[The 'Arbeitsgemeinschaft Gestose-Frauen e.V.': A self-help organization with extensive experience in the aftercare of women with preeclampsia or HELLP syndrome]. / Arbeitsgemeinschaft Gestose-Frauen e.V.: Langjährige Erfahrungen in der Nachbetreuung nach Präeklampsie und HELLP-Syndrom aus der Sicht Betroffener.

The 'Arbeitsgemeinschaft Gestose-Frauen e.V.' was founded in 1984 with a couple of sufferers and has advised more than 24,000 women so far. In addition to the care by the midwife and gynaecologist, this self-help organization offers the possibility to exchange experiences with other sufferers, but also to receive medical and psychological counselling.

Family stability during childhood and the risk to develop hypertensive diseases in pregnancy.

BACKGROUND: Parental care giving, divorce and death are associated with physical health as an adult. AIM: To investigate whether the structure of the nuclear family during childhood shows any correlation with the development of hypertensive diseases in pregnancy as an adult. STUDY DESIGN: Self-administered questionnaires were sent to 2600 women with hypertensive diseases in pregnancy and to 1484 controls. SUBJECTS: After confirmation of the diagnosis data from 842 patients and 623 control women were evaluated. OUTCOME MEASURES: Type, number and involvement of different caregivers, parental separation, parental death. RESULTS: In both groups parental separation and parental death were found equally often. In all age groups during childhood fathers were involved significantly less often in care giving when women with hypertensive disorders in pregnancy were compared to control women (1st-3rd year 23.4%/17%, <0.0001; 4th-10th year 25.7%/19.3%, <0.0001; 11th-18th year 30.1%/23.9%, <0.0001). The total number of caregivers involved was significantly higher in patients. CONCLUSIONS: The quality of parental care giving, i.e. the involvement of fathers and the total number of caregivers correlate with the risk to develop HDP. Further research is needed to specify underlying mechanisms and the relevant factors of the parent-child relationship.

The influence of antiphospholipid antibodies on the pregnancy outcome of patients with recurrent spontaneous abortion.

Several therapeutic regimens have been proposed for women with recurrent spontaneous abortion (RSA) and antiphospholipid antibodies (APA). Conflicting results have been reported about women with history of RSA, positive APA, and failure of standard therapy. To evaluate the use of intravenous immunoglobulin in RSA patients with APA and history of treatment failure, we initiated a study with standard therapy (aspirin and low-molecular-weight heparin) and intravenous immunoglobulin. We used an enzyme-linked immunosorbent assay (ELISA) test to screen IgG and IgM anticardiolipin antibodies, and a diluted Russel viper venom time assay for the lupus anticoagulant activity. Altogether, 66 pregnant women with positive APAs at the first visit could be included. Patients with hereditable thrombophilic factors were excluded. After confirmation of the pregnancy, women received a basis immunization of 0.3 g/kg immunoglobulin in a 4-week cycle until the 28th to 32nd week of gestation. All patients received 100 mg/d aspirin and 3,000 anti-Xa U/d certoparin. Among the 66 pregnant women, 17 were persistently autoantibody positive (25.8%), of whom 11 (16.7%) were ACA positive alone, 2 (3%) were lupus anticoagulant positive, and 4 (6.4%) had both antibody types. A total of 49 patients had positive APAs at the initial test, but were negative for ACA and lupus anticoagulant at the second test administered approximately 5 weeks after the start of therapy. We described this group in our following observation as "antibody negative." Sixteen of the 17 autoantibody-positive patients (94.1%) were delivered of live infants compared with 40 patients (81.6%) in the antibody-negative group (odds ratio [OR]: 1.2; 95% CI: 0.98 to 1.4). The overall miscarriage rate was 12.1% and the fetal loss rate was 15.2%. Four patients (25%) in the antibody-positive group developed symptoms of preeclampsia and fetal growth retardation compared with four patients (9.8%) in the antibody-negative group. In conclusion, we see a reduction of the fetal loss rate in patients with RSA and positive APA (5.8%) compared with APA-negative (18.4%) women with the same therapy (OR: 0.3; 95% CI: 0.04 to 2.3).

Enhanced efficacy of nilvadipine in hypertensives whose raised ambulatory blood pressure is sustained during sleep.

This study was designed to clarify the relationship between the antihypertensive effects of the calcium antagonist nilvadipine, and circadian changes in blood pressure. Based on measurements using an ambulatory blood pressure monitoring system (ABPM), 17 outpatients with untreated essential hypertension were divided into two groups: a sustained hypertensive group (with a fall in blood pressure during sleep < 10%, n = 7) and a waking time hypertensive group (with a fall in blood pressure during sleep > or = 10%, n = 10). During treatment with nilvadipine (8 mg/day, > or = 2 weeks), patients were reexamined by ABPM. The antihypertensive effect of nilvadipine was significantly and negatively correlated with the night time fall in blood pressure: this effect was significantly greater in the sustained hypertensive group than in the waking time hypertensive group. These data suggest that the long acting calcium antagonist nilvadipine has more potent antihypertensive effects in patients with sustained hypertension ("nondippers") than in those whose hypertension lessens during sleep ("dippers").

[The relation of dental examination results at corporation offices to occupation, subjective symptoms of fatigue and daily lifestyle--an investigation based on the number of missing teeth].

Our investigation was intended to find a relationship between the dental health of labourers and, their jobs, subjective symptoms of fatigue and daily lifestyle. Dentists checked the dental health of 2,565 corporation employees (790 male and 775 female) of small to medium-sized enterprises in Hiroshima prefecture. At the same time they examined the employees' occupation, subjective symptoms of fatigue and their health maintenance behavior according to Breslow's criteria. The data were divided into age groups spanning 10 years. Among males in their 30s, those engaged in transport/driving and engineering/production had more missing teeth than others. We found a relationship between the number of missing teeth and subjective symptoms of fatigue among men in their 30s. This suggests that the greater the number of missing teeth, the greater their subjective symptoms of fatigue. The results suggest that missing teeth cause malocclusion which leads to subjective symptoms of fatigue.