Effectiveness of Slow Breathing on Blood Pressure and Quality of Life in Patients with Hypertension: A Randomized Trial

Background: Hypertension constitutes a significant cardiovascular burden globally. Non-pharmacological interventions arehighly sought either as an adjunct or primary means of managing hypertension. Slow breathing (SB) is one of such approachwhich gains attention in recent times due to its multiple physiological benefits in lowering blood pressure (BP). However, thereis a gap in literature testing the ability of SB training on quality of life (QOL) of hypertensive (HT) patients.Aim of the Study: This study aims to find out the effectiveness of SB on reduction of BP and improvement in the health-relatedQOL in HT patients.Materials and Methods: It was a randomized, open, and parallel-group trial design carried out at the Outpatient Departmentof Medicine in Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India. The studyconsists of 60 HT patients assigned equally to either study or control group. The study group was trained with SB training for4 weeks, whereas no specific treatment was given for controls.Results: The mean drop in systolic BP (SBP) for the study group was 14.24 ± 3.30 mmHg, whereas the mean drop was only5.28 ± 2.26 mmHg for controls. The mean drop in diastolic BP (DBP) was 6.20 ± 2.69 mmHg for the study group, whereasit was only 3.12 ± 2.05 mmHg for controls. There was significantly higher drop in systolic as well as DBP in the study group.Likewise, the World Health Organization QOL-BREF (WHOQOL-BREF) was improved to 10.79 ± 5.47 in the 0–100 scale forthe study group, whereas the mean improvement in the WHOQOL-BREF for control was 5.95 ± 0.01 in the 0–100 point scale.Conclusions: It was concluded that 4 weeks of SB training were effective in reducing BP and improving QOL in patients with HT.

Risk factors analysis and prognosis of renal pelvis dilatation in high-risk infants in monocenter / 中华儿科杂志

Objective@#To explore the prognosis and risk factors of pyelectasis in high-risk infants.@*Methods@#This was a retrospective study. Totally 960 high-risk infants, who accepted type B ultrasonic examination for fetus at 28th week of gestation and for newborns in 48 hours after birth, were included in the study in departments of obstetrics and eonatology, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital during May 2012 to April 2013. The degree of pyelectasis was classified using Grignon grade and the paients were followed up for 3 years. The factors of epidemiology, high risk pregnant women, fetus and high-risk newborns that relate to pyelectasis were summarized. High-risk factors were analyzed by using logistic multivariate regression analysis.@*Results@#Of 960 high-risk infants, 103 had abnormal urinary ultrasound results, 87 (9.1% of high-risk infants) were diagnosed with pyelectasis, 16 (1.7% of high-risk infants) were diagnosed with congenital anomalies of the kidney and urinary tract. According to the degree of pyelectasis, 68 infants were Grignon grade Ⅰ, male:female ratio=5.8∶1, left side:right side ratio=1.91∶1; 19 infants were Grignon grade Ⅱ, male:female ratio=5.33∶1, left side:right side ratio=2.12∶1. Postnatal follow-up results showed that pyelectasis disappeared in 48 cases (55% of pyelectasis cae), 40 infants were Grignon grade Ⅰ (59% of all Grignon grade Ⅰ patients), 8 infants were Grignon grade Ⅱ (42% of all Grignon grade Ⅱ patients); The result of risk factors analysis showed that the risk of pyelectasis in males was 4.368 times that of females (95%CI: 2.33-8.189, P<0.05); the risk of pyelectasis in low birth weight infants was 22.434 times that of non low birth weight infants (95% CI: 5.883-85.547, P<0.05).@*Conclusion@#The incidence of pyelectasis in high-risk infants was 9.1%. The mitigation rate of pyelectasis in Grignon grade Ⅰ to Ⅱ in fetal or newborn period is high. Patients in Grignon grade Ⅲ and above in fetal or new born period had high risk of congenital anomalies of the kidney and urinary tract. The risk of pyelectasis of male was higher than that of female; the risk of pyelectasis of low birth weight infant was higher than appropriate for gestational age infants.

