Associação entre a antropometria e a leptina circulante nos compartimentos materno, fetal e placentário, na gravidez normal Association between anthropometry and circulating leptin in maternal, fetal and placental compartments, in healthy pregnancy

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Flávia Cipriano Castro

2004-10-01

Full Text Available OBJETIVO: avaliar a importância da leptina materna e fetal circulantes na gestação saudável por meio da avaliação de sua associação com variáveis antropométricas materna, placentária e fetal ao nascimento e as relações entre os compartimentos avaliados. MÉTODOS: em estudo transversal foi incluída amostra de 33 gestações únicas, a termo, com fetos saudáveis. As variáveis avaliadas foram idade materna, peso materno, índice de massa corporal, peso do recém-nascido, peso placentário e índice placentário. Amostras de sangue materno foram obtidas imediatamente antes do parto e em sangue do cordão umbilical ao nascimento. A dosagem da leptina sérica foi realizada por meio de radioimunoensaio convencional. As relações entre as concentrações de leptina sérica materna e da artéria e veia umbilicais com as variáveis de estudo foram verificadas através da regressão linear. RESULTADOS: a leptina foi detectada no sangue de todas as 33 gestantes e seus respectivos recém-nascidos, sendo a concentração no sangue materno (17,1±1,77 ng/ml superior à dos vasos umbilicais (veia 9,0±1,16 ng/mL; artéria 8,2±1,02 ng/mL, pPURPOSE: to evaluate the importance of circulating maternal and fetal leptin in the healthy gestation, using its association with maternal, placental and fetal anthropometric variables, obtained at birth, and the relationship between the evaluated compartments. METHODS: in a transversal study a population of 33 single, healthy and term gestations was studied. The evaluated variables were maternal age, maternal weight, body mass index (BMF, weight of the newborn, placental weight, and placental index. Samples of maternal blood were immediately obtained before birth and from fetal umbilical cord blood at birth. Determination of serum leptin was performed using conventional radioimmunoassay. The relationships between serum leptin concentrations in maternal blood, umbilical artery and vein and the studied

Intermittent auscultation of fetal heart rate during labour - a widely accepted technique for low risk pregnancies: but are the current national guidelines robust and practical?

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Sholapurkar, S L

2010-01-01

Intermittent auscultation of fetal heart rate is an accepted practice in low risk labours in many countries. National guidelines on intrapartum fetal monitoring were critically reviewed regarding timing and frequency of intermittent auscultation. Hypothetical but plausible examples are presented to illustrate that it may be possible to miss significant fetal distress with strict adherence to current guidelines. Opinion is forwarded that intermittent auscultation should be performed for 60 seconds before and after three contractions over about 10 min every half an hour in the first stage of labour. Reasons are put forward to show how this could be more practical and patient friendly and at the same time could improve detection of fetal distress. The current recommendation of intermittent auscultation every 15 min in the first stage is associated with poor compliance and leads to unnecessary burden, stress and medicolegal liability for birth attendants. Modification of current national guidelines would be desirable.

Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women

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2014-01-01

Background Research-informed fetal monitoring guidelines recommend intermittent auscultation (IA) for fetal heart monitoring for low-risk women. However, the use of cardiotocography (CTG) continues to dominate many institutional maternity settings. Methods A mixed methods intervention study with before and after measurement was undertaken in one secondary level health service to facilitate the implementation of an initiative to encourage the use of IA. The intervention initiative was a decision-making framework called Intelligent Structured Intermittent Auscultation (ISIA) introduced through an education session. Results Following the intervention, medical records review revealed an increase in the use of IA during labour represented by a relative change of 12%, with improved documentation of clinical findings from assessments, and a significant reduction in the risk of receiving an admission CTG (RR 0.75, 95% CI, 0.60 – 0.95, p = 0.016). Conclusion The ISIA informed decision-making framework transformed the practice of IA and provided a mechanism for knowledge translation that enabled midwives to implement evidence-based fetal heart monitoring for low risk women. PMID:24884597

Fetal contamination with cadmium following chronic exposure of rat ...

African Journals Online (AJOL)

Fetal contamination with cadmium following chronic exposure of rat dams during gestation. ... African Journal of Applied Zoology and Environmental Biology ... It was concluded that cadmium, contrary to previous reports, can pass through the placenta in appreciable quantity to contaminate the fetus to possibly cause fetal ...

Acute and Chronic Fetal Anemia as a Result of Fetomaternal Hemorrhage

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Paul Singh

2014-01-01

Full Text Available Introduction. Fetomaternal hemorrhage represents a transfer of fetal blood to the maternal circulation. Although many etiologies have been described, most causes of fetomaternal hemorrhage remain unidentified. The differentiation between acute and chronic fetomaternal hemorrhage may be accomplished antenatally and may influence perinatal management. Case. A 36-year-old gravida 6 para 3 presented at 37 and 5/7 completed gestational weeks with ultrasound findings suggestive of chronic fetal anemia such as right ventricular enlargement, diminished cerebral vascular resistance, and elevated middle cerebral artery end-diastolic velocity. On the other hand, signs of acute fetal decompensation such as deterioration of the fetal heart tracing, diminished biophysical score, decreased cord pH, and increased cord base deficit were noted. Following delivery, the neonate’s initial hemoglobin was 4.0 g/dL and the maternal KB ratio was 0.015 indicative of a significant fetomaternal hemorrhage. Discussion. One should consider FMH as part of the differential diagnosis for fetal or immediate neonatal anemia. We describe a unique case of FMH that demonstrated both acute and chronic clinical features. It is our hope that this case will assist practitioners in differentiating acute FMH that may require emergent delivery from chronic FMH which may be able to be expectantly managed.

Acute and chronic fetal anemia as a result of fetomaternal hemorrhage.

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Singh, Paul; Swanson, Tara

2014-01-01

Introduction. Fetomaternal hemorrhage represents a transfer of fetal blood to the maternal circulation. Although many etiologies have been described, most causes of fetomaternal hemorrhage remain unidentified. The differentiation between acute and chronic fetomaternal hemorrhage may be accomplished antenatally and may influence perinatal management. Case. A 36-year-old gravida 6 para 3 presented at 37 and 5/7 completed gestational weeks with ultrasound findings suggestive of chronic fetal anemia such as right ventricular enlargement, diminished cerebral vascular resistance, and elevated middle cerebral artery end-diastolic velocity. On the other hand, signs of acute fetal decompensation such as deterioration of the fetal heart tracing, diminished biophysical score, decreased cord pH, and increased cord base deficit were noted. Following delivery, the neonate's initial hemoglobin was 4.0 g/dL and the maternal KB ratio was 0.015 indicative of a significant fetomaternal hemorrhage. Discussion. One should consider FMH as part of the differential diagnosis for fetal or immediate neonatal anemia. We describe a unique case of FMH that demonstrated both acute and chronic clinical features. It is our hope that this case will assist practitioners in differentiating acute FMH that may require emergent delivery from chronic FMH which may be able to be expectantly managed.

Chronic intermittent hypoxia induces cardiac inflammation and dysfunction in a rat obstructive sleep apnea model.

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Wei, Qin; Bian, Yeping; Yu, Fuchao; Zhang, Qiang; Zhang, Guanghao; Li, Yang; Song, Songsong; Ren, Xiaomei; Tong, Jiayi

2016-11-01

Chronic intermittent hypoxia is considered to play an important role in cardiovascular pathogenesis during the development of obstructive sleep apnea (OSA). We used a well-described OSA rat model induced with simultaneous intermittent hypoxia. Male Sprague Dawley rats were individually placed into plexiglass chambers with air pressure and components were electronically controlled. The rats were exposed to intermittent hypoxia 8 hours daily for 5 weeks. The changes of cardiac structure and function were examined by ultrasound. The cardiac pathology, apoptosis, and fibrosis were analyzed by H&E staining, TUNNEL assay, and picosirius staining, respectively. The expression of inflammation and fibrosis marker genes was analyzed by quantitative real-time PCR and Western blot. Chronic intermittent hypoxia/low pressure resulted in significant increase of left ventricular internal diameters (LVIDs), end-systolic volume (ESV), end-diastolic volume (EDV), and blood lactate level and marked reduction in ejection fraction and fractional shortening. Chronic intermittent hypoxia increased TUNNEL-positive myocytes, disrupted normal arrangement of cardiac fibers, and increased Sirius stained collagen fibers. The expression levels of hypoxia induced factor (HIF)-1α, NF-kB, IL-6, and matrix metallopeptidase 2 (MMP-2) were significantly increased in the heart of rats exposed to chronic intermittent hypoxia. In conclusion, the left ventricular function was adversely affected by chronic intermittent hypoxia, which is associated with increased expression of HIF-1α and NF-kB signaling molecules and development of cardiac inflammation, apoptosis and fibrosis. © 2016 by the Journal of Biomedical Research. All rights reserved.

Moléculas que participan en el transporte de hierro materno-fetal: importancia del receptor 1 de transferrina y de la ferroportina en la placenta humana = Molecules implicated in maternal-fetal iron transport across the placental barrier: Role of Transferrin Receptor 1 and Ferroportin

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Corrales Agudelo, Lady Vanessa

2011-03-01

Full Text Available La adecuada transferencia placentaria de hierro es crucial para satisfacer los altos requerimientos del feto y promover su adecuado crecimiento y desarrollo intrauterino; de otra parte, contribuye a prevenir la ferropenia y la anemia, entidades altamente prevalentes en los lactantes durante los primeros dos años de edad, que se asocian con mayor morbilidad y mortalidad en la infancia. La placenta es un órgano capaz de realizar diferentes adaptaciones en la producción de moléculas que participan en el transporte de hierro materno-fetal en respuesta al estado de hierro celular, para proveer la mayor disponibilidad de este mineral al feto. Esta revisión, pretende acercar al lector a los mecanismos metabólicos y moleculares relacionados con la captación, el transporte y la salida de hierro por la placenta hacia el feto, así como su regulación, para proporcionar elementos que le permitan comprender en forma integrada, la importancia de un adecuado estado de hierro materno antes y durante la gestación.

Acute and Chronic Fetal Anemia as a Result of Fetomaternal Hemorrhage

OpenAIRE

Singh, Paul; Swanson, Tara

2014-01-01

Introduction. Fetomaternal hemorrhage represents a transfer of fetal blood to the maternal circulation. Although many etiologies have been described, most causes of fetomaternal hemorrhage remain unidentified. The differentiation between acute and chronic fetomaternal hemorrhage may be accomplished antenatally and may influence perinatal management. Case. A 36-year-old gravida 6 para 3 presented at 37 and 5/7 completed gestational weeks with ultrasound findings suggestive of chronic fetal ane...

Conhecimento de mulheres com diabetes mellitus sobre cuidados pré-concepcionais e riscos materno-fetais

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Escolástica Rejane Ferreira Moura

2012-02-01

Full Text Available Objetivou-se descrever o perfil reprodutivo de mulheres com diabetes mellitus (DM e verificar o nível de conhecimento destas quanto aos riscos maternos e fetais e os cuidados pré-concepcionais. Estudo exploratório, que contou com a participação de 106 mulheres, realizado no Centro Integrado de Hipertensão e Diabetes, de março a julho de 2009. As variáveis reprodutivas foram: número de gestações, partos e abortos e planejamento da gravidez. Os dados foram coletados por meio de entrevista que seguiu um formulário pré-estabelecido. O perfil reprodutivo de mulheres com DM mostrou-se permeado de riscos e repercussões reprodutivas negativas à saúde materna e fetal. Das 106 (100% mulheres estudadas, 44 (41,5% apresentaram conhecimento moderado sobre os cuidados pré-concepcionais e 58 (54,7% conhecimento limitado sobre os riscos maternos e fetais. Faz-se necessário oferecer informações às mulheres a fim de promover o conhecimento sobre os riscos maternos e fetais e os cuidados pré-concepcionais.

Sympatho-adrenal activation by chronic intermittent hypoxia

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Prabhakar, Nanduri R.; Kumar, Ganesh K.; Peng, Ying-Jie

2012-01-01

Recurrent apnea with chronic intermittent hypoxia (CIH) is a major clinical problem in adult humans and infants born preterm. Patients with recurrent apnea exhibit heightened sympathetic activity as well as elevated plasma catecholamine levels, and these phenotypes are effectively recapitulated in rodent models of CIH. This article summarizes findings from studies addressing sympathetic activation in recurrent apnea patients and rodent models of CIH and the underlying cellular and molecular m...

Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing.

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Devane, Declan; Lalor, Joan G; Daly, Sean; McGuire, William; Cuthbert, Anna; Smith, Valerie

2017-01-26

The admission cardiotocograph (CTG) is a commonly used screening test consisting of a short (usually 20 minutes) recording of the fetal heart rate (FHR) and uterine activity performed on the mother's admission to the labour ward. This is an update of a review published in 2012. To compare the effects of admission cardiotocography with intermittent auscultation of the FHR on maternal and infant outcomes for pregnant women without risk factors on their admission to the labour ward. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register to 30 November 2016 and we planned to review the reference list of retrieved papers All randomised and quasi-randomised trials comparing admission CTG with intermittent auscultation of the FHR for pregnant women between 37 and 42 completed weeks of pregnancy and considered to be at low risk of intrapartum fetal hypoxia and of developing complications during labour. Two authors independently assessed trial eligibility and quality, and extracted data. Data were checked for accuracy. We included no new trials in this update. We included four trials involving more than 13,000 women which were conducted in the UK and Ireland and included women in labour. Three trials were funded by the hospitals where the trials took place and one trial was funded by the Scottish government. No declarations of interest were made in two trials; the remaining two trials did not mention declarations of interest. Overall, the studies were assessed as low risk of bias. Results reported in the 2012 review remain unchanged.Although not statistically significant using a strict P auscultation (risk ratio (RR) 1.20, 95% confidence interval (CI) 1.00 to 1.44, 4 trials, 11,338 women, I² = 0%, moderate quality evidence). There was no clear difference in the average treatment effect across included trials between women allocated to admission CTG and women allocated to intermittent auscultation in instrumental vaginal birth (RR 1.10, 95% CI 0.95 to 1

Intermittent auscultation versus continuous fetal monitoring: exploring factors that influence birthing unit nurses' fetal surveillance practice using theoretical domains framework.

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Patey, Andrea M; Curran, Janet A; Sprague, Ann E; Francis, Jill J; Driedger, S Michelle; Légaré, France; Lemyre, Louise; Pomey, Marie-Pascale A; Grimshaw, Jeremy M

2017-09-25

Intermittent Auscultation (IA) is the recommended method of fetal surveillance for healthy women in labour. However, the majority of women receive continuous electronic monitoring. We used the Theoretical Domains Framework (TDF) to explore the views of Birthing Unit nurses about using IA as their primary method of fetal surveillance for healthy women in labour. Using a semi-structured interview guide, we interviewed a convenience sample of birthing unit nurses throughout Ontario, Canada to elicit their views about fetal surveillance. Interviews were recorded and transcribed verbatim. Transcripts were content analysed using the TDF and themes were framed as belief statements. Domains potentially key to changing fetal surveillance behaviour and informing intervention design were identified by noting the frequencies of beliefs, content, and their reported influence on the use of IA. We interviewed 12 birthing unit nurses. Seven of the 12 TDF domains were perceived to be key to changing birthing unit nurses' behaviour The nurses reported that competing tasks, time constraints and the necessity to multitask often limit their ability to perform IA (domains Beliefs about capabilities; Environmental context and resources). Some nurses noted the decision to use IA was something that they consciously thought about with every patient while others stated it their default decision as long as there were no risk factors (Memory, attention and decision processes, Nature of behaviour). They identified positive consequences (e.g. avoid unnecessary interventions, mother-centered care) and negative consequences of using IA (e.g. legal concerns) and reported that the negative consequences can often outweigh positive consequences (Beliefs about consequences). Some reported that hospital policies and varying support from care teams inhibited their use of IA (Social influences), and that support from the entire team and hospital management would likely increase their use (Social

The influence of job stress, social support and health status on intermittent and chronic sleep disturbance: an 8-year longitudinal analysis.

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Gosling, John A; Batterham, Philip J; Glozier, Nick; Christensen, Helen

2014-08-01

To determine the role of health status and social support in the relationship between job stress and sleep disturbance, for both intermittent and chronic sleep disturbance. A total of 1946 mid-life adults completed three questionnaires spanning an 8-year time frame. Sleep disturbance was assessed at each time point, and participants were classified as experiencing intermittent, chronic or no sleep disturbance across this 8-year period. Independent variables included a range of job stress measures, social support, physical and mental health, and demographic characteristics. After controlling for physical and mental health, perceived lack of job marketability increased risk of intermittent sleep disturbance (odds ratio (OR)=1.33, p=0.012). No other job stress measures were associated with either intermittent or chronic sleep disturbance after adjusting for years of education, social support, and employment status. Poorer mental and physical health status, although significantly increasing odds for intermittent sleep disturbance, represented a significantly greater increase in the odds for chronic sleep disturbance over and above intermittent disturbance (OR=0.96, pjob stress had an independent effect on chronic or intermittent sleep disturbance independent of health, social support, and education. Risk profiles for intermittent and chronic sleep disturbance did not differ with regard to job stress; however, various demographic and social support factors were distinguishing factors. Health status, both physical and mental, also showed a significantly greater impact on chronic sleep disturbance than intermittent sleep disturbance. Karasek's model of job strain had little value in predicting sleep disturbance outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

[Fetal programming as a cause of chronic diseases in adult life].

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Seremak-Mrozikiewicz, Agnieszka; Barlik, Magdalena; Drews, Krzysztof

2014-01-01

Long-term adaptive changes occurring in a developing fetus in response to unstable in utero environmental conditions, which appear at a particular time (critical window), are called intrauterine or fetal programming. These adaptive changes are beneficial during the intrauterine period because they adapt the fetus to current needs, but may turn out to be harmful in the end and lead to development of chronic diseases in adult life. Fetal programming means the structural and functional changing of an organism, metabolism and function of some cells, tissues and systems, that occur even despite intrauterine limitations. Events of fetal life influence the determination of physiological patterns which may manifest as disease processes in the adulthood (Barker's hypothesis). Genetic and environmental factors (poor diet in pregnancy chronic intrauterine fetal hypoxia, the effects of xenobiotics and drugs, as well as hormonal disorders) influence the phenotype of a newborn and are involved in the intrauterine programming process. The effects of fetal programming may be passed along to the next generations via not fully understood pathways, which probably include epigenetic mechanisms. Most of the mechanisms underlying this process remain unclear and need to be elucidated.

Concentraciones de aminoácidos maternos secundarias al uso de betametasona para la

OpenAIRE

Keibis Jiménez-Castillejo; Eduardo Reyna-Villasmil; Duly Torres- Cepeda; Joel Santos-Bolívar; Jorly Mejia-Montilla

2016-01-01

El objetivo de la investigación fue determinar las concentraciones plasmáticas de aminoácidos maternos secundarias al uso de betametasona para la maduración pulmonar fetal. Se realizó una investigación con un diseño tipo cuasi-experimental y una muestra no probabilística intencional de 106 pacientes que acudieron a la Consulta Pe-Natal de Alto Riesgo del Hospital Central “Dr. Urquinaona". A las pacientes seleccionadas se les administró betametasona intramuscular (12 mg) por dos dí...

Angiotensin converting enzyme 1 in the median preoptic nucleus contributes to chronic intermittent hypoxia hypertension.

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Faulk, Katelynn E; Nedungadi, T Prashant; Cunningham, J Thomas

2017-05-01

Obstructive sleep apnea is associated with hypertension and cardiovascular disease. Chronic intermittent hypoxia is used to model the arterial hypoxemia seen in sleep apnea patients and is associated with increased sympathetic nerve activity and a sustained diurnal increase in blood pressure. The renin angiotensin system has been associated with hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1, which cleaves angiotensin I to the active counterpart angiotensin II, is present within the central nervous system and has been shown to be regulated by AP-1 transcription factors, such as ΔFosB. Our previous study suggested that this transcriptional regulation in the median preoptic nucleus contributes to the sustained blood pressure seen following chronic intermittent hypoxia. Viral mediated delivery of a short hairpin RNA against angiotensin converting enzyme 1 in the median preoptic nucleus was used along with radio-telemetry measurements of blood pressure to test this hypothesis. FosB immunohistochemistry was utilized in order to assess the effects of angiotensin converting enzyme 1 knockdown on the activity of nuclei downstream from median preoptic nucleus. Angiotensin converting enzyme 1 knockdown within median preoptic nucleus significantly attenuated the sustained hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1 seems to be partly responsible for regulating downstream regions involved in sympathetic and blood pressure control, such as the paraventricular nucleus and the rostral ventrolateral medulla. The data suggest that angiotensin converting enzyme 1 within median preoptic nucleus plays a critical role in the sustained hypertension seen in chronic intermittent hypoxia. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Effect of superoxide anion scavenger on rat hearts with chronic intermittent hypoxia.

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Pai, Peiying; Lai, Ching Jung; Lin, Ching-Yuang; Liou, Yi-Fan; Huang, Chih-Yang; Lee, Shin-Da

2016-04-15

Only very limited information regarding the protective effects of the superoxide anion scavenger on chronic intermittent hypoxia-induced cardiac apoptosis is available. The purpose of this study is to evaluate the effects of the superoxide anion scavenger on cardiac apoptotic and prosurvival pathways in rats with sleep apnea. Forty-two Sprague-Dawley rats were divided into three groups, rats with normoxic exposure (Control, 21% O2, 1 mo), rats with chronic intermittent hypoxia exposure (Hypoxia, 3-7% O2vs. 21% O2per 40 s cycle, 8 h per day, 1 mo), and rats with pretreatment of the superoxide anion scavenger and chronic intermittent hypoxia exposure (Hypoxia-O2 (-)-Scavenger, MnTMPyP pentachloride, 1 mg/kg ip per day; 3-7% O2vs. 21% O2per 40 s cycle, 8 h per day, 1 mo) at 5-6 mo of age. After 1 mo, the protein levels and apoptotic cells of excised hearts from three groups were measured by Western blotting and terminal deoxynucleotide transferase-mediated dUTP nick end labeling (TUNEL) assay. The superoxide anion scavenger decreased hypoxia-induced myocardial architecture abnormalities, left ventricular hypertrophy, and TUNEL-positive apoptosis. The superoxide anion scavenger decreased hypoxia-induced Fas ligand, Fas death receptors, Fas-associated death domain (FADD), activated caspase-8, and activated caspase-3 (Fas-dependent apoptotic pathway) as well as Bad, activated caspase-9 and activated caspase-3 (mitochondria-dependent apoptotic pathway), endonuclease G (EndoG), apoptosis-inducing factor (AIF), and TUNEL-positive apoptosis. The superoxide anion scavenger increased IGF-1, IGF-1R, p-PI3k, p-Akt, p-Bad, Bcl-2, and Bcl-xL (survival pathway). Our findings imply that the superoxide anion scavenger might prevent cardiac Fas-mediated and mitochondrial-mediated apoptosis and enhance the IGF-1-related survival pathway in chronic intermittent hypoxia. The superoxide anion scavenger may prevent chronic sleep apnea-enhanced cardiac apoptotic pathways and enhances

Effects of chronic pollution and water flow intermittency on stream biofilms biodegradation capacity.

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Rožman, Marko; Acuña, Vicenç; Petrović, Mira

2018-02-01

A mesocosm case study was conducted to gain understanding and practical knowledge on biofilm emerging contaminants biodegradation capacity under stressor and multiple stressor conditions. Two real life scenarios: I) biodegradation in a pristine intermittent stream experiencing acute pollution and II) biodegradation in a chronically polluted intermittent stream, were examined via a multifactorial experiment using an artificial stream facility. Stream biofilms were exposed to different water flow conditions i.e. permanent and intermittent water flow. Venlafaxine, a readily biodegradable pharmaceutical was used as a measure of biodegradation capacity while pollution was simulated by a mixture of four emerging contaminants (erythromycin, sulfisoxazole, diclofenac and imidacloprid in addition to venlafaxine) in environmentally relevant concentrations. Biodegradation kinetics monitored via LC-MS/MS was established, statistically evaluated, and used to link biodegradation with stress events. The results suggest that the effects of intermittent flow do not hinder and may even stimulate pristine biofilm biodegradation capacity. Chronic pollution completely reduced biodegradation in permanent water flow experimental treatments while no change in intermittent streams was observed. A combined effect of water flow conditions and emerging contaminants exposure on biodegradation was found. The decrease in biodegradation due to exposure to emerging contaminants is significantly greater in streams with permanent water flow suggesting that the short and medium term biodegradation capacity in intermittent systems may be preserved or even greater than in perennial streams. Copyright © 2017 Elsevier Ltd. All rights reserved.

The organ specificity in pathological damage of chronic intermittent hypoxia: an experimental study on rat with high-fat diet.

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Wang, Hui; Tian, Jian-li; Feng, Shu-zhi; Sun, Ning; Chen, Bao-yuan; Zhang, Yun

2013-09-01

It is known today that sleep apnea hypopnea syndrome and its characteristic chronic intermittent hypoxia can cause damages to multiple organs, including the cardiovascular system, urinary system, and liver. It is still unclear, however, whether the damage caused by sleep apnea hypopnea syndrome and the severity of the damage are organ-specific. This research observed the pathological effects of chronic intermittent hypoxia on rat's thoracic aorta, myocardium, liver, and kidney, under the condition of lipid metabolism disturbance, through establishing the rat model of chronic intermittent hypoxia with high-fat diet by imitating the features of human sleep apnea hypopnea syndrome. In this model, 24 male Wistar rats were randomly divided into three groups: a control group fed by regular diet, a high-fat group fed by high-fat diet, and a high-fat plus intermittent hypoxia group fed by high-fat diet and treated with intermittent hypoxia 7 h a day. At the end of the ninth week, the pathological changes of rat's organs, including the thoracic aorta, myocardium, liver, and kidney are observed (under both optical microscopy and transmission electron microscopy). As the result of the experiment shows, while there was no abnormal effect observed on any organs of the control group, slight pathological changes were found in the organs of the high-fat group. For the high-fat plus intermittent hypoxia group, however, remarkably severer damages were found on all the organs. It also showed that the severity of the damage varies by organ in the high-fat plus intermittent hypoxia group, with the thoracic aorta being the worst, followed by the liver and myocardium, and the kidney being the slightest. Chronic intermittent hypoxia can lead to multiple-organ damage to rat with high-fat diet. Different organs appear to have different sensitivity to chronic intermittent hypoxia.

Impact of chronic maternal stress during early gestation on maternal-fetal stress transfer and fetal stress sensitivity in sheep.

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Dreiling, Michelle; Schiffner, Rene; Bischoff, Sabine; Rupprecht, Sven; Kroegel, Nasim; Schubert, Harald; Witte, Otto W; Schwab, Matthias; Rakers, Florian

2018-01-01

Acute stress-induced reduction of uterine blood flow (UBF) is an indirect mechanism of maternal-fetal stress transfer during late gestation. Effects of chronic psychosocial maternal stress (CMS) during early gestation, as may be experienced by many working women, on this stress signaling mechanism are unclear. We hypothesized that CMS in sheep during early gestation augments later acute stress-induced decreases of UBF, and aggravates the fetal hormonal, cardiovascular, and metabolic stress responses during later development. Six pregnant ewes underwent repeated isolation stress (CMS) between 30 and 100 days of gestation (dGA, term: 150 dGA) and seven pregnant ewes served as controls. At 110 dGA, ewes were chronically instrumented and underwent acute isolation stress. The acute stress decreased UBF by 19% in both the CMS and control groups (p stress-induced cortisol and norepinephrine concentrations indicating a hyperactive hypothalamus-pituitary-adrenal (HPA)-axis and sympathetic-adrenal-medullary system. Increased fetal norepinephrine is endogenous as maternal catecholamines do not cross the placenta. Cortisol in the control but not in the CMS fetuses was correlated with maternal cortisol blood concentrations; these findings indicate: (1) no increased maternal-fetal cortisol transfer with CMS, (2) cortisol production in CMS fetuses when the HPA-axis is normally inactive, due to early maturation of the fetal HPA-axis. CMS fetuses were better oxygenated, without shift towards acidosis compared to the controls, potentially reflecting adaptation to repeated stress. Hence, CMS enhances maternal-fetal stress transfer by prolonged reduction in UBF and increased fetal HPA responsiveness.

