Physiology of Pregnancy
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal in Principles of Physiology for the Anaesthetist, 2020
This chapter reviews the physiological changes that occur during pregnancy and details the basis of physiological changes. The basal metabolic rate increases to 20% above non-pregnant levels at 36 weeks of pregnancy and then falls slightly to 15% above baseline levels at term. Significant cardiovascular changes occur within the first 8 weeks of pregnancy. Studies carried out on pregnant women found no changes in airway closure, closing capacity or flow–volume curves during pregnancy. Pregnancy is associated with increased coagulability and platelet turnover. Progressive dilatation of the renal pelvis, calyces and ureters begins from the second or third month of pregnancy, primarily due to obstruction of urine flow by the gravid uterus or dilated ovarian plexuses. The placenta produces endorphins and enkephalins that may be analgesic during pregnancy. Endorphin production increases significantly in proportion to the frequency and duration of uterine contractions during labour and delivery, but their role in pregnancy is not completely understood.
Thyroid disease
Judy Bothamley, Maureen Boyle in Medical Conditions Affecting Pregnancy and Childbirth, 2020
Thyroid hormones control the metabolic process of cellular activity and therefore influence a range of body functions including heart rate, heat production, response to stress and mental processing. Midwives need to be aware of the features of thyroid hormone imbalance and make appropriate referral for assessment and treatment. Iodine is found in seafood, vegetables grown in iodine-rich soil and iodised table salt. Active thyroid hormones are delivered to the cells, where they act to speed cellular metabolic reactions leading to an increase in basal metabolic rate. A number of physiological changes occur to the thyroid function in pregnancy, with an important relationship existing between maternal and fetal thyroid function. Fetal intellectual development is dependent on adequate amounts of thyroid hormone. Deficiencies can lead to impaired growth and irreversible intellectual disability. Abnormal maternal thyroid hormone levels can impact milk letdown and therefore the ability to successfully breastfeed.
Physiological measurements
Pearl Shihab in Numeracy in Nursing and Healthcare, 2014
This chapter discusses the various physiological measurements that are used in the nursing and the healthcare centres. The purpose of the chapter is to introduce the some of the common tests that are carried out to assist with diagnosis and monitor treatment. The body is kept healthy by all the systems being maintained in a state of balance and it is known as homeostasis. Basal metabolic rate (BMR) is the measurement of metabolic rate under particular conditions and is used to see whether the rate is within the normal range. When blood is taken for a white cell count, a count of each type of cell is usually requested, and the calculation of the percentage of each is called as differential count. Arterial blood gas estimation is carried out on a small sample of blood taken from an artery usually by a doctor and immediately analysed without allowing atmospheric air to contaminate the sample.
Evaluation of factors associated with locomotive syndrome in Japanese elderly and younger patients with rheumatoid arthritis
Published in Modern Rheumatology, 2019
Takeshi Mochizuki, Katsunori Ikari, Koichiro Yano, Ken Okazaki
Objectives: We aimed to determine the prevalence of locomotive syndrome (LS) using the 25-question geriatric locomotive function scale (GLFS-25) and identify factors associated with LS in elderly and younger patients with rheumatoid arthritis (RA). Methods: Overall, 390 patients with RA who underwent GLFS-25 measurement, bone mineral density determination, and bioelectrical impedance analysis were enrolled. Factors associated with LS were analyzed by comparing patients with and without LS among both elderly and younger patients with RA. Results: The prevalence of LS was 41.5%, 47.7% and 32.3% in all patients, elderly patients, and younger patients with RA, respectively. Pain visual analog scale (VAS) and Health Assessment Questionnaire Disability Index (HAQ-DI) were associated with LS in both elderly and younger patients. Moreover, in younger patients with RA, disease activity score in 28 joints (DAS28), erythrocyte sedimentation rate (ESR), basal metabolic rate, and legs muscle mass were identified as being associated with LS. Conclusion: This study demonstrated that to prevent LS, we should aim to control pain and maintain a low HAQ-DI in elderly and younger patients with RA, and improve disease activity and maintain a higher basal metabolic rate, and legs muscle mass in younger patients with RA.
Arterial stiffness, plasma atherogenic index and soluble cell adhesion molecules in healthy young adults with reduced physical activity
Published in Archives of Physiology and Biochemistry, 2018
Mariana G. Bacelova, Julia G. Nikolova, Tania Deneva, Petar F. Nikolov
Objective: To examine some anthropometric parameters, arterial stiffness, lipid profile, and soluble adhesion molecules in young adults with reduced physical activity. Material and methods: The study is carried on 54 healthy young adults aged 20.97 ± 2.04 years. Two groups: 23 with reduced physical activity (INAC) and 31 with optimal physical activity (AC). Body mass index (BMI), basal metabolic rate (BMR), central aortic systolic blood pressure (CSBP, mmHg), plasma atherogenic index (AIP), and serum soluble cell adhesion molecules (sICAM-1, sVCAM-1) are followed up. Results: CSBP [115.56 ± 10.22 vs. 105.13 ± 9.88*], AIP [−0.04 ± 0.18 vs. −0.08 ± 0.08**] and sICAM-1 [362.5 ± 49.95 vs. 281.75 ± 80.39**] are significantly higher, and BMR [1431 ± 297.9 vs. 1674.6 ± 365.57*] is significantly lower in the physically inactive young healthy adults. Conclusions: CSBP, AIP, and sICAM-1 are higher in young adults with reduced physical activity. This plays substantial role in the acceleration of atherogenic process and in long-term perspective could promote cardiovascular diseases.
Correlation among lipid parameters, pulse wave velocity and central blood pressure in young Korean population
Published in Clinical and Experimental Hypertension, 2019
Dhananjay Yadav, Suk-Jeong Kim, Jae-Ryong Kim, Kyung-Hyun Cho
Background: Central blood pressure is closely related to the important cardiovascular intermediate end points, such as vascular hypertrophy and extent of carotid atherosclerosis. Therefore it is prudent to study correlation among central aortic blood pressure, body composition, lipid profiles, and pulse wave velocity in population-based study. Consequently, we investigate the correlation between central aortic blood pressure and other risk parameters of hypertension such as body composition and lipid profile. Methods: We recruited 20 young participants diagnosed with hypertension as well as 30 without hypertension. The study used an X-SCAN PLUS 950 machine for measurement of overall body composition. Measurements of central blood pressure and carotid–femoral pulse wave velocity were carried out using SphygmoCor XCEL. Results: The hypertensive participants had significantly higher total weight without fat, body moisture mass, muscle mass, body mass index, basal metabolic rate, intracellular and extracellular water contents, protein and mineral contents along with brachial and central aortic blood pressures. In both hypertensive and non-hypertensive participants, central aortic diastolic blood pressure were significantly related to the lipid parameters. Conclusion: Overall, the correlations between central blood pressure, pulse wave velocity, and lipid profile in hypertensive and non-hypertensive participants were substantial.