolol antianginal effect, bad tolerability of the drug.

  8. Orthostatic hypotension and cognitive impairment: a dangerous association?

    Science.gov (United States)

    Sambati, Luisa; Calandra-Buonaura, Giovanna; Poda, Roberto; Guaraldi, Pietro; Cortelli, Pietro

    2014-06-01

    Many studies have addressed the relation between orthostatic hypotension (OH) and cognitive impairment (CI) in the elderly, in mild cognitive impairment, vascular and neurodegenerative dementias and movement disorders, such as Parkinson's disease. However, results concerning both the increased coexistence of the two conditions and their causal relationship remain controversial. According to the literature three hypotheses can be formulated on the relation between OH and CI. In neurodegenerative disease, OH and CI may result from a common pathological process which affects areas involved in both cognition and cardiovascular autonomic control. Alternatively, OH may lead to cerebral hypoperfusion which is supposed to play a role in the development of CI. Finally, recent data suggest that CI should probably be considered more a transient symptom of OH than a chronic effect. This study reviews the literature reports on the relationship between OH and CI, and emphasises the need for longitudinal studies designed to investigate this topic.

  9. Intracranial hypotension and hypertension in children and adolescents.

    Science.gov (United States)

    Ozge, Aynur; Bolay, Hayrunnisa

    2014-07-01

    The specific aim of this review is to report the features of intracranial pressure changes [spontaneous intracranial hypotension (SIH) and idiopathic intracranial hypertension (IIH)] in children and adolescents, with emphasis on the presentation, diagnosis, and treatment modalities. Headache associated with intracranial pressure changes are relatively rare and less known in children and adolescents. SIH is a specific syndrome involving reduced intracranial pressure with orthostatic headache, frequently encountered connective tissue disorders, and a good prognosis with medical management, initial epidural blood patching, and sometimes further interventions may be required. IIH is an uncommon condition in children and different from the disease in adults, not only with respect to clinical features (likely to present with strabismus and stiff neck rather than headache or pulsatile tinnitus) but also different in outcome. Consequently, specific ICP changes of pediatric ages required specific attention both of exact diagnosis and entire management.

  10. Central haemodynamics in patients with severe postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Haedersdal, C; Trap-Jensen, J

    1991-01-01

    Central haemodynamics in the supine and head-up tilted positions were studied in 24 patients with severe postural hypotension with and without supine hypertension. Results were compared with those obtained in eight normotensive and eight untreated hypertensive controls. In the supine position...... the patients had higher vascular resistances, lower stroke volumes and longer left ventricular ejection time indexes compared to controls, whereas left ventricular ejection fractions did not differ significantly. The patients with supine hypertension had significantly higher vascular resistance compared...... to those with supine normotension. The highest supine blood pressure levels were found in patients with multiple system atrophy. During tilt, vascular resistance and heart rates were increased and stroke volumes and left ventricular ejection time indexes were decreased in the controls. The patients were...

  11. Ultrasound for critical care physicians: hypotension after a MVA

    Directory of Open Access Journals (Sweden)

    Schmitz E

    2014-03-01

    Full Text Available No abstract available. Article truncated after first page. A 25 year old woman was a restrained driver in a rollover motor vehicle accident (MVA and suffered a C5-C6 fracture-dislocation with spinal cord injury. She was lucid and able to follow commands and could move her upper extremities but not her lower extremities. She was given approximately 6 liters of fluid but required vasopressors to maintain her blood pressure. Initial ECG revealed a normal sinus rhythm without significant ST changes (Figure 1. Upon initial evaluation her blood pressure was low. Bedside ultrasound of the left anterior second intercostal space revealed a sliding lung sign and a 4 chamber view of her heart was performed (Figure 2. Which of the following is the most likely cause of her hypotension? 1. Blunt cardiac injury; 2. Intravascular volume depletion; 3. Neurogenic stunned myocardium; 4. Pericardial tamponade; 5. Pneumothorax ...

  12. Pharmacognosy and hypotensive evaluation of Ficus exasperata Vahl (Moraceae) leaf.

    Science.gov (United States)

    Ayinde, Buniyamin A; Omogbai, Eric K I; Amaechina, Fabian C

    2007-01-01

    There is already a literature report on the anti-ulcer effect of water extract of Ficus exasperata. Some communities in Edo and Delta States of Nigeria use the decoction of the leaf as hypotensive crude drug. Verification of this claim and also the microscopy and other pharmacognostic parameters which can be used to establish the identity of the leaf were carried out. The microscopy of the leaf powder revealed the presence of straight walled epidermal cells, cone or nail shaped trichomes or epidermal hairs, clustered or prismatic calcium oxalate crystals of varying dimensions. The percentage weight loss on drying was 9.84 +/- 0.08 whereas water and alcohol extractive values were 5.29 +/- 0.07 and 2.21 +/- 0.11, respectively. The ash value was 30.68 +/- 0.44 whereas the acid insoluble ash and water soluble ash values were 17.87 +/- 0.37 and 16.73 +/- 0.13, respectively. Preliminary phytochemistry of leaf showed that it contains tannins, flavonoids and saponins with no traces of alkaloids or anthraquinones. The water extract showed a dose related reduction in mean arterial blood pressure. At 10 mg/kg, a reduction of 16.6 +/- 1.1 mmHg was observed, whereas at 30 mg/kg, a fall in mean arterial pressure of 38.3 +/- 0.6 mmHg was obtained. The hypotensive effect of the extract was significantly reduced with a prior administration of 2.5 mg of either atropine or chlorpheniramine. This suggests the probable stimulation of muscarinic receptors in the heart or release of histamine into the circulatory system thereby causing the initial fall in blood pressure.

  13. Perspectives in Pig Science

    NARCIS (Netherlands)

    Wiseman, J.; Varley, M.A.; Kemp, B.

    2003-01-01

    Perspectives in Pig Science features a collection of papers on five key areas: breeding and genetics; management, marketing and meat quality; health and welfare; reproduction and reproductive management; nutrition.

  14. Emergency department septic shock patient mortality with refractory hypotension vs hyperlactatemia: A retrospective cohort study.

    Science.gov (United States)

    April, Michael D; Donaldson, Chase; Tannenbaum, Lloyd I; Moore, Tyler; Aguirre, Jose; Pingree, Alexander; Lantry, James H

    2017-10-01

    Our objective was to compare in-hospital mortality among emergency department (ED) patients meeting trial-based criteria for septic shock based upon whether presenting with refractory hypotension (systolic blood pressurerefractory hypotension or hyperlactatemia. Trained chart abstractors blinded to the study hypothesis double entered data from each patient's record including demographics, clinical data, treatments, and in-hospital mortality. We compared in-hospital mortality among patients with isolated refractory hypotension, isolated hyperlactatemia, or both. We also calculated odds ratios (ORs) via logistic regression for in-hospital mortality based on presence of refractory hypotension or hyperlactatemia. Of 202 patients included in the analysis, 38 (18.8%) died during hospitalization. Mortality was 10.9% among 101 patients with isolated refractory hypotension, 24.4% among 41 patients with isolated hyperlactatemia, and 28.3% among 60 patients with both (p=0.01). Logistic regression analyses yielded in-hospital mortality OR for refractory hypotension of 1.3 (95% CI 0.5-3.8) versus OR for hyperlactatemia of 2.9 (95% CI 1.2-7.4). Hyperlactatemia appears associated with higher in-hospital mortality compared to refractory hypotension among ED patients with septic shock. Published by Elsevier Inc.

  15. Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes

    Directory of Open Access Journals (Sweden)

    Pornswan Ngamprasertwong

    2013-01-01

    Full Text Available In this retrospective cohort study, we aimed to determine the incidence of intraoperative maternal hypotension during fetoscopic surgery for twin-twin transfusion syndrome (TTTS and to evaluate the impact of intraoperative hypotension on fetal survival. A total of 328 TTTS patients with recipient twin cardiomyopathy who underwent fetoscopic surgery under epidural anesthesia were included. The exposure of interest was maternal medical therapy with nifedipine for the treatment of fetal cardiomyopathy. We found that intraoperative hypotension occurred in 53.4% (175/328 patients. There was no statistically significant difference in incidence of hypotension between nifedipine exposure and nonexposure groups (54.8% versus 50.8%, P=0.479. However, the nifedipine exposure group received a statistically significant higher dose of phenylephrine (7.04 ± 6.38 mcg/kg versus 4.70 ± 4.14 mcg/kg, P=0.018 and higher doses of other vasopressor, as counted by number of treatments (6.06 ± 4.58 versus 4.96 ± 3.42, P=0.022. There were no statistically significant differences in acute fetal survival rate (within 5 days and fetal survival rate at birth between hypotensive and nonhypotensive patients. We concluded that preoperative exposure to nifedipine resulted in increased intraoperative maternal vasopressor requirement during fetoscopic surgery under epidural anesthesia. In patients who had intraoperative maternal hypotension, there was no correlation between the presence of maternal hypotension and postoperative fetal survival.

  16. Hypotensive Response Magnitude and Duration in Hypertensives: Continuous and Interval Exercise

    Directory of Open Access Journals (Sweden)

    Raphael Santos Teodoro de Carvalho

    2015-03-01

    Full Text Available Background: Although exercise training is known to promote post-exercise hypotension, there is currently no consistent argument about the effects of manipulating its various components (intensity, duration, rest periods, types of exercise, training methods on the magnitude and duration of hypotensive response. Objective: To compare the effect of continuous and interval exercises on hypotensive response magnitude and duration in hypertensive patients by using ambulatory blood pressure monitoring (ABPM. Methods: The sample consisted of 20 elderly hypertensives. Each participant underwent three ABPM sessions: one control ABPM, without exercise; one ABPM after continuous exercise; and one ABPM after interval exercise. Systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial pressure (MAP, heart rate (HR and double product (DP were monitored to check post-exercise hypotension and for comparison between each ABPM. Results: ABPM after continuous exercise and after interval exercise showed post-exercise hypotension and a significant reduction (p < 0.05 in SBP, DBP, MAP and DP for 20 hours as compared with control ABPM. Comparing ABPM after continuous and ABPM after interval exercise, a significant reduction (p < 0.05 in SBP, DBP, MAP and DP was observed in the latter. Conclusion: Continuous and interval exercise trainings promote post-exercise hypotension with reduction in SBP, DBP, MAP and DP in the 20 hours following exercise. Interval exercise training causes greater post-exercise hypotension and lower cardiovascular overload as compared with continuous exercise.

  17. Cerebral Blood Flow Velocities in Hypotensive Extremely Low Birth Weight Infants and Normotensive Infants

    Science.gov (United States)

    Lightburn, Marla H.; Gauss, C. Heath; Williams, D. Keith; Kaiser, Jeffrey R.

    2009-01-01

    Objective To determine if hypotensive extremely low birth weight (ELBW) infants have similar cerebral hemodynamics when compared with normotensive controls. We hypothesized that hypotensive and normotensive ELBW infants have similar cerebral blood flow (CBF) velocity. Study design In this case–control study, CBF velocity (using Doppler ultrasound), PCO2, and mean arterial blood pressure (MABP) were continuously monitored twice daily prior to intensive care procedures. If an infant became hypotensive (MABP ≤ gestational age in weeks), additional monitoring was performed for 10–20 minutes, prior to treatment with dopamine. Thirty ELBW infants were enrolled (637 ± 140 g, 24.2 ± 1.1 weeks); 15 were hypotensive and 15 were gestational age/birth weight-matched normotensive controls. CBF velocity was compared using the Mann-Whitney U test. Results The groups did not differ significantly in gestational age, birth weight, race, sex, PCO2, Apgar scores, or occurrence of severe intraventricular hemorrhage. There was no difference in mean CBF velocity (P = .934) in hypotensive infants (MABP: 23 [20–24.9] mm Hg) compared with normotensive infants (MABP: 32.6 [27.5–35.7] mm Hg). Conclusion Despite being hypotensive, ELBW infants (prior to treatment), had similar CBF velocity compared with normotensive controls. Based on these results, hypotension may not indicate decreased CBF. PMID:19324371

  18. Newborn Screening for X-Linked Adrenoleukodystrophy

    Directory of Open Access Journals (Sweden)

    Ann B. Moser

    2016-12-01

    Full Text Available Early diagnosis of males with X-linked adrenoleukodystrophy (X-ALD is essential for preventing loss of life due to adrenal insufficiency and for timely therapy of the childhood cerebral form of X-ALD with hematopoietic cell transplantation. This article describes X-ALD, the current therapies, the history of the development of the newborn screening test, the approval by the Secretary of Health and Human Services for the addition of X-ALD newborn screening to the recommended uniform panel of disorders screened as newborns (RUSP and the successful implementation of X-ALD newborn screening in the state of New York beginning on 30 December 2013. Follow-up guidelines that have been established in New York are outlined. Based on the success of newborn screening in New York, and early results in Connecticut, where X-ALD newborn screening started in December 2015, and in California, where X-ALD newborn screening began in September 2016, we are confident and hopeful that X-ALD newborn screening will expand to include all US states and to countries that have established neonatal screening programs. The Minster of Health in the Netherlands has approved the addition of X-ALD to the newborn screening program with a start date expected in 2017. The states, such as Massachusetts, Illinois, Minnesota, New Jersey, Florida and Washington, that have legislative approval will commence screening as soon as budgetary resources, testing and follow-up procedures are in place.

  19. State of the World's Newborns: A Report from Saving Newborn Lives.

    Science.gov (United States)

    Costello, Anthony; Francis, Victoria; Byrne, Ali; Puddephatt, Claire

    There has been little change in newborn mortality in the past 20 years, even through proven, cost-effective solutions exist to save many of these young lives. This report reviews the most recent data on the newborn, revealing the alarming poor health and quality of health care for mothers and newborns in virtually all impoverished countries. The…

  20. Mortality is Greater in Septic Patients With Hyperlactatemia Than With Refractory Hypotension.

    Science.gov (United States)

    Gotmaker, Robert; Peake, Sandra L; Forbes, Andrew; Bellomo, Rinaldo

    2017-09-01

    In septic patients, it is uncertain whether isolated hyperlactatemia (lactate ≥4 mmol/L without refractory hypotension) can be used to diagnose septic shock and whether mortality rate differs from that of isolated refractory hypotension (refractory to 1000 mL or greater fluid bolus). To compare baseline characteristics, treatments, and outcomes of participants enrolled into the Australian Resuscitation in Sepsis Evaluation (ARISE) trial according to the presence of isolated hyperlactatemia or isolated refractory hypotension. Cohort of 1,332 ARISE participants with sepsis and either isolated hyperlactatemia or isolated refractory hypotension. We performed a secondary analysis of the ARISE data, constructing a propensity score model to discriminate between hyperlactatemia and isolated refractory hypotension. We analyzed 90-day all-cause mortality using a generalized linear model and inverse propensity score weighting. We modeled length of intensive care unit (ICU) and hospital stay using time to event analyses incorporating mortality as a competing risk. There were 478 participants (35.9%) with isolated hyperlactatemia and 854 (64.1%) with isolated refractory hypotension. They had similar median (interquartile range) ages (66.2 [54.2, 76.3] years vs. 65.2 [50.9, 75.5] years) and similar sources of infection. However, isolated hyperlactatemia participants had higher mean (standard deviation) baseline APACHE II scores (isolated hyperlactatemia 16.2 [6.4]) vs. 14.5 [6.4] for isolated refractory hypotension; P refractory hypotension. In septic patients, isolated hyperlactatemia may define greater illness severity and worse outcomes than isolated refractory hypotension.

  1. A case of hypotension after intranasal adrenaline infiltration causing a clinical dilemma during the intraoperative period

    Directory of Open Access Journals (Sweden)

    Shyam Bhandari

    2011-01-01

    Full Text Available Solutions containing adrenaline are widely used for presurgical infiltration. Haemodynamic changes associated with its use are well documented in the literature. Prolonged intraoperative hypotension after subcutaneous infiltration of diluted adrenaline is an uncommon scenario. We believe that our case of the prolonged episode of hypotension was secondary to infiltration of nasal septum with a high concentration of adrenaline. As β2 receptor activation leads to skeletal muscle vasodilation, a decrease in preload may have lead to profound hypotension. Postoperatively, the patient was examined and any autonomic or endocrinological pathology was ruled out.

  2. Maternal vitamin C deficiency during pregnancy persistently impairs hippocampal neurogenesis in offspring of guinea pigs

    DEFF Research Database (Denmark)

    Tveden-Nyborg, Pernille; Vogt, Lucile; Schjoldager, Janne G

    2012-01-01

    While having the highest vitamin C (VitC) concentrations in the body, specific functions of VitC in the brain have only recently been acknowledged. We have shown that postnatal VitC deficiency in guinea pigs causes impairment of hippocampal memory function and leads to 30% less neurons. This study...... investigates how prenatal VitC deficiency affects postnatal hippocampal development and if any such effect can be reversed by postnatal VitC repletion. Eighty pregnant Dunkin Hartley guinea pig dams were randomized into weight stratified groups receiving High (900 mg) or Low (100 mg) VitC per kg diet. Newborn...... pups (n = 157) were randomized into a total of four postnatal feeding regimens: High/High (Control); High/Low (Depleted), Low/Low (Deficient); and Low/High (Repleted). Proliferation and migration of newborn cells in the dentate gyrus was assessed by BrdU labeling and hippocampal volumes were determined...

  3. Newborn Screening (NBS): Answers to Frequently Asked Questions

    Science.gov (United States)

    ... PARENTS: FREE ADDITONAL NEWBORN SCREENING PACKETS What is Newborn Screening (NBS)? NBS is a system that helps ... of the condition. What are the benefits of Newborn Screening? Early detection of disorders and conditions detectable ...

  4. The impact of colloid infusion prior to spinal anaesthesia for caesarean section on the condition of a newborn--a comparison of balanced and unbalanced hydroxyethyl starch 130/0.4.

    Science.gov (United States)

    Marciniak, Andrzej; Wujtewicz, Maria; Owczuk, Radosław

    2013-01-01

    Fluid therapy is the most commonly used treatment to prevent hypotension associated with spinal anaesthesia. The aim of this study was to test the hypothesis that a balanced solution of 6% hydroxyethyl starch will have a more beneficial impact on the condition of newborns at birth than an unbalanced 6% solution of HES. The study participants included 51 healthy parturients undergoing elective caesarean section with spinal anaesthesia. Patients received a transfusion of 500 mL of unbalanced 6% HES (Voluven) or balanced 6% HES (Tetraspan) prior to anaesthesia. The condition of the newborn was assessed using the Apgar score, and the acid-base balances of venous and arterial umbilical cord blood were also measured. The incidence of hypotension after spinal anaesthesia was 80% in Group A and 76.9% in Group B (P = 1.0). There were no differences between the two groups in the total doses of ephedrine and no differences between treatment groups in Apgar scores. Also, no differences in acid-base balance parameters (pH, H(+), pCO(2), pO(2), HCO(3)(-), BE) were found. A balanced 6% solution of hydroxyethyl starch (HES 130/0.42) did not significantly influence the condition of the newborns at birth or the acid-base and electrolyte concentration of newborns compared to an unbalanced solution of 6% hydroxyethyl starch (HES 130/0.4).

  5. Melatonin and the newborn brain.

    Science.gov (United States)

    Colella, Marina; Biran, Valérie; Baud, Olivier

    2016-11-01

    Brain injury related to preterm birth and neonatal asphyxia is a leading cause of childhood neuromotor and cognitive disabilities. Unfortunately, the strategies to prevent perinatal brain damages remain limited. Among the candidate molecules, melatonin appears to be one of the most promising agents for its antioxidant and neuromodulatory action. Robust preclinical evidences and few clinical studies have suggested a neuroprotective benefit conferred by neonatal exposure to melatonin. This review recapitulates current basic research, safety and pharmacokinetic data and ongoing clinical trials on the use of melatonin as a neuroprotective agent in the newborn. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Newborn screening in southeastern Europe.

    Science.gov (United States)

    Groselj, Urh; Tansek, Mojca Zerjav; Smon, Andraz; Angelkova, Natalija; Anton, Dana; Baric, Ivo; Djordjevic, Maja; Grimci, Lindita; Ivanova, Maria; Kadam, Adil; Kotori, Vjosa Mulliqi; Maksic, Hajrija; Marginean, Oana; Margineanu, Otilia; Milijanovic, Olivera; Moldovanu, Florentina; Muresan, Mariana; Murko, Simona; Nanu, Michaela; Lampret, Barbka Repic; Samardzic, Mira; Sarnavka, Vladimir; Savov, Aleksei; Stojiljkovic, Maja; Suzic, Biljana; Tincheva, Radka; Tahirovic, Husref; Toromanovic, Alma; Usurelu, Natalia; Battelino, Tadej

    2014-01-01

    The aim of our study was to assess the current state of newborn screening (NBS) in the region of southeastern Europe, as an example of a developing region, focusing also on future plans. Responses were obtained from 11 countries. Phenylketonuria screening was not introduced in four of 11 countries, while congenital hypothyroidism screening was not introduced in three of them; extended NBS programs were non-existent. The primary challenges were identified. Implementation of NBS to developing countries worldwide should be considered as a priority. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Unusual osteopathy in a newborn

    Energy Technology Data Exchange (ETDEWEB)

    Jequier, S.; Nogrady, M.B.; Wesenberg, R.L.

    1983-06-01

    A newborn baby presented with hyaline membrane disease, interstitial pneumonia, jaundice, hepatosplenomegaly, and unusual bone manifestations with lytic and sclerotic bone lesions and virtually absent periosteal reaction. He subsequently developed intracranial calcifications and mental retardation. The pneumonia and hepatosplenomegaly resolved. At the time of the delivery, a sibling was suffering from a severe undetermined viral infection. The clinical evolution of the disease and the radiologic findings led us to believe that this patient has a prenatal viral infection. The laboratory tests and the histologic picture of the bone biopsy supported the diagnosis.

  8. Flooring choices for newborn ICUs.

    Science.gov (United States)

    White, R D

    2007-12-01

    Floors are a major element of newborn intensive care unit (NICU) construction. They provide visual cues, sound control, and with certain materials, some degree of physical comfort for workers. Flooring materials may entail a significant cost for installation and upkeep and can have substantial ecological impact, both in the choice of the flooring itself, as well as the substances used to clean it. In this article the important aspects to consider for each factor are explored and recommendations are offered for appropriate choices in various NICU areas.

  9. Iodine Supplementation in the Newborn

    Directory of Open Access Journals (Sweden)

    Paolo Ghirri

    2014-01-01

    Full Text Available Iodine deficiency can be defined as the world’s greatest single cause of preventable brain damage. Fetal and neonatal hypothyroidism, caused by iodine deficiency can be prevented prior to conception and then during pregnancy and lactation when an adequate iodine supplementation is ensured. Extremely low birth weight preterm babies risk having a negative iodine balance status in the first weeks of life, exacerbating the hypothyroxinaemia of the prematurity. It is important to ensure that these babies are provided with an adequate iodine intake from the first days of life. Mothers and newborns should avoid environmental iodine excess during pregnancy or lactation.

  10. A newborn with neck mass

    Directory of Open Access Journals (Sweden)

    Rita Calado Pereira

    2011-03-01

    Full Text Available Congenital goiter is a rare cause of neonatal neck mass and may result from a fetal defectin synthesis of thyroxine, or administration of antithyroid drugs or iodides during pregnancy. The thyroid dysfunction often accompanies it. This report describes a case of a male term newborn with congenital goiter and primary hypothyroidism. Hormonal replacement treatment was started leading to normal levels of free thyroxine and triiodothyronine. In face of a maternal negative investigation, dyshormonogenesis was considered to be the most probable cause of hypothyroidism.

  11. 42 CFR 436.124 - Newborn children.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Newborn children. 436.124 Section 436.124 Public... the Categorically Needy § 436.124 Newborn children. (a) The agency must provide Medicaid eligibility to a child born to a woman who has applied for, has been determined eligible and is receiving...

  12. Newborn screening for hemoglobinopathies at Muhimbili National ...

    African Journals Online (AJOL)

    Background: Newborn screening (NBS) for hemoglobinopathies is important for the early detection and effective management of affected children. Objectives: To determine the frequency of occurrence, types of, and factors associated with abnormal haemoglobins in newborns at Muhimbili National Hospital (MNH), Dar es ...

  13. Distinct mechanisms of the newborn innate immunity.

    Science.gov (United States)

    Kumar, S Kingsley Manoj; Bhat, B Vishnu

    2016-05-01

    The ontogeny of immunity during early life is of high importance as it shapes the immune system for the entire course of life. The microbiome and the environment contribute to the development of immunity in newborns. As immune responses in newborns are predominantly less experienced they are increasingly susceptible to infections. Though the immune cells in newborns are in 'naïve' state, they have been shown to mount adult-like responses in several circumstances. The innate immunity plays a vital role in providing protection during the neonatal period. Various stimulants have been shown to enhance the potential and functioning of the innate immune cells in newborns. They are biased against the production of pro-inflammatory cytokines and this makes them susceptible to wide variety of intracellular pathogens. The adaptive immunity requires prior antigenic experience which is very limited in newborns. This review discusses in detail the characteristics of innate immunity in newborns and the underlying developmental and functional mechanisms involved in the immune response. A better understanding of the immunological milieu in newborns could help the medical fraternity to find novel methods for prevention and treatment of infection in newborns. Copyright © 2016 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  14. Infant and Newborn Nutrition - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Infant and Newborn Nutrition URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Infant and Newborn Nutrition - Multiple Languages To use the sharing features on ...

  15. Chlamydiaceae infections in pig

    Science.gov (United States)

    2011-01-01

    Chlamydiaceae are Gram-negative obligate intracellular bacteria. They are responsible for a broad range of diseases in animals and humans. In pigs, Chlamydia suis, Chlamydia abortus, Chlamydia pecorum and Chlamydia psittaci have been isolated. Chlamydiaceae infections in pigs are associated with different pathologies such as conjunctivitis, pneumonia, pericarditis, polyarthritis, polyserositis, pseudo-membranous or necrotizing enteritis, periparturient dysgalactiae syndrome, vaginal discharge, return to oestrus, abortion, mummification, delivery of weak piglets, increased perinatal and neonatal mortality and inferior semen quality, orchitis, epididymitis and urethritis in boars. However, Chlamydiaceae are still considered as non-important pathogens because reports of porcine chlamydiosis are rare. Furthermore, Chlamydiaceae infections are often unnoticed because tests for Chlamydiaceae are not routinely performed in all veterinary diagnostic laboratories and Chlamydiaceae are often found in association with other pathogens, which are sometimes more easily to detect. However, recent studies have demonstrated that Chlamydiaceae infections in breeding sows, boars and piglets occur more often than thought and are economically important. This paper presents an overview on: the taxonomy of Chlamydiaceae occurring in pigs, diagnostic considerations, epidemiology and pathology of infections with Chlamydiaceae in pigs, public health significance and finally on prevention and treatment of Chlamydiaceae infections in pigs. PMID:21314912

  16. Chlamydiaceae infections in pig

    Directory of Open Access Journals (Sweden)

    Schautteet Katelijn

    2011-02-01

    Full Text Available Abstract Chlamydiaceae are Gram-negative obligate intracellular bacteria. They are responsible for a broad range of diseases in animals and humans. In pigs, Chlamydia suis, Chlamydia abortus, Chlamydia pecorum and Chlamydia psittaci have been isolated. Chlamydiaceae infections in pigs are associated with different pathologies such as conjunctivitis, pneumonia, pericarditis, polyarthritis, polyserositis, pseudo-membranous or necrotizing enteritis, periparturient dysgalactiae syndrome, vaginal discharge, return to oestrus, abortion, mummification, delivery of weak piglets, increased perinatal and neonatal mortality and inferior semen quality, orchitis, epididymitis and urethritis in boars. However, Chlamydiaceae are still considered as non-important pathogens because reports of porcine chlamydiosis are rare. Furthermore, Chlamydiaceae infections are often unnoticed because tests for Chlamydiaceae are not routinely performed in all veterinary diagnostic laboratories and Chlamydiaceae are often found in association with other pathogens, which are sometimes more easily to detect. However, recent studies have demonstrated that Chlamydiaceae infections in breeding sows, boars and piglets occur more often than thought and are economically important. This paper presents an overview on: the taxonomy of Chlamydiaceae occurring in pigs, diagnostic considerations, epidemiology and pathology of infections with Chlamydiaceae in pigs, public health significance and finally on prevention and treatment of Chlamydiaceae infections in pigs.

  17. Traumatic brain lesions in newborns

    Directory of Open Access Journals (Sweden)

    Nícollas Nunes Rabelo

    Full Text Available ABSTRACT The neonatal period is a highly vulnerable time for an infant. The high neonatal morbidity and mortality rates attest to the fragility of life during this period. The incidence of birth trauma is 0.8%, varying from 0.2-2 per 1,000 births. The aim of this study is to describe brain traumas, and their mechanism, anatomy considerations, and physiopathology of the newborn traumatic brain injury. Methods A literature review using the PubMed data base, MEDLINE, EMBASE, Science Direct, The Cochrane Database, Google Scholar, and clinical trials. Selected papers from 1922 to 2016 were studied. We selected 109 papers, through key-words, with inclusion and exclusion criteria. Discussion This paper discusses the risk factors for birth trauma, the anatomy of the occipito-anterior and vertex presentation, and traumatic brain lesions. Conclusion Birth-related traumatic brain injury may cause serious complications in newborn infants. Its successful management includes special training, teamwork, and an individual approach.

  18. Orthostatic hypotension due to suppression of vasomotor outflow after amphetamine intoxication

    NARCIS (Netherlands)

    Smit, A. A.; Wieling, W.; Voogel, A. J.; Koster, R. W.; van Zwieten, P. A.

    1996-01-01

    Ten hours after ingestion of amphetamines, a previously healthy 17-year-old female adolescent experienced dizziness on standing. Examination revealed pronounced drowsiness and severe orthostatic hypotension. Assessment of arterial baroreflex function suggested that suppressed sympathetic vasomotor

  19. Control of Hemorraghic Hypotension With Gly-Gin, a Non-Opiod Beta-Endorphin Peptide

    National Research Council Canada - National Science Library

    Millington, William

    2000-01-01

    ... the physiological and receptor mechanisms of its action. Tests in laboratory animals indicated that Gly-Gin produced a dose-related inhibition of hemorraghic hypotension when injected immediately before blood withdrawal...

  20. Tamsulosin-induced severe hypotension during general anesthesia: a case report

    Directory of Open Access Journals (Sweden)

    Khan Fauzia

    2010-11-01

    Full Text Available Abstract Introduction Tamsulosin, a selective α1-adrenergic receptor (α1-AR antagonist, is a widely prescribed first-line agent for benign prostatic hypertrophy (BPH. Its interaction with anesthetic agents has not been described. Case presentation We report the case of 54-year-old Asian man undergoing elective left thyroid lobectomy. The only medication the patient was taking was tamsulosin 0.4 mg for the past year for BPH. He developed persistent hypotension during the maintenance phase of anesthesia while receiving oxygen, nitrous oxide and 1% isoflurane. The hypotension could have been attributable to a possible interaction between inhalational anesthetic and tamsulosin. Conclusion Vigilance for unexpected hypotension is important in surgical patients who are treated with selective α1-AR blockers. If hypotension occurs, vasopressors that act directly on adrenergic receptors could be more effective.

  1. Acute hypotensive and diuretic activities of Artemisia herba alba aqueous extract in normal rats

    Directory of Open Access Journals (Sweden)

    Naoufel Ali Zeggwagh

    2014-07-01

    Conclusions: We conclude that the aqueous A. herba alba extract possesses a potent acute hypotensive effect on normal rats. In addition, A. herba alba perfusion may affect renal function to increase urine and electrolytes excretion.

  2. Oral Midodrine Hydrochloride for Prevention of Orthostatic Hypotension during Early Mobilization after Hip Arthroplasty

    DEFF Research Database (Denmark)

    Jans, Øivind; Mehlsen, Jesper; Kjærsgaard-Andersen, Per

    2015-01-01

    BACKGROUND: Early postoperative mobilization is essential for rapid recovery but may be impaired by orthostatic intolerance (OI) and orthostatic hypotension (OH), which are highly prevalent after major surgery. Pathogenic mechanisms include an insufficient postoperative vasopressor response...

  3. Vasopressin vs Dopamine for Treatment of Hypotension in ELBW Infants: A Randomized, Blinded Pilot Study

    Science.gov (United States)

    Rios, Danielle R.; Kaiser, Jeffrey R.

    2015-01-01

    Objective To evaluate vasopressin vs dopamine as initial therapy in ELBW infants with hypotension during the first 24 hours of life. Study design Hypotensive ELBW infants ≤ 30 weeks’ gestation and ≤ 24 hours old randomly received treatment with vasopressin or dopamine in a blinded fashion. Normotensive infants not receiving vasopressor support served as a comparison group. Results Twenty hypotensive ELBW infants received vasopressin (n=10) or dopamine (n=10), and 50 were enrolled for comparison. Mean gestational age was 25.6 ± 1.4 weeks and birth weight 705 ± 154 g. Response to vasopressin paralleled that of dopamine in time to adequate mean BP (Kaplan-Meier curve, p=0.986); 90% of infants in each treatment group responded with adequate BP. The vasopressin group received fewer doses of surfactant (phypotension appeared safe. This pilot study supports a larger randomized controlled trial of vasopressin vs dopamine therapy in ELBW infants with hypotension. PMID:25641242

  4. Permissive Hypotension Strategies for the Far-Forward Fluid Resuscitation of Significant Hemorrhage

    National Research Council Canada - National Science Library

    Dubick, Michael A; Atkins, James L

    2004-01-01

    ... within the Army's Combat Casualty Care Research Program is focused to investigate limited- or small-volume fluid resuscitation strategies, including permissive hypotension, in far forward areas for the treatment...

  5. Hypotension and bleeding with various anatomic patterns of blunt splenic injury in adults.

    Science.gov (United States)

    Buckman, R F; Dunham, C M; Kerr, T M; Militello, P R

    1989-09-01

    A retrospective study of 112 consecutive adult patients with blunt splenic lacerations was performed. All of the patients had operative grading of the splenic injuries according to a prospective protocol. Data on preoperative hypotension (systolic blood pressure of less than 100) and intraoperative splenic bleeding were collected from hospital records. Patients with subcapsular hematomas were excluded. Over-all, 55.4 per cent of the patients with splenic lacerations were hypotensive preoperatively and 76.6 per cent were noted to be bleeding from the spleen at operation. For injuries not involving the hilum, seven of 22 of the patients with Grade I injuries were hypotensive preoperatively versus 19 of 29 of the patients with Grade IV injuries (p = 0.025). Fourteen of 21 patients with Grade I injuries were noted to be bleeding at operation. Seventeen of 23 with Grade IV injuries were noted to be bleeding. This difference was not significant. Of the patients with injuries involving the hilum, 25 of 38 were hypotensive preoperatively and 25 of 29 were noted to be bleeding at operation. No difference in the incidence of hypotension or bleeding was found between superficial and deep hilar injuries. No significant difference was found between the active bleeding with hilar and nonhilar injuries (p = 0.19). For isolated splenic injuries (N = 36), the incidence of hypotension was 39 per cent. However, 79 per cent of the patients with isolated splenic injuries were noted to be bleeding at operation. Of 49 patients with nonisolated splenic injuries who had been hypotensive preoperatively, 72.9 per cent were found to be bleeding at operation. Of the 27 patients never hypotensive preoperatively, 78 per cent were noted to be bleeding at operation (NS). For isolated splenic injury also, no relationship was found between preoperative hypotension and the presence of operative bleeding. No significant correlation was found between preoperative hypotension or the anatomic grade of

  6. Hypotension in patients administered indigo carmine containing impurities -A case report-.

    Science.gov (United States)

    Kim, Sung-Hoon; Suk, Eun Ha; Kil, So Hyun; Hahm, Kyung Don; Hwang, Jai-Hyun

    2011-11-01

    Indigo carmine has been used for eight decades with few adverse effects. Several of our patients, however, experienced severe hypotensive episodes after indigo carmine administration within a period of one month. Analysis of the raw materials used to formulate the preparation of indigo carmine we used showed that they contained impurities. Following recall of these impure materials, none of our patients experienced further hypotensive episodes.

  7. Hypotension in patients administered indigo carmine containing impurities -A case report-

    OpenAIRE

    Kim, Sung-Hoon; Suk, Eun Ha; Kil, So Hyun; Hahm, Kyung Don; Hwang, Jai-Hyun

    2011-01-01

    Indigo carmine has been used for eight decades with few adverse effects. Several of our patients, however, experienced severe hypotensive episodes after indigo carmine administration within a period of one month. Analysis of the raw materials used to formulate the preparation of indigo carmine we used showed that they contained impurities. Following recall of these impure materials, none of our patients experienced further hypotensive episodes.

  8. Permissive hypotension in the extremely low birthweight infant with signs of good perfusion.

    LENUS (Irish Health Repository)

    Dempsey, E M

    2012-01-31

    INTRODUCTION: Many practitioners routinely treat infants whose mean arterial blood pressure in mm Hg is less than their gestational age in weeks (GA). OBJECTIVE: To assess the effectiveness of utilising a combined approach of clinical signs, metabolic acidosis and absolute blood pressure (BP) values when deciding to treat hypotension in the extremely low birthweight (ELBW) infant. METHODS: Retrospective cohort study of all live born ELBW infants admitted to our neonatal intensive care unit over a 4-year period. Patients were grouped as either normotensive (BP never less than GA), hypotensive and not treated (BPhypotension) and hypotensive treated (BPhypotensive (mean BP in mm Hg less than GA in weeks). Treated patients had lower birth weight and GA, and significantly lower blood pressure at 6, 12, 18 and 24 h. Normotensive patients and patients designated as having permissive hypotension had similar outcomes. Mean blood pressure in the permissive group increased from 26 mm Hg at 6 h to 31 mm Hg at 24 h. In a logistic regression model, treated hypotension is independently associated with mortality, odds ratio 8.0 (95% CI 2.3 to 28, p<0.001). CONCLUSIONS: Blood pressure spontaneously improves in ELBW infants during the first 24 h. Infants hypotensive on GA criteria but with clinical evidence of good perfusion had as good an outcome as normotensive patients. Treated low blood pressure was associated with adverse outcome.

  9. [Incidence and drug prevention of anemia in pigs in commercial swine breeding].

    Science.gov (United States)

    Dilov, P; Chakŭrov, R

    1984-01-01

    Studies were carried out to establish the severity of anemia in newborn pigs of sows under various raising technologies and some aspects of its drug prophylaxis. It was found that in the swine-breeding complexes that were investigated more than 50 per cent of the day-old piglets had the subclinical form of anemia (6 to 8 g% of hemoglobin content). With some raising technologies (tying the sows up to the feeders) about 17 per cent of the pigs were born with pathologic anemia (the hemoglobin content was below 6 g%). With the introduction of the new technologies the pigs were born with lower erythrocyte count of the blood. The decrease in the indices of the red blood picture (with some technologies there was also a drop of the serum iron) was seen in the sows too (better manifested when these were tied up to the feeders). The intamuscular injection of the fericin preparation of ferridextran, zinc, and vitamin B12 and B6 (doses of 4.0 g Fe3+) to the sows 21 days prior to farrowing neither hypochlorosis nor erythropenia of the newborns could be overcome. On the other hand, the i/m introduction in the thigh region of the preparation dextrofer-100 at the rate of 200 mg Fe3+ in a single injection to the newborns prevented anemia for 30 days. A second injection 7 days later of one more dose of the preparation did not bring about an essential improvement in the development of pigs. The single dose of 100 mg Fe per pig in the form of dextrofer-100 was not sufficient to produce an optimal antianemic effect.

