Predictors of increased blood pressure in women after induction of superovulation for extracorporeal fertilization

Objective is to study the relationship of hemodynamic, hormonal and metabolic changes with increased blood pressure (BP) in women after the induction of superovulation for extracorporeal fertilization (ECF).Design and methods. We examined 80 women aged from 25 to 38 years (mean age 32,3 ± 3,6 years). All patients underwent ECF at the Center for Reproductive Technologies of the St Petersburg Mariinsky Hospital. Daily monitoring of BP was carried out twice: before the induction of superovulation for ECF and on the first day after this manipulation.Results. After induction of superovulation, an increase in average daily BP ≥ 135/85 mm Hg occurred in 52,5 % of women and an increase in average night BP ≥ 120/70 mm Hg was registered in 13,8 %. In women with initially increased average daily BP, the relative risk of its further increase on the first day after induction of superovulation was 1,46 (95 % confidence interval (CI) 0,79–2,68) compared with women who had normal average daily BP. In women with initially elevated average nightly BP, the relative risk of its further increase after induction of superovulation was 1,16 (95 % CI 1,06–1,27). An increase of BP after induction of superovulation may be associated with age, female factor infertility, the presence of chronic diseases of the genitourinary system in past, changes in the metabolic profile (increase in total cholesterol, urea, creatinine, glucose, estradiol; decreased thyroid-stimulating hormone level), heart rhythm disturbances, episodes of apnea/hypopnea during sleep, increase in heart rate, increased sympathetic activity.Conclusions. Induction of superovulation during in vitro fertilization has an adverse effect on the circadian BP profile. While planning in vitro fertilization, the risk factors for BP increase should be identified and modified. This will help to avoid adverse cardiovascular reactions associated with the procedure. Women with the hypertensive reaction after the induction of superovulation require dynamic BP monitoring.

Clinicopathogenetic features of cardiovascular system affection in influenza patients with hypertensive reaction revealed for the first time

Aim. To study the state of central hemodynamics, oxygen metabolism and tissue blood flow in patients with influenza who suffered from hypertensive reaction detected for the first time, in dynamics of infectious process. Materials and methods. At Perm Regional Clinical Infectious Hospital, 65 patients with influenza underwent a deepened study of cardiovascular system: central hemodynamics and local blood flow. Results. While studying the central hemodynamics, there was detected the increased general peripheric vascular resistance without normalization during the follow-up period. Investigation of gas exchange showed decrease in tissue oxygenation, vasodilatation and tissue blood flow. Conclusions. Among patients with influenza, the oxygen transport system functions in a tense regime. In dynamics of infectious process and after the disease, the following is observed: development of tissue hypoxia, decrease in local blood flow tempo and elevation of general peripheric vascular resistance.

ASSESSMENT OF INFLUENCE OF SMOKING ON VISCERAL BODIES AND REGULATORY FUNCTIONS OF THE ORGANISM

Comparative assessment of influence of smoking on visceral bodies and regulatory functions of an organism of young men before and after smoking had been carried out. Hypertensive reaction of cardiovascular system of examinees to nicotine influence causing a vasoconstriction is performed. In this regard vasoactive nicotine influence to vascular motor center of a medulla is suggested. Saliva crystalloscopy examinees allowed to establish deterioration of crystallogenesis owing to the growth of emitted saliva during smoking that can demonstrate the negative impact of nicotine on the salivation center localized in a medulla. It is suggested that the medulla can be one of physiological targets of negative impact of nicotine.

Diagnostic value of assessment of microcirculation and of pressor response to cold stressor test in patients with coronary artery disease

62 patients with coronary heart disease (CHD), II-III functional class of angina pectoris were observed during rest and stress cold exposure conditions (hand dipping in 4°C water). 75 % of patients had concomitant hypertension. Finger microcirculation flow (FMCF) was measured by laser doppler flowmetry (LDF) method. According to the results of the cold test and systolic blood pressure (SBP) response normotensive patients were divided into 3 groups: 1nd group included patients with normal tonic type of reaction (SBP increase for 0-10 mmHg); 2nd group - with moderate hypertensive reaction (SBP increase for 10-20 mmHg); 3nd group - with marked hypertensive reaction (SBP increase for more than 20 mmHg). The changes in FMCF, hand temperature (HT), finger temperature (FT) and cardiovascular system indices (BP and heart rate (HR)) were assessed. The 3'1 group was found to be different from the others by the lowest FMCF at rest (24,1 ± 3,2 ml/100 g/min.). At the same time FMCF decline during cooling was lower than in the others groups (21,8 ± 3,1 ml/100 g/min.). as well as was FMCF increase (15,4 ± 2,58 ml/100 g/min.) after the test. This testifies the increased sympathetic activity. The local cold test enables establishing the BP response type in normotensivc subjects with CHD and assessment of FMCF changes.

Methemoglobinemia as a Result of Excessive Topical Anesthesia; Severe MAOI Hypertensive Reaction Unrecognized by ED Personnel; Pulmonary Toxicity Secondary to Procarbazine; Acute Pancreatitis Associated with Propofol; Delirium Caused by Donepezil; Fatal Aspergillus Infection following Short-Term Corticosteroid Therapy

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