Книги з теми "Maternal blood pressure"

Preeclampsia and other hypertensive diseases during pregnancy are common causes of maternal morbidity and increase the risk for adverse fetal outcomes. Women are monitored for changes in blood pressure throughout pregnancy and depending on gestational age, once such changes are noted providers may opt to move toward delivery. Blood pressure control and magnesium sulfate are the cornerstone of therapy as well as the key to preventing progression to eclampsia. A thorough understanding of this disease process is essential for anesthesiologists and other anesthesia providers to provide optimal and safe care for labor analgesia and cesarean delivery, or to manage sequelae of advanced disease processes, such as seizure.

Developed by a distinguished editorial board, the Perinatal Continuing Education Program (PCEP) is a comprehensive, self-paced education program in four volumes. This popular resource features step-by-step skill instruction, and practice-focused exercises covering maternal and fetal evaluaton and immediate newborn care. The PCEP workbooks feature leading-edge procedures and techniques, and are filled with clear explanations, step-by-step skill instruction, and practice-focused exercises. Book IV includes 6 units dealing with complex neonatal therapies, such as assisted ventilation, as well as a unit on continuing care for at-risk babies and those with special problems following intensive care. Contents include: Unit 1: Direct Blood Pressure Measurement Skills Units: Transducer Blood Pressure Monitoring Unit 2: Exchange, Reduction, and Direct Transfusions Part 1: Respiratory Distress Skills Unit: Exchange Transfusions Unit 3: Continuous Positive Airway Pressure Skills Unit: Delivery of Continuous Positive Airway Pressure Unit 4: Assisted Ventilation With Mechanical Ventilators Skills Unit: Endotracheal Tubes Unit 5: Surfactant Therapy Skills Unit: Surfactant Administration Unit 6: Continuing Care for At-Risk Babies

The placenta is a complex and changing organ necessary for normal fetal growth and development and for maintenance of a healthy pregnancy. It has three major functions: a protective function of the fetus, an endocrine function, and a metabolic function. The main functional unit of the placenta is the chorionic villous, responsible for the majority of the fetal–maternal exchanges. Migration of trophoblastic cells induces a remodelling of the uterine arteries, with vasodilatated and compliant vessels, unresponsive to maternal vasomotor control. Therefore, any significant change in maternal blood pressure, in particular in the context of general or regional anaesthesia, can directly impact on uteroplacental perfusion. Most anaesthetic drugs cross the placental barrier, but without significant consequences on the fetal well-being.

Myelomeningocele (MMC) is a spinal birth defect associated with significant morbidity directly related to the exposure of meninges and neural structures. Further neurological dysfunction may occur secondary to Chiari II malformation and hydrocephalus. MMC repair is typically performed postnatally within the first 24 to 48 hours of life due to the concern for infection. Prenatal MMC correction is performed in select cases after studies showed improved neurological outcomes. Anesthesia for MMC repairs can be challenging, and appropriate screening should be performed preoperatively. During postnatal repair, care must be taken when positioning the infant to avoid any pressure on the MMC sac. Anesthesia can be maintained with a combination of inhalational agents and intravenous opioids. Prenatal MMC repairs must consider both fetal and maternal safety outcomes. They can be performed through both open and fetoscopic routes, with anesthesia focused on maintaining maternal blood pressure, optimizing uterine relaxation, and adequate pain control.

This chapter describes the steps in management, applications, challenges, and potential complications when a microcatheter becomes clogged during an embolization. If a microcatheter does become occluded during an embolization, it can be a challenge to clear it without removing the catheter completely, thus losing access to the desired location. If a standard 1-cc syringe is placed and manual pressure is applied to clear the catheter, this can generate pressures up to 100 times the arterial blood pressure, thus risking nontarget embolization from the residual embolic material in the microcatheter. This chapter describes the steps involved in safely clearing an occluded microcatheter with the use of a standard balloon insufflator.

This concluding chapter illustrates segments of various interviews Paul Thomas Anderson has given about his feature films, and interviews with actors, such as Philip Seymour Hoffman on The Master. Ultimately, one of the main strands of argument in this book is that Anderson continues to guard the story of his mother that “he might tell;” and yet, the story is always working its way into his narratives about fathers, and carries the real burden of the narrative mystery. The motivation of Anderson's male protagonists in the three films—Punch-Drunk Love, There Will Be Blood, and The Master—becomes increasingly deformed, and in each case the mangling pressure derives from the protagonist's inability to secure a crucial lost balance and alignment with absent maternal shades.

The roles of the hypothalamus in regulating fluid balance and supporting the calm affective state needed for maternal care are described. Hypothalamic control of hormone release is reviewed and related disorders such as Addison’s disease and acromegaly are introduced. Basic thermoregulatory principles are presented and the biological danger of ambient heat is emphasized. The concept of set point is explained in the context of fever, antipyresis and hyperthermia. Neural regulation of blood pressure and orthostatic hypotension are briefly described. The patterns and neural circuits involved in breathing during rest or while exercising or sleeping are detailed. A description of neural control of micturition is used to explain detrusor-sphincter dyssenergia secondary to spinal cord injury. The enteric nervous system is briefly described and Hirschsprung disease is introduced. Finally, the neural control of sleep, disorders of sleep-wake control, and von Economo’s discovery of encephalitis lethargica are detailed.