  10. Cerebral circulation, neurological and neuropsychological disorders in idiopathic arterial hypotension

    Directory of Open Access Journals (Sweden)

    Andrei Viktorovich Fonyakin

    2011-01-01

    Full Text Available Objective: to evaluate the cerebral circulation in idiopathic arterial hypotension (IAH in relation to neurological and neuropsychological disorders. Patients and methods. Sixty-five patients (mean age 40.2 [8, 14] years with prolonged IAH were examined. Neuropsychological examination was made using the procedure adapted by A.R. Luria; different psychic functions (memory, speech, gnosis, praxis, thinking, attention, counting, writing, and reading were studied. Cerebral hemodynamics was investigated using duplex scanning of the brachiocephalic arteries (BCA, middle cerebral arteries (MCA, internal jugular (IJV and vertebral veins (VV. The patients were assigned to 2 groups: 1 19 (29% patients with somatoform disorders, 2 46 (71% patients with signs of the initial manifestations of chronic cerebrovascular insufficiency. Group 2 patients were older and had a longer history of IAH. Results. In all the patients, cerebral blood supply in the carotid system showed moderately lower arterial blood inflow with a compensatory vascular resistance decrease and balanced venous outflow reduction with increased vascular resistance. Group 2 patients had a substantial (to the lower normal range blood flow decline in the vertebral artery along with increased peripheral resistance in the VV. The degree of neuropsychological derangement was inversely proportional to blood flow velocity in BCA and MCA and to blood outflow in IJV and VV.

  11. Interventions for improving adherence to ocular hypotensive therapy.

    Science.gov (United States)

    Waterman, Heather; Evans, Jennifer R; Gray, Trish A; Henson, David; Harper, Robert

    2013-04-30

    Poor adherence to therapy is a significant healthcare issue, particularly in patients with chronic disease such as open-angle glaucoma. Treatment failure may necessitate unwarranted changes of medications, increased healthcare expenditure and risk to the patient if surgical intervention is required. Simplifying eye drop regimes, providing adequate information, teaching drop instillation technique and ongoing support according to the patient need may have a positive effect on improving adherence. To summarise the effects of interventions for improving adherence to ocular hypotensive therapy in people with ocular hypertension (OHT) or glaucoma. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (June 1946 to June 2012), EMBASE (June 1980 to June 2012), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (June 1937 to June 2012), PsycINFO (1806 to June 2012), PsycEXTRA (1908 to June 2012), Web of Science (1970 to June 2012), ZETOC (1993 to June 2012), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 26 June 2012. We did not search the National Research Register (NNR) as this resource has now been now archived. We contacted pharmaceutical manufacturers to request unpublished data and searched conference proceedings for the Association for Research in Vision and Ophthalmology (ARVO), and the Annual Congress for the Royal College of Ophthalmologists (RCO). We included randomised controlled trials (RCTs) and quasi-RCTs that compared interventions to improve adherence to ocular hypotensive therapy

  12. The influence of menstrual cycle phase upon postexercise hypotension.

    Science.gov (United States)

    Esformes, Joseph I; Norman, Frances; Sigley, Joanne; Birch, Karen M

    2006-03-01

    Postexercise hypotension (PEH) has been observed in males and females; however, the impact of menstrual cycle phase upon PEH has not been evaluated. We examined the pattern of PEH in the early follicular (EF), late follicular (LF), and midluteal (ML) phases of the menstrual cycle in eight eumenorrheic women following 30 min of exercise at 80% lactate threshold. Supine hemodynamic measurements were assessed at rest and then for 45 min following exercise. Blood pressure was measured with manual sphygmomanometry, calf vascular resistance (CVR) via venous occlusion plethysmography, and central hemodynamics with echocardiography. Cardiovascular parameters did not differ between menstrual phases at rest (P > 0.05). The pattern of PEH was unaffected by menstrual phase, but mean arterial and diastolic (DBP) pressures dropped to significantly lower levels across the recovery period in the EF phase than in the LF and ML phases (mean DBP EF: 69 +/- 4; LF 74 +/- 3; ML 72 +/- 5; P 0.05). These parameters, except for left ventricular dimensions in systole and heart rate, varied with recovery time, increasing to a peak between 5 and 10 min postexercise (P resistance increased to greater values in the ML phase compared with the EF and LF phases following 30 min of postexercise recovery (P < 0.05). Buffering of PEH appears to be enhanced in the LF and ML phases of the cycle where estrogen concentrations are known to be elevated.

  13. Chemical Composition and Hypotensive Effect of Campomanesia xanthocarpa

    Directory of Open Access Journals (Sweden)

    Liane Santariano Sant’Anna

    2017-01-01

    Full Text Available Campomanesia xanthocarpa is known in Brazil as Guabiroba and is popularly used for various diseases, such as inflammatory, renal, and digestive diseases and dyslipidemia. The aim of the study was to analyze the chemical composition and investigate the effects of aqueous extract of C. xanthocarpa on the blood pressure of normotensive rats, analyzing the possible action mechanism using experimental and in silico procedures. The extract was evaluated for total phenolic compounds and total flavonoid content. The chemical components were determined by HPLC analyses. Systolic and diastolic blood pressure and heart rate were measured with extract and drugs administration. The leaves of C. xanthocarpa presented the relevant content of phenolics and flavonoids, and we suggested the presence of chlorogenic acid, gallic acid, quercetin, and theobromine. The acute administration of aqueous extract of C. xanthocarpa has a dose-dependent hypotensive effect in normotensive rats, suggesting that the action mechanism may be mediated through the renin-angiotensin system by AT1 receptor blockade and sympathetic autonomic response. Docking studies showed models that indicated an interaction between chlorogenic acid and quercetin with the AT1 receptor (AT1R active site. The findings of these docking studies suggest the potential of C. xanthocarpa constituents for use as preventive agents for blood pressure.

  14. The hemodynamic pattern of the syndrome of delayed orthostatic hypotension.

    Science.gov (United States)

    Podoleanu, Cristian; Maggi, Roberto; Oddone, Daniele; Solano, Alberto; Donateo, Paolo; Croci, Francesco; Carasca, Emilian; Ginghina, Carmen; Brignole, Michele

    2009-11-01

    We investigated the hemodynamic mechanisms underlying the syndrome of delayed orthostatic hypotension (OH) and the hemodynamic effect of the treatment with leg compression bandages. Non-invasive monitoring of systolic blood pressure (SBP), heart rate (HR), cardiac output (CO), stroke volume (SV), and total peripheral resistance (TPR) was performed during tilt testing in patients affected by delayed OH compared to age- and sex-matched controls. Thirteen patients (68 +/- 14 years) and nine controls (68 +/- 8 years) were studied. Immediately after tilt-up, SBP progressively decreased in patients but not in controls. Symptoms developed at 100 +/- 7 mmHg. At the end of the test, SBP was significantly lower in patients than in controls. TPR progressively decreased in patients but not in controls. SV and CO did not change significantly. HR increased progressively in the patients until the end of the test and remained unchanged in controls. Active treatment with compression bandages avoided the decrease in SBP and TPR, while CO showed minimal variation. In patients affected by delayed OH, the progressive decrease of SBP is associated with progressive decrease of TPR, while CO and SV show little variation; the compensatory increase in HR is insufficient to compensate for the decline in blood pressure.

  15. Transient thermal sympathectomy as a possible mechanism for hypotension after kyphoplasty: a case report.

    Science.gov (United States)

    Soto, Eliezer; Galperin, Mark; Portenoy, Russell K

    2013-12-01

    Vertebroplasty and kyphoplasty are minimally invasive treatments for vertebral compression fractures. Although infrequent, both transitory and persistent adverse effects have been reported. They range from asymptomatic to severe neurological deficits that are caused directly by polymethylmethacrylate (PMMA) leakage or may be related to local or general reactions not due to PMMA leakage. Transitory hypotension after the procedure has been observed, but the characteristics and etiology of this phenomenon are not defined. To describe a case of prolonged hypotension after kyphoplasty and suggest a possible mechanism. Six months after L2 kyphoplasty, a 63-year-old woman with severe osteoporosis developed a new back pain due to compression fracture of L1 and compression deformity of the superior L3 endplate. The patient underwent bilateral kyphoplasty at the L1 and L3 levels. She developed persistent hypotension for approximately 46 hours immediately after the procedure. Common causes of hypotension were ruled out and the event resolved spontaneously. On the basis of needle placement, the temporal relationship between the procedure and blood pressure change, and the lack of other identifiable causes, thermal sympathectomy from heating of the PMMA adjacent to the paravertebral sympathetic chain is proposed as a potential mechanism. Single case report based on clinical observation. Prolonged hypotension can complicate kyphoplasty at upper lumbar levels. Two days of severe hypotension has not been described as a complication of kyphoplasty. Although the mechanism is unknown, a transient thermal sympathectomy may be the cause.

  16. Modeling of the acute effects of primary hypertension and hypotension on the hemodynamics of intracranial aneurysms.

    Science.gov (United States)

    Sarrami-Foroushani, Ali; Villa-Uriol, Maria-Cruz; Nasr Esfahany, Mohsen; Coley, Stuart C; Di Marco, Luigi Yuri; Frangi, Alejandro F; Marzo, Alberto

    2015-01-01

    Hemodynamics is a risk factor in intracranial aneurysms (IA). Hypertension and pharmacologically induced hypotension are common in IA patients. This study investigates how hypertension and hypotension may influence aneurysmal hemodynamics. Images of 23 IAs at typical locations were used to build patient-specific Computational Fluid Dynamics models. The effects of hypotension and hypertension were simulated through boundary conditions by modulating the normotensive flow and pressure waveforms, in turn produced by a 1D systemic vascular model. Aneurysm location and flow pattern types were used to categorize the influence of hypotension and hypertension on relevant flow variables (velocity, pressure and wall shear stress). Results indicate that, compared to other locations, vertebrobasilar aneurysms (VBA) are more sensitive to flow changes. In VBAs, space-averaged velocity at peak systole increased by 30% in hypertension (16-21% in other locations). Flow in VBAs in hypotension decreased by 20% (10-13% in other locations). Momentum-driven hemodynamic types were also more affected by hypotension and hypertension, than shear-driven types. This study shows how patient-specific modeling can be effectively used to identify location-specific flow patterns in a clinically-relevant study, thus reinforcing the role played by modeling technologies in furthering our understanding of cardiovascular disease, and their potential in future healthcare.

  17. Effect of controlled hypotension on regional cerebral oxygen saturation during rhinoplasty: a prospective study.

    Science.gov (United States)

    Erdem, Ali Fuat; Kayabasoglu, Gurkan; Tas Tuna, Ayca; Palabiyik, Onur; Tomak, Yakup; Beyaz, Serbulent Gokhan

    2016-10-01

    The aim of this study was to investigate the effect of controlled hypotension on cerebral oxygen saturation (rSO2) using near infrared spectroscopy (NIRS) and evaluation of postoperative cognitive function in patients undergoing rhinoplasty. Fifty adult patients who were scheduled for elective rhinoplasty surgery and required controlled hypotension were enrolled in this prospective study. Controlled hypotension was provided using a combination of propofol and remifentanil infusion supplemented with nitroglycerin infusion as necessary. rSO2 was evaluated during controlled hypotension by NIRS. Cerebral desaturation was observed in 5 out of 50 patients (10 %) during hypotensive anesthesia. The greatest decrease from baseline was 28 % when MAP was 57 mmHg. In both non-desaturated and desaturated patients, postoperative MMSE scores were significantly lower than preoperative scores. There was a 4 % decrease in the non-desaturated patients and a 7 % decrease in the desaturated patients when preoperative and postoperative MMSE scores were compared. A decline in cognitive function 1 day after surgery was observed in 23 patients (46 %) and in all patients with intraoperative cerebral desaturation. The current study showed that even if SpO2 is in the normal range, there might be a decrease of more than 20 % in cerebral oxygen saturation during controlled hypotension.

  18. Effects of Gelofusine Infusion Applied Before Spinal Anaesthesia on Hypotension and Coagulation

    Directory of Open Access Journals (Sweden)

    Sedat Kaya

    2006-01-01

    Full Text Available Hypotension is one of the most important complications of spinal anaesthesia. Hypotension may cause catastrophic side effects in hemodynamically unstable and/or old patients. Gelofusine has been used widely for many years for volume replacement therapies. But, it has disadvantages such as coagulopathy or trombositopenia.The aim of this study was to compare three different doses of gelofusine applied prophylactically before spinal anaesthesia for prevention of hypotension induced by spinal anaesthesia.The study was implemented 45 American Society of Anaesthesiologist physical status I-II orthopaedic patients. Fourty-five patients were allocated randomly into three groups. Gelofusine 5,10,15 mg/kg were infused intravenously in15 minutes in Group I,II and III respectively. Hypotension was observed in one patient for each group, which were treated with efedrin. Gelofusine prevented hypotension successfully in all three doses. Moreover, even the dose of 15mg/kg cause neither coagulopathy nor trombositopenia.We concluded that 5 mg/kg gelofusine is enough to avoid hypotension. Infusion of gelofusine in up to15 mg/kg was found to be safe for spinal anaesthesia; it does not have such side effect as coagulopathy or trombositopenia this doses.

  19. Modulation of oxidative stress and microinflammatory status by colloids in refractory dialytic hypotension

    Directory of Open Access Journals (Sweden)

    Rostoker Guy

    2011-10-01

    Full Text Available Abstract Background Intradialytic hypotension may adversely affect the outcome of chronic hemodialysis. Therapeutic albumin has powerful anti-oxidant and anti-inflammatory properties. We have recently shown that systematic colloid infusion during hemodialysis sessions improves hemodynamic parameters in most dialysis hypotension-prone patients unresponsive to usual of preventive measures. We postulated that frequent hypotensive episodes may lead to a noxious inflammatory response mediated by oxidative stress induced by ischemia-reperfusion. The aim of this study was therefore to analyze the effect of 20% albumin and 4% gelatin infusions on oxidative stress and microinflammatory status in hypotension-prone patients unresponsive to usual preventive measures. Methods Prospective cross-over study (lasting 20 weeks of routine infusion of 200 ml of 20% albumin versus 200 ml of 4% gelatin in 10 patients with refractory intradialytic hypotension. We analyzed the effect of 20% albumin and 4% gelatin on microinflammatory status, oxidative stress, serum nitrite and nitrate levels by analysis of variance. Results A significant decrease in serum ceruloplasmin and serum C3 was observed during the albumin period (p Conclusions We conclude that the improvement in microinflammatory status observed during colloid infusion in hypotension-prone dialysis patients may be related to a decrease in ischemia-reperfusion of noble organs, together with a specific reduction in oxidative stress by albumin. Trial registration ISRCTN 20957055

  20. Plasma cortisol response to ACTH challenge in hypoxic newborn piglets resuscitated with 21% and 100% oxygen.

    Science.gov (United States)

    Chapados, Isabelle; Chik, Constance L; Cheung, Po-Yin

    2010-05-01

    Although the use of supplemental oxygen to resuscitate asphyxiated neonates remains controversial, the effects of hypoxia and reoxygenation (room air versus pure oxygen) on the hypothalamo-pituitary-adrenal axis are unknown. We aimed to evaluate the effect of hypoxia and reoxygenation with either 21% or 100% oxygen on plasma cortisol before and after an adrenocorticotrophin (ACTH) challenge in newborn piglets. Thirty-five piglets (aged 1-3 days, weighing 1.5-2.4 kg) were instrumented to measure heart rate, MAP, and cardiac output. After 2 h of normocapnic hypoxia (PaO2, 20-30 mmHg; pH, cortisol levels were determined after a blinded randomized administration of ACTH (4 microg/kg, i.v.) or saline at 2 h reoxygenation. The expression of steroidogenic factor 1 in the adrenals was studied. Cardiac output decreased with hypoxia and recovered with resuscitation. Piglets developed hypotension similarly in 21% and 100% H-R groups during reoxygenation (versus sham-operated group, P cortisol levels (versus sham-operated group, P cortisol levels increased significantly post-ACTH administration in 21% H-R and sham-operated piglets (115% +/-50% and 126% +/- 25% at 120 min, respectively, P clinical significance of high cortisol levels and cortisol response to ACTH in H-R newborn piglets is uncertain, a preserved cortisol response may support using room air in neonatal resuscitation.

  1. Pig design patterns

    CERN Document Server

    Pasupuleti, Pradeep

    2014-01-01

    Pig makes Hadoop programming simple, intuitive, and fun to work with. It removes the complexity from Map Reduce programming by giving the programmer immense power through its flexibility. What used to be extremely lengthy and intricate code written in other high level languages can now be written in almost one tenth of the size using its easy to understand constructs. Pig has proven to be the easiest way to learn how to program Hadoop clusters, as evidenced by its widespread adoption. This comprehensive guide enables readers to readily use design patterns to simplify the creation of complex da

  2. Supplementation with Lactobacillus paracasei or Pediococcus pentosaceus does not prevent diarrhoea in neonatal pigs infected with Escherichia coli F18.

    Science.gov (United States)

    Andersen, Anders D; Cilieborg, Malene S; Lauridsen, Charlotte; Mørkbak, Anne Louise; Sangild, Per Torp

    2017-07-01

    Infectious diarrhoea is a worldwide problem in newborns. Optimal bacterial colonisation may enhance gut maturation and protect against pathogenic bacteria after birth. We hypothesised that lactic acid bacteria (LAB) administration prevents pathogen-induced diarrhoea in formula-fed newborns. Newborn caesarean-delivered, colostrum-deprived term piglets on parenteral nutrition for the first 15 h, were used as models for sensitive newborn infants. A commercially available probiotic strain, Lactobacillus paracasei F19 (LAP, 2·6×108 colony-forming units (CFU)/kg per d) and a novel LAB isolate, Pediococcus pentosaceus (PEP, 1·3×1010 CFU/kg per d), were administered for 5 d with or without inoculation of the porcine pathogen, Escherichia coli F18 (F18, 1010 CFU/d). This resulted in six treatment groups: Controls (n 9), LAP (n 10), PEP (n 10), F18 (n 10), F18-LAP (n 10) and F18-PEP (n 10). The pathogen challenge increased diarrhoea and density of F18 in the intestinal mucosa (Pcoli-induced diarrhoea in sensitive newborn pigs. In vulnerable newborns there may be a delicate balance among bacterial composition and load, diet and the host. Caution may be required when administering LAB to compromised newborns suffering from enteric infections.

  3. Orthostatic Hypotension (Postural Hypotension)

    Science.gov (United States)

    ... with your doctor. Causes When you stand up, gravity causes blood to pool in your legs and ... trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo Foundation for Medical Education and ...

  4. Producing Newborn Synchronous Mammalian Cells

    Science.gov (United States)

    Gonda, Steve R.; Helmstetter, Charles E.; Thornton, Maureen

    2008-01-01

    A method and bioreactor for the continuous production of synchronous (same age) population of mammalian cells have been invented. The invention involves the attachment and growth of cells on an adhesive-coated porous membrane immersed in a perfused liquid culture medium in a microgravity analog bioreactor. When cells attach to the surface divide, newborn cells are released into the flowing culture medium. The released cells, consisting of a uniform population of synchronous cells are then collected from the effluent culture medium. This invention could be of interest to researchers investigating the effects of the geneotoxic effects of the space environment (microgravity, radiation, chemicals, gases) and to pharmaceutical and biotechnology companies involved in research on aging and cancer, and in new drug development and testing.

  5. Newborn cord care practices in Haiti.

    Science.gov (United States)

    Walsh, Susan; Norr, Kathleen; Sankar, Girija; Sipsma, Heather

    2015-10-01

    Newborn cord infections commonly lead to neonatal sepsis and death, particularly in low-resource countries where newborns may receive unhygienic cord care. Topical application of chlorhexidine to the newborn's cord has been shown to prevent infection. Such benefits may be particularly important in Haiti. We explored current cord care practices by conducting a qualitative study using five focus groups among key community stakeholders (mothers of newborns/children under age two years, pregnant women, traditional birth attendants, community health workers, traditional healers) in Petit-Goâve, Haiti. Data collection was guided by the Health Belief Model. Results suggest community stakeholders recognise that infants are susceptible to cord infection and that cord infection is a serious threat to newborns. Long-held traditional cord care practices are potential barriers to adopting a new cord care intervention. However, all groups acknowledged that traditional practices could be harmful to the newborn while expressing a willingness to adopt practices that would protect the newborn. Results demonstrate potential acceptability for altering traditional cord care practices among neonatal caretakers in Haiti. An informational campaign designed to educate local health workers and new mothers to eliminate unhygienic cord applications while promoting chlorhexidine application may be a strong approach for preventing neonatal cord infections.

  6. Immobility reaction at birth in newborn infant.

    Science.gov (United States)

    Rousseau, Pierre Victor; Francotte, Jacques; Fabbricatore, Maria; Frischen, Caroline; Duchateau, Delphine; Perin, Marie; Gauthier, Jean-Marie; Lahaye, Willy

    2014-08-01

    To describe an immobility reaction (IR) that was not previously reported at or immediately after birth in human newborns. We analyzed 31 videos of normal term vaginal deliveries recorded from Time 0 of birth defined as the as the moment that lies between the birth of the thorax and the pelvis of the infant. We searched for perinatal factors associated with newborn's IR. IR at birth was observed in 8 of the 31 newborns. The main features of their behavior were immobilization, frozen face, shallow breathing and bradycardia. One of the 8 newborns had sudden collapse 2h after birth. We found significant relationships between maternal prenatal stress (PS) and IR (p=.037), and a close to significant one between infants' lividness at Time 0 and IR (p=.053). The first breath of the 31 newborns occurred before and was not associated with the first cry (pnewborns needs further research to determine if they are at risk for sudden infant death syndrome. This first report of an IR reaction at birth in human infants could open up new paths for improving early neonatal care. Further research is needed for maternal PS, stress hormones, umbilical cord blood pH measurements in IR newborns. The challenge of education and support for parents of IR newborns is outlined. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Delayed development of systemic immunity in preterm pigs as a model for preterm infants

    DEFF Research Database (Denmark)

    Nguyen, Duc Ninh; Jiang, Pingping; Frøkiær, Hanne

    2016-01-01

    Preterm neonates are highly sensitive to systemic infections in early life but little is known about systemic immune development following preterm birth. We hypothesized that preterm neonates have immature systemic immunity with distinct developmental trajectory for the first several weeks of life......, relative to those born at near-term or term. Using pigs as a model, we characterized blood leukocyte subsets, antimicrobial activities and TLR-mediated cytokine production during the first weeks after preterm birth. Relative to near-term and term pigs, newborn preterm pigs had low blood leukocyte counts......, poor neutrophil phagocytic rate, and limited cytokine responses to TLR1/2/5/7/9 and NOD1/2 agonists. The preterm systemic responses remained immature during the first postnatal week, but thereafter showed increased blood leukocyte numbers, NK cell proportion, neutrophil phagocytic rate and TLR2...

  8. Social behaviour of pigs

    NARCIS (Netherlands)

    Park, S. Y,; Oord, R. van; Staay, F.J. van der; Nordquist, R.E.

    2010-01-01

    Improper social behavior development brings problems in later social life. Several time points are known to be crucial for the development and in other words, susceptible to interruptions during those time points. In conventional pigs, those time points could be categorized to three interaction

  9. BHA STUDY IN PIGS

    DEFF Research Database (Denmark)

    Würtzen, G.; Olsen, P.

    1986-01-01

    Butylated hydroxyanisole (BHA) was given to pregnant SPF pigs (Danish Landrace) in doses of 0, 50, 200 and 400 mg/kg body weight/day from mating to day 110 of the gestation period. The BHA was mixed in the diet (pelleted). Caesarean section was performed on gestation day 110. BHA affected neither...

  10. Guinea pig maximization test

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner

    1985-01-01

    Guinea pig maximization tests (GPMT) with chlorocresol were performed to ascertain whether the sensitization rate was affected by minor changes in the Freund's complete adjuvant (FCA) emulsion used. Three types of emulsion were evaluated: the oil phase was mixed with propylene glycol, saline...

  11. Smallholder pig production

    DEFF Research Database (Denmark)

    Braae, Uffe Christian; Ngowi, Helena; Johansen, Maria Vang

    2013-01-01

    (2%) were found infested with Sarcoptes scabiei var. suis. Ticks found belonged to four genera; Amblyomma spp., Rhipicephalus spp., Haemaphysalis spp., and Boophilus spp. The prevalence of hard ticks among the free-range pigs was 50%. Ectoparasites were more prevalent in the free-range system...

  12. Sokosi Aliah = Little Pigs.

    Science.gov (United States)

    Boykin, Deborah; And Others

    Written in Choctaw and English, the illustrated booklet presents a Choctaw version of "This Little Pig Went to Market." The finger play activity emphasizes Choctaw values and cultural information such as generosity, humor, traditional clothing, designs, food, sports and art. The last page provides a teacher's guide with objectives and…

  13. pig production in Zimbabwe

    African Journals Online (AJOL)

    Pig Industry Board, PO. Box H6297, Highlands, Harare, Zimbabwe. Received April I 998; accepted August 1999. The effect of environmental factors on preweaning performance traits was studied using 3556 records collected between 1980 and 1995. Sow performance in terms of number born alive was higher if sows ...

  14. ETEC vaccination in pigs.

    Science.gov (United States)

    Melkebeek, Vesna; Goddeeris, Bruno M; Cox, Eric

    2013-03-15

    Enterotoxigenic Escherichia coli (ETEC) remain an important cause of neonatal and post-weaning diarrhoea in pigs. In general, neonatal infections can be prevented effectively by passive colostral and lactogenic immunity obtained by vaccination of the sow. In this respect, several maternal vaccines are on the market. These are applied mainly parenterally in the pregnant sow. However at weaning, lactogenic protection disappears. Strains involved in post-weaning diarrhoea mostly express F4 or F18 fimbriae. These fimbriae are important virulence factors since they allow the bacteria to bind to specific receptors on small intestinal enterocytes, resulting in colonization and subsequently the secretion of enterotoxins causing diarrhoea. Consequently, an active mucosal immunity, in which the local production of F4- and/or F18-specific sIgA plays an important role, is required to protect pigs against post-weaning diarrhoea. This review aims to give an overview of the immunization strategies applied in the pig model to prevent post-weaning diarrhoea caused by F4- and/or F18- positive ETEC in pigs. These include the use of oral live and subunit vaccines, encapsulation strategies and parenteral immunization. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. PRINCIPLES OF DRUG THERAPY IN NEWBORNS

    Directory of Open Access Journals (Sweden)

    G.V. Yatsyk

    2011-01-01

    Full Text Available The article is devoted to the neonats adequate pharmacotherapy, including use of medications off-label. The authors emphasize the characteristics of a newborn child organism (as a full-term and preterm that define the distinct processes of pharmacokinetics and pharmacodynamics in the older children. This paper discusses the problem of the optimal route of administration choice, provides basic information about medications used in the most common pathological conditions in newborns. Key words: drug therapy, drugs, newborns, premature infants. (Pediatric pharmacology. — 2011; 8 (6: 50–56.

  16. Preventing herpes simplex virus in the newborn.

    Science.gov (United States)

    Pinninti, Swetha G; Kimberlin, David W

    2014-12-01

    Genital herpes simplex virus (HSV) infections are very common worldwide. Approximately 22% of pregnant women are infected genitally with HSV, and most of them are unaware of this. The most devastating consequence of maternal genital herpes is HSV disease in the newborn. Although neonatal HSV infections remain uncommon, due to the significant morbidity and mortality associated with the infection, HSV infection in the newborn is often considered in the differential diagnosis of ill neonates. This review summarizes the epidemiology and management of neonatal HSV infections and discusses strategies to prevent HSV infection in the newborn. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Newborn care seeking practices in Central and Southern Ethiopia ...

    African Journals Online (AJOL)

    Background: In Ethiopia, close to 120,000 newborns die annually and newborn mortality now constitutes 42% of under-five deaths. The use of health care for newborn illnesses is very limited. Objective: To investigate local perspectives and practices related to newborn care-seeking and the factors affecting them. Methods: ...

  18. Harmful traditional practices in a newborn: A case report | Peterside ...

    African Journals Online (AJOL)

    Ninetynine percent of the nearly four million newborn deaths occur in developing countries with newborn deaths remaining relatively invisible and neglected1. In these countries, traditional attitudes and practices dominate newborn care and are often harzadous2. As most births and newborn deaths in developing countries ...

  19. Multifactorial Model and Treatment Approaches of Refractory Hypotension in a Patient Who Took an ACE Inhibitor the Day of Surgery

    Directory of Open Access Journals (Sweden)

    Karan Srivastava

    2013-01-01

    Full Text Available In the field of anesthesiology, there is wide debate on discontinuing angiotensin-converting enzyme inhibitor (ACEI and angiotensin receptor blocker (ARB therapy the day of noncardiac surgery. Although there have been many studies attributing perioperative hypotension to same-day ACEI and ARB use, there are many additional variables that play a role in perioperative hypotension. Additionally, restoring blood pressure in these patients presents a unique challenge to anesthesiologists. A case report is presented in which a patient took her ACEI the day of surgery and developed refractory hypotension during surgery. The evidence of ACEI use on the day of surgery and development of hypotension is reviewed, and additional variables that contributed to this hypotensive episode are discussed. Lastly, current challenges in restoring blood pressure are presented, and a basic model on treatment approaches for refractory hypotension in the setting of perioperative ACEI use is proposed.

  20. Artemisia copa aqueous extract as vasorelaxant and hypotensive agent.

    Science.gov (United States)

    Gorzalczany, Susana; Moscatelli, Valeria; Ferraro, Graciela

    2013-06-21

    Artemisia copa Phil. (Asteraceae) is a medicinal plant commonly used in traditional medicine in Argentina. The vasorelaxant and hypotensive activities of the aqueous extract of Artemisia copa have been investigated. The in vitro effect of the extract and isolated compounds from Artemisia copa was investigated using isolated rat aortic rings. The acute effect caused by the intravenous (i.v.) infusion (0.1-300mg/kg) on blood pressure and heart rate was evaluated in spontaneous hypertensive rats. In addition, a phytochemical analysis of the extract was performed by HPLC. Artemisia copa had a relaxant effect in endothelium-intact aortic rings that had been pre-contracted with 10(-7)M phenylephrine (Emax=96.7±1.3%, EC50=1.1mg/ml), 10(-5)M 5-hydroxytriptamine (Emax=96.7±3.5%, EC50=1.5mg/ml) and 80mM KCl (Emax=97.9± 4.4%, EC50=1.6mg/ml). In denuded aortic rings contracted by phenylephrine, a similar pattern was observed (Emax=92.7±6.5%, EC50=1.8mg/ml). l-NAME, indomethacin, tetraethylammonium and glibenclamide were not able to block the relaxation induced by the extract. Nevertheless, the pre-treatment with Artemisia copa attenuated the CaCl2-induced contraction in a concentration-dependent manner (Emax: 86% of inhibition for 3mg/ml and 52% de-inhibition for 1mg/ml). This pre-treatment also induced a significant attenuation of the norepinephrine-induced contraction in a concentration-dependent manner (Emax: 72.7% of inhibition for 3mg/ml and 27% de inhibition for 1mg/ml) in a Ca(2+) free medium. Upon analyzing the composition of the extract, the presence of p-coumaric acid, isovitexin, luteolin and chrysoeriol were found. Luteolin (CE50: 1.5μg/ml), chrysoeriol (CE50: 13.2μg/ml) and p-coumaric acid (CE50: 95.2μg/ml), isolated from the aqueous extract, caused dilatation of thoracic aortic rings pre-contracted with phenylephrine. Artemisia copa administered i.v. also induced a decrease in the mean arterial pressure but did not affect the heart rate in hypertensive

  1. Wave reflections, arterial stiffness, heart rate variability and orthostatic hypotension.

    Science.gov (United States)

    Lu, Dai-Yin; Sung, Shih-Hsien; Yu, Wen-Chung; Cheng, Hao-Min; Chuang, Shao-Yuan; Chen, Chen-Huan

    2014-12-01

    Increased arterial stiffness and wave reflections are independently associated with orthostatic hypotension (OH). This study investigated whether heart rate variability (HRV) is also involved in the modulation of orthostatic blood pressure (BP) change. A total of 429 subjects (65.1 ± 16.4 years, 77.4% men) were enrolled in this study. OH was defined as a ⩾ 20 mm Hg decrease in brachial systolic blood pressure (SBP) or a ⩾ 10 mm Hg diastolic blood pressure (DBP) decrease upon standing. Measurements of carotid-femoral pulse wave velocity (cf-PWV) and the amplitude of the reflected pressure wave from a decomposed carotid pressure wave (Pb) were obtained by carotid tonometry in the supine position. The power spectrum from a 5-min recording of an electrocardiogram at rest was analyzed to provide components in the high frequency (HF) and low frequency (LF) ranges. Subjects with OH (n = 59, 13.8%) had significantly higher cf-PWV and Pb and significantly lower LogHF and LogLF than those without OH (n = 370). The cf-PWV, Pb, LogHF and LogLF were significantly associated with postural SBP and DBP changes. Furthermore, cf-PWV but not Pb was significantly associated with LogHF and LogLF. Multivariate analysis showed that Pb (odds ratio (OR) per 1 s.d. 1.65, 95% confidence interval (CI) 1.282-2.137; P = 0.003) and LogHF (OR 0.628, 95% CI 0.459-0.860, P = 0.004), but not cf-PWV (OR 1.279, 95% CI 0.932-1.755, P = 0.128), were significant independent determinants of OH. Increased wave reflections may predispose OH independently of arterial stiffness and HRV. In contrast, increased arterial stiffness may cause OH through the modulation of HRV.

  2. Orthostatic Hypotension in Middle-Age and Risk of Falls.

    Science.gov (United States)

    Juraschek, Stephen P; Daya, Natalie; Appel, Lawrence J; Miller, Edgar R; Windham, Beverly Gwen; Pompeii, Lisa; Griswold, Michael E; Kucharska-Newton, Anna; Selvin, Elizabeth

    2017-02-01

    One-third of older adults fall each year. Orthostatic hypotension (OH) has been hypothesized as an important risk factor for falls, but findings from prior studies have been inconsistent. We conducted a prospective study of the association between baseline OH (1987-1989) and risk of falls in the Atherosclerosis Risk in Communities (ARIC) Study. Falls were ascertained during follow-up via ICD-9 hospital discharge codes or Centers for Medicare & Medicaid Services claims data. OH was defined as a drop in systolic blood pressure (SBP) ≥20mm Hg or diastolic blood pressure (DBP) ≥10mm Hg within 2 minutes of moving from the supine to standing position. Changes in SBP or DBP during OH assessments were also examined as continuous variables. During a median follow-up of 23 years, there were 2,384 falls among 12,661 participants (mean age 54 years, 55% women, 26% black). OH was associated with risk of falls even after adjustment for demographic characteristics and other risk factors (hazard ratio (HR): 1.30; 95% confidence interval (CI): 1.10, 1.54; P = 0.002). Postural change in DBP was more significantly associated with risk of falls (HR 1.09 per -5mm Hg change in DBP; 95% CI: 1.05, 1.13; P < 0.001) than postural change in SBP (HR 1.03 per -5mm Hg change in SBP; 95% CI: 1.01, 1.05; P = 0.002). In a community-based, middle-aged population, OH, and in particular, postural change in DBP, were independent risk factors for falls over 2 decades of follow-up. Future studies are needed to examine OH thresholds associated with increased risk of falls. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. The clinical relevance of orthostatic hypotension in elderly patients.

    Science.gov (United States)

    Hartog, Laura; Kleefstra, Nanne; Luigies, Rene; de Rooij, Sophia; Bilo, Henk; van Hateren, Kornelis

    2017-02-22

    Orthostatic hypotension (OH) is highly prevalent in old age. The impact of OH on orthostatic complaints and falling is questionable. We wondered if the consensus definition of OH plays an essential role in the accuracy and direction of the prediction of these endpoints. We aimed to explore the relation between different definitions of OH, including relative decrease of blood pressure, and orthostatic complaints and falling. A cross-sectional study was performed with 1415 participants aged ≥65 years visiting a mobile fall-prevention team. The CAREFALL Triage Instrument and data on blood pressure, orthostatic complaints and previous fall incidents were collected. Multivariate binary logistic regression analyses were performed to assess the association of different definitions of OH and orthostatic complaints or falling. Ten different definitions of OH based on different relative declines of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were defined. The 2011 consensus definition of OH was not related to orthostatic complaints (Odds Ratio (OR) 1.07 (95 % Confidence Interval (CI) 0.68-1.69)) or previous fall incidents (OR 1.08 (95%CI 0.83-1.41)). A ≥ 25 % SBP decrease was significantly related to orthostatic complaints (OR 2.81 (95%CI 1.31-6.05)) and a ≥ 25 % DBP decrease was related to previous fall incidents (OR 2.56 (95%CI 1.08-6.09)). With the exception of a decrease of ≥25 % SBP or DBP, the clinical relevance of incidental OH blood pressure measurements seems very limited with respect to orthostatic complaints or fall incidents in elderly patients. Using relative decreases may be more appropriate in clinical practice. Geriatr Gerontol Int 2016; ••: ••-••. © 2017 Japan Geriatrics Society.

  4. POWERLIFTING SESSIONS PROMOTE SIGNIFICANT POST-EXERCISE HYPOTENSION

    Directory of Open Access Journals (Sweden)

    Gustavo Allegretti João

    Full Text Available ABSTRACT Introduction: Powerlifting (PWL is a worldwide method, frequently used in resistance training programs. However, the relationship between cardiovascular responses and PWL is still unclear in the literature. Objective: To evaluate acute cardiovascular overload and post-exercise hypotension (PEH after acute powerlifting exercise session in subjects with experience in the modality. Methods: Nine powerlifting athletes (34 ± 5 years participated voluntarily in this study. The following exercises were used in the session: squat, bench press and deadlift (95% of 1 RM, 2 to 5 repetitions. The anthropometric parameters and blood pressure (systolic, diastolic and mean were evaluated immediately, 5', 10', 30', 60' and 24 hours after the exercise session with a non-invasive automatic pressure monitor. Results: Significant differences (p<0.05 were found between rest and immediately after exercise on systolic (135 ± 6 vs. 153 ± 10 mmHg and mean (102 ± 3 vs. 108 ± 3 mmHg blood pressures, but no difference was found at diastolic (85 ± 3 vs. 85 ± 4 mmHg blood pressure. Additionally, the increase in systolic pressure did not reach values considered as a risk of cardiovascular overload. Significant PEH was found after 60 minutes (systolic: -12 ± 12%, diastolic: -5 ± 6% and mean: -7 ± 5% and 24 hours after PWL session (systolic: -5 ± 4%, diastolic: -8 ± 4% and mean: -7 ± 3%. Conclusion: Our data demonstrated that a PWL session does not increase systolic blood pressure up to the risk range and promotes PEH after 60 minutes of exercise and that this cardiovascular response persisted after 24 hours post-exertion in powerlifting athletes.