Chronic intermittent hyperoxia alters the development of the hypoxic ventilatory response in neonatal rats.

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Logan, Sarah; Tobin, Kristina E; Fallon, Sarah C; Deng, Kevin S; McDonough, Amy B; Bavis, Ryan W

2016-01-01

Chronic exposure to sustained hyperoxia alters the development of the respiratory control system, but the respiratory effects of chronic intermittent hyperoxia have rarely been investigated. We exposed newborn rats to short, repeated bouts of 30% O2 or 60% O2 (5 bouts h(-1)) for 4-15 days and then assessed their hypoxic ventilatory response (HVR; 10 min at 12% O2) by plethysmography. The HVR tended to be enhanced by intermittent hyperoxia at P4 (early phase of the HVR), but it was significantly reduced at P14-15 (primarily late phase of the HVR) compared to age-matched controls; the HVR recovered when individuals were returned to room air and re-studied as adults. To investigate the role of carotid body function in this plasticity, single-unit carotid chemoafferent activity was recorded in vitro. Intermittent hyperoxia tended to decrease spontaneous action potential frequency under normoxic conditions but, contrary to expectations, hypoxic responses were only reduced at P4 (not at P14) and only in rats exposed to higher O2 levels (i.e., intermittent 60% O2). Rats exposed to intermittent hyperoxia had smaller carotid bodies, and this morphological change may contribute to the blunted HVR. In contrast to rats exposed to intermittent hyperoxia beginning at birth, two weeks of intermittent 60% O2 had no effect on the HVR or carotid body size of rats exposed beginning at P28; therefore, intermittent hyperoxia-induced respiratory plasticity appears to be unique to development. Although both intermittent and sustained hyperoxia alter carotid body development and the HVR of rats, the specific effects and time course of this plasticity differs. Copyright © 2015 Elsevier B.V. All rights reserved.

ECOCARDIOGRAFIA FETAL E SUA ACUIDADE DIAGNÓSTICA – CMIN 2014

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Inês Alencoão

2016-07-01

Conclusão: A detecção pré-natal de CC mantém-se um dos maiores desafios em DPN. A ecocardiografia fetal registou eleva- da sensibilidade e especificidade. Os falsos negativos encontra- dos corresponderam a CC simples. A elevada incidência de CC poderá ser explicada por constituirmos um centro de referência materno-infantil de alto risco. A ecocardiografia fetal é fundamental no diagnóstico pré-natal de CC, permitindo o aconselhamento ao casal e a orientação e planeamento dos cuidados perinatais.

Real-Time Automatic Fetal Brain Extraction in Fetal MRI by Deep Learning

OpenAIRE

Salehi, Seyed Sadegh Mohseni; Hashemi, Seyed Raein; Velasco-Annis, Clemente; Ouaalam, Abdelhakim; Estroff, Judy A.; Erdogmus, Deniz; Warfield, Simon K.; Gholipour, Ali

2017-01-01

Brain segmentation is a fundamental first step in neuroimage analysis. In the case of fetal MRI, it is particularly challenging and important due to the arbitrary orientation of the fetus, organs that surround the fetal head, and intermittent fetal motion. Several promising methods have been proposed but are limited in their performance in challenging cases and in real-time segmentation. We aimed to develop a fully automatic segmentation method that independently segments sections of the feta...

Ácidos graxos trans: doenças cardiovasculares e saúde materno-infantil

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CHIARA Vera Lucia

2002-01-01

Full Text Available Este estudo revê a literatura sobre o tema nas últimas décadas, destacando seu efeito no metabolismo humano quanto às doenças coronarianas e à saúde materno-infantil. Recentemente, os ácidos graxos trans foram incluídos entre os fatores dietéticos de risco para doenças cardiovasculares. Discute-se ainda sua relação com o processo de crescimento e desenvolvimento da criança desde a fase fetal e período gestacional. Os trans originam-se dos ácidos graxos insaturados no processo de hidrogenação e bio-hidrogenação, apresentando ação diferenciada destes. Diversas pesquisas ressaltam seu efeito hipercolesterolêmico e o bloqueio e inibição da biossíntese de ácidos graxos essenciais. Estas ações têm repercussões na saúde materno-infantil e elevam o risco de doenças cardiovasculares. Recomenda-se a redução do consumo de alimentos que contenham gordura hidrogenada, adotando os limites de 2% a 5% de gorduras trans/energia totais, já empregados em outros países.

Dosagem de folatos maternos e fetais, séricos e eritrocitários em malformações por defeito de fechamento do tubo neural no feto Maternal and fetal serum and red blood cell folate levels in pregnancies complicated by neural tube defects

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Victor Bunduki

1998-07-01

Full Text Available Objetivos: avaliar os níveis de folatos maternos e fetais gestações com malformações por defeitos de fechamento do tubo neural (DFTN. Métodos: o estudo foi do tipo caso-controle, no qual 14 casos de fetos com DFTN (grupo estudo e 14 casos de fetos com outras malformações (grupo controle foram estudados em gestantes de baixo risco para DFTN. Propusemo-nos a dosar o ácido fólico, na sua forma total e metilada, nos compartimentos fetal e materno, utilizando dosagens séricas e tissulares (eritrocitárias, assim como o volume corpuscular médio, o hematócrito e a hemoglobina. As coletas foram realizadas imediatamente antes da interrupção da gestação. Os resultados nos dois grupos foram comparados pelo teste t de Student, método de amostras pareados pela idade gestacional. Resultados: não se encontrou diferença nas taxas de folatos fetais e nos parâmetros hematológicos dos fetos, entre os dois grupos. Por outro lado, taxas anormalmente baixas de folatos foram encontradas nos eritrócitos das mães portadoras de fetos com DFTN, tanto para as formas totais(293,9 ng/mL contra 399,1 ng/mL no grupo controle, p=0,01 quanto para as formas metiladas (201,9 ng/mL contra 314,0 ng/mL para o grupo controle, p=0,02. Os folatos séricos maternos não se mostraram diferentes nos grupos estudo e controle. Conclusão: este estudo demonstrou que há uma menor taxa de folatos intratissulares, nas mães de fetos acometidos por DFTN, porém com taxas de folatos séricos semelhantes em relação ao grupo controle.Objective: to analyze maternal and fetal folate status in cases of neural tube defects (NTD. Methods: a case-control study was designed with 14 cases of fetuses with neural tube defects (study group and 14 cases of fetuses with other unrelated malformations (control group gestational age matched, in low-risk pregnant women. Both total and methylated folic acid levels in fetal and maternal compartments using serum and tissular (red blood cells

Chronic intermittent hypoxia preserves bone density in a mouse model of sleep apnea.

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Torres, Marta; Montserrat, Josep M; Pavía, Javier; Dalmases, Mireia; Ros, Domenec; Fernandez, Yolanda; Barbé, Ferran; Navajas, Daniel; Farré, Ramon

2013-12-01

Very recent clinical research has investigated whether obstructive sleep apnea (OSA) may modulate bone homeostasis but the few data available are conflicting. Here we report novel data obtained in a mouse study specifically designed to determine whether chronic intermittent hypoxia realistically mimicking OSA modifies bone mineral density (BMD). Normal male and female mice and orchidectomized mice (N=10 each group) were subjected to a pattern of high-frequency intermittent hypoxia (20s at 5% and 40s at 21%, 60 cycles/h) for 6h/day. Identical groups breathing room air (normoxia) were the controls. After 32 days of intermittent hypoxia/normoxia the trabecular bone mineral density (BMD) in the peripheral femora were measured by micro-CT scanning. When compared with normoxia (two-way ANOVA), intermittent hypoxia did not significantly modify BMD in the three animal groups tested. Data in this study suggest that the type of intermittent hypoxia characterizing OSA, applied as a single challenge, preserves bone homeostasis. Copyright © 2013 Elsevier B.V. All rights reserved.

Chronic intermittent hypoxia predisposes to liver injury.

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Savransky, Vladimir; Nanayakkara, Ashika; Vivero, Angelica; Li, Jianguo; Bevans, Shannon; Smith, Philip L; Torbenson, Michael S; Polotsky, Vsevolod Y

2007-04-01

Obstructive sleep apnea (OSA) is characterized by chronic intermittent hypoxia (CIH). OSA is associated with nonalcoholic steatohepatitis (NASH) in obese subjects. The aim of this study was to investigate the effects of CIH on the liver in the absence of obesity. Lean C57BL/6J mice (n = 15) on a regular chow diet were exposed to CIH for 12 weeks and compared with pair-fed mice exposed to intermittent air (IA, n = 15). CIH caused liver injury with an increase in serum ALT (224 +/- 39 U/l versus 118 +/- 22 U/l in the IA group, P fasting serum insulin levels, and mild elevation of fasting serum total cholesterol and triglycerides (TG). Liver TG content was unchanged, whereas cholesterol content was decreased. Histology showed swelling of hepatocytes, no evidence of hepatic steatosis, and marked accumulation of glycogen in hepatocytes. CIH led to lipid peroxidation of liver tissue with a malondialdehyde (MDA)/free fatty acids (FFA) ratio of 0.54 +/- 0.07 mmol/mol versus 0.30 +/- 0.01 mmol/mol in control animals (P obesity, CIH leads to mild liver injury via oxidative stress and excessive glycogen accumulation in hepatocytes and sensitizes the liver to a second insult, whereas NASH does not develop.

Intermittent cranial lung herniation in two dogs.

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Guglielmini, Carlo; De Simone, Antonio; Valbonetti, Luca; Diana, Alessia

2007-01-01

Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.

Early cerebral hemodynamic, metabolic and histological changes in hypoxic-ischemic fetal lambs during postnatal life

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Carmen eRey-Santano

2011-09-01

Full Text Available The hemodynamic, metabolic and biochemical changes produce during transition from fetal to neonatal life could be aggravated if asphyctic event occur during fetal life. The aim of the study was to examine the regional cerebral blood flow (RCBF, histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress for the first hours of postnatal life following severe fetal asphyxia. 18 chronically instrumented fetal lambs were assigned to: hypoxic-ischemic group, following fetal asphyxia animals were delivered and maintained on intermittent-positive-pressure-ventilation for 3 hours, and non-injured animals that were managed similarly to the previous group and used as control group. During hypoxic-ischemic insult, injured group developed acidosis, hypoxia, hypercapnia, latacidaemia and tachycardia in comparison to control group, without hypotension. Intermittent-positive-pressure-ventilation transiently improved gas exchange and cardiovascular parameters. After HI injury and during ventilation-support, the increased RCBF in inner zones was maintained for hypoxic-ischemic group, but cortical flow did not exhibit differences compared to the control group. Also, the increase of TUNEL positive cells (apoptosis and antioxidant enzymes, and decrease of ATP reserves was significantly higher in the brain regions where the RCBF were not increased.In conclusion, early metabolic, histological and hemodynamic changes involved in brain damage have been intensively investigated and reported in premature asphyctic lambs for the first 3 hours of postnatal life. Those changes have been described in human neonates, so our model could be useful to test the security and the effectiveness of different neuroprotective or ventilatory strategies when are applied in the first hours after fetal hypoxic-ischemic injury.

Carotid body denervation prevents fasting hyperglycemia during chronic intermittent hypoxia.

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Shin, Mi-Kyung; Yao, Qiaoling; Jun, Jonathan C; Bevans-Fonti, Shannon; Yoo, Doo-Young; Han, Woobum; Mesarwi, Omar; Richardson, Ria; Fu, Ya-Yuan; Pasricha, Pankaj J; Schwartz, Alan R; Shirahata, Machiko; Polotsky, Vsevolod Y

2014-10-01

Obstructive sleep apnea causes chronic intermittent hypoxia (IH) and is associated with impaired glucose metabolism, but mechanisms are unknown. Carotid bodies orchestrate physiological responses to hypoxemia by activating the sympathetic nervous system. Therefore, we hypothesized that carotid body denervation would abolish glucose intolerance and insulin resistance induced by chronic IH. Male C57BL/6J mice underwent carotid sinus nerve dissection (CSND) or sham surgery and then were exposed to IH or intermittent air (IA) for 4 or 6 wk. Hypoxia was administered by decreasing a fraction of inspired oxygen from 20.9% to 6.5% once per minute, during the 12-h light phase (9 a.m.-9 p.m.). As expected, denervated mice exhibited blunted hypoxic ventilatory responses. In sham-operated mice, IH increased fasting blood glucose, baseline hepatic glucose output (HGO), and expression of a rate-liming hepatic enzyme of gluconeogenesis phosphoenolpyruvate carboxykinase (PEPCK), whereas the whole body glucose flux during hyperinsulinemic euglycemic clamp was not changed. IH did not affect glucose tolerance after adjustment for fasting hyperglycemia in the intraperitoneal glucose tolerance test. CSND prevented IH-induced fasting hyperglycemia and increases in baseline HGO and liver PEPCK expression. CSND trended to augment the insulin-stimulated glucose flux and enhanced liver Akt phosphorylation at both hypoxic and normoxic conditions. IH increased serum epinephrine levels and liver sympathetic innervation, and both increases were abolished by CSND. We conclude that chronic IH induces fasting hyperglycemia increasing baseline HGO via the CSN sympathetic output from carotid body chemoreceptors, but does not significantly impair whole body insulin sensitivity. Copyright © 2014 the American Physiological Society.

Chronic Intermittent Hypoxia Induces Chronic Low-Grade Neuroinflammation in the Dorsal Hippocampus of Mice.

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Sapin, Emilie; Peyron, Christelle; Roche, Frédéric; Gay, Nadine; Carcenac, Carole; Savasta, Marc; Levy, Patrick; Dematteis, Maurice

2015-10-01

Obstructive sleep apnea (OSA) induces cognitive impairment that involves intermittent hypoxia (IH). Because OSA is recognized as a low-grade systemic inflammatory disease and only some patients develop cognitive deficits, we investigated whether IH-related brain consequences shared similar pathophysiology and required additional factors such as systemic inflammation to develop. Nine-week-old male C57BL/6J mice were exposed to 1 day, 6 or 24 w of IH (alternating 21-5% FiO2 every 30 sec, 8 h/day) or normoxia. Microglial changes were assessed in the functionally distinct dorsal (dH) and ventral (vH) regions of the hippocampus using Iba1 immunolabeling. Then the study concerned dH, as vH only tended to be lately affected. Seven proinflammatory and anti-inflammatory cytokine messenger RNA (mRNA) were assessed at all time points using semiquantitative real-time reverse transcription polymerase chain reaction (RT-PCR). Similar mRNA analysis was performed after 6 w IH or normoxia associated for the past 3 w with repeated intraperitoneal low-dose lipopolysaccharide or saline. Chronic (6, 24 w) but not acute IH induced significant microglial changes in dH only, including increased density and morphological features of microglia priming. In dH, acute but not chronic IH increased IL-1β and RANTES/CCL5 mRNA, whereas the other cytokines remained unchanged. In contrast, chronic IH plus lipopolysaccharide increased interleukin (IL)-6 and IL10 mRNA whereas lipopolysaccharide alone did not affect these cytokines. The obstructive sleep apnea component intermittent hypoxia (IH) causes low-grade neuroinflammation in the dorsal hippocampus of mice, including early but transient cytokine elevations, delayed but long-term microglial changes, and cytokine response alterations to lipopolysaccharide inflammatory challenge. These changes may contribute to IH-induced cognitive impairment and pathological brain aging. © 2015 Associated Professional Sleep Societies, LLC.

Chronic intermittent fasting improves the survival following large myocardial ischemia by activation of BDNF/VEGF/PI3K signaling pathway.

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Katare, Rajesh G; Kakinuma, Yoshihiko; Arikawa, Mikihiko; Yamasaki, Fumiyasu; Sato, Takayuki

2009-03-01

Chronic heart failure (CHF) is the major cause of death in the developed countries. Calorie restriction is known to improve the recovery in these patients; however, the exact mechanism behind this protective effect is unknown. Here we demonstrate the activation of cell survival PI3kinase/Akt and VEGF pathway as the mechanism behind the protection induced by intermittent fasting in a rat model of established chronic myocardial ischemia (MI). Chronic MI was induced in rats by occlusion of the left coronary artery. Two weeks later, the rats were randomly assigned to a normal feeding group (MI-NF) and an alternate-day feeding group (MI-IF). After 6 weeks of observation, we evaluated the effect of intermittent fasting on cellular and ventricular remodeling and long-term survival after CHF. Compared with the normally fed group, intermittent fasting markedly improved the survival of rats with CHF (88.5% versus 23% survival, Pfasted hearts. Immunohistochemical studies confirmed increased capillary density (Pfasting also upregulated the expression of other anti-apoptotic factors such as Akt and Bcl-2 and reduced the TUNEL positive apoptotic nuclei in the border zone. Chronic intermittent fasting markedly improves the long-term survival after CHF by activation through its pro-angiogenic, anti-apoptotic and anti-remodeling effects.

A safe strategy to decrease fetal lead exposure in a woman with chronic intoxication.

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Leiba, Adi; Hu, Howard; Zheng, Amin; Kales, Stefanos N

2010-08-01

During pregnancy skeletal lead is mobilized by maternal bone turnover and can threaten fetal development. The exact strategy suggested to women of childbearing age, who were chronically exposed to lead, and, thus, have high bone lead burden, is not well established. We describe 4 years of follow-up of a 29-year-old woman with chronic lead intoxication. We (a) advised her to delay conception until 'toxicological clearance', (b) treated her with multiple courses of lead chelator, DMSA, and (c) prescribed oral calcium. Patient had low blood lead and protoporphyrin level during pregnancy until delivery. Delaying conception, lead chelation, and calcium supplementation can decrease fetal exposure.

Influência do estado nutricional materno, ganho de peso e consumo energético sobre o crescimento fetal, em gestações de alto risco Influence of maternal nutritional status, weight gain and energy intake on fetal growth in high-risk pregnancies

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Roseli Mieko Yamamoto Nomura

2012-03-01

Full Text Available OBJETIVO: Analisar a influência do estado nutricional materno, ganho de peso e consumo energético sobre o crescimento fetal em gestações de alto risco. MÉTODOS: Estudo prospectivo de agosto de 2009 a agosto de 2010, com os seguintes critérios de inclusão: puérperas até o 5º dia; gestação de alto risco (caracterizada por complicações médicas ou obstétricas durante a gravidez; feto único e vivo no início do trabalho de parto; parto na instituição; peso materno aferido no dia do parto, e presença de intercorrência clínica e/ou obstétrica caracterizando a gravidez como de alto risco. O estado nutricional foi avaliado pelo índice de massa corporal pré-gestacional e no final da gestação, sendo as pacientes classificadas em: baixo peso, adequado, sobrepeso e obesidade. Para avaliação do consumo energético foi aplicado o Questionário de Frequência de Consumo Alimentar. Foram investigados o ganho de peso materno, dados do parto e resultados perinatais, investigando-se o crescimento fetal pela ocorrência de neonatos pequenos para a idade gestacional e grandes para a idade gestacional. RESULTADOS: Foram incluídas 374 gestantes que constituíram 3 grupos de estudo, de acordo com a adequação do peso do recém-nascido: idade gestacional adequada (270 casos, 72,2%, pequenos para a idade gestacional (91 casos, 24,3% e grandes para a idade gestacional (13 casos, 3,5%. Na análise univariada, as mulheres com neonatos pequenos para a idade gestacional apresentaram média significativamente menor do índice de massa corporal pré-gestacional (23,5 kg/m², pPURPOSE: To analyze the influence of maternal nutritional status, weight gain and energy consumption on fetal growth in high-risk pregnancies. METHODS: A prospective study from August 2009 to August 2010 with the following inclusion criteria: puerperae up to the 5th postpartum day; high-risk singleton pregnancies (characterized by medical or obstetrical complications during

Male fertility is reduced by chronic intermittent hypoxia mimicking sleep apnea in mice.

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Torres, Marta; Laguna-Barraza, Ricardo; Dalmases, Mireia; Calle, Alexandra; Pericuesta, Eva; Montserrat, Josep M; Navajas, Daniel; Gutierrez-Adan, Alfonso; Farré, Ramon

2014-11-01

Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and oxidative stress. However, it is unknown whether intermittent hypoxia mimicking OSA modifies male fertility. We tested the hypothesis that male fertility is reduced by chronic intermittent hypoxia mimicking OSA in a mouse model. Case-control comparison in a murine model. University research laboratory. Eighteen F1 (C57BL/6xCBA) male mice. Mice were subjected to a pattern of periodic hypoxia (20 sec at 5% O2 followed by 40 sec of room air) 6 h/day for 60 days or normoxia. After this period, mice performed a mating trial to determine effective fertility by assessing the number of pregnant females and fetuses. After euthanasia, oxidative stress in testes was assessed by measuring the expression of glutathione peroxidase 1 (Gpx1) and superoxide dismutase-1 (Sod1) by reverse-transcription polymerase chain reaction. Sperm motility was determined by Integrated Semen Analysis System (ISAS). Intermittent hypoxia significantly increased testicular oxidative stress, showing a reduction in the expression of Gpx1 and Sod1 by 38.9% and 34.4%, respectively, as compared with normoxia (P intermittent hypoxia group (P = 0.04). The proportion of pregnant females and number of fetuses per mating was significantly lower in the intermittent hypoxia group (0.33 ± 0.10 and 2.45 ± 0.73, respectively) than in normoxic controls (0.72 ± 0.16 and 5.80 ± 1.24, respectively). These results suggest that the intermittent hypoxia associated with obstructive sleep apnea (OSA) could induce fertility reduction in male patients with this sleep breathing disorder.

Diagnóstico prenatal no invasivo: Ácidos nucleicos de origen fetal en sangre materna

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Carla Sesarini

2010-12-01

Full Text Available Las técnicas actuales de diagnóstico prenatal de enfermedades génicas y cromosómicas incluyen procedimientos invasivos que conllevan un pequeño, pero significativo, riesgo. Por muchos años se ha estudiado la posibilidad de utilizar células fetales en circulación materna; sin embargo, ha fracasado su implementación clínica debido a su escasez y persistencia luego del parto. Desde hace más de una década se detectó ADN fetal libre en sangre de embarazadas. Este sería de origen placentario e indetectable después del parto, y fuente de material fetal para el desarrollo de técnicas diagnósticas utilizando sangre materna. No obstante, la mayoría del ADN libre en circulación materna es de origen materno con una contribución fetal del 3% al 6% aumentando a lo largo de la gestación. Dado que los métodos actuales no permiten separar el ADN libre fetal del materno, las aplicaciones se focalizan en el análisis de genes no presentes en la madre, tales como secuencias del cromosoma Y, o gen RHD en madres Rh negativas, o mutaciones paternas o de novo. Asimismo, la detección de ARN fetal libre en sangre de embarazadas abrió la posibilidad de obtener información acerca de patrones de expresión génica de tejidos embrionarios y, utilizando genes que se expresan sólo en la unidad feto-placentaria, se podría establecer un control de presencia de material fetal, independiente del material genético de la madre. El presente trabajo describe las evidencias acerca del pasaje de ácidos nucleicos fetales a circulación materna, su aplicación actual en el diagnóstico prenatal y posibles usos futuros.

Early Cerebral Hemodynamic, Metabolic, and Histological Changes in Hypoxic-Ischemic Fetal Lambs during Postnatal Life.

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Rey-Santano, Carmen; Mielgo, Victoria E; Gastiasoro, Elena; Murgia, Xabier; Lafuente, Hector; Ruiz-Del-Yerro, Estibaliz; Valls-I-Soler, Adolf; Hilario, Enrique; Alvarez, Francisco J

2011-01-01

The hemodynamic, metabolic, and biochemical changes produced during the transition from fetal to neonatal life may be aggravated if an episode of asphyxia occurs during fetal life. The aim of the study was to examine regional cerebral blood flow (RCBF), histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress in the first hours of postnatal life following severe fetal asphyxia. Eighteen chronically instrumented newborn lambs were randomly assigned to either a control group or the hypoxic-ischemic (HI) group, in which case fetal asphyxia was induced just before delivery. All the animals were maintained on intermittent positive pressure ventilation for 3 h after delivery. During the HI insult, the injured group developed acidosis, hypoxia, hypercapnia, lactic acidosis, and tachycardia (relative to the control group), without hypotension. The intermittent positive pressure ventilation transiently improved gas exchange and cardiovascular parameters. After HI injury and during ventilatory support, there continued to be an increased RCBF in inner regions among the HI group, but no significant differences were detected in cortical flow compared to the control group. Also, the magnitude of the increase in TUNEL positive cells (apoptosis) and antioxidant enzymes, and decrease of ATP reserves was significantly greater in the brain regions where the RCBF was not higher. In conclusion, our findings identify early metabolic, histological, and hemodynamic changes involved in brain damage in premature asphyxiated lambs. Such changes have been described in human neonates, so our model could be useful to test the safety and the effectiveness of different neuroprotective or ventilation strategies applied in the first hours after fetal HI injury.

Factores nutricionales maternos y el bajo peso al nacer en un área de salud

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Arley Rey Vilchez

2013-01-01

Full Text Available Fundamento: el bajo peso al nacer es multifactorial y se atribuye a causas maternas, fetales y ambientales. Los hábitos alimentarios inadecuados unidos a otros factores nutricionales maternos son determinantes. Objetivo: identificar los factores nutricionales maternos relacionados con el bajo peso al nacer en pacientes del Área I del municipio Cienfuegos. Métodos: se realizó un estudio analítico, retrospectivo, de casos y controles entre enero 2006 y diciembre 2008. Se estudiaron 50 madres de recién nacidos bajo peso (casos y 100 madres de niños normopesos (controles a razón de 2 por cada caso, seleccionadas del registro de nacimientos del área. Se revisaron las historias clínicas obstétricas y se entrevistó a cada paciente para evaluar sus hábitos alimentarios según frecuencia de comidas y grupos de alimentos consumidos. El procesamiento de la información se realizó utilizando el programa estadístico SPSS versión 15,0. Los resultados se presentaron en tablas con frecuencias absolutas, porcentajes y resultados de las técnicas estadísticas empleadas. Resultados: se comportaron como factores de riesgo: la edad materna, el estado nutricional al inicio del embarazo, la ganancia de peso durante la gestación y la hemoglobina del tercer trimestre. Las mujeres con hábitos alimentarios inestables e insuficientes tuvieron 33 veces más probabilidades de tener neonatos bajo peso y las que refirieron dietas no saludables según grupos de alimentos consumidos tuvieron 9 veces más riesgo. Conclusiones: los factores nutricionales maternos influyeron en la incidencia del bajo peso al nacer, fundamentalmente los hábitos alimentarios inadecuados.