Prenatal natural history of isolated fetal mild bilateral pyelectasis

OBJECTIVE: To analyze the prenatal outcomes in a cohort of fetuses with mild bilateral pyelectasis and determine whether performing serial ultrasounds is a good follow-up strategy. METHODS: A prospective longitudinal study was conducted on 62 fetuses with mild bilateral pyelectasis. Fetal mild bilateral pyelectasis was considered when the renal pelvis measured (in millimeters) ≥5.0 to 10.0, ≥7.0 to 10.0, and ≥10.0 to 15 at ≤23 weeks 6 days, 24 to 31 weeks 6 days, and ≥32 weeks, respectively, with no uretero-calyceal dilatation. Ultrasounds were performed every 3 weeks to assess whether the mild bilateral pyelectasis regressed, remained unchanged (Group 1) or progressed (Group 2). RESULTS: Group 1 consisted of 53 fetuses (85.4%), and progression was observed in 9 cases (Group 2, 14.6%). The initial renal pelvis diameter was significantly larger in fetuses with progression (p=0.028). Statistically significant differences in the renal pelvis diameter were also found at weeks 31 and 35 for both kidneys (p<0.05). The cases requiring intrauterine procedures or early delivery were not observed. CONCLUSION: Fetal mild bilateral pyelectasis with no calyceal dilatation is a benign condition that can be managed in the postnatal period. The initial renal pelvis diameter and the diameter in week 31 or 35 were valuable parameters for identifying cases that would eventually need specific postnatal procedures.

Diagnosis of isolated fetal renal pyelectasis during midtrimester and follow-up the outcome in utero by prenatal ;ultrasonography / 中华超声影像学杂志

Objective To assess the clinical significance of fetal pyelectasis and its changing in utero. Methods One hundred and ninty-seven isolated pyelectasis cases were retrospective reviewed from Jan 2012 to Jul 2014.Isolated pyelectasis was defined as a renal pelvis anteroposterior diameter (RPAPD)of ≥5 mm without other fetal anomaly in second trimester.Persistent or progressive pyelectasis was defined as a RPAPD of ≥10 mm before delivery.They were divided into two groups according to the size of renal pelvis in second trimester:group A (RPAPD 5 - 10 mm)and group B (RPAPD ≥ 10 mm).As the same,there were two groups after 32 weeks of gestation:group C (RPAPD < 10 mm)and group D (RPAPD ≥ 10 mm).Results Totally 1 54 cases were followed up.There were 1 88 cases (95.4%)in group A,with 41 cases lost,141 cases (95.9%)RPAPD <10 mm,6 cases (4.1 %)RPAPD ≥10 mm before delivery.There were 9 cases (4.6%)in group B,with 2 cases lost,remained 7 cases RPAPD ≥ 10 mm before delivery. Conclusions Although most of the fetuses with RPAPD 5 - 10 mm in second trimester will remain the same or resolved before delivery,those with RPAPD ≥ 10 mm may persistent or progress.Prenatal assessment of fetal renal pelvis may provide properly consultation.

Clinical analysis of 109 cases of isolated fetal pyelectasis and pregnancy outcome / 中华围产医学杂志

Objective To investigate the prognosis of isolated fetal pyelectasis detected by ultrasound.Methods A total of 109 cases of isolated fetal pyelectasis (renal pelvis anteroposterior diameter ≥ 5 mm by ultrasound screening at any gestational age without structural or chromosome abnormalities) detected by prenatal ultrasound screening from March 2004 to July 2014 in Obstetrics & Gynecology Hospital of Fudan University,were delivered and followed up until neonatal period on chromosome examination,prenatal B ultrasound and outcome of neonates.Receiver operating characteristics curves were plotted and used to predict the optimal critical point of poor prognosis and the warning point of follow-up.Results Among the 109 cases,83 cases tended to have a natural recovery during pregnancy,71 of them had normal renal pelvis.Two of the neonates died,9 cases needed surgical treatment,and 98 cases had normal renal pelvis or need follow-up only.The area under the receiver operating characteristics curves was 0.860 (95％CI:0.860± 1.96 × 0.112).The optimal critical point of poor prognosis was determined at ≥ 11 mm in anteroposterior diameter with sensitivity 81.8％,and specificity 83.7％,and the warning point of prenatal follow-up was at ≥ 7 mm in anteroposterior diameter with sensitivity 100.0％ and specificity 50.0％.Conclusions The prognosis of isolated fetal pyelectasis is mostly good.The fetus with pyelectasis thicker than 7 mm should be followed-up closely during prenatal and neonatal period,and the fetus with pyelectasis thicker than 11 mm is likely to have poor prognosis in neonatal period.