First- and Third-Trimester Urinary Phthalate Metabolites in the Development of Hypertensive Diseases of Pregnancy

The purpose of this study was to determine whether maternal urinary phthalate metabolite concentrations are associated with the development of higher blood pressure or pregnancy-induced hypertension (PIH). Participants were women without chronic hypertension who enrolled in The Infant Development and the Environment Study, a prospective pregnancy cohort conducted at four U.S. academic medical centers from 2010–2012. Prenatal records were reviewed to obtain blood pressure measurements and diagnoses of PIH (gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome, defined as hemolysis, elevated liver enzymes, and low platelet count). Complete-case analyses used multivariable linear and logistic regression for analysis of blood pressure measurements and PIH diagnoses, respectively. In the final dataset (N = 668), higher concentrations of first-trimester monoethyl phthalate (MEP) and mono-3-carboxypropyl phthalate (MCPP) and third-trimester mono-isobutyl phthalate (MiBP) were significantly associated with a medical chart diagnosis of PIH. First-trimester mono-n-butyl phthalate (MBP) and MEP along with the sum of di-(2-ethylhexyl) phthalate metabolites (∑DEHP) were each associated with increased systolic blood pressure across pregnancy. In conclusion, several phthalate metabolite concentrations were significantly associated with PIH and greater increases in systolic blood pressure across pregnancy.

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Association between phthalates and externalizing behaviors and cortical thickness in children with attention deficit hyperactivity disorder

Psychological Medicine ◽

10.1017/s0033291714002694 ◽

2014 ◽

Vol 45 (8) ◽

pp. 1601-1612 ◽

Cited By ~ 25

Author(s):

S. Park ◽

J.-M. Lee ◽

J.-W. Kim ◽

J. H. Cheong ◽

H. J. Yun ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Cortical Thickness ◽

Attention Deficit ◽

Symptom Severity ◽

Adhd Symptoms ◽

Phthalate Metabolites ◽

Children With Adhd ◽

Hyperactivity Disorder ◽

Metabolite Concentrations ◽

Phthalate Metabolite

Background.Previous studies have implicated the relationship between environmental phthalate exposure and attention deficit hyperactivity disorder (ADHD) symptoms of childhood, but no studies have been conducted in children who have a confirmed diagnosis of ADHD obtained through meticulous diagnostic testing. We aimed to determine whether phthalate metabolites in urine would be higher in children with ADHD than in those without ADHD and would correlate with symptom severity and cortical thickness in ADHD children.Method.A cross-sectional examination of urine phthalate metabolite concentrations was performed; scores for ADHD symptoms, externalizing problems, and continuous performance tests were obtained from 180 children with ADHD, and brain-imaging data were obtained from 115 participants. For the control group, children without ADHD (N = 438) were recruited. Correlations between phthalate metabolite concentrations and clinical measures and brain cortical thickness were investigated.Results.Concentrations of phthalate metabolites, particularly the di(2-ethylhexyl) phthalate (DEHP) metabolite, were significantly higher in boys with ADHD than in boys without ADHD. Concentrations of the di-n-butyl phthalate (DBP) metabolite were significantly higher in the combined or hyperactive-impulsive subtypes compared to the inattentive subtype, and the metabolite was positively correlated with the severity of externalizing symptoms. Concentrations of the DEHP metabolite were negatively correlated with cortical thickness in the right middle and superior temporal gyri.Conclusions.The results of this study suggest an association between phthalate concentrations and both the diagnosis and symptom severity of ADHD. Imaging findings suggest a negative impact of phthalates on regional cortical maturation in children with ADHD.

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Peer Review #1 of "Effects of various factors on Doppler flow ultrasonic radial and coccygeal artery systolic blood pressure measurements in privately-owned, conscious dogs (v0.1)"

10.7287/peerj.3101v0.1/reviews/1 ◽

2017 ◽

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Peer Review ◽

Conscious Dogs ◽

Pressure Measurements ◽

Doppler Flow ◽

Privately Owned

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Measuring Blood Pressure

Nursing OSCEs ◽

10.1093/oso/9780199693580.003.0014 ◽

2012 ◽

Author(s):