  5. Effect of profound normovolemic hypotension and moderate hypothermia on circulating cytokines and adhesion molecules.

    Science.gov (United States)

    Hansen, D; Bogatzki, S; Syben, R; Bechrakis, N E; Dopjans, D; Spies, C; Welte, M; Schaffartzik, W

    1999-11-01

    Hypotension caused by hypovolemic, hemorrhagic shock induces disturbances in the immune system that may contribute to an increased susceptibility to sepsis. The effect of chemically induced hypotension on circulating cytokines and adhesion molecules has not been investigated yet. In 21 patients scheduled for resection of malignant choroidal melanoma of the eye the perioperative serum levels of the cytokines IL-1beta, IL-6, IL-10, TNF-alpha, and the adhesion molecules sE-Selectin and sICAM-1 were investigated. Moderate hypothermia of 32 degrees C was induced in all patients. In 14 patients profound hypotension (mean arterial blood pressure 35-40 mmHg, hypotension group) was induced by enalapril and nitroglycerin for a mean duration of 71 min. In 7 patients the tumor was not resectable, and hypotension was not induced (controls). We did not detect significant differences in serum levels of cytokines or sE-Selectin perioperatively in patients with profound hypotension compared with controls. In both groups IL-6 serum levels increased significantly and reached a maximum after rewarming (17 +/- 6 and 16 +/- 5 pg/dL, respectively, P < 0.001). IL-1beta, IL-10, and TNF-alpha did not change perioperatively in both groups. On the first postoperative day sICAM-1 serum levels were significantly increased in both groups (mean increase of 96 and 54 ng/mL, respectively, P < 0.01 and P < 0.05). We conclude from this study that profound normovolemic arterial hypotension does not seem to have effects on serum levels of circulating IL-1beta, IL-6, IL-10, TNF-alpha, and sE-Selectin. Perioperative moderate hypothermia may be the reason for the postoperative increase in sICAM-1 levels independent of the blood pressure.

  6. Newborn Screening: MedlinePlus Health Topic

    Science.gov (United States)

    ... from MEDLINE/PubMed (National Library of Medicine) Article: Promotion of early pediatric hearing detection through patient navigation: ... screening tests (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Newborn Screening updates by ...

  7. Looking at Your Newborn: What's Normal

    Science.gov (United States)

    ... newborns to breathe somewhat irregularly. When infants are awake, their breathing rate may vary widely, sometimes exceeding ... a rash present at birth, is characterized by dark brown bumps or blisters scattered over the neck, ...

  8. Complete albinism in a Podarcis muralis newborn

    Directory of Open Access Journals (Sweden)

    Filippo Spadola

    2007-01-01

    Full Text Available The authors describe a case of complete albinism in a Podarcis muralis newborn, from Chieti (Abruzzo, central Italy in September 2004. This is the first complete albinism case in a Podarcis spp. In the world.

  9. Group B Strep Infection in Newborns

    Science.gov (United States)

    ... Bacterial Core surveillance (ABCs) CDC Streptococcus Laboratory Sepsis Group B Strep Infection in Newborns Language: English Español ( ... Explains the difference between early- and late-onset group B strep diseases in newborns… How it Spreads ...

  10. Amplitude-Integrated EEG in the Newborn

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-11-01

    Full Text Available Th value of amplitude-integrated electroencephalography (aEEG in the newborn is explored by researchers at Washington University, St Louis; Wilhelmina Children’s Hospital, Utrecht, Netherlands; and Uppsala University Hospital, Sweden.

  11. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  12. Whole Genome Sequencing and Newborn Screening.

    Science.gov (United States)

    Botkin, Jeffrey R; Rothwell, Erin

    2016-03-01

    Clinical applications of next generation sequencing are growing at a tremendous pace. Currently the largest application of genetic testing in medicine occurs with newborn screening through state-mandated public health programs, and there are suggestions that sequencing could become a standard component of newborn care within the next decade. As such, newborn screening may appear to be a logical starting point to explore whole genome and whole exome sequencing on a population level. Yet, there are a number of ethical, social and legal implications about the use of a mandatory public health screening program that create challenges for the use of sequencing technologies in this context. Additionally, at this time we still have limited understanding and strategies for managing genomic data, supporting our conclusion that genome sequencing is not justified within population based public health programs for newborn screening.

  13. Panniculitis in the newborn: a case report

    Directory of Open Access Journals (Sweden)

    Fernando Bastos

    2011-12-01

    Full Text Available The authors present a case of panniculitis in a newborn, a rare disease in the neonatal period discussing its causes and differential diagnosis, emphasizing a possible diagnosis of erythema nodosum.

  14. Conjunctivitis in the newborn- a comparative study.

    Science.gov (United States)

    Wadhwani, Meenakshi; D'souza, Pamela; Jain, Rajesh; Dutta, Renu; Saili, Arvind; Singh, Abha

    2011-01-01

    Conjunctivitis of the newborn is defined as hyperemia and eye discharge in the neonates and is a common infection occurring in the neonates in the first month of life. In the United States, the incidence of neonatal conjunctivitis ranges from 1-2%, in India, the prevalence is 0.5-33% and varies in the world from 0.9-21% depending on the socioeconomic status. To study the organisms causing conjunctivitis of the newborn and to correlate the etiology with the mode of delivery. Single center, prospective, observational study. A total of 300 mothers and their newborns, born over a period of one year, were included in the study. Of these 200 newborns were delivered through vaginal route (Group A) and 100 (Group B) delivered by lower segment caesarean section (LSCS). At the time of labour, high vaginal swabs were taken from the mothers. Two conjunctival swabs each from both eyes of the newborn were collected at birth and transported to Microbiology department in a candle jar immediately. Eight babies in Group A, developed conjunctivitis at birth. None of the babies in Group B developed conjunctivitis, this difference was statistically highly significant (Pconjunctivitis in the newborn in this study was Coagulase negative Staphylococcus. It was observed that the mothers of 5 out of 8 babies (60%) developing conjunctivitis gave history of midwife interference and premature rupture of membranes so the presence of risk factors contribute to the occurrence of conjunctivitis in the newborn. It is inferred that the mode of delivery and the presence of risk factors is responsible for conjunctivitis in the newborn.

  15. [Morbidity in newborns exposed to organophosphorus pesticides].

    Science.gov (United States)

    Dordević, Momcilo; Sazdanović, Predrag; Dordević, Gordana; Jovanović, Bozidar

    2010-01-01

    Insecticides are toxins by which we destroy harmful insects. The most frequent insecticides which are used today are organophosphorus pesticides. This group of compounds make substances whose activity mechanism is based on the inhibition of acetylcholinesterase in nerve synapsis, thus producing holynergic syndrome, resulting from the accumulation of acetylcholine which developed due to the absence of decomposition under the influence of cholinesterase. In the clinical picture of acute toxication by cholinesterase inhibitors there is a clear difference between muscarinic and nicotine effects. The basic aim of the study was to establish the effects of organophosphorus pesticides present in blood and breast milk of mothers on newborns morbidity. The study group consisted of 18 newborns whose mothers had isolated organophosphorus pesticides in their blood and breast-milk on the third day after delivery, and the control group consisted of 84 newborns whose mothers did not have isolated organophosphorus pesticides in their blood and breastmilk. Morbidity is three times greater, often in combination with some disorders of the central nervous system, and the relative risk for its appearance is eight time greater in newborns exposed to organophosphorus pesticides. Disorders that appear in newborns exposed to pesticides are mutagenic, cancerogenic and neurotoxic and some agenses could disturb the immune system which is reflected in morbidity increase, primarly of the central nervous system. The presence of organophosphorus pesticides in blood and breast milk has negative effects on newborns. In addition to acetylcholinesterase inhibition, organophosphorus pesticides react by means of other mechanisms as well.

  16. Neuroprotective body hypothermia among newborns with hypoxic ischemic encephalopathy: three-year experience in a tertiary university hospital. A retrospective observational study

    Directory of Open Access Journals (Sweden)

    Mauricio Magalhães

    Full Text Available CONTEXT AND OBJECTIVE:Neonatal hypoxic-ischemic encephalopathy is associated with high morbidity and mortality. Studies have shown that therapeutic hypothermia decreases neurological sequelae and death. Our aim was therefore to report on a three-year experience of therapeutic hypothermia among asphyxiated newborns.DESIGN AND SETTING:Retrospective study, conducted in a university hospital.METHODS:Thirty-five patients with perinatal asphyxia undergoing body cooling between May 2009 and November 2012 were evaluated.RESULTS:Thirty-nine infants fulfilled the hypothermia protocol criteria. Four newborns were removed from study due to refractory septic shock, non-maintenance of temperature and severe coagulopathy. The median Apgar scores at 1 and 5 minutes were 2 and 5. The main complication was infection, diagnosed in seven mothers (20% and 14 newborns (40%. Convulsions occurred in 15 infants (43%. Thirty-one patients (88.6% required mechanical ventilation and 14 of them (45% were extubated within 24 hours. The duration of mechanical ventilation among the others was 7.7 days. The cooling protocol was started 1.8 hours after birth. All patients showed elevated levels of creatine phosphokinase, creatine phosphokinase- MB and lactate dehydrogenase. There was no severe arrhythmia; one newborn (2.9% presented controlled coagulopathy. Four patients (11.4% presented controlled hypotension. Twenty-nine patients (82.9% underwent cerebral ultrasonography and 10 of them (34.5% presented white matter hyper-echogenicity. Brain magnetic resonance imaging was performed on 33 infants (94.3% and 11 of them (33.3% presented hypoxic-ischemic changes. The hospital stay was 23 days. All newborns were discharged. Two patients (5.8% needed gastrostomy.CONCLUSION:Hypothermia as therapy for asphyxiated newborns was shown to be safe.

  17. The Pig PeptideAtlas

    DEFF Research Database (Denmark)

    Hesselager, Marianne Overgaard; Codrea, Marius; Sun, Zhi

    2016-01-01

    Biological research of Sus scrofa, the domestic pig, is of immediate relevance for food production sciences, and for developing pig as a model organism for human biomedical research. Publicly available data repositories play a fundamental role for all biological sciences, and protein data...... repositories are in particular essential for the successful development of new proteomic methods. Cumulative proteome data repositories, including the PeptideAtlas, provide the means for targeted proteomics, system-wide observations, and cross-species observational studies, but pigs have so far been...... underrepresented in existing repositories. We here present a significantly improved build of the Pig PeptideAtlas, which includes pig proteome data from 25 tissues and three body fluid types mapped to 7139 canonical proteins. The content of the Pig PeptideAtlas reflects actively ongoing research within...

  18. Hypothyroidism in the Newborn Period

    Science.gov (United States)

    Wassner, Ari J.; Brown, Rosalind S.

    2014-01-01

    Purpose of Review This review summarizes significant advances in the epidemiology, pathophysiology, and treatment of congenital hypothyroidism (CH), with a focus on thyroid dysfunction in preterm infants. Recent Findings CH appears to be increasing in incidence, primarily due to increased stringency of screening strategies, with smaller contributions from changing demographics and improved survival of increasingly premature infants. The greatest increase has been in mildly affected infants. Although many such cases are transient, some eventually prove to be severe and/or permanent. In preterm infants, transient hypothyroidism is common and may be delayed in onset. The etiology is probably multifactorial, and inadequate iodine intake may contribute to some cases. Transient hypothyroxinemia of prematurity (THOP), also common in premature infants, is correlated with markers of inflammation. Despite concern about the potential morbidity of THOP, the benefits and safety of treatment have not been established. Novel genetic causes of CH continue to be identified, and accumulating data support the sensitivity of infants with severe CH to small changes in levothyroxine formulation. Summary Changes in newborn screening strategies have increasingly identified thyroid function abnormalities of unclear clinical significance. Novel causes of CH continue to be identified, and new data continue to emerge regarding optimal therapy. PMID:23974774

  19. Behavioral fever in newborn rabbits

    Science.gov (United States)

    Satinoff, E.; Mcewen, G. N., Jr.; Williams, B. A.

    1976-01-01

    New Zealand white rabbit pups aged 12 to 72 hr were divided into three groups and given an intraperitoneal injection of Pseudomonas polysaccharide, a saline vehicle alone, and no treatment, respectively. The animals injected with pyrogen and maintained at an ambient temperature of 32 C for 2 hr did not develop fever. When placed in a thermally graded alleyway, the animals injected with pyrogen selected gradient positions that represented significantly higher temperatures than controls injected with saline. Further stay at selected positions for 5 min caused a considerable increase in the rectal temperature of the pyrogen-injected pups but not that of controls. The results support the hypothesis that newborn rabbits will develop a fever by behavioral means after a single injection of an exogenous pyrogen if the opportunity for thermoregulatory behavior is present. No fever develops if the pups must rely solely on internal thermoregulatory mechanisms. The behavioral system for producing a fever is mature at birth, but an adequate system of internal reflexes does not appear to develop for some days.

  20. Phosphorus in pig diets

    OpenAIRE

    Lyberg, Karin

    2006-01-01

    Pig feed is mainly based on cereals where phosphorus (P) is mostly present in inositol hexaphosphate (IP6), which is not readily available to monogastric animals. More available P sources are often added to ensure that pigs’ requirements are fulfilled; this results in high excretion levels of P. The digestibility of P depends on phytase activity and amount of IP6 in feedstuffs. The overall aim was to study effects of liquid feeding, P levels and phytase supplementation on digestibility and pe...

  1. Differential effects of beta-adrenoceptor partial agonists in patients with postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Stadeager, C; Trap-Jensen, J

    1993-01-01

    The central haemodynamic effects of pindolol and xamoterol have been investigated in patients with postural hypotension. Pindolol is a non-selective beta-adrenoceptor partial agonist, whereas xamoterol is beta 1-selective and possesses a higher degree of agonist activity. The study comprised 16...... patients with postural hypotension of different aetiologies. Blood pressure, heart rate and stroke volume were measured in the supine and head-up tilted positions. Left ventricular ejection fraction (LVEF) was measured in the supine position, and vascular resistance, left ventricular volume, and left...... pressure from 108 to 123 mm Hg. It is concluded that the degree of agonist activity of a beta-adrenergic agent is of importance if it is given to a patient with postural hypotension....

  2. Food Protein-Induced Enterocolitis Syndrome as a Cause for Infant Hypotension

    Directory of Open Access Journals (Sweden)

    Marna Rayl Greenberg

    2011-05-01

    Full Text Available Infants with food protein-induced enterocolitis syndrome (FPIES may present to the emergency department (ED with vomiting and hypotension. A previously healthy, 5-month-old male presented with vomiting and hypotension 2 to 3 hours after eating squash. The patient was resuscitated with intravenous fluids, antibiotics, and admitted for presumed sepsis. No source of infection was ever found and the patient was discharged. The patient returned 8 days later with the same symptoms after eating sweet potatoes; the diagnosis of FPIES was made during this admission. Two additional ED visits occurred requiring hydration after new food exposure. FPIES should be considered in infants presenting with gastrointestinal complaints and hypotension. A dietary history, including if a new food has been introduced in the last few hours, may help facilitate earlier recognition of the syndrome. [West J Emerg Med. 2011;12(4:512–514.

  3. Tepoxalin on renal function and liver enzymes in cats exposed to hypotension with isoflurane

    Directory of Open Access Journals (Sweden)

    Gabrielle Coelho Freitas

    2014-06-01

    Full Text Available This study aimed to evaluate the possible renal and hepatic toxicity of tepoxalin administered before or after isoflurane-induced hypotension, as well as for five consecutive days. Twelve healthy mixed-breed cats, adult males, weighing 4.0±0.8kg were allocated into two groups. They received 25mgkg-1 of tepoxalin orally, two hours before the anesthetic procedure (PRE or after the procedure (POST and daily for five days. Cats were anesthetized with isoflurane and the concentration was increased until mean arterial pressure reached 40-60mmHg and kept at this level for 60 minutes. During hypotension, the physiological variables were measured at time 0 and every 10 minutes until 60 minutes, and bleeding time was measured at time 0, 30 and 60 minutes. Blood samples were drawn for a hemogram and determination of concentrations of alanine aminotransferase, alkaline phosphatase, urea, creatinine and Na+ at baseline, 24 hours, 48 hours and 7 days post-hypotension. Urine was collected at baseline, 24 hours, 48 hours and 7 days post-hypotension for determination of concentrations of creatinine, gamma-glutamyltransferase, urine specific gravity, protein, albumin and Na+. During the anesthetic procedure there were no important variations in physiological variables and bleeding time. There were differences only in fractional excretion of Na+, which was elevated at 7 days of evaluation in PRE and in the urine protein/creatinine ratio in PRE, which was higher than in POST at 24 and 48 hours post-hypotension. We conclude that tepoxalin does not cause alterations in hepatic enzymes but can cause discrete renal injury, resulting in proteinuria, in cats subjected to 60min of hypotension.

  4. [Hydrocortisone for the treatment of refractory hypotension: a randomized controlled trial].

    Science.gov (United States)

    Salas, G; Travaglianti, M; Leone, A; Couceiro, C; Rodríguez, S; Fariña, D

    2014-06-01

    Systemic hypotension is a common sign in critically sick infants. Several studies have suggested that the use of short series of corticosteroids increases arterial blood pressure and reduces the inotropic support needs in preterm neonates with hypotension. There are a small number of reports on the use of hydrocortisone (HC) for the treatment of refractory hypotension in infants. To assess the effectiveness of hydrocortisone in the reduction of inotropic support in infants with refractory hypotension. infants who required dopamine ≥ 14 μg/kg/min and/or epinephrine. prospective, controlled, randomized, double blind trial with placebo. 2.5mg/kg every 12 hours, for 48 hours intravenously (intervention group [IG]); placebo: isotonic saline 1.25 ml/kg/doses intravenously (placebo group [PG]) every 12 hours, for 48 hours. Randomization was performed in blocks with blind assignment. A total of 50 infants with refractory systemic hypotension were prospectively recruited. Patient characteristics were similar in both groups. Requirements for inotropic support at 48 hrs were achieved in 60%, of the IG versus 24% of the PG (P=.009, RR: 2.5, 95% CI, 1.16-5.38). A significant association was observed between the administration of HC in infants treated with epinephrine and the presence of hyperglycemia (P =.008). In patients with refractory hypotension hydrocortisone administration reduced the need for inotropic support. Further studies with a greater number of patients are needed to confirm the effectiveness of HC as a therapeutic tool in these infants. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  5. Efficacy of dexamethasone with controlled hypotension on intraoperative bleeding, postoperative oedema and ecchymosis in rhinoplasty.

    Science.gov (United States)

    Tuncel, Umut; Turan, Aydin; Bayraktar, M Alper; Erkorkmaz, Unal; Kostakoglu, Naci

    2013-03-01

    The aim of this retrospective study was to evaluate the efficacy of dexamethasone with controlled hypotension on intraoperative bleeding and postoperative morbidity in rhinoplasty. Sixty rhinoplasty patients required hump resection and lateral osteotomy were included in this study. The patients were randomized into four groups. In group I (n=15), a single dose of 10mg/kg dexamethasone was intravenously administered at the beginning of the operation. In group II (n=15), the patients were given 2 doses of 10mg/kg intravenously dexamethasone at the beginning of the operation, and 24 hours after the operation. In group III (n=15), 3 doses of 10mg/kg intravenously dexamethasone were given at the beginning of the operation, before osteotomy and 24 hours after the operation. Group IV (n=15) was assigned as control group and the patients were neither administered dexamethasone nor applied hypotension. All cases in groups I, II and III were operated under controlled hypotension. Systolic arterial pressure was aimed to keep between 65 and 75 mmHg for controlled hypotensive anaesthesia. Controlled hypotension was achieved by a remifentanil infusion of 0.1-0.5 microg/kg/min, following a bolus of 1 microg/kg. Degree of eyelid oedema and periorbital soft-tissue ecchymosis was evaluated separately using a scale of 0-4. Intraoperative blood loss was recorded for each patient. Patients were evaluated at 24 hours and postoperative days 2, 5, 7, and 10. In groups I, II and III, intraoperative bleeding was more decreased and the operation time was significantly shorter compared with control group (Pcontrolled hypotension considerably reduced postoperative morbidities of rhinoplasty with osteotomy as well as intraoperative bleeding. Thus, in group III receiving 3 doses of steroid, when compared to other groups, more uneventful postoperative period were provided for surgeon and the patients. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier

  6. Effects of Prophylactic Indomethacin on Vasopressor-Dependent Hypotension in Extremely Preterm Infants.

    Science.gov (United States)

    Liebowitz, Melissa; Koo, Jane; Wickremasinghe, Andrea; Allen, Isabel Elaine; Clyman, Ronald I

    2017-03-01

    To determine whether a moderate-to-large patent ductus arteriosus (PDA) is responsible for vasopressor-dependent hypotension, occurring at the end of the first postnatal week. We performed a retrospective, double cohort controlled study of infants delivered at ≤27 +6 weeks' gestation (n = 313). From January 2004 through April 2011, all infants were treated with prophylactic indomethacin ([PINDO] epoch). From May 2011 through December 2015, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch). Echocardiograms were performed on postnatal days 6 or 7. Hypotension was managed by a predefined protocol. The primary outcome was the incidence of dopamine-dependent hypotension, defined as having received at least 6 µg/kg/min dopamine for at least 24 hours during postnatal days 4-7. As expected, the incidence of moderate-to-large PDA at the end of the first week differed significantly between epochs (PINDO = 8%; conservative = 64%). In multivariate analyses, infants in the PINDO epoch had a significantly lower incidence of vasopressor-dependent hypotension (11%) than infants in the conservative epoch (21%; OR = 0.40, 95% CI 0.20-0.82). Infants in the PINDO epoch also required less mean airway pressure, had a lower respiratory severity score, and lower mode of ventilation score than infants in the conservative epoch during postnatal days 4-7. The effects of PINDO on both the incidence of vasopressor-dependent hypotension and the need for respiratory support were no longer significant when analyses were adjusted for "presence or absence of a moderate-to-large PDA." PINDO decreases vasopressor-dependent hypotension and the need for respiratory support at the end of the first postnatal week. These effects are mediated by closure of the PDA. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Adverse Drug Reactions for Medicines Newly Approved in Japan from 1999 to 2013: Hypertension and Hypotension.

    Science.gov (United States)

    Nagayama, Takashi; Nishida, Minoru; Hizue, Masanori; Ogino, Yamato; Fujiyoshi, Masato

    2016-04-01

    In this survey, the correlation between adverse drug reactions (ADRs) in human and animal toxicities was investigated for 393 medicines which were approved in Japan from September 1999 to March 2013. ADRs were collected from each Japanese package insert. Comparable animal toxicities with ADRs were collected by thorough investigation of common technical documents. The results of this survey show that hypertension and/or hypotension were mainly observed in medicines affecting the central nervous system. Hypertension was also observed in antipyretics, analgesics, anti-inflammatory agents, vasoconstrictors and agents using antibody. Concordance between human ADRs and animal toxicities was analysed. True-positive rate for hypertension and hypotension is 0.29 and 0.52, respectively. Positive likelihood ratio and inverse negative likelihood ratio are 1.98 and 1.21, respectively, in hypertension and 1.67 and 1.44, respectively, in hypotension. Concordance between human ADRs and animal toxicities is not so high in hypertension and hypotension. Identified mechanisms as on-target for hypertension and hypotension are 29.8% and 30.5%, respectively. More than half of the causative factors of hypertension and hypotension were unable to be elucidated. Our results show that the intake of medicines is often linked to blood pressure variations that are not predicted in animal toxicity studies. Improvement of drug development processes may be necessary to provide safer medicines because current animal toxicity studies are insufficient to predict all ADRs in human beings. © 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  8. Neurogenic hyperadrenergic orthostatic hypotension: a newly recognized variant of orthostatic hypotension in older adults with elevated norepinephrine (noradrenaline).

    Science.gov (United States)

    Mar, Philip L; Shibao, Cyndya A; Garland, Emily M; Black, Bonnie K; Biaggioni, Italo; Diedrich, André; Paranjape, Sachin Y; Robertson, David; Raj, Satish R

    2015-07-01

    Patients with neurogenic orthostatic hypotension (OH) typically have impaired sympathetic nervous system tone and therefore low levels of upright plasma norepinephrine (NE) (noradrenaline). We report a subset of patients who clinically have typical neurogenic OH but who paradoxically have elevated upright levels of plasma NE. We retrospectively studied 83 OH patients evaluated at the Vanderbilt Autonomic Dysfunction Center between August 2007 and May 2013. Based on standing NE, patients were dichotomized into a hyperadrenergic OH group [hyperOH: upright NE ≥ 3.55 nmol/l (600 pg/ml), n=19] or a non-hyperadrenergic OH group [nOH: upright NE < 3.55 nmol/l (600 pg/ml), n=64]. Medical history and data from autonomic testing, including the Valsalva manoeuvre (VM), were analysed. HyperOH patients had profound orthostatic falls in blood pressure (BP), but less severe than in nOH [change in SBP (systolic blood pressure): -53 ± 31 mmHg compared with -68 ± 33 mmHg, P=0.050; change in DBP (diastolic blood pressure): -18 ± 23 mmHg compared with -30 ± 17 mmHg, P=0.01]. The expected compensatory increase in standing heart rate (HR) was similarly blunted in both hyperOH and nOH groups [84 ± 15 beats per minute (bpm) compared with 82 ± 14 bpm; P=0.6]. HyperOH patients had less severe sympathetic failure as evidenced by smaller falls in DBP during phase 2 of VM and a shorter VM phase 4 BP recovery time (16.5 ± 8.9 s compared with 31.6 ± 16.6 s; P<0.001) than nOH patients. Neurogenic hyperOH patients have severe neurogenic OH, but have less severe adrenergic dysfunction than nOH patients. Further work is required to understand whether hyperOH patients will progress to nOH or whether this represents a different disorder.

  9. Changes in superior mesenteric artery Doppler waveform during reduction of cardiac stroke volume and hypotension

    DEFF Research Database (Denmark)

    Perko, M J; Perko, Grazyna; Just, S

    1996-01-01

    Influence of stroke volume reduction and hypotension on the superior mesenteric artery (SMA) Doppler waveform was evaluated during head-up tilt-induced central hypovolemia in 11 healthy volunteers. During normotensive reduction in stroke volume, peak systolic velocity (pV), mean velocity, pulsati......Influence of stroke volume reduction and hypotension on the superior mesenteric artery (SMA) Doppler waveform was evaluated during head-up tilt-induced central hypovolemia in 11 healthy volunteers. During normotensive reduction in stroke volume, peak systolic velocity (pV), mean velocity...

  10. Inhibitory effects of xanthones from guttiferae plants on PAF-induced hypotension in mice.

    Science.gov (United States)

    Oku, Hisae; Ueda, Yoshimi; Iinuma, Munekazu; Ishiguro, Kyoko

    2005-01-01

    The inhibitory effects of 22 xanthones from three Guttiferae plants (Hypericum patulum, Calophyllum inophyllum and C. austroindium) on exogenous platelet activating factor (PAF)-induced hypotension were examined using a blood pressure monitoring in vivo assay method. Guanandin (2), caloxanthone E (3), 1,3,5,6-tetrahydroxy-2-isoprenylxanthone (8), 6-deoxyjacareubin (11) and patulone (18) showed strong inhibition of PAF-induced hypotension, with inhibitory effects of more than 60 %. Their ID50 values were greater than that of ginkgolide B (BN-52 021), a natural PAF-antagonist from the Ginkgo biloba.

  11. Progressively invalidating orthostatic hypotension: A common symptom for a challenging diagnosis

    Directory of Open Access Journals (Sweden)

    Serena Pelusi

    2016-01-01

    Full Text Available We discuss here an uncommon condition of neurogenic hypotension in the context of immunoglobulin light chain (amyloid light-chain amyloidosis. The most serious feature was autonomic nervous system impairment, mainly characterized by severe refractory orthostatic hypotension, which became progressively invalidating, forcing the patient to bed. Moreover, since the systemic involvement of the disease, the patient presented also diarrhea, dysphagia, asthenia, peripheral edema because of gastrointestinal, and kidney dysfunction. Eventually, the massive myocardial depression and infiltration led to a fatal outcome.

  12. Xamoterol, a new selective beta-1-adrenoceptor partial agonist, in the treatment of postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Trap-Jensen, J

    1986-01-01

    Three patients severely disabled from postural hypotension were treated with xamoterol, a selective beta-1-adrenoceptor antagonist with a high degree of partial agonist activity. Oral treatment (200 mg b.i.d.) was chosen on the basis of the effects of acute intravenous administration of xamoterol...... and pindolol, a non-selective beta-adrenoceptor antagonist with partial agonist activity. In these patients pindolol had a predominantly antagonist effect, whereas xamoterol had a predominantly agonist effect after intravenous administration. Oral treatment was carried out with placebo control in a single...... hypotension....

  13. Vasopressin and its analogues for the treatment of refractory hypotension in neonates.

    Science.gov (United States)

    Shivanna, Binoy; Rios, Danielle; Rossano, Joseph; Fernandes, Caraciolo J; Pammi, Mohan

    2013-03-28

    Neonatal hypotension that is refractory to volume expansion, catecholamines, or corticosteroids has a mortality of about 50%. Optimization of blood pressure and tissue perfusion in refractory hypotension may be crucial to improve clinical outcomes. Vasopressin, a neuropeptide hormone, or its analogue terlipressin has been used to treat refractory hypotension in neonates and may be effective. Our primary objective was to evaluate the efficacy and safety of vasopressin and its synthetic analogues (e.g. terlipressin) in decreasing mortality and adverse neurodevelopmental outcomes, and improving survival in neonates with refractory hypotension. Our secondary objectives were to determine the effects of vasopressin and its analogues (terlipressin) on improvement in blood pressure, increase in urine output, decrease in inotrope score, necrotizing enterocolitis (NEC), periventricular leukomalacia, intraventricular hemorrhage, chronic lung disease, and retinopathy of prematurity (ROP) in neonates with refractory hypotension. We searched the literature in January 2012, using the search strategy recommended by the Cochrane Neonatal Group. We searched electronic databases (CENTRAL (The Cochrane Library), MEDLINE, CINAHL, EMBASE), abstracts of the Pediatric Academic Societies, web sites for registered trials at www.clinicaltrials.gov and www.controlled-trials.com and in the reference list of identified articles. Randomized or quasi-randomized trials evaluating vasopressin or its analogues, at any dosage or duration used as an adjunct to standard therapy (any combination of volume expansion, inotropic agents and corticosteroids) to treat refractory hypotension in neonates. We followed the standard methods of The Cochrane Collaboration for conducting a systematic review. Two review authors (BS and MP) independently assessed the titles and abstracts of studies identified by the search strategy for eligibility for inclusion. We obtained the full text version if eligibility could

  14. Hypotensive Anesthesia Is Associated With Shortened Length of Hospital Stay Following Orthognathic Surgery.

    Science.gov (United States)

    Ettinger, Kyle S; Yildirim, Yavuz; Weingarten, Toby N; Van Ess, James M; Viozzi, Christopher F; Arce, Kevin

    2016-01-01

    To evaluate the impact of induced hypotensive anesthesia on length of hospital stay (LOS) for patients undergoing maxillary Le Fort I osteotomy in isolation or in combination with mandibular orthognathic surgery. A retrospective cohort study design was implemented and patients undergoing a Le Fort I osteotomy as a component of orthognathic surgery at the Mayo Clinic from 2010 through 2014 were identified. The primary predictor variable was the presence of induced hypotensive anesthesia during orthognathic surgery. Hypotensive anesthesia was defined as at least 10 consecutive minutes of a mean arterial pressure no higher than 60 mmHg documented within the anesthetic record. The primary outcome variable was LOS in hours after completion of orthognathic surgery. The secondary outcome variable was the duration of surgery in hours. Multiple covariates also abstracted included patient age, patient gender, American Society of Anesthesiologists score, complexity of surgical procedure, and volume of intraoperative fluids administered during surgery. Univariable and multivariable models were developed to evaluate associations between the primary predictor variable and covariates relative to the primary and secondary outcome variables. A total of 117 patients were identified undergoing Le Fort I orthognathic surgery in isolation or in combination with mandibular surgery. Induced hypotensive anesthesia was significantly associated with shortened LOS (odds ratio [OR] = 0.33; 95% confidence interval [CI], 0.12-0.88; P = .026) relative to patients with normotensive regimens. This association between hypotensive anesthesia and LOS remained statistically significant in a subgroup analysis of 47 patients in whom isolated Le Fort I surgery was performed (OR = 0.13; 95% CI, 0.03-0.62; P = .010). Induced hypotensive anesthesia was not statistically associated with shorter duration of surgery. Induced hypotensive anesthesia represents a potential factor that minimizes

  15. The duration of hypotension determines the evolution of bacteremia-induced acute kidney injury in the intensive care unit.

    Directory of Open Access Journals (Sweden)

    Karin Janssen van Doorn

    Full Text Available BACKGROUND: Exploration of the impact of severe hypotension on the evolution of acute kidney injury in septic patients. METHODS AND RESULTS: We reviewed the hemodynamic parameters of 137 adults with septic shock and proven blood stream infection in the ICU. Severe hypotension was defined as a mean arterial blood pressure (MAP ≤65 mmHg. The influence of the duration of severe hypotension on the evolution of acute kidney injury was evaluated according to the RIFLE classification, with day 0 defined as the day of a positive blood stream infection. After bloodstream infection, the probability for a patient to be in Failure was significantly higher than before blood stream infection (OR = 1.94, p = 0.0276. Patients have a significantly higher risk of evolving to Failure if the duration of severe hypotension is longer (OR = 1.02 for each 10 minutes increase in duration of a MAP <65 mmHg, p = 0.0472. A cut-off of at least 51 minutes of severe hypotension (<65 mmHg or at least 5.5 periods of severe hypotension within 1 day identified patients with increased risk to evolve to Failure. CONCLUSIONS: There is a significant influence of both the duration and the number of periods of severe hypotension on the evolution to Failure. Blood stream infection has a significantly negative effect on the relationship between severe hypotension and Failure.

  16. Maternal and Neonatal Effects of Vasopressors Used for Treating Hypotension after Spinal Anesthesia for Caesarean Section: A Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Alma Soxhuku-Isufi

    2015-12-01

    CONCLUSIONS: Ephedrine and phenylephrine have the same efficacy in treating hypotension after spinal anesthesia for caesarean section. The use of Phenylephrine was associated with better fetal acid-base status, and there were no differences on Apgar score values and on the incidence of maternal bradycardia and hypotension.

  17. Improvement of quality of reporting in randomised controlled trials to prevent hypotension after spinal anaesthesia for caesarean section

    NARCIS (Netherlands)

    A. Herdan; R. Roth; D. Grass; M. Klimek (Markus); S. Will; B. Schauf; R. Rossaint; M. Heesen

    2011-01-01

    textabstractHypotension is a frequent complication of spinal anaesthesia for caesarean section and can threaten the well-being of the unborn child. Numerous randomised controlled trials (RCTs) dealt with measures to prevent hypotension. The aim of this study was to determine the reporting quality of

  18. Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system.

    Science.gov (United States)

    Brenck, F; Hartmann, B; Katzer, C; Obaid, R; Brüggmann, D; Benson, M; Röhrig, R; Junger, A

    2009-04-01

    To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of >20% from baseline value or readings of <90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables (P < 0.05). Hypotension was found in 284 cases (56.5%). The univariate analysis identified the neonate's weight, mother's age, body mass index, and peak sensory block height associated with hypotension. Body mass index, age and sensory block height were detected as independent factors for hypotension (odds-ratio: 1.61 each). Knowledge of these risk factors should increase the anesthesiologist's attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.

  19. Evaluation of the efficacy of desflurane with or without labetalol for hypotensive anesthesia in middle ear microsurgery

    Directory of Open Access Journals (Sweden)

    Neha Gupta

    2017-01-01

    Conclusion: Although desflurane is effective for inducing deliberate hypotension in middle ear microsurgery, the combination of desflurane with labetalol is associated with decreased requirement of desflurane, absence of reflex tachycardia, faster induction of hypotension, faster recovery from anesthesia, and less postoperative sedation.

  20. Transient severe hypotension with once-weekly subcutaneous injection of teriparatide in osteoporotic patient: a case report and insight for the drug interaction between hypotensive agents and teriparatide.

    Science.gov (United States)

    Enishi, Tetsuya; Uemura, Hirokazu; Katoh, Shinsuke; Inatsugi, Masanori; Minato, Sho; Inatsugi, Kei; Inatsugi, Mikiko; Sato, Nori; Siryo, Koichi

    2015-01-01

    Teriparatide, a recombinant form of parathyroid hormone, were well recognized as a useful option for the treatment of the osteoporosis. Although some side effects of teriparatide include headache, nausea, dizziness, and limb pain were reported. Here we present a 80-year-old woman of transient asymptomatic hypotension with once-weekly subcutaneous injection of teriparatide for the treatment of osteoporosis with hypertension disease as acute-phase reactions. Systolic blood pressure decreased in both 30 min and 60 min after injection compared with before injection. Heart rate increased with passage of time. Statistically significant were observed among before, 30 min, 60 min after injection of teriparatide. Slight nausea was seen as subjective symptoms with the first and second injection after 30 min. This case indicates careful attention, at least 1 hr, was recommended with weekly subcutaneous injections of teriparatide in the treatment for osoteoproteic patient with hypertension decreases. This is a first report, to the best of our knowledge, to demonstrate the transient asymptomatic hypotension after once-weekly injection of teriparatide with hypertension disease. Transient hypotension occurred after injection of teriparatide during the treatment period and was asymptomatic except for the first 2 injections.

  1. Effect of oxygen inhalation at birth on the reduction of early postnatal mortality in pigs.

    Science.gov (United States)

    Herpin, P; Hulin, J C; Le Dividich, J; Fillaut, M

    2001-01-01

    Asphyxia during delivery is considered a main cause of stillbirth in pigs, but piglets suffering from intermittent asphyxia during delivery are also less viable at birth and less prone to adapt to extrauterine life. In an effort to improve pig viability, one attractive solution would be to increase oxygen supply through oxygen inhalation by the newborn pig. The objective of this study was to test effects of oxygen inhalation immediately after birth on various physiological parameters and piglet survival. The experiment was performed on 252 Piétrain x Large White piglets, half of them reoxygenated immediately after birth. They were maintained during 20 min in a chamber where oxygen concentration was monitored at 40% and were then put back with the sow and the control pigs. Oxygen inhalation affected piglet metabolism. Through stimulation of oxidative metabolism (reduction of circulating levels of lactate) and lowering of the level of postnatal hypothermia (particularly for the lightest pigs), oxygen inhalation increased piglet viability and reduced mortality during the 1st d of life by 75% (2 vs 8%). No additional effects were observed during the following days and overall mortality between birth and weaning at 21 d was reduced from 12 to 8%.

  2. Stunting at 5 Years Among SGA Newborns.

    Science.gov (United States)

    Xie, Chuanbo; Epstein, Leonard H; Eiden, Rina D; Shenassa, Edmond D; Li, Xiuhong; Liao, Yan; Wen, Xiaozhong

    2016-02-01

    To compare risk of stunting at 5 years across etiological subgroups of small for gestational age (SGA) newborns. We analyzed data of a subsample (N = 1100) of the Early Childhood Longitudinal Study-Birth Cohort. We defined SGA as birth weight SGA subgroups, adjusting for confounders. SGA subgroup with maternal short stature (odds ratio [OR] = 3.88; 95% confidence interval [CI] = 2.16-6.96) or inadequate GWG (OR = 2.18; 95% CI = 1.23-3.84) had higher risk of stunting at 5 years, compared with the SGA subgroup without the corresponding risk factor. SGA newborns with both maternal smoking and inadequate GWG during pregnancy had much higher risk of stunting at 5 years (OR = 3.10; 95% CI = 1.21-7.91), compared with SGA newborns without any of these 2 SGA risk factors. Etiological subgroups of SGA differed in risk of stunting at 5 years. SGA newborns of inadequate GWG mothers who smoke and SGA newborns of short mothers were at particularly high risk of stunting. Copyright © 2016 by the American Academy of Pediatrics.