Prevalência do aleitamento materno Prevalence of breastfeeding

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Amauri Pinto da Silva

2005-06-01

Full Text Available OBJETIVO: Avaliar os indicadores de aleitamento materno em consultórios particulares e centros de saúde no município de Lins, SP, e comparar a prevalência de aleitamento materno exclusivo dessa região com a encontrada em outras pesquisas. MÉTODOS: Estudo de corte transversal com amostra aleatória de 255 crianças de quatro a doze meses de idade, estratificada por sexo, condição socioeconômica e escolaridade dos pais. Foram avaliados os indicadores de aleitamento materno em dois grupos de crianças: as acompanhadas em consultórios particulares e as acompanhadas em centros de saúde. Foram utilizados questionários respondidos pelos responsáveis. Os dados desta pesquisa foram comparados aos de outros estudos. RESULTADOS: Apesar de haver diferenças significativas nas condições de renda, estrato social e escolaridade dos pais, não houve diferença significativa nos índices de aleitamento materno entre os dois grupos. No grupo total, a prevalência de aleitamento materno exclusivo aos quatro meses foi de 61,1% e a mediana de aleitamento materno exclusivo foi de 120 dias. Os resultados foram superiores aos dos demais estudos consultados. CONCLUSÃO: Os resultados mostraram diferenças relacionadas às condições socioeconômicas, porém, os índices de aleitamento materno foram semelhantes entre os dois grupos. Os resultados de aleitamento materno exclusivo foram superiores aos das demais pesquisas.OBJECTIVE: To evaluate the breastfeeding indicators registered for two groups of infants in the city of Lins, São Paulo, Brazil. To compare the prevalence of exclusive breastfeeding in this area with data found in other studies. METHODS: A cross-sectional study with a random sample of 255 infants between 4 and 12 months of age, found in two groups: the infants attended at private medical offices, and those attended at the county health care centers of the city of Lins. The subjects were stratified by sex, parental socioeconomic class and

Maternal and fetal genomes interplay through phosphoinositol 3-kinase(PI3K)-p110α signaling to modify placental resource allocation

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Sferruzzi-Perri, Amanda N.; López-Tello, Jorge; Fowden, Abigail L.; Constancia, Miguel

2016-01-01

Pregnancy success and life-long health depend on a cooperative interaction between the mother and the fetus in the allocation of resources. As the site of materno-fetal nutrient transfer, the placenta is central to this interplay; however, the relative importance of the maternal versus fetal genotypes in modifying the allocation of resources to the fetus is unknown. Using genetic inactivation of the growth and metabolism regulator, Pik3ca (encoding PIK3CA also known as p110α, α/+), we examined the interplay between the maternal genome and the fetal genome on placental phenotype in litters of mixed genotype generated through reciprocal crosses of WT and α/+ mice. We demonstrate that placental growth and structure were impaired and associated with reduced growth of α/+ fetuses. Despite its defective development, the α/+ placenta adapted functionally to increase the supply of maternal glucose and amino acid to the fetus. The specific nature of these changes, however, depended on whether the mother was α/+ or WT and related to alterations in endocrine and metabolic profile induced by maternal p110α deficiency. Our findings thus show that the maternal genotype and environment programs placental growth and function and identify the placenta as critical in integrating both intrinsic and extrinsic signals governing materno-fetal resource allocation. PMID:27621448

Chronic intermittent but not constant hypoxia decreases NAA/Cr ratios in neonatal mouse hippocampus and thalamus.

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Douglas, Robert M; Miyasaka, Naoyuki; Takahashi, Kan; Latuszek-Barrantes, Adrianna; Haddad, Gabriel G; Hetherington, Hoby P

2007-03-01

Chronic constant hypoxia (CCH) and chronic intermittent hypoxia (CIH) are known to have deleterious effects on the central nervous system. Because of the difference in the pattern of hypoxic exposure, it is possible that the pathological outcome would vary. The N-acetyl aspartate/creatine (NAA/Cr) ratio is a reliable marker of neuronal integrity, and this can be noninvasively measured by proton nuclear magnetic resonance spectroscopy. P2 CD1 mouse pups with their dams were exposed to either CCH, where the Fi(O(2)) was maintained at 11% continuously or to CIH, where the Fi(O(2)) was varied between 21 and 11% every 4 min. P30 mice exposed to intermittent hypoxia for 4 wk demonstrated a significant decrease in the NAA/Cr ratio in the hippocampus and thalamus, which was reversed by a subsequent exposure to 4 wk of normoxia. Meanwhile, mice exposed to 4 wk of constant hypoxia did not demonstrate any differences in their NAA/Cr ratios from controls in these brain regions. These results indicate that an intermittent pattern of hypoxic exposure may have a more adverse effect on neuronal function and integrity than a continuous one. The reversal of NAA/Cr levels to baseline during the return to normoxia indicates that therapeutic strategies targeted at alleviating the intermittent hypoxic stress in diseases, such as obstructive sleep apnea, have the potential for inducing significant neurocognitive recovery in these patients.

Effect of chronic intermittent hypoxia on glycometabolism in rat’ liver and the mechanism thereof

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Wei YU

2018-03-01

Full Text Available Objective To investigate the effects of chronic intermittent hypoxia on the adipose factor and the expressions of insulin receptor substrate 2 (IRS-2, glucose transporter 2 (GLUT-2 and leptin in rat liver. Methods Twenty-four mature SD rats were randomly divided into 3 groups: control group (UC, chronic intermittent hypoxia group (CIH and reoxygenation group (RH. The arterial blood gas analysis was performed after the establishment of rat model. The serum fasting blood glucose (FBG and fasting insulin (FINS in each group were detected by peroxidase method; the concentrations of free fatty acids (FFA and leptin were detected by ELISA. The expressions of mRNA and protein of GLUT-2, IRS-2 and leptin were detected by qRT-PCR and Western blotting. Results The serous concentrations of FBG, FINS, FFA and leptin were significantly higher in CIH group than in UC group (P<0.05, and were dramatically higher in RH group than in both CIH group (P=0.003 and UC group (P=0.000. Western blotting and qRT-PCR detection showed that the protein and mRNA expressions of GLUT-2 and IRS-2 were significantly lower in CIH group than in RH group of rat liver (P<0.05, while were markedly lower in RH group than in UC group (P<0.05; the expressions of leptin protein and mRNA were significantly higher in CIH group than in RH group (P<0.05, while were obviously higher in RH group than in UC group of rat liver (P<0.05. Conclusion Insulin resistance induced by chronic intermittent hypoxia may be associated with the elevation of serum FFA and leptin, and be related to the decreased expression of GLUT-2 and IRS-2 and increased expression of leptin in liver. DOI: 10.11855/j.issn.0577-7402.2018.03.05

Correlação entre a fração inspirada de oxigênio, a pressão parcial de oxigênio materno e a pressão parcial de oxigênio fetal durante parto cesáreo em gestações normais Correlación entre la fracción inspirada de oxígeno, la presión parcial de oxígeno materno y la presión parcial de oxígeno fetal durante el parto por cesárea en embarazos normales Correlation between the inspired fraction of oxygen, maternal partial oxygen pressure, and fetal partial oxygen pressure during cesarean section of normal pregnancies

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Carlos Henrique Viana de Castro

2009-08-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Apesar das alterações na função pulmonar, a oxigenação materna se mantém nas anestesias regionais para obstetrícia. Mesmo assim, nessas situações, o fornecimento de oxigênio suplementar para a mãe é prática disseminada. A principal justificativa é a boa oxigenação fetal; entretanto, não há devida comprovação. Este estudo prospectivo e com distribuição randômica das pacientes teve o objetivo de testar a hipótese da existência ou não de correlação entre hiperóxia materna e elevação de parâmetros gasométricos fetais na cesariana eletiva. MÉTODO: Foram estudadas vinte pacientes grávidas, submetidas à raquianestesia, através de gasometrias arteriais, com diferentes frações inspiradas de oxigênio e correlacionadas com a gasometria fetal. RESULTADOS: O aumento da fração inspirada de oxigênio materno não se correlacionou com o aumento da pressão parcial de oxigênio fetal. CONCLUSÕES: A indução de hiperóxia materna através de oxigenoterapia suplementar não foi capaz de aumentar a pressão parcial de oxigênio no feto. Não houve modificação nos parâmetros gasométricos fetais, mesmo em caso de mudança desses parâmetros na parturiente, induzidos pela hiperóxia durante a cesariana sob raquianestesia.JUSTIFICATIVA Y OBJETIVOS: A pesar de las alteraciones en la función pulmonar, la oxigenación materna se mantiene en las anestesias regionales para obstetricia. Pero incluso así, en esas situaciones, el suministro de oxígeno suplementario para la madre se practica en forma diseminada. La principal justificación es la buena oxigenación fetal, sin embargo, no existe la debida comprobación al respecto. Este estudio prospectivo y con distribución randómica de las pacientes, tuvo el objetivo de comprobar la hipótesis de la existencia o no de una correlación entre la hiperoxia materna y la elevación de los parámetros gasométricos fetales en la cesárea por elecci

Fatores maternos associados ao peso fetal estimado pela ultra-sonografia

OpenAIRE

Melo,Adriana Suely de Oliveira; Amorim,Melania Maria Ramos de; Assunção,Paula Lisiane; Melo,Fabiana de Oliveira; Gondim,Sheila Sherezaide Rocha; Carvalho,Danielle Franklin de; Cardoso,Maria Aparecida Alves

2008-01-01

OBJETIVO: avaliar o efeito de variáveis maternas, socioeconômicas e obstétricas, assim como a presença de incisuras na 20ª e na 24ª semana, sobre o peso fetal estimado no final da gravidez (36ª semana) em gestantes atendidas pelo Programa Saúde da Família em uma cidade do interior do Nordeste do Brasil. MÉTODOS: estudo longitudinal incluindo 137 gestantes. As gestantes foram acompanhadas a cada quatro semanas para aferição das condições clínicas, socioeconômicas e obstétricas, incluindo o pes...

Utilidad de una prueba cualitativa para la detección de fibronectina fetal en secreción cervicovaginal como predictor de parto prematuro

OpenAIRE

L.R. López-Ocaña; F. Palacios-Torres; M.O. Coreño-Juárez; D.A. Obando-Izquierdo; E. Krug-Llamas; R.R. Villanueva-Romero; M. Rodríguez-Gutiérrez; Y.M. Gómez Alegre; M.L. Martínez Morgado

2015-01-01

La fibronectina fetal es una glucoproteína de la matriz extracelular que se localiza en la interfase materno-fetal de las membranas amnióticas, entre la decidua y el corion. Los niveles séricos de fibronectina fetal ≥ 50 ng/ml a partir de las 22 semanas de gestación más se han asociado con un riesgo de partos prematuros espontáneos. El parto prematuro es el nacimiento que se presenta antes de las 37 semanas de gestación, es multicausal, contribuye con un 70% de la mortalidad perinatal y su...

Cell-free fetal DNA in maternal plasma and noninvasive prenatal diagnosis DNA fetal libre en el plasma materno y diagnóstico prenatal no invasivo DNA livre fetal em plasma materno e diagnóstico pré-natal não invasivo

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Ester Silveira Ramos

2006-12-01

Full Text Available The noninvasive nature of the detection of fetal DNA in the maternal circulation represents the greatest advantage over the conventional methods of prenatal diagnosis. The applications of this methodology involve the detection of the fetal sex, and diagnosis, intra-uterine treatment, and evaluation of the prognosis of many diseases. Fetal cells detected in the maternal circulation have also been shown to be implicated in autoimmune diseases and to represent a potential source of stem cells. On the other hand, with the introduction of a technology that detects the fetal sex as early as at 6-8 weeks of gestation, there is the possibility of early abortion based on sex selection for social purposes. This implies an ethical discussion about the question. The introduction of new noninvasive techniques of prenatal diagnosis and the knowledge of the Nursing Team regarding new methodologies can be of great benefit to the mother and her children, and can help the Genetic Counseling of the families.La naturaleza no invasiva de la investigación del DNA fetal en la circulación materna representa una ventaja importante con relación a los métodos convencionales de diagnóstico prenatal. El uso de esta metodología implica la determinación del sexo fetal y el diagnóstico, el tratamiento intra-útero y la evaluación del pronóstico en muchas enfermedades. Las células fetales detectadas en la circulación maternal también pueden ser implicadas en enfermedades autoinmunes y representar una fuente potencial de células madre. Por otra parte, con la introducción de una tecnología que detecte el sexo fetal entre 6-8 semanas de gestación, existe la posibilidad de aborto precoz basada en la selección del sexo para los propósitos sociales. Esto implica una discusión ética previa sobre este problema. La introducción de nuevas técnicas no invasivas de diagnóstico prenatal y el conocimiento del Equipo de Enfermería con respecto a las nuevas metodolog

A novel adjustable automated system for inducing chronic intermittent hypoxia in mice.

Science.gov (United States)

Polšek, Dora; Bago, Marcel; Živaljić, Marija; Rosenzweig, Ivana; Lacza, Zsombor; Gajović, Srećko

2017-01-01

Sleep apnea is a chronic, widely underdiagnosed condition characterized by disruption of sleep architecture and intermittent hypoxia due to short cessations of breathing. It is a major independent risk factor for myocardial infarction, congestive heart failure and stroke as well as one of the rare modifiable risk factors for Alzheimer's Dementia. Reliable animal disease models are needed to understand the link between sleep apnea and the various clinically linked disorders. An automated system for inducing hypoxia was developed, in which the major improvement was the possibility to efficiently adjust the length and intensity of hypoxia in two different periods. The chamber used a small volume of gas allowing for fast exchanges of different oxygen levels. The mice were kept in their cages adapted with the system on the cage lid. As a proof of principle, they were exposed to a three week period of intermittent hypoxia for 8 hours a day, with 90 s intervals of 5, 7% and 21% oxygen to validate the model. Treated (n = 8) and control mice (no hypoxia, n = 7) were handled in the same manner and their hippocampal brain regions compared by histology. The chamber provided a fast, reliable and precise intermittent hypoxia, without inducing noticeable side effects to the animals. The validation experiment showed that apoptotic neurons in the hippocampus were more numerous in the mice exposed to intermittent hypoxia than in the control group, in all tested hippocampal regions (cornu ammonis 1 (CA1) P apnea, which was validated by apoptosis of hippocampal neurons.

Effects of chronic carbon monoxide exposure on fetal growth and development in mice

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Venditti Carolina C

2011-12-01

Full Text Available Abstract Background Carbon monoxide (CO is produced endogenously, and can also be acquired from many exogenous sources: ie. cigarette smoking, automobile exhaust. Although toxic at high levels, low level production or exposure lends to normal physiologic functions: smooth muscle cell relaxation, control of vascular tone, platelet aggregation, anti- inflammatory and anti-apoptotic events. In pregnancy, it is unclear at what level maternal CO exposure becomes toxic to the fetus. In this study, we hypothesized that CO would be embryotoxic, and we sought to determine at what level of chronic CO exposure in pregnancy embryo/fetotoxic effects are observed. Methods Pregnant CD1 mice were exposed to continuous levels of CO (0 to 400 ppm from conception to gestation day 17. The effect on fetal/placental growth and development, and fetal/maternal CO concentrations were determined. Results Maternal and fetal CO blood concentrations ranged from 1.12- 15.6 percent carboxyhemoglobin (%COHb and 1.0- 28.6%COHb, respectively. No significant difference was observed in placental histological morphology or in placental mass with any CO exposure. At 400 ppm CO vs. control, decreased litter size and fetal mass (p Conclusions Exposure to levels at or below 300 ppm CO throughout pregnancy has little demonstrable effect on fetal growth and development in the mouse.

Structured intermittent interruption of chronic HIV infection treatment with highly active antiretroviral therapy: effects on leptin and TNF-alpha.

Science.gov (United States)

Arjona, M Montes de Oca; Pérez-Cano, R; Garcia-Juárez, R; Martín-Aspas, A; del Alamo, C Fernández Gutiérrez; Girón-González, J A

2006-04-01

The changes in nutritional parameters and adipocytokines after structured intermittent interruption of highly active antiretroviral treatment of patients with chronic HIV infection are analyzed. Twenty-seven patients with chronic HIV infection (median CD4+ T cell count/microl: nadir, 394; at the beginning of structured interruptions, 1041; HIV viral load: nadir, 41,521 copies/ml; at the beginning of structured interruptions triglycerides, cholesterol, leptin, and tumor necrosis factor and its soluble receptors I and II were determined. After the three cycles of intermittent interruptions of therapy, no significant differences in CD4+ T cell count/microl, viral load, or serum concentrations of cholesterol or triglycerides with reference to baseline values were found. A near-significant higher fatty mass (skinfold thicknesses, at the end, 121 mm, at the beginning, 100 mm, p = 0.100), combined with a significant increase of concentration of leptin (1.5 vs. 4.7 ng/ml, p = 0,044), as well as a decrease in serum concentrations of soluble receptors of tumor necrosis factor (TNFRI, 104 vs. 73 pg/ml, p = 0.022; TNFRII 253 vs. 195 pg/ml, p = 0.098) were detected. Structured intermittent interruption of highly active antiretroviral treatment of patients with chronic HIV infection induces a valuable positive modification in markers of lipid turnover and adipose tissue mass.

Diagnóstico prenatal no invasivo: Ácidos nucleicos de origen fetal en sangre materna Non invasive prenatal diagnosis: Fetal nucleic acid analysis in maternal blood

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Carla Sesarini

2010-12-01

Full Text Available Las técnicas actuales de diagnóstico prenatal de enfermedades génicas y cromosómicas incluyen procedimientos invasivos que conllevan un pequeño, pero significativo, riesgo. Por muchos años se ha estudiado la posibilidad de utilizar células fetales en circulación materna; sin embargo, ha fracasado su implementación clínica debido a su escasez y persistencia luego del parto. Desde hace más de una década se detectó ADN fetal libre en sangre de embarazadas. Este sería de origen placentario e indetectable después del parto, y fuente de material fetal para el desarrollo de técnicas diagnósticas utilizando sangre materna. No obstante, la mayoría del ADN libre en circulación materna es de origen materno con una contribución fetal del 3% al 6% aumentando a lo largo de la gestación. Dado que los métodos actuales no permiten separar el ADN libre fetal del materno, las aplicaciones se focalizan en el análisis de genes no presentes en la madre, tales como secuencias del cromosoma Y, o gen RHD en madres Rh negativas, o mutaciones paternas o de novo. Asimismo, la detección de ARN fetal libre en sangre de embarazadas abrió la posibilidad de obtener información acerca de patrones de expresión génica de tejidos embrionarios y, utilizando genes que se expresan sólo en la unidad feto-placentaria, se podría establecer un control de presencia de material fetal, independiente del material genético de la madre. El presente trabajo describe las evidencias acerca del pasaje de ácidos nucleicos fetales a circulación materna, su aplicación actual en el diagnóstico prenatal y posibles usos futuros.Current prenatal diagnosis of monogeneic and chromosomal diseases, includes invasive procedures which carry a small but significant risk. For many years, analysis of fetal cells in maternal circulation has been studied, however it has failed its clinical use due to the scarcity of these cells and their persistance after delivery. For more than a

Intermittent Access to Ethanol Drinking Facilitates the Transition to Excessive Drinking After Chronic Intermittent Ethanol Vapor Exposure.

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Kimbrough, Adam; Kim, Sarah; Cole, Maury; Brennan, Molly; George, Olivier

2017-08-01

Alcohol binge drinking in humans is thought to increase the risk for alcohol use disorder (AUD). Unclear is whether drinking patterns (e.g., bingelike or stable drinking) differentially affect the transition to compulsive-like drinking in dependent individuals. We examined whether chronic bingelike drinking facilitates the transition to compulsive-like drinking in rats. Male Wistar rats were given 5 months of intermittent access to ethanol (EtOH) (IAE) or continuous access to EtOH (CAE) in a 2-bottle choice paradigm. Then, rats were given chronic intermittent EtOH (CIE) vapor exposure. Escalation of EtOH intake and compulsive-like responding for EtOH, using a progressive-ratio schedule of reinforcement and quinine-adulterated EtOH, were measured. IAE rats escalated EtOH drinking after 2 weeks of 2-bottle choice, whereas CAE rats exhibited stable EtOH drinking for 5 months. After 8 weeks of CIE, both IAE + CIE and CAE + CIE rats escalated their EtOH intake. However, IAE rats escalated their EtOH intake weeks sooner than CAE rats and exhibited greater EtOH intake. No differences in compulsive-like responding were found between IAE + CIE and CAE + CIE rats. However, both IAE + CIE and CAE + CIE rats showed strong compulsive-like responding compared with rats without prior IAE or CAE. Chronic EtOH drinking at stable or escalated levels for several months is associated with more compulsive-like responding for EtOH in rats that are exposed to CIE compared with rats without a prior history of EtOH drinking. Moreover, IAE facilitated the transition to compulsive-like responding for EtOH after CIE exposure, reflected by the escalation of EtOH intake. These results suggest that IAE may facilitate the transition to AUD. This study indicates that despite a moderate level of EtOH drinking, the IAE animal model is highly relevant to early stages of alcohol abuse and suggests that it may be associated with neuroadaptations that produce a faster transition to

Síndrome metabólico durante el embarazo: Complicaciones materno-fetales

OpenAIRE

Yépez, Mayel Cristina; Zeppenfel, María Eugenia; Colón, José Antonio; Zimmer, Eveline

2011-01-01

Objetivo: Determinar la asociación entre el síndrome metabólico y las complicaciones maternas, fetales y neonatales, en un grupo de embarazadas entre agosto 2008 y septiembre 2009. Ambiente: Servicio Prenatal de la Maternidad “Concepción Palacios”. Métodos: Estudio prospectivo, longitudinal, comparativo, con una muestra de 130 embarazadas, 38 cumplieron los criterios de la Federación Internacional de Diabetes para síndrome metabólico y 92 fueron el grupo control. Resultados: El promedio de ed...

Tecnologia simplificada na enfermagem materno infantil

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Selma Campestrini

1991-09-01

Full Text Available A autora apresenta três modelos de tecnologia simplificada da enfermagem materno infantil: o equipamento didático SEIO COBAIA para treinar exercícios e massagens da mama e mamilo; a peça indumentária SUPRETRAUMA - sutiã preventivo de traumatismo mamilar - usado por gestantes; e, a técnica para reverter mamilo umbilicado durante o puerperio imediato. Além de corroborar na promoção do aleitamento materno e na prevenção de desmame precoce, demonstra a possibilidade da enfermagem relacionar o saber teórico-científico com o saber tecnico-prático, na saúde da mulher e da criança, com tecnologia adequada às necessidades, à compreensão e ao bem estar da população.

Antioxidant tempol suppresses heart cytosolic phospholipase A(2)alpha stimulated by chronic intermittent hypoxia

Czech Academy of Sciences Publication Activity Database

Míčová, P.; Klevstig, Martina; Holzerová, Kristýna; Vecka, M.; Žurmanová, J.; Neckář, Jan; Kolář, František; Nováková, Olga; Novotný, J.; Hlaváčková, Markéta

2017-01-01

Roč. 95, č. 8 (2017), s. 920-927 ISSN 0008-4212 R&D Projects: GA ČR(CZ) GJ16-12420Y; GA ČR(CZ) GA13-10267S Institutional support: RVO:67985823 Keywords : heart * chronic intermittent hypoxia * oxidative stress * phospholipases A(2) * tempol Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery OBOR OECD: Biochemistry and molecular biology Impact factor: 1.822, year: 2016

Intermittent targeted therapies and stochastic evolution in patients affected by chronic myeloid leukemia

Science.gov (United States)

Pizzolato, N.; Persano Adorno, D.; Valenti, D.; Spagnolo, B.

2016-05-01

Front line therapy for the treatment of patients affected by chronic myeloid leukemia (CML) is based on the administration of tyrosine kinase inhibitors, namely imatinib or, more recently, axitinib. Although imatinib is highly effective and represents an example of a successful molecular targeted therapy, the appearance of resistance is observed in a proportion of patients, especially those in advanced stages. In this work, we investigate the appearance of resistance in patients affected by CML, by modeling the evolutionary dynamics of cancerous cell populations in a simulated patient treated by an intermittent targeted therapy. We simulate, with the Monte Carlo method, the stochastic evolution of initially healthy cells to leukemic clones, due to genetic mutations and changes in their reproductive behavior. We first present the model and its validation with experimental data by considering a continuous therapy. Then, we investigate how fluctuations in the number of leukemic cells affect patient response to the therapy when the drug is administered with an intermittent time scheduling. Here we show that an intermittent therapy (IT) represents a valid choice in patients with high risk of toxicity, despite an associated delay to the complete restoration of healthy cells. Moreover, a suitably tuned IT can reduce the probability of developing resistance.

Intermittent hemodialysis in dogs with chronic kidney disease stage III

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Alessandra Melchert

2017-08-01

Full Text Available ABSTRACT: Intermittent hemodialysis (IHD is a form of renal replacement that is used in veterinary medicine for cases involving drug removal, electrolyte imbalance, acute kidney injury, and chronic kidney disease (CKD. The aim of the present study was to verify the efficacy of IHD in dogs with CKD staged at grade III and to evaluate the effect of IHD on quality of life. Twelve dogs with CKD at stage III met the inclusion criteria and were divided equally into two groups. The control group (n=6 received only clinical treatment and intravenous fluid therapy, and the hemodialysis group (n=6 received clinical and IHD treatments. Blood samples were collected before and after treatments in both groups. We evaluated complications and clinical parameters of IHD every 30 minutes. Hemodialysis decreased serum urea, creatinine, and phosphorus. Despite the evident removal of nitrogen compounds, dialysis treatment did not increase survival time in these patients. The results of this study do not support the early use of dialysis in dogs with chronic kidney disease stage III.

Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach

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Sforza, Emilia; Roche, Fréderic

2016-01-01

Obstructive sleep apnea (OSA) is a prevalent sleep disorder considered as an independent risk factor for cardiovascular consequences, such as systemic arterial hypertension, ischemic heart disease, cardiac arrhythmias, metabolic disorders, and cognitive dysfunction. The pathogenesis of OSA-related consequence is assumed to be chronic intermittent hypoxia (IH) inducing alterations at the molecular level, oxidative stress, persistent systemic inflammation, oxygen sensor activation, and increase of sympathetic activity. Overall, these mechanisms have an effect on vessel permeability and are considered to be important factors for explaining vascular, metabolic, and cognitive OSA-related consequences. The present review attempts to examine together the research paradigms and clinical studies on the effect of acute and chronic IH and the potential link with OSA. We firstly describe the literature data on the mechanisms activated by acute and chronic IH at the experimental level, which are very helpful and beneficial to explaining OSA consequences. Then, we describe in detail the effect of IH in patients with OSA that we can consider “the human model” of chronic IH. In this way, we can better understand the specific pathophysiological mechanisms proposed to explain the consequences of IH in OSA. PMID:27800512

Chronic hypoxia alters maternal uterine and fetal hemodynamics in the full-term pregnant guinea pig.

Science.gov (United States)

Turan, Sifa; Aberdeen, Graham W; Thompson, Loren P

2017-10-01

Placental hypoxia is associated with maternal hypertension, placental insufficiency, and fetal growth restriction. In the pregnant guinea pig, prenatal hypoxia during early gestation inhibits cytotrophoblast invasion of spiral arteries, increases maternal blood pressure, and induces fetal growth restriction. In this study the impact of chronic maternal hypoxia on fetal heart structure was evaluated using four-dimensional echocardiography with spatiotemporal image correlation and tomographic ultrasound, and uterine and umbilical artery resistance/pulsatility indexes and fetal heart function were evaluated using pulsed-wave Doppler ultrasound. Pregnant guinea pigs were exposed to normoxia ( n = 7) or hypoxia (10.5% O 2 , n = 9) at 28-30 days gestation, which was maintained until full term (65 days). At full term, fetal heart structure and outflow tracts were evaluated in the four-chamber view. Fetal heart diastolic function was assessed by E wave-to-A wave diastolic filling ratios (E/A ratios) of both ventricles and systolic function by the myocardial performance index (or Tie) of left ventricles of normoxic ( n = 21) and hypoxic ( n = 17) fetuses. There were no structural abnormalities in fetal hearts. However, hypoxia induced asymmetric fetal growth restriction and increased the placental/fetal weight compared with normoxic controls. Hypoxia increased Doppler resistance and pulsatility indexes in the uterine, but not umbilical, arteries, had no effect on the Tie index, and increased the E/A ratio in left, but not right, ventricles. Thus, prolonged hypoxia, starting at midgestation, increases uterine artery resistance and generates fetal growth restriction at full term. Furthermore, the enhanced cardiac diastolic filling with no changes in systolic function or umbilical artery resistance suggests that the fetal guinea pig systemic circulation undergoes a compensated, adaptive response to prolonged hypoxia exposure. Copyright © 2017 the American Physiological

Revisión Bibliográfica: Relación de la subunidad beta de gonadotropina corionica humana, testosterona libre y sexo fetal con el desarrollo de preeclampsia.