Kate Devis

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Pressure Measurement ◽

Gold Standard ◽

Blood Pressure Measurement ◽

Maximum Pressure ◽

Pressure Measurements ◽

Health Care Settings ◽

Pressure Cuff ◽

The Uk

Blood pressure measurements are one part of a circulatory assessment (Docherty and McCallum 2009). Treatments for raised or low blood pressure may be initiated or altered according to blood pressure readings; therefore correct measurement and interpretation of blood pressure is an important nursing skill. Blood pressure should be determined using a standardized technique in order to avoid discrepancies in measurement (Torrance and Serginson 1996). Both manual and automated sphygmomanometers may be used to monitor blood pressure. The manual auscultatory method of taking blood pressure is considered the gold standard (MRHA 2006), as automated monitoring can give false readings (Coe and Houghton 2002), and automated devices produced by different manufacturers may not give consistent figures (MRHA 2006). So, although automated sphygmomanometers are in common use within health care settings in the UK, the skill of taking blood pressure measurement manually is still required by nurses. As a fundamental nursing skill, blood pressure measurement, using manual and automated sphygmomanometers, and interpretation of findings are often assessed via an OSCE. Within this chapter revision of key areas will allow you to prepare thoroughly for your OSCE, in terms of practical skill and understanding of the procedure of taking blood pressure. Blood pressure is defined as the force exerted by blood against the walls of the vessels in which it is contained (Docherty and McCallum 2009). A blood pressure measurement uses two figures—the systolic and diastolic readings. The systolic reading is always the higher figure and represents the maximum pressure of blood against the artery wall during ventricular contraction. The diastolic reading represents the minimum pressure of the blood against the wall of the artery between ventricular contractions (Doughetry and Lister 2008). You will need to be able to accurately identify systolic and diastolic measurements during your OSCE. When a blood pressure cuff is applied to the upper arm and inflated above the level of systolic blood pressure no sounds will be detected when listening to the brachial artery with a stethoscope. The cuff clamps off blood supply. As the cuff is deflated a noise, which is usually a tapping sound, will be heard as the pressure equals the systolic blood pressure —this is the first Korotkoff ’s sound.

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Outcome of Primary Intracerebral Hemorrhage: A Study in Tertiary Care Center

Eastern Green Neurosurgery ◽

10.3126/egn.v2i2.29246 ◽

2020 ◽

Vol 2 (2) ◽

pp. 35-40

Author(s):

Jagat Narayan Rajbanshi ◽

Pankaj Raj Nepal

Keyword(s):

Blood Pressure ◽

Intracerebral Hemorrhage ◽

Systolic Blood Pressure ◽

Care Center ◽

Tertiary Care ◽

Brain Parenchyma ◽

Chronic Hypertension ◽

Midline Shift ◽

Male Predominance ◽

The Mean

Background: Intracerebral hemorrhage (ICH) is an irreversible phenomenon inside the brain parenchyma resulting in mild to severe neurological deficit. Based on etiology it is broadly divided into primary and secondary. Primary ICH is usually due to the rupture of Charcot-Bouchard aneurysm and chronic hypertension. Charcot – Bouchard aneurysms are supposed to get formed due to lipohyalinosis. With the aim to evaluate the outcome of primary ICH admitted to our institute this study is performed. Materials and methods: This is a prospective analytical study, where all the consecutive patients of the primary ICH were collected. Quantitative variables like age, the volume of hematoma, midline shift, GCS, and systolic blood pressure (SBP) were presented as mean and standard deviation (S.D). Whereas, qualitative variables like gender, site, and side of hematoma, type of treatment, best motor response were presented in frequency and percentage. The outcome of the patient was measured using the Glasgow outcome scale (GOS) and the association between qualitative/quantitative variables and GOS was done using the chi-square test or Fischer exact test whenever applicable in SPSS20. Results: There were a total of 31 patients with a mean age of 59.81(S. D 15.8) year and male predominance (74%). The mean volume of hematoma was 40 ml. Similarly, midline shift ranged from zero to 14 mm. The majority of primary ICH were located in basal ganglia (35%) and on the right side (52%). The mean GCS at presentation was 12.1 (S.D 2.166). Mean Systolic blood pressure was 163.77 mmHg (S.D 34.6 mmHg) with maximum SBP up to 240mmHg. There was a 14% mortality in this study group with favorable outcome (GOS 4 and 5) in 82%. GOS was significantly associated with the volume of hematoma and midline shift. Conclusion: The outcome of primary ICH is strongly associated with the volume of hematoma and midline shift. They were generally associated with hypertension with a mean systolic blood pressure of >160 mm Hg.

