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El Fathi W, van Ochten M, Rehman M, van Kuijk SMJ, IntHout J, Ghossein-Doha C, de Haas S, Spaanderman MEA, van Drongelen J. Active plasma renin concentration throughout healthy and complicated pregnancy: a systematic review and meta-analysis. Reprod Biol Endocrinol 2024; 22:29. [PMID: 38454417 PMCID: PMC10918957 DOI: 10.1186/s12958-024-01200-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Pregnancy is characterized by profound circulatory changes and compensatory adjustments in the renin-angiotensin-aldosterone system (RAAS). Differences in regulatory response may antedate or accompany vascular complicated pregnancy. We performed a systematic review and meta-analysis to delineate the trajectory of active plasma renin concentration (APRC) in healthy pregnancy and compare this to complicated pregnancy. METHODS We performed a systematic review and meta-analysis on APRC during normotensive and hypertensive pregnancies, using PubMed (NCBI) and Embase (Ovid) databases. We included only studies reporting measurements during pregnancy together with a nonpregnant reference group measurement. Risk of bias was assessed with QUIPS. Ratio of the mean (ROM) and 95% confidence intervals (CI) of APRC values between pregnant and nonpregnant women were estimated for predefined intervals of gestational age using a random-effects model. Meta-regression was used to analyze APRC over time. RESULTS In total, we included 18 studies. As compared to nonpregnant, APRC significantly increased as early as the first weeks of healthy pregnancy and stayed increased throughout the whole pregnancy (ROM 2.77; 95% CI 2.26-3.39). APRC in hypertensive complicated pregnancy was not significantly different from nonpregnancy (ROM 1.32; 95% CI 0.97-1.80). CONCLUSION Healthy pregnancy is accompanied by a profound rise in APRC in the first trimester that is maintained until term. In hypertensive complicated pregnancy, this increase in APRC is not observed.
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Affiliation(s)
- Wisal El Fathi
- Department of Gynecology and Obstetrics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maaike van Ochten
- Department of Gynecology and Obstetrics, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Munieb Rehman
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Joanna IntHout
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chahinda Ghossein-Doha
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sander de Haas
- Department of Gynecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marc E A Spaanderman
- Department of Gynecology and Obstetrics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Gynecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Joris van Drongelen
- Department of Gynecology and Obstetrics, Radboud University Medical Center, Nijmegen, The Netherlands
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van Luik EM, Vaes EWP, Vesseur MAM, Wilmes N, Meijs DAM, Laven SAJS, Mohseni-Alsalhi Z, de Haas S, Spaanderman MEA, Ghossein-Doha C. Sex Differences in the Anti-Hypertensive Effect of Calcium-Channel Blockers: A Systematic Review and Meta-Analysis. Biomedicines 2023; 11:1622. [PMID: 37371717 DOI: 10.3390/biomedicines11061622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Cardiovascular disease (CVD) is the number one cause of death worldwide, with hypertension as the leading risk factor for both sexes. As sex may affect responsiveness to antihypertensive compounds, guidelines for CVD prevention might necessitate divergence between females and males. To this end, we studied the effectiveness of calcium channel blockers (CCB) on blood pressure (BP), heart rate (HR) and cardiac function between sexes. We performed a systematic review and meta-analysis on studies on CCB from inception to May 2020. Studies had to present both baseline and follow-up measurements of the outcome variables of interest and present data in a sex-stratified manner. Mean differences were calculated using a random-effects model. In total, 38 studies with 8202 participants were used for this review. In females as compared to males, systolic BP decreased by -27.6 mmHg (95%CI -36.4; -18.8) (-17.1% (95%CI -22.5;-11.6)) versus -14.4 mmHg (95%CI -19.0; -9.9) (-9.8% (95%CI -12.9;-6.7)) (between-sex difference p < 0.01), diastolic BP decreased by -14.1 (95%CI -18.8; -9.3) (-15.2%(95%CI -20.3;-10.1)) versus -10.6 mmHg (95%CI -14.0; -7.3) (-11.2% (95%CI -14.8;-7.7)) (between-sex difference p = 0.24). HR decreased by -1.8 bpm (95%CI -2.5; -1.2) (-2.5% (95%CI -3.4; -1.6)) in females compared to no change in males (0.3 bpm (95% CI -1.2; 1.8)) (between-sex difference p = 0.01). In conclusion, CCB lowers BP in both sexes, but the observed effect is larger in females as compared to males.
