The prevention of the maternal manifestations of preeclampsia by intensive antihypertensive treatment

Article Abstract:

Preeclampsia is a condition that can develop during pregnancy characterized by an increase in blood pressure (hypertension), fluid retention (edema), an increase in the amount of protein excreted in the urine (proteinuria), and impaired liver and kidney function. In severe cases it can lead to blood vessel spasms, convulsions, blood clotting, and extreme hypertension. In most cases, it appears after the 20th week of pregnancy. The exact cause of preeclampsia is unknown. A standard treatment for hypertension involves drugs that dilate the blood vessels. To determine if these drugs can reduce blood pressure during pregnancy and prevent the symptoms associated with preeclampsia, 36 pregnant women with hypertension were studied. Seventeen of the women were treated with atenolol, methyldopa, and bendrofluazide to lower blood pressure, and 19 were untreated. An increase in the amount of protein in the urine was used as an indicator of preeclampsia. Blood pressure was measured before and during drug treatment. Drug treatment resulted in a decrease in blood pressure. Six of the 19 women who did not receive drug treatment developed proteinuria compared with only 1 of the 17 women who received drug treatment. These results suggest that drug treatment to reduce blood pressure may reduce or prevent the symptoms of preeclampsia. However, it is not known if these drugs will harm the fetus. Therefore, it is recommended that hypertension during pregnancy be treated only to the point necessary to protect the mother from serious physiological damage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Antihypertensive drugs, Antihypertensive agents, Hypertension in pregnancy, Gestational hypertension

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Altered skin integrity in children admitted to a pediatric intensive care unit

Article Abstract:

Patients in a pediatric intensive care unit were studied for incidence of skin breakdown in the hope that associated risk factors could be determined. The sample included 271 patients, 26% of whom experienced changes in skin integrity. Some of the injuries observed were probably not caused solely by pressure. Using univariate analysis, many factors were correlated with skin breakdown. Logistic regression, however, showed that only white race and severity of illness, measured by the standard Pediatric Risk of Mortality Score, led to significant risk of skin integrity breakdown.

Risk factors, Quality management, Bedsores, Decubitus ulcer, Pediatric intensive care, Erythema, Skin lesions

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Resolving Discrepancies Between a Meta-analysis and a Subsequent Large Controlled Trial

Article Abstract:

The results of a meta-analysis may be inaccurate if the results of the individual studies are substantially different. Meta-analysis is a way of statistically combining the results of several studies into one single result. When this was done to analyze the effect of calcium supplements in pregnant women, it showed that calcium could prevent preeclampsia. However, a large clinical trial showed no effect. Further analysis showed that calcium was only effective in women who were at high risk of preeclampsia, but not in those with a low risk.

Health aspects, Evaluation, Calcium, Calcium (Chemical element), Meta-analysis

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