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Influence of quality of sleep in the first trimester on blood pressure in the third trimester in primipara women

Blood Pressure ◽

10.1080/08037051.2019.1637246 ◽

2019 ◽

Vol 28 (5) ◽

pp. 345-355 ◽

Cited By ~ 4

Author(s):

Kimie Okada ◽

Izumi Saito ◽

Chihiro Katada ◽

Takeshi Tsujino

Keyword(s):

Blood Pressure ◽

First Trimester ◽

Quality Of Sleep ◽

Third Trimester ◽

The Third

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Optimizing finger systolic blood pressure measurements with laser Doppler: Validation of the second phalanx site

Microvascular Research ◽

10.1016/j.mvr.2020.104029 ◽

2020 ◽

Vol 131 ◽

pp. 104029

Author(s):

Sophie Blaise ◽

Joël Constans ◽

Laure Pellegrini ◽

Patricia Senet ◽

Isabelle Lazareth ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Laser Doppler ◽

Pressure Measurements ◽

Finger Systolic Blood Pressure

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Isradipine Therapy in Hypertensive Pediatric Patients

Annals of Pharmacotherapy ◽

10.1177/106002809703100606 ◽

1997 ◽

Vol 31 (6) ◽

pp. 704-707 ◽

Cited By ~ 23

Author(s):

Cary E Johnson ◽

Pamala A Jacobson ◽

Min H Song

Keyword(s):

Blood Pressure ◽

Pediatric Patients ◽

Diastolic Pressure ◽

University Teaching ◽

Chronic Hypertension ◽

Pressure Measurements ◽

Disease States ◽

The Mean ◽

Record Review ◽

Retrospective Medical Record Review

OBJECTIVE: To evaluate the dosage and effectiveness of isradipine to control acute or chronic hypertension in pediatric patients. DESIGN: Retrospective medical record review. SETTING: University teaching hospital. PARTICIPANTS: Hospitalized pediatric patients aged 1 day to 16 years with hypertension treated with isradipine between January 1994 and March 1996. MEASURES: Patient age, gender, weight, disease states, current medications, isradipine dosage and formulation, pre- and postsystolic, and pre- and postdiastolic blood pressure measurements with each dose of isradipine. RESULTS: Fifty-three patients with a mean age of 5.8 ± 4.0 years were evaluated. A mean change in the blood pressure measurements taken before the first dose of isradipine compared with the values recorded after the last dose or at discharge for all patients was −11.8% ± 12.5% and −17.4% ± 19.6%, respectively, for systolic and diastolic pressure. The mean dosage of isradipine in 46 patients who received regularly scheduled doses was 0.38 ± 0.22 mg/kg/d. Patients who demonstrated a response received a mean dosage of 0.40 ± 0.20 mg/kg/d. The total daily dosage was administered in one dose for 1 patient, two doses for 15 patients, three doses for 27 patients, and four doses for 3 patients. CONCLUSIONS: Isradipine was an effective antihypertensive agent to reduce the systolic and/or diastolic blood pressure 10% or more compared with pretreatment measurements in 43 (81 %) of 53 pediatric patients. The mean dosage was 0.38 ± 0.22 mg/kg/d, most frequently administered in two or three equally divided doses, which is higher than the normal recommended dosage for adults.

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A comparison of CAT Doppler and oscillometric Memoprint machines for non-invasive blood pressure measurement in conscious cats

Journal of Feline Medicine and Surgery ◽

10.1016/j.jfms.2004.08.003 ◽

2005 ◽

Vol 7 (3) ◽

pp. 147-152 ◽

Cited By ~ 31

Author(s):

Rosanne E. Jepson ◽

Vivien Hartley ◽

Michael Mendl ◽

Sarah ME Caney ◽

David J Gould

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Blood Pressure Measurement ◽

Systemic Hypertension ◽

Pressure Measurements ◽

Non Invasive ◽

Measuring Devices ◽

Oscillometric Device ◽

Significant Difference

Indirect blood pressure measurements were compared in 28 conscious cats using Doppler and oscillometric blood pressure-measuring devices. Ten cats were used to compare Doppler measurements between two examiners and 18 cats were used to compare Doppler and oscillometric measurements. The Doppler machine obtained systolic and diastolic blood pressure readings in 100% and 51% of attempts, respectively. With the oscillometric machine, systolic and diastolic blood pressure readings were obtained in 52% of the attempts. With the Doppler, measures of mean systolic blood pressure between two examiners were positively correlated, but there was no correlation for diastolic blood pressure measures. When comparing the results obtained by Doppler and oscillometric machines there was no significant difference between mean systolic blood pressure readings, but the oscillometric machine produced significantly higher estimates of diastolic blood pressure. In both cases, the standard deviations for the oscillometric machine were considerably larger than those for the Doppler machine. The first reading of systolic blood pressure obtained with the Doppler machine was an excellent predictor of the mean of five readings, but this was not so for the oscillometric machine. It took less than 5 min to obtain five readings in 37.5% of cases with the Doppler machine but this was true for only 5% of cases with the oscillometric machine. Two cats with ophthalmological lesions consistent with systemic hypertension were identified. In these two patients, systolic blood pressure measurements were between 200 and 225 mmHg when measured by Doppler, and between 140 and 150 mmHg when measured by the oscillometric machine. This suggests that a lower reference range for normal systolic blood pressure values should be used for the oscillometric device.

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