OpenAIRE

Francisco A. Yegüez M; Olivar C. Castejón; Marisol García de Yegüez

2007-01-01

La hipertensión arterial que complica al embarazo, constituye una patología compleja que comprende entidades clínicas como la preeclampsia (PE), eclampsia (E) y síndrome de HELLP. En su etiopatogenia se imbrican innumerables factores conducentes a disfunción endotelial que desencadena una cascada de manifestacionesclínicas que generan un gran impacto en la salud materno fetal: restricción del crecimiento fetal, parto prematuro y/o asfixia perinatal, abruptio placentae, hemorragias maternas in...

Sympatho-adrenal activation by chronic intermittent hypoxia.

Science.gov (United States)

Prabhakar, Nanduri R; Kumar, Ganesh K; Peng, Ying-Jie

2012-10-15

Recurrent apnea with chronic intermittent hypoxia (CIH) is a major clinical problem in adult humans and infants born preterm. Patients with recurrent apnea exhibit heightened sympathetic activity as well as elevated plasma catecholamine levels, and these phenotypes are effectively recapitulated in rodent models of CIH. This article summarizes findings from studies addressing sympathetic activation in recurrent apnea patients and rodent models of CIH and the underlying cellular and molecular mechanisms. Available evidence suggests that augmented chemoreflex and attenuated baroreflex contribute to sympathetic activation by CIH. Studies on rodents showed that CIH augments the carotid body response to hypoxia and attenuates the carotid baroreceptor response to increased sinus pressures. Processing of afferent information from chemoreceptors at the central nervous system is also facilitated by CIH. Adult and neonatal rats exposed to CIH exhibit augmented catecholamine secretion from the adrenal medulla. Adrenal demedullation prevents the elevation of circulating catecholamines in CIH-exposed rodents. Reactive oxygen species (ROS)-mediated signaling is emerging as the major cellular mechanism triggering sympatho-adrenal activation by CIH. Molecular mechanisms underlying increased ROS generation by CIH seem to involve transcriptional dysregulation of genes encoding pro-and antioxidant enzymes by hypoxia-inducible factor-1 and -2, respectively.

MRI of fetal acquired brain lesions

International Nuclear Information System (INIS)

Prayer, Daniela; Brugger, Peter C.; Kasprian, Gregor; Witzani, Linde; Helmer, Hanns; Dietrich, Wolfgang; Eppel, Wolfgang; Langer, Martin

2006-01-01

Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images

MRI of fetal acquired brain lesions

Energy Technology Data Exchange (ETDEWEB)

Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: daniela.prayer@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Kasprian, Gregor [Department of Radiodiagnostics, Medical University of Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna (Austria); Helmer, Hanns [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Dietrich, Wolfgang [Department of Neurosurgery, Medical University of Vienna (Austria); Eppel, Wolfgang [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Langer, Martin [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria)

2006-02-15

Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

Asymptomatic bacteriuria in pregnancy: maternal and fetal complications.

Science.gov (United States)

Grio, R; Porpiglia, M; Vetro, E; Uligini, R; Piacentino, R; Minì, D; Marchino, G L

1994-12-01

From an analysis of the data reported in the literature it is clear that pregnancy is a predisposing factor for urinary tract infection and that pregnant women with this pathology are exposed to dangerous risks which may influence maternal wellbeing and fetal prognosis. Authors do not concur on the specific risks to the mother and fetus, one reason being that the statistics reported to date reveal discrepancies relating to the presence of disorders prior to pregnancy and the environmental, working and socio-hygienic conditions of the populations studied. The apparently paradoxical finding of a higher incidence of perinatal problems in pregnant women with asymptomatic bacteriuria compared to manifest forms can be attributed to the fact that the latter are treated with adequate therapies whereas asymptomatic bacteriuria, which is difficult to diagnose, may persist throughout pregnancy. This underlines the importance of early diagnosis using a protocol which entails the execution of serial urine tests and urine cultures and adequate treatment of all cases of asymptomatic bacteriuria in order to reduce the incidence of urinary tract infections and materno-fetal complications. Non-treated asymptomatic bacteriuria in fact represents a considerable risk factor since it may lead to the onset of acute pyelonephritis in approximately 5% of pregnant women and may increase the risk of fetal mortality.

Chronic intermittent hypoxia induces atherosclerosis via activation of adipose angiopoietin-like 4.

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Drager, Luciano F; Yao, Qiaoling; Hernandez, Karen L; Shin, Mi-Kyung; Bevans-Fonti, Shannon; Gay, Jason; Sussan, Thomas E; Jun, Jonathan C; Myers, Allen C; Olivecrona, Gunilla; Schwartz, Alan R; Halberg, Nils; Scherer, Philipp E; Semenza, Gregg L; Powell, David R; Polotsky, Vsevolod Y

2013-07-15

Obstructive sleep apnea is a risk factor for dyslipidemia and atherosclerosis, which have been attributed to chronic intermittent hypoxia (CIH). Intermittent hypoxia inhibits a key enzyme of lipoprotein clearance, lipoprotein lipase, and up-regulates a lipoprotein lipase inhibitor, angiopoietin-like 4 (Angptl4), in adipose tissue. The effects and mechanisms of Angptl4 up-regulation in sleep apnea are unknown. To examine whether CIH induces dyslipidemia and atherosclerosis by increasing adipose Angptl4 via hypoxia-inducible factor-1 (HIF-1). ApoE(-/-) mice were exposed to intermittent hypoxia or air for 4 weeks while being treated with Angptl4-neutralizing antibody or vehicle. In vehicle-treated mice, hypoxia increased adipose Angptl4 levels, inhibited adipose lipoprotein lipase, increased fasting levels of plasma triglycerides and very low density lipoprotein cholesterol, and increased the size of atherosclerotic plaques. The effects of CIH were abolished by the antibody. Hypoxia-induced increases in plasma fasting triglycerides and adipose Angptl4 were not observed in mice with germline heterozygosity for a HIF-1α knockout allele. Transgenic overexpression of HIF-1α in adipose tissue led to dyslipidemia and increased levels of adipose Angptl4. In cultured adipocytes, constitutive expression of HIF-1α increased Angptl4 levels, which was abolished by siRNA. Finally, in obese patients undergoing bariatric surgery, the severity of nocturnal hypoxemia predicted Angptl4 levels in subcutaneous adipose tissue. HIF-1-mediated increase in adipose Angptl4 and the ensuing lipoprotein lipase inactivation may contribute to atherosclerosis in patients with sleep apnea.

Effect of endothelin antagonism on apnea frequency following chronic intermittent hypoxia.

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Donovan, Lucas M; Liu, Yuzhen; Weiss, J Woodrow

2014-04-01

Chronic hypoxia increases the hypoxic ventilatory response (HVR). Augmented HVR contributes to central apneas seen in heart failure and complex sleep apnea. Endothelin receptor (ETR) antagonism decreases carotid body afferent activity following chronic intermittent hypoxia (CIH). We speculated ETR antagonism would reduce HVR and apneas following CIH. HVR and apneas were measured after exposure to CIH and room air sham (SHAM). ETR blocker Ambrisentan was administered via the chow of CIH-exposed animals from days 1 to 12 of CIH (CIH/AMB). A separate crossover group was exposed to CIH and fed normal chow (placebo) days 1-6, and Ambrisentan days 7-12 (CIH/PLA-AMB). SHAM and CIH/PLA animals were fed placebo days 1-12. The CIH/AMB and CIH/PLA-AMB rats had reduced HVR compared to CIH/PLA, similar HVR compared to sham exposed animals, and reduced apnea frequency compared to CIH/PLA animals. The reduced HVR and post-hypoxic apneas resulting from Ambrisentan administration suggests ETR antagonists may have utility in reducing central apneas following CIH. Copyright © 2014 Elsevier B.V. All rights reserved.

Hormonal influences on growth of the fetal pig

International Nuclear Information System (INIS)

Spencer, G.S.

1986-01-01

Although there is considerable information on hormonal systems regulating growth postnatally, little is known about hormonal influences on growth in the fetuw. It has long been postulated that insulin is the major fetal growth promoting hormone. However, chronic administration of insulin to the fetal pig during 14 days in utero, although producing hyperinsulinaemia and elevated somatomedin levels, did not stimulate an increase in length, weight or cell number. Postnatally the principal growth promoting hormones are the growth hormone dependent somatomedins. It is thought that multiplication stimulating activity (MSA) is the fetal somatomedin. However, under similar conditions to those used for insulin administration, MSA did not affect growth in the fetal pig. Administration of somatostatin to chronically catheterized fetuses inhibited (p≤0.01) and thyrotrophin releasing factor stimulated (≤0.01) GH release. However, chronic administration of SRIF did not inhibit fetal growth. Thus there does seem to be some hypothalamic control over GH secretion but this may not play a major role in regulating fetal growth

A novel adjustable automated system for inducing chronic intermittent hypoxia in mice.

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Dora Polšek

Full Text Available Sleep apnea is a chronic, widely underdiagnosed condition characterized by disruption of sleep architecture and intermittent hypoxia due to short cessations of breathing. It is a major independent risk factor for myocardial infarction, congestive heart failure and stroke as well as one of the rare modifiable risk factors for Alzheimer's Dementia. Reliable animal disease models are needed to understand the link between sleep apnea and the various clinically linked disorders.An automated system for inducing hypoxia was developed, in which the major improvement was the possibility to efficiently adjust the length and intensity of hypoxia in two different periods. The chamber used a small volume of gas allowing for fast exchanges of different oxygen levels. The mice were kept in their cages adapted with the system on the cage lid. As a proof of principle, they were exposed to a three week period of intermittent hypoxia for 8 hours a day, with 90 s intervals of 5, 7% and 21% oxygen to validate the model. Treated (n = 8 and control mice (no hypoxia, n = 7 were handled in the same manner and their hippocampal brain regions compared by histology.The chamber provided a fast, reliable and precise intermittent hypoxia, without inducing noticeable side effects to the animals. The validation experiment showed that apoptotic neurons in the hippocampus were more numerous in the mice exposed to intermittent hypoxia than in the control group, in all tested hippocampal regions (cornu ammonis 1 (CA1 P <0.001; cornu ammonis 3 (CA3 P <0.001; and dentate gyrus (DG P = 0.023. In both, control and hypoxic conditions, there was a significantly higher number of apoptotic neurons in the DG compared to the CA1 and CA3 subfields (P <0.001.The new design of a hypoxic chamber provides a fast, adjustable and reliable model of obstructive sleep apnea, which was validated by apoptosis of hippocampal neurons.

CHRONIC DIETARY EXPOSURE WITH INTERMITTENT SPIKE DOSES OF CHLORPYRIFOS FAILS TO ALTER FLASH OR PATTERN REVERSAL EVOKED POTENTIALS IN RATS.

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Human exposure to pesticides is often characterized by chronic low level exposure with intermittent spiked higher exposures. Visual disturbances are often reported following exposure to xenobiotics, and cholinesterase-inhibiting compounds have been reported to alter visual functi...

Sympatho-adrenal activation by chronic intermittent hypoxia

Science.gov (United States)

Kumar, Ganesh K.; Peng, Ying-Jie

2012-01-01

Recurrent apnea with chronic intermittent hypoxia (CIH) is a major clinical problem in adult humans and infants born preterm. Patients with recurrent apnea exhibit heightened sympathetic activity as well as elevated plasma catecholamine levels, and these phenotypes are effectively recapitulated in rodent models of CIH. This article summarizes findings from studies addressing sympathetic activation in recurrent apnea patients and rodent models of CIH and the underlying cellular and molecular mechanisms. Available evidence suggests that augmented chemoreflex and attenuated baroreflex contribute to sympathetic activation by CIH. Studies on rodents showed that CIH augments the carotid body response to hypoxia and attenuates the carotid baroreceptor response to increased sinus pressures. Processing of afferent information from chemoreceptors at the central nervous system is also facilitated by CIH. Adult and neonatal rats exposed to CIH exhibit augmented catecholamine secretion from the adrenal medulla. Adrenal demedullation prevents the elevation of circulating catecholamines in CIH-exposed rodents. Reactive oxygen species (ROS)-mediated signaling is emerging as the major cellular mechanism triggering sympatho-adrenal activation by CIH. Molecular mechanisms underlying increased ROS generation by CIH seem to involve transcriptional dysregulation of genes encoding pro-and antioxidant enzymes by hypoxia-inducible factor-1 and -2, respectively. PMID:22723632

Iniciativa Hospital Amigo da Criança e aleitamento materno em unidade de neonatologia

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Vannuchi Marli T Oliveira

2004-01-01

Full Text Available OBJETIVO: Avaliar o impacto da iniciativa Hospital Amigo da Criança sobre a prática do aleitamento materno durante a internação de recém-nascidos em unidade de neonatologia e durante os primeiros seis meses de vida. MÉTODOS: Foram consultados todos os prontuários de recém-nascidos internados em unidade de neonatologia de um hospital de ensino durante os anos de 1994 (N=285 e 1998 (N=368. Foram analisadas informações sobre o regime alimentar durante a internação e após a alta hospitalar, até os primeiros seis meses de vida. Para estimar a duração do aleitamento materno e do aleitamento materno exclusivo e as diferenças entre os dois anos, foram utilizados a técnica de Kaplan-Meier e o teste de Log-Rank. Análises de regressão logística e de Cox foram aplicadas para controlar variáveis de confusão. RESULTADOS: Durante o período de internação, houve aumento expressivo do percentual de crianças em aleitamento materno exclusivo (de 1,9%, em 1994, para 41,7%, em 1998 e alimentação exclusiva por fórmula, que era de 17,9%, em 1994, e deixou de existir em 1998. Quanto à amamentação nos primeiros seis meses de vida, o tempo mediano do aleitamento materno exclusivo aumentou de 12 para 45 dias. Para o aleitamento materno, que inclui a ingestão de outros alimentos, não houve diferença significativa. CONCLUSÕES: A implantação da iniciativa do hospital estudado contribuiu para aumentar o índice de aleitamento materno exclusivo durante a internação de recém-nascidos em uma unidade de neonatologia e nos primeiros seis meses de vida.

Neuroprotective Role of Intermittent Hypobaric Hypoxia in Unpredictable Chronic Mild Stress Induced Depression in Rats

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Deep, Satayanarayan; Prasad, Dipti; Singh, Shashi Bala; Khan, Nilofar

2016-01-01

Hypoxic exposure results in several pathophysiological conditions associated with nervous system, these include acute and chronic mountain sickness, loss of memory, and high altitude cerebral edema. Previous reports have also suggested the role of hypoxia in pathogenesis of depression and related psychological conditions. On the other hand, sub lethal intermittent hypoxic exposure induces protection against future lethal hypoxia and may have beneficial effect. Therefore, the present study was designed to explore the neuroprotective role of intermittent hypobaric hypoxia (IHH) in Unpredictable Chronic Mild Stress (UCMS) induced depression like behaviour in rats. The IHH refers to the periodic exposures to hypoxic conditions interrupted by the normoxic or lesser hypoxic conditions. The current study examines the effect of IHH against UCMS induced depression, using elevated plus maze (EPM), open field test (OFT), force swim test (FST), as behavioural paradigm and related histological and molecular approaches. The data indicated the UCMS induced depression like behaviour as evident from decreased exploration activity in OFT with increased anxiety levels in EPM, and increased immobility time in the FST; whereas on providing the IHH (5000m altitude, 4hrs/day for two weeks) these behavioural changes were ameliorated. The morphological and molecular studies also validated the neuroprotective effect of IHH against UCMS induced neuronal loss and decreased neurogenesis. Here, we also explored the role of Brain-Derived Neurotrophic Factor (BDNF) in anticipatory action of IHH against detrimental effect of UCMS as upon blocking of BDNF-TrkB signalling the beneficial effect of IHH was nullified. Taken together, the findings of our study demonstrate that the intermittent hypoxia has a therapeutic potential similar to an antidepressant in animal model of depression and could be developed as a preventive therapeutic option against this pathophysiological state. PMID:26901349

Neuroprotective Role of Intermittent Hypobaric Hypoxia in Unpredictable Chronic Mild Stress Induced Depression in Rats.

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Neetu Kushwah

Full Text Available Hypoxic exposure results in several pathophysiological conditions associated with nervous system, these include acute and chronic mountain sickness, loss of memory, and high altitude cerebral edema. Previous reports have also suggested the role of hypoxia in pathogenesis of depression and related psychological conditions. On the other hand, sub lethal intermittent hypoxic exposure induces protection against future lethal hypoxia and may have beneficial effect. Therefore, the present study was designed to explore the neuroprotective role of intermittent hypobaric hypoxia (IHH in Unpredictable Chronic Mild Stress (UCMS induced depression like behaviour in rats. The IHH refers to the periodic exposures to hypoxic conditions interrupted by the normoxic or lesser hypoxic conditions. The current study examines the effect of IHH against UCMS induced depression, using elevated plus maze (EPM, open field test (OFT, force swim test (FST, as behavioural paradigm and related histological and molecular approaches. The data indicated the UCMS induced depression like behaviour as evident from decreased exploration activity in OFT with increased anxiety levels in EPM, and increased immobility time in the FST; whereas on providing the IHH (5000m altitude, 4hrs/day for two weeks these behavioural changes were ameliorated. The morphological and molecular studies also validated the neuroprotective effect of IHH against UCMS induced neuronal loss and decreased neurogenesis. Here, we also explored the role of Brain-Derived Neurotrophic Factor (BDNF in anticipatory action of IHH against detrimental effect of UCMS as upon blocking of BDNF-TrkB signalling the beneficial effect of IHH was nullified. Taken together, the findings of our study demonstrate that the intermittent hypoxia has a therapeutic potential similar to an antidepressant in animal model of depression and could be developed as a preventive therapeutic option against this pathophysiological state.

[Active management of labor with cesarean index 6.4% and very good materno-fetal outcome].

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Crespo Ruiz, Eliodoro; Rodríguez Fernández, Jesús Javier

2002-11-01

The objective of this study is to reduce the incidence of cesarean section and to evaluate the impact on fetal-maternal morbidity and mortality by strictly following the guidelines of the National Health Office (Secretaria de Salud) at the Hospital of Gynecology and Obstetrics of Garza Garcia in Nuevo Leon, Mexico. A prospective and observational study was made. All the patients who culminated their pregnancy on Saturdays and Sundays between 7:00 and 19:00 hrs, in the period June 2000 to June 2001, were included in this study. The incidence of Cesarean sections and its impact on maternal-fetal morbidity and mortality were observed. A total of 798 patients were included in the study. The total number of newborns was 801. The age average was of 23.4 years (14 years-40 years). Of the 798 patients, 280 (35.1%) presented dystocia at vaginal delivery, 467 patients (58.5%) had an eutocic vaginal delivery and 51 patients (6.4%) went through a Caesarean section. The Apgar scores were: 8 at the first minute and 9 at the fifth minute for 681 neonates (85.01%); and 7/9 for 53 (6.6%). According to the results obtained in the present study we can conclude that the incidence of Cesarean section can be reduced by strictly following the guidelines of the National Health Office without affecting the maternal-fetal morbidity and mortality.

The effect of intermittent dosing of Nicotiana glauca on teratogenesis in goats.

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Welch, K D; Panter, K E; Lee, S T; Gardner, D R

2015-01-01

Sustained inhibition of fetal movement in livestock species, induced by several poisonous plants, can result in numerous skeletal-contracture malformations. Lupines are responsible for a condition in cattle referred to as "crooked calf syndrome" that occurs when pregnant cattle graze teratogenic lupines. Similar malformations are also seen in animals poisoned by Conium maculatum (coniine) and Nicotiana glauca (anabasine). A proposed management strategy to limit these types of birth defects includes utilizing an intermittent grazing schedule to allow short durations of grazing lupine-infested areas interrupted by movement to a lupine-free pasture. The objective of this study was to use a goat model to determine if an intermittent schedule of five continuous days on treatment followed by two days off treatment would be sufficient to decrease, or prevent, the incidence of anabasine-induced malformations. The data from this study suggest that, for N. glauca in goats, the intermittent grazing program of five days exposure with two days of non-exposure is insufficient to prevent significant skeletal malformations from occurring. However, this study did demonstrate an inverse relationship between the amount of serum anabasine in the dam and the extent of fetal movement. Published by Elsevier Ltd.

Intermittent versus continuous exercise training in chronic heart failure: a meta-analysis.

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Smart, Neil A; Dieberg, Gudrun; Giallauria, Francesco

2013-06-20

We conducted a meta-analysis of randomized, controlled trials of combined strength and intermittent aerobic training, intermittent aerobic training only and continuous exercise training in heart failure patients. A systematic search was conducted of Medline (Ovid) (1950-September 2011), Embase.com (1974-September 2011), Cochrane Central Register of Controlled Trials and CINAHL (1981-September 19 2011). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, exercise training, interval training and intermittent exercise training. The included studies contained an aggregate of 446 patients, 212 completed intermittent exercise training, 66 only continuous exercise training, 59 completed combined intermittent and strength training and 109 sedentary controls. Weighted mean difference (MD) in Peak VO2 was 1.04mlkg(-1)min(-1) and (95% C.I.) was 0.42-1.66 (p=0.0009) in intermittent versus continuous exercise training respectively. Weighted mean difference in Peak VO2 was -1.10mlkg(-1)min(-1) (95% C.I.) was -1.83-0.37 p=0.003 for intermittent only versus intermittent and strength (combined) training respectively. In studies reporting VE/VCO2 for intermittent versus control groups, MD was -1.50 [(95% C.I. -2.64, -0.37), p=0.01] and for intermittent versus continuous exercise training MD was -1.35 [(95% C.I. -2.15, -0.55), p=0.001]. Change in peak VO2 was positively correlated with weekly exercise energy expenditure for intermittent exercise groups (r=0.48, p=0.05). Combined strength and intermittent exercise appears superior for peak VO2 changes when compared to intermittent exercise of similar exercise energy expenditure. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Chronic antepartum maternal hyperoxygenation in a case of severe fetal Ebstein's anomaly with circular shunt physiology

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Alisa Arunamata

2017-01-01

Full Text Available Perinatal mortality remains high among fetuses diagnosed with Ebstein's anomaly of the tricuspid valve. The subgroup of patients with pulmonary valve regurgitation is at particularly high risk. In the setting of pulmonary valve regurgitation, early constriction of the ductus arteriosus may be a novel perinatal management strategy to reduce systemic steal resulting from circular shunt physiology. We report the use of chronic antepartum maternal oxygen therapy for constriction of the fetal ductus arteriosus and modulation of fetal pulmonary vascular resistance in a late presentation of Ebstein's anomaly with severe tricuspid valve regurgitation, reversal of flow in the ductus arteriosus, and continuous pulmonary valve regurgitation.

Conducta médica posnatal ante la dilatación del tracto urinario superior fetal

OpenAIRE

Sandalio Durán Álvarez

2012-01-01

El seguimiento sistemático del embarazo normal mediante el estudio ultrasonográfico materno-fetal ha demostrado que por cada 500 embarazos debemos esperar una anomalía importante del tracto urinario. La anomalía detectada con mayor frecuencia es la dilatación del tracto urinario superior, que si bien la mayoría de las veces no se traduce en una alteración importante, obliga a su estudio posnatal para poder valorar su significación. Una dilatación del tracto urinario superior puede ser la trad...

Propuesta de un nuevo puntaje para optimizar estimados ecográficos de peso fetal: estudio piloto

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José Rojas Camayo

2009-06-01

Full Text Available Introducción: La estimación del peso fetal es importante para las decisiones obstétricas; la precisión de los estimados ecográficos no ha sido estudiada. Objetivos: Determinar la precisión del estimado ecográfico del peso fetal mediante un puntaje basado en parámetros clínicos, ecográficos y maternos. Diseño: Estudio de tipo transversal. Lugar: Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú. Participantes: 130 gestantes y sus fetos. Intervenciones: Se consignó datos clínicos, ecográficos y maternos. Se procedió a dicotomizar los aciertos entre menor o igual a ±10% (acertadas y mayor a ±10% (erradas del peso real. Se analizó las variables clínicas, ecográficas y maternas mediante el uso de las curvas ROC, para identificar aquellas que tuvieron más influencia en la precisión ecográfica. Con las variables identificadas, se procedió al desarrollo de un modelo de regresión logística, para establecer un puntaje que estimara la probabilidad de variación, teniendo como punto de corte ±10% del peso real. Principales medidas de resultados: Precisión de un puntaje que relaciona la edad gestacional con la circunferencia abdominal y el diámetro biparietal del feto, el ponderado clínico y el peso materno. Resultados: El nuevo puntaje tuvo un buena capacidad de discriminación de las ecografías, según su variación a ±10% del peso real (área bajo la curva ROC: 0,76 p<0,001. Según los puntajes obtenidos, se obtuvo tres grupos: rendimiento alto 20%, rendimiento convencional 44,4% y rendimiento bajo 71,2%. Conclusiones: El nuevo puntaje propuesto tiene la capacidad de estimar la probabilidad de variación de los estimados ecográficos mayores al ±10% del peso real, conformando tres grupos de rendimiento: alto, convencional y bajo.

Estrés Materno y Configuración Familiar: Estudio comparativo en Familias Chilenas Monoparentales y Nucleares de bajos ingresos

OpenAIRE

Olhaberry, Marcia; Pontificia Universidad Católica de Chile; Farkas, Chamarrita

2012-01-01

Los estudios sobre estrés materno durante la crianza infantil han considerado variables contextuales para explicarlo. El nivel socioeconómico, así como la configuración familiar han sido variables relevantes, asociándose monoparentalidad en familias de bajos ingresos a mayores niveles de estrés materno. Se estudian los niveles de estrés materno en familias chilenas nucleares y monoparentales de N.S.E. bajo, considerando el estrés en distintas dimensiones, asociado al rol materno, a la interac...

Clinical implications from monitoring fetal activity.

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Rayburn, W F

1982-12-15

The monitoring of fetal motion in high-risk pregnancies has been shown to be worthwhile in predicting fetal distress and impending fetal death. The maternal recording of perceived fetal activity is an inexpensive surveillance technique which is most useful when there is chronic uteroplacental insufficiency or when a stillbirth may be expected. The presence of an active, vigorous fetus is reassuring, but documented fetal inactivity required a reassessment of the underlying antepartum complication and further fetal evaluation with real-time ultrasonography, fetal heart rate testing, and biochemical testing. Fetal distress from such acute changes as abruptio placentae or umbilical cord compression may not be predicted by monitoring fetal motion. Although not used for routine clinical investigation, electromechanical devices such as tocodynamometry have provided much insight into fetal behavioral patterns at many stages of pregnancy and in pregnancies with an antepartum complication.

The multi-level impact of chronic intermittent hypoxia on central auditory processing.

