Increased plasma norepinephrine levels in previously pre-eclamptic women.

A history of pre-eclampsia increases the risk of cardiovascular morbidity by mechanisms yet unknown. The aim of the present study was to assess whether plasma norepinephrine (NE) levels are increased 5-6 years after pre-eclamptic pregnancy and to investigate associations with pathophysiological mechanisms of cardiovascular disease: insulin sensitivity, vascular function and arterial pressure. A total of 28 women with previous pre-eclampsia and 20 controls were examined. Blood pressure (BP) and plasma levels of NE and endothelin-1 (ET-1) were measured at rest and after standing for 5 min. Insulin sensitivity was assessed with minimal model analysis and vascular function was assessed using venous occlusion plethysmography and pulse wave analysis. Twenty-four-hour BP measurements were carried out. Women with previous pre-eclampsia had higher levels of NE at rest (P=0.02), which did not associate significantly with insulin sensitivity or overall vasodilatory capacity. The 24-h mean of systolic and diastolic blood pressures (BPs) and heart rate did not differ between the groups (P=0.30, P=0.10 and P=0.46, respectively), and there was no significant association with NE levels. ET-1 levels were similar between the groups, but a positive correlation with systolic (P=0.04) and diastolic (P=0.03) BPs in the upright position was shown in the patient group. Increased levels of plasma NE are sustained in women with previous pre-eclampsia and may contribute to the increased risk for cardiovascular disease in these women.

Renal and vascular function in women with previous preeclampsia: a comparison of low- and high-degree proteinuria.

The degree of proteinuria during preeclampsia has been considered to be a marker of severity of the disease and of endothelial dysfunction. The aim of the study was to assess whether the degree of proteinuria in preeclamptic pregnancy is related to impairment of vascular dilatation and/or kidney function years after the index pregnancy. Thirty women with a history of severe preeclampsia divided into low (n=8, dU-prot <5 g/day) and high (n=22, dU-prot >/=5 g/day) proteinuric groups and 21 women with previous normotensive pregnancy were studied 5-6 years after index pregnancy. Renal function and blood pressure were assessed together with venous occlusion plethysmography, where changes in brachial artery blood flow, induced by intra-arterial infusions of an endothelium-independent (sodium nitroprusside) and an endothelium-dependent (acetylcholine) vasodilator, were measured. The results showed similar renal function in all groups. There was no difference in vasodilation between preeclamptic groups and controls or correlation between degree of proteinuria during index pregnancy and present vasodilation. We conclude that the degree of proteinuria during preeclampsia does not predict vascular dilatation or renal function 5-6 years after preeclamptic pregnancy.

Costs and practicability of clean feeding of dairy cattle during radioactive contamination of grasslands.

Both the farm-specific and regional costs of clean feeding as a countermeasure to reduce ingestion of contaminated grass when there is insufficient supply of other types of roughage were estimated for dairy farming in Finland in the first year after contamination. The cost estimation considered expenditures and revenues associated with milk production and were calculated using farm models developed for economic planning. A hypothetical contamination scenario was designed using RODOS models for atmospheric dispersion and transfer in terrestrial food chains. Costs for intervention after two similar hypothetical atmospheric dispersion and deposition scenarios in early June and in July were estimated. As a reference, the cost of complete replacement of fodder throughout the area was also calculated. Feed substitution costs were higher in June than in July, due to the availability of some harvested silage in the later scenario. In the first case, the additional costs of clean feeding amounted to one-fifth of the normal production costs. Effective advisory/support services, available to farmers, can substantially improve the implementation of countermeasures. However, high costs and insufficient sources of clean feed would restrict the use of clean feeding as the sole countermeasure after serious contamination during the growing season.

Plasma exchange in severe postpartum HELLP syndrome.

We present a case of extremely severe postpartum HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome, associated with activation of coagulation, massive recurrent intra-abdominal bleeding requiring two laparotomies, renal failure, and central nervous system symptoms. This case underlines the complexity of pregnancy-related thrombotic microangiopathies regarding their differential diagnosis, multiple organ dysfunction, as well as management. Systemic endothelial cell injury plays a central role in the pathogenesis of thrombotic microangiopathies. Treatment of HELLP syndrome usually consists of administration of antihypertensive therapy and magnesium sulfate. No consensus exists regarding the use of plasma exchange or corticosteroids. Plasma exchange was a major part of the treatment regime in our patient. Early plasma exchange may be considered as an adjuvant therapy in severe and progressive postpartum HELLP syndrome.

Responses of blood and plasma lactate and plasma purine concentrations to maximal exercise and their relation to performance in standardbred trotters.

OBJECTIVE: To study whether end products of 2 pathways of anaerobic energy metabolism, lactate and purines, that accumulate in the blood after intense exercise indicate any relation to exercise performance. DESIGN: Venous blood samples were taken within 1 and 15 minutes after a trotting race of 2,100 m. ANIMALS: 16 Clinically healthy Standardbred trotters. PROCEDURE: Blood and plasma lactate concentrations were measured by enzymatic analyzer, and purines, uric acid and allantoin, were determined by high-performance liquid chromatography. The concentrations of metabolites were then correlated to racing time and individual performance indexes that are annually calculated from the percentage of winnings, placings, and starts rejected, average earnings per start, and the racing record. RESULTS: Blood lactate concentration immediately and calculated cell lactate concentration immediately and 15 minutes after the race correlated positively (P < 0.05 to P < 0.01) with the individual performance indexes. Plasma lactate concentration was not correlated to the individual performance indexes. Uric acid concentration, immediately and 15 minutes after the race, was negatively correlated (P < 0.05) to the individual performance indexes, and a positive relation (P < 0.05) was found between the highest concentration of uric acid and the racing time. Concentration of allantoin immediately or 15 minutes after the race did not have any significant correlation to the individual performance indexes. CONCLUSIONS: Accumulation of lactate in the blood, which was greater in the superior performing horses, may prove to be an useful predictor of anaerobic capacity. The results also indicate that the loss of purine nucleotides was less in the superior performing horses, although further studies are needed to confirm this.