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Affiliation(s)
- Eveline M van Luik
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Esmée W P Vaes
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Maud A M Vesseur
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Nick Wilmes
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Daniek A M Meijs
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Sophie A J S Laven
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Zenab Mohseni-Alsalhi
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Sander de Haas
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Chahinda Ghossein-Doha
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
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3
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Wilmes N, van Luik EM, Vaes EWP, Vesseur MAM, Laven SAJS, Mohseni-Alsalhi Z, Meijs DAM, Dikovec CJR, de Haas S, Spaanderman MEA, Ghossein-Doha C. Exploring Sex Differences of Beta-Blockers in the Treatment of Hypertension: A Systematic Review and Meta-Analysis. Biomedicines 2023; 11:biomedicines11051494. [PMID: 37239165 DOI: 10.3390/biomedicines11051494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
AIMS In the prevention of cardiovascular morbidity and mortality, early recognition and adequate treatment of hypertension are of leading importance. However, the efficacy of antihypertensives may be depending on sex disparities. Our objective was to evaluate and quantify the sex-diverse effects of beta-blockers (BB) on hypertension and cardiac function. We focussed on comparing hypertensive female versus male individuals. METHODS AND RESULTS A systematic search was performed for studies on BBs from inception to May 2020. A total of 66 studies were included that contained baseline and follow up measurements on blood pressure (BP), heart rate (HR), and cardiac function. Data also had to be stratified for sex. Mean differences were calculated using a random-effects model. In females as compared to males, BB treatment decreased systolic BP 11.1 mmHg (95% CI, -14.5; -7.8) vs. 11.1 mmHg (95% CI, -14.0; -8.2), diastolic BP 8.0 mmHg (95% CI, -10.6; -5.3) vs. 8.0 mmHg (95% CI, -10.1; -6.0), and HR 10.8 beats per minute (bpm) (95% CI, -17.4; -4.2) vs. 9.8 bpm (95% CI, -11.1; -8.4)), respectively, in both sexes' absolute and relative changes comparably. Left ventricular ejection fraction increased only in males (3.7% (95% CI, 0.6; 6.9)). Changes in left ventricular mass and cardiac output (CO) were only reported in males and changed -20.6 g (95% CI, -56.3; 15.1) and -0.1 L (95% CI, -0.5; 0.2), respectively. CONCLUSIONS BBs comparably lowered BP and HR in both sexes. The lack of change in CO in males suggests that the reduction in BP is primarily due to a decrease in vascular resistance. Furthermore, females were underrepresented compared to males. We recommend that future research should include more females and sex-stratified data when researching the treatment effects of antihypertensives.
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Affiliation(s)
- Nick Wilmes
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Eveline M van Luik
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
| | - Esmée W P Vaes
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
| | - Maud A M Vesseur
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
| | - Sophie A J S Laven
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
| | - Zenab Mohseni-Alsalhi
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- GROW-School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Daniek A M Meijs
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Cédric J R Dikovec
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
| | - Sander de Haas
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- GROW-School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- GROW-School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Chahinda Ghossein-Doha
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
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Mohseni-Alsalhi Z, Vesseur MAM, Wilmes N, Laven SAJS, Meijs DAM, van Luik EM, Vaes EWP, Dikovec CJR, Wiesenberg J, Almutairi MF, Janssen EBNJ, de Haas S, Spaanderman MEA, Ghossein-Doha C. The Representation of Females in Studies on Antihypertensive Medication over the Years: A Scoping Review. Biomedicines 2023; 11:biomedicines11051435. [PMID: 37239106 DOI: 10.3390/biomedicines11051435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The leading global risk factor for cardiovascular-disease-related morbidity and mortality is hypertension. In the past decade, attention has been paid to increase females' representation. The aim of this study is to investigate whether the representation of females and presentation of sex-stratified data in studies investigating the effect of antihypertensive drugs has increased over the past decades. METHODS After systematically searching PubMed and Embase for studies evaluating the effect of the five major antihypertensive medication groups until May 2020, a scoping review was performed. The primary outcome was the proportion of included females. The secondary outcome was whether sex stratification was performed. RESULTS The search resulted in 73,867 articles. After the selection progress, 2046 studies were included for further analysis. These studies included 1,348,172 adults with a mean percentage of females participating of 38.1%. Female participation in antihypertensive studies showed an increase each year by 0.2% (95% CI 0.36-0.52), p < 0.01). Only 75 (3.7%) studies performed sex stratification, and this was the highest between 2011 and 2020 (7.2%). CONCLUSION Female participation showed a slight increase in the past decade but is still underrepresented compared to males. As data are infrequently sex-stratified, more attention is needed to possible sex-related differences in treatment effects to different antihypertensive compounds.