Chronic kidney disease (CKD) affects a small but increasing minority of women becoming pregnant. It is associated with additional risks depending on pre-pregnancy glomerular filtration rate, proteinuria, and hypertension. Some drugs are contraindicated in pregnancy. These are powerful reasons for counselling all women of childbearing age about pregnancy in CKD. With minor CKD the main issue is moderately increased risk of pregnancy-associated hypertension and pre-eclampsia. More advanced CKD is associated with reduced fertility, progressively increased risk of pre-term delivery and a significant chance of permanent loss of maternal renal function. Distinguishing pre-eclampsia from the natural effects of pregnancy on manifestations of CKD can be challenging. Blood pressure targets may be modified during pregnancy and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are contraindicated. Dialysis may be initiated if pregnancy occurs at advanced levels of CKD. Pregnancy may also occur in patients on dialysis, usually in women with some residual native renal function. More intensive dialysis may improve outcomes.

This chapter describes a considered, thematic, and stylistic account of the viewing experiences of three films by Paul Thomas Anderson and their backgrounds—Punch-Drunk Love (2002), There Will Be Blood (2007), and The Master (2012). Writer Geoffrey O'Brien, in his essay on The Master, captures the feel of Anderson's recurring landscape of disconnection. He goes on to speak of the expressionist treatment of milieu in the films, as though in each narrative there is an attempt both to acknowledge the claims of material reality and at the same time to reconfigure the real. The chapter also examines the contradictory pressures at work in the avowedly autobiographical, densely verbal Magnolia, which may have necessitated a change in Anderson's method and technique in the films that followed.

This book examines the phenomenon of work suicides in France and asks why, in the present historical juncture, conditions of work can push individuals to take their own lives. During the 2000s, France experienced what commentators have described as a ‘suicide epidemic’, whereby increasing numbers of workers in the face of extreme pressures of work, chose to take their own lives. This book analyses a corpus of testimonial material linked to 66 suicide cases across three large French companies during the period from 2005 to 2015. A key aim is to consider what the extreme and subjective experiences of self-killing narrated in suicide letters can tell us about the contemporary economic order and its impact on flesh and blood experiences of work. What do rising work suicides tell us about conditions of human labour in the 21^st century? Does neoliberal economics condition a desire for suicide? How do suicidal individuals describe the causes and motivations of their self-killing? Combining critical perspectives from sociology, history, testimony studies, economics, cultural studies and public health, the book raises critical questions about the human costs of the shift to a finance-driven neoliberal order and its everyday effects within the localised spaces of the French workplace.

The research about the relation of mining and health has traditionally been carried out ex post, that is, with evaluation of the effects of mining on the health profiles of miners or exposed people, time after to the start of this economic activity. This limits the evaluation of the impact of mining on health, given the lack of knowledge about health indicators prior to the start of mining, or due to the absence of a baseline to analyze series of time. In addition, specific indicators such as vector-borne diseases (for example, malaria morbidity or mortality in endemic areas with mining activity), respiratory problems, effects of contamination with materials used in mining, among other topics, are generally investigated in illegal mining contexts. In Colombia there are few publications about the health profiles in legal mining areas, prior to the mining phase, as a determining aspect to establish a baseline that allows quantitative evaluation of the impacts of this economic activity on the health of the exposed people. This research analyzes the health profile of the residents of a geographic area with the presence of underground gold mining in Buriticá-Antioquia, according to sociodemographic conditions during 2019. The central outcomes of this profile were risk factors related to health services and lifestyle, felt morbidity, overweight and obesity, high blood pressure, STIs, breast disorders, lung conditions, all with their potential socio-economic risks.

Advanced Fitness Assessment and Exercise Prescription, Eighth Edition With Online Video, provides a comprehensive approach to physical fitness appraisal and customized exercise prescription. The text synthesizes research and practice with concepts and theories from exercise physiology, kinesiology, measurement, psychology, and nutrition to clearly convey how assessments from physical fitness testing inform the design of individualized exercise programs. The eighth edition of Advanced Fitness Assessment and Exercise Prescription reflects the latest exercise testing and prescription guidelines from the American College of Sports Medicine (ACSM) as well as physical activity recommendations from the U.S. government and American Heart Association. It also takes into account recent ACSM guidelines for medical exam and exercise testing requirements to consider before beginning exercise programs. Additional updates to the eighth edition include the following: • Significant expansion of the online video clips, which now demonstrate nearly 75 fitness tests, including functional movement assessment and push-up and pull-up testing • New protocols and assessments for each of the five fitness components, from self-paced treadmill protocols for cardiorespiratory fitness to the Balance Error Scoring System (BESS) for assessment of balance • Updated blood pressure standards for hypertension • Expanded information on the use of technology to monitor physical activity, including wearable activity trackers and mobile apps • Updated information on the use of workspace design to promote physical activity and exercise • Extensive updates to the supporting research for the assessment and testing protocols Advanced Fitness Assessment and Exercise Prescription, Eighth Edition, is structured around five physical fitness components: cardiorespiratory endurance, muscular fitness (strength, endurance, and power), body composition, flexibility, and balance. The text begins with an overview of physical activity, health, and chronic disease, including a discussion of preliminary health screening and risk classification. It then leads into field and laboratory assessment and testing protocols, followed by prescription guidelines for designing exercise programs to improve each fitness component. Readers will find the latest information on maximal and submaximal graded exercise testing in healthy populations, as well as muscular fitness testing protocols and norms for children and adults. Each chapter begins with key questions to help readers focus on essential information. Sidebars lend practical insight to the content. Key points, review questions, and key terms reinforce concepts and summarize chapter content for better retention. An instructor guide, test package, chapter quizzes, and presentation package plus image bank provide tools for instructors to use for lecture preparation, creative content delivery, and class assessment. The online video clips, newly revised for the eighth edition, further aid student comprehension of the material and provide instructors an additional tool for classroom demonstration. Advanced Fitness Assessment and Exercise Prescription, Eighth Edition, truly bridges the gap between research and practice. Its unique scope, depth of coverage, and clearly outlined approach make it an invaluable resource for students and exercise science professionals who want to increase their knowledge, skill, and competence in assessing clients' fitness and designing individualized exercise programs.