  3. Newborn analgesia mediated by oxytocin during delivery

    Directory of Open Access Journals (Sweden)

    Michel eMazzuca

    2011-04-01

    Full Text Available The mechanisms controlling pain in newborns during delivery are poorly understood. We explored the hypothesis that oxytocin, an essential hormone for labor and a powerful neuromodulator, exerts analgesic actions on newborns during delivery. Using a thermal tail-flick assay, we report that pain sensitivity is two fold lower in rat pups immediately after birth than two days later. Oxytocin receptor antagonists strongly enhanced pain sensitivity in newborn, but not in two days-old rats, whereas oxytocin reduced pain at both ages suggesting an endogenous analgesia by oxytocin during delivery. Similar analgesic effects of oxytocin, measured as attenuation of pain-vocalization induced by electrical whisker pad stimulation, were also observed in decerebrated newborns. Oxytocin reduced GABA-evoked calcium responses and depolarizing GABA driving force in isolated neonatal trigeminal neurons suggesting that oxytocin effects are mediated by alterations of intracellular chloride. Unlike GABA signaling, oxytocin did not affect responses mediated by P2X3 and TRPV1 receptors. In keeping with a GABAergic mechanism, reduction of intracellular chloride by the diuretic NKCC1 choride co-transporter antagonist bumetanide mimicked the analgesic actions of oxytocin and its effects on GABA responses in nociceptive neurons. Therefore, endogenous oxytocin exerts an analgesic action in newborn pups that involves a reduction of the depolarizing action of GABA on nociceptive neurons. Therefore, the same hormone that triggers delivery also acts as a natural pain killer revealing a novel facet of the protective actions of oxytocin in the fetus at birth.

  4. Severe hypernatremia in newborns due to salting.

    Science.gov (United States)

    Peker, Erdal; Kirimi, Ercan; Tuncer, Oguz; Ceylan, Abdullah

    2010-07-01

    The aim of this study was to evaluate the etiology, clinical, and laboratory findings and prognostic features of life-threatening hypernatremic newborns secondary to salting. Ten severely hypernatremic newborns (four females) with a mean age of 6.5 +/- 2.6 days were followed up. Nine of them were full term, and one was preterm. It was noticeable that 60% of them were small for gestational age. In the laboratory investigation, five uremias were detected. It was interesting to find in the etiologic history that 40% of the patients had been salted just after birth. Twenty percent of them had also hyperbilirubinemia and kernicterus, 20% had neonatal convulsion, and 50% had dehydration. Two of the hypernatremic newborns died during the study; the others were followed up. One case had spasticity and developmental disability at the 3rd month, and another one had developmental disability at the 6th month of ages. As a conclusion, although salting of newborns is not so frequent, it could be seen in rural places of our country, and this may be one of the reasons for serious hypernatremia in newborns whose skin integrity have not been formed completely. These cases should be treated carefully.

  5. A Study Of Fungal Colonization In Newborn

    Directory of Open Access Journals (Sweden)

    S Rashid Husain

    1997-04-01

    Full Text Available Research Problem: What are the factors responsible for fungal colonization in newborns?Objective: To study the pattern of and predisposing fac­tors for the development of superficial candidiasis and fungal colonization in the newborns.Study Design: Prospective study.Setting: Neonatology unitof the Paediatrics department of a teaching hospital.Participants: Randomly selected pregnant mothers admit­ted to the maternity ward and the newborns delivered to them.Sample Size: 120 pregnant mothers and the newborns delivered.Study Variables: Candida, Site of colonization.Statistical Analysis: By tests of significanceResults: Candida was isolated from 23 (19.16% infants on the first day increasing to 52 (43.33% infants on the sixth day. The most common site of colonization was oral cavity. Candida colonization was more common in prema­ture infants (p<0.05. Oral thrush was seen in 29 (24.17% infants during the study and a significant number of these infants showed colonization from the first day of life.Conclusions: Fungal colonization of the newborns due to Candida species is quite common, and in the first week of life predominantly occurred in the ora I cavity. Superficial clinical candidiasis, especially oral thrush is more common in those colonized on the first day of life.

  6. Common respiratory conditions of the newborn

    Science.gov (United States)

    Gallacher, David J.; Hart, Kylie

    2016-01-01

    Key points Respiratory distress is a common presenting feature among newborn infants. Prompt investigation to ascertain the underlying diagnosis and appropriate subsequent management is important to improve outcomes. Many of the underlying causes of respiratory distress in a newborn are unique to this age group. A chest radiograph is crucial to assist in diagnosis of an underlying cause. Educational aims To inform readers of the common respiratory problems encountered in neonatology and the evidence-based management of these conditions. To enable readers to develop a framework for diagnosis of an infant with respiratory distress. The first hours and days of life are of crucial importance for the newborn infant as the infant adapts to the extra-uterine environment. The newborn infant is vulnerable to a range of respiratory diseases, many unique to this period of early life as the developing fluid-filled fetal lungs adapt to the extrauterine environment. The clinical signs of respiratory distress are important to recognise and further investigate, to identify the underlying cause. The epidemiology, diagnostic features and management of common neonatal respiratory conditions are covered in this review article aimed at all healthcare professionals who come into contact with newborn infants. PMID:27064402

  7. Exercise enclosures for guinea pigs.

    Science.gov (United States)

    Brown, Cyndi

    2009-11-01

    Exercise and exploration are important to the health and happiness of guinea pigs. Laboratory housing does not always provide the space necessary for such opportunities. This article presents an inexpensive, versatile option for an enclosed exercise area for the laboratory guinea pig.

  8. Effect of ondansetron on prevention of post-induction hypotension in elderly patients undergoing general anesthesia: A randomized, double-blind placebo-controlled clinical trial

    OpenAIRE

    Mohammad Golparvar; Mahmoud Saghaei; Mohammad Ali Saadati; Shadi Farsaei

    2015-01-01

    Background: Elderly patients are susceptible to post-induction hypotension. Volume loading and vasopressors for prevention of hypotension in elderly patients may increase perioperative cardiovascular risks. Ondansetron by blocking Bezold?Jarisch reflex (BJR) through inhibition of serotonin receptors has been effective in the prevention of post-spinal hypotension, and bradycardia. Bradycardia frequently accompanies post-induction hypotension in elderly patients, which signifies a possible prev...

  9. People, Pigs, Pork and Preferences

    DEFF Research Database (Denmark)

    Thorslund, Cecilie Agnete H

    This thesis presents results from a qualitative research project on public perception of animal welfare and meat quality related to the pig industry in Denmark, Sweden and England. The aim is to deepen our understanding of people’s role in pig welfare management in order to shed some light...... on the barriers and potential for a market-driven pig welfare strategy. Firstly, overall, it was found that animal welfare is perceived both as a quality in itself and as an attribute with links to other important meat quality attributes. Secondly, it was found that public concerns about pig welfare vary......, depending on whether they relate to an everyday or production context. Furthermore, some interesting national differences emerged, pointing at the need for more than one marketing strategy if pig welfare is to be supported through consumer demand. Overall, this thesis contributes with important findings...

  10. The Pig PeptideAtlas

    DEFF Research Database (Denmark)

    Hesselager, Marianne O.; Codrea, Marius C.; Sun, Zhi

    2016-01-01

    underrepresented in existing repositories. We here present a significantly improved build of the Pig PeptideAtlas, which includes pig proteome data from 25 tissues and three body fluid types mapped to 7139 canonical proteins. The content of the Pig PeptideAtlas reflects actively ongoing research within...... the veterinary proteomics domain, and this article demonstrates how the expression of isoform-unique peptides can be observed across distinct tissues and body fluids. The Pig PeptideAtlas is a unique resource for use in animal proteome research, particularly biomarker discovery and for preliminary design of SRM...... assays, which are equally important for progress in research that supports farm animal production and veterinary health, as for developing pig models with relevance to human health research....

  11. Whipworms in humans and pigs

    DEFF Research Database (Denmark)

    Hawash, Mohamed Bayoumi Fahmy; Betson, Martha; Al-Jubury, Azmi

    2016-01-01

    -human primates suggesting a common African origin of the parasite, which then was transmitted to Asia and further to South America. On the other hand, there was no differentiation between pig-derived Trichuris from Europe and the New World suggesting dispersal relates to human activities by transporting pigs......BACKGROUND: Trichuris suis and T. trichiura are two different whipworm species that infect pigs and humans, respectively. T. suis is found in pigs worldwide while T. trichiura is responsible for nearly 460 million infections in people, mainly in areas of poor sanitation in tropical and subtropical...... areas. The evolutionary relationship and the historical factors responsible for this worldwide distribution are poorly understood. In this study, we aimed to reconstruct the demographic history of Trichuris in humans and pigs, the evolutionary origin of Trichuris in these hosts and factors responsible...

  12. Newborn genetic screening: blessing or curse?

    Science.gov (United States)

    Kenner, C; Amlung, S

    1999-10-01

    Newly discovered genes and advances in genetic screening programs prompt many questions reflecting the kinds of ethical dilemmas that go hand in hand with life-changing discoveries. Neonatal genetic screening has been a standard of care for some time, but as our knowledge in the field of genetics expands, should we continue with the same approach? What newborn genetic screening tests should be mandatory, and what are the long-range consequences associated with testing? This article reviews genetic modes of inheritance, outlines and explains the most common newborn screening tests, and enumerates the ethical issues associated with these screening procedures. The role of the neonatal nurse in the newborn genetic screening process is discussed.

  13. Oxidative Stress Related Diseases in Newborns

    Directory of Open Access Journals (Sweden)

    Yasemin Ozsurekci

    2016-01-01

    Full Text Available We review oxidative stress-related newborn disease and the mechanism of oxidative damage. In addition, we outline diagnostic and therapeutic strategies and future directions. Many reports have defined oxidative stress as an imbalance between an enhanced reactive oxygen/nitrogen species and the lack of protective ability of antioxidants. From that point of view, free radical-induced damage caused by oxidative stress seems to be a probable contributing factor to the pathogenesis of many newborn diseases, such as respiratory distress syndrome, bronchopulmonary dysplasia, periventricular leukomalacia, necrotizing enterocolitis, patent ductus arteriosus, and retinopathy of prematurity. We share the hope that the new understanding of the concept of oxidative stress and its relation to newborn diseases that has been made possible by new diagnostic techniques will throw light on the treatment of those diseases.

  14. Immune thrombocytopenia in the newborn

    Directory of Open Access Journals (Sweden)

    Murat Yurdakök

    2017-02-01

    Full Text Available The leading cause of moderate or severe thrombocytopenia in otherwise healthy appearing neonates is immune thrombocytopenia. Immune thrombocytopenia in the fetus or newborn may result from platelet alloantibodies against paternal antigens inherited by the fetus (alloimmune thrombocytopenia or platelet autoantibodies in the mother with immune thrombocytopenic purpura (ITP. Only 10% of human platelet antigen (HPA-1a negative mothers who are exposed to HPA-1a positive fetal platelets during pregnancy develop HPA-1a alloantibodies, and 30% of fetuses/neonates will develop thrombocytopenia and 20% of these cases being severe. The most serious complication of severe fetal and neonatal alloimmune thrombocytopenia (FNAIT is intracranial hemorrhage (ICH, which is detected in 10-20% of affected fetuses/neonates, with most cases occurring antenatally. ICH leads to neurological sequelae in 20%, and deaths in 5-10% cases. There is no evidence-based optimal treatment strategy. Platelet antibody titration in maternal plasma is not helpful for decision-making. The best indicator for current pregnancy is the outcome of the previous pregnancy. The risk of recurrence among subsequent HPA-positive sibling is close to 100% where the previous sibling was affected with antenatal intracranial ICH. The risk of ICH becomes higher with more severe and earlier onset in each subsequent pregnancy. Serial platelet counts should be obtained for the first 5-7 days of delivery to keep the platelet counts higher than 30,000/µL without active bleeding and higher that 50,000-100,000/µL with active bleeding. Intravenous immunoglobulin (IVIG is not alternative to platelet transfusions, since platelet counts don’t rise before 24-48 h. In platelet- transfused patients, IVIG can be given to potentially prolong the survival of the incompatible platelets. ITP during pregnancy is not considered a serious risk of perinatal bleeding, but may cause a moderate thrombocytopenia in neonate

  15. The guinea-pig

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner; Maibach, H I; Anjo, M D

    1980-01-01

    was 2.4% (s.d. = 0.5; n = 3) and 31.4% (s.d. = 9.1; n = 3) of the applied dose respectively, similar to published human absorption data. Testosterone was absorbed to a greater extent in guinea-pigs (34.9% +/- 5.4; n = 5) than man. A thioglycollate based depilatory cream significantly increased the skin...... absorption of testosterone, while the absorption velocity was unaltered. Two analytical methods were compared, direct counting versus wet ashing; results were in the same range for the three compounds. Two methods of quantifying skin absorption were compared; urine recovery corrected for incomplete urinary...

  16. Developmental stage-specific imprinting of IPL in domestic pigs (Sus scrofa).

    Science.gov (United States)

    Hou, Shengping; Chen, Yuming; Liang, Jie; Li, Li; Wu, Tongshan; Tian, X Cindy; Zhang, Shouquan

    2010-01-01

    Imprinted in placenta and liver (IPL) gene has been identified as an imprinted gene in the mouse and human. Its sequence and imprinting status, however, have not been determined in the domestic pigs. In the present study, a 259 base pair-specific sequence for IPL gene of the domestic pig was obtained and a novel SNP, a T/C transition, was identified in IPL exon 1. The C allele of this polymorphism was found to be the predominant allele in Landrace,Yorkshire, and Duroc. The frequency of CC genotype and C allele are different in Duroc as compared with Yorkshire (P = .038 and P = .005, resp.). Variable imprinting status of this gene was observed in different developmental stages. For example, it is imprinted in 1-day old newborns (expressed from the maternal allele), but imprinting was lost in 180-day-old adult (expressed from both parental alleles). Real-time PCR analysis showed the porcine IPL gene is expressed in all tested eight organ/tissues. The expression level was significantly higher in spleen, duodenum, lung, and bladder of 180-day-old Lantang adult compared to that in 1-day-old newborns Lantang pigs (P IPL gene is developmental stage and tissue specific.

  17. Developmental Stage, Muscle and Genetic Type Modify Muscle Transcriptome in Pigs: Effects on Gene Expression and Regulatory Factors Involved in Growth and Metabolism.

    Directory of Open Access Journals (Sweden)

    Miriam Ayuso

    Full Text Available Iberian pig production includes purebred (IB and Duroc-crossbred (IBxDU pigs, which show important differences in growth, fattening and tissue composition. This experiment was conducted to investigate the effects of genetic type and muscle (Longissimus dorsi (LD vs Biceps femoris (BF on gene expression and transcriptional regulation at two developmental stages. Nine IB and 10 IBxDU piglets were slaughtered at birth, and seven IB and 10 IBxDU at four months of age (growing period. Carcass traits and LD intramuscular fat (IMF content were measured. Muscle transcriptome was analyzed on LD samples with RNA-Seq technology. Carcasses were smaller in IB than in IBxDU neonates (p 1.5 by the developmental stage (5,812 genes, muscle type (135 genes, and genetic type (261 genes at birth and 113 at growth. Newborns transcriptome reflected a highly proliferative developmental stage, while older pigs showed upregulation of catabolic and muscle functioning processes. Regarding the genetic type effect, IBxDU newborns showed enrichment of gene pathways involved in muscle growth, in agreement with the higher prenatal growth observed in these pigs. However, IB growing pigs showed enrichment of pathways involved in protein deposition and cellular growth, supporting the compensatory gain experienced by IB pigs during this period. Moreover, newborn and growing IB pigs showed more active glucose and lipid metabolism than IBxDU pigs. Moreover, LD muscle seems to have more active muscular and cell growth, while BF points towards lipid metabolism and fat deposition. Several regulators controlling transcriptome changes in both genotypes were identified across muscles and ages (SIM1, PVALB, MEFs, TCF7L2 or FOXO1, being strong candidate genes to drive expression and thus, phenotypic differences between IB and IBxDU pigs. Many of the identified regulators were known to be involved in muscle and adipose tissues development, but others not previously associated with pig muscle

  18. Developmental Stage, Muscle and Genetic Type Modify Muscle Transcriptome in Pigs: Effects on Gene Expression and Regulatory Factors Involved in Growth and Metabolism.

    Science.gov (United States)

    Ayuso, Miriam; Fernández, Almudena; Núñez, Yolanda; Benítez, Rita; Isabel, Beatriz; Fernández, Ana I; Rey, Ana I; González-Bulnes, Antonio; Medrano, Juan F; Cánovas, Ángela; López-Bote, Clemente J; Óvilo, Cristina

    2016-01-01

    Iberian pig production includes purebred (IB) and Duroc-crossbred (IBxDU) pigs, which show important differences in growth, fattening and tissue composition. This experiment was conducted to investigate the effects of genetic type and muscle (Longissimus dorsi (LD) vs Biceps femoris (BF)) on gene expression and transcriptional regulation at two developmental stages. Nine IB and 10 IBxDU piglets were slaughtered at birth, and seven IB and 10 IBxDU at four months of age (growing period). Carcass traits and LD intramuscular fat (IMF) content were measured. Muscle transcriptome was analyzed on LD samples with RNA-Seq technology. Carcasses were smaller in IB than in IBxDU neonates (p IMF content (p 1.5) by the developmental stage (5,812 genes), muscle type (135 genes), and genetic type (261 genes at birth and 113 at growth). Newborns transcriptome reflected a highly proliferative developmental stage, while older pigs showed upregulation of catabolic and muscle functioning processes. Regarding the genetic type effect, IBxDU newborns showed enrichment of gene pathways involved in muscle growth, in agreement with the higher prenatal growth observed in these pigs. However, IB growing pigs showed enrichment of pathways involved in protein deposition and cellular growth, supporting the compensatory gain experienced by IB pigs during this period. Moreover, newborn and growing IB pigs showed more active glucose and lipid metabolism than IBxDU pigs. Moreover, LD muscle seems to have more active muscular and cell growth, while BF points towards lipid metabolism and fat deposition. Several regulators controlling transcriptome changes in both genotypes were identified across muscles and ages (SIM1, PVALB, MEFs, TCF7L2 or FOXO1), being strong candidate genes to drive expression and thus, phenotypic differences between IB and IBxDU pigs. Many of the identified regulators were known to be involved in muscle and adipose tissues development, but others not previously associated with pig

  19. Oral nifedipine as a premedication for induced hypotension in functional endoscopic sinus surgery (FESS

    Directory of Open Access Journals (Sweden)

    Ahmed Hassanein

    2015-10-01

    Conclusion: Administration of a single preoperative dose of nifedipine (20 mg can significantly reduce the blood loss during FESS and improves the visualization of the operative field and it also lowers the amount of GTN needed to achieve target hypotension.

  20. Oxytocin antagonist disrupts hypotension-evoked renin secretion and other responses in conscious rats

    DEFF Research Database (Denmark)

    Huang, W.; Sjöquist, M.; Skøtt, O.

    2001-01-01

    Previous experiments have indicated that arterial hypotension increases plasma oxytocin (OT) levels in rats and that OT infused intravenously causes an increase in plasma renin activity (PRA). The goal of the present study was to determine whether systemic administration of an OT receptor...

  1. Increase in vagal activity during hypotensive lower-body negative pressure in humans

    DEFF Research Database (Denmark)

    Sander-Jensen, K; Mehlsen, J; Stadeager, C

    1988-01-01

    Progressive central hypovolemia is characterized by a normotensive, tachycardic stage followed by a reversible, hypotensive stage with slowing of the heart rate (HR). We investigated circulatory changes and arterial hormone concentrations in response to lower-body negative pressure (LBNP) in six...

  2. A Short Review of Some Medicinal Plants And Phytocompounds With Hypotensive And Hypoglycemic Activities

    OpenAIRE

    Eddouks M; Zeggwagh NA

    2014-01-01

    This paper aims to review some medicinal plants and compounds of botanical origin which are capable to lower plasma glucose levels and blood pressure. Hypoglycemic natural products comprise flavonoids, xanthones, triterpenoids, alkaloids, glycosides, alkyldisulfides. aminobutyric acid derivatives, guanidine, polysaccharides and peptides. Hypotensive compounds include flavonoids, diterpenes, alkaloids, glycosides, polysaccharides and proteins.

  3. Acute hypotension induced by aortic clamp vs. PTH provokes distinct proximal tubule Na+ transporter redistribution patterns

    DEFF Research Database (Denmark)

    Leong, Patrick K K; Yang, Li E; Lin, Harrison W

    2004-01-01

    in renal cortical membranes fractionated on sorbitol density gradients. Aortic clamp-induced acute hypotension (from 100 +/- 3 to 78 +/- 2 mmHg) provoked a 62% decrease in urine output and a significant decrease in volume flow from the proximal tubule detected as a 66% decrease in endogenous lithium......-density membranes enriched in apical markers. PTH at much lower doses (

  4. The association between orthostatic hypotension, falling and successful rehabilitation in a nursing home population

    NARCIS (Netherlands)

    Hartog, L. C.; Cizmar-Sweelssen, M.; Knipscheer, A.; Groenier, K. H.; Kleefstra, N.; Bilo, H. J. G.; van Hateren, K. J. J.

    2015-01-01

    Purpose of the study: Our objectives were to identify the prevalence of orthostatic hypotension (OH) in frail, elderly nursing home residents, and assess its possible association with falling and chances of successful rehabilitation. Materials and methods: A prospective observational cohort study. A

  5. Lower vascular tone and larger plasma volume in Parkinson's disease with orthostatic hypotension

    NARCIS (Netherlands)

    Groothuis, J.T.; Esselink, R.A.J.; Seeger, J.P.H.; Aalst, M.J. van; Hopman, M.T.E.; Bloem, B.R.

    2011-01-01

    The pathophysiology of orthostatic hypotension in Parkinson's disease (PD) is incompletely understood. The primary focus has thus far been on failure of the baroreflex, a central mediated vasoconstrictor mechanism. Here, we test the role of two other possible factors: 1) a reduced peripheral

  6. Spontan cerebrospinalvæskelækage kan give intrakraniel hypotension

    DEFF Research Database (Denmark)

    Christiansen, Ingelise

    2015-01-01

    Spontaneous intracranial hypotension (SIH) is often misinterpreted as migraine or tension headache. This type of headache is, however, orthostatic and resolves in supine position. CT scan/MRI of the brain has characteristic findings, enhancement of the pachymeninges and bilateral hygroma...

  7. Association Between Orthostatic Hypotension and Handgrip Strength With Successful Rehabilitation in Elderly Hip Fracture Patients

    NARCIS (Netherlands)

    Hartog, L. C.; Winters, A. M.; Roijen, H.; Kamper, A. M.; Inia, H.; Kleefstra, N.; Bilo, H. J. G.; van Hateren, K. J. J.

    Objective: To investigate the relationship between orthostatic hypotension (OH) and muscle strength versus time to successful rehabilitation within elderly patients with hip fracture. Design: A prospective, observational cohort study. Handgrip strength was measured at the day of admission and OH as

  8. Orthostatic hypotension, diabetes, and falling in older patients : a cross-sectional study

    NARCIS (Netherlands)

    van Hateren, Kornelis J. J.; Kleefstra, Nanne; Blanker, Marco H.; Ubink-Veltmaat, Lielith J.; Groenier, Klaas H.; Houweling, Sebastiaan; Kemper, Adriaan M.; van der Meer, Klaas; Bilo, Henk J. G.

    2012-01-01

    Background: Although orthostatic hypotension (OH) is more prevalent in old age, and in patients with diabetes, the prevalence of OH in older patients with type 2 diabetes mellitus is unknown. Aim: To establish the prevalence of OH, and its association with falling, in home-dwelling older

  9. Vasorelaxing Action of the Kynurenine Metabolite, Xanthurenic Acid: The Missing Link in Endotoxin-Induced Hypotension?

    Directory of Open Access Journals (Sweden)

    Carmine Vecchione

    2017-05-01

    Full Text Available The kynurenine pathway of tryptophan metabolism is activated by pro-inflammatory cytokines. L-kynurenine, an upstream metabolite of the pathway, acts as a putative endothelium-derived relaxing factor, and has been hypothesized to play a causative role in the pathophysiology of inflammation-induced hypotension. Here, we show that xanthurenic acid (XA, the transamination product of 3-hydroxykynurenine, is more efficacious than L-kynurenine in causing relaxation of a resistance artery, but fails to relax pre-contracted aortic rings. In the mesenteric artery, XA enhanced activating phosphorylation of endothelial nitric oxide synthase (NOS, and the relaxing action of XA was abrogated by pharmacological inhibition of NOS and endothelial-derived hyperpolarizing factor. Systemic injection of XA reduced blood pressure in mice, and serum levels of XA increased by several fold in response to a pulse with the endotoxin, lipopolysaccharide (LPS. LPS-induced hypotension in mice was prevented by pre-treatment with the kynurenine monooxygenase (KMO inhibitor, Ro-618048, which lowered serum levels of XA but enhanced serum levels of L-kynurenine. UPF 648, another KMO inhibitor, could also abrogate LPS-induced hypotension. Our data identify XA as a novel vasoactive compound and suggest that formation of XA is a key event in the pathophysiology of inflammation-induced hypotension.

  10. Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture

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    Louhab N

    2014-01-01

    Full Text Available Nissrine Louhab,1 Nawal Adali,1 Mehdi Laghmari,2 Wafae El Hymer,2 Said Ait Ben Ali,2 Najib Kissani11Neurology Department, 2Neurosurgery Department, University Hospital of Mohammed the VIth, Cadi Ayyad University, Marrakech, MoroccoIntroduction: Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF hypovolemia.Objective: To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture.Observation: A 34-year-old man presented with acute postural headache. The first cerebral computed tomography scan was normal. Lumbar puncture showed hyperproteinorachy at 2 g/L with six lymphocytic cells. The headache became very intense. At admission, clinical examination was normal. Ophthalmological examination did not show any abnormalities. Encephalic magnetic resonance imaging (MRI showed bilateral subdural hematoma with tonsillar descent simulating Chiari type I malformation. After surgical drainage and symptomatic treatment, the patient was discharged with no recurrence.Conclusion: Spontaneous intracranial hypotension is associated with simple clinical presentation, orthostatic headache, and characteristic MRI findings. Misdiagnosed, it leads to unnecessary procedures.Keywords: intracranial hypotension, headache, magnetic resonance imaging

  11. Effects of hemorrhagic hypotension on tyrosine concentrations in rat spinal cord and plasma

    Science.gov (United States)

    Conlay, L. A.; Maher, T. J.; Roberts, C. H.; Wurtman, R. J.

    1988-01-01

    Tyrosine is the precursor for catecholamine neurotransmitters. When catecholamine-containing neurons are physiologically active (as sympathoadrenal cells are in hypotension), tyrosine administration increases catecholamine synthesis and release. Since hypotension can alter plasma amino acid composition, the effects of an acute hypotensive insult on tyrosine concentrations in plasma and spinal cord were examined. Rats were cannulated and bled until the systolic blood pressure was 50 mmHg, or were kept normotensive for 1 h. Tyrosine and other large neutral amino acids (LNAA) known to compete with tyrosine for brain uptake were assayed in plasma and spinal cord. The rate at which intra-arterial (H-3)tyrosine disappeared from the plasma was also estimated in hemorrhaged and control rats. In plasma of hemorrhaged animals, both the tyrosine concentration and the tyrosine/LNAA ratio was elevated; moreover, the disappearance of (H-3)tyrosine was slowed. Tyrosine concentrations also increased in spinal cords of hemorrhaged-hypotensive rats when compared to normotensive controls. Changes in plasma amino acid patterns may thus influence spinal cord concentrations of amino acid precursors for neurotransmitters during the stress of hemorrhagic shock.

  12. Hypotension in patients on chronic peritoneal dialysis: etiology, management, and outcome.

    Science.gov (United States)

    Malliara, Maria; Passadakis, Ploumis; Panagoutsos, Stylianos; Theodoridis, Marios; Thodis, Elias; Bargman, Joanne; Jassal, Vanita; Vas, Stephen; Vargemezis, Vassilios; Oreopoulos, Dimitrios

    2002-01-01

    We retrospectively evaluated the phenomenon of arterial hypotension in peritoneal dialysis (PD) in a large cohort of 633 PD patients from two centers (Toronto Western Hospital, Toronto, Canada, and Division of Nephrology, Democritus University of Thrace, Greece), thus extending our previously reported experience for an additional 6 years (1995-2000). Together, the units had 81 hypotensive patients (12.8%), whose mean age was 63.8 +/- 14.2 years and whose mean duration of peritoneal dialysis was 49.3 +/- 30 months. Based on the underlying pathophysiology, the hypotensive PD patients were divided into four groups: (A) hypovolemia, 32 patients (39.5%); (B) congestive heart failure (CHF), 15 patients (18.5%); (C) receiving antihypertensive medications, 11 patients (13.6%); and (D) "unknown" etiology, 23 patients (28.4%). All patients in the hypovolemic and antihypertensive groups responded well to treatment (volume expansion and discontinuation of antihypertensive medication, respectively), but in the CHF and "unknown" groups, only 40% improved with the appropriate intervention. Patients in the latter two groups showed the poorest prognosis, with an approximate death rate of 65%. The hypovolemic group had better outcomes, which might reflect prompt response to fluid replacement in that group. We conclude that, in PD patients, careful use of antihypertensive medication, the right evaluation of target weight (especially in patients with cardiac failure), and judicious use of hypertonic exchanges may prevent the severe complication of arterial hypotension.

  13. Effects of exercise intensity and creatine loading on post-resistance exercise hypotension

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    Moreno Rodrigues Moreno

    2009-01-01

    Postexercise hypotension plays an important role in the non-pharmacological treat-ment of hypertension and is characterized by a decrease in blood pressure after a single exercise bout in relation to pre-exercise levels. This study investigated the effects of exercise intensity and creatine monohydrate supplementation on postexercise hypotension, as well as the possible role of blood lactate in this response. Ten normotensive subjects underwent resistance exercise sessions before (BC and after (AC creatine supplementation: 1 muscle endurance (ME consisting of 30 repetitions at 30% of one-repetition maximum; 2 hypertrophy (HP consisting of 8 repetitions at 75% of one-repetition maximum. Blood pressure was measured before and after the exercise bout. Blood lactate was measured after the exercise bout. The HP and ME sessions promoted a decrease in systolic blood pressure (∆ -19 ± 1.0 mmHg; ∆ -15 ± 0.9 mmHg, respectively, P 0.05. In conclusion, resistance exercise intensity did not influence postexercise hypotension. Creatine supplementation attenuated the decrease in blood pressure after resistance exercise. The results suggest the involvement of blood lactate in post-resistance exercise hypotension.

  14. Effects of exercise intensity and creatine loading on post-resistance exercise hypotension

    Directory of Open Access Journals (Sweden)

    Moreno Rodrigues Moreno

    2009-09-01

    Full Text Available Postexercise hypotension plays an important role in the non-pharmacological treat-ment of hypertension and is characterized by a decrease in blood pressure after a single exercise bout in relation to pre-exercise levels. This study investigated the effects of exercise intensity and creatine monohydrate supplementation on postexercise hypotension, as well as the possible role of blood lactate in this response. Ten normotensive subjects underwent resistance exercise sessions before (BC and after (AC creatine supplementation: 1 muscle endurance (ME consisting of 30 repetitions at 30% of one-repetition maximum; 2 hypertrophy (HP consisting of 8 repetitions at 75% of one-repetition maximum. Blood pressure was measured before and after the exercise bout. Blood lactate was measured after the exercise bout. The HP and ME sessions promoted a decrease in systolic blood pressure (∆ -19 ± 1.0 mmHg; ∆ -15 ± 0.9 mmHg, respectively, P 0.05. In conclusion, resistance exercise intensity did not influence postexercise hypotension. Creatine supplementation attenuated the decrease in blood pressure after resistance exercise. The results suggest the involvement of blood lactate in post-resistance exercise hypotension.

  15. Profound hypotension after an intradermal injection of indigo carmine for sentinel node mapping.

    Science.gov (United States)

    Jo, Youn Yi; Lee, Mi Geum; Yun, Soon Young; Lee, Kyung Cheon

    2013-03-01

    Intradermal injections of indigo carmine for sentinel node mapping are considered safe and no report of an adverse reaction has been published. The authors described two cases of profound hypotension in women that underwent breast-conserving surgery after an intradermal injection of indigo carmine into the periareolar area for sentinel node mapping.

  16. Profound Hypotension after an Intradermal Injection of Indigo Carmine for Sentinel Node Mapping

    OpenAIRE

    Jo, Youn Yi; Lee, Mi Geum; Yun, Soon Young; Lee, Kyung Cheon

    2013-01-01

    Intradermal injections of indigo carmine for sentinel node mapping are considered safe and no report of an adverse reaction has been published. The authors described two cases of profound hypotension in women that underwent breast-conserving surgery after an intradermal injection of indigo carmine into the periareolar area for sentinel node mapping.

  17. Effect of controlled hypotension on myocardial ischemia marker in eye-nose related surgery.

    Science.gov (United States)

    Jin, Yuexi; Jiang, Wanna; Ye, Wenlian; Jiang, Aifen; Liu, Le

    2016-11-01

    We aimed to investigate the effect of different controlled hypotension levels on myocardial enzymes and myocardial ischemia protein in elderly hypertension patients, and then provide clinical evidence of suitable controlled hypotension level for them. Then, 45 elderly hypertension patients received elective eye-nose related surgery with nasal endoscope, who were randomly and evenly divided into three groups, including A, B and C groups, with mean arterial pressure (MAP) decreased by 20%, 30% and 40% respectively. The change of myocardial enzymes, myocardial ischemia modified albumin, score of surgical field quality and 12-lead electrocardiogram at different perioperative points were recorded. Then operative time, urine output and postoperative adverse complications of the patients were recorded too. Myocardial enzymes of group C were higher than that of both group A and B at T4, T5 points (pControlled hypotension with MAP reduced by 30% brings minimum myocardial damage and fewer complications, while meeting the demand of surgical field. Thus it is an ideal controlled hypotension level and can be used for elderly hypertension patients safely.

  18. Use of remifentanil in comparison with sodium nitroprusside for controlled hypotension during rhinoplasty: Randomized controlled trail

    Directory of Open Access Journals (Sweden)

    Eman Mohammed Kamal Aboseif

    2015-10-01

    Conclusion: This study confirmed that remifentanil infusion with dose of 0.25–0.5 μg/kg/min. induced desired controlled hypotension intraoperatively during rhinoplasty with no complications occurred either intra- or postoperative with advantage of rapid recovery from anesthesia.

  19. Dynamic regulation of heart rate during acute hypotension: new insight into baroreflex function

    Science.gov (United States)

    Zhang, R.; Behbehani, K.; Crandall, C. G.; Zuckerman, J. H.; Levine, B. D.; Blomqvist, C. G. (Principal Investigator)

    2001-01-01

    To examine the dynamic properties of baroreflex function, we measured beat-to-beat changes in arterial blood pressure (ABP) and heart rate (HR) during acute hypotension induced by thigh cuff deflation in 10 healthy subjects under supine resting conditions and during progressive lower body negative pressure (LBNP). The quantitative, temporal relationship between ABP and HR was fitted by a second-order autoregressive (AR) model. The frequency response was evaluated by transfer function analysis. Results: HR changes during acute hypotension appear to be controlled by an ABP error signal between baseline and induced hypotension. The quantitative relationship between changes in ABP and HR is characterized by a second-order AR model with a pure time delay of 0.75 s containing low-pass filter properties. During LBNP, the change in HR/change in ABP during induced hypotension significantly decreased, as did the numerator coefficients of the AR model and transfer function gain. Conclusions: 1) Beat-to-beat HR responses to dynamic changes in ABP may be controlled by an error signal rather than directional changes in pressure, suggesting a "set point" mechanism in short-term ABP control. 2) The quantitative relationship between dynamic changes in ABP and HR can be described by a second-order AR model with a pure time delay. 3) The ability of the baroreflex to evoke a HR response to transient changes in pressure was reduced during LBNP, which was due primarily to a reduction of the static gain of the baroreflex.

  20. Orthostatic hypotension and risk of cardiovascular disease in elderly people: The Rotterdam study

    NARCIS (Netherlands)

    G.C. Verwoert (Germaine); F.U.S. Mattace Raso (Francesco); J. Heeringa (Jan); B.H.Ch. Stricker (Bruno); M.M.B. Breteler (Monique); J.C.M. Witteman (Jacqueline); A. Hofman (Albert)

    2008-01-01

    textabstractOBJECTIVES: To determine the prognostic role of orthostatic hypotension for cardiovascular disease (CVD) and all-cause mortality in elderly people. DESIGN: Prospective study. SETTING: Community based. PARTICIPANTS: Five thousand sixty-four subjects from the Rotterdam study aged 55 and

  1. A thin line between Meniere’s disease and spontaneous intracranial hypotension syndrome

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    Iva Botica

    2016-02-01

    Full Text Available Aim To point out the similarity of Meniere disease and spontaneous intracranial hypotension and difference of their treatment. Methods A case of a 54-year-old male patient with previously diagnosed Meniere’s disease and newly diagnosed spontaneous intracranial hypotension syndrome is presented. Additional neuroradiological examination, Brain contrast-enhanced MRI and MR myelography were used for diagnosis. Results Due to deterioration of vertigo, hearing loss and tinnitus in the right ear the patient was referred to the additional neuroradiological examination which confirmed the diagnosis of spontaneous intracranial hypotension syndrome. Brain contrast-enhanced MRI showed increased pachymeningeal contrast enhancement, and MR myelography identified the location of CSF leak. The patient was successfully treated conservatively. Conclusion According to our knowledge this is the fifth case report of Meniere’s disease and spontaneous intracranial hypotension coexistence. Both diseases have similar clinical presentation and initial treatment. We suggest procedures of additional examination when the treatment fails and initial diagnosis becomes questionable.

  2. Brain function after near-term birth : the effects of hypoxemia and hypotension

    NARCIS (Netherlands)

    Os, Sandra Henrica Gerarda van

    2005-01-01

    This thesis describes the effects of hypoxemia and hypotension on brain cell function and brain metabolism in the near-term born lamb. Electrocortical brain activity (ECBA), which was used as a measure of brain cell function, was correlated to measures of energy failure and brain cell damage. Lambs

  3. Mesenteric artery response to head-up tilt-induced central hypovolaemia and hypotension

    DEFF Research Database (Denmark)

    Perko, M J; Madsen, P; Perko, Grazyna

    1997-01-01

    Superior mesenteric artery (SMA) blood flow and impedance were evaluated by duplex ultrasound during head-up tilt (HUT)-induced central hypovolaemia and hypotension in eight healthy volunteers. HUT induced a reduction in cardiac stroke volume from 88.8 +/- 6.3 to 64.7 +/- 6.3 ml (mean +/- SEM; P ...

  4. The Pig--Pet, Pork or Sacrifice?

    Science.gov (United States)

    Arnold, Arthur

    1988-01-01

    Discusses the various roles of the pig in children's books, including E. B. White's CHARLOTTE'S WEB and Nina Bawden's PEPPERMINT PIG. Notes that, although pigs are often used as metaphors for greed, gluttony, and squalor, the portrayal of pigs in children's literature is typically positive. (MM)

  5. Metabolomic phenotyping of af cloned pig model

    DEFF Research Database (Denmark)

    Clausen, Morten Rahr; Christensen, Kirstine Lykke; Hedemann, Mette Skou

    2011-01-01

    outbred pigs. Results The metabolic phenotype of cloned pigs (n = 5) was for the first time elucidated by nuclear magnetic resonance (NMR)-based metabolomic analysis of multiple bio-fluids including plasma, bile and urine. The metabolic phenotype of the cloned pigs was compared with normal outbred pigs (n...