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Affiliation(s)
- Zenab Mohseni-Alsalhi
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Maud A M Vesseur
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Nick Wilmes
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Sophie A J S Laven
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Daniek A M Meijs
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Intensive Care Medicine, Maastricht University Medical Center (MUMC+), Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Eveline M van Luik
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Esmée W P Vaes
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Cédric J R Dikovec
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Jan Wiesenberg
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Mohamad F Almutairi
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Emma B N J Janssen
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
| | - Sander de Haas
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Department of Obstetrics and Gynecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Chahinda Ghossein-Doha
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6229 ER Maastricht, The Netherlands
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de Haas S, Mulder E, Schartmann N, Mohseni Z, Abo Hasson F, Alsadah F, van Kuijk S, van Drongelen J, Ghossein-Doha C, Spaanderman M. Blood pressure adjustments throughout healthy and hypertensive pregnancy: A systematic review and meta-analysis. Pregnancy Hypertens 2021; 27:51-58. [PMID: 34929556 DOI: 10.1016/j.preghy.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 12/03/2021] [Indexed: 01/20/2023]
Abstract
Gestational hypertensive complications are preceded by deviant hemodynamic adjustments affecting blood pressure. Our objective was to determine the timing and magnitude of changes in blood pressure during singleton normotensive and hypertensive pregnancies. PubMed (NCBI) and Embase (Ovid) databases were searched for relevant studies up to November 2019. Studies reporting original blood pressure measurements during pregnancy together with a non-pregnant reference measurement were included. Studies including women with a history of cardiovascular or metabolic disease, or women using antihypertensive drugs were excluded. Pooled mean differences between pregnant and non-pregnant women, and absolute blood pressure values were calculated for predefined gestational intervals in normotensive and hypertensive pregnancy, using a random-effects model. Meta-regression analysis was used to analyze group differences in adjustments. In early normotensive pregnancy, both systolic and diastolic blood pressure decreased, reaching their maximum reduction of -4 mmHg (95%CI -6 to -1 mmHg) and -4 mmHg (95%CI, -5 to -3 mmHg), respectively in the second trimester. Thereafter, blood pressure gradually increased towards non-pregnant values. All absolute blood pressure measurements throughout normotensive pregnancy were below 130/80 mmHg. In hypertensive pregnancies, only diastolic blood pressure decreased early in pregnancy. In conclusion, this meta-analysis showed a clinically moderate, but significant mid-pregnancy drop in blood pressure during normotensive pregnancy. Reference curves with absolute values underscore the current liberal cut-off limit for gestational hypertension. A lack of a mid-pregnancy systolic blood pressure drop might reflect increased vascular resistance in women destined to develop hypertensive pregnancy complications.
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Affiliation(s)
- Sander de Haas
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands.