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Wong, Eddie; Yang, Bin; Du, Lida; Ho, Wai Hong; Lau, Condon; Ke, Ya; Chan, Ying Shing; Yung, Wing Ho; Wu, Ed X

2017-08-01

During hypoxia, the tissues do not obtain adequate oxygen. Chronic hypoxia can lead to many health problems. A relatively common cause of chronic hypoxia is sleep apnea. Sleep apnea is a sleep breathing disorder that affects 3-7% of the population. During sleep, the patient's breathing starts and stops. This can lead to hypertension, attention deficits, and hearing disorders. In this study, we apply an established chronic intermittent hypoxemia (CIH) model of sleep apnea to study its impact on auditory processing. Adult rats were reared for seven days during sleeping hours in a gas chamber with oxygen level cycled between 10% and 21% (normal atmosphere) every 90s. During awake hours, the subjects were housed in standard conditions with normal atmosphere. CIH treatment significantly reduces arterial oxygen partial pressure and oxygen saturation during sleeping hours (relative to controls). After treatment, subjects underwent functional magnetic resonance imaging (fMRI) with broadband sound stimulation. Responses are observed in major auditory centers in all subjects, including the auditory cortex (AC) and auditory midbrain. fMRI signals from the AC are statistically significantly increased after CIH by 0.13% in the contralateral hemisphere and 0.10% in the ipsilateral hemisphere. In contrast, signals from the lateral lemniscus of the midbrain are significantly reduced by 0.39%. Signals from the neighboring inferior colliculus of the midbrain are relatively unaffected. Chronic hypoxia affects multiple levels of the auditory system and these changes are likely related to hearing disorders associated with sleep apnea. Copyright © 2017 Elsevier Inc. All rights reserved.

As necessidades comunicacionais das práticas educativas na prevenção da transmissão materno-fetal do HIV Communication needs of education practices in preventing maternal-fetal HIV transmission

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Katia Virginia de O Feliciano

2003-12-01

Full Text Available OBJETIVOS: elucidar a fecundidade da prática educativa centrada na prevenção da transmissão materno-fetal da AIDS para promover a comunicação usuárias-serviços. MÉTODOS: Estudo exploratório, parte de uma pesquisa sobre atenção pré-natal, realizado em 19 centros de saúde, duas maternidades e seis unidades de saúde da família da Secretaria de Saúde da cidade do Recife, de maio a julho de 1998. O processo de trabalho foi observado, equipes técnicas entrevistadas e um questionário foi aplicado às 355 mulheres em atendimento; dessas, 81 foram submetidas à sondagem. RESULTADOS: nenhum serviço faz aconselhamento, mesmo quando informam sobre o teste anti-HIV (48,1%. O trabalho educativo está focalizado no fornecimento de informações durante a consulta, pois, as atividades coletivas, nas unidades que realizam-nas (48,1%, não ocorrem em todos os horários do pré-natal. A prática educativa baseada na racionalidade estratégica subestima a importância da aproximação às decisões valorativas das mulheres, das quais somente 11,1% utilizam camisinha de modo sistemático. CONCLUSÕES: a pequena oferta de atividades educativas no pré-natal e o "monólogo tecnocrático" que predomina nas relações entre usuárias e serviços de saúde têm repercussões negativas na vulnerabilidade da população feminina e de seus filhos.OBJECTIVES: to determine the efficiency of educational methods in preventing maternal-fetal AIDS transmission through communication among users and health services providers. METHODS: exploratory study, part of the survey on pre-natal care, accomplished in 19 clinics, two maternity hospitals and six family health units performed by the Health Secretariat of the city of Recife, from May to July, 1998. Procedures were observed, technical teams were interviewed and questionnaires applied to 355 women being seen, of these, 81 participated of the survey. RESULTS: healthcare providers do not perform counseling, even

The materno-fetal interface in llama (Lama guanicoe glama A interface materno-fetal em lhamas (Lama guanicoe glama

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David M. Iturrizaga

2007-06-01

Full Text Available Samples from 9 llamas (28 through 36 weeks of gestation were collected and fixed in 4% buffered paraformaldehyde (light microscopy and in 2.5% buffered glutaraldehyde (transmission and scanning electron microscopy. The material was processed in paraplast and slides (5mm were stained with HE, PAS, Masson-Trichrome, acid phosphatase and Perl's. The uteroferrin was immunolocalized. The results show that llama placenta is chorioallantoic, diffuse, folded and epitheliochorial, and the fetus is covered with an epidermal membrane. The trophoblast cells have variable morphology: cubic, rounded and triangular cells, with cytoplasm containing PAS-positive granules. Binucleated cells with large cytoplasm and rounded nuclei, as well as giant trophoblastic cells with multiple nuclei were also observed. Numerous blood vessels were observed beneath the cells of the uterine epithelium and around the chorionic subdivided branches. Glandular activity was shown by PAS, Perl's, and acid phosphatase positive reactions in the cytoplasm and glandular lumen, and by immunolocalization of the uteroferrin in the glandular epithelium. The uterine glands open in spaces formed by the areoles, which are filled by PAS-positive material. The llama fetus was covered by the epidermal membrane, composed of stratified epithelium, with up to seven layers of mono-, bi- or trinucleated cells. The high level of maternal and fetal vascularization surfaces indicates an intense exchange of substances across both surfaces. The metabolic activity shown in the uterine glands suggests an adaptation of the gestation to the high altitudes of the natural habitat of this species.Fragmentos da placenta de 9 animais (28-36 semanas de gestação, provenientes do Instituto Veterinario de Investigaciones Tropicales y de Altura (IVITA, Cusco-Peru, e da Universidad del Altiplano (UNA, Puno-Peru, foram colhidos e fixados em paraformoldeído 4% em PBS para microscopia de luz e em glutaraldeido em 2,5% PBS

Characterisation of the maternal response to chronic phase shifts during gestation in the rat: implications for fetal metabolic programming.

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Tamara J Varcoe

Full Text Available Disrupting maternal circadian rhythms through exposure to chronic phase shifts of the photoperiod has lifelong consequences for the metabolic homeostasis of the fetus, such that offspring develop increased adiposity, hyperinsulinaemia and poor glucose and insulin tolerance. In an attempt to determine the mechanisms by which these poor metabolic outcomes arise, we investigated the impact of chronic phase shifts (CPS on maternal and fetal hormonal, metabolic and circadian rhythms. We assessed weight gain and food consumption of dams exposed to either CPS or control lighting conditions throughout gestation. At day 20, dams were assessed for plasma hormone and metabolite concentrations and glucose and insulin tolerance. Additionally, the expression of a range of circadian and metabolic genes was assessed in maternal, placental and fetal tissue. Control and CPS dams consumed the same amount of food, yet CPS dams gained 70% less weight during the first week of gestation. At day 20, CPS dams had reduced retroperitoneal fat pad weight (-15%, and time-of-day dependent decreases in liver weight, whereas fetal and placental weight was not affected. Melatonin secretion was not altered, yet the timing of corticosterone, leptin, glucose, insulin, free fatty acids, triglycerides and cholesterol concentrations were profoundly disrupted. The expression of gluconeogenic and circadian clock genes in maternal and fetal liver became either arrhythmic or were in antiphase to the controls. These results demonstrate that disruptions of the photoperiod can severely disrupt normal circadian profiles of plasma hormones and metabolites, as well as gene expression in maternal and fetal tissues. Disruptions in the timing of food consumption and the downstream metabolic processes required to utilise that food, may lead to reduced efficiency of growth such that maternal weight gain is reduced during early embryonic development. It is these perturbations that may contribute to

Characterisation of the maternal response to chronic phase shifts during gestation in the rat: implications for fetal metabolic programming.

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Varcoe, Tamara J; Boden, Michael J; Voultsios, Athena; Salkeld, Mark D; Rattanatray, Leewen; Kennaway, David J

2013-01-01

Disrupting maternal circadian rhythms through exposure to chronic phase shifts of the photoperiod has lifelong consequences for the metabolic homeostasis of the fetus, such that offspring develop increased adiposity, hyperinsulinaemia and poor glucose and insulin tolerance. In an attempt to determine the mechanisms by which these poor metabolic outcomes arise, we investigated the impact of chronic phase shifts (CPS) on maternal and fetal hormonal, metabolic and circadian rhythms. We assessed weight gain and food consumption of dams exposed to either CPS or control lighting conditions throughout gestation. At day 20, dams were assessed for plasma hormone and metabolite concentrations and glucose and insulin tolerance. Additionally, the expression of a range of circadian and metabolic genes was assessed in maternal, placental and fetal tissue. Control and CPS dams consumed the same amount of food, yet CPS dams gained 70% less weight during the first week of gestation. At day 20, CPS dams had reduced retroperitoneal fat pad weight (-15%), and time-of-day dependent decreases in liver weight, whereas fetal and placental weight was not affected. Melatonin secretion was not altered, yet the timing of corticosterone, leptin, glucose, insulin, free fatty acids, triglycerides and cholesterol concentrations were profoundly disrupted. The expression of gluconeogenic and circadian clock genes in maternal and fetal liver became either arrhythmic or were in antiphase to the controls. These results demonstrate that disruptions of the photoperiod can severely disrupt normal circadian profiles of plasma hormones and metabolites, as well as gene expression in maternal and fetal tissues. Disruptions in the timing of food consumption and the downstream metabolic processes required to utilise that food, may lead to reduced efficiency of growth such that maternal weight gain is reduced during early embryonic development. It is these perturbations that may contribute to the programming of

Influence of obstructive sleep apnea on fatty liver disease: role of chronic intermittent hypoxia.

Science.gov (United States)

Türkay, Cansel; Ozol, Duygu; Kasapoğlu, Benan; Kirbas, Ismail; Yıldırım, Zeki; Yiğitoğlu, Ramazan

2012-02-01

Currently the common pathogenetic mechanisms in nonalcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) are gaining increased attention. The aim of this study is to find out the influence of chronic intermittent hypoxemia and OSA related parameters to the severity of NAFLD. We examined the liver functions tests and ultrasonographic data of liver as well as markers of OSA severity (apnea-hypopnea index [AHI], oxygen desaturation index, minimum oxygen saturation, percentage of time spent with S(pO(2)) hypoxia during sleep. The prevalence of NAFLD was higher in patients with severe OSA, suggesting a role for nocturnal hypoxemia in the pathogenesis of fatty liver disease.

Prematuros e prematuros tardios: suas diferenças e o aleitamento materno

OpenAIRE

Silva,Waléria Ferreira da; Guedes,Zelita Caldeira Ferreira

2015-01-01

Resumo:OBJETIVO:verificar se há diferenças entre recém nascidos prematuros e prematuros tardios no que se refere ao tempo de aleitamento materno e aleitamento materno exclusivo causas e consequências do desmame precoce. Ademais, foi observado o uso de oxigenoterapia e sonda para alimentação, número de sessões de fonoterapia e o tempo de internação.MÉTODOS:pesquisa de campo, de caráter exploratório e longitudinal. Participaram do estudo 82 mães de prematuros. Os dados categóricos foram resumid...

Roles and Mechanisms of Obstructive Sleep Apnea-Hypopnea Syndrome and Chronic Intermittent Hypoxia in Atherosclerosis: Evidence and Prospective

OpenAIRE

Ma, Linqin; Zhang, Jingchun; Liu, Yue

2016-01-01

The morbidity and mortality of obstructive sleep apnea-hypopnea syndrome (OSAHS) are regarded as consequences of its adverse effects on the cardiovascular system. Chronic intermittent hypoxia (CIH) induced by OSAHS can result in vascular endothelial injury, thus promoting development of atherosclerosis (AS). Studies have shown that CIH is an independent risk factor for the occurrence and development of AS, but the underlying mechanism remains unclear. Here, we review clinical and fundamental ...

Implantacao da Rede Amamenta Brasil e prevalencia de aleitamento materno exclusivo

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Adriana Passanha

2013-12-01

Full Text Available OBJETIVO : Analisar a associação entre grau de implantação da Rede Amamenta Brasil e prevalência de aleitamento materno exclusivo. MÉTODOS : Estudo transversal, com amostra representativa de 916 crianças < 6 meses em Ribeirão Preto, SP, em 2011. Foram coletados dados sobre aleitamento materno, local de acompanhamento ambulatorial e demais características, durante a Campanha Nacional de Vacinação. O fator de estudo correspondeu ao local de acompanhamento ambulatorial: Privado; Público não Rede; Público com Oficina da Rede; e Público certificado na Rede. O efeito individualizado do fator de estudo sobre o desfecho foi avaliado mediante análise de regressão de Poisson com variância robusta. RESULTADOS : A comparação entre os locais privados (categoria de referência e os demais mostrou relação dose-resposta significativa com elevação progressiva da prevalência de aleitamento materno exclusivo em locais públicos não Rede, em locais públicos com Oficina da Rede e em locais públicos certificados na Rede (p = 0,047. A Razão de Prevalência para amamentação exclusiva foi igual a 1,47 (IC95% 1,00;2,17 para o estrato das Unidades Básicas de Saúde certificadas na Rede, após ajuste pelas variáveis de confusão. CONCLUSÕES : A prevalência de aleitamento materno exclusivo em < 6 meses foi maior nos locais certificados na Rede, evidenciando a relevância de investir na certificação de Unidades Básicas de Saúde nessa ação.

Intermittent fasting decreases oxidative stress parameters in Wistar rats (Rattus norvegicus)

OpenAIRE

Titis Nurmasitoh; Shindy Yudha Utami; Endah Kusumawardani; Abdulhalim Ahmad Najmuddin; Ika Fidianingsih

2018-01-01

Background Chronic and degenerative diseases are closely related to modern lifestyles that tend to be deficient in physical activity but excessive in food intake. One method used to overcome this problem is dietary restriction through intermittent fasting. Intermittent fasting decreases the risk of chronic and degenerative diseases, e.g. by lowering oxidative stress. Oxidative stress can be determined from the malondialdehyde (MDA) levels and lipid profile in the blood. The present study a...

Estilo de vida materno e aspectos nutricionais do pré-escolar

OpenAIRE

Érica Bezerra Nobre

2016-01-01

INTRODUÇÃO: Muitos dos comportamentos de saúde envolvidos no aparecimento das doenças crônicas não comunicáveis são originados na infância sob influência dos pais. A mãe é a pessoa mais envolvida na educação e nos cuidados de saúde da criança. O estilo de vida (EdV) é um determinante social da saúde. Nunca se compreendeu características de EdV materno associadas com aspectos da nutrição infantil. OBJETIVO: Verificar a associação dos EdV materno comportamental e não comportamental com aspectos...

Chronic intermittent fasting improves cognitive functions and brain structures in mice.

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Liaoliao Li

Full Text Available Obesity is a major health issue. Obesity started from teenagers has become a major health concern in recent years. Intermittent fasting increases the life span. However, it is not known whether obesity and intermittent fasting affect brain functions and structures before brain aging. Here, we subjected 7-week old CD-1 wild type male mice to intermittent (alternate-day fasting or high fat diet (45% caloric supplied by fat for 11 months. Mice on intermittent fasting had better learning and memory assessed by the Barnes maze and fear conditioning, thicker CA1 pyramidal cell layer, higher expression of drebrin, a dendritic protein, and lower oxidative stress than mice that had free access to regular diet (control mice. Mice fed with high fat diet was obese and with hyperlipidemia. They also had poorer exercise tolerance. However, these obese mice did not present significant learning and memory impairment or changes in brain structures or oxidative stress compared with control mice. These results suggest that intermittent fasting improves brain functions and structures and that high fat diet feeding started early in life does not cause significant changes in brain functions and structures in obese middle-aged animals.

Chronic intermittent fasting improves cognitive functions and brain structures in mice.

Science.gov (United States)

Li, Liaoliao; Wang, Zhi; Zuo, Zhiyi

2013-01-01

Obesity is a major health issue. Obesity started from teenagers has become a major health concern in recent years. Intermittent fasting increases the life span. However, it is not known whether obesity and intermittent fasting affect brain functions and structures before brain aging. Here, we subjected 7-week old CD-1 wild type male mice to intermittent (alternate-day) fasting or high fat diet (45% caloric supplied by fat) for 11 months. Mice on intermittent fasting had better learning and memory assessed by the Barnes maze and fear conditioning, thicker CA1 pyramidal cell layer, higher expression of drebrin, a dendritic protein, and lower oxidative stress than mice that had free access to regular diet (control mice). Mice fed with high fat diet was obese and with hyperlipidemia. They also had poorer exercise tolerance. However, these obese mice did not present significant learning and memory impairment or changes in brain structures or oxidative stress compared with control mice. These results suggest that intermittent fasting improves brain functions and structures and that high fat diet feeding started early in life does not cause significant changes in brain functions and structures in obese middle-aged animals.

Increasing Neuroplasticity to Bolster Chronic Pain Treatment: A Role for Intermittent Fasting and Glucose Administration?

Science.gov (United States)

Sibille, KT; Bartsch, F; Reddy, D; Fillingim, RB; Keil, A

2016-01-01

Neuroplastic changes in brain structure and function are not only a consequence of chronic pain but are involved in the maintenance of pain symptoms. Thus, promoting adaptive, treatment responsive neuroplasticity represents a promising clinical target. Emerging evidence about the human brain’s response to an array of behavioral and environmental interventions may assist in identifying targets to facilitate increased neurobiological receptivity, promoting healthy neuroplastic changes. Specifically, strategies to maximize neuroplastic responsiveness to chronic pain treatment could enhance treatment gains by optimizing learning and positive central nervous system (CNS) adaptation. Periods of heightened plasticity have been traditionally identified with the early years of development. More recent research however has identified a wide spectrum of methods that can be used to “re-open” and enhance plasticity and learning in adults. In addition to transcranial direct current stimulation and transcranial magnetic stimulation, behavioral and pharmacological interventions have been investigated. Intermittent fasting and glucose administration are two propitious strategies, which are non-invasive, inexpensive to administer, implementable in numerous settings, and may be applicable across differing chronic pain treatments. Key findings and neurophysiological mechanisms are summarized, providing evidence for the potential clinical contributions of these two strategies toward ameliorating chronic pain. PMID:26848123

Interhemispheric Plasticity following Intermittent Theta Burst Stimulation in Chronic Poststroke Aphasia

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Joseph C. Griffis

2016-01-01

Full Text Available The effects of noninvasive neurostimulation on brain structure and function in chronic poststroke aphasia are poorly understood. We investigated the effects of intermittent theta burst stimulation (iTBS applied to residual language-responsive cortex in chronic patients using functional and anatomical MRI data acquired before and after iTBS. Lateralization index (LI analyses, along with comparisons of inferior frontal gyrus (IFG activation and connectivity during covert verb generation, were used to assess changes in cortical language function. Voxel-based morphometry (VBM was used to assess effects on regional grey matter (GM. LI analyses revealed a leftward shift in IFG activity after treatment. While left IFG activation increased, right IFG activation decreased. Changes in right to left IFG connectivity during covert verb generation also decreased after iTBS. Behavioral correlations revealed a negative relationship between changes in right IFG activation and improvements in fluency. While anatomical analyses did not reveal statistically significant changes in grey matter volume, the fMRI results provide evidence for changes in right and left IFG function after iTBS. The negative relationship between post-iTBS changes in right IFG activity during covert verb generation and improvements in fluency suggests that iTBS applied to residual left-hemispheric language areas may reduce contralateral responses related to language production and facilitate recruitment of residual language areas after stroke.

Interhemispheric Plasticity following Intermittent Theta Burst Stimulation in Chronic Poststroke Aphasia.

Science.gov (United States)

Griffis, Joseph C; Nenert, Rodolphe; Allendorfer, Jane B; Szaflarski, Jerzy P

2016-01-01

The effects of noninvasive neurostimulation on brain structure and function in chronic poststroke aphasia are poorly understood. We investigated the effects of intermittent theta burst stimulation (iTBS) applied to residual language-responsive cortex in chronic patients using functional and anatomical MRI data acquired before and after iTBS. Lateralization index (LI) analyses, along with comparisons of inferior frontal gyrus (IFG) activation and connectivity during covert verb generation, were used to assess changes in cortical language function. Voxel-based morphometry (VBM) was used to assess effects on regional grey matter (GM). LI analyses revealed a leftward shift in IFG activity after treatment. While left IFG activation increased, right IFG activation decreased. Changes in right to left IFG connectivity during covert verb generation also decreased after iTBS. Behavioral correlations revealed a negative relationship between changes in right IFG activation and improvements in fluency. While anatomical analyses did not reveal statistically significant changes in grey matter volume, the fMRI results provide evidence for changes in right and left IFG function after iTBS. The negative relationship between post-iTBS changes in right IFG activity during covert verb generation and improvements in fluency suggests that iTBS applied to residual left-hemispheric language areas may reduce contralateral responses related to language production and facilitate recruitment of residual language areas after stroke.

Fatores de risco para morte fetal no município de Pato Branco (Brasil Factores de riesgo para muerte fetal en el municipio de Pato Branco (Brasil Risk factors for fetal death in the city of Pato Branco (Brazil

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Letícia de Lima Trindade

2011-11-01

Full Text Available Objetivo. Descrever os fatores de risco para mortalidade fetal na cidade de Pato Branco (Brasil. Metodologia. Realizou-se um estudo descritivo, no qual foram analisados os casos de nascidos mortos de 2000 a 2008 na cidade de Pato Branco. A informação foi obtida do Sistema de Informação de Mortalidade. Resultados. Registraram-se 91 mortes fetais no período estudado para uma taxa média de 9.27 por mil nascidos vivos. Os principais fatores de risco de origem maternos foram: placenta prévia (38.5%, hipertensão induzida na gravidez (13.2%, idade de 21 a 30 anos (40.7%, ter três e menos anos de escolaridade (25.7% e a ocupação de dona de casa (34.1%. Para os fetos, o único fator de risco registrado foi o sexo, no que o masculino contribuiu o 52.7% das mortes. Conclusão. Identificaram-se alguns fatores de risco previsíveis que é necessário intervir com o fim de reduzir a mortalidade fetal no município.Objetivo. Describir los factores de riesgo para natimortalidad en la ciudad de Pato Branco (Brasil. Metodología. Se realizó un estudio descriptivo, en el cual fueron analizados los casos de nacidos muertos de 2000 a 2008 en la ciudad de Pato Branco. La información fue obtenida del Sistema de Información de Mortalidad. Resultados. Se registraron 91 muertes fetales en el periodo estudiado para una tasa media de 9.27 por mil nacidos vivos. Los principales factores de riesgo de origen maternos fueron: placenta previa e hipertensión inducida en el embarazo como complicaciones del embarazo (38.5% y 13.2%, edad de 21 a 30 años (40.7%, baja escolaridad (25.7% y como ocupación de ama de casa (34.1%. Para los fetos, el único factor de riesgo registrado fue el sexo: el masculino aportó el 52.7% de las muertes. Conclusión. Se identificaron algunos factores de riesgo prevenibles que merecen intervención con el fin de reducir la natimortalidad en el municipio.Objective. To describe risk factors for fetal mortality in the city of Pato Branco

Conducta médica posnatal ante la dilatación del tracto urinario superior fetal

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Sandalio Durán Álvarez

2012-03-01

Full Text Available El seguimiento sistemático del embarazo normal mediante el estudio ultrasonográfico materno-fetal ha demostrado que por cada 500 embarazos debemos esperar una anomalía importante del tracto urinario. La anomalía detectada con mayor frecuencia es la dilatación del tracto urinario superior, que si bien la mayoría de las veces no se traduce en una alteración importante, obliga a su estudio posnatal para poder valorar su significación. Una dilatación del tracto urinario superior puede ser la traducción de una hidronefrosis obstructiva por estenosis ureteropiélica, una hidronefrosis no obstructiva, un reflujo vesicoureteral o una pielectasia, y menos frecuentemente, puede ser la imagen de un doble sistema excretor con el superior obstruido, un megauréter obstructivo o no obstructivo, o una valva de uretra posterior en el sexo masculino. En esta revisión se presentan los criterios diagnósticos y el tratamiento clínico de las hidronefrosis y pielectasias, así como el estudio de los casos en que se sospecha reflujo vesicoureteral, y se relatan las anomalías encontradas en 318 niños en que el ultrasonido materno-fetal detectó alguna alteración del tracto urinario. Aunque no tan frecuente como las pielectasias y las hidronefrosis no obstructivas, las estenosis pieloureterales que producen obstrucción, pueden traer serias consecuencias sobre la función renal, que obligan a tomar decisiones médicas, y, en ocasiones, quirúrgicas, para mejorar la calidad de vida de estos niños.

Fetal programming of chronic kidney disease: the role of maternal smoking, mitochondrial dysfunction, and epigenetic modfification.

Science.gov (United States)

Stangenberg, Stephanie; Chen, Hui; Wong, Muh Geot; Pollock, Carol A; Saad, Sonia

2015-06-01

The role of an adverse in utero environment in the programming of chronic kidney disease in the adult offspring is increasingly recognized. The cellular and molecular mechanisms linking the in utero environment and future disease susceptibility remain unknown. Maternal smoking is a common modifiable adverse in utero exposure, potentially associated with both mitochondrial dysfunction and epigenetic modification in the offspring. While studies are emerging that point toward a key role of mitochondrial dysfunction in acute and chronic kidney disease, it may have its origin in early development, becoming clinically apparent when secondary insults occur. Aberrant epigenetic programming may add an additional layer of complexity to orchestrate fibrogenesis in the kidney and susceptibility to chronic kidney disease in later life. In this review, we explore the evidence for mitochondrial dysfunction and epigenetic modification through aberrant DNA methylation as key mechanistic aspects of fetal programming of chronic kidney disease and discuss their potential use in diagnostics and targets for therapy. Copyright © 2015 the American Physiological Society.

Ambiente receptivo uterino: control materno, control embrionario, muerte embrionaria

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Ángela Gonella D

2010-04-01

Full Text Available El ambiente receptivo en el útero, o ambiente embriotrófico, se define como la capacidad del organismo materno para hospedar el conceptus exitosamente. La receptividad uterina depende de la correcta sincronía del eje conceptus - cuerpo lúteo - endometrio y está controlada por dos mecanismos. El primero depende de la madre y se establece a través de las relaciones entre los estrógenos (E2 y la Progesterona (P4. El segundo es mediado por el trofoblasto que secreta interferón Tau (INFt. Los estrógenos se sintetizan en las células foliculares y determinan los cambios fisicoquímicos, morfológicos y del comportamiento expresadas por la hembra durante el celo. La P4 es sintetizada por el cuerpo lúteo (CL, y promueve, entre otros, cambios a nivel endometrial para la manutención de la gestación. Cuando la fertilización y desarrollo embrionario son exitosos, el INFt ejerce su efecto luteotrópico entre los días 15 y 19 de la gestación, desencadenando el proceso de reconocimiento materno para evitar la regresión luteal y asegurar la sobrevivencia del embrión. Además, el INFt estimula al organismo materno para producir un microambiente que le provea al embrión condiciones nutricionales, inmunológicas y fisiológicas óptimas para su desarrollo. La presente revisión pretende contextualizar cuales son los cambios que sufre el endometrio para proveer las condiciones necesarias permitiendo que el embrión se desarrolle correctamente y se establezca una gestación.

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour.

Science.gov (United States)

Alfirevic, Zarko; Devane, Declan; Gyte, Gillian Ml; Cuthbert, Anna

2017-02-03

Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 November 2016) and reference lists of retrieved studies. Randomised and quasi-randomised controlled trials involving a comparison of continuous cardiotocography (with and without fetal blood sampling) with no fetal monitoring, intermittent auscultation intermittent cardiotocography. Two review authors independently assessed study eligibility, quality and extracted data from included studies. Data were checked for accuracy. We included 13 trials involving over 37,000 women. No new studies were included in this update.One trial (4044 women) compared continuous CTG with intermittent CTG, all other trials compared continuous CTG with intermittent auscultation. No data were found comparing no fetal monitoring with continuous CTG. Overall, methodological quality was mixed. All included studies were at high risk of performance bias, unclear or high risk of detection bias, and unclear risk of reporting bias. Only two trials were assessed at high methodological quality.Compared with intermittent auscultation, continuous cardiotocography showed no significant improvement in overall perinatal death rate (risk ratio (RR) 0.86, 95% confidence interval (CI) 0.59 to 1.23, N = 33,513, 11 trials, low quality evidence), but was associated with halving neonatal seizure rates (RR 0.50, 95% CI 0.31 to 0.80, N = 32,386, 9 trials, moderate quality evidence). There was no

Accouchement par forceps: indications et pronostic materno-foetal ...