  6. Candida infections in newborns: a review.

    Science.gov (United States)

    Khoory, B J; Vino, L; Dall'Agnola, A; Fanos, V

    1999-10-01

    Despite adequate treatment, nosocomial fungal infections have become an increasingly important cause of morbidity, extended hospitalization, and mortality in critically ill newborn babies. Furthermore, the high incidence of central nervous system involvement in septic newborns frequently results in serious neurological damage and psychomotorial sequelae. The prevention of fungal colonization in the population at risk, together with prompt diagnosis and treatment, are an efficient combination which lead to a better outcome of neonatal fungal infections. New drugs characterized by great efficacy and tolerance have recently been employed in clinical practice. This article summarizes certain aspects of Candida spp. infections in the neonatal period with regard to multisystemic presentation and involvement.

  7. Effects of prophylactic ondansetron on spinal anesthesia-induced hypotension: a meta-analysis.

    Science.gov (United States)

    Gao, L; Zheng, G; Han, J; Wang, Y; Zheng, J

    2015-11-01

    A range of strategies including physical interventions, intravenous fluids and vasopressor drugs have been used to minimize or prevent spinal anesthesia-induced hypotension. Recent studies suggest that ondansetron, a commonly used antiemetic, also affects hypotension. This systematic review investigated the effects of prophylactic ondansetron on hemodynamic changes following spinal anesthesia. Medline, Embase, Cochrane Library databases and www.clinicaltrials.gov were searched for randomized controlled trials studying the effects of ondansetron on hemodynamic changes induced by spinal anesthesia. The primary outcome was hypotension. Relative risk (RR) or mean difference, with 95% confidence intervals (CI), were used to analyze outcomes. Ten randomized controlled trials with 863 patients were included in the analysis. Prophylactic ondansetron reduced the incidence of spinal anesthesia-induced hypotension in both obstetric and non-obstetric patients. The RR of spinal anesthesia-induced hypotension after ondansetron administration was 0.53 (95% CI 0.32 to 0.86) in obstetric patients and 0.16 (95% CI 0.05 to 0.51) in non-obstetric patients. There was significant heterogeneity among obstetric studies (I(2) = 71%). Ondansetron also reduced the incidence of bradycardia, nausea and vomiting after spinal anesthesia with RRs of 0.27 (95% CI 0.16 to 0.47), 0.24 (95% CI 0.14 to 0.42) and 0.48 (95% CI 0.08 to 3.08), respectively. The doses of ephedrine and phenylephrine required to treat hypotension were reduced by ondansetron with mean differences of -2.35 mg (95% CI -4.14 to -0.55 mg) and -31.16 μg (95% CI -57.46 to -4.87 μg), respectively. This review suggests that prophylactic ondansetron reduces the incidence of spinal anesthesia-induced hypotension and vasopressor consumption in both obstetric and non-obstetric patients. In addition, ondansetron can also reduce related adverse outcomes such as bradycardia, nausea and vomiting. However, given the relatively large

  8. The Effect of Combined Out-of-Hospital Hypotension and Hypoxia on Mortality in Major Traumatic Brain Injury.

    Science.gov (United States)

    Spaite, Daniel W; Hu, Chengcheng; Bobrow, Bentley J; Chikani, Vatsal; Barnhart, Bruce; Gaither, Joshua B; Denninghoff, Kurt R; Adelson, P David; Keim, Samuel M; Viscusi, Chad; Mullins, Terry; Sherrill, Duane

    2017-01-01

    Survival is significantly reduced by either hypotension or hypoxia during the out-of-hospital management of major traumatic brain injury. However, only a handful of small studies have investigated the influence of the combination of both hypotension and hypoxia occurring together. In patients with major traumatic brain injury, we evaluate the associations between mortality and out-of-hospital hypotension and hypoxia separately and in combination. All moderate or severe traumatic brain injury cases in the preimplementation cohort of the Excellence in Prehospital Injury Care study (a statewide, before/after, controlled study of the effect of implementing the out-of-hospital traumatic brain injury treatment guidelines) from January 1, 2007, to March 31, 2014, were evaluated (exclusions: 200 mm Hg). The relationship between mortality and hypotension (systolic blood pressure controlling for Injury Severity Score, head region severity, injury type (blunt versus penetrating), age, sex, race, ethnicity, payer, interhospital transfer, and trauma center. Among the 13,151 patients who met inclusion criteria (median age 45 years; 68.6% men), 11,545 (87.8%) had neither hypotension nor hypoxia, 604 (4.6%) had hypotension only, 790 (6.0%) had hypoxia only, and 212 (1.6%) had both hypotension and hypoxia. Mortality for the 4 study cohorts was 5.6%, 20.7%, 28.1%, and 43.9%, respectively. The crude and adjusted odds ratios for death within the cohorts, using the patients with neither hypotension nor hypoxia as the reference, were 4.4 and 2.5, 6.6 and 3.0, and 13.2 and 6.1, respectively. Evaluation for an interaction between hypotension and hypoxia revealed that the effects were additive on the log odds of death. In this statewide analysis of major traumatic brain injury, combined out-of-hospital hypotension and hypoxia were associated with significantly increased mortality. This effect on survival persisted even after controlling for multiple potential confounders. In fact, the

  9. In vivo hypotensive effect and in vitro inhibitory activity of some Cyperaceae species

    Directory of Open Access Journals (Sweden)

    Monica Lacerda Lopes Martins

    2013-12-01

    Full Text Available In 1820, French naturalist August Saint Hillaire, during a visit in Espírito Santo (ES, a state in southeastern Brazil, reported a popular use of Cyperaceae species as antidote to snake bites. The plant may even have a hypotensive effect, though it was never properly researched. The in vitro inhibitory of the angiotensin converting enzyme (ACE activity of eigth ethanolic extracts of Cyperaceae was evaluated by colorimetric assay. Total phenolic and flavonoids were determined using colorimetric assay. The hypotensive effect of the active specie (Rhychonospora exaltata, ERE and the in vivo ACE assay was measured in vivo using male Wistar Kyoto (ERE, 0.01-100mg/kg, with acetylcholine (ACh as positive control (5 µg/kg, i.v.. The evaluation of ACE in vivo inhibitory effect was performed comparing the mean arterial pressure before and after ERE (10 mg/kg in animals which received injection of angiotensin I (ANG I; 0,03, 03 and 300 µg/kg, i.v.. Captopril (30 mg/kg was used as positive control. Bulbostylis capillaris (86.89 ± 15.20% and ERE (74.89 ± 11.95%, ERE were considered active in the in vitro ACE inhibition assay, at 100 µg/mL concentration. ACh lead to a hypotensive effect before and after ERE's curve (-40±5% and -41±3%. ERE showed a dose-dependent hypotensive effect and a in vivo ACE inhibitory effect. Cyperaceae species showed an inhibitory activity of ACE, in vitro, as well as high content of total phenolic and flavonoids. ERE exhibited an inhibitory effect on both in vitro and in vivo ACE. The selection of species used in popular medicine as antidotes, along with the in vitro assay of ACE inhibition, might be a biomonitoring method for the screening of new medicinal plants with hypotensive properties.

  10. Risk of intraoperative hypotension with loop diuretics: a randomized controlled trial.

    Science.gov (United States)

    Khan, Nadia A; Campbell, Norman R; Frost, Shaun D; Gilbert, Ken; Michota, Frank A; Usmani, Ali; Seal, Doug; Ghali, William A

    2010-11-01

    There is growing concern regarding the safety of blood pressure-lowering medications administered during the perioperative period. Whether loop diuretics also induce intraoperative hypotension is uncertain. Our objective was to compare the effects of continuing or withholding furosemide on the day of noncardiac elective surgery on intraoperative hypotension among chronic users of furosemide. A double blind, randomized, placebo controlled trial was conducted at 3 North American university centers between September 2000 and December 2006. Participants were randomly assigned in a 1:1 ratio to receive either furosemide or placebo on the day of surgery. The primary outcome was risk of developing intraoperative hypotension. A priori secondary outcomes included risk of heart failure; composite cardiovascular event (myocardial infarction, arrhythmia, stroke or transient ischemic attack, or death); and change in renal function and electrolytes. Of the 212 patients enrolled, 193 patients underwent surgery. There was no significant difference in risk of developing intraoperative hypotension between the furosemide (49%) and placebo (51.9%) groups (relative risk [RR], 0.95; 95% confidence interval [CI], 0.72-1.24; P = .78). The intraoperative administration of vasopressors and fluids were similar between both groups. The risk of developing postoperative cardiovascular events was not significantly different between those randomized to furosemide (4.8%) or placebo (2.8%) (RR, 1.73; 95% CI, 0.42-7.06; P = .49). There was no significant difference in renal function or electrolytes between the 2 groups. Among elective, noncardiac surgeries in patients chronically treated with furosemide, the administration of furosemide on the day of surgery did not significantly increase the risk for intraoperative hypotension. Copyright © 2010 Elsevier Inc. All rights reserved.

  11. Neurogenic orthostatic hypotension: a double-blind, placebo-controlled study with midodrine

    Science.gov (United States)

    Jankovic, J.; Gilden, J. L.; Hiner, B. C.; Kaufmann, H.; Brown, D. C.; Coghlan, C. H.; Rubin, M.; Fouad-Tarazi, F. M.

    1993-01-01

    PURPOSE: To investigate the efficacy and safety of midodrine for treatment of patients with orthostatic hypotension due to autonomic failure. PATIENTS: Ninety-seven patients with orthostatic hypotension were randomized in a 4-week, double-blinded, placebo-controlled study with a 1-week placebo run-in period. Patients ranged in age from 22 to 86 years (mean: 61 years). METHODS: After a 1-week run-in phase, either placebo or midodrine at a dose of 2.5 mg, 5 mg, or 10 mg was administered three times a day for 4 weeks. Both the placebo group and the 2.5-mg midodrine group received constant doses throughout the double-blind phase. The patients receiving 5 mg or 10 mg of midodrine were given doses that were increased at weekly intervals by 2.5-mg increments until the designated dose was reached. Efficacy evaluations were based on an improvement at 1-hour postdose in standing systolic blood pressure and in symptoms of orthostatic hypotension (syncope, dizziness/lightheadedness, weakness/fatigue, and low energy level). RESULTS: Midodrine (10 mg) increased standing systolic blood pressure by 22 mm Hg (28%, p hypotension compared to placebo: dizziness/lightheadedness, weakness/fatigue, syncope, low energy level, impaired ability to stand, and feelings of depression. The overall side effects were mainly mild to moderate. One or more side effects were reported by 22% of the placebo group compared with 27% of the midodrine-treated group. Scalp pruritus/tingling, which was reported by 10 of 74 (13.5%) of the midodrine-treated patients, was most frequent. Other reported side effects included supine hypertension (8%) and feelings of urinary urgency (4%). CONCLUSION: We conclude that midodrine is an effective and well-tolerated treatment for moderate-to-severe orthostatic hypotension associated with autonomic failure.

  12. Controlled hypotension for functional endoscopic sinus surgery: comparison of esmolol and nitroglycerine.

    Science.gov (United States)

    Srivastava, U; Dupargude, A B; Kumar, D; Joshi, K; Gupta, A

    2013-08-01

    Intraoperative bleeding causing poor visibility of surgical field is of major concern during functional endoscopic sinus surgery (FESS) and impaired visibility may result in many complications. The study aimed to compare surgical conditions for FESS during controlled hypotension provided by esmolol or nitroglycerine (NTG) under general anaesthesia. 52 adult patients of both sexes requiring FESS under general anaesthesia were randomly divided to receive either esmolol (group ESM, n = 26) or NTG (group NTG, n = 26) to provide controlled hypotension. Surgical condition was assessed by surgeon using average category scale (ACS) of 0-5, a value of 2-3 being ideal. In both groups mean arterial blood pressure (MABP) was gradually reduced till ACS for assessment of surgical condition (ACS) of 2-3 or lowest targeted MABP (60 mm of Hg) was achieved. Both the drugs produced desired hypotension and improved surgical condition by reducing operative field bleeding but ideal operative conditions were achieved at mild hypotension (MABP 75-70) in ESM group while same conditions were achieved at MABP of 69-65 mm of Hg in NTG group. Mean heart rate was significantly higher in NTG group as compared to ESM group. Blood loss was significantly less in ESM group. Both NTG and esmolol can be used safely to provide controlled hypotension during FESS. Both the drugs improved visibility of surgical field by reducing capillary bleeding. But esmolol offered better operative conditions with only minimal reduction in MABP. No reflex tachycardia and less intraoperative haemorrhage were additional advantages of esmolol.

  13. Effects of noise exposure on neonatal auditory brainstem response thresholds in pregnant guinea pigs at different gestational periods.

    Science.gov (United States)

    Morimoto, Chihiro; Nario, Kazuhiko; Nishimura, Tadashi; Shimokura, Ryota; Hosoi, Hiroshi; Kitahara, Tadashi

    2017-01-01

    Noise exposure during pregnancy has been reported to cause fetal hearing impairment. However, little is known about the effects of noise exposure during various gestational stages on postnatal hearing. In the present study, we investigated the effects of noise exposure on auditory brainstem response (ABR) at the early, mid-, and late gestational periods in newborn guinea pigs. Pregnant guinea pigs were exposed to 4-kHz pure tone at a 120-dB sound pressure level for 4 h. We divided the animals into four groups as follows: the control, early gestational exposure, mid-gestational exposure, and late gestational exposure groups. ABR thresholds and latencies in newborns were recorded using 1-, 2-, and 4-kHz tone burst on postnatal days 1, 7, 14, and 28. Changes in ABR thresholds and latencies were measured between the 4 × 4 and 4 × 3 factorial groups mentioned above (gestational periods × postnatal days, gestational periods × frequencies). The thresholds were low in the order of control group exposure group exposure group and late gestational exposure group. Noise exposure during pregnancy influenced ABR thresholds in neonatal guinea pigs. This is the first study to show that noise exposure during the early, mid-, and late gestational periods significantly elevated ABR thresholds in neonatal guinea pigs. © 2016 Japan Society of Obstetrics and Gynecology.

  14. [Comparative studies on the resorption, anti-anemic action and growth effect of FV-82 and dextrofer-100 on pigs].

    Science.gov (United States)

    Dilov, P; Chakŭrov, R; Iotsev, M; Iordanov, S

    1984-01-01

    Comparative investigations were carried out on the absorption, antianemic action, and growth effect with newborn pigs with FB-82 and dextrofer-100 (an iron dextran complex with 100 mg Fe3+ per cm3) injected i/m. The FB-82 is a combined preparation of 3500000 IU Tylosine tartrate, 0.008 g cyanocobalamin, 0.5 g pyridoxine hydrochloride, 0.1 g tartaric acid, and iron dextran up to 100 cm3 (= 100 mg Fe3+/cm3). Dextrofer-100 enriched with 50 mg Zn, 0.5 mg Co, 200 micrograms cyanocobalamin, and 100 mg pyridoxine hydrochloride for 100 cm3 under the compound name of fericin was also used to compare the anti-anemic effect of FB-82 and dextrofer-100. It was found that FB-82 applied to newborn pigs in a single dose of 2 cm3, i/m, was well absorbed; it developed high concentrations of tylosine in the plasma, and its sideremia and antianemic action were similar to those induced by an equivalent (with regard to iron) amount of dextrofer-100, whereas the result concerning the hematocrit value was better. Compared to dextrofer-100 the FB-82 preparation have better protection to pigs (lowered the mortality rate) and induced better development of the animals. Fericin did not differ essentially from FB-82 in terms of its effect on the red blood picture, however, the percent of protected pigs was lower.

  15. Newborn Screening for Lysosomal Storage Disorders and Other Neuronopathic Conditions

    Science.gov (United States)

    Matern, Dietrich; Oglesbee, Devin; Tortorelli, Silvia

    2013-01-01

    Newborn screening (NBS) is a public health program aimed at identifying treatable conditions in presymptomatic newborns to avoid premature mortality, morbidity, and disabilities. Currently, every newborn in the Unites States is screened for at least 29 conditions where evidence suggests that early detection is possible and beneficial. With new or…

  16. Infrared thermography--a non-invasive tool to evaluate thermal status of neonatal pigs based on surface temperature.

    Science.gov (United States)

    Kammersgaard, T S; Malmkvist, J; Pedersen, L J

    2013-12-01

    Hypothermia is a major cause of mortality in neonatal pigs. Infrared (IR) thermography is a promising non-invasive method to assess thermal status, but has not been evaluated for use on neonatal pigs from birth. The aim of this study was to evaluate the application of IR thermography as a non-invasive tool to estimate body temperature and assess the thermal status in newborn pigs by (1) estimating the relationship between surface temperature and rectal temperature (RT) in neonatal pigs; and (2) estimating the influence of air temperature (AT), birth weight and the time from birth on the relationship between surface temperature and RT. The method was evaluated on the basis of 1695 thermograms and 915 RTs on 91 neonatal pigs born in loose farrowing pens with floor heating at 34°C, and three different ATs (15°C, 20°C and 25°C). Full-body thermograms of the back and the side of the pigs and RT were acquired at 11 sampling times between birth and 48 h after birth. The maximum (IRmax), minimum, average of the full body and ear minimum IR surface temperatures were derived from the thermograms. IRmax had the highest correlation with RT (0.82) and was therefore used in the statistical analysis. The relation of RT by IRmax depended on time at: 0 h (slope: 0.20°C, Pthermal status in neonatal piglets but not as an identical substitute for RT.

  17. Survival analysis of hypotensive cats admitted to an intensive care unit with or without hyperlactatemia: 39 cases (2005-2011).

    Science.gov (United States)

    Shea, Emily K; Dombrowski, Stefan C; Silverstein, Deborah C

    2017-04-15

    OBJECTIVE To examine the association between blood lactate concentration and survival to hospital discharge in critically ill hypotensive cats. DESIGN Retrospective case series. ANIMALS 39 cats admitted to an intensive care unit of a university veterinary hospital between January 2005 and December 2011 for which blood lactate concentration was recorded ≤ 1 hour before or after a Doppler-derived arterial blood pressure measurement ≤ 90 mm Hg (ie, hypotension) was obtained. PROCEDURES Medical records of each cat were reviewed to assess survival to hospital discharge, illness severity, duration of hospitalization, age, body weight, and PCV. Results were compared between hypotensive cats with and without hyperlactatemia (blood lactate concentration ≥ 2.5 mmol/L). RESULTS 6 of 39 (15%) hypotensive cats survived to hospital discharge. Twelve (31%) cats were normolactatemic (blood lactate concentration cats with normolactatemia had a higher blood pressure and higher survival rate than hypotensive cats with hyperlactatemia. Five-day Kaplan-Meier survival rates were 57% for normolactatemic cats and 17% for hyperlactatemic cats. Age, body weight, duration of hospitalization, PCV, and illness severity did not differ significantly between hypotensive cats with and without hyperlactatemia. CONCLUSIONS AND CLINICAL RELEVANCE Hypotensive, normolactatemic cats in an intensive care unit had a significantly greater chance of survival to hospital discharge than their hyperlactatemic counterparts. Blood lactate concentration may be a useful prognostic indicator for this patient population when used in conjunction with other clinical and laboratory findings.

  18. The organizational structure of an intensive care unit influences treatment of hypotension among critically ill patients: A retrospective cohort study.

    Science.gov (United States)

    Boone, M Dustin; Massa, Jennifer; Mueller, Ariel; Jinadasa, Sayuri P; Lee, Joon; Kothari, Rishi; Scott, Daniel J; Callahan, Julie; Celi, Leo Anthony; Hacker, Michele R

    2016-06-01

    Prior studies report that weekend admission to an intensive care unit is associated with increased mortality, potentially attributed to the organizational structure of the unit. This study aims to determine whether treatment of hypotension, a risk factor for mortality, differs according to level of staffing. Using the Multiparameter Intelligent Monitoring in Intensive Care database, we conducted a retrospective study of patients admitted to an intensive care unit at Beth Israel Deaconess Medical Center who experienced one or more episodes of hypotension. Episodes were categorized according to the staffing level, defined as high during weekday daytime (7 am-7 pm) and low during weekends or nighttime (7 pm-7 am). Patients with a hypotensive event on a weekend were less likely to be treated compared with those that occurred during the weekday daytime (P = .02). No association between weekday daytime vs weekday nighttime staffing levels and treatment of hypotension was found (risk ratio, 1.02; 95% confidence interval, 0.98-1.07). Patients with a hypotensive event on a weekend were less likely to be treated than patients with an event during high-staffing periods. No association between weekday nighttime staffing and hypotension treatment was observed. We conclude that treatment of a hypotensive episode relies on more than solely staffing levels. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Period-dependent Associations between Hypotension during and for Four Days after Noncardiac Surgery and a Composite of Myocardial Infarction and Death

    DEFF Research Database (Denmark)

    Sessler, Daniel I; Meyhoff, Christian S; Zimmerman, Nicole M

    2018-01-01

    BACKGROUND: The relative contributions of intraoperative and postoperative hypotension to perioperative morbidity remain unclear. We determined the association between hypotension and a composite of 30-day myocardial infarction and death over three periods: (1) intraoperative, (2) remaining day...... using a distinct effect generalized estimating model, adjusting for hypotension during earlier periods. RESULTS: Among 9,765 patients, 42% experienced hypotension, 590 (6.0%) had an infarction, and 116 (1.2%) died within 30 days of surgery. Intraoperatively, the estimated average relative effect across...... perioperative periods, even after adjustment for previous hypotension....

  20. Peritoneal drainage for newborn intestinal perforation: primary ...

    African Journals Online (AJOL)

    Tel: +1 915 545 6855; fax: +1 915 545 6864; e-mail: donald.meier@ttuhsc.edu. Received 10 September 2012 accepted 23 February 2013. Introduction. Peritoneal drainage (PD) was first described as a temporizing measure for the treatment of extremely ill newborns with intestinal perforation (IP) [1]. Subse- quent reports ...

  1. Congenital Malaria Among Newborns Admitted for Suspected ...

    African Journals Online (AJOL)

    None of the clinical feature had good sensitivity, specificity or predictive value for congenital malaria, and only 1.6% death was recorded in a baby with high parasite density. Conclusion: Congenital malaria is common in newborns with suspected neonatal sepsis. History of peripartum pyrexia, prematurity and intrauterine ...

  2. Distinct DNA methylomes of newborns and centenarians

    DEFF Research Database (Denmark)

    Heyn, Holger; Li, Ning; Ferreira, Humberto J.

    2012-01-01

    Human aging cannot be fully understood in terms of the constrained genetic setting. Epigenetic drift is an alternative means of explaining age-associated alterations. To address this issue, we performed whole-genome bisulfite sequencing (WGBS) of newborn and centenarian genomes. The centenarian D...

  3. Rapid Targeted Genomics in Critically Ill Newborns

    NARCIS (Netherlands)

    van Diemen, Cleo C; Kerstjens-Frederikse, Wilhelmina S; Bergman, Klasien A; de Koning, Tom J; Sikkema-Raddatz, Birgit; van der Velde, Joeri K; Abbott, Kristin M; Herkert, Johanna C; Löhner, Katharina; Rump, Patrick; Meems-Veldhuis, Martine T; Neerincx, Pieter B T; Jongbloed, Jan D H; van Ravenswaaij-Arts, Conny M; Swertz, Morris A; Sinke, Richard J; van Langen, Irene M; Wijmenga, Cisca

    2017-01-01

    BACKGROUND: Rapid diagnostic whole-genome sequencing has been explored in critically ill newborns, hoping to improve their clinical care and replace time-consuming and/ or invasive diagnostic testing. A previous retrospective study in a research setting showed promising results with diagnoses in

  4. Transient Tachypnea of the Newborn (TTN)

    Science.gov (United States)

    ... if you see any. Call 911 if your baby: has trouble breathing breathes rapidly has skin that looks blue has skin in between the ribs or under the ribcage that pulls in during breathing Reviewed by: Rupal Christine Gupta, MD Date reviewed: October ... THIS TOPIC Common Diagnoses in the NICU When Your Baby's in the NICU Looking at Your Newborn: What's ...

  5. Birth defects in children with newborn encephalopathy

    NARCIS (Netherlands)

    Felix, JF; Badawi, N; Kurinczuk, JJ; Bower, C; Keogh, JM; Pemberton, PJ

    2000-01-01

    This study was designed to investigate birth defects found in association with newborn encephalopathy. All possible birth defects were ascertained in a population-based study of 276 term infants with moderate or severe encephalopathy and 564 unmatched term control infants. A strong association

  6. Congenital malformations among newborns in Kenya | Muga ...

    African Journals Online (AJOL)

    Available literature suggests that congenital malformations are a major cause of prenatal infant deaths and postnatal physical defects [1, 2]. Therefore, a study was conducted to determine the patterns and incidence of congenital malformations at birth in newborns in Kenya and thereby analyze associated predisposing ...

  7. Unexpected behavioural consequences of preterm newborns' clothing.

    Science.gov (United States)

    Durier, Virginie; Henry, Séverine; Martin, Emmanuelle; Dollion, Nicolas; Hausberger, Martine; Sizun, Jacques

    2015-03-17

    Restrictions of preterm newborns' movements could have consequences ranging from stress enhancement to impairment of their motor development. Therefore, ability to freely express motor activities appears crucial for their behavioural and physiological development. Our aim was to evaluate behavioural issues of two types of clothing used in NICU. We observed 18 healthy 34-37 post-conception week-old preterm newborns, during resting periods, when they were undisturbed by any interventions. Newborns wore either light clothing (bodysuit and a light wrapping) or heavy clothing (pyjamas, cardigan and sleep-sack). The percentages of time each subject spent in different postures were compared between clothing situations. Arm and hand postures differed in relation to clothing: babies bent their arms more and held their hands nearer their heads when in bodysuits than when in sleepwear. Consequently, babies in bodysuits spent more time touching their body or their environment whereas the others generally were touching nothing. Self-touch is an important way to comfort one's self. Heavy clothing may impair self-soothing behaviours of preterm newborn babies that already lack other forms of contact. Results suggest that more attention should be paid to apparently routine and marginal decisions such as choice of clothes.

  8. Macromastia in a newborn with Alagille syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Zinn, H.L.; Haller, J.O. [Department of Radiology, SUNY-Health Science Center at Brooklyn, NY (United States); Kedia, S. [Department of Radiology, St. Vincent`s Medical Center of Richmond, Staten Island, NY (United States)

    1999-05-01

    We present a case of macromastia in a newborn with Alagille syndrome. A review of the literature failed to find any prior reports of this finding in Alagille syndrome patients. We propose that this patient`s macromastia may be related to her liver failure and abnormal estrogen metabolism. (orig.) With 2 figs., 5 refs.

  9. Haemolytic disease of the fetus and newborn

    NARCIS (Netherlands)

    de Haas, M.; Thurik, F. F.; Koelewijn, J. M.; van der Schoot, C. E.

    2015-01-01

    Haemolytic Disease of the Fetus and Newborn (HDFN) is caused by maternal alloimmunization against red blood cell antigens. In severe cases, HDFN may lead to fetal anaemia with a risk for fetal death and to severe forms of neonatal hyperbilirubinaemia with a risk for kernicterus. Most severe cases

  10. Haemolytic disease of the fetus and newborn

    NARCIS (Netherlands)

    de Haas, M.; Thurik, F. F.; Koelewijn, J. M.; van der Schoot, C. E.

    Haemolytic Disease of the Fetus and Newborn (HDFN) is caused by maternal alloimmunization against red blood cell antigens. In severe cases, HDFN may lead to fetal anaemia with a risk for fetal death and to severe forms of neonatal hyperbilirubinaemia with a risk for kernicterus. Most severe cases

  11. Resuscitation of the Newborn: AN IMPROVED NEONATAL ...

    African Journals Online (AJOL)

    Insufflatory resuscitation of a newborn baby that has not breathed presents many problems. These are dependent not only on the size and prematurity of the neonate, but on the amount of fluid which is present in the alveoli of the lungs, and the absence of the functional residual capacity (FRC). Before adequate gaseous ...

  12. Peritoneal drainage for newborn intestinal perforation: primary ...

    African Journals Online (AJOL)

    Background Peritoneal drainage (PD) was introduced 30 years ago as a temporizing treatment for extremely ill newborns with intestinal perforation (IP). Subsequent reports have shown it to be helpful as a definitive treatment, whereas others have labeled it as an unnecessary delay before laparotomy. Methods This is a ...

  13. Congenital granular cell lesion in newborn mandible

    African Journals Online (AJOL)

    2011-07-06

    Jul 6, 2011 ... Congenital granular cell lesion (CGCL) is a rare non-neoplastic lesion found in newborns also known as Neumann's tumor. This benign lesion occurs predominantly in females mostly as a single mass. The histogenesis and natural history of the lesion remains obscure. It arises from the mucosa of the ...

  14. Multiple congenital defects in a newborn foal

    Directory of Open Access Journals (Sweden)

    J.F. Silva

    2014-12-01

    Full Text Available A case of multiple congenital defects in a newborn foal is reported. The animal showed hypoplasia of the left pelvic limb bones, uterus unicornis, congenital diaphragmatic hernia, and unilateral renal and ureteral agenesis. This report includes the macroscopic and microscopic lesions observed in the case.

  15. Reproductive, maternal, newborn, child & adolescent health in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This research project will contribute to evidence from four country case studies in Syria, South Sudan, Mali, and Colombia or the Democratic Republic of Congo as part of a global project to inform developing operational guidance on interventions related to reproductive, maternal, newborn, child, and adolescent health ...

  16. Preclinical electrogastrography in experimental pigs

    Science.gov (United States)

    Květina, Jaroslav; Varayil, Jithinraj Edakkanambeth; Ali, Shahzad Marghoob; Kuneš, Martin; Bureš, Jan; Tachecí, Ilja; Rejchrt, Stanislav; Kopáčová, Marcela

    2010-01-01

    Surface electrogastrography (EGG) is a non-invasive means of recording gastric myoelectric activity or slow waves from cutaneous leads placed over the stomach. This paper provides a comprehensive review of preclinical EGG. Our group recently set up and worked out the methods for EGG in experimental pigs. We gained our initial experience in the use of EGG in assessment of porcine gastric myoelectric activity after volume challenge and after intragastric administration of itopride and erythromycin. The mean dominant frequency in pigs is comparable with that found in humans. EGG in experimental pigs is feasible. Experimental EGG is an important basis for further preclinical projects in pharmacology and toxicology. PMID:21217873

  17. General reproductive properties in pigs

    OpenAIRE

    Tur, İrfan

    2013-01-01

    Pig breeding is usually undertaken for fat and meat production, but different sectors (cosmetics industry, pharmaceutical industry, medical sector, etc.) can also use pigs for alternate purposes. Pork is evaluated based on the status of an amended law regarding butchers' meat in Turkey. There have been 25 pig farms registered in Turkey since 7 July 2006 in the framework of compliance with the European Union. On average, a sow has 2.3 farrowings per year, producing 9.5 to 12.5 piglets...

  18. Virtual dissection of pig carcasses

    DEFF Research Database (Denmark)

    Vester-Christensen, Martin; Erbou, Søren Gylling Hemmingsen; Hansen, Mads Fogtmann

    2009-01-01

    This paper proposes the use of computed tomography (CT) as a reference method for estimating the lean meat percentage (LMP) of pig carcasses. The current reference is manual dissection which has a limited accuracy due to variability between butchers. A contextual Bayesian classification scheme...... is applied to classify volume elements of full body CT-scans of pig carcasses into three tissue types. A linear model describes the relation between voxels and the full weight of the half carcass, which can be determined more accurately than that of the lean meat content. Two hundred and ninety-nine half pig...

  19. Circadian rhythm in hypotensive effect of sodium nitroprusside in rats and its relevance to sympathetic nervous activity.

    Science.gov (United States)

    Sato, K; Chatani, F; Ando, T

    1999-03-01

    Circadian rhythmicity in the hypotensive effects of sodium nitroprusside (SNP) was determined to characterize the rhythmicity in hypotension mediated by nitric oxide (NO) donor in rats. When SNP was infused for 90 seconds every hour for 48 hours and the mean blood pressure was determined automatically by telemetry under light-dark conditions (LD), the degree of SNP-induced hypotension was shown to be minimal at the onset of the dark phase and to have marked circadian rhythmicity. The possible relationship between the circadian rhythm of the sympathetic nervous system (SNS) activity and SNP-induced hypotension was examined under LD conditions. The SNS activity assessed by blood pressure beat-to-beat variability analysis using the maximum entropy method (MEM) was higher at the preinfusion time at the onset of the dark phase than during the middle of the light phase. In addition, pretreatment with an alpha-blocker, phentolamine, followed by SNP infusion at the onset of the dark phase restored the SNP-induced hypotension and consequently dampened the daily variation in the degree of SNP-induced hypotension. The circadian rhythmicity determined by MEM was weakened, but persisted, in constant dark conditions (DD), suggesting partial involvement of endogenously driven circadian rhythms. In conclusion, the hypotensive effect of hourly infused SNP in rats was decreased in the dark phase in LD, especially at the onset of the dark phase, and clearly showed circadian rhythmicity in both LD and DD. The SNP-induced hypotension may be affected by rapid activation of the SNS at the onset of the dark phase in LD, and regulation of the circadian rhythm in SNP-induced hypotension in rats may be affected by both exogenous light stimuli and the endogenous biological clock.

  20. Effect of discontinuation of antihypertensive medication on orthostatic hypotension in older persons with mild cognitive impairment: the DANTE Study Leiden.

    Science.gov (United States)

    Moonen, Justine E F; Foster-Dingley, Jessica C; de Ruijter, Wouter; van der Grond, Jeroen; de Craen, Anton J M; van der Mast, Roos C

    2016-03-01

    the relationship between antihypertensive medication and orthostatic hypotension in older persons remains ambiguous, due to conflicting observational evidence and lack of data of clinical trials. to assess the effect of discontinuation of antihypertensive medication on orthostatic hypotension in older persons with mild cognitive impairment. a total of 162 participants with orthostatic hypotension were selected from the Discontinuation of Antihypertensive Treatment in Elderly people (DANTE) Study. This randomised clinical trial included community-dwelling participants aged ≥75 years, with mild cognitive impairment, using antihypertensive medication and without serious cardiovascular disease. Participants were randomised to discontinuation or continuation of antihypertensive treatment (ratio 1:1). Orthostatic hypotension was defined as a drop of at least 20 mmHg in systolic blood pressure and/or 10 mmHg in diastolic blood pressure on standing from a seated position. Outcome was the absence of orthostatic hypotension at 4-month follow-up. Relative risks (RR) were calculated by intention-to-treat and per-protocol analyses. at follow-up, according to intention-to-treat analyses, of the 86 persons assigned to discontinuation of antihypertensive medication, 43 (50%) were free from orthostatic hypotension, compared with 29 (38%) of the 76 persons assigned to continuation of medication [RR 1.31 (95% confidence interval (CI) 0.92-1.87); P = 0.13]. Per-protocol analysis showed that recovery from orthostatic hypotension was significantly higher in persons who completely discontinued all antihypertensive medication (61%) compared with the continuation group (38%) [RR 1.60 (95% CI 1.10-2.31); P = 0.01]. in older persons with mild cognitive impairment and orthostatic hypotension receiving antihypertensive medication, discontinuation of antihypertensive medication may increase the probability of recovery from orthostatic hypotension. © The Author 2016. Published by Oxford

  1. Prevalence of ST9 Methicillin-Resistant Staphylococcus aureus among Pigs and Pig Handlers in Malaysia▿

    Science.gov (United States)

    Neela, Vasanthakumari; Mohd Zafrul, Arif; Mariana, Nor Shamsudin; van Belkum, Alex; Liew, Yun Khoon; Rad, Ehsanollah Ghaznavi

    2009-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) of sequence type 398 (ST398) has frequently been detected in pigs and pig handlers. However, in Malaysia, sampling 360 pigs and 90 pig handlers from 30 farms identified novel ST9-spa type t4358-staphylococcal cassette chromosome mec type V MRSA strains that were found to transiently colonize more than 1% of pigs and 5.5% of pig handlers. PMID:19812280

  2. Diuretics for transient tachypnoea of the newborn.

    Science.gov (United States)

    Kassab, Manal; Khriesat, Wadah M; Anabrees, Jasim

    2015-11-21

    Transient tachypnoea of the newborn (TTN) results from delayed clearance of lung liquid and is a common cause of admission of full-term infants to neonatal intensive care units. The condition is particularly common after elective caesarean section. Conventional treatment involves appropriate oxygen administration and continuous positive airway pressure in some cases. Most infants receive antibiotic therapy. Hastening the clearance of lung liquid may shorten the duration of the symptoms and reduce complications. To determine whether diuretic administration reduces the duration of oxygen therapy and respiratory symptoms and shortens hospital stay in term infants presenting with transient tachypnoea of the newborn. An updated search was carried out in September 2015 of the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 9, 2015), MEDLINE via Ovid, EMBASE, PubMed, and CINAHL via OVID. We included randomised and quasi-randomised controlled trials that compared the effect of diuretics administration versus placebo or no treatment in infants of less than seven days of age, born at 37 or more weeks of gestation with the clinical picture of transient tachypnoea of the newborn. We extracted and analysed data according to the methods outlined in the latest Cochrane Handbook for Systematic Reviews of Interventions. Two review authors assessed trial quality in each potentially eligible manuscript and two review authors extracted data. Our previous systematic review included two trials enrolling a total of 100 infants with transient tachypnoea of the newborn (Wiswell 1985; Karabayir 2006). The updated search revealed no new trials. Wiswell 1985 randomised 50 infants to receive either oral furosemide (2 mg/kg body weight at time of diagnosis followed by a 1 mg/kg dose 12 hours later if the tachypnoea persisted) or placebo. Karabayir 2006 randomised 50 infants to receive either intravenous furosemide (2 mg/kg body

  3. Newborn care practices in rural Bangladesh

    Directory of Open Access Journals (Sweden)

    Islam MT

    2015-07-01

    Full Text Available Mohammad Tajul Islam,1 Nazrul Islam,2 Yukie Yoshimura,1 Monjura Khatun Nisha,3 Nawzia Yasmin4 1Safe Motherhood Promotion Project, Japan International Cooperation Agency (JICA, Dhaka, Bangladesh; 2School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; 3International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b; 4Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh Background: Neonatal mortality is high in Bangladesh. Most of the neonatal deaths are preventable through simple and cost-effective essential newborn care interventions. Studies to document the determinants of unhealthy newborn care practices are scarce. Objective: The objective of this study is to describe the pattern of neonatal care practices and their determinants in rural Bangladesh. Methodology: This study is based on baseline data of a community-based intervention to assess impact of limited postnatal care services on maternal and neonatal health-seeking behavior. Data from 510 women, who had a live birth at home 1 year prior to survey, of six randomly selected unions of an Upazila (subdistrict were analyzed. Results: Majority of the respondents were at an age group of 20–34 years. Only 6% had delivery by skilled providers. Immediate drying and wrapping, and giving colostrums to newborns were almost universal. Unhealthy practices, like unclean cord care (42%, delayed initiation of breastfeeding (60%, use of prelacteals (36%, and early bathing (71% were very common. Muslims were more likely to give early bath (adjusted odds ratio [OR]: 2.01; 95% confidence interval [CI]: 1.13–3.59; P=0.018 and delay in initiating breastfeeding (adjusted OR: 1.45; 95% CI: 1.18–1.78; P<0.001 to newborns. Practice of giving prelacteals was associated with teenage mothers (adjusted OR: 2.26; 95% CI: 1.19–4.28; P=0.013 and women’s lack of education (adjusted OR: 2.64; 95% CI: 1.46–4.77; P=0

  4. ASCENDING WAY INFECTION NEWBORNS AND THE FORMATION OF INTESTINAL MICROBIOCENOSIS OF THE NEWBORN

    Directory of Open Access Journals (Sweden)

    Kunovskaya L. M.