| | - Eva Mulder
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Niklas Schartmann
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Zenab Mohseni
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Fatimah Abo Hasson
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Fatimah Alsadah
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Sander van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, PO box 5800, 6202 AZ Maastricht, Maastricht University Medical Center, The Netherlands
| | - Joris van Drongelen
- Department of Obstetrics and Gynecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Chahinda Ghossein-Doha
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands; Department of Cardiology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands
| | - Marc Spaanderman
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, PO box 5800, 6202 AZ Maastricht, The Netherlands; Department of Obstetrics and Gynecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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de Haas S, Spaanderman M, van Kuijk S, van Drongelen J, Ghossein-Doha C. 231. Adaptation of cardiac diastolic function during pregnancy – A systematic review and meta-analysis. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mulder E, de Haas S, Ghossein-Doha C, Schartmann N, Mohseni Z, Hasson FA, Alsadah F, van Kuijk S, Spaanderman M. 49. Adaptation of cardiac output and systemic vascular resistance during pregnancy: Systematic review and meta-analysis. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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de Haas S, Spaanderman M, Mulder E, Schartmann N, Mohseni Z, van Kuijk S, van Drongelen J, Ghossein-Doha C. 232. Adaptation of blood pressure during normotensive pregnancies and pregnancies complicated by hypertension – A systematic review and meta-analysis. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Taučer-Kapteijn M, Hoogenboezem W, Hoogenboezem R, de Haas S, Medema G. Source tracking of Enterococcus moraviensis and E. haemoperoxidus. J Water Health 2017; 15:41-49. [PMID: 28151438 DOI: 10.2166/wh.2016.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Enterococci were detected occasionally in 100 L samples of water abstracted from a shallow aquifer in a natural dune infiltration area for drinking water production. Enterococcus moraviensis was the species most frequently identified in these samples. Because there are no existing reports of faecal sources of E. moraviensis and the closely related E. hemoperoxidus, this study aimed to find such sources of these two species in the dunes. Faecal samples from various animal species living in the vicinity of abstraction wells, were analysed for enterococci on Slanetz and Bartley Agar. From these samples, enterococci isolates (1,386 in total) were subsequently identified using matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. E. moraviensis was found in the faeces of geese, foxes and rabbits. Also, E. haemoperoxidus was isolated from goose faeces. Using hierarchical clustering, the species composition of Enterococcus spp. isolated from abstracted water formed one cluster with the species composition found in geese droppings. A sanitary survey supported the indication that feral geese may provide a substantial faecal load in particular parts of this dune infiltration area, close to the water abstraction system. This study confirms the faecal origin of E. moraviensis and E. haemoperoxidus from specific animals, which strengthens their significance as faecal indicators.
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Affiliation(s)
- Maja Taučer-Kapteijn
- Het Waterlaboratorium, J.W. Lucasweg 2, Haarlem 2031 BE, The Netherlands E-mail: ; Faculty of Civil Engineering & Geosciences, Department of Water Management, Delft University of Technology, Stevinweg 1, Delft 2628 CN, The Netherlands
| | - Wim Hoogenboezem
- Het Waterlaboratorium, J.W. Lucasweg 2, Haarlem 2031 BE, The Netherlands E-mail:
| | - Remco Hoogenboezem
- Erasmus University Medical Center, Wytemaweg 80, Rotterdam 3015 CN, The Netherlands
| | - Sander de Haas
- PWN Drinking Water Supply Company, Rijksweg 501, Velserbroek 1991 AS, The Netherlands
| | - Gertjan Medema
- Faculty of Civil Engineering & Geosciences, Department of Water Management, Delft University of Technology, Stevinweg 1, Delft 2628 CN, The Netherlands; KWR Watercycle Research Institute, Groningenhaven 7, Nieuwegein 3433 PE, The Netherlands
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Card CE, Haas SD. Pseudocyst of the spermatic cord of a gelding. Can Vet J 1997; 38:567-9. [PMID: 9285138 PMCID: PMC1576760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Clinical, echographic, and histopathological features of an unusual enlarging scrotal mass in a 5-year-old gelding are described. Echography of the scrotal mass in this case provided valuable information concerning the nature of the tissue present, and assisted in narrowing the differential diagnosis.
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Affiliation(s)
- C E Card
- Department of Herd Medicine and Theriogenology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon
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Haas SD, Bristol F, Card CE. Risk factors associated with the incidence of foal mortality in an extensively managed mare herd. Can Vet J 1996; 37:91-5. [PMID: 8640655 PMCID: PMC1576626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this study was to determine the incidence of neonatal mortality in a large, extensively managed mare herd and what risk factors were involved in foal mortality. For a 6 wk period between April 18, 1994, and May 31, 1994, 334 foals were born, of which 74 died before reaching 10 d of age, giving an overall mortality of 22% for this period. Seventy four percent of the foal deaths occurred within 48 h of parturition. The major causes of foal mortality included starvation/exposure 27%, septicemia 26%, and dystocia 20%. Weekly incidences varied significantly, ranging from 67% for week 1 to 14% for week 5 (P < 0.01). Other risk factors that were associated with foal death included failure of passive transfer (P < 0.0001), poor mothering ability (P < 0.0001), the presence of dystocia (P < 0.0001), low birth weight (p < 0.05), lack of rainfall (P < 0.01), and low temperatures (P < 0.1). The effect of sire, mare age, mare body condition, and foal sex were not significant risk factors for foal survival (P > 0.1). Further studies are required to determine if changing management procedures will be effective in reducing the incidence of neonatal foal mortality in this extensively managed herd.
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Affiliation(s)
- S D Haas
- Department of Herd Medicine and Theriogenology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon
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