African Journals Online (AJOL)

L'accouchement par voie basse, peut être parfois compromis par des facteurs maternels, foetaux ou materno-foetaux nécessitant des moyens thérapeutiques comme le forceps pour achever l'accouchement par voie naturelle. Le forceps, une méthode qui n'est pas sans risque pour la mère et le nouveau-né. Nous avons ...

Characterization of the fetal blood transcriptome and proteome in maternal anti-fetal rejection: evidence of a distinct and novel type of human fetal systemic inflammatory response.

Science.gov (United States)

Lee, Joonho; Romero, Roberto; Chaiworapongsa, Tinnakorn; Dong, Zhong; Tarca, Adi L; Xu, Yi; Chiang, Po Jen; Kusanovic, Juan Pedro; Hassan, Sonia S; Yeo, Lami; Yoon, Bo Hyun; Than, Nandor Gabor; Kim, Chong Jai

2013-10-01

The human fetus is able to mount a systemic inflammatory response when exposed to microorganisms. This stereotypic response has been termed the 'fetal inflammatory response syndrome' (FIRS), defined as an elevation of fetal plasma interleukin-6 (IL-6). FIRS is frequently observed in patients whose preterm deliveries are associated with intra-amniotic infection, acute inflammatory lesions of the placenta, and a high rate of neonatal morbidity. Recently, a novel form of fetal systemic inflammation, characterized by an elevation of fetal plasma CXCL10, has been identified in patients with placental lesions consistent with 'maternal anti-fetal rejection'. These lesions include chronic chorioamnionitis, plasma cell deciduitis, and villitis of unknown etiology. In addition, positivity for human leukocyte antigen (HLA) panel-reactive antibodies (PRA) in maternal sera can also be used to increase the index of suspicion for maternal anti-fetal rejection. The purpose of this study was to determine (i) the frequency of pathologic lesions consistent with maternal anti-fetal rejection in term and spontaneous preterm births; (ii) the fetal serum concentration of CXCL10 in patients with and without evidence of maternal anti-fetal rejection; and (iii) the fetal blood transcriptome and proteome in cases with a fetal inflammatory response associated with maternal anti-fetal rejection. Maternal and fetal sera were obtained from normal term (n = 150) and spontaneous preterm births (n = 150). A fetal inflammatory response associated with maternal anti-fetal rejection was diagnosed when the patients met two or more of the following criteria: (i) presence of chronic placental inflammation; (ii) ≥80% of maternal HLA class I PRA positivity; and (iii) fetal serum CXCL10 concentration >75th percentile. Maternal HLA PRA was analyzed by flow cytometry. The concentrations of fetal CXCL10 and IL-6 were determined by ELISA. Transcriptome analysis was undertaken after the extraction of total RNA

Superando o falicismo: sofrimento materno na psicanálise de crianças

OpenAIRE

Melo, Henriqueta Lúcia Arcoverde de; Andrade, Fernando Cezar Bezerra de; Lima, Hélida Magalhães da Costa

2012-01-01

Interpreta-se, no contexto da psicanálise de uma criança psicótica, o sofrimento materno e suas implicações nos destinos do tratamento. O sofrimento parental interfere negativamente quando compele à repetição fantasmática de traumatismos cujas mensagens, uma vez intrometidas, não são elaboradas pelos pais. Como demonstra o caso clínico, o falicismo materno e a foraclusão da função paterna não necessariamente estão presentes na geração da psicose. Longe de ser falo, originalmente ao paciente f...

Intermittent intravenous followed by intermittent oral 1 alpha(OH)D3 treatment of secondary hyperparathyroidism in uraemia

DEFF Research Database (Denmark)

Brandi, L; Daugaard, H; Egsmose, C

1996-01-01

OBJECTIVES: To examine whether intermittent oral 1 alpha(OH)D3 treatment of patients on haemodialysis with secondary hyperparathyroidism (HPT) was able to maintain the marked suppression of PTH, which previously had been induced by an intermittent intravenous administration of 1 alpha(OH)D3....... Simultaneously, the effect of the different routes of administration of 1 alpha(OH)D3 on the circulating levels of N- and C-terminal PTH fragments was measured. DESIGN: An open study of patients on chronic haemodialysis. SETTING: Renal division, Rigshospitalet, Copenhagen, Denmark. SUBJECTS: A total of 26...

Iniciativa Unidade Basica Amiga da Amamentacao e sua relacao com o aleitamento materno exclusivo

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Ana Lucia Naves Alves

2013-12-01

Full Text Available OBJETIVO : Analisar a prevalência do aleitamento materno exclusivo e sua associação com a assistência pela Iniciativa Unidade Básica Amiga da Amamentação. MÉTODOS : Estudo transversal, com dados da pesquisa sobre práticas alimentares no primeiro ano de vida conduzida nas campanhas de vacinação em Barra Mansa, RJ, em 2003 e 2006. Foram selecionadas as crianças < 6 meses, no total 589 em 2003 e 707 em 2006. Tomou-se por base o inquérito de 2006 para estimar a relação entre ser assistido pela Iniciativa Unidade Básica Amiga da Amamentação e a prática do aleitamento materno exclusivo. Variáveis de exposição que se mostraram associadas (p ≤ 0,20 ao desfecho na análise bivariada foram selecionadas para a análise múltipla. As razões de prevalência ajustadas foram obtidas por modelo de regressão de Poisson com variância robusta, segundo modelo conceitual hierarquizado. O modelo final foi composto por variáveis de exposição que obtiveram p ≤ 0,05. RESULTADOS : A prevalência do aleitamento materno exclusivo aumentou de 30,2% em 2003 para 46,7% em 2006. Baixa escolaridade materna reduziu o aleitamento materno exclusivo em 20,0% (RP = 0,798; IC95% 0,684;0,931, o parto cesariano em 16,0% (RP = 0,838; IC95% 0,719;0,976, o uso de chupeta em 41,0% (RP = 0,589; IC95% 0,495;0,701 e a prevalência de aleitamento materno exclusivo foi 1,0% menor a cada dia de vida da criança (RP = 0,992; IC95% 0,991;0,994 na análise múltipla. O acompanhamento do bebê por unidade credenciada na Iniciativa Unidade Básica Amiga da Amamentação aumentou o desfecho em 19,0% (RP = 1,193; IC95% 1,020;1,395. CONCLUSÕES : A Iniciativa Unidade Básica Amiga da Amamentação contribuiu para a prática do aleitamento materno exclusivo e para orientação de gestantes e mães quando implementada na rede primária de saúde.

Características de la enterocolitis necrotizante en neonatos Instituto Nacional Materno Perinatal 2010 - 2014

OpenAIRE

Anicama Elias, Erika Lucila

2017-01-01

Objetivo: Conocer las características de la enterocolitis necrotizante en neonatos del Instituto Nacional Materno Perinatal de Lima, 2010 – 2014 Método: Investigación descriptiva, observacional, transversal, retrospectiva, diseño no experimental. La población constituida por los 31 neonatos con diagnóstico de enterocolitis necrotizante hospitalizada en la Unidad de Cuidados Intensivos del Instituto Nacional Materno Perinatal durante los años 2010-2014. Resultados: La variable prematuridad est...

Induction of Severe Chronic Hyperplastic Candidiasis in Rat by Opportunistic Infection of C. albicans through Combination of Diabetes and Intermittent Prednisolone Administration.

Science.gov (United States)

Terayama, Yui; Matsuura, Tetsuro; Ozaki, Kiyokazu

2017-08-01

Chronic hyperplastic candidiasis progresses from squamous cell hyperplasia to squamous cell carcinoma (SCC); however, the oncogenic mechanism remains unclear. In the present study, we attempted to induce opportunistic Candida albicans infection and establish chronic hyperplastic candidiasis in rats by combining diabetic condition and prednisolone administration, followed by analysis of the inflammatory cells involved in the disease progression. Female Wistar Bunn/Kobori (WBN/Kob) rats were divided into 3 groups: alloxan-induced diabetic rats (A group) along with diabetic (AP group) and nondiabetic (P group) rats intermittently treated with prednisolone. Animals were euthanized at 42 weeks of age. Squamous cell hyperplasia following C. albicans infection in the forestomach was observed in almost all AP and A group rats. The lesions in the AP group were significantly more severe than those in the A group. In addition, SCC was detected in 1 AP group animal. Cluster of differentiation (CD)4-positive T cell and CD68-positive macrophage infiltration in the AP group was significantly stronger than that in the A group. These findings suggest that the combination of diabetes and intermittent prednisolone administration could induce chronic hyperplastic candidiasis without direct C. albicans inoculation and that CD4-positive T cells and CD68-positive macrophages may be highly involved in the pathogenesis of these hyperplastic lesions.

Increasing Neuroplasticity to Bolster Chronic Pain Treatment: A Role for Intermittent Fasting and Glucose Administration?

Science.gov (United States)

Sibille, Kimberly T; Bartsch, Felix; Reddy, Divya; Fillingim, Roger B; Keil, Andreas

2016-03-01

Neuroplastic changes in brain structure and function are not only a consequence of chronic pain but are involved in the maintenance of pain symptoms. Thus, promotion of adaptive, treatment-responsive neuroplasticity represents a promising clinical target. Emerging evidence about the human brain's response to an array of behavioral and environmental interventions may assist in identifying targets to facilitate increased neurobiological receptivity, promoting healthy neuroplastic changes. Specifically, strategies to maximize neuroplastic responsiveness to chronic pain treatment could enhance treatment gains by optimization of learning and positive central nervous system adaptation. Periods of heightened plasticity have been traditionally identified with the early years of development. More recent research, however, has identified a wide spectrum of methods that can be used to "reopen" and enhance plasticity and learning in adults. In addition to transcranial direct current stimulation and transcranial magnetic stimulation, behavioral and pharmacological interventions have been investigated. Intermittent fasting and glucose administration are two propitious strategies, that are noninvasive, inexpensive to administer, implementable in numerous settings, and might be applicable across differing chronic pain treatments. Key findings and neurophysiological mechanisms are summarized, and evidence for the potential clinical contributions of these two strategies toward ameliorating chronic pain is presented. Neuroplastic changes are a defining feature of chronic pain and a complicating factor in treatment. Noninvasive strategies to optimize the brain's response to treatment interventions might improve learning and memory, increase the positive adaptability of the central nervous system, and enhance treatment outcomes. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Epigenetic regulation and fetal programming.

Science.gov (United States)

Gicquel, Christine; El-Osta, Assam; Le Bouc, Yves

2008-02-01

Fetal programming encompasses the role of developmental plasticity in response to environmental and nutritional signals during early life and its potential adverse consequences (risk of cardiovascular, metabolic and behavioural diseases) in later life. The first studies in this field highlighted an association between poor fetal growth and chronic adult diseases. However, environmental signals during early life may lead to adverse long-term effects independently of obvious effects on fetal growth. Adverse long-term effects reflect a mismatch between early (fetal and neonatal) environmental conditions and the conditions that the individual will confront later in life. The mechanisms underlying this risk remain unclear. However, experimental data in rodents and recent observations in humans suggest that epigenetic changes in regulatory genes and growth-related genes play a significant role in fetal programming. Improvements in our understanding of the biochemical and molecular mechanisms at play in fetal programming would make it possible to identify biomarkers for detecting infants at high risk of adult-onset diseases. Such improvements should also lead to the development of preventive and therapeutic strategies.

Increased expression of protein kinase A inhibitor alpha (PKI-alpha) and decreased PKA-regulated genes in chronic intermittent alcohol exposure.

Science.gov (United States)

Repunte-Canonigo, Vez; Lutjens, Robert; van der Stap, Lena D; Sanna, Pietro Paolo

2007-03-23

Intermittent models of alcohol exposure that mimic human patterns of alcohol consumption produce profound physiological and biochemical changes and induce rapid increases in alcohol self-administration. We used high-density oligonucleotide microarrays to investigate gene expression changes during chronic intermittent alcohol exposure in three brain regions that receive mesocorticolimbic dopaminergic projections and that are believed to be involved in alcohol's reinforcing actions: the medial prefrontal cortex, the nucleus accumbens and the amygdala. An independent replication of the experiment was used for RT-PCR validation of the microarray results. The protein kinase A inhibitor alpha (PKI-alpha, Pkia), a member of the endogenous PKI family implicated in reducing nuclear PKA activity, was found to be increased in all three regions tested. Conversely, we observed a downregulation of the expression of several PKA-regulated transcripts in one or more of the brain regions studied, including the activity and neurotransmitter-regulated early gene (Ania) - 1, -3, -7, -8, the transcription factors Egr1 and NGFI-B (Nr4a1) and the neuropeptide NPY. Reduced expression of PKA-regulated genes in mesocorticolimbic projection areas may have motivational significance in the rapid increase in alcohol self-administration induced by intermittent alcohol exposure.

Fatores associados com a duração do aleitamento materno Factors associated with duration of breastfeeding

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Roberto G. Chaves

2007-06-01

Full Text Available OBJETIVOS: Determinar os índices de aleitamento materno exclusivo e complementado e identificar variáveis que interferem na prática da amamentação no município de Itaúna (MG. MÉTODOS: Estudo longitudinal realizado com 246 mulheres assistidas na maternidade do Hospital Manoel Gonçalves, no município de Itaúna (MG. O acompanhamento das mães e recém-nascidos foi realizado mensalmente nos primeiros 12 meses após o parto ou até a interrupção da amamentação. A análise da duração do aleitamento materno exclusivo e complementado foi realizada utilizando procedimentos de análise de sobrevivência. O efeito das co-variáveis sobre o tempo de aleitamento foi avaliado através do modelo de regressão de Cox. RESULTADOS: A prevalência de aleitamento materno exclusivo no sexto mês foi de 5,3%, e de aleitamento materno aos 12 meses, 33,7%. A mediana de aleitamento materno exclusivo foi de 40 dias, e a mediana de aleitamento materno, 237 dias. A análise multivariada mostrou associação negativa (p 9 consultas, uso de álcool ou tabaco, tempo da primeira mamada (> 6 horas e uso de chupeta. CONCLUSÕES: Os índices de aleitamento materno no município de Itaúna (MG estão muito abaixo daqueles preconizados pela Organização Mundial da Saúde. As principais variáveis relacionadas negativamente ao tempo de aleitamento materno exclusivo e complementado estão associadas à assistência materno-infantil, sendo, portanto, passíveis de intervenção.OBJECTIVES: To determine rates of exclusive breastfeeding and of complementary feeding and to identify variables that interfere with breastfeeding in the municipality of Itaúna, MG, Brazil. METHODS: A longitudinal study was undertaken enrolling 246 women who gave birth at the maternity unit of the Manoel Gonçalves Hospital, in Itaúna, MG. The mothers and their infants were seen monthly for the first 12 months after birth or until they stopped breastfeeding. Survival analysis procedures were

Incidência do near miss materno no parto e pós-parto hospitalar: dados da pesquisa Nascer no Brasil

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Marcos Augusto Bastos Dias

2014-08-01

Full Text Available Este estudo avaliou os dados sobre a incidência do near miss materno, identificados segundo os critérios da Organização Mundial da Saúde, na pesquisa Nascer no Brasil. O estudo foi realizado entre fevereiro/2011 e outubro/2012 e os resultados apresentados são estimativas para a população estudada (2.337.476 partos, baseados na amostra de 23.894 puérperas entrevistadas. Os resultados mostraram uma incidência de near miss materno de 10,21 por mil nascidos vivos e uma razão de mortalidade do near miss materno de 30,8 casos para cada morte materna. Os critérios clínicos para identificação do near miss materno foram os mais prevalentes e tiveram incidência de 5,2 por mil nascidos vivos. O near miss materno esteve associado com a idade materna de 35 anos ou mais (RR = 1,6; IC95%: 1,1-2,5, com história de cesariana anterior (RR = 1,9; IC95%: 1,1-3,4 e gestação de risco (RR = 4,5; IC95%: 2,8-7,0. Os hospitais localizados nas capitais (RR = 2,2; IC95%: 1,3-3,8 e os pertencentes ao SUS (RR = 3,2; IC95%: 1,6-6,6 também apresentaram maior incidência de casos de near miss materno. A qualificação dos serviços de assistência ao parto pode ajudar a reduzir a mortalidade materna no Brasil.

[Role of hippocampal neuronal intracellular calcium overload in modulating cognitive dysfunction and the neuronprotective effect of mematine in a mouse model of chronic intermittent hypoxia].

Science.gov (United States)

Ming, Hong; Chen, Rui; Wang, Jing; Ju, Jingmei; Sun, Li; Zhang, Guoxing

2014-12-01

To investigate the role of hippocampal intracellular calcium overload in modulating cognitive dysfunction and the neuronprotective effect of mematine in a mouse model of chronic intermittent hypoxia. 45 ICR male mice were randomly divided into 3 groups: the unhandled control group (UC group, n = 15), the chronic intermittent hypoxia (CIH group, n = 15) and the pretreatment memantine group (MEM group, n = 15). CIH and MEM mice were subjected to intermittent hypoxia while UC mice to room air for 8 h per day during 4 weeks. Mice in the MEM group were pretreated with memantine (5 mg/kg) by intraperitoneal injection before the cycle started, and those in the UC group and the CIH group were treated with same volume of physiological saline. Neurobehavioral assessments were performed by Open filed and Morris water maze, [Ca²⁺]i in hippocampal neurons was evaluate by flow cytometry, and the expression of cleaved caspase-3, phospho-ERK1/2 in hippocampus were detected by Western blotting. Compared with the UC group, CIH mice displayed markedly more locomotor activity (P overload, neuron apoptosis, dephosphorylation of ERK1/2, which can be attenuated by memantine. Memantine may have a therapeutic effect in the neurocognitive impairment associated with OSAHS.

Mother-to-child transmission of different HIV-1 subtypes among ARV Naïve infected pregnant women in Nigeria Transmissão materno-fetal de diferentes subtipos de HIV-1 entre gestantes infectadas na Nigéria

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G.N. Odaibo

2006-04-01

Full Text Available The rate of mother-to-child transmission (MTCT of HIV as well as the implications of the circulating multiple subtypes to MTCT in Nigeria are not known. This study was therefore undertaken to determine the differential rates of MTCT of HIV-1 subtypes detected among infected pregnant women before ARV intervention therapy became available in Nigeria. Twenty of the HIV-positive women who signed the informed consent form during pregnancy brought their babies for follow-up testing at age 18-24 months. Plasma samples from both mother and baby were tested for HIV antibody at the Department of Virology, UCH, Ibadan, Nigeria. All positive samples (plasma and peripheral blood mononuclear cells - PBMCs were shipped to the Institute of Tropical Medicine, Antwerp, Belgium, where the subtype of the infecting virus was determined using the HMA technique. Overall, a mother-to-child HIV transmission rate of 45% was found in this cohort. Specifically, 36.4%, 66.7% and 100% of the women infected with HIV-1 CRF02 (IbNg, G and B, respectively, transmitted the virus to their babies. As far as it can be ascertained, this is the first report on the rate of MTCT of HIV in Nigeria. The findings reported in this paper will form a useful reference for assessment of currently available therapeutic intervention of MTCT in the country.A taxa de transmissão materno-fetal (MTCT do HIV bem como as implicações dos múltiplos subtipos circulantes para MTCT na Nigéria não são conhecidos. Este estudo foi realizado para determinar as diferentes taxas de MTCT dos subtipos de HIV-1 detectados entre gestantes infectadas antes que a administração da terapia ARV estivesse disponível na Nigéria. Vinte das mulheres HIV positivas que assinaram o consentimento durante a gravidez trouxeram seus filhos para seguimento na idade de 18-24 meses. Amostras de plasma de ambos, mãe e filho foram testadas para anticorpos HIV no Departamento de Virologia, UCH, Ibadan, Nigéria. Todas as

Obesity and Lifespan Health—Importance of the Fetal Environment

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Alice F. Tarantal

2014-04-01

Full Text Available A marked increase in the frequency of obesity at the population level has resulted in an increasing number of obese women entering pregnancy. The increasing realization of the importance of the fetal environment in relation to chronic disease across the lifespan has focused attention on the role of maternal obesity in fetal development. Previous studies have demonstrated that obesity during adolescence and adulthood can be traced back to fetal and early childhood exposures. This review focuses on factors that contribute to early developmental events, such as epigenetic modifications, the potential for an increase in inflammatory burden, early developmental programming changes such as the variable development of white versus brown adipose tissue, and alterations in organ ontogeny. We hypothesize that these mechanisms promote an unfavorable fetal environment and can have a long-standing impact, with early manifestations of chronic disease that can result in an increased demand for future health care. In order to identify appropriate preventive measures, attention needs to be placed both on reducing maternal obesity as well as understanding the molecular, cellular, and epigenetic mechanisms that may be responsible for the prenatal onset of chronic disease.

Early Life Exposure to Chronic Intermittent Hypoxia Primes Increased Susceptibility to Hypoxia-Induced Weakness in Rat Sternohyoid Muscle During Adulthood

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Fiona B Mcdonald

2016-03-01

Full Text Available Intermittent hypoxia is a feature of apnea of prematurity, chronic lung disease and sleep apnea. Despite the clinical relevance, the long-term effects of hypoxic exposure in early life on respiratory control are not well defined. We recently reported that exposure to chronic intermittent hypoxia (CIH during postnatal development (pCIH causes upper airway muscle weakness in both sexes, which persists for several weeks. We sought to examine if there are persistent sex-dependent effects of pCIH on respiratory muscle function into adulthood and/or increased susceptibility to re-exposure to CIH in adulthood in animals previously exposed to CIH during postnatal development. We hypothesized that pCIH would cause long-lasting muscle impairment and increased susceptibility to subsequent hypoxia. Within 24 hours of delivery, pups and their respective dams were exposed to CIH: 90s of hypoxia reaching 5% O2 at nadir; once every 5 min, 8 hrs per day for 3 weeks. Sham groups were exposed to normoxia in parallel. Three groups were studied: sham; pCIH; and pCIH combined with adult CIH (p+aCIH, where a subset of the pCIH-exposed pups were re-exposed to the same CIH paradigm beginning at 13 weeks. Following gas exposures, sternohyoid and diaphragm muscle isometric contractile and endurance properties were examined ex vivo. There was no apparent lasting effect of pCIH on respiratory muscle function in adults. However, in both males and females, re-exposure to CIH in adulthood in pCIH-exposed animals caused sternohyoid (but not diaphragm weakness. Exposure to this paradigm of CIH in adulthood alone had no effect on muscle function. Persistent susceptibility in pCIH-exposed airway dilator muscle to subsequent hypoxic insult may have implications for the control of airway patency in adult humans exposed to intermittent hypoxic stress during early life.

Early life exposure to chronic intermittent Hypoxia Primes Increased Susceptibility to Hypoxia-Induced Weakness in Rat Sternohyoid Muscle during adulthood.

LENUS (Irish Health Repository)

McDonald, Fiona B

2016-03-01

Intermittent hypoxia is a feature of apnea of prematurity (AOP), chronic lung disease, and sleep apnea. Despite the clinical relevance, the long-term effects of hypoxic exposure in early life on respiratory control are not well defined. We recently reported that exposure to chronic intermittent hypoxia (CIH) during postnatal development (pCIH) causes upper airway muscle weakness in both sexes, which persists for several weeks. We sought to examine if there are persistent sex-dependent effects of pCIH on respiratory muscle function into adulthood and\\/or increased susceptibility to re-exposure to CIH in adulthood in animals previously exposed to CIH during postnatal development. We hypothesized that pCIH would cause long-lasting muscle impairment and increased susceptibility to subsequent hypoxia. Within 24 h of delivery, pups and their respective dams were exposed to CIH: 90 s of hypoxia reaching 5% O2 at nadir; once every 5 min, 8 h per day for 3 weeks. Sham groups were exposed to normoxia in parallel. Three groups were studied: sham; pCIH; and pCIH combined with adult CIH (p+aCIH), where a subset of the pCIH-exposed pups were re-exposed to the same CIH paradigm beginning at 13 weeks. Following gas exposures, sternohyoid and diaphragm muscle isometric contractile and endurance properties were examined ex vivo. There was no apparent lasting effect of pCIH on respiratory muscle function in adults. However, in both males and females, re-exposure to CIH in adulthood in pCIH-exposed animals caused sternohyoid (but not diaphragm) weakness. Exposure to this paradigm of CIH in adulthood alone had no effect on muscle function. Persistent susceptibility in pCIH-exposed airway dilator muscle to subsequent hypoxic insult may have implications for the control of airway patency in adult humans exposed to intermittent hypoxic stress during early life.

Superando o falicismo: sofrimento materno na psicanálise de crianças Superando el falicismo: sufrimiento materno en el psicoanálisis de niños Beyond phallicism: maternal suffering in child psychoanalysis

OpenAIRE

Henriqueta Lúcia Arcoverde de Melo; Fernando Cezar Bezerra de Andrade; Hélida Magalhães da Costa Lima

2012-01-01

Interpreta-se, no contexto da psicanálise de uma criança psicótica, o sofrimento materno e suas implicações nos destinos do tratamento. O sofrimento parental interfere negativamente quando compele à repetição fantasmática de traumatismos cujas mensagens, uma vez intrometidas, não são elaboradas pelos pais. Como demonstra o caso clínico, o falicismo materno e a foraclusão da função paterna não necessariamente estão presentes na geração da psicose. Longe de ser falo, originalmente ao paciente f...

INFEZIONI VIRALI CONGENITE, PERINATALI E NEONATALI VIRAL INFECTIONS OF THE FETUS AND NEWBORN INFANT

Science.gov (United States)

Tremolada, Sara; Delbue, Serena; Ferrante, Pasquale

2009-01-01

Riassunto Alcuni virus possono essere trasmessi verticalmente da madre a figlio in seguito allo sviluppo, da parte della madre, di un’infezione primaria, ricorrente o cronica. La trasmissione materno-fetale dei virus, che può avvenire in utero (infezione congenita), durante il travaglio del parto (infezione perinatale), oppure attraverso l’allattamento (infezione postnatale), può causare aborto spontaneo, morte fetale, ritardo di crescita intrauterino, anomalie congenite e patologie neonatali o postnatali di diversa entità. Alcuni fattori di rischio sembrano influenzare l’incidenza di trasmissione materno-fetale dei virus, come ad esempio la presenza di altre infezioni virali, la carica virale materna, il tipo di infezione (primaria o ricorrente), la durata della rottura delle membrane, la modalità con cui avviene il parto, le condizioni socio-economiche e l’allattamento. Oggi è possibile prevenire la trasmissione materno-fetale di molti virus grazie all’utilizzo di vaccini, immunizzazione passiva e farmaci antivirali. Il rischio di trasmissione delle infezioni perinatali e postnatali, inoltre, può essere diminuito evitando l’allattamento o ricorrendo ad un parto cesareo. PMID:19216201

Subclinical decelerations during developing hypotension in preterm fetal sheep after acute on chronic lipopolysaccharide exposure

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Lear, Christopher A.; Davidson, Joanne O.; Galinsky, Robert; Yuill, Caroline A.; Wassink, Guido; Booth, Lindsea C.; Drury, Paul P.; Bennet, Laura; Gunn, Alistair J.

