[Nocturnal fall of blood pressure in the first half of pregnancy]. / Nocne obnizenie cisnienia tetniczego w pierwszej polowie ciazy.

OBJECTIVES: Arterial blood pressure (BP) shows circadian variation. The most important feature of the circadian variation of BP is it fall during sleep. Nocturnal fall of BP achieves at least 10% ("dip"). Very scanty literature is available on the diurnal BP pattern in healthy gravidae with uncomplicated pregnancy. DESIGN: The aim of the study was to evaluate of the day-time/night-time mean arterial blood pressure (MAP) fall in pregnant woman in the first half of pregnancy in comparison with healthy non-pregnant women. MATERIALS AND METHODS: Fifty seven healthy woman were included into the study, and divided into two groups: 23 pregnant woman in 7-20 weeks of first gestation and 34 non-pregnant woman. All the subjects were included into the 24-hours non-invasive automated blood pressure monitoring (ABPM). RESULTS AND CONCLUSIONS: Nocturnal fall of BP appeared to be the most pronounced element of the circadian BP pattern in the studied women. Women in the first half of pregnancy exhibit reduction of BP in the night-time similar to that observed in the non-pregnant subjects. In average, 2/3 of pregnant women below 20 weeks of gestation belong to "dippers" in the MAP range. Women with higher mean diurnal BP value have less pronounced nocturnal BP "dip".

Does the change of the polarity of electrodes influence the results of transoesophageal bidirectional DC cardioversion?

The aim of the study was to compare the bidirectional transoesophageal DC cardioversion (BOC) with unidirectional transoesophageal DC cardioversion (UOC) and to evaluate, if the reversion of the polarity of electrodes alters the effectiveness and the amount of energy during BOC. UOC was attempted in 300 patients (pts) with atrial fibrillation (AF) and BOC in 241 pts with AF. In UOC mode shocks were delivered between the 4-ring oesophageal electrode (cathode) and the chest pad (anode) positioned in the precordial region. In BOC shocks were delivered between the same oesophageal electrode and two chest pads joined with each other, positioned on both sides of the sternum. First 147 pts were cardioverted with the oesophageal electrode as a cathode, next 94 with an anode in oesophageal position. The effectiveness of both modes (UOC and BOC) was very high, however in pts with chronic AF success rate was better in BOC approach (82% vs 100%). BOC, compared with UOC, allowed to decrease the threshold defibrillation significantly: in pts with recent onset of AF from 61.5 J to 33.3 J and in pts with chronic AF from 99.8 J to 75.2 J. In pts with long standing AF the reduction of the defibrillation threshold was statistically not significant (from 68.6 J to 50.6 J). The effectiveness of BOC was also very high independently of the polarity of electrodes. The change of the polarity did not affect the minimal and total successful energy of shocks, too. In pts with oesophageal electrode as a cathode defibrillation threshold was 48.4 J and in pts with the anodal electrode 43.7 J. In conclusions we found BOC as a very effective method in pts with AF. Defibrillation threshold in BOC is lower than in UOC and the polarity of electrodes does not influence the success rate and successful energy.

[Use of Hospital Anxiety and Depression Scale in psychosomatic disorders]. / Zastosowanie Skali Leku i Depresji-HADS w chorobach psychosomatycznych.

Sixty-three psychosomatic patients were examined using three self-evaluation scales: Beck Depression Inventory-BDI, State-Trait Anxiety Inventory-STAI and Hospital Anxiety and Depression Scale-HADS in order to attain a description of the level of anxiety and depression in the group as well as to make an opinion on the reliability of HADS and to make a comparison from the results of the two scales: STAI and BDI. The final results indicated that HADS could perhaps stand-up to be a useful instrument for medical patients for screening and examining the disturbed emotion in groups of psychosomatic patients.