    2013-06-01

    Full Text Available The role and value of the bacterial factor in development pre-natal infection of newborns is studied. It is considered microflora of patrimonial ways of pregnant women, as basic pathogenesis factor of an ascending way infection of newborns. On an example of the spent bacteriological researches correlation communication between microflora of patrimonial ways, placenta and an ascending way infection of newborns is shown. At crops gastric swallowing at newborn children with pre-natal infection of newborns it is ascertained growth aerobic and аanaerobic microflora in the majority (87,7 % supervision in the form of microbes associations gramme-positive coccus Staphylococcus epidermidis and Staphylococcus aureus and Candida. The inclusion in the treatment of Saccharomyces boulardіi contributes to the restoration of intesti­nal microflora in 90 % of newborns. Found significant growth of the colonies of Bifidobacterium spp. (3.7-4,9 lg CFU/ml and Lactobacillus spp. (7.2 lg CFU/ml.

  5. Maternal vitamin C deficiency during pregnancy persistently impairs hippocampal neurogenesis in offspring of guinea pigs.

    Directory of Open Access Journals (Sweden)

    Pernille Tveden-Nyborg

    Full Text Available While having the highest vitamin C (VitC concentrations in the body, specific functions of VitC in the brain have only recently been acknowledged. We have shown that postnatal VitC deficiency in guinea pigs causes impairment of hippocampal memory function and leads to 30% less neurons. This study investigates how prenatal VitC deficiency affects postnatal hippocampal development and if any such effect can be reversed by postnatal VitC repletion. Eighty pregnant Dunkin Hartley guinea pig dams were randomized into weight stratified groups receiving High (900 mg or Low (100 mg VitC per kg diet. Newborn pups (n = 157 were randomized into a total of four postnatal feeding regimens: High/High (Control; High/Low (Depleted, Low/Low (Deficient; and Low/High (Repleted. Proliferation and migration of newborn cells in the dentate gyrus was assessed by BrdU labeling and hippocampal volumes were determined by stereology. Prenatal VitC deficiency resulted in a significant reduction in postnatal hippocampal volume (P<0.001 which was not reversed by postnatal repletion. There was no difference in postnatal cellular proliferation and survival rates in the hippocampus between dietary groups, however, migration of newborn cells into the granular layer of the hippocampus dentate gyrus was significantly reduced in prenatally deficient animals (P<0.01. We conclude that a prenatal VitC deficiency in guinea pigs leads to persistent impairment of postnatal hippocampal development which is not alleviated by postnatal repletion. Our findings place attention on a yet unrecognized consequence of marginal VitC deficiency during pregnancy.

  6. SPARQling Pig - Processing Linked data with Pig Latin

    DEFF Research Database (Denmark)

    Hagedorn, Stefan; Hose, Katja; Sattler, Kai-Uwe

    2015-01-01

    In recent years, dataflow languages such as Pig Latin have emerged as flexible and powerful tools for handling complex analysis tasks on big data. These languages support schema flexibility as well as common programming patterns such as iteration. They offer extensibility through user-defined fun......In recent years, dataflow languages such as Pig Latin have emerged as flexible and powerful tools for handling complex analysis tasks on big data. These languages support schema flexibility as well as common programming patterns such as iteration. They offer extensibility through user......-defined functions while running on top of scalable distributed platforms. In doing so, these languages enable analytical tasks while avoiding the limitations of classical query languages such as SQL and SPARQL. However, the tuple-oriented view of general-purpose languages like Pig does not match very well...... this problem by proposing extensions to Pig that deal with linked data in RDF to bridge the gap between Pig and SPARQL for analytics. These extensions are realized by a set of user-defined functions and rewriting rules, still allowing to compile the enhanced Pig scripts to plain MapReduce programs. For all...

  7. Serological evidence of hepatitis E virus infection in pigs and jaundice among pig handlers in Bangladesh

    DEFF Research Database (Denmark)

    Haider, Najmul; Khan, M. S. U.; Hossain, M. B.

    2017-01-01

    the history of jaundice between pig handlers and people not exposed to pigs and pork. Blood and faecal samples were col-lected from 100 pigs derived from three slaughterhouses in the Gazipur district of Bangladesh from January to June, 2011. We also interviewed 200 pig handlers and 250 non- exposed people who...... with jaundice in the past 2 years. Pigs in Bangladesh demonstrated evidence of HEV infec-tion, and a history of jaundice was significantly more frequent in pig handlers. Identifying and genotyping HEV in pigs and pig handlers may provide further evidence of the pig’s role in zoonotic HEV transmission...... in Bangladesh....

  8. Investigation of the disposal of dead pigs by pig farmers in mainland China by simulation experiment.

    Science.gov (United States)

    Wu, Linhai; Xu, Guoyan; Li, Qingguang; Hou, Bo; Hu, Wuyang; Wang, Jianhua

    2017-01-01

    Dead pigs are a major waste by-product of pig farming. Thus, safe disposal of dead pigs is important to the protection of consumer health and the ecological environment by preventing marketing of slaughtered and processed dead pigs and improper dumping of dead pigs. In this study, a probability model was constructed for the disposal of dead pigs by pig farmers by selecting factors affecting disposal. To that end, we drew on the definition and meaning of behavior probability based on survey data collected from 654 pig farmers in Funing County, Jiangsu Province, China. Moreover, the role of influencing factors in pig farmers' behavioral choices regarding the disposal of dead pigs was simulated by simulation experiment. The results indicated that years of farming had a positive impact on pig farmers' choice of negative disposal of dead pigs. Moreover, there was not a simple linear relationship between scale of farming and pig farmers' behavioral choices related to the disposal of dead pigs. The probability for farmers to choose the safe disposal of dead pigs increased with the improvement of their knowledge of government policies and relevant laws and regulations. Pig farmers' behavioral choice about the disposal of dead pigs was also affected by government subsidy policies, regulation, and punishment. Government regulation and punishment were more effective than subsidy. The findings of our simulation experiment provide important decision-making support for the governance in preventing the marketing of dead pigs at the source.

  9. Pigs in Public Health

    DEFF Research Database (Denmark)

    Svendsen, Mette N.

    2017-01-01

    me mindful and watchful of the porous passages between animal and human bodies and environments that do not confine themselves to ‘national health programs’ directed towards a specific (human) population. These unrecognized species encounters and relationships, which exceed the conventional framework......Animals are rare topics in public health science texts and speech despite the fact that animal bodies and lives are woven into the health of human populations, and vice versa. Years of ethnographic and documentary research – following pigs and their humans in and out of biomedical research – made......-economic, material, and bacterial passages between humans and animals that constitute the various publics of public health and profoundly shape the health of human and animal populations in a globalized world....

  10. Carbon monoxide contributes to hypotension-induced cerebrovascular vasodilation in piglets

    National Research Council Canada - National Science Library

    Alie Kanu; John Whitfield; Charles W. Leffler

    2006-01-01

    The gaseous compound carbon monoxide (CO) has been identified as an important endogenous biological messenger in brain and is a major component in regulation of cerebrovascular circulation in newborns...

  11. A polymorphism in the glucocorticoid receptor gene is associated with refractory hypotension in premature infants.

    Science.gov (United States)

    Ogasawara, Kei; Sato, Maki; Hashimoto, Koichi; Imamura, Takashi; Go, Hayato; Hosoya, Mitsuaki

    2017-09-27

    Glucocorticoids play an important role in endocrine control. The association of glucocorticoid receptor (GR) gene polymorphisms with altered sensitivity to glucocorticoid therapy has been reported in adults. However, there are few such reports in infants. The present study analyzed the prevalence of four GR polymorphisms in preterm infants born before 30 weeks of gestation and determined the associations between these polymorphisms and clinical outcomes in the infants. Totally, 41 preterm infants born at two hospitals in Fukushima were retrospectively screened for the presence of four GR gene polymorphisms, using a TaqMan single-nucleotide polymorphism genotyping assay. The effect of GR gene polymorphisms on clinical outcomes during hospitalization was evaluated. The following primary clinical outcomes were assessed: refractory hypotension in the acute phase and/or severe bronchopulmonary dysplasia, maximum dopamine and dobutamine doses administered, and total hydrocortisone dose administered in the first 48 h of life. Multivariate analysis with logistic regression was used to assess the association between clinical factors and refractory hypotension. Of the four GR polymorphisms, only the BclI polymorphism was detected. The genotype distribution was as follows: C/C, 33; C/G, 8; and G/G, 0 infants. Significant differences were observed between the C/C and C/G genotypes with respect to the following variables: refractory hypotension (6% vs. 50%), dopamine dose [3.0 (2.0-4.0) vs. 4.8 (4.0-7.5) μg/kg/min], dobutamine dose [2.4 (0.0-3.6) vs. 4.0 (0-10.0) μg/kg/min], and total hydrocortisone dose administered in the first 48 h of life [2.0 (0-10.0) vs. 6.0 (0-12.0) mg/kg]. Multivariate analysis showed that the BclI genotype (C/C) was significantly less associated with refractory hypotension in the acute phase (odds ratio, 0.008; 95% confidence interval, 0.000-0.371; p = 0.013). The incidence of refractory hypotension in infants with the C/C genotype was initially

  12. The SLUScore: A Novel Method for Detecting Hazardous Hypotension in Adult Patients Undergoing Noncardiac Surgical Procedures.

    Science.gov (United States)

    Stapelfeldt, Wolf H; Yuan, Hui; Dryden, Jefferson K; Strehl, Kristen E; Cywinski, Jacek B; Ehrenfeld, Jesse M; Bromley, Pamela

    2017-04-01

    It has been suggested that longer-term postsurgical outcome may be adversely affected by less than severe hypotension under anesthesia. However, evidence-based guidelines are unavailable. The present study was designed to develop a method for identifying patients at increased risk of death within 30 days in association with the severity and duration of intraoperative hypotension. Intraoperative mean arterial blood pressure recordings of 152,445 adult patients undergoing noncardiac surgery were analyzed for periods of time accumulated below each one of the 31 thresholds between 75 and 45 mm Hg (hypotensive exposure times). In a development cohort of 35,904 patients, the associations were sought between each of these 31 cumulative hypotensive exposure times and 30-day postsurgical mortality. On the basis of covariable-adjusted percentage increases in the odds of mortality per minute elapsed of hypotensive exposure time, certain sets of exposure time limits were calculated that portended certain percentage increases in the odds of mortality. A novel risk-scoring method was conceived by counting the number of exposure time limits that had been exceeded within each respective set, one of them being called the SLUScore. The validity of this new method in identifying patients at increased risk was tested in a multicenter validation cohort consisting of 116,541 patients from Cleveland Clinic, Vanderbilt and Saint Louis Universities. Data were expressed as 95% confidence interval, P limits were identified for time accumulated below each of the thresholds that portended certain identical (5%-50%) percentage expected increases in the odds of mortality. These exposure time limit sets were shorter in patients with a history of hypertension. A novel risk score, the SLUScore (range 0-31), was conceived as the number of exposure limits exceeded for one of these sets (20% set). A SLUScore > 0 (average 13.8) was found in 40% of patients who had twice the mortality, adjusted odds

  13. Association and moderation of self-reported hypotension with traffic noise exposure: A neglected relationship

    Directory of Open Access Journals (Sweden)

    Peter Lercher

    2013-01-01

    Full Text Available In a short-term experimental study about one-third of subjects exposed to noise shows both increases and decreases in blood pressure. While the association of noise with hypertension is established it is not yet known whether hypotension is associated with noise in field studies. In a cross-sectional study the association of self-reported hypotension and low blood pressure readings with traffic noise was examined in adults (age 25-65, N = 1989, participation = 62%. Noise exposure was based on both, short and long-term day/night recordings and standard noise mapping. Questionnaire data on socio-demographics, housing, life-style, noise and weather sensitivity, health status, mental and physical symptoms were available to adjust for potential confounding and testing for moderation. Non-linear multiple regression was applied to estimate the association between the two outcomes and overall noise exposure. We did not observe a stable relation between noise and low blood pressure readings since the number of subjects based on the recommended cut-off points (5 th percentile or 110 (100/60 mmHg was too small. However, self-reported hypotension was non-linearly associated with noise exposure ( P = 0.044 in the presence of a strong sex × age effect modification ( P < 0.0001. Another significant moderation by noise were observed with reported symptoms of exhaustion ( P = 0.03. Weather sensitivity showed a significant interaction with noise sensitivity ( P = 0.02 and also a non-linear interaction with age ( P = 0.02. The results remained stable after adjustment for variables known to be associated with constitutional hypotension. The exposure-effect curve ascends around sound levels of 55 dBA. The results suggest a novel moderated association of noise with self-reported hypotension, predominantly in weather sensitive women with symptoms of exhaustion. Further and larger studies are needed to replicate the potential moderating effect of noise on persons with

  14. An investigation of patterns in hemodynamic data indicative of impending hypotension in intensive care

    Directory of Open Access Journals (Sweden)

    Lee Joon

    2010-10-01

    Full Text Available Abstract Background In the intensive care unit (ICU, clinical staff must stay vigilant to promptly detect and treat hypotensive episodes (HEs. Given the stressful context of busy ICUs, an automated hypotensive risk stratifier can help ICU clinicians focus care and resources by prospectively identifying patients at increased risk of impending HEs. The objective of this study was to investigate the possible existence of discriminatory patterns in hemodynamic data that can be indicative of future hypotensive risk. Methods Given the complexity and heterogeneity of ICU data, a machine learning approach was used in this study. Time series of minute-by-minute measures of mean arterial blood pressure, heart rate, pulse pressure, and relative cardiac output from 1,311 records from the MIMIC II Database were used. An HE was defined as a 30-minute period during which the mean arterial pressure was below 60 mmHg for at least 90% of the time. Features extracted from the hemodynamic data during an observation period of either 30 or 60 minutes were analyzed to predict the occurrence of HEs 1 or 2 hours into the future. Artificial neural networks (ANNs were trained for binary classification (normotensive vs. hypotensive and regression (estimation of future mean blood pressure. Results The ANNs were successfully trained to discriminate patterns in the multidimensional hemodynamic data that were predictive of future HEs. The best overall binary classification performance resulted in a mean area under ROC curve of 0.918, a sensitivity of 0.826, and a specificity of 0.859. Predicting further into the future resulted in poorer performance, whereas observation duration minimally affected performance. The low prevalence of HEs led to poor positive predictive values. In regression, the best mean absolute error was 9.67%. Conclusions The promising pattern recognition performance demonstrates the existence of discriminatory patterns in hemodynamic data that can indicate

  15. Structural variations in pig genomes

    NARCIS (Netherlands)

    Paudel, Y.

    2015-01-01

    Abstract Paudel, Y. (2015). Structural variations in pig genomes. PhD thesis, Wageningen University, the Netherlands Structural variations are chromosomal rearrangements such as insertions-deletions (INDELs), duplications, inversions, translocations, and copy number variations

  16. Brachyspira murdochii colitis in pigs

    DEFF Research Database (Denmark)

    Jensen, Tim Kåre; Christensen, A. S.; Boye, Mette

    2010-01-01

    The weakly beta-hemolytic porcine spirochete Brachyspira murdochii is considered a normal intestinal commensal. In the present study, however, a field case of B murdochii–associated catarrhal colitis was identified in a pig, as characterized by extensive spirochetal colonization of the surface...... epithelium. Experimentally, 8 weaned pigs were challenged with the B murdochii isolate, reproducing catarrhal colitis in 2 animals. By applying fluorescent in situ hybridization using a species-specific oligonucleotide probe targeting 23S rRNA, B murdochii organisms were found in high numbers and were...... closely associated with the surface epithelium in the pigs with catarrhal colitis. The results indicate that, when present in high numbers, B murdochii is low pathogenic for pigs....

  17. Comparative host specificity of human- and pig- associated Staphylococcus aureus clonal lineages.

    Directory of Open Access Journals (Sweden)

    Arshnee Moodley

    Full Text Available Bacterial adhesion is a crucial step in colonization of the skin. In this study, we investigated the differential adherence to human and pig corneocytes of six Staphylococcus aureus strains belonging to three human-associated [ST8 (CC8, ST22 (CC22 and ST36(CC30] and two pig-associated [ST398 (CC398 and ST433(CC30] clonal lineages, and their colonization potential in the pig host was assessed by in vivo competition experiments. Corneocytes were collected from 11 humans and 21 pigs using D-squame® adhesive discs, and bacterial adherence to corneocytes was quantified by a standardized light microscopy assay. A previously described porcine colonization model was used to assess the potential of the six strains to colonize the pig host. Three pregnant, S. aureus-free sows were inoculated intravaginally shortly before farrowing with different strain mixes [mix 1 human and porcine ST398; mix 2 human ST36 and porcine ST433; and mix 3 human ST8, ST22, ST36 and porcine ST398] and the ability of individual strains to colonize the nasal cavity of newborn piglets was evaluated for 28 days after birth by strain-specific antibiotic selective culture. In the corneocyte assay, the pig-associated ST433 strain and the human-associated ST22 and ST36 strains showed significantly greater adhesion to porcine and human corneocytes, respectively (p<0.0001. In contrast, ST8 and ST398 did not display preferential host binding patterns. In the in vivo competition experiment, ST8 was a better colonizer compared to ST22, ST36, and ST433 prevailed over ST36 in colonizing the newborn piglets. These results are partly in agreement with previous genetic and epidemiological studies indicating the host specificity of ST22, ST36 and ST433 and the broad-host range of ST398. However, our in vitro and in vivo experiments revealed an unexpected ability of ST8 to adhere to porcine corneocytes and persist in the nasal cavity of pigs.

  18. Magnitude of Hypotension Based on Office and Ambulatory Blood Pressure Monitoring: Results From a Cohort of 5066 Treated Hypertensive Patients Aged 80 Years and Older.

    Science.gov (United States)

    Divisón-Garrote, Juan A; Ruilope, Luis M; de la Sierra, Alejandro; de la Cruz, Juan J; Vinyoles, Ernest; Gorostidi, Manuel; Escobar-Cervantes, Carlos; Velilla-Zancada, Sonsoles M; Segura, Julián; Banegas, José R

    2017-05-01

    Elderly patients can be particularly susceptible to the adverse effects of excessive blood pressure (BP) lowering by antihypertensive treatment. The identification of hypotension is thus especially important. Ambulatory BP monitoring (ABPM) is a more accurate technique than office for classifying BP status. This study examined the prevalence of hypotension and associated demographic and clinical factors among very old treated hypertensive patients undergoing ABPM. Cross-sectional study in which 5066 patients aged 80 years and older with treated hypertension drawn from the Spanish ABPM Registry were included. Office BP and 24-hour ambulatory BP were determined using validated devices under standardized conditions. Based on previous studies, hypotension was defined as systolic/diastolic BP office measurement, office hypotension, 33.7% daytime hypotension, 9.2% nighttime hypotension, and 20.5% 24-hour ABPM hypotension. Low diastolic BP values were responsible for 90% of cases of hypotension. In addition, 59.1% of the cases of hypotension detected by daytime ABPM did not correspond to hypotension according to office BP. The variables independently associated with office and ABPM hypotension were diabetes, coronary heart disease, and a higher number of antihypertensive medications. One in 3 very elderly treated hypertensive patients attended in usual clinical practice were potentially at risk of having hypotension according to daytime ABPM. More than half of them had masked hypotension; that is, they were not identified if relying on office BP alone. Thus, ABPM could be especially helpful for identifying ambulatory hypotension and avoiding overtreatment, in particular, in patients with diabetes, heart disease, or on antihypertensive polytherapy. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  19. Brain Mass and Encephalization Quotients in the Domestic Industrial Pig (Sus scrofa.

    Directory of Open Access Journals (Sweden)

    Serena Minervini

    Full Text Available In the present study we examined the brain of fetal, newborn, and adult pigs raised for meat production. The fresh and formalin-fixed weights of the brain have been recorded and used, together with body weight, to calculate the Encephalization Quotient (EQ. The weight of the cerebellum has been used to calculate the Cerebellar Quotient (CQ. The results have been discussed together with analogue data obtained in other terrestrial Cetartiodactyla (including the domestic bovine, sheep, goat, and camel, domesticated Carnivora, Proboscidata, and Primates. Our study, based on a relatively large experimental series, corrects former observations present in the literature based on smaller samples, and emphasizes that the domestic pig has a small brain relative to its body size (EQ = 0.38 for adults, possibly due to factors linked to the necessity of meat production and improved body weight. Comparison with other terrestrial Cetartiodactyla indicates a similar trend for all domesticated species.

  20. Supplementation with Lactobacillus paracasei or Pediococcus pentosaceus does not prevent diarrhoea in neonatal pigs infected with Escherichia coli F18

    DEFF Research Database (Denmark)

    Andersen, Anders Daniel; Cilieborg, Malene Skovsted; Lauridsen, Charlotte

    2017-01-01

    Infectious diarrhoea is a worldwide problem in newborns. Optimal bacterial colonisation may enhance gut maturation and protect against pathogenic bacteria after birth. We hypothesised that lactic acid bacteria (LAB) administration prevents pathogen-induced diarrhoea in formula-fed newborns. Newbo....... coli-induced diarrhoea in sensitive newborn pigs. In vulnerable newborns there may be a delicate balance among bacterial composition and load, diet and the host. Caution may be required when administering LAB to compromised newborns suffering from enteric infections....... pentosaceus (PEP, 1·3x1010 CFU/kg per d), were administered for 5 d with or without inoculation of the porcine pathogen, Escherichia coli F18 (F18, 1010 CFU/d). This resulted in six treatment groups: Controls (n 9), LAP (n 10), PEP (n 10), F18 (n 10), F18-LAP (n 10) and F18-PEP (n 10). The pathogen challenge...... increased diarrhoea and density of F18 in the intestinal mucosa (PIntestinal structure and permeability were similar among groups, whereas brush border enzymes were affected in variable intestinal regions...

  1. Salbutamol for transient tachypnea of the newborn.

    Science.gov (United States)

    Moresco, Luca; Bruschettini, Matteo; Cohen, Amnon; Gaiero, Alberto; Calevo, Maria Grazia

    2016-05-23

    Transient tachypnea of the newborn is characterized by tachypnea and signs of respiratory distress. Transient tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of salbutamol (albuterol) for transient tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. To assess whether salbutamol compared to placebo, no treatment or any other drugs administered to treat transient tachypnea of the newborn, is effective and safe in the treatment of transient tachypnea of the newborn in infants born at 34 weeks' gestational age or more. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia New Zealand and Pediatric Academic Societies) from 2000 to 2015 and clinical trial registries. Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing salbutamol versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient tachypnea of the newborn. For each of the included trials, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy, need for

  2. Maternal anti-M induced hemolytic disease of newborn followed by prolonged anemia in newborn twins

    Directory of Open Access Journals (Sweden)

    Satyam Arora

    2015-01-01

    Full Text Available Allo-anti-M often has an immunoglobulin G (IgG component but is rarely clinically significant. We report a case of hemolytic disease of the fetus and newborn along with prolonged anemia in newborn twins that persisted for up to 70 days postbirth. The aim was to diagnose and successfully manage hemolytic disease of newborn (HDN due to maternal alloimmunization. Direct antiglobulin test (DAT, antigen typing, irregular antibody screening and identification were done by polyspecific antihuman globulin cards and standard tube method. At presentation, the newborn twins (T1, T2 had HDN with resultant low reticulocyte count and prolonged anemia, which continued for up to 70 days of life. Blood group of the twins and the mother was O RhD positive. DAT of the both newborns at birth was negative. Anti-M was detected in mothers as well as newborns. Type of antibody in mother was IgG and IgM type whereas in twins it was IgG type only. M antigen negative blood was transfused thrice to twin-1 and twice to twin-2. Recurring reduction of the hematocrit along with low reticulocyte count and normal other cell line indicated a pure red cell aplastic state. Anti-M is capable of causing HDN as well as prolonged anemia (red cell aplasia due to its ability to destroy the erythroid precursor cells. Newborns with anemia should be evaluated for all the possible causes to establish a diagnosis and its efficient management. Mother should be closely monitored for future pregnancies as well.

  3. Cerebral blood flow and metabolism during isoflurane-induced hypotension in patients subjected to surgery for cerebral aneurysms

    DEFF Research Database (Denmark)

    Madsen, J B; Cold, G E; Hansen, E S

    1987-01-01

    ). Controlled hypotension to an average MAP of 50-55 mm Hg was induced by increasing the dose of isoflurane, and maintained at an inspired concentration of 2.2 +/- 0.2%. This resulted in a significant decrease in CMRO2 (to 1.73 +/- 0.16 ml/100 g min-1), while CBF was unchanged. After the clipping......Cerebral blood flow and cerebral metabolic rate for oxygen were measured during isoflurane-induced hypotension in 10 patients subjected to craniotomy for clipping of a cerebral aneurysm. Flow and metabolism were measured 5-13 days after the subarachnoid haemorrhage by a modification...... of the aneurysm the isoflurane concentration was reduced to 0.75%. There was a significant increase in CBF, although CMRO2 was unchanged, compared with pre-hypotensive values. These changes might offer protection to brain tissue during periods of induced hypotension....

  4. Phenylephrine but not ephedrine reduces frontal lobe oxygenation following anesthesia-induced hypotension

    DEFF Research Database (Denmark)

    Nissen, Peter; Brassard, Patrice; Jørgensen, Thomas

    2010-01-01

    BACKGROUND: Vasopressor agents are used to correct anesthesia-induced hypotension. We describe the effect of phenylephrine and ephedrine on frontal lobe oxygenation (S(c)O(2)) following anesthesia-induced hypotension. METHODS: Following induction of anesthesia by fentanyl (0.15 mg kg(-1......)) and propofol (2.0 mg kg(-1)), 13 patients received phenylephrine (0.1 mg iv) and 12 patients received ephedrine (10 mg iv) to restore mean arterial pressure (MAP). Heart rate (HR), MAP, stroke volume (SV), cardiac output (CO), and frontal lobe oxygenation (S(c)O(2)) were registered. RESULTS: Induction...... induced by anesthesia has a negative impact on S(c)O(2) while ephedrine maintains frontal lobe oxygenation potentially related to an increase in CO....

  5. Severe hypotension during hemofiltration in an uremic patient with metabolic alkalosis.

    Science.gov (United States)

    Panichi, Vincenzo; Rizza, Giovanni Manca; Taccola, Daniele; Consani, Cristina; Barsotti, Giuliano

    2004-01-01

    We describe a case of medication induced metabolic alkalosis in a maintenance dialysis patient who developed severe hypotension while undergoing a lactate hemofiltration procedure. A 73-year-old man with ESRD due to renovascular disease was used to ingesting up to 30 grams per day of a non-prescription medication (Effervescent granulare 250 grams, CRASTAN, Pisa Italy) consisting of sodium bicarbonate, citric acid, glucose and lemon flavor. For technical problem lactate hemofiltration was performed and thirty minutes after dialysis was started a severe symptomatic hypotension occurred (blood pressure 65/35 mmHg). Lactate hemofiltration was suspended and one-hour later standard bicarbonate dialysis was performed without any clinical problem. The different mechanisms in acidosis buffering occurring in lactate and bicarbonate hemofiltration were discussed.

  6. Spontaneous intracranial hypotension with bilateral subdural hemorrhage: Is conservative management adequate?

    Directory of Open Access Journals (Sweden)

    Mohammed Tauqeer Ahmad

    2013-01-01

    Full Text Available The aim of this study is to report a case of spontaneous intracranial hypotension complicated by bilateral subdural hemorrhage that resolved with conservative management. A young male presented with severe orthostatic headache associated with dizziness, neck pain and diplopia. Brain imaging revealed characteristic pachymeningeal enhancement and bilateral subdural hemorrhage. Radionuclide cisternography confirmed the Cerebrospinal fluid leak at the cervical 5 and cervical 6 vertebral level. He had clinical and radiological resolution with bed rest, hydration and analgesics and has remained symptom free since then. Spontaneous intracranial hypotension may be complicated by bilateral subdural hemorrhage. A conservative treatment approach is a viable option, as it may help improve the clinical and radiological outcome, especially when interventional facilities are not available.

  7. Mesenteric artery response to head-up tilt-induced central hypovolaemia and hypotension

    DEFF Research Database (Denmark)

    Perko, M J; Madsen, P; Perko, Grazyna

    1997-01-01

    Superior mesenteric artery (SMA) blood flow and impedance were evaluated by duplex ultrasound during head-up tilt (HUT)-induced central hypovolaemia and hypotension in eight healthy volunteers. HUT induced a reduction in cardiac stroke volume from 88.8 +/- 6.3 to 64.7 +/- 6.3 ml (mean +/- SEM; P ... the normotensive and the hypotensive phase of HUT, the SMA diameter (5.7 +/- 0.03 mm) and blood flow (514 +/- 75 ml min-1) did not change significantly, although the end-diastolic velocity increased from 9.7 +/- 4.8 to 39.7 +/- 4.0 cm s-1 (P ... or reduced arterial pressure, supports a reduction in the SMA impedance as it was reproduced during a meal test when a moderate reduction in mean arterial pressure (87 +/- 4 to 80 +/- 4 mm Hg; P = 0.04) was accompanied by a ninefold increase in the end-diastolic velocity (P

  8. Delayed development of systemic immunity in preterm pigs as a model for preterm infants

    Science.gov (United States)

    Nguyen, Duc Ninh; Jiang, Pingping; Frøkiær, Hanne; Heegaard, Peter M. H.; Thymann, Thomas; Sangild, Per T.

    2016-01-01

    Preterm neonates are highly sensitive to systemic infections in early life but little is known about systemic immune development following preterm birth. We hypothesized that preterm neonates have immature systemic immunity with distinct developmental trajectory for the first several weeks of life, relative to those born at near-term or term. Using pigs as a model, we characterized blood leukocyte subsets, antimicrobial activities and TLR-mediated cytokine production during the first weeks after preterm birth. Relative to near-term and term pigs, newborn preterm pigs had low blood leukocyte counts, poor neutrophil phagocytic rate, and limited cytokine responses to TLR1/2/5/7/9 and NOD1/2 agonists. The preterm systemic responses remained immature during the first postnatal week, but thereafter showed increased blood leukocyte numbers, NK cell proportion, neutrophil phagocytic rate and TLR2-mediated IL-6 and TNF-α production. These immune parameters remained different between preterm and near-term pigs at 2–3 weeks, even when adjusted for post-conceptional age. Our data suggest that systemic immunity follows a distinct developmental trajectory following preterm birth that may be influenced by postnatal age, complications of prematurity and environmental factors. Consequently, the immediate postnatal period may represent a window of opportunity to improve innate immunity in preterm neonates by medical, antimicrobial or dietary interventions. PMID:27830761

  9. Viability of Iberian x Meishan F2 newborn pigs. II. Survival analysis up to weaning.

    Science.gov (United States)

    Casellas, J; Noguera, J L; Varona, L; Sánchez, A; Arqué, M; Piedrafita, J

    2004-07-01

    Iberian x Meishan F2 piglet's preweaning survivability was analyzed using categorical data regression procedures within the proportional hazards assumption. A frailty sire model was assumed with the litter effect treated as an additional random source of variation. Moreover, the relative birth weight within litter and the litter effect were considered time-dependent covariates that changed their values in the second day of life due to cross fostering carried out to standardize litters. Six variables had a significant effect on survivability: birth weight (P piglets (Piglets that were small in relation to their siblings (relative birth weight within litter) also suffered an increased death risk, with a hazard ratio of 1.81 (P Piglets with a rectal temperature lower than 35.4 degrees C 60 min after birth showed the highest hazard ratio (7.18; P piglet survival involves several systematic influences related to birth weight, thermoregulatory ability, and injuries suffered during gestation and farrowing. The genetic variance was small compared with those generated by the common environment, for which the genetic improvement of piglet survival seems difficult.

  10. An activated immune and inflammatory response targets the pancreas of newborn pigs with cystic fibrosis

    Czech Academy of Sciences Publication Activity Database

    Abu-El-Haija, M.; Šinkora, Marek; Meyerholz, D. K.; Welsh, M. J.; McCray, P.B.; Butler, J. E.; Uc, A.

    2011-01-01

    Roč. 11, č. 5 (2011), s. 506-515 ISSN 1424-3903 R&D Projects: GA MŠk ME09089 Institutional research plan: CEZ:AV0Z50200510 Keywords : cystic fibrosis * pancreatitis * flow cytometry Subject RIV: EC - Immunology Impact factor: 1.987, year: 2011

  11. Premature delivery reduces intestinal cytoskeleton, metabolism, and stress response proteins in newborn formula-fed pigs

    DEFF Research Database (Denmark)

    Jiang, Pingping; Wan, Jennifer Man-Fan; Cilieborg, Malene Skovsted

    2013-01-01

    OBJECTIVE:: Preterm infants often show intolerance to the first enteral feeds, and the structural and functional basis of this intolerance remains unclear. We hypothesized that preterm and term neonates show similar gut trophic responses to feeding, but different expression of intestinal function...

  12. Physical activity level is impaired and diet dependent in preterm newborn pigs

    DEFF Research Database (Denmark)

    Cao, Muqing; Andersen, Anders Daniel; Van Ginneken, Chris

    2015-01-01

    milk (HM) for 10 d. Incubator home cage activity (HCA) was quantified by continuous camera recordings. RESULTS: Preterm birth was associated with reduced intestinal weight and HCA (experiment 1), and BC or formula supplementation increased intestinal weights and HCA (experiments 1+2). Enteral BC and HM...

  13. Adrenal Insufficiency in a Cancer Patient Presenting as Acute Hypotension During Induction of Anaesthesia

    Directory of Open Access Journals (Sweden)

    Shilpi Singhal

    2008-01-01

    Full Text Available A 54 year-old-male, a case of squamous cell carcinoma of right pyriform fossa, treated with radical radiotherapy & chemo-therapy in 2004, presented in January 2007, with difficulty in swallowing. He was diagnosed to have squamous cell carcinoma of upper third of oesophagus & surgery was planned. Patient had history of recurrent blackouts which were attributed to general-ized weakness and diarrhoea. During induction, he developed Hypotension & on evaluation, was diagnosed to have primary adrenal insufficiency.

  14. Oral nifedipine as a premedication for induced hypotension in functional endoscopic sinus surgery (FESS)

    OpenAIRE

    Hassanein, Ahmed; Talaat, Moustafa

    2015-01-01

    Objective: To evaluate the effects of oral nifedipine as pretreatment, quality of surgical field and amount of hypotensive agent during functional endoscopic sinus surgery (FESS) under general anesthesia. Methods: Sixty patients ASA I or II scheduled for FESS were randomly allocated into two equal groups. Oral nifedipine 20 mg was given one hour before induction of anesthesia (nifedipine) group and placebo. In the other group (control), all the patients received standard anesthesia and mon...

  15. A quality improvement project: Strategies to reduce intradialytic hypotension in hemodialysis patients.

    Science.gov (United States)

    Ghaffar, Umbar; Easom, Andrea K

    2015-05-01

    Intradialytic hypotension is defined as a decrease in systolic blood pressure by ≥ 20 mm Hg or a decrease in mean arterial pressure by 10 mm Hg, and is associated with symptoms that include abdominal discomfort, yawning, sighing, nausea, vomiting, muscle cramps, restlessness, dizziness or fainting, and anxiety. The incidence of a symptomatic reduction in blood pressure during (or immediately following) dialysis ranges from 15-50% of dialysis sessions. It is a major cause for morbidity in elderly hemodialysis patients and those with cardiovascular compromise. It impairs patient well-being, limits ultrafiltration, and increases the risk for coronary and cerebral ischemic events as well as vascular access thrombosis. Several studies have shown a poorer survival in dialysis patients who experience frequent hypotensive episodes on dialysis as opposed to those who do not. In our outpatient dialysis unit, we identified that 9% of our dialysis patients experienced a decrease in their systolic blood pressure to below 80 during dialysis. The purpose of this quality improvement project was to study the factors associated with intradialytic hypotension in these patients and institute appropriate measures to mitigate this issue. Another aim was to educate the dialysis staff on how to manage these patients. Patients were selected using data from weekly rounding reports and orders were written for interventions including ultrafiltration profiling, cool (36 degrees C) dialysate, weight-based ultrafiltration, etc. Outcomes were studied over a period of 3 months. We found that up to 40% of patients experienced an improvement in their blood pressure profile over the period of the study, suggesting that simple changes to dialysis prescription can result in a significant reduction in the incidence of intradialytic hypotension.

  16. Comparison of hypotensive, diuretic and renal effects between cladodes of Opuntia ficus-indica and furosemide.

    Science.gov (United States)

    Bakour, Meryem; Al-Waili, Noori; El-Haskoury, Redouan; El-Menyiy, Nawal; Al-Waili, Thia; Al-Waili, Ali; Lyoussi, Badiaa

    2017-09-01

    To investigate the diuretic, hypotensive and renal effect of Opuntia ficus-indica in two different species in oral and intravenous administration. Diuretic activity was evaluated in rats with the plant cladode gel and aqueous extract administrated orally, and was evaluated in rabbits with plant extract administered intravenously. Single and repeated doses of cladode gel or aqueous extract of cladode were tested. Urine volume and blood and urine creatinine, sodium and potassium were measured, and creatinine clearance was calculated. The hypotensive effect of lyophilized extract of cladode was evaluated in rabbits. Two polyethylene PE50 catheters were used: one in the jugular vein for the infusion of the plant extract and the other in the carotid for the evaluation of the arterial pressure. The cladode gel or aqueous extract increased urine volume, creatinine clearance and urinary excretion of sodium and potassium without significant effect on serum creatinine or blood urea. Furosemide, gel and aqueous extract of cladode insignificantly lowered plasma potassium in rats. Intravenous administration of the lyophilized extract caused a significant decrease in mean arterial pressure in rabbits with a significant increase in urine volume and urine sodium and potassium; the effect was dose dependent. Intravenous administration of lyophilized extract did not affect plasma sodium or potassium. Gel and aqueous extract of Opuntia ficus-indica cladode have a significant diuretic effect on rats, and the lyophilized extract has a diuretic and hypotensive effect on normotensive rabbits without deterioration in renal function test. Additional studies on active ingredients are essential to pave the way for clinical studies on diuretic and hypotensive effect of the plant. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  17. Norepinephrine reduces arterial compliance less than phenylephrine when treating general anesthesia-induced arterial hypotension.

    Science.gov (United States)

    Vallée, F; Passouant, O; Le Gall, A; Joachim, J; Mateo, J; Mebazaa, A; Gayat, E

    2017-07-01

    During general anesthesia, arterial hypotension is frequent and may be an important contributor to perioperative morbidity. We assessed the effect of a 5 μg bolus of Norepinephrine (NA) when compared with 50 μg bolus of Phenylephrine (PE) administered to treat hypotension during maintenance anesthesia, on MAP, derived cardiac output and arterial stiffness parameters. Patients scheduled for a neurosurgical procedure under general anesthesia were prospectively included. Monitoring included invasive blood pressure, esophageal Doppler, and arterial tonometer used to estimate central aortic pressure with arterial stiffness parameters, such as augmentation index (Aix). After initial resuscitation, hypotensive episodes were corrected by a bolus administration of NA or PE in a peripheral venous line. There were 269 bolus administrations of vasopressors (149 NA, 120 PE) in 47 patients with no adverse effects detected. A decrease in stroke volume (SV) was observed with PE compared with NA (-18 ± 9% vs. -14 ± 7%, P < 0.001). This decrease was associated with an increase in Aix, which was greater for PE than for NA (+10 ± 8% vs. +6 ± 6%, P < 0.0001), and a decrease in total arterial compliance greater for PE compared to NA (Ctot = SV/Central Pulse Pressure) (-35 ± 9% vs. -29 ± 10%, P < 0.001). This study suggests that 5 μg of NA administered as a bolus in a peripheral venous line could treat general anesthesia-induced arterial hypotension with a smaller decrease in SV and arterial compliance when compared to PE. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. The Microcirculation is Preserved in Emergency Department Low‐acuity Sepsis Patients Without Hypotension

    DEFF Research Database (Denmark)

    Skibsted, Simon; Filbin, Michael; Hou, Peter

    2014-01-01

    Objectives Microcirculatory dysfunction plays an important role in sepsis pathophysiology. Previous studies using sidestream dark-field (SDF) imaging have demonstrated microcirculatory flow abnormalities in patients with septic shock; however, the microcirculation is relatively unstudied in lower......, conducted in three urban, tertiary care emergency departments (EDs) in the United States. Sepsis was defined as suspected infection plus two or more systemic inflammatory response syndrome (SIRS) criteria; those with hypotension were excluded. Noninfected controls were ED patients without infection...

  19. Noncardiogenic Pulmonary Edema after Amlodipine Overdose without Refractory Hypotension and Bradycardia

    Directory of Open Access Journals (Sweden)

    M. Hedaiaty

    2015-01-01

    Full Text Available Amlodipine overdose can be life-threatening when manifesting as noncardiogenic pulmonary edema. Treatment remains challenging. We describe a case of noncardiogenic pulmonary edema without refractory hypotension and bradycardia after ingestion of 500 milligram amlodipine with suicidal intent. Mechanical ventilation, dexamethasone, atrovent HFA (ipratropium, pulmicort inhalation, and antibiotic therapy were used for the management. Length of hospital stay was 11 days. The patient was discharged with full recovery.

  20. Influence of Orthostatic Hypotension on Mortality Among Patients Discharged from an Acute Geriatric Ward

    Science.gov (United States)

    Weiss, Avraham; Beloosesky, Yichayaou; Kornowski, Ran; Yalov, Alexandra; Grinblat, Joseph; Grossman, Ehud

    2006-01-01

    BACKGROUND Orthostatic hypotension (OH) is a common finding among older patients. The impact of OH on mortality is unknown. OBJECTIVE To study the long-term effect of OH on total and cardiovascular mortality. PATIENTS AND METHODS A total of 471 inpatients (227 males and 244 females), with a mean age of 81.5 years who were hospitalized in an acute geriatric ward between the years 1999 and 2000 were included in the study. Orthostatic tests were performed 3 times during the day on all patients near the time of discharge. Orthostatic hypotension was defined as a fall of at least 20 mmHg in systolic blood pressure (BP) and/or 10 mmHg in diastolic BP upon assuming an upright posture at least twice during the day. Patients were followed until August 31, 2004. Mortality data were taken from death certificates. RESULTS One hundred and sixty-one patients (34.2%) experienced OH at least twice. Orthostatic hypotension had no effect on all cause and cause specific mortality. Over a follow-up of 3.47±1.87 years 249 patients (52.8%) had died 83 of whom (33.3%) had OH. Age-adjusted mortality rates in those with and without OH were 13.4 and 15.7 per 100 person-years, respectively. Cox proportional hazards model analysis demonstrated that male gender, age, diabetes mellitus, and congestive heart failure increased and high body mass index decreased total mortality. CONCLUSIONS Orthostatic hypotension is relatively common in elderly patients discharged from acute geriatric wards, but has no impact on vascular and nonvascular mortality. PMID:16808743

  1. HYPOTENSIVE AND CARDIOINHIBOTORY EFFECTS OF THE AQUEOUS AND ETHANOL EXTRACTS OF CELERY (APIUM GRAVEOLENS, APIACEAE

    Directory of Open Access Journals (Sweden)

    Dragana Pavlović

    2010-03-01

    Full Text Available In this study we present the effects of aqueous and ethanol extracts of celery (Apium graveolens L., Apiaceae investigated on the mean blood pressure of anaesthetized rabbits and contractility of isolated atria of the rats. In our experiments were used rabbits and Wistar albino rats. The effects of extracts (0.5-15 mg/kg on blood pressure were recorded directly from the carotid artery. Rat isolated atria was mounted in 10 ml tissue bath. An equilibrium period of 30 min was given before the application of the extracts (0.02-0.75 mg/ml. In anesthetized rabbit, intravenous administration of aqueous extracts induced least hypotensive effects (14.35±2.94%, while the ethanol extract caused the greatest fall in the blood pressure (45.79±10.86%. Hypotensive effects of the extracts were partially blocked by atropine (0.3 mg/kg, an unselective muscarinic receptor antagonist. In isolated rat atria both aqueous and ethanolic extracts of celery, exhibit a negative chronotropic and an inotropic action. Aqueous extract decreased rate of contractions for 12.88±2.74% and amplitude for 8.73±0.89%. Ethanol extract inhibited rate of the atria contractions for 34.26±5.69%, and amplitude for 25.40±3.61%. Pretreatment of the atria with atropine (1μM partially blocked inhibitory response of aqueous and ethanol extracts. Ethanol extract of celery exhibited significantly greater hypotensive and cardio-depressant activities then aqueous extract (p<0.05. These data suggest that the aqueous and ethanol extracts of celery caused the hypotensive, negative inotropic and chronotropic effects, which could partially be mediated possibly via stimulation of muscarinic receptors. Inhibitory effect of ethanol extract was significant comparing to aqueous extract of celery.

  2. Nontraumatic hypotension and shock in the emergency department and the prehospital setting, prevalence, etiology, and mortality: a systematic review.

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    Jon Gitz Holler

    Full Text Available Acute patients presenting with hypotension in the prehospital or emergency department (ED setting are in need of focused management and knowledge of the epidemiology characteristics might help the clinician. The aim of this review was to address prevalence, etiology and mortality of nontraumatic hypotension (SBP ≤ 90 mmHg with or without the presence of shock in the prehospital and ED setting.We performed a systematic literature search up to August 2013, using Medline, Embase, Cinahl, Dare and The Cochrane Library. The analysis and eligibility criteria were documented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-guidelines and The Cochrane Collaboration. No restrictions on language, publication date, or status were imposed. We used the Newcastle-Ottawa quality assessment scale (NOS-scale and the Strengthening the Reporting of Observational studies in Epidemiology (STROBE-statement to assess the quality.Six observational studies were considered eligible for analysis based on the evaluation of 11,880 identified papers. Prehospital prevalence of hypotension was 19.5/1000 emergency medicine service (EMS contacts, and the prevalence of hypotensive shock was 9.5-19/1000 EMS contacts with an inhospital mortality of shock between 33 to 52%. ED prevalence of hypotension was 4-13/1000 contacts with a mortality of 12%. Information on mortality, prevalence and etiology of shock in the ED was limited. A meta-analysis was not feasible due to substantial heterogeneity between studies.There is inadequate evidence to establish concise estimates of the characteristics of nontraumatic hypotension and shock in the ED or in the prehospital setting. The available studies suggest that 2% of EMS contacts present with nontraumatic hypotension while 1-2% present with shock. The inhospital mortality of prehospital shock is 33-52%. Prevalence of hypotension in the ED is 1% with an inhospital mortality of 12%. Prevalence

  3. [Effects of transcutaneous electrical acupoint stimulation combined with general anesthesia on changes of gastric dynamics in controlled hypotension dogs].

    Science.gov (United States)

    Fang, Jian-Qiao; Zhang, Le-Le; Shao, Xiao-Mei; Lian, Lin-Li; Yu, Xiao-Jing; Dong, Zhen-Hua; Mo, Ya-Di

    2011-12-01

    To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with general anesthesia on gastric dynamics in controlled hypotension dogs, so as to provide experimental evidence for compound acupuncture anesthesia. Eighteen male beagle dogs were randomly divided into general anesthesia group (GA group, n = 6), general anesthesia + controlled hypotension group (GA + OHT group, n = 6) and general anesthesia combined with TEAS + controlled hypotension group (TEAS group, n = 6). The latter two groups were administered with the same anesthetics [isofluane inhalation and intravenous sodium nitroprusside (SNP)] for inducing controlled hypotension (being the 40% of the baseline level). Beagles of the GA group were not treated with controlled hypotension (the initial concentration of SNP = 1 microg/kg x min(-1), and with an increase rate of 1 microg/kg x min(-1) until the controlled hypotension phase). In the TEAS group, TEAS [2 Hz/100 Hz, (4 +/- 1) mA]was applied to "Quchi" (LI 11) , "Zusanli" (ST 36), "Hegu" (LI 4), and "Sanyinjiao" (SP 6) from the beginning of the stable physiological condition phase to the end of the controlled-low mean arterial pressure (MAP) phase. Electrogastrogram (EGG) was recorded, and serum gastrin (GAS) and motilin (MTL) contents were detected by enzyme-linked immunosorbent assay. Compared with the basic level, the amplitude value of EGG at 60 mm after controlled hypotension in the GA + CHT group was significantly lower (P 0.05), and serum GAS level at the time-point of 2 h after MAP recovery in the TEAS group was considerably higher than those in the GA and GA + CHT groups (P 0.05). TEAS combining with general anesthesia for controlled hypotension can improve the amplitude of EGG, and serum MTL and GAS contents, favoring the recovery of gastric dynamics and the functional protection of stomach.

  4. Impaired innate immunity in the newborn: newborn neutrophils are deficient in bactericidal/permeability-increasing protein.

    Science.gov (United States)

    Levy, O; Martin, S; Eichenwald, E; Ganz, T; Valore, E; Carroll, S F; Lee, K; Goldmann, D; Thorne, G M

    1999-12-01

    The mechanisms by which newborns are at increased risk for invasive bacterial infections have been incompletely defined. A central element of innate immunity to bacterial infection is the neutrophil-a cell that contains cytoplasmic granules replete with antibiotic proteins and peptides. The activity of adult neutrophils against gram-negative bacteria is believed to depend to a significant degree on the presence in neutrophil primary (azurophilic) granules of the 55-kDa bactericidal/permeability-increasing protein (BPI), which binds with high affinity to bacterial lipopolysaccharides and kills gram-negative bacteria. In light of the importance of BPI to antibacterial host defense and to investigate possible factors underlying the risk of neonatal bacterial infections, we determined the relative content of BPI in the neutrophils of adults and newborns. The cellular content of BPI was determined by Western blotting of neutrophils derived from full-term newborn cord blood (n = 21; mean gestational age: 38.6 weeks) and from adult peripheral blood (n = 22; mean age: 29 years). Extracellular levels of BPI in adult and newborn plasma were assessed by enzyme-linked immunosorbent assay. Neutrophil content of other azurophil granule markers also was assessed: myeloperoxidase by Western blotting and defensin peptides by acid-urea polyacrylamide gel electrophoresis and Coomassie staining. Acid extracts of newborn and adult neutrophils were analyzed for antibacterial activity against serum-resistant encapsulated isolate Escherichia coli K1/r. The neutrophils of newborns contain at least threefold to fourfold less BPI per cell than adult neutrophils (67 +/- 13 ng per 10(6) cells vs 234 +/- 27 ng per 10(6) cells). The relative BPI-deficiency of newborn neutrophils apparently was not attributable to perinatal stress-related degranulation of intracellular BPI stores because: 1) newborn and adult neutrophils contained nearly identical amounts of 2 microbicidal constituents derived

  5. Lactic acidosis and diastolic hypotension after intermittent albuterol nebulization in a pediatric patient

    Directory of Open Access Journals (Sweden)

    Tehila A. Saadia

    2015-01-01

    Full Text Available We describe a case of 13-year-old female with intermittent asthma who developed lactic acidosis and diastolic hypotension after receiving intermittent albuterol nebulizer treatment. She presented to the emergency department (ED with sudden onset of shortness of breath and chest pain. She received two albuterol nebulizer treatments at home without symptomatic relief. She was treated in the ED with intermittent albuterol nebulization for a total of 22.5 mg over the next 5 hours. A decrease in diastolic blood pressure from 60 mmHg to 40 mmHg was noted after the treatment. Blood lactate level was 5.9 mmol/L. She recovered from it and was discharged to home but she had recurrence of shortness of breath and presented to the ED two days later. She was treated with albuterol nebulization for a total of 17.5 mg over the next two and half hours and developed diastolic hypotension again, as low as 30 mm Hg. After discontinuation of albuterol nebulization, her BP normalized. Cardiopulmonary and metabolic side effects of continuous albuterol therapy have been reported in the recent medical literature. Our patient, however, developed these adverse effects on intermittent albuterol nebulizer treatment. It is important for the pediatrician to recognize the adverse effects of β2-agonist therapy to avoid carrying out extensive workup for hypotension and hyperlactatemia prolonging hospital stay.

  6. Anti-hypertensive therapy and risk factors associated with hypotension during colonoscopy under conscious sedation.

    Science.gov (United States)

    Tang, Derek M; Simmons, Kellie; Friedenberg, Frank K

    2012-06-01

    Pre-operative use of select anti-hypertensive therapy has been associated with peri-operative hypotension in the surgical setting. Our aim was to determine the effect of anti-hypertensive medications on blood pressure (BP) and procedural outcomes in gastrointestinal endoscopy. Our study was a prospective, cross-sectional survey of outpatients undergoing colonoscopy with conscious sedation. We enrolled patients with hypertension that took anti-hypertensive medications within 24 hours of the procedure and patients without hypertension that were not on BP-lowering agents. We recorded mean BP prior to, during, and after the procedure. 626 patients (338 males; mean age 56.0 +/- 10.4 years) were enrolled, and 158 patients were on anti-hypertensive therapy. There were 57 patients who developed hypotension, defined as systolic BP 0.05). Age, body mass index, gender, duration, fentanyl dose, midazolam dose, and co-morbidities (asthma, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease) were also not associated (all p >0.05). Instead, a lower pre-procedure systolic BP (OR=0.97, 95% CI=0.95-0.99; p=0.004) and diastolic BP (OR=0.95, 95% CI=0.92-0.97; panti-hypertensive therapy leading up to endoscopy. A lower pre-procedure BP is the main risk factor for procedural hypotension in patients undergoing colonoscopy with conscious sedation. Future studies should explore other factors, such as bowel preparation, that can affect pre-procedure BP.

  7. Hypotensive effects of resistance exercise with continuous and intermittent blood flow restriction

    Directory of Open Access Journals (Sweden)

    Gabriel Rodrigues Neto

    Full Text Available Abstract The aim of this study was to compare the acute effects of low-intensity (LI resistance exercise (RE with continuous blood flow restriction (CBFR and intermittent blood flow restriction (IBFR on systolic blood pressure (SBP, diastolic blood pressure (DBP, and mean arterial pressure (MAP. After a one-repetition maximum test, 10 normotensive recreationally trained men performed three experimental protocols. In the three RE protocols, increases in SBP, DBP, and MAP were observed immediately after exercise, but the effect sizes (ESs were greater for the LI + CBFR and high-intensity protocols. There were hypotensive effects on SBP, DBP, and MAP in all three protocols; however, the effects on MAP lasted longer for the LI + IBFR and LI + CBFR protocols. These long-lasting hypotensive effects on DBP and MAP occurred in all three protocols. Thus, we conclude that the post exercise hypotensive effects on SBP, DBP, and MAP appear to occur in all three RE protocols, with the effect on SBP being longer in the LI + IBFR and LI + CBFR protocols.

  8. Hypotension, lipodystrophy, and insulin resistance in generalized PPARγ-deficient mice rescued from embryonic lethality

    Science.gov (United States)

    Duan, Sheng Zhong; Ivashchenko, Christine Y.; Whitesall, Steven E.; D’Alecy, Louis G.; Duquaine, Damon C.; Brosius, Frank C.; Gonzalez, Frank J.; Vinson, Charles; Pierre, Melissa A.; Milstone, David S.; Mortensen, Richard M.

    2007-01-01

    We rescued the embryonic lethality of global PPARγ knockout by breeding Mox2-Cre (MORE) mice with floxed PPARγ mice to inactivate PPARγ in the embryo but not in trophoblasts and created a generalized PPARγ knockout mouse model, MORE-PPARγ knockout (MORE-PGKO) mice. PPARγ inactivation caused severe lipodystrophy and insulin resistance; surprisingly, it also caused hypotension. Paradoxically, PPARγ agonists had the same effect. We showed that another mouse model of lipodystrophy was hypertensive, ruling out the lipodystrophy as a cause. Further, high salt loading did not correct the hypotension in MORE-PGKO mice. In vitro studies showed that the vasculature from MORE-PGKO mice was more sensitive to endothelial-dependent relaxation caused by muscarinic stimulation, but was not associated with changes in eNOS expression or phosphorylation. In addition, vascular smooth muscle had impaired contraction in response to α-adrenergic agents. The renin-angiotensin-aldosterone system was mildly activated, consistent with increased vascular capacitance or decreased volume. These effects are likely mechanisms contributing to the hypotension. Our results demonstrated that PPARγ is required to maintain normal adiposity and insulin sensitivity in adult mice. Surprisingly, genetic loss of PPARγ function, like activation by agonists, lowered blood pressure, likely through a mechanism involving increased vascular relaxation. PMID:17304352

  9. Effect of orthostatic hypotension on sustained attention in patients with autonomic failure.

    Science.gov (United States)

    van Vliet, P; Hilt, A D; Thijs, R D; van Dijk, J G

    2016-02-01

    Orthostatic hypotension has been associated with impaired cognitive function, but cognitive function during orthostatic hypotension has hardly been studied. We studied the effect of orthostatic hypotension, induced by head-up tilt (HUT), on sustained attention in patients with autonomic failure. We studied the sustained attention to response task (SART) in the supine position and during HUT in 10 patients with autonomic failure and 10 age-matched and sex-matched controls. To avoid syncope, the tilting angle was tailored to patients to reach a stable systolic blood pressure below 100 mm Hg. Controls were all tilted at an angle of 60°. Cerebral blood flow velocity, blood pressure and heart rate were measured continuously. In patients, systolic blood pressure was 61.4 mm Hg lower during HUT than in the supine position (pattention. This might partly be explained by the observation that SART performance led to a blood pressure increase. Moreover, the upright position was associated with better performance in controls and, to a lesser extent, also in patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Range of S-100β levels during functional endoscopic sinus surgery with moderately controlled hypotension.

    Science.gov (United States)

    Kwon, Youngsuk; Jang, Ji Su; Hwang, Sung Mi; Lee, Jae Jun; Lee, Jun Ho; Joo, Sungmin; Lee, In-Gon; Hong, Sung Jun

    2017-09-01

    The aim of this study is to determine the range of S-100β levels during functional endoscopic sinus surgery (FESS) when the mean arterial pressure (MAP) was controlled within 60-70 mmHg. After anesthesia induction with propofol and remifentanil, the patient was positioned in the reverse Trendelenburg position and MAP was controlled within 60-70 mmHg during surgery. For the S-100β assay, blood was taken from a radial arterial catheter before (baseline) and at 20 (T 20 ) and 60 (T 60 ) min after setting the reverse Trendelenburg position and controlled hypotension, and at 60 (T post60 ) min after the end of the operation. In total, 34 patients completed the study. Baseline S-100β was 0.00837 ± 0.00785 ng/mL. The levels at T 20 and T 60 were 0.02057 ± 0.01739 and 0.01987 ± 0.01145 ng/mL, respectively. The level of T post60 was 0.05436 ± 0.02318 ng/mL. The level at T 20 increased significantly versus the baseline level (P hypotension (MAP >60 mmHg) was provided. Thus, moderate hypotension would be seemed to be a safe and effective anesthetic technique for FESS without risk for cerebral ischemia.

  11. Permissive Hypotension: Potentially Harmful in the Elderly? A National Trauma Data Bank Analysis.

    Science.gov (United States)

    Bridges, Lindsay C; Waibel, Brett H; Newell, Mark A

    2015-08-01

    Permissive hypotension is a component of damage control resuscitation that aims to provide a directed, controlled resuscitation, while countering the "lethal triad." This principle has not been specifically studied in elderly (ELD) trauma patients (≥55 years). Given the ELD population's lack of physiologic reserve and risk of inadequate perfusion with "normal" blood pressures, we hypothesized that utilized a permissive hypotension strategy in ELD trauma patients would result in worse outcomes compared with younger patients (18-54 years). A retrospective review of National Trauma Data Bank reports from 2009 and 2010, identifying critically ill patients undergoing a "damage control laparotomy," was performed to determine the effect of age and systolic blood pressure on outcome. Logistic regression analysis, including evaluation of an interaction between age and admission blood pressure, was performed on mortality using admission demographics, physiology, injury severity, mechanism of injury, and in-hospital complications. Although there was a higher likelihood of death with greater age, lower admission systolic blood pressure, lower Glasgow Coma Score, increased injury severity score, and acute renal failure, a synergistic effect of age and blood pressure on mortality was not identified. Permissive hypotension appears to be a possible management strategy in ELD trauma patients.

  12. Evaluation of renal function under controlled hypotension in zero ischemia robotic assisted partial nephrectomy.

    Science.gov (United States)

    Forastiere, Ester; Claroni, Claudia; Sofra, Maria; Torregiani, Giulia; Covotta, Marco; Marchione, Maria Grazia; Giannarelli, Diana; Papalia, Rocco

    2013-01-01

    In partial nephrectomy with hilar clamping every minute of ischemia can impair renal function, thus great importance is having the controlled hypotension as a part of zero ischemia technique. The aim of the study is to evaluate the effects of hypotensive anesthesia on renal function, in patients undergoing robotic assisted partial nephrectomy (RAPN) , during surgery and at 3 months follow up. This is a prospective study of 100 patients, ASA 1-2, who underwent zero ischemia RAPN under controlled hypotension (CH) from December 2011 through to May 2013. Serum creatinine, BUN, estimated glomerular filtration rates (eGFR), fractional excretion of sodium (FSE) and technetium Tc 99m mercaptoacetyltriglycine (99mTC-MAG-3), renal scintigraphy with effective renal plasma flow (ERPF) were evaluated. Mean duration of CH was 50 ± 4 minutes. Acute renal failure wasn't observed in any of the patients. A significant variation of eGFR during the procedure and 24 hours after surgery was observed. No significant variation of BUN and FSE was detected. Comparing preoperative ERPF of the operated kidney with ERPF 3 months after surgery, it decreased by 2%. In patients with normal preoperative renal function CH didn't show any detrimental impact on renal function during and after robotic assisted partial nephrectomy.

  13. Evaluation of Renal Function Under Controlled Hypotension in Zero Ischemia Robotic Assisted Partial Nephrectomy

    Directory of Open Access Journals (Sweden)

    Ester Forastiere

    2014-04-01

    Full Text Available Background/Aims: In partial nephrectomy with hilar clamping every minute of ischemia can impair renal function, thus great importance is having the controlled hypotension as a part of zero ischemia technique. The aim of the study is to evaluate the effects of hypotensive anesthesia on renal function, in patients undergoing robotic assisted partial nephrectomy (RAPN , during surgery and at 3 months follow up. Methods: This is a prospective study of 100 patients, ASA 1-2, who underwent zero ischemia RAPN under controlled hypotension (CH from December 2011 through to May 2013. Serum creatinine, BUN, estimated glomerular filtration rates (eGFR, fractional excretion of sodium (FSE and technetium Tc 99m mercaptoacetyltriglycine (99mTC-MAG-3, renal scintigraphy with effective renal plasma flow (ERPF were evaluated. Results: Mean duration of CH was 50±4 minutes. Acute renal failure wasn't observed in any of the patients. A significant variation of eGFR during the procedure and 24 hours after surgery was observed. No significant variation of BUN and FSE was detected. Comparing preoperative ERPF of the operated kidney with ERPF 3 months after surgery, it decreased by 2%. Conclusion: In patients with normal preoperative renal function CH didn't show any detrimental impact on renal function during and after robotic assisted partial nephrectomy.

  14. A piglet with surgically induced exocrine pancreatic insufficiency as an animal model of newborns to study fat digestion.

    Science.gov (United States)

    Goncharova, Kateryna; Pierzynowski, Stefan G; Grujic, Danica; Kirko, Siarhei; Szwiec, Katarzyna; Wang, Jing; Kovalenko, Tetiana; Osadchenko, Iryna; Ushakova, Galyna; Shmigel, Halyna; Fedkiv, Olexandr; Majda, Blanka; Prykhodko, Olena

    2014-12-28

    The maldigestion and malabsorption of fat in infants fed milk formula results due to the minimal production of pancreatic lipase. Thus, to investigate lipid digestion and absorption and mimic the situation in newborns, a young porcine exocrine pancreatic insufficient (EPI) model was adapted and validated in the present study. A total of thirteen EPI pigs, aged 8 weeks old, were randomised into three groups and fed either a milk-based formula or a milk-based formula supplemented with either bacterial or fungal lipase. Digestion and absorption of fat was directly correlated with the addition of lipases as demonstrated by a 30% increase in the coefficient of fat absorption. In comparison to the control group, a 40 and 25% reduction in total fat content and 26 and 45% reduction in n-3 and n-6 fatty acid (FA) content in the stool was observed for lipases 1 and 2, respectively. Improved fat absorption was reflected in the blood levels of lipid parameters. During the experiment, only a very slight gain in body weight was observed in EPI piglets, which can be explained by the absence of pancreatic protease and amylase in the gastrointestinal tract. This is similar to newborn babies that have reduced physiological function of exocrine pancreas. In conclusion, we postulate that the EPI pig model fed with infant formula mimics the growth and lipid digestion and absorption in human neonates and can be used to elucidate further importance of fat and FA in the development and growth of newborns, as well as for testing novel formula compositions.

  15. A 90-year-old patient presenting with postoperative hypotension and a new murmur: a case report.

    Science.gov (United States)

    Hartog, Nicholas L; Kamath, Aparna

    2014-11-10

    Hospitalists are frequently consulted on postoperative patients with hypotension. Postoperative hypotension is common and can be due to variety of causes. Systolic anterior motion of the mitral valve leading to left ventricular outflow tract obstruction is a rare cause of postoperative hypotension and can occur without prior structural heart disease. A high index of suspicion can lead to early recognition of this unique condition. A 90-year-old Caucasian woman with no known structural heart abnormality was admitted to the intensive care unit with hypotension after a left hip arthroplasty revision. A transthoracic echocardiogram revealed systolic anterior motion of the mitral valve and dynamic left ventricular outflow tract obstruction as the likely cause of her hypotension. Our patient was treated with fluid resuscitation and phenylephrine with improvement in blood pressure. A repeat echocardiogram on postoperative day 5 showed resolution of the left ventricular outflow tract obstruction. Intraoperative vasodilatation and volume loss that caused underfilling of the left ventricle likely led to dynamic outflow tract obstruction in our patient. Hospitalists should be aware of systolic anterior motion of the mitral valve as a rare peri-operative complication in patients with or without underlying cardiac pathology as it is treated differently than other causes of peri-operative hypotension. Clinical suspicion, early recognition, and prompt treatment can improve clinical outcomes in these patients.

  16. Controlled hypotension in adults undergoing choroidal melanoma resection: comparison between the efficacy of nitroprusside and magnesium sulphate.

    Science.gov (United States)

    Yosry, M; Othman, I S

    2008-11-01

    To determine whether magnesium sulphate could induce controlled hypotension, reduce choroidal blood flow, provide a 'dry' operative field and could be compared with sodium nitroprusside in the recently raised issue of the use of hypotensive anaesthesia in eye surgery, i.e. for choroidal tumour surgery as the choroid is the most fragile and vascular structure in the eye. Forty adult patients undergoing choroidal melanoma resection and anaesthetized with 2.5 mg kg(-1) propofol, followed by a constant infusion of 120 microg kg(-1) min(-1), and remifentanil 1 microg kg(-1), followed by a continuous infusion of 0.25 microg kg(-1) min(-1), were randomly assigned to two groups to receive either magnesium sulphate or sodium nitroprusside. Controlled hypotension was achieved at the target systolic pressure of 80 mmHg within 107 +/- 16 and 69 +/- 4.4 s for magnesium sulphate and sodium nitroprusside, respectively. Choroidal blood flow decreased by 24 +/- 0.3% and 22 +/- 3.3% for magnesium sulphate and sodium nitroprusside, respectively. Controlled hypotension was sustained in both groups throughout surgery, and the surgical field rating decreased in a range of 80% in both groups. Sodium nitroprusside decreased pH and increased PaCO2. There were no postoperative complications in any of the groups. Magnesium sulphate controlled hypotension, reduced intraoperative pressure and provided good surgical conditions for choroidal melanoma resection with no need for additional use of a potent hypotensive agent in adults.

  17. Managing hypertension in the newborn infants

    OpenAIRE

    Azar Nickavar; Farahnak Assadi

    2014-01-01

    Hypertension in newborn infants, particularly those requiring intensive care, is becoming increasingly recognized, with prevalence of 0.2-3%. Recent studies have established normative tables for blood pressure (BP) in both term and pre-term infants based on the gestational age, postnatal age, gender, weight and height, identifying the neonates at increased risk for early-onset cardiovascular disease. Common causes of neonatal hypertension include thromboembolic complications secondary to umbi...

  18. Submandibular neck mass in a newborn.

    Science.gov (United States)

    Skoog, Hunter; Clark, David W

    2017-10-01

    A deep neck abscess is uncommon in the newborn period. In this case, we noted a clindamycin-sensitive methicillin-resistant Staphylococcus aureus infection characterized as a deep neck abscess in an 8-day-old boy. He was admitted to the pediatric intensive care unit with a progressively enlarging indurated mass below the mandible. Imaging confirmed the mass as a submandibular abscess. The patient received antibiotics in addition to incision and drainage, with resolution of the abscess.

  19. Hair dehydroepiandrosterone (DHEA concentrations in newborn dogs

    Directory of Open Access Journals (Sweden)

    Barbara Bolis

    2015-07-01

    Full Text Available During the last intrauterine fetal stage of development and the neonatal period the hypothalamic-pituitary-adrenal axis (HPA is a key system. Apart of cortisol, the adrenals produce dehydroepiandrosterone (DHEA, the major steroid produced by the fetus itself, so that it could be considered as a marker of offspring HPA activity. Non invasive, long time-frame retrospective hormonal levels analysis were performed in the hair of humans and animals, but not in newborn puppies, and DHEA never investigated in puppies. This study was aimed to assess DHEA concentrations in the hair of newborn puppies, and to evaluate the influence of newborn age, gender, and breed size on DHEA concentrations. The study enrolled 116 spontaneously dead puppies, grouped on the base of mother bodyweight to small or medium-large breeds, and on the base of age at death. Hair samples were collected by shaving, and stored at room temperature until RIA analysis. The overall hair DHEA concentrations were 46.8±14.8 pg/mg. DHEA levels were 48.6±15.66 pg/mg in females vs 45.1±13.73 pg/mg in males, without significant differences. DHEA levels were 45.5±13.61 pg/mg in small size puppies and 47.8±15.61 pg/mg in medium-large size puppies, with no significant differences. DHEA concentrations in premature puppies (52.5±15.12 pg/mg were significant higher (p<0.05 than in puppies dead between 1 and 30 days after birth (44.5±17.78 pg/mg, but similar to fresh term born-dead puppies (46.2±16.5 pg/mg.  This study demonstrated that DHEA is quantifiable in the hair of newborn dogs, and that DHEA levels are significantly influenced by the puppies age.

  20. Reye's syndrome in a newborn infant

    Science.gov (United States)

    Papageorgiou, Apostolos; Wiglesworth, F. W.; Schiff, David; Stern, Leo

    1973-01-01

    A case of Reye's syndrome in a newborn infant, believed to be the first recorded in the perinatal period, is reported. The clinical, biochemical and histological findings are those previously recognized in older infants. The intractable acidosis, hypoglycemia and extreme degree of lactic acidosis reflect an advanced degree of hepatic involvement, probably initiated in utero, with resultant impairment of glycogenolysis and intermediary metabolism. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5 PMID:4746131

  1. Sexuality among fathers of newborns in Jamaica

    OpenAIRE

    Gray, Peter B; Reece, Jody-Ann; Coore-Desai, Charlene; Dinnall-Johnson, Twana; Pellington, Sydonnie; Samms-Vaughan, Maureen

    2015-01-01

    Background While a growing body of research has addressed pregnancy and postpartum impacts on female sexuality, relatively little work has been focused upon men. A few studies suggest that a fraction of men report decreases in libido during a partner?s pregnancy and/or postpartum, with alterations in men?s sexual behavior also commonly aligning with those of a partner. Here, we investigate sexuality among fathers of newborn children in Jamaica. In Jamaica, as elsewhere in the Caribbean, relat...

  2. Effect of ondansetron on prevention of post-induction hypotension in elderly patients undergoing general anesthesia: A randomized, double-blind placebo-controlled clinical trial.

    Science.gov (United States)

    Golparvar, Mohammad; Saghaei, Mahmoud; Saadati, Mohammad Ali; Farsaei, Shadi

    2015-01-01

    Elderly patients are susceptible to post-induction hypotension. Volume loading and vasopressors for prevention of hypotension in elderly patients may increase perioperative cardiovascular risks. Ondansetron by blocking Bezold-Jarisch reflex (BJR) through inhibition of serotonin receptors has been effective in the prevention of post-spinal hypotension, and bradycardia. Bradycardia frequently accompanies post-induction hypotension in elderly patients, which signifies a possible preventing role for ondansetron. No previous study has evaluated the prophylactic effects of ondansetron for the prevention of post-induction hypotension. In this randomized placebo-controlled clinical trial, ondansetron 4 mg was given intravenously to 65 elderly patients, 20 min before induction of general anesthesia, and the rate of post-induction hypotension defined as 25% or more reduction in mean arterial blood pressure, compared with a placebo groups. A total of 114 patients completed the study (58 in ondansetron and 56 in the placebo group). Proportions of post-induction hypotension were 9 (16%) and 25 (45%) in ondansetron and placebo groups, respectively, (P = 0.001). Forty-five patients (40%) developed bradycardia. Rates of bradycardia were not significantly different between two groups. The results of this study show the effectiveness of intravenous ondansetron for prevention of post-induction hypotension in elderly patients. The mechanism of this effect largely is unknown. Role of ondansetron for prevention of post-induction hypotension may not fully understandable by its interaction with BJR, as has been shown in post-spinal hypotension.

  3. Prenatal and newborn screening for hemoglobinopathies.

    Science.gov (United States)

    Hoppe, C C

    2013-06-01

    The hemoglobinopathies encompass a heterogeneous group of disorders associated with mutations in both the alpha-globin and beta-globin genes. Increased immigration of high-risk populations has prompted the implementation of prenatal and newborn screening programs for hemoglobinopathies across Europe and North America. In Canada, the UK, and other European countries, prenatal screening to identify hemoglobinopathy carriers and offer prenatal diagnostic testing to couples at risk is linked to newborn screening, while in the United States, it is still not universally performed. The structure of screening programs, whether prenatal or postnatal, universal or selective, varies greatly among these countries and within the United States. The laboratory methods used to identify hemoglobinopathies are based on the prevalence of hemoglobinopathies within the population and the type of screening performed. Advances in molecular testing have facilitated the diagnosis of complex thalassemias and sickling disorders observed in ethnically diverse populations. This review summarizes the current approaches and methods used for carrier detection, prenatal diagnosis, and newborn screening. © 2013 Blackwell Publishing Ltd.

  4. URETERO PELVIC JUNCTION OBSTRUCTION IN THE NEWBORN

    Directory of Open Access Journals (Sweden)

    J. Kouranloo

    2006-06-01

    Full Text Available Uretero pelvic junction (UPJ obstruction is a common cause of hydronephrosis in infants. The frequent use of fetal ultrasound is allowing early (prenatal diagnosis of numerous uropathies previously delayed until the child either became symptomatic or had a palpable mass. Newborn with severe obstruction often has marked improvement following correction, therefore, early diagnosis and operation are important. From 1993 to 2002, 21 patients were operated on for severe UPJ obstruction who were diagnosed before 6 weeks of age. Only 10 patients (63% had antenatal ultrasonographic diagnosis, the remaining were diagnosed by postnatal ultrasound and IVP or radionuclide scan for palpable renal enlargement or for associated anomalies. Eighteen of them had unilateral and three had bilateral obstruction. Twenty-four pyeloplasties were done; all pyeloplasties were dismembered with tailoring of the dilatated renal pelvis. Postoperative renal function was followed with laboratory blood test, urine test or radionuclide scan or IVP. Postoperative complications included urinary tract infection in three patients and postoperative stenosis in one patient were seen. No mortality occurred on infants in unilateral but one occurred in bilateral obstruction. Also, there was one unrelated late death. We report documented functional improvement with minimal complications in unilateral or bilateral pyeloplasty in newborns with UPJ obstruction. We recommend that if the initial scan shows substantially reduced function in the obstructed kidney, a pyeloplasty (rather than nephrectomy generally should be performed, because the newborn kidney has tremendous capacity for improvement in renal function following decompression.

  5. Congenital malformations in newborns of alcoholic mothers

    Directory of Open Access Journals (Sweden)

    Maria dos Anjos Mesquita

    2010-12-01

    Full Text Available Objective: To identify the presence of fetal alcohol syndrome, other alcohol-related congenital defects, and/or neurodevelopment disorders in newborns of mothers who consumed alcohol during gestation. Methods: In a public maternity in the city of São Paulo, 1,964 puerperal women were interviewed and 654 had consumed alcohol at some point during gestation. The newborns were clinically and laboratorially examined in order to identify the occurrence of fetal alcohol syndrome, congenital defects or neurodevelopment disorders related to alcohol. Results: Three children were found with fetal alcohol syndrome (1.5/1,000 live births, 6 with congenital defects related to alcohol (3.0/1,000 live births, and 67 with developmental disorders related to alcohol (34.1/1,000 live births. The congenital malformations found in these children were thin or absent corpus callosum, brain cyst, asymmetry of the cerebral ventricles, meningomyelocele, cleft lip, anteverted nose, low-set ears, megaureter, hydronephrosis, polydactyly, congenital clubfoot, aphalangia of the toes, cryptorchidism, and hypospadia. Conclusion: Newborns of mothers who consumed alcohol may have congenital malformations of various organs and systems, and early diagnosis is fundamental for a probable and occasional more effective resolution and progress.

  6. Respiratory distress of the term newborn infant.

    Science.gov (United States)

    Edwards, Martin O; Kotecha, Sarah J; Kotecha, Sailesh

    2013-03-01

    Respiratory distress is recognised as any signs of breathing difficulties in neonates. In the early neonatal period respiratory distress is common, occurring in up to 7% of newborn infants, resulting in significant numbers of term-born infants being admitted to neonatal units. Many risk factors are involved; the increasing number of term infants delivered by elective caesarean section has also increased the incidence. Additionally the risk decreases with each advancing week of gestation. At 37 weeks, the chances are three times greater than at 39-40 weeks gestation. Multiple conditions can present with features of respiratory distress. Common causes in term newborn infants include transient tachypnoea of the newborn, respiratory distress syndrome, pneumonia, meconium aspiration syndrome, persistent pulmonary hypertension of the neonate and pneumothorax. Early recognition of respiratory distress and initiation of appropriate treatment is important to ensure optimal outcomes. This review will discuss these common causes of respiratory distress in term-born infants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. [Hand allograft in agenesic newborn: feasibility study].