2015-01-01

Subclinical (shallow) heart rate decelerations occur during neonatal sepsis, but there is limited information on their relationship with hypotension or whether they occur before birth. We examined whether subclinical decelerations, a fall in fetal heart rate (FHR) that remained above 100 bpm, were associated with hypotension in preterm fetal sheep exposed to lipopolysaccharide (LPS). Chronically-instrumented fetal sheep at 0.7 gestation received continuous low-dose LPS infusions (n = 15, 100 ng/kg over 24 h, followed by 250 ng/kg/24 h for 96 h) or saline (n = 8). Boluses of 1 μg LPS or saline were given at 48 and 72 h. FHR variability (FHRV) was calculated, and sample asymmetry was used to assess the severity and frequency of decelerations. Low-dose LPS infusion did not affect FHR. After the first LPS bolus, 7 fetuses remained normotensive, while 8 developed hypotension (a fall in mean arterial blood pressure of ≥5 mmHg). Developing hypotension was associated with subclinical decelerations, with a corresponding increase in sample asymmetry and FHRV (p < 0.05). The second LPS bolus was associated with similar but attenuated changes in FHR and blood pressure (p < 0.05). In conclusion, subclinical decelerations are not consistently seen during prenatal exposure to LPS, but may be a useful marker of developing inflammation-related hypotension before birth. PMID:26537688

Factores maternos y bajo peso al nacer, Bahía Honda Maternal factors and low-weight at birth, Bahia Honda

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Xiomara Elsa Martínez Argudín

2011-03-01

Full Text Available Introducción: el bajo peso al nacer ha constituido un enigma para la ciencia a través de los tiempos. Objetivo: realizar una evaluación de algunos de los factores de riesgo maternos asociados al bajo peso al nacer en el municipio Bahía Honda durante el período de enero 2006-junio 2009.Métodos: se realizó un estudio observacional, descriptivo y transversal. Este permitió hacer una caracterización de las gestantes, cuyo producto fueron los niños con bajo peso al nacer. Se aplicó una encuesta tipo planilla de recolección de datos, la cual fue aplicada a las historias clínicas obstétricas, pertenecientes a los Policlínicos Docentes "Manuel González Díaz" y "Pablo de la Torriente Brau"; los datos fueron procesados mediante la estadística descriptiva: medida de resumen para variables cuantitativas y cualitativas, y el estadígrafo de Ji cuadrado para la correlación entre variables. Resultados: el mayor porciento de niños con bajo peso al nacer correspondió a las madres comprendidas entre los 20-24 años y 30-34 años de edad y entre las 34.0-36.6 semanas y 37.0 semanas y más de gestación. La mayoría comenzaron la gestación con un peso adecuado, sin embargo, predominó la ganancia de insuficiente durante ésta. La hipertensión arterial predominó entre los antecedentes patológicos de las gestantes. Conclusiones: se ha demostrado que los factores de riesgo maternos tienen una importante asociación con el bajo peso al nacer, es por ello, la necesidad de identificarlos en el momento oportuno y modificarlos, con el objetivo de proporcionar bienestar materno y fetal.Introduction: low-weight at birth constitutes an enigma to the current science. Objective: to carry out an assessment of some maternal risk factors associated with low-weight at birth in Bahia Honda municipality from January 2006 to June 2009. Methods: an observational, descriptive and cross-sectional study was conducted which allowed characterizing women who

Late arrival in hospital during labour: any correlation with materno ...

African Journals Online (AJOL)

Background: Late arrival in labour is a common occurrence in my centre, It has been said to be associated with poor maternal and foetal outcome because of the lack of intrapartum materno-foetal monitoring. It gave me a great concern why booked patients should deliver in vehicles in 21st century. Objectives: Is to ...

Atención neonatal y materno con enfoque de riesgo

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Ruiz de Cárdenas Carmen Helena

1991-12-01

Full Text Available

En los últimos años el enfoque de la atención en salud ha estado orientado hacia la atención primaria ejercida dentro de una comunidad determinada y vinculada a los organismos de nivel primario. Este enfoque que de por sí es una estrategia muy importante para el progreso de las comunidades, no ha permitido el desarrollo de acciones desde los niveles de atención secundaria y terciaria hacia la comunidad y los organismos de primer nivel. En el presente trabajo se pretende desarrollar un programa docente asistencial coordinado por una enfermera, con la participación de las facultades de Enfermería y Medicina de la Universidad Nacional y el Instituto Materno Infantil e implementar algunas estrategias de atención primaria con la participación de otros profesionales y la coordinación inter- institucional, en un organismo de tercer nivel como es el Instituto Materno Infantil y proyectarlos hacia la comunidad y los centros de salud correspondientes al área de influencia de la institución.

Parvovirose congênita: relato de caso Congenital parvovirus infection: case report

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Daniela F. Gradia

1998-02-01

Full Text Available Apresentamos um caso de regressão espontânea de hidropisia fetal provavelmente causada por infecção materno-fetal pelo parvovírus B19. Além de hidropisia, observamos anemia e hipocontratilidade cardíaca no feto. O diagnóstico foi estabelecido pela soma dos achados ultra-sonográficos, detecção do vírus no soro materno, hemograma fetal e dosagem de enzimas hepáticas fetais.We report a case in which there was spontaneous regression of hydrops fetalis. Hydrops was probably caused by fetal infection with parvovirus B19. Anemia and hypokinesia of the heart were also observed. Diagnosis was accomplished by the ultrasound, virus detection in maternal serum, complete fetal blood count, and analysis of hepatic enzymes.

Angiotensin-(1?7) inhibits inflammation and oxidative stress to relieve lung injury induced by chronic intermittent hypoxia in rats

OpenAIRE

Lu, W.; Kang, J.; Hu, K.; Tang, S.; Zhou, X.; Yu, S.; Li, Y.; Xu, L.

2016-01-01

Obstructive sleep apnea is associated with inflammation and oxidative stress in lung tissues and can lead to metabolic abnormalities. We investigated the effects of angiotensin1–7 [Ang-(1–7)] on lung injury in rats induced by chronic intermittent hypoxia (CIH). We randomly assigned 32 male Sprague-Dawley rats (180–200 g) to normoxia control (NC), CIH-untreated (uCIH), Ang-(1–7)-treated normoxia control (N-A), and Ang-(1–7)-treated CIH (CIH-A) groups. Oxidative stress biomarkers were measured ...

High intensity aerobic exercise training improves chronic intermittent hypoxia-induced insulin resistance without basal autophagy modulation.

Science.gov (United States)

Pauly, Marion; Assense, Allan; Rondon, Aurélie; Thomas, Amandine; Dubouchaud, Hervé; Freyssenet, Damien; Benoit, Henri; Castells, Josiane; Flore, Patrice

2017-03-03

Chronic intermittent hypoxia (IH) associated with obstructive sleep apnea (OSA) is a major risk factor for cardiovascular and metabolic diseases (insulin resistance: IR). Autophagy is involved in the pathophysiology of IR and high intensity training (HIT) has recently emerged as a potential therapy. We aimed to confirm IH-induced IR in a tissue-dependent way and to explore the preventive effect of HIT on IR-induced by IH. Thirty Swiss 129 male mice were randomly assigned to Normoxia (N), Intermittent Hypoxia (IH: 21-5% FiO 2 , 30 s cycle, 8 h/day) or IH associated with high intensity training (IH HIT). After 8 days of HIT (2*24 min, 50 to 90% of Maximal Aerobic Speed or MAS on a treadmill) mice underwent 14 days IH or N. We found that IH induced IR, characterized by a greater glycemia, an impaired insulin sensitivity and lower AKT phosphorylation in adipose tissue and liver. Nevertheless, MAS and AKT phosphorylation were greater in muscle after IH. IH associated with HIT induced better systemic insulin sensitivity and AKT phosphorylation in liver. Autophagy markers were not altered in both conditions. These findings suggest that HIT could represent a preventive strategy to limit IH-induced IR without change of basal autophagy.

Fetal activity patterns in hypertensive pregnancies.

Science.gov (United States)

Rayburn, W F

1982-01-01

This prospective investigation attempts to determine whether the maternal recording of perceived fetal motion is useful for fetal assessment in pregnancies complicated by hypertension. During a 21 month period, 124 patients whose pregnancies were complicated by either chronic or pregnancy-induced hypertension participated. The number of perceived movements per hour (24 +/- 11, mean +/- S.D.) and evidence for fetal inactivity (7 cases, 6%) did not vary significantly from a control group of normotensive pregnancies (p greater than 0.05). Fetal inactivity was predictive of an unfavorable perinatal outcome in 6 of 7 cases, including the three stillborn infants. No perinatal deaths occurred among the 117 hypertensive pregnancies with active fetuses, and the 6 cases with an unfavorable outcome were associated with mild intrauterine growth delay, prematurity, or acute changes such as placental abruption or umbilical cord accidents. Realizing these limitations, a record of fetal inactivity is worthwhile in managing the pregnancy complicated by hypertension.

Chronic intermittent hypoxia activates nuclear factor-κB in cardiovascular tissues in vivo

International Nuclear Information System (INIS)

Greenberg, Harly; Ye Xiaobing; Wilson, David; Htoo, Aung K.; Hendersen, Todd; Liu Shufang

2006-01-01

Obstructive sleep apnea (OSA) is an important risk factor for cardiovascular morbidity and mortality. The mechanisms through which OSA promotes the development of cardiovascular disease are poorly understood. In this study, we tested the hypotheses that chronic exposure to intermittent hypoxia and reoxygenation (CIH) is a major pathologic factor causing cardiovascular inflammation, and that CIH-induces cardiovascular inflammation and pathology by activating the NF-κB pathway. We demonstrated that exposure of mice to CIH activated NF-κB in cardiovascular tissues, and that OSA patients had markedly elevated monocyte NF-κB activity, which was significantly decreased when obstructive apneas and their resultant CIH were eliminated by nocturnal CPAP therapy. The elevated NF-κB activity induced by CIH is accompanied by and temporally correlated to the increased expression of iNOS protein, a putative and important NF-κB-dependent gene product. Thus, CIH-mediated NF-κB activation may be a molecular mechanism linking OSA and cardiovascular pathologies seen in OSA patients

Óbito fetal no descolamento prematuro da placenta: comparação entre dois períodos Fetal death in placental abruption: comparison of two different time periods

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Fábio Roberto Cabar

2008-06-01

Full Text Available OBJETIVOS: Comparar a incidência de descolamento prematuro da placenta (DPP, de óbito fetal e o perfil dos fatores maternos associados ao óbito fetal em casos acometidos por DPP em dois períodos, num mesmo serviço médico terciário. MÉTODOS: Avaliação retrospectiva dos casos de DPP ocorridos entre 1º de janeiro de 1994 a 31 de dezembro de 1997 (período 94-97 e 1º de abril de 2001 a 31 de março de 2005 (período 01-05, em gestações únicas com peso do recém-nascido superior a 500g e idade gestacional acima da 20ª semana. Foram analisados os fatores: idade materna, cor, antecedentes obstétricos, ocorrência de hipertensão arterial ou ruptura prematura de membranas ovulares, presença de sangramento genital, hemoâmnio, características do tônus uterino, ocorrência de CIVD, insuficiência renal, anemia puerperal, bem como a idade gestacional e peso do RN no parto. RESULTADOS: No período 94-97, foram realizados 7.692 partos e o DPP ocorreu em 0,78% (60 casos, e no período 01-05 foram 8.644 partos com 0,59% (51 casos de DPP, sem diferença significativa. No período 94-97, a proporção de casos sem sangramento genital foi significativamente maior no grupo que evoluiu com óbito fetal quando comparado aos casos cujo feto nasceu vivo (57,9% vs 22,0%; p=0,01. No período 01-05, a proporção de casos com hipertonia uterina foi significativamente maior no grupo que evoluiu com óbito fetal quando comparado aos casos com recém-nascido nativivo (66,7% vs 29,3%; p=0,04. As complicações maternas no pós-parto foram mais freqüentes nos casos de óbito fetal, em ambos os períodos 94-97 e 01-05 (31,6% vs 4,9%, p=0,009, e, 50,0% vs 5,1%, p=0,001, respectivamente. CONCLUSÃO: O DPP permanece grave problema obstétrico com conseqüências potencialmente fatais, principalmente nos casos com maior área de descolamento da placenta. Maior gravidade do quadro clínico materno é observada nos casos de óbito fetal.OBJECTIVE: To compare the

Quality of life and functional status after revascularization or conservative treatment in patients with intermittent claudication

DEFF Research Database (Denmark)

Hedeager Momsen, Anne-Mette; Bach Jensen, Martin; Norager, Charlotte Buchard

2011-01-01

Revascularization of patients with intermittent claudication (IC) is recommended only for selected patients who have chronic pain or disabling disease. However, improvement in the quality of life (QoL) could justify more widespread use.......Revascularization of patients with intermittent claudication (IC) is recommended only for selected patients who have chronic pain or disabling disease. However, improvement in the quality of life (QoL) could justify more widespread use....

ALEITAMENTO MATERNO E AS CRENÇAS ALIMENTARES

OpenAIRE

Ichisato,Sueli Mutsumi Tsukuda; Shimo,Antonieta Keiko Kakuda

2001-01-01

A hipogalactia tem levado ao desmame precoce. As crenças e os tabus influenciam a alimentação materna durante a lactação. O presente estudo tem como objetivo identificar lactogogos regionais utilizados como suporte do aleitamento materno (AM), pautados nos tabus e crenças. Trata-se de um estudo de caso utilizando a análise de prosa(12). Alimentar-se ou não de certos alimentos, ter vivenciado a amamentação, as crenças transmitidas por familiares e médicos, crescimento e desenvolvimento da cria...

Estilo de crianza materno y el desarrollo emocional en una cuna- jardín Callao-2014

OpenAIRE

Vera Condori, Gabi Milagritos

2015-01-01

La presente investigación educativa titulada “Estilo de crianza materno y el desarrollo emocional en una cuna-jardín Callao-2014”, siendo el objetivo determinar la asociación que existe entre el estilo de crianza materno y el desarrollo emocional de los niños de 2 años de la Institución Educativa Inicial “Stella Maris”. La metodología de la investigación es de tipo Básica o fundamental ya que sólo busca ampliar y profundizar los conocimientos científicos existentes acerca ...

Validation of housekeeping genes in the brains of rats submitted to chronic intermittent hypoxia, a sleep apnea model.

Science.gov (United States)

Julian, Guilherme Silva; de Oliveira, Renato Watanabe; Perry, Juliana Cini; Tufik, Sergio; Chagas, Jair Ribeiro

2014-01-01

Obstructive sleep apnea (OSA) is a syndrome characterized by intermittent nocturnal hypoxia, sleep fragmentation, hypercapnia and respiratory effort, and it has been associated with several complications, such as diabetes, hypertension and obesity. Quantitative real-time PCR has been performed in previous OSA-related studies; however, these studies were not validated using proper reference genes. We have examined the effects of chronic intermittent hypoxia (CIH), which is an experimental model mainly of cardiovascular consequences of OSA, on reference genes, including beta-actin, beta-2-microglobulin, glyceraldehyde-3-phosphate dehydrogenase, hypoxanthine guanine phosphoribosyl transferase and eukaryotic 18S rRNA, in different areas of the brain. All stability analyses were performed using the geNorm, Normfinder and BestKeeper software programs. With exception of the 18S rRNA, all of the evaluated genes were shown to be stable following CIH exposure. However, gene stability rankings were dependent on the area of the brain that was analyzed and varied according to the software that was used. This study demonstrated that CIH affects various brain structures differently. With the exception of the 18S rRNA, all of the tested genes are suitable for use as housekeeping genes in expression analyses.

Ventilatory drive is enhanced in male and female rats following chronic intermittent hypoxia.

Science.gov (United States)

Edge, D; Skelly, J R; Bradford, A; O'Halloran, K D

2009-01-01

Obstructive sleep apnoea is characterized by chronic intermittent hypoxia (CIH) due to recurrent apnoea. We have developed a rat model of CIH, which shows evidence of impaired respiratory muscle function. In this study, we wished to characterize the ventilatory effects of CIH in conscious male and female animals. Adult male (n=14) and female (n=8) Wistar rats were used. Animals were placed in chambers daily for 8 h with free access to food and water. The gas supply to one half of the chambers alternated between air and nitrogen every 90 s, for 8 h per day, reducing ambient oxygen concentration in the chambers to 5% at the nadir (intermittent hypoxia; n=7 male, n=4 female). Air supplying the other chambers was switched every 90 s to air from a separate source, at the same flow rates, and animals in these chambers served as controls (n=7 male, n=4 female). Ventilatory measurements were made in conscious animals (typically sleeping) after 10 days using whole-body plethysmography. Normoxic ventilation was increased in both male and female CIH-treated rats compared to controls but this did not achieve statistical significance. However, ventilatory drive was increased in CIH-treated rats of both sexes as evidenced by significant increases in mean and peak inspiratory flow. Ventilatory responses to acute hypoxia (F(I)O(2) = 0.10; 6 min) and hyperoxic hypercapnia (F(I)CO(2) = 0.05; 6 min) were unaffected by CIH treatment in male and female rats (P>0.05, ANOVA). We conclude that CIH increases respiratory drive in adult rats. We speculate that this represents a form of neural plasticity that may compensate for respiratory muscle impairment that occurs in this animal model.

Currículo en el nivel preescolar costarricense: El Ciclo Materno Infantil (CMI

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Ana Lucía Chaves-Álvarez

2009-12-01

Full Text Available Recibido 20 de abril de 2009 • Aprobado 14 de setiembre de 2009 • Corregido 15 de octubre de 2009     Este artículo aborda la conceptuación y la descripción del Ciclo Materno Infantil como parte del nivel de preescolar del sistema educativo formal costarricense. Con el propósito de tener una visión más amplia de este Ciclo, se hace un repaso por el concepto de currículo, así como de los elementos que lo conforman, y, luego, se detallan específicamente los aspectos relacionados con el currículo de preescolar costarricense del Ciclo Materno Infantil, tomando como punto de partida el Programa de Estudio que se elaboró para atender este Ciclo en el sistema educativo de Costa Rica.

Variations in management of mild prenatal hydronephrosis among maternal-fetal medicine obstetricians, and pediatric urologists and radiologists.

Science.gov (United States)

Zanetta, Vitor C; Rosman, Brian M; Bromley, Bryan; Shipp, Thomas D; Chow, Jeanne S; Campbell, Jeffrey B; Herndon, C D Anthony; Passerotti, Carlo C; Cendron, Marc; Retik, Alan B; Nguyen, Hiep T

2012-11-01

There are no current guidelines for diagnosing and managing mild prenatal hydronephrosis. Variations in physician approach make it difficult to analyze outcomes and establish optimal management. We determined the variability of diagnostic approach and management regarding prenatal hydronephrosis among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists. Online surveys were sent to mailing lists for national societies for each specialty. Participants were surveyed regarding criteria for diagnosing mild prenatal hydronephrosis and recommendations for postnatal management, including use of antibiotic prophylaxis, followup scheduling and type of followup imaging. A total of 308 maternal-fetal medicine obstetricians, 126 pediatric urologists and 112 pediatric radiologists responded. Pediatric urologists and radiologists were divided between Society for Fetal Urology criteria and use of anteroposterior pelvic diameter for diagnosis, while maternal-fetal medicine obstetricians preferred using the latter. For postnatal evaluation radiologists preferred using personal criteria, while urologists preferred using anteroposterior pelvic diameter or Society for Fetal Urology grading system. There was wide variation in the use of antibiotic prophylaxis among pediatric urologists. Regarding the use of voiding cystourethrography/radionuclide cystography in patients with prenatal hydronephrosis, neither urologists nor radiologists were consistent in their recommendations. Finally, there was no agreement on length of followup for mild prenatal hydronephrosis. We observed a lack of uniformity regarding grading criteria in diagnosing hydronephrosis prenatally and postnatally among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists. There was also a lack of agreement on the management of mild intermittent prenatal hydronephrosis, resulting in these cases being managed inconsistently. A unified set of guidelines for

The Effects of Intrauterine Malnutrition on Maternal-Fetal Cholesterol Transport and Fetal Lipid Synthesis in Mice

NARCIS (Netherlands)

van Meer, Hester; van Straten, Esther M. E.; Baller, Julius F. W.; van Dijk, Theo H.; Kuipers, Folkert; Verkade, Henkjan J.; Plosch, Torsten

Intrauterine malnutrition is associated with increased susceptibility to chronic diseases in adulthood. Growth-restricted infants display a less favorable lipid profile already shortly postnatal. Maternal low protein diet (LPD) during gestation is a well-defined model of fetal programming in rodents

Tempo de aleitamento materno exclusivo em recém-nascidos prematuros e a termo Time of exclusive breastfeeding of preterm and term newborn babies

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Waléria Ferreira da Silva

2012-01-01

Full Text Available OBJETIVOS: determinar o tempo de aleitamento materno exclusivo de recém nascidos prematuros e observar se estes apresentam um índice de aleitamento materno exclusivo diferente do apresentado pelo município de Maceió, na I e II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras e no Distrito Federal. Além de comparar o tempo de aleitamento materno e aleitamento materno exclusivo de recém nascidos prematuros e a termo e verificar as causas do desmame precoce e suas consequências. MÉTODO: trata-se de uma investigação de campo, de caráter exploratório e longitudinal da prevalência do aleitamento materno exclusivo de recém nascidos prematuro e à termo. RESULTADOS: o percentual de aleitamento materno e de aleitamento materno exclusivo de prematuros aos 6 meses. Houve diferença significante para a variável peso ao nascimento. Dentre as causas do desmame precoce, os fatores educacionais seguidos dos fatores culturais apareceram em maior porcentagem. Como consequência do desmame precoce a prática de hábitos orais ocorreu em 98,1% das crianças. CONCLUSÃO: as crianças prematuras permaneceram mais tempo em aleitamento materno e em aleitamento materno exclusivo que as nascidas a termo. Os fatores educacionais e culturais foram as principais causas do desmame precoce e sua consequência foi o uso de chupeta e mamadeira.PURPOSE: to determine the benefits of exclusive breastfeeding. However, only a minority of women engage in breastfeeding practices. This research is aimed to establish the time of exclusive breastfeeding as for preterm babies and observe whether they have a different level of exclusive breastfeeding in relation to the level achieved by the city of Maceió at the I and II PPAM-CDF. Additionally, other goals are to compare the breastfeeding and exclusive breastfeeding types of preterm and term newborns and determine the causes of early weaning and its consequences. METHOD: this is a field investigation

Tempo de aleitamento materno exclusivo em recém-nascidos prematuros e a termo Time of exclusive breastfeeding of preterm and term newborn babies

Directory of Open Access Journals (Sweden)

Waléria Ferreira da Silva

2013-02-01

Full Text Available OBJETIVOS: determinar o tempo de aleitamento materno exclusivo de recém nascidos prematuros e observar se estes apresentam um índice de aleitamento materno exclusivo diferente do apresentado pelo município de Maceió, na I e II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras e no Distrito Federal. Além de comparar o tempo de aleitamento materno e aleitamento materno exclusivo de recém nascidos prematuros e a termo e verificar as causas do desmame precoce e suas consequências. MÉTODO: trata-se de uma investigação de campo, de caráter exploratório e longitudinal da prevalência do aleitamento materno exclusivo de recém nascidos prematuro e à termo. RESULTADOS: o percentual de aleitamento materno e de aleitamento materno exclusivo de prematuros aos 6 meses. Houve diferença significante para a variável peso ao nascimento. Dentre as causas do desmame precoce, os fatores educacionais seguidos dos fatores culturais apareceram em maior porcentagem. Como consequência do desmame precoce a prática de hábitos orais ocorreu em 98,1% das crianças. CONCLUSÃO: as crianças prematuras permaneceram mais tempo em aleitamento materno e em aleitamento materno exclusivo que as nascidas a termo. Os fatores educacionais e culturais foram as principais causas do desmame precoce e sua consequência foi o uso de chupeta e mamadeira.PURPOSE: to determine the benefits of exclusive breastfeeding. However, only a minority of women engage in breastfeeding practices. This research is aimed to establish the time of exclusive breastfeeding as for preterm babies and observe whether they have a different level of exclusive breastfeeding in relation to the level achieved by the city of Maceió at the I and II PPAM-CDF. Additionally, other goals are to compare the breastfeeding and exclusive breastfeeding types of preterm and term newborns and determine the causes of early weaning and its consequences. METHOD: this is a field investigation

Aleitamento materno e seus benefícios: primeiro passo para a promoção saúde

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Izabella Santos Nogueira de Andrade

2014-06-01

Full Text Available O aleitamento materno é reconhecido pelo Ministério da Saúde, em consonância com a Organização Mundial de Saúde (OMS e Fundo das Nações Unidas para a Infância (UNICEF, como uma das estratégias fundamentais para a diminuição dos índices de mortalidade neonatal(1. É pacífico o fato de que o aleitamento materno deva ser iniciado após o parto, uma vez que o colostro é considerado a primeira imunização do neonato pela presença de imunoglobulinas e maior quantidade de proteínas e vitamina A(2. Recomenda-se o aleitamento materno exclusivo até o sexto mês de vida, podendo ser dado como suplemento alimentar até os dois anos de idade ou mais(3,4. Então, é papel do profissional de saúde, em qualquer área de atuação, incentivar, estimular e apoiar o aleitamento materno(5. Dentre as ações de promoção, proteção e apoio ao aleitamento materno do Ministério da Saúde implementadas nos últimos 30 anos destacam-se a Iniciativa Hospital Amiga da Criança (IHAC, que prioriza os 10 passos para o aleitamento materno, a criação da Norma Brasileira de Comercialização de Alimentos para Lactentes (NBCAL, a Rede Brasileira de Bancos de Leite Humano (REDEBLH, as campanhas anuais como Semana Mundial da Amamentação (SMAM e Dia Nacional de Doação de Leite Humano, e, mais recentemente, a Rede Amamenta Brasil(6. Observam-se os inúmeros benefícios do aleitamento materno relacionados aos aspectos nutricionais e emocionais, em que esse aleitamento aparece como fonte de nutrientes, em quantidade e qualidade adequadas ao bebê, sendo ao mesmo tempo promotor da relação mãe-filho(5. A interação mãe-filho durante a amamentação favorece o desenvolvimento dos laços afetivos para a aprendizagem mútua, visto que gera afeto, segurança, acolhimento e contribui para o desenvolvimento da linguagem e a construção da inteligência. A mãe aprende sobre o comportamento do bebê e sobre seu papel de mãe; o bebê aprende a se relacionar

Chronic intermittent hypoxia induces changes on the expression and activity of neprilysin (EC 3.4.24.16) in the brain of rats.

Science.gov (United States)

de Oliveira, Renato W; Julian, Guilherme S; Perry, Juliana C; Tufik, Sergio; Chagas, Jair R

2018-04-24

Obstructive sleep apnea (OSA) is a frequent sleeping breathing disorder associated with cognitive impairments. Neprilysin (NEP) is responsible for degrading several substrates related to cognition; however, the effect of chronic intermittent hypoxia (CIH) on NEP is still unknown. This study aimed to evaluate the expression and activity of NEP under CIH in cognitive-related brain structures. Western blot, qRT-PCR and enzyme activity assay, demonstrated that a six-week intermittent hypoxia increased NEP expression and activity, selectively in temporal cortex, but not in the hippocampus and frontal cortex. The increase in NEP activity and expression was reverted followed by two weeks recovery in normoxia. These data show that CIH protocol increases the expression and activity of NEP selectively in the temporal cortex. Additional mechanisms must be investigated to elucidate the effects of CIH in cognition. Copyright © 2018. Published by Elsevier B.V.

