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VISION BLURRED Symptoms and Causes

What is high blood pressure in pregnancy?

Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps blood. High blood pressure, or hypertension, is when this force against your artery walls is too high. There are different types of high blood pressure in pregnancy:

  • Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. It sometimes can be severe, which may lead to low birth weight or preterm birth. Some women with gestational hypertension do go on to develop preeclampsia.
  • Chronic hypertension is high blood pressure that started before the 20th week of pregnancy or before you became pregnant. Some women may have had it long before becoming pregnant, but didn’t know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
  • Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. In rare cases, symptoms may not start until after delivery. This is called postpartum preeclampsia. Preeclampsia also includes signs of damage to some of your organs, such as your liver or kidney. The signs may include protein in the urine and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.
What causes preeclampsia?

The cause of preeclampsia is not known.

Who is at risk for preeclampsia?

You are at higher risk of preeclampsia if you

  • Had chronic high blood pressure or chronic kidney disease before pregnancy
  • Had high blood pressure or preeclampsia in a previous pregnancy
  • Have obesity
  • Are over age 40
  • Are pregnant with more than one baby
  • Are African American
  • Have a family history of preeclampsia
  • Have certain health conditions, such as diabetes, lupus, or thrombophilia (a disorder which raises your risk of blood clots)
  • Used in vitro fertilization, egg donation, or donor insemination
What problems can preeclampsia cause?

Preeclampsia can cause

  • Placental abruption, where the placenta separates from the uterus
  • Poor fetal growth, caused by a lack of nutrients and oxygen
  • Preterm birth
  • A low birth weight baby
  • Stillbirth
  • Damage to your kidneys, liver, brain, and other organ and blood systems
  • A higher risk of heart disease for you
  • Eclampsia, which happens when preeclampsia is severe enough to affect brain function, causing seizures or coma
  • HELLP syndrome, which happens when a woman with preeclampsia or eclampsia has damage to the liver and blood cells. It is rare, but very serious.
What are the symptoms of preeclampsia?

Possible symptoms of preeclampsia include

  • High blood pressure
  • Too much protein in your urine (called proteinuria)
  • Swelling in your face and hands. Your feet may also swell, but many women have swollen feet during pregnancy. So swollen feet by themselves may not be a sign of a problem.
  • Headache that does not go away
  • Vision problems, including blurred vision or seeing spots
  • Pain in your upper right abdomen
  • Trouble breathing
  • Eclampsia can also cause seizures, nausea and/or vomiting, and low urine output. If you go on to develop HELLP syndrome, you may also have bleeding or bruising easily, extreme fatigue, and liver failure.

    How is preeclampsia diagnosed?

    Your health care provider will check your blood pressure and urine at each prenatal visit. If your blood pressure reading is high (140/90 or higher), especially after the 20th week of pregnancy, your provider will likely want to run some tests. They may include blood tests other lab tests to look for extra protein in the urine as well as other symptoms.

    How is preeclampsia treated?

    Delivering the baby can often cure preeclampsia. When making a decision about treatment, your provider take into account several factors. They include how severe it is, how many weeks pregnant you are, and what the potential risks to you and your baby are:

    • If you are more than 37 weeks pregnant, your provider will likely want to deliver the baby.
    • If you are less than 37 weeks pregnant, your health care provider will closely monitor you and your baby. This includes blood and urine tests for you. Monitoring for the baby often involves ultrasound, heart rate monitoring, and checking on the baby's growth. You may need to take medicines, to control your blood pressure and to prevent seizures. Some women also get steroid injections, to help the baby's lungs mature faster. If the preeclampsia is severe, you provider may want you to deliver the baby early.

    The symptoms usually go away within 6 weeks of delivery. In rare cases, symptoms may not go away, or they may not start until after delivery (postpartum preeclampsia). This can be very serious, and it needs to be treated right away.

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VISION BLURRED Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Recruiting Using Novel Canadian Resources to Improve Medication Reconciliation at Discharge
Conditions: Medication Reconciliation;   Adverse Drug Events
Intervention: Other: Electronic Medication Reconciliation
Outcome Measures: Adverse Drug Event;   Emergency Room Visit/Hospital Readmission;   Failure to re-start community Medications used for chronic conditions after discharge from hospital.;   Readiness for hospital discharge;   Time to complete medication history and discharge medication reconciliation with prescription.;   Therapy Duplication
2 Recruiting Pharmacokinetic Study of Antiretroviral Drugs and Related Drugs During and After Pregnancy
Condition: HIV Infections
Interventions: Drug: Current ARV Medications;   Drug: Current TB Medications;   Drug: Current hormonal contraceptive Medications
Outcome Measures: Drug parameter: Area under the curve from 0 to 12 hours (AUC 0-12);   Drug parameter: Area under the curve from 0 to 24 hours (AUC 0-24);   Drug parameter: Maximum concentration (Cmax);   Drug parameter: Pre-dose concentration (Cdose);   Drug parameter: Minimum concentration (Cmin);   Drug parameter: Time after administration of drug when maximum plasma concentration is reached (Tmax);   Drug parameter: Clearance over systemic availability (Cl/F);   Drug parameter: Volume of distribution over systemic availability (V/F);   Drug parameter: Half-life (t1/2);   ARV concentrations in vaginal secretions;   ARV concentrations in plasma;   For contraceptives: plasma concentration;   Ratio of cord blood concentration to maternal blood concentration;   Ratio of unbound/total drug concentrations;   Rate of detection of study drugs in vaginal secretions;   Ratio of vaginal drug concentrations to simultaneous blood concentrations;   Rate of detection of HIV RNA/DNA in vaginal secretions and comparison to level in blood;   ARV exposure (as measured by area under the curve or other PK parameters) during pregnancy and postpartum according to genotype;   Adverse events of grade 3 or higher;   Infant neurological events of grade 1 or higher;   Adverse pregnancy outcome: preterm birth;   Adverse pregnancy outcome: low birth weight;   Adverse pregnancy outcome: fetal demise;   Adverse pregnancy outcome: congenital anomalies;   Infant HIV infection status
3 Unknown  Monitoring and Adjustment of Medication Therapy for Patients With Heart Disease
Conditions: Coronary Heart Disease;   Myocardial Infarction
Interventions: Other: Titration of Medications;   Behavioral: Lifestyle Counseling;   Behavioral: Medication Counseling;   Other: Usual Care with Medication Reconciliation
Outcome Measures: Percentage of patients at guideline goal for both blood pressure and lipids;   Composite cardiovascular morbidity and all-cause mortality;   Patient Satisfaction with Clinical Pharmacist Services;   Change in Adherence with 8-item Morisky Adherence Tool
4 Not yet recruiting Clinical Decision Support System for Quality Assurance in Potassium-Increasing Drug-Drug-Interactions
Condition: Hyperkalemia
Intervention: Behavioral: decision support in potassium-inc. drug-drug-interactions
Outcome Measures: Impact on serum potassium monitoring during potassium-increasing drug-drug-interactions;   Frequency of hyperkalemia during potassium-increasing drug-drug-interactions;   Frequency of potassium-increasing drug-drug-interactions ordered in the presence of hyperkalemia;   Frequency of transfers to the ICU during potassium-increasing drug-drug-interactions in function of the serum potassium level;   Frequency of death during potassium-increasing drug-drug-interactions in the presence or absence of hyperkalemia;   Change in frequency distribution of serum potassium monitoring intervals;   Response of physicians to the computer-based alerts and reminders
5 Recruiting The Effect of Medication Reminder Technology on Medication Adherence and Hypertension Outcomes
Conditions: Medication Adherence;   Blood Pressure
Intervention: Device: Medication reminder
Outcome Measures: self-reported medication adherence using the Morisky 8-Item Medication Adherence Scale(MMAS-8) tool;   systolic blood pressure in mmHg using a valid automated device
6 Recruiting Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients
Condition: Potentially Inappropriate Medications
Intervention: Other: " Optimisation de la Prescription MEDicamenteuse " ("Optimization of drug prescribing")
Outcome Measures: Proportion of potentially inappropriate Medications (PIM) prescribed in discharge of hospitalized patients from 75 years old.;   Total number of drugs prescribed per discharge prescription sheet;   Number of rehospitalization within 12 months following discharge;   Number of emergency admission within 12 months following hospitalization;   Mortality within 12 months after hospitalization
7 Recruiting Multi-Center Medication Reconciliation Quality Improvement Study
Conditions: Adverse Drug Events;   Medication Administered in Error
Intervention: Other: Mentored medication reconciliation quality improvement
Outcome Measures: The primary outcome will be unintentional medication discrepancies in admission orders and discharge orders with potential for patient harm;   Patient satisfaction;   Administrative outcomes
8 Not yet recruiting A Randomized Comparative Effectiveness Research Trial of Three Treatments for COPD Patients
Condition: Pulmonary Disease, Chronic Obstructive
Interventions: Drug: Salbutamol (Ventolin®);   Drug: Formoterol (Oxis Turbuhaler®);   Drug: Salmeterol / fluticasone (Seretide®);   Drug: Bufei granule;   Drug: Bufeijianpi granule;   Drug: Bufeiyishen granule;   Drug: Yiqizishen granule;   Drug: conventional medicine + TCM
Outcome Measures: the frequency of exacerbation;   Forced expiratory volume in one second;   Dyspnea;   6 Minutes Walking Distance Test(6MWD);   Quality of life;   Economic Evaluation
9 Recruiting Improving Communication of Medication Instructions to Parents
Conditions: Medication Errors;   Medication Adherence
Intervention: Other: HELPix
Outcome Measure: Medication dosing error (observed)
10 Recruiting The Effect of a Pharmacist Home Visit on Drug-related Problems Post-discharge.
Conditions: Adverse Drug Event;   Patient Readmission;   Patient Compliance
Intervention: Behavioral: HomeCoMe-program
Outcome Measures: Identifying and solving adverse drug events (ADEs) and other drug-related problems (DRPs) post-discharge;   Improvement of adherence to medication at hospital discharge;   Patient assessment of medication knowledge at time of home visit;   Types of interventions made at the pharmacist home visit;   Patient satisfaction with the pharmacist home visit;   Assessment of patient reported health rating;   General practitioners satisfaction with the pharmacist home visit
11 Not yet recruiting Pharmacists and Pharmacy Technicians to Improve Admission Medication History Accuracy
Condition: Adverse Drug Events
Interventions: Other: Pharmacist obtains admission medication history;   Other: Pharmacy technician obtains admission medication history
Outcome Measure: Medication History Errors, or Medication Order Errors
12 Recruiting the Pharmacy Intervention Team Hospital-based (PITH) for People Study: Effect on Clinical and Economic Outcomes
Conditions: Adverse Drug Reaction;   Medication Administered in Error
Intervention: Other: integrated medicines management
Outcome Measures: number of rehospitalizations;   numbers of ADEs;   numbers of DRPs;   cost per prevented re-hospitalization;   general health care use
13 Recruiting Regional Data Exchange to Improve Medication Safety
Condition: Drug Toxicity
Intervention: Other: Medication reconciliation enhanced by regional health information exchange
Outcome Measures: Transition drug risk;   Adverse drug events;   Care duplication;   Transitional care satisfaction "Care Transitions Measure"
14 Recruiting Comparison of Drug Eluting Balloon and Drug Eluting Stent
Conditions: Coronary Artery Disease;   Stable Angina;   Unstable Angina;   NSTEMI
Interventions: Device: Drug eluting balloon + Bare metal stent;   Device: drug eluting stent (Zotarolimus-eluting stent)
Outcome Measures: in-segment late loss;   stent thrombosis;   angiographic and procedure success;   MACE
15 Not yet recruiting Supplemental Transcranial Magnetic Stimulation (TMS) vs. Standard Medication Monotherapy for Treating Major Depression: An Exploratory Field Study
Condition: 1. Major Depressive Disorder.
Interventions: Device: Supplemental TMS;   Drug: Standard Medication Monotherapy
Outcome Measures: Montgomery-Åsberg Depression Rating Scale (MADRS);   Hamilton Rating Scale for Depression (HRSD)
16 Recruiting Pharmacist-led Medicines Management Outpatient Service
Condition: High Risk of Medication-related Problems
Intervention: Other: Medicines Management Outpatient service
Outcome Measures: Time to readmission to hospital;   Number of Readmission;   Number of GP consultations and GP home visits;   Number of Accident and Emergency (A&E) visits;   Medication Appropriateness Index (MAI) score;   Health-related quality of life (HRQOL);   Medication Adherence Assessments;;   Cost Utility Analysis
17 Unknown  Enhancing the Detection and Management of Adverse Drug Events in Nursing Homes
Condition: Adverse Drug Event
Intervention: Behavioral: Active medication monitoring
Outcome Measures: Adverse drug event detection;   Adverse drug event response time
18 Not yet recruiting ADHD Medication and Predictors of Treatment Outcome
Condition: Attention Deficit Disorder With Hyperactivity (ADHD)
Interventions: Drug: methylphenidate medication;   Drug: atomoxetine medication;   Drug: lisdexamphetamine medication
Outcome Measures: change in SNAP-IV Teacher and Parent rating scale (Swanson, Nolan and Pelham ADHD Rating Scale);   change in P-SEC (Pediatric Side Effects Checklist);   change in CGI-S (Clinical Global Impression- of Severity);   change in C-GAS (Children´s global assessment scale);   change in SNAP-IV Teacher and Parent rating scale;   change in Spence Children's Anxiety Scale (SCAS);   change in heart rate;   change in systolic blood pressure;   change in diastolic blood pressure;   change in weight z-score;   change in height z-score
19 Recruiting Optimization of Mass Drug Administration With Existing Drug Regimens for Lymphatic Filariasis and Onchocerciasis for Liberia
Conditions: Lymphatic Filariasis;   Onchocerciasis;   Soil Transmitted Helminth (STH) Infections
Intervention: Drug: Annual versus Semiannual Albendazole plus Ivermectin Mass Drug Administration
Outcome Measures: Microfilaria prevalence based on results of microscopic examination of blood smears and skin snips.;   Prevalence of filarial antigenemia in blood and intensity of filarial and intestinal worm infections based on results of microscopy.
20 Not yet recruiting Observational Study to Reduce Medication Errors
Condition: Medication Errors
Intervention:
Outcome Measures: Number of participants with adverse drug reactions due to medication errors occurring during hospitalization;   Number of participants with preventable ADRs due to medication errors