    Science.gov (United States)

    Gazarian, A; Abrahamyan, D O

    2007-10-01

    Would a newborn with a single hand benefit from hand allograft? Transantebrachial aplasia is the chosen clinical form of agenesia in our interrogation. The feasibility study presents several aspects: 1) ethical and psychological aspects. Is this a desired surgery for agenesic population? Which are the functional, psychological and social situations of agenesic patient? Is the hand transplantation in newborn ethically acceptable? What is the parents' attitude toward agenesia? Can we envisage organ donation in neonatal period? 2) immunological aspects. The non-vital character of this condition and its' good functional tolerance cannot make accepting the risk of adverse effects of hand allotransplantation. Hence, one may consider this surgery only without immunosuppression. Can the peculiarities of the neonate "immature" immune system represent an opportunity of easier tolerance obtaining, avoiding immunosuppression? 3) anatomical and technical aspects. The proximal tissues at the level of amputation are all hypoplastic in agenesic patients. Can we efficaciously suture those structures with donor eutrophic tissues? 4) cognitive aspects. Is a neonate born with only one hand is able to use two? A feasibility study on such a subject needs to take into account all these aspects. This research is useful because, even if hand allograft in agenesic newborn will never be done, the provided information will allow to progress in the vaster domain of composite tissue allotransplantation in perinatology.

  8. Serological evidence of hepatitis E virus infection in pigs and jaundice among pig handlers in Bangladesh.

    Science.gov (United States)

    Haider, N; Khan, M S U; Hossain, M B; Sazzad, H M S; Rahman, M Z; Ahmed, F; Zeidner, N S

    2017-11-01

    Hepatitis E virus (HEV) is the most common cause of viral hepatitis in humans. Pigs may act as a reservoir of HEV, and pig handlers were frequently identified with a higher prevalence of antibodies to HEV. The objectives of this study were to identify evidence of HEV infection in pigs and compare the history of jaundice between pig handlers and people not exposed to pigs and pork. Blood and faecal samples were collected from 100 pigs derived from three slaughterhouses in the Gazipur district of Bangladesh from January to June, 2011. We also interviewed 200 pig handlers and 250 non-exposed people who did not eat pork or handled pigs in the past 2 years. We tested the pig sera for HEV-specific antibodies using a competitive ELISA and pig faecal samples for HEV RNA using real-time RT-PCR. Of 100 pig sera, 82% (n = 82) had detectable antibody against HEV. Of the 200 pig handlers, 28% (56/200) demonstrated jaundice within the past 2 years, whereas only 17% (43/250) of controls had a history of jaundice (p Bangladesh demonstrated evidence of HEV infection, and a history of jaundice was significantly more frequent in pig handlers. Identifying and genotyping HEV in pigs and pig handlers may provide further evidence of the pig's role in zoonotic HEV transmission in Bangladesh. © 2017 Blackwell Verlag GmbH.

  9. [Gastric dynamics analysis of TEAS combined SNP induced general anesthesia when controlled hypotension dropped to 60% of the MAP baseline].

    Science.gov (United States)

    Zhang, Le-Le; Fang, Jian-Qiao; Shao, Xiao; Lian, Lin-Li; Yu, Xiao-Jing; Dong, Zhen-Hua; Mo, Ya-Di

    2015-01-01

    To observe the effect of gastric dynamics by transcutaneous electrical acupoint stimulation (TEAS) combined general anesthesia when controlled hypotension dropped to 60% of the mean arterial prenssure (MAP) baseline, and to provide experimental evidence for organ protection in clinical controlled hypotension. Eighteen male beagles were randomly divided into three groups, the general anesthesia group (blank), the general anesthesia induced controlled hypotension group (control), and the general anesthesia combined TEAS induced controlled hypotension group (experiment), 6 in each group. Controlled hypotension was performed in the latter two groups with isoflurane inhalation and intravenous injection of sodium nitroprusside (SNP). The mean arterial pressure (MAP) was lowered to 60% of the MAP baseline and kept for 60 min. Controlled hypotension was not performed in Beagles of the control group. For Beagles in the experiment group, TEAS [2/100 Hz, (4 ± 1) mA] was applied to bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36), and Sanyinjiao (SP6) from stable physiological conditions to the end of maintaining stages. Changes of EGG frequencies and EGG amplitudes were monitored. Serum levels of gastrin (GAS) and motilin (MTL) were also detected at corresponding time points during and after experiment. As for the pressure control effect of TEAS combined general anesthesia in the controlled hypotension, during the process of controlled hypotension (T1-T4), MAP levels of two controlled pressure groups remained relatively stable, and were kept at 60% of the MAP baseline. When the blood pressure dropped to the target low MAP and maintained at 60 min (T1-T4), EGG amplitudes of Beagles in all the three groups showed decreasing tendency. But it was more obviously lower than its basic level in the control group (P control group and the blank group (P control group. During this period, EGG frequencies of the two controlled hypotension groups decreased more than those of the blank

  10. Controlled hypotension versus normotensive resuscitation strategy for people with ruptured abdominal aortic aneurysm.

    Science.gov (United States)

    Moreno, Daniel H; Cacione, Daniel G; Baptista-Silva, Jose C C

    2016-05-13

    An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair. The management of haemorrhagic shock is crucial for the person's outcome and aims to restore organ perfusion and systolic blood pressure above 100 mm Hg through immediate and aggressive fluid replacement. This rapid fluid replacement is known as the normotensive resuscitation strategy. However, evidence suggests that infusing large volumes of cold fluid causes dilutional and hypothermic coagulopathy. The association of these factors may exacerbate bleeding, resulting in a 'lethal triad' of hypothermia, acidaemia, and coagulopathy. An alternative to the normotensive resuscitation strategy is the controlled (permissive) hypotension resuscitation strategy, with a target systolic blood pressure of 50 to 100 mm Hg. The principle of controlled or hypotensive resuscitation has been used in some management protocols for endovascular repair of ruptured AAA. It may be beneficial in preventing blood loss by avoiding the clot disruption caused by the rapid increase in systolic blood pressure; avoiding dilution of clotting factors, platelets and fibrinogen; and by avoiding the temperature decrease that inhibits enzyme activity involved in platelet and clotting factor function. To compare the effects of controlled (permissive) hypotension resuscitation and normotensive resuscitation strategies for people with ruptured AAA. The Cochrane Vascular Information Specialist searched the Specialised Register (April 2016) and the Cochrane Register of Studies (CENTRAL (2016

  11. Environmental systems analysis of pig production

    OpenAIRE

    Strid Eriksson, Ingrid

    2004-01-01

    The aim of this thesis was to develop the SALSA models (Systems AnaLysis for Sustainable Agriculture), and to apply them to studies for the benefit of more sustainable pig production. Within the framework of environmental systems analysis, the SALSA models were constructed as substance and energy flow models using life cycle assessment methodology for impact assessment and scope definition. The pig production system studied included rearing of growing-finishing pigs (SALSA-pig model) and prod...

  12. Nimodipine Prevents Memory Impairment Caused by Nitroglycerin-Induced Hypotension in Adult Mice

    Science.gov (United States)

    Bekker, Alex; Haile, Michael; Li, Yong-Sheng; Galoyan, Samuel; Garcia, Edwardo; Quartermain, David; Kamer, Angela; Blanck, Thomas

    2010-01-01

    BACKGROUND: Hypotension and a resultant decrease in cerebral blood flow have been implicated in the development of cognitive dysfunction. We tested the hypothesis that nimodipine (NIMO) administered at the onset of nitroglycerin (NTG)-induced hypotension would preserve long-term associative memory. METHODS: The passive avoidance (PA) paradigm was used to assess memory retention. For PA training, latencies (seconds) were recorded for entry from a suspended platform into a Plexiglas tube where a shock was automatically delivered. Latencies were recorded 48 h later for a testing trial. Ninety-six Swiss-Webster mice (30–35 g, 6–8 wk), were randomized into 6 groups 1) saline (control), 2) NTG immediately after learning, 3) NTG 3 h after learning, 4) NTG and NIMO, 5) vehicle, and 6) NIMO alone. The extent of hypotension and changes in brain tissue oxygenation (PbtO2) and in cerebral blood flow were studied in a separate group of animals. RESULTS: All groups exhibited similar training latencies (17.0 ± 4.6 s). Mice subjected to hypotensive episodes showed a significant decrease in latency time (178 ± 156 s) compared with those injected with saline, NTG + NIMO, or delayed NTG (580 ± 81 s, 557 ± 67 s, and 493 ± 146 s, respectively). A Kruskal-Wallis 1-way analysis of variance indicated a significant difference among the 4 treatment groups (H = 15.34; P < 0.001). In a separate group of mice not subjected to behavioral studies, the same dose of NTG (n = 3) and NTG + NIMO (n = 3) caused mean arterial blood pressure to decrease from 85.9 ± 3.8 mm Hg sem to 31.6 ± 0.8 mm Hg sem and from 86.2 ± 3.7 mm Hg sem to 32.6 ± 0.2 mm Hg sem, respectively. Mean arterial blood pressure in mice treated with NIMO alone decreased from 88.1 ± 3.8 mm Hg to 80.0 ± 2.9 mm Hg. The intergroup difference was statistically significant (P < 0.05). PbtO2 decreased from 51.7 ± 4.5 mm Hg sem to 33.8 ± 5.2 mm Hg sem in the NTG group and from 38.6 ± 6.1 mm Hg sem to 25.4 ± 2.0 mm Hg sem

  13. Evaluation of pain in healthy newborns and in newborns with developmental problems (Down syndrome).

    Science.gov (United States)

    Aguilar Cordero, Maria José; Mur Villar, Norma; García García, Inmaculada

    2015-06-01

    Newborns are often subjected to invasive and painful medical procedures. This happens even more frequently when they require hospitalization. The aim of this paper was to evaluate pain in healthy newborns and in newborns with Down syndrome (DS). We performed a prospective cohort study in the neonatal service of the San Cecilio University Hospital in Granada (Spain) from January 2008 to September 2013. The universe of our study comprised a study group of 20 newborns with DS and a control group of 20 newborns without DS. All of the infants were hospitalized, and thus had to undergo painful medical procedures. The variables studied were basal recovery time (as reflected in crying and the normalization of biological constants), number of punctures, oxygen saturation, heartbeat, blood pressure, response to skin-to-skin contact, and gestational age. The evaluation was performed during blood extraction, vein canalization, and heel puncture. The significant differences in the basal recovery time between the two groups of newborns indicated that those with DS were slower to express pain, and when they did, their response was not as clearly defined as that of babies without DS. The oxygen saturation in babies with DS after the puncture was found to be significantly lower than that of the control group (p < .001). The results of this study revealed that babies with DS were not as quick to perceive pain after a puncture. However, when pain was finally perceived, it persisted for a longer time. This situation should be taken into account in the design of pharmacologic and nonpharmacologic therapies. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. Newborn body compositon and its relationship to linear growth.

    Science.gov (United States)

    Frisancho, A R; Klayman, J E; Matos, J

    1977-05-01

    Anthropometric measurements were made on 4,952 newborns from a Peruvian urgan population. Newborns characterized by high subcutaneous fat and high muscle had significantly greater birth weights and recumbent lengths when compared to their counterparts with low subcutaneous fat and muscle. Similarly, newborns characterized by high muscle and low fat had significantly greater birth weights and recumbent lengths that newborns characterized by low muscle and high fat. It is postulated that an increase in newborn protein and calorie reserves results in a greater increase in birth weight and recumbent length than an increase in calorie reserves alone. Evaluations of maternal antropometric characteristics indicate that variations in birth weight and recumbent length of the newborn are affected more by maternal nutritional status than by maternal stature.

  15. Epinephrine for transient tachypnea of the newborn.

    Science.gov (United States)

    Moresco, Luca; Calevo, Maria Grazia; Baldi, Federica; Cohen, Amnon; Bruschettini, Matteo

    2016-05-23

    Transient tachypnea of the newborn is characterized by tachypnea and signs of respiratory distress. Transient tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of epinephrine (adrenaline) for transient tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. To assess whether epinephrine compared to placebo, no treatment or any other drugs (excluding salbutamol) is effective and safe in the treatment of transient tachypnea of the newborn in infants born at 34 weeks' gestational age or more. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia and New Zealand and Pediatric Academic Societies) from 2000 to 2015. Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing epinephrine versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient tachypnea of the newborn. For the included trial, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy (hours), need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy (hours), need for continuous positive airway pressure and need for

  16. Odors from evaporation of acidified pig urine

    NARCIS (Netherlands)

    Willers, H.C.; Hobbs, P.J.; Ogink, N.W.M.

    2004-01-01

    In the Dutch Hercules project feces and urine from pigs are collected separately underneath the slatted floor in a pig house and treated in two processes. Feces are composted and urine is concentrated by water evaporation in a packed bed. Exhaust air from the pig house is used for the evaporation in

  17. Pig slaughtering in southwestern Nigeria: peculiarities, animal ...

    African Journals Online (AJOL)

    Background: Pig slaughtering methods influence the quality of pig products and also serves as a critical point for the control of zoonosis and other food-borne infections. This study aimed at assessing the peculiarities, the animal welfare concerns and the public health implications of pig slaughtering activities was conducted ...

  18. Weaning the pig - Concepts and consequences

    NARCIS (Netherlands)

    Pluske, J.R.; Dividich, Le J.; Verstegen, M.W.A.

    2003-01-01

    Weaning the Pig: Concepts and Consequences addresses the major issues surrounding the weaning process, both for piglets and the breeding herd, in modern-day pig production. The post-weaned pig presents many challenges to the manager, stockperson and nutritionist, and as such is a critical phase in

  19. Genetic characterization of Nigerian indigenous pig using ...

    African Journals Online (AJOL)

    The high genetic similarity observed in the indigenous pig samples in Ogbooro indicated a level of inbreeding of pig stocks in this locality which can be conserved as a genetic resource for breeding programmes for pure NIP in the future. Key words: Animal genetic resources, conservation, Nigeria indigenous pig, ...

  20. Salmonella in the lairage of pig slaughterhouses

    NARCIS (Netherlands)

    Swanenburg, M.; Urlings, H.A.P.; Keuzenkamp, D.A.; Snijders, J.M.A.

    2001-01-01

    The purpose of this study was to determine if lairages of pig slaughterhouses can act as a source of contamination of slaughtered pigs with Salmonella. The prevalence and variety of serotypes of Salmonella in the lairages of two pig slaughterhouses were determined, and the efficacy of the usual

  1. Angiogenesis dysregulation in term asphyxiated newborns treated with hypothermia.

    Directory of Open Access Journals (Sweden)

    Henna Shaikh

    Full Text Available Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesis-related markers following birth asphyxia in human newborns.This study aimed to evaluate the expression of angiogenesis-related protein markers in asphyxiated newborns developing and not developing brain injury compared to healthy control newborns.Twelve asphyxiated newborns treated with hypothermia were prospectively enrolled; six developed eventual brain injury and six did not. Four healthy control newborns were also included. We used Rules-Based Medicine multi-analyte profiling and protein array technologies to study the plasma concentration of 49 angiogenesis-related proteins. Mean protein concentrations were compared between each group of newborns.Compared to healthy newborns, asphyxiated newborns not developing brain injury showed up-regulation of pro-angiogenic proteins, including fatty acid binding protein-4, glucose-6-phosphate isomerase, neuropilin-1, and receptor tyrosine-protein kinase erbB-3; this up-regulation was not evident in asphyxiated newborns eventually developing brain injury. Also, asphyxiated newborns developing brain injury showed a decreased expression of anti-angiogenic proteins, including insulin-growth factor binding proteins -1, -4, and -6, compared to healthy newborns.These findings suggest that angiogenesis pathways are dysregulated following birth asphyxia and are putatively involved in brain injury pathology and recovery.

  2. High Compliance with Newborn Community-to-Facility Referral in Eastern Uganda:.An Opportunity to Improve Newborn Survival

    Science.gov (United States)

    Nalwadda, Christine Kayemba; Waiswa, Peter; Kiguli, Juliet; Namazzi, Gertrude; Namutamba, Sarah; Tomson, Göran; Peterson, Stefan; Guwatudde, David

    2013-01-01

    Background Seventy-five percent of newborn deaths happen in the first-week of life, with the highest risk of death in the first 24-hours after birth.WHO and UNICEF recommend home-visits for babies in the first-week of life to assess for danger-signs and counsel caretakers for immediate referral of sick newborns. We assessed timely compliance with newborn referrals made by community-health workers (CHWs), and its determinants in Iganga and Mayuge Districts in rural eastern Uganda. Methods A historical cohort study design was used to retrospectively follow up newborns referred to health facilities between September 2009 and August 2011. Timely compliance was defined as caretakers of newborns complying with CHWs’ referral advice within 24-hours. Results A total of 724 newborns were referred by CHWs of whom 700 were successfully traced. Of the 700 newborns, 373 (53%) were referred for immunization and postnatal-care, and 327 (47%) because of a danger-sign. Overall, 439 (63%) complied, and of the 327 sick newborns, 243 (74%) caretakers complied with the referrals. Predictors of referral compliance were; the newborn being sick at the time of referral- Adjusted Odds Ratio (AOR) = 2.3, and 95% Confidence-Interval (CI) of [1.6 - 3.5]), the CHW making a reminder visit to the referred newborn shortly after referral (AOR =1.7; 95% CI: [1.2 -2.7]); and age of mother (25-29) and (30-34) years, (AOR =0.4; 95% CI: [0.2 - 0.8]) and (AOR = 0.4; 95% CI: [0.2 - 0.8]) respectively. Conclusion Caretakers’ newborn referral compliance was high in this setting. The newborn being sick, being born to a younger mother and a reminder visit by the CHW to a referred newborn were predictors of newborn referral compliance. Integration of CHWs into maternal and newborn care programs has the potential to increase care seeking for newborns, which may contribute to reduction of newborn mortality. PMID:24312326

  3. Gut health in the pig

    DEFF Research Database (Denmark)

    Pluske, J. R.; Hansen, Christian Fink; Payne, H. G.

    2007-01-01

    ' and caused enormous interest in alternative means to control diseases and conditions of the GIT. There are now available a wide array of products and strategies available to the pig industry that influence 'gut health'. The products in the market place are characterised predominately not only...... by their (claimed) different modes of action, but also by the variation in responses seen when offered to pigs, and not only in the post-weaning period. This variation is presumably a consequence of the many different conditions of management that pigs are under, that in turn influences factors such as composition...... of the microbiota and mucosal immunity. Other strategies, such as the manipulation of particle size and changing the protein content of a diet, might also be adopted to influence the expression of enteric pathogens and the expression of disease. Ultimately, the cost-benefit of adopting such practices to influence...

  4. Injurious tail biting in pigs

    DEFF Research Database (Denmark)

    D'Eath, R.B.; Amott, G.; Turner, S. P.

    2014-01-01

    Tail biting is a serious animal welfare and economic problem in pig production. Tail docking, which reduces but does not eliminate tail biting, remains widespread. However, in the EU tail docking may not be used routinely, and some ‘alternative’ forms of pig production and certain countries do...... not allow tail docking at all. Against this background, using a novel approach focusing on research where tail injuries were quantified, we review the measures that can be used to control tail biting in pigs without tail docking. Using this strict criterion, there was good evidence that manipulable...... substrates and feeder space affect damaging tail biting. Only epidemiological evidence was available for effects of temperature and season, and the effect of stocking density was unclear. Studies suggest that group size has little effect, and the effects of nutrition, disease and breed require further...

  5. The current revolution in newborn screening: new technology, old controversies.

    Science.gov (United States)

    Tarini, Beth A

    2007-08-01

    Newborn screening has provided a model of a successful public health screening program for the past 40 years. However, the history of newborn screening is not without controversy. Many of these controversies have been rekindled with the introduction of tandem mass spectrometry, a technology that has greatly increased our ability to detect potential disease in asymptomatic newborns. This review highlights the challenges raised by this and future technological advances as we strive to maintain the success of newborn screening in the 21st century.

  6. Anesthesia information management system-based near real-time decision support to manage intraoperative hypotension and hypertension.

    Science.gov (United States)

    Nair, Bala G; Horibe, Mayumi; Newman, Shu-Fang; Wu, Wei-Ying; Peterson, Gene N; Schwid, Howard A

    2014-01-01

    Intraoperative hypotension and hypertension are associated with adverse clinical outcomes and morbidity. Clinical decision support mediated through an anesthesia information management system (AIMS) has been shown to improve quality of care. We hypothesized that an AIMS-based clinical decision support system could be used to improve management of intraoperative hypotension and hypertension. A near real-time AIMS-based decision support module, Smart Anesthesia Manager (SAM), was used to detect selected scenarios contributing to hypotension and hypertension. Specifically, hypotension (systolic blood pressure 1.25 minimum alveolar concentration [MAC]) of inhaled drug and hypertension (systolic blood pressure >160 mm Hg) with concurrent phenylephrine infusion were detected, and anesthesia providers were notified via "pop-up" computer screen messages. AIMS data were retrospectively analyzed to evaluate the effect of SAM notification messages on hypotensive and hypertensive episodes. For anesthetic cases 12 months before (N = 16913) and after (N = 17132) institution of SAM messages, the median duration of hypotensive episodes with concurrent high MAC decreased with notifications (Mann Whitney rank sum test, P = 0.031). However, the reduction in the median duration of hypertensive episodes with concurrent phenylephrine infusion was not significant (P = 0.47). The frequency of prolonged episodes that lasted >6 minutes (sampling period of SAM), represented in terms of the number of cases with episodes per 100 surgical cases (or percentage occurrence), declined with notifications for both hypotension with >1.25 MAC inhaled drug episodes (δ = -0.26% [confidence interval, -0.38% to -0.11%], P 1.25 MAC inhaled drug episodes. However, since phenylephrine infusion is manually documented in an AIMS, the impact of notification messages was less pronounced in reducing episodes of hypertension with concurrent phenylephrine infusion. Automated data capture and a higher frequency of

  7. Influence of the timing of administration of crystalloid on maternal hypotension during spinal anesthesia for cesarean delivery: preload versus coload.

    Science.gov (United States)

    Oh, Ah-Young; Hwang, Jung-Won; Song, In-Ae; Kim, Mi-Hyun; Ryu, Jung-Hee; Park, Hee-Pyoung; Jeon, Yeong-Tae; Do, Sang-Hwan

    2014-01-01

    Prophylactic fluid preloading before spinal anesthesia has been a routine procedure to prevent maternal hypotension during cesarean delivery. Unlike colloid, timing of infusion of crystalloid may be important because of its short stay in intravascular space. We hypothesized that crystalloid loading just after intrathecal injection compared to preload would be more effective in preventing maternal hypotension. In this prospective controlled study, sixty parturients were randomized to receive 15 ml/kg of crystalloid before (preload group) or after (coload group) intrathecal drug injection for spinal anesthesia. Hypotension was defined if systolic arterial pressure decreased below 80% of baseline and ephedrine was administered to treat hypotension. The incidence of hypotension and the total dose of ephedrine were checked. Blood pressure, heart rate and nausea before childbirth were assessed. Neonatal outcomes were evaluated with Apgar scores and umbilical blood gas analysis. The incidence of hypotension was lower in the coload group compared to the preload group (53% vs. 83%, P = 0.026). The blood pressure showed the bigger drop during spinal anesthesia in the preload group (34 ± 13 vs. 25 ± 10 mmHg, P = 0.002) and smaller dose of ephedrine was required in the coload group (7.5 [0-30] vs. 15 [0-40] mg, P = 0.015). The incidence of nausea was also lower in the coload group (27% vs. 60%, P = 0.019). Neonatal outcome measures were comparable between two groups. In case of using crystalloids for cesarean delivery, coload is more effective than preload for the prevention of maternal hypotension after spinal anesthesia. Clinical Research Information Service KCT0000324 (Jan 12(th), 2012).

  8. A presedation fluid bolus does not decrease the incidence of propofol-induced hypotension in pediatric patients.

    Science.gov (United States)

    Jager, Matthew D; Aldag, Jean C; Deshpande, Girish G

    2015-02-01

    Propofol is commonly used in pediatric sedation, which may cause hypotension during induction. Our goal was to determine the effect of a preinduction 20-mL/kg isotonic fluid bolus on propofol-induced hypotension, assess clinical signs of hypoperfusion during hypotension, and evaluate for age-related propofol dosing differences. This prospective, randomized, controlled, nonblinded study was conducted at Children's Hospital of Illinois. Patients were children 6 to 60 months of age who needed sedation for MRI or auditory brainstem-evoked response testing. The treatment group received a preinduction 20-mL/kg isotonic saline bolus before procedure initiation. Patients were continuously monitored via cardiorespiratory monitor with pulse oximetry and end-tidal carbon dioxide measurements. Cardiovascular indices and clinical signs of hypoperfusion were compared between groups, and propofol dosing differences were compared between age groups. One hundred twenty-six patients were randomly assigned to treatment (n=52) or control (n=74) conditions. Twelve patients in the treatment group and 14 patients in the control group experienced postinduction hypotension, as defined by the Pediatric Advanced Life Support guidelines. One patient in each group was given volume resuscitation when blood pressure did not improve after a reduction in the propofol infusion rate. No hypotensive patients had physical signs of hypoperfusion, and patients≤1 year of age needed significantly more propofol. A 20-mL/kg preinduction isotonic saline bolus does not prevent propofol-induced hypotension. No clinical signs of hypoperfusion were noted with induced hypotension, and infants≤12 months old need significantly more propofol per kilogram for procedures. Copyright © 2015 by the American Academy of Pediatrics.

  9. Agronomic recycling of pig slurry and pig sewage

    Science.gov (United States)

    Gómez Garrido, Melisa; Sánchez García, Pablo; Faz Cano, Ángel; Büyükkılıç Yanardag, Asuman; Yanardag, Ibrahim; Kabas, Sebla; Ángeles Múñoz García, María; María Rosales Aranda, Rosa; Segura Ruíz, Juan Carlos

    2013-04-01

    Recycling pig slurry as organic fertilizer is a convenient and suitable way of waste elimination due to its low cost and high agronomic benefits. The objectives of this two year study are focused on improving and recycling pig slurry appropriately, and monitoring the soil-plant system at the same time. The evaluation of the agronomic effectiveness of different types of pig slurry (raw, solid, treated and depurated) in different doses (170 kg N ha-1 (legislated dose), 340 and 510 kg N ha-1) is innovative because the fertilizer value of each amendment can be balanced. Furthermore environmental issues such us volatilisation, leaching and salinisation have been considered for each treatment in order to set the viability of the study and to justify the treatments applied. Electrical conductivity, Kjeldhal nitrogen, sodium and potassium are the physico-chemical parameters most influenced in soils treated with doses 340 and 510 kg N ha-1. Additionally plant samples, especially halophyte, have shown the highest major and minor nutrients contents. Finally, pig slurry application in legislated doses could be considered a useful environmental practice; however, the development of the crop will be very influenced by the type of dose and amendment selected.

  10. Integration of the Newborn Behavioral Observations (NBO) System into Care Settings for High-Risk Newborns

    Science.gov (United States)

    McManus, Beth M.

    2015-01-01

    Research suggests that early self-regulatory difficulties among high-risk newborns can lead to poor interactional difficulties and negative long-term cognitive and social-emotional outcomes if not identified and treated early. This article describes why an individualized, developmentally supportive, relationship-based program, such as the Newborn…

  11. Factors affecting newborn care practices in Bangladesh.

    Science.gov (United States)

    Shahjahan, Md; Ahmed, M Ranzu; Rahman, M Mokhlesur; Afroz, Afsana

    2012-01-01

    Newborn care is of immense importance for the proper development and healthy life of a baby. Although child and infant mortality in South Asia has reduced substantially, the rate of neonatal mortality is still high, although these deaths can be prevented by adopting simple interventions at the community level. The aim of the study was to identify the associated factors which affect newborn care practices. Data for the study were drawn from the Bangladesh Demographic and Health Survey 2007, in which 6150 mothers were considered. The mean age of the mothers was 18 (±3.2) years. A little over 62% of the pregnant women received at least one antenatal check-up during the entire period of their pregnancy. About 70% of deliveries were conducted at home either by unskilled family members or by relatives. A clean instrument was used for cutting the cord of 87% of the newborn babies, while about 34% of them were reported to have had their first bath immediately after delivery. Initiation of breast feeding immediately after birth was practised in only about 19% of the cases. Compared with mothers with no education, those with secondary or higher levels were associated with clean cord care [odds ratio (OR) = 1.3, 95% confidence interval (CI) 1.0, 1.9] and early breast feeding [OR = 1.6, 95% CI 1.2, 2.2]. The study revealed an urgent need to educate mothers, and train traditional birth attendants and health workers on clean delivery practices and early neonatal care. Increasing the number of skilled birth attendants can be an effective strategy to increase safe delivery practices, and to reduce delivery complications. © 2011 Blackwell Publishing Ltd.

  12. Birth order and health of newborns

    DEFF Research Database (Denmark)

    Brenøe, Anne Ardila; Molitor, Ramona

    2017-01-01

    We examine birth order differences in health of newborns and follow the children throughout childhood using high-quality administrative data on individuals born in Denmark between 1981 and 2010. Family fixed effects models show a positive and robust effect of birth order on health at birth...... in the first years of life, disappears by age seven, and becomes a health advantage in adolescence. In contrast, later-born children are throughout childhood more likely to suffer an injury. The results on health in adolescence are consistent with previous evidence of a firstborn advantage in education...

  13. Radioimmunoassay in screening studies of newborns

    Energy Technology Data Exchange (ETDEWEB)

    Laricheva, I.P.; Chulkova, V.I.; Smirnova, T.A.; Lenni, V.G.

    1983-08-01

    A radioimmunological examination (screening) of hypaphyseal-thyroid function in 2400 newborns within the 1st week of life revealed 111 infants with transitory forms of hypothyroidism that was observed during the 1st month of the life. The main causes of disturbed thyroid function were endocrine diseases in mothers, a complicated course of pregnancy and delivery. It makes possible to detect not only congenital thyroid diseases but also to evaluate the function of the most important hormonal system in the adaptation of an infant in the postnatal period.

  14. Weight monitoring system for newborn incubator application

    Science.gov (United States)

    Widianto, Arif; Nurfitri, Intan; Mahatidana, Pradipta; Abuzairi, Tomy; Poespawati, N. R.; Purnamaningsih., Retno W.

    2018-02-01

    We proposed weight monitoring system using load cell sensor for newborn incubator application. The weight sensing system consists of a load cell, conditioning signal circuit, and microcontroller Arduino Uno R3. The performance of the sensor was investigated by using the various weight from 0 up to 3000 g. Experiment results showed that this system has a small error of 4.313% and 12.5 g of threshold and resolution value. Compared to the typical baby scale available in local market, the proposed system has a lower error value and hysteresis.

  15. A prospective, open-label trial of clevidipine for controlled hypotension during posterior spinal fusion.

    Science.gov (United States)

    Kako, Hiromi; Gable, Andrew; Martin, David; Beebe, Allan; Thung, Arlyne; Samora, Walter; Klamar, Jan; Bhalla, Tarun; Tobias, Joseph D

    2015-01-01

    Controlled hypotension is one means to limit or avoid the need for allogeneic blood products. Clevidipine is a short-acting, intravenous calcium channel antagonist with a half-life of 1 to 3 minutes due to rapid metabolism by non-specific blood and tissue esterases. To date, there are no prospective evaluations with clevidipine in the pediatric population. We prospectively evaluated the dosing requirements, efficacy, and safety of clevidipine for ontrolled hypotension during spinal surgery for neuromuscular scoliosis in the pediatric population. Patients undergoing posterior spinal fusion for neuromuscular scoliosis were eligible for inclusion. The study was an open label, observational study. Maintenance anesthesia included desflurane titrated to maintain a bispectral index at 40 to 60 and a remifentanil infusion. Motor and somatosensory evoked potentials were monitored intraoperatively. When the mean arterial pressure (MAP) was ≥ 65 mmHg despite remifentanil at 0.3 mcg/kg/min, clevidipine was added to maintain the MAP at 55 to 65 mmHg. Clevidipine was initiated at 0.25 to 1 mcg/kg/min and titrated up in increments of 0.25 to 1 mcg/kg/min every 3 to 5 minutes to achieve the desired MAP. The study cohort included 45 patients. Fifteen patients (33.3%) did not require a clevidipine infusion to maintain the desired MAP range, leaving 30 patients including 13 males and 17 females for analysis. These patients ranged in age from 7.9 to 17.4 years (mean ± SD: 13.7 ± 2.2 years) and in weight from 18.9 to 78.1 kg (mean ± SD: 43.4 ± 14.2 kg). Intraoperatively, the clevidipine infusion was stopped in 6 patients as the surgeon expressed concerns regarding spinal cord perfusion and requested a higher MAP than the study protocol allowed. The data until that point were included for analysis. The target MAP was initially achieved at a mean time of 8.9 minutes. Sixteen of the 30 patients (53.3%) achieved the target MAP within 5 minutes. Heart rate (HR) increased from a

  16. Quality maternal and newborn care to ensure a healthy start for every newborn in the World Health Organization Western Pacific Region.

    Science.gov (United States)

    Obara, H; Sobel, H

    2014-09-01

    In the World Health Organization Western Pacific Region, the high rates of births attended by skilled health personnel (SHP) do not equal access to quality maternal or newborn care. 'A healthy start for every newborn' for 23 million annual births in the region means that SHP and newborn care providers give quality intrapartum, postpartum and newborn care. WHO and the UNICEF Regional Action Plan for Healthy Newborn Infants provide a platform for countries to scale-up Early Essential Newborn Care (EENC). The plan emphasises the creation of an enabling environment for the practice of EENC; thereby, preventing 50,000 newborn deaths annually. © 2014 Royal College of Obstetricians and Gynaecologists.

  17. ABO incompatibility hemolytic disease following exchange transfusion 96 newborn

    Directory of Open Access Journals (Sweden)

    Khatami S.F

    2007-09-01

    Full Text Available Background: ABO incompatibility hemolytic disease of the newborn is a common cause of clinical jaundice and causes two-thirds of the hemolytic disease in newborns. This study was undertaken to determine the frequency of ABO incompatibility hemolytic disease and its complications in newborns undergoing exchange transfusion.Methods: This prospective and descriptive study was performed in jaundiced newborn infants during a three-year period. Inclusion criteria were: maternal blood type O, newborn blood type A or B, rising indirect hyperbilirubinemia in the first two days of life, positive immunohematologic test for newborns and exchange transfusion. Exclusion criteria were: incomplete information, other accompanying diseases that induce hyperbilirubinemia. All newborn infants received phototherapy before and after exchange transfusion. We did not use intravenous immunoglobulin, hemoxygenase inhibitor drugs and blood products before exchange transfusion.Results: Double-volume exchange transfusion via umbilical cord catheter was performed in 96 patients, 19 (20% of whom suffered from ABO incompatibility. Of these 19 newborns, two-thirds (13 were preterm infants. The minimum level of serum bilirubin was 10 mg/dl and the maximum serum bilirubin level was 35 mg/dl. In six patients (32% serum bilirubin levels were >25mg/dl. The most common blood group was type A for newborns. Immunohematologic tests were positive in 84% of the mothers. ABO incompatibility hemolytic disease was the fourth and second most common reasons for blood exchange transfusion in preterm and term infants, respectively. Laboratory complications were more common than clinical complications. The etiology of 48% of the alloimmunization and 42% of the hemolytic disease in these newborns was ABO incompatibility.Conclusions: Mothers with blood group O and newborns with blood group A or B with positive immunohematologic tests in first hours of life are at high risk for hemolytic disease

  18. Modeling maternal fetal RSV F vaccine induced antibody transfer in guinea pigs.

    Science.gov (United States)

    Glenn, Gregory M; Fries, Louis F; Smith, Gale; Kpamegan, Eloi; Lu, Hanxin; Guebre-Xabier, Mimi; Hickman, Somia P; Flyer, David

    2015-11-25

    Protection of newborns and young infants against RSV disease via maternal immunization mediated by transplacental transfer of antibodies is under evaluation in third-trimester pregnant women with the RSV recombinant F nanoparticle vaccine (RSV F vaccine). Since the hemichorial placental architecture in guinea pigs and humans is similar, the guinea pig model was employed to assess RSV F vaccine immunogenicity in pregnant sows and to compare RSV-specific maternal antibody levels in their pups. Thirty (30) presumptive pregnant guinea pigs were immunized on gestational day 25 and 46 with placebo (PBS), 30μg RSV F, or 30μg RSV F+400μg aluminum phosphate. Sera at delivery/birth (sows/pups) and 15 and 30 days post-partum (pups) were analyzed for the presence of anti-F IgG, palivizumab-competitive antibody (PCA) and RSV/A microneutralization (MN). The rates of pregnancy and stillbirth were similar between controls and vaccinees. The vaccine induced high levels of anti-F IgG, PCA and MN in sows, with the highest levels observed in adjuvanted vaccinees. Placental transfer to pups was proportional to the maternal antibody levels, with concentration effects observed for all immune measures. The RSV F vaccine was safe and immunogenic in pregnant guinea pigs and supported robust transplacental antibody transfer to their pups. Relative concentration of antibodies in the pups was observed even in the presence of high levels of maternal antibody. Guinea pigs may be an important safety and immunogenicity model for preclinical assessment of candidate vaccines for maternal immunization. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. PigSurfer- SURveillance, FEedback & Reporting within ProPIG for communication with 75 pig farmers

    OpenAIRE

    Leeb, Christine; Bochicchio, Davide; Butler, G.; Edwards, S.; Früh, Barbara; Illmann, Gudrun; Rousing, T.; Prunier, Armelle; Rudolph, G.; Dippel, Sabine

    2014-01-01

    The CoreOrganic2 research project ProPIG is carried out in 75 organic pig farms in 8 European countries (AT; CH; CZ; DE; DK; FR; IT; UK) to improve animal health, welfare and nutrition using farm customised strategies. For future on-farm application (e.g. advisory/certification activities, which are mostly carried out during one day visits), a practical, automatic recording and feedback tool was developed. This should allow on-farm data collection, import of data into a database and the possi...

  20. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial

    Science.gov (United States)

    Walker, Ann F; Marakis, Georgios; Simpson, Eleanor; Hope, Jessica L; Robinson, Paul A; Hassanein, Mohamed; Simpson, Hugh CR

    2006-01-01

    Background Hawthorn (Crataegus laevigata) leaves, flowers and berries are used by herbal practitioners in the UK to treat hypertension in conjunction with prescribed drugs. Small-scale human studies support this approach. Aim To investigate the effects of hawthorn for hypertension in patients with type 2 diabetes taking prescribed drugs. Design of study Randomised controlled trial. Setting General practices in Reading, UK. Method Patients with type 2 diabetes (n = 79) were randomised to daily 1200 mg hawthorn extract (n = 39) or placebo (n = 40) for 16 weeks. At baseline and outcome a wellbeing questionnaire was completed and blood pressure and fasting blood samples taken. A food frequency questionnaire estimated nutrient intake. Results Hypotensive drugs were used by 71% of the study population with a mean intake of 4.4 hypoglycaemic and/or hypotensive drugs. Fat intake was lower and sugar intake higher than recommendations, and low micronutrient intake was prevalent. There was a significant group difference in mean diastolic blood pressure reductions (P = 0.035): the hawthorn group showed greater reductions (baseline: 85.6 mmHg, 95% confidence interval [CI] = 83.3 to 87.8; outcome: 83.0 mmHg, 95% CI = 80.5 to 85.7) than the placebo group (baseline: 84.5 mmHg, 95% CI = 82 to 87; outcome: 85.0 mmHg, 95% CI = 82.2 to 87.8). There was no group difference in systolic blood pressure reduction from baseline (3.6 and 0.8 mmHg for hawthorn and placebo groups, respectively; P = 0.329). Although mean fat intake met current recommendations, mean sugar intake was higher and there were indications of potential multiple micronutrient deficiencies. No herb–drug interaction was found and minor health complaints were reduced from baseline in both groups. Conclusions This is the first randomised controlled trial to demonstrate a hypotensive effect of hawthorn in patients with diabetes taking medication. PMID:16762125