Políticas del amor materno, Chile 1927-1937

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Javiera Poblete Vargas

2015-11-01

Full Text Available El presente artículo, se ha propuesto determinar la utilidad política y económica que los médicos y las “visitadoras sociales” le confirieron al amor materno en Chile, en el tratamiento del problema del Binomio “Madre y Niño” al interior de sus artículos escritos en cuatro revistas de circulación científica entre 1927 y1937: Servicio Social, Beneficencia, Asistencia Social y Acción Social. Con las herramientas teóricas que le ha proporcionado a la historiografía los estudios culturales, los estudios de género, el análisis crítico del discurso y la filosofía política, analizaremos las fuentes históricas disponibles y buscaremos demostrar que en el proyecto político e ideológico de los profesionales de la salud y del servicio social,  dicha dimensión afectiva, tendrá una utilidad  política y económica, en la medida que logre naturalizar y afianzar en las mujeres del pueblo su rol social/sexual materno para la formación y cuidado de la vida de futuras madres y ciudadanos del país, en medio de un escenario de crisis

Triploidia fetal associada à diminuição da subunidade beta e do estriol não-conjugado no soro materno Fetal triploidy associated with low levels of unconjugated estriol and beta-subunit in maternal serum

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Eduardo Vieira Neto

1999-05-01

Full Text Available Relatamos um caso de triploidia fetal não-molar detectada na 20ª semana gestacional por cordocentese realizada em razão de estudo ultra-sonográfico que revelou retardo do crescimento intra-uterino e grave oligoidrâmnio. Na 19ª semana foram verificados acentuada diminuição da subunidade beta livre da gonadotrofina coriônica humana e do estriol não-conjugado e níveis de alfa-fetoproteína normais, apontando para um risco aumentado de síndrome de Edwards. Houve morte fetal um dia após a cordocentese e a resolução do caso foi por parto vaginal induzido com misoprostol e ocitocina, sob analgesia peridural. Estudo cromossômico das células sangüíneas fetais revelou o cariótipo 69,XXX. O grave retardo do crescimento intra-uterino, a macrocefalia, constatada no estudo anatomopatológico do feto, e os níveis muito baixos de hCG e de estriol não-conjugado sugerem um caso de triploidia por diginia, fertilização de um óvulo diplóide por um espermatozóide haplóide.We report a case of nonmolar fetal triploidy detected by fetal blood sampling at 20 weeks of gestation, performed as an investigation of intrauterine growth retardation and severe oligohydramnios found by ultrasound scan. At 19 weeks of gestation very low levels of maternal free serum beta-subunit of human chorionic gonadotropin and unconjugated estriol, and normal levels of alpha-fetoprotein were found, which were interpreted as a high risk of fetal Edwards syndrome. Fetal death supervened the day after fetal blood sampling, and the pregnancy was terminated by vaginal delivery induced by misoprostol and oxytocin, under epidural anesthesia. Chromosome study of the fetal blood cells showed a 69,XXX karyotype. The severe intrauterine growth retardation and macrocephaly noted on pathological review plus the very low levels of hCG and unconjugated estriol suggest a fetal gynoid triploidy case, caused by the fertilization of a diploid egg by a haploid sperm.

Cistoadenocarcinoma mucinoso de ovario en estadio terminal, en embarazo complicado con muerte fetal tardía. Presentación de un caso.

OpenAIRE

Hansy Díaz Pérez; Rafael Pérez Castro; Juan Carlos Maura Tandrón; Caridad Cordovés Brito; Julio Concepción Bombino

2007-01-01

Presentamos un caso de Cistoadenocarcinoma mucinoso de ovario en un embarazo de 36.4 semanas de gestación complicado con muerte fetal tardía. que ingresó en el Hospital Materno Provincial “Isabel María de Valdivia y Salas de Sancti-Spíritus” diagnosticándose el tumor de ovario en un estadío avanzado de la enfermedad con un cuadro clínico florido y múltiples hallazgos al exámen físico que motivó varios planteamientos y dudas en el diagnóstico ,no realizándose el mismo durante la vigilancia pr...

Atividade física durante a gestação e associação com indicadores de saúde materno-infantil Actividad física durante la gestación y asociación con indicadores de salud materno-infantil Physical activity during pregnancy and its association with maternal and child health indicators

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Samuel C Dumith

2012-04-01

Full Text Available OBJETIVO: Analisar fatores associados à prática de atividade física durante a gestação e sua relação com indicadores de saúde materno-infantil. MÉTODOS: Estudo transversal realizado com todos os nascimentos ocorridos em maternidades no município de Rio Grande, RS, durante o ano de 2007 (N = 2.557. As informações foram obtidas por entrevista, por meio de um questionário pré-codificado aplicado às mães. Os desfechos de saúde materno-infantil analisados foram: hospitalização durante a gravidez, parto por cesárea, prematuridade (idade gestacional menor de 37 semanas, baixo peso ao nascer (OBJETIVO: Analizar factores asociados con la práctica de actividad física durante la gestación y su relación con indicadores de salud materno-infantil. MÉTODOS: Estudio transversal realizado con todos los nacimientos ocurridos en maternidades en el municipio de Rio Grande, Sur de Brasil, durante el año 2007 (N=2.557. Las informaciones fueron obtenidas por entrevista, por medio de un cuestionario pre-codificado aplicado a las madres. Los desenlaces de salud materno-infantil analizados fueron: hospitalización durante el embarazo, parto por cesárea, prematuridad (edad gestacional menor de 37 semanas, bajo peso al nacer (OBJECTIVE: To analyze factors associated with the practice of physical activity during pregnancy and its relationship to maternal and child health indicators. METHODS: Cross-sectional study carried out with all births that occurred at maternity hospitals in the municipality of Rio Grande (Southern Brazil during the year of 2007 (N = 2,557. Information was collected through interviews, by means of a pre-coded questionnaire administered to the mothers. The analyzed maternal and child health outcomes were: hospitalization during pregnancy, cesarean delivery, preterm birth (gestational age < 37 weeks, low birth weight (< 2500g, and fetal death. RESULTS: A total of 32.8% of mothers (95%CI 31.0;34.6 reported having practiced

Interrupción terapéutica del embarazo en el Instituto Nacional Materno Perinatal , Perú, 2009-2013

OpenAIRE

Guevara Ríos, Enrique

2016-01-01

Objetivo: Describir las causas de la interrupción terapéutica del embarazo en el Instituto Nacional Materno Perinatal. Diseño: Estudio observacional descriptivo, tipo revisión de casos. Institución: Instituto Nacional Materno Perinatal, Lima, Perú. Material: Solicitudes para interrupción terapéutica del embarazo. Métodos: Se revisó todos los casos de interrupción terapéutica del embarazo realizados en los diferentes servicios de la institución entre los años 2009 y el 2013. Principales medida...

[The value of Doppler sonography in the detection of fetal hypoxia].

Science.gov (United States)

Aranyosi, János; Zatik, János; Juhász, A Gábor; Fülesdi, Béla; Major, Tamás

2002-10-27

Doppler ultrasound has become a part of routine antenatal fetal surveillance during the past two decades. It provides insight into the utero-placental and fetal arterial, venous circulation non-invasively. Doppler examination has a key role in the detection of hypoxic risk since abnormal blood flow patterns can be demonstrated before the clinical manifestation of fetal disorder. Doppler velocimetry facilitates judgment in the diagnosis, monitoring fetal well-being during pregnancy and labor, scheduling antenatal tests and timing delivery. Authors review the effects of chronic and acute hypoxia on fetal hemodynamics. On the basis of the present knowledge and experience a brief summary is given about the role of Doppler velocimetry in the early detection of hypoxic fetal jeopardy during pregnancy and labor.

Características técnicas y resultados maternos y perinatales de las pacientes isoinmunizadas sometidas a transfusión fetal intrauterina Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 1998-2006

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Carlos Alberto Rebolledo López

2008-02-01

Full Text Available

OBJETIVO: describir las características sociodemográficas, clínicas y técnicas y los resultados maternos y perinatales de las pacientes isoinmunizadas sometidas a transfusión fetal intrauterina (TFI en el Hospital Universitario San Vicente de Paúl (HUSVP de Medellín, Colombia, entre los años 1998 y 2006.

METODOLOGÍA: se realizó un estudio descriptivo retrospectivo de 13 pacientes isoinmunizadas que requirieron TFI en el HUSVP entre 1998 y 2006. Se analizaron variables como ruptura prematura de membranas ovulares (RPMO, corioamnionitis, sufrimiento fetal agudo (SFA, muerte perinatal e hidropesía fetal; además se describen las características técnicas de las transfusiones así como las complicaciones relacionadas con el procedimiento.

RESULTADOS: a un total de 13 madres isoinmunizadas se les hicieron 29 TFI. La tasa de supervivencia fetal fue del 77%. Se complicaron 5 de las madres (38,5% así: RPMO en 3 casos (23% y corioamnionitis en 2 (15,4%. Seis fetos (46,1% presentaron al menos una complicación. Tres fetos fallecieron (23%, 2 (15,4% presentaron hidropesía inmune, y en 4 (30,8% hubo SFA. En total se realizaron 29 transfusiones durante las cuales hubo 11complicaciones en 6 fetos así: bradicardia fetal 4 (13,7%, desgarro del cordón 1 (3,4%, hematomas del cordón 2 (6,8% y sangrado postransfusión 4

O papel do aleitamento materno no desenvolvimento de alergias respiratórias = The role of breastfeeding on the development of respiratory allergies

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Silva, Denise Rizzo Nique da

2009-01-01

Conclusões: apesar das muitas pesquisas sobre o tema, não se pode concluir se o aleitamento materno ajudará a prevenir a sensibilização a alérgenos em crianças com enfermidades como asma. No entanto, por todas as suas conhecidas vantagens, o aleitamento materno exclusivo deve ser encorajado nos primeiros meses de vida

ALEITAMENTO MATERNO E AS CRENÇAS ALIMENTARES

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Sueli Mutsumi Tsukuda Ichisato

Full Text Available A hipogalactia tem levado ao desmame precoce. As crenças e os tabus influenciam a alimentação materna durante a lactação. O presente estudo tem como objetivo identificar lactogogos regionais utilizados como suporte do aleitamento materno (AM, pautados nos tabus e crenças. Trata-se de um estudo de caso utilizando a análise de prosa(12. Alimentar-se ou não de certos alimentos, ter vivenciado a amamentação, as crenças transmitidas por familiares e médicos, crescimento e desenvolvimento da criança foram os fatores que estimularam o AM na nossa pesquisa

Atrial natriuretic factor in maternal and fetal sheep

International Nuclear Information System (INIS)

Cheung, C.Y.; Gibbs, D.M.; Brace, R.A.

1987-01-01

To determine atrial natriuretic factor (ANF) concentrations in the circulation and body fluids of adult pregnant sheep and their fetuses, pregnant ewes were anesthetized with pentobarbital sodium, and the fetuses were exteriorized for sampling. ANF concentration, as measured by radioimmunoassay, was 47 +/- 6 (SE) pg/ml in maternal plasma, which was significantly higher than the 15 +/- 3 pg/ml in maternal urine. In the fetus, plasma ANF concentration was 265 +/- 49 pg/ml, 5.6 times that in maternal plasma. No umbilical arterial and venous difference in ANF concentration was observed. Fetal urine ANF concentration was significantly lower than that in fetal plasma, and was similar to that measured in amniotic and allantoic fluid. In chronically catheterized maternal and fetal sheep, fetal plasma ANF was again 5.1 times that in maternal plasma, and these levels were not different from those measured in acutely anesthetized animals. These results demonstrate that immunoreactive ANF is present in the fetal circulation at levels higher than those found in the mother. The low concentration of ANF in fetal urine suggests that ANF is probably metabolized and/or reabsorbed by the fetal kidney

Anomalia anorretal e cuidados maternos

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Manuela Costa Melo

Full Text Available O objetivo deste artigo foi realizar um estudo de revisão bibliográfica sobre anomalia anorretal e cuidados maternos. O assunto foi abordado por meio de revisão integrativa realizada em consulta de artigos publicados nas bases de dados indexados na Biblioteca Virtual em Saúde. Foram identificadas 25 publicações que atenderam aos critérios de inclusão e exclusão pré-estabelecidos. Nos estudos analisados observaram-se distintos desenhos metodológicos demonstrando que algumas crianças nascidas com anomalia anorretal necessitam de cirurgia de urgência. Os profissionais de saúde, juntamente aos pais, precisam desenvolver parcerias que possibilitem um acompanhamento a longo prazo e orientações cuidadosas. Faz-se necessário que novas pesquisas sejam realizadas sobre o tema, com propostas metodológicas que retratem melhor a essência do cuidado com as crianças estomizadas

Anomalia anorretal e cuidados maternos

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Manuela Costa Melo

2011-02-01

Full Text Available O objetivo deste artigo foi realizar um estudo de revisão bibliográfica sobre anomalia anorretal e cuidados maternos. O assunto foi abordado por meio de revisão integrativa realizada em consulta de artigos publicados nas bases de dados indexados na Biblioteca Virtual em Saúde. Foram identificadas 25 publicações que atenderam aos critérios de inclusão e exclusão pré-estabelecidos. Nos estudos analisados observaram-se distintos desenhos metodológicos demonstrando que algumas crianças nascidas com anomalia anorretal necessitam de cirurgia de urgência. Os profissionais de saúde, juntamente aos pais, precisam desenvolver parcerias que possibilitem um acompanhamento a longo prazo e orientações cuidadosas. Faz-se necessário que novas pesquisas sejam realizadas sobre o tema, com propostas metodológicas que retratem melhor a essência do cuidado com as crianças estomizadas

Evolução da assistência materno-infantil na cidade de São Paulo (1984-1996

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Carlos Augusto Monteiro

2000-12-01

Full Text Available OBJETIVO: Descrever a evolução da assistência materno-infantil, com base nas informações extraídas de dois inquéritos domiciliares realizados nos anos de 1984/85 e de 1995/96, na cidade de São Paulo, SP. MÉTODOS: Foram estudadas amostras probabilísticas da população entre zero e 59 meses de idade: 1.016 crianças em 1984/85 e 1.280 crianças em 1995/96. Três componentes da assistência materno-infantil foram investigados: assistência pré-natal, assistência ao parto e ao recém-nascido e assistência de puericultura. RESULTADOS: Aspectos favoráveis da evolução da assistência materno-infantil na cidade de São Paulo foram a manutenção da cobertura universal da assistência hospitalar ao parto, a expansão substancial do alojamento conjunto mãe-filho na maternidade, o aumento no número de consultas de puericultura no primeiro ano de vida e, sobretudo, a universalização da cobertura das vacinas BCG, tríplice e anti-sarampo. Aspectos desfavoráveis foram o progresso muito modesto e claramente insuficiente da assistência pré-natal, a manutenção de quase 50% de cesarianas e a não expansão da puericultura após o primeiro ano de vida. CONCLUSÕES: Estimativas sobre a evolução da assistência materno-infantil no conjunto das áreas urbanas do País em período semelhante confirma e acentua o desempenho insatisfatório da assistência pré-natal na cidade de São Paulo. Comparações favoráveis a São Paulo são registradas apenas quanto a cobertura vacinal. A influência que mudanças na assistência materno-infantil podem ter exercido sobre a evolução de diferentes indicadores do estado de saúde das crianças da cidade é examinada em artigos subseqüentes.

Evolução da assistência materno-infantil na cidade de São Paulo (1984-1996

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Monteiro Carlos Augusto

2000-01-01

Full Text Available OBJETIVO: Descrever a evolução da assistência materno-infantil, com base nas informações extraídas de dois inquéritos domiciliares realizados nos anos de 1984/85 e de 1995/96, na cidade de São Paulo, SP. MÉTODOS: Foram estudadas amostras probabilísticas da população entre zero e 59 meses de idade: 1.016 crianças em 1984/85 e 1.280 crianças em 1995/96. Três componentes da assistência materno-infantil foram investigados: assistência pré-natal, assistência ao parto e ao recém-nascido e assistência de puericultura. RESULTADOS: Aspectos favoráveis da evolução da assistência materno-infantil na cidade de São Paulo foram a manutenção da cobertura universal da assistência hospitalar ao parto, a expansão substancial do alojamento conjunto mãe-filho na maternidade, o aumento no número de consultas de puericultura no primeiro ano de vida e, sobretudo, a universalização da cobertura das vacinas BCG, tríplice e anti-sarampo. Aspectos desfavoráveis foram o progresso muito modesto e claramente insuficiente da assistência pré-natal, a manutenção de quase 50% de cesarianas e a não expansão da puericultura após o primeiro ano de vida. CONCLUSÕES: Estimativas sobre a evolução da assistência materno-infantil no conjunto das áreas urbanas do País em período semelhante confirma e acentua o desempenho insatisfatório da assistência pré-natal na cidade de São Paulo. Comparações favoráveis a São Paulo são registradas apenas quanto a cobertura vacinal. A influência que mudanças na assistência materno-infantil podem ter exercido sobre a evolução de diferentes indicadores do estado de saúde das crianças da cidade é examinada em artigos subseqüentes.

Daily intermittent hypoxia enhances walking after chronic spinal cord injury

Science.gov (United States)

Hayes, Heather B.; Jayaraman, Arun; Herrmann, Megan; Mitchell, Gordon S.; Rymer, William Z.

2014-01-01

Objectives: To test the hypothesis that daily acute intermittent hypoxia (dAIH) and dAIH combined with overground walking improve walking speed and endurance in persons with chronic incomplete spinal cord injury (iSCI). Methods: Nineteen subjects completed the randomized, double-blind, placebo-controlled, crossover study. Participants received 15, 90-second hypoxic exposures (dAIH, fraction of inspired oxygen [Fio2] = 0.09) or daily normoxia (dSHAM, Fio2 = 0.21) at 60-second normoxic intervals on 5 consecutive days; dAIH was given alone or combined with 30 minutes of overground walking 1 hour later. Walking speed and endurance were quantified using 10-Meter and 6-Minute Walk Tests. The trial is registered at ClinicalTrials.gov (NCT01272349). Results: dAIH improved walking speed and endurance. Ten-Meter Walk time improved with dAIH vs dSHAM after 1 day (mean difference [MD] 3.8 seconds, 95% confidence interval [CI] 1.1–6.5 seconds, p = 0.006) and 2 weeks (MD 3.8 seconds, 95% CI 0.9–6.7 seconds, p = 0.010). Six-Minute Walk distance increased with combined dAIH + walking vs dSHAM + walking after 5 days (MD 94.4 m, 95% CI 17.5–171.3 m, p = 0.017) and 1-week follow-up (MD 97.0 m, 95% CI 20.1–173.9 m, p = 0.014). dAIH + walking increased walking distance more than dAIH after 1 day (MD 67.7 m, 95% CI 1.3–134.1 m, p = 0.046), 5 days (MD 107.0 m, 95% CI 40.6–173.4 m, p = 0.002), and 1-week follow-up (MD 136.0 m, 95% CI 65.3–206.6 m, p walking improved walking speed and distance in persons with chronic iSCI. The impact of dAIH is enhanced by combination with walking, demonstrating that combinatorial therapies may promote greater functional benefits in persons with iSCI. Classification of evidence: This study provides Class I evidence that transient hypoxia (through measured breathing treatments), along with overground walking training, improves walking speed and endurance after iSCI. PMID:24285617

Efecto de la aplicación de oxitocina en variables críticas sanguíneas de cerdas distócicas

OpenAIRE

González-Lozano, Miguel; Trujillo Ortega, Ma. Elena; Becerril-Herrera, Marcelino; Alonso-Spilsbury, María; Ramírez-Necoechea, Ramiro; Hernández-González, Rafael; Mota-Rojas, Daniel

2009-01-01

Con el propósito de evaluar las respuestas maternas a dosis baja de oxitocina en estado avanzado del parto en cerdas con eutocia y distocia materno-fetal, se seleccionaron 60 cerdas de la cruza Yorkshire x Landrace, 30 eutócicas y 30 con distocia materno-fetal. Las cerdas de cada grupo fueron divididas en subgrupos: 15 recibieron 0.083 UI/kg de oxitocina después de la expulsión del quinto lechón, las otras 15 no fueron tratadas. Se obtuvieron muestras sanguíneas en cada una de las cerdas medi...

CAROTID BODY POTENTIATION DURING CHRONIC INTERMITTENT HYPOXIA: IMPLICATION FOR HYPERTENSION

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Rodrigo eDel Rio

2014-11-01

Full Text Available Autonomic dysfunction is involved in the development of hypertension in humans with obstructive sleep apnea, and animals exposed to chronic intermittent hypoxia (CIH. It has been proposed that a crucial step in the development of the hypertension is the potentiation of the carotid body (CB chemosensory responses to hypoxia, but the temporal progression of the CB chemosensory, autonomic and hypertensive changes induced by CIH are not known. We tested the hypothesis that CB potentiation precedes the autonomic imbalance and the hypertension in rats exposed to CIH. Thus, we studied the changes in CB chemosensory and ventilatory responsiveness to hypoxia, the spontaneous baroreflex sensitivity (BRS, heart rate variability (HRV and arterial blood pressure in pentobarbital anesthetized rats exposed to CIH for 7, 14 and 21 days. After 7 days of CIH, CB chemosensory and ventilatory responses to hypoxia were enhanced, while BRS was significantly reduced by 2-fold in CIH-rats compared to sham-rats. These alterations persisted until 21 days of CIH. After 14 days, CIH shifted the HRV power spectra suggesting a predominance of sympathetic over parasympathetic tone. In contrast, hypertension was found after 21 days of CIH. Concomitant changes between the gain of spectral HRV, BRS and ventilatory hypoxic chemoreflex showed that the CIH-induced BRS attenuation preceded the HRV changes. CIH induced a simultaneous decrease of the BRS gain along with an increase of the hypoxic ventilatory gain. Present results show that CIH-induced persistent hypertension was preceded by early changes in CB chemosensory control of cardiorespiratory and autonomic function.

Fetal Alcohol Syndrome: A Behavioral Teratology.

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Kavale, Kenneth A.; Karge, Belinda D.

1986-01-01

The review examines the literature on the behaviorally teratogenic aspects of Fetal Alcohol Syndrome, including: (1) prevalence of alcohol abuse among women, (2) acute and chronic effects of alcohol on the fetus, (3) genetic susceptibility, (4) neuropathology, (5) correlative conditions, and (6) animal studies. (Author/DB)

Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care.

Science.gov (United States)

Barbosa, Isabela Roberta Cruz; Silva, Wesley Bruno Merencio; Cerqueira, Grace Sanches Gutierrez; Novo, Neil Ferreira; Almeida, Fernando Antonio; Novo, Joe Luiz Vieira Garcia

2015-08-01

Hypertensive disorders of pregnancy (HDP) are the most important cause of maternal and fetal death and pregnancy complications in Latin America and the Caribbean. The objective of this study was to characterize the epidemiological profile of women with HDP admitted to a Brazilian tertiary reference hospital, and to evaluate maternal and fetal outcome in each HDP and the impact of prenatal care on the maternal and fetal outcome. HDP in 1501 women were classified according to usual definitions as chronic hypertension (n = 564), pre-eclampsia (n = 579), eclampsia (n = 74) and pre-eclampsia/eclampsia superimposed on chronic hypertension (n = 284). Adverse maternal and fetal outcomes registered as maternal death and near miss and fetal outcomes documented as stillbirth, neonatal death and newborn respiratory complications were compiled. Prenatal care was classified as complete (⩾ 6 visits), incomplete (prenatal care or prenatal not done had progressive higher mortality rates and greater frequency of near miss cases, and their children had higher mortality rates. In a tertiary reference hospital, eclampsia and chronic hypertension superimposed on pre-eclampsia are associated with a worst outcome for mothers and fetuses, whereas complete prenatal care is associated with a better maternal and fetal outcome in HDP. © The Author(s), 2015.

Energy intermittency

CERN Document Server

Sorensen, Bent

2014-01-01

The first book to consider intermittency as a key point of an energy system, Energy Intermittency describes different levels of variability for traditional and renewable energy sources, presenting detailed solutions for handling energy intermittency through trade, collaboration, demand management, and active energy storage. Addressing energy supply intermittency systematically, this practical text:Analyzes typical time-distributions and intervals between episodes of demand-supply mismatch and explores their dependence on system layouts and energy source characteristicsSimulates scenarios regar

Aleitamento materno exclusivo e adiposidade Amamantamiento materno exclusivo y adiposidad Exclusive breastfeeding and adiposity

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José Fernando V. N. Moraes

2011-06-01

Full Text Available OBJETIVO: Associar o tempo de amamentação exclusiva da criança à adiposidade central e periférica, por meio do índice de massa corporal, dos perímetros da cintura e do braço, e das dobras cutâneas triciptal, subescapular e a somatória destas em pré-escolares. MÉTODOS: Pesquisa de delineamento transversal, em que 134 pré-escolares entre três e cinco anos de idade de uma escola par-ticular de Brasília, DF, foram avaliados quanto a: massa corporal, estatura, perímetros do braço e da cintura, dobras cutâneas triciptal e subescapular. Os pais das crianças responderam a um questionário sobre tempo de amamentação. O diagnóstico de sobrepeso e obe-sidade foi realizado de acordo com a classificação da Organização Mundial da Saúde para o índice de massa corporal por idade. RESULTADOS: As meninas tiveram maior concentração adiposa na dobra cutânea triciptal (p=0,001, subescapular (p=0,044 e na somatória destas (p=0,003 em relação aos meninos. A prevalência de sobrepeso e obesidade foi similar nos dois sexos (25,4% nos meninos e 22,6% nas meninas, assim como o tempo médio de amamentação exclusiva (4,3 meses para meninos e 4,6 meses para meninas. Notou-se correlação inversa significativa entre tempo de amamentação exclusiva e perímetro da cintura (r=-0,166; p=0,05. As demais variáveis também mostraram tendência de correlação inversa com o tempo de aleitamento materno exclusivo, porém sem valores significativos. CONCLUSÕES: A associação inversa entre o tempo de ama-mentação e o perímetro da cintura mostra um possível efeito do aleitamento materno sobre a distribuição de gordura corporal no pré-escolar.OBJETIVO: Asociar el tiempo de amamantamiento exclusivo del niño con la adiposidad central y periférica mediante el índice de masa corporal, perímetros de la cintura y del brazo, y pliegues cutáneos ticipital, subescapular y la suma de estos en pre-escolares. MÉTODOS: Investigación de delineaci

Internações por complicações obstétricas na gestação e desfechos maternos e perinatais, em uma coorte de gestantes no Sistema Único de Saúde no Município de São Paulo, Brasil

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Barbara Laisa Alves Moura

2018-02-01

Full Text Available A morbidade materna, a mortalidade neonatal e a mortalidade fetal são importantes indicadores da saúde materna infantil. O estudo tem por objetivo descrever desfechos maternos e perinatais (baixo peso ao nascer, prematuridade, óbito fetal e neonatal, internações pós-parto e readmissão dos recém-nascidos de uma coorte de gestantes cujos partos foram financiados pelo Sistema Único de Saúde (SUS no Município de São Paulo, Brasil, no segundo semestre de 2012. Foi obtida uma coorte retrospectiva de 55.404 gestantes com vinculação (determinística e probabilística das informações do Sistema de Informações Hospitalares do SUS (SIH/SUS, Sistema de Informações sobre Nascidos Vivos (SINASC, Sistema de Informações sobre Mortalidade (SIM e Cadastro Nacional de Estabelecimentos de Saúde (CNES. Internações por complicações obstétricas da gestação ocorreram em 4,3% das gestantes. Diagnósticos mais frequentes foram: infecções, doenças hipertensivas e diabetes. As internações prévias ao parto foram mais frequentes nas gestantes a partir de 35 anos, de gestações múltiplas e com baixa escolaridade. As internações das gestantes no pós-parto foram 3 vezes maior e a mortalidade materna 9 vezes maior entre as gestantes com internação prévia por complicações obstétricas. Os desfechos perinatais (mortalidade fetal e neonatal, prematuridade e baixo peso ao nascer foram 2 vezes mais frequentes entre os conceptos de gestantes com internação prévia que aquelas sem internação. Comportamento semelhante foi encontrado com relação à internação dