Search

Caffeine consumption during pregnancy is reported to increase the risk of in utero growth restriction and spontaneous abortion. In the present study, we tested the hypothesis that modest maternal caffeine exposure affects in utero developing embryonic cardiovascular (CV) function and growth without altering maternal hemodynamics. Caffeine (10 mg.[kg.sup-1].[day.sup.-1] subcutaneous) was administered daily to pregnant CD-1 mice from embryonic days (EDs) 9.5 to 18.5 of a 21-day gestation. We assessed maternal and embryonic CV function at baseline and at peak maternal serum caffeine concentration using high-resolution echocardiography on EDs 9.5, 11.5, 13.5, and 18.5. Maternal caffeine exposure did not influence maternal body weight gain, maternal CV function, or embryo resorption. However, crown-rump length and body weight were reduced in maternal caffeine treated embryos by ED 18.5 (P < 0.05). At peak maternal serum caffeine concentration, embryonic carotid artery, dorsal aorta, and umbilical artery flows transiently decreased from baseline at ED 11.5 (P < 0.05). By ED 13.5, embryonic aortic and umbilical artery flows were insensitive to the peak maternal caffeine concentration; however, the carotid artery flow remained affected. By ED 18.5, baseline embryonic carotid artery flow increased and descending aortic flow decreased versus non-caffeine-exposed embryos. Maternal treatment with the adenosine [A.sub.2A] receptor inhibitor reproduced the embryonic hemodynamic effects of maternal caffeine exposure. Adenosine [A.sub.2A] receptor gene expression levels of ED 11.5 embryo and ED 18.5 uterus were decreased. Results suggest that modest maternal caffeine exposure has adverse effects on developing embryonic CV function and growth, possibly mediated via adenosine [A.sub.2A] receptor blockade. adenosine [A.sub.2A] receptor; cardiovascular development; carotid artery; pregnancy

A seven-month-old Hispanic girl was referred to the pediatric emergency department for evaluation of acute onset of supraventricular tachycardia. Physical exam revealed an extremely agitated infant with inconsolable crying, tachycardia, tachypnea and hypertension. Toxicologic studies of urine were positive for pseudoephedrine. The possible mechanisms and the principle of management of pseudoephedrine toxicity are discussed. [ABSTRACT FROM AUTHOR]

Pseudoaneurysm formation is a dangerous, but uncommon, complication after the Ross procedure. We describe a patient in whom two pseudoaneurysms formed at the proximal suture line of the pulmonary autograft. These were successfully treated percutaneously, one by placement of an Amplatzer Septal Occluder (AGA Medical, Golden Valley, MN), and the other with coil embolization. [Copyright &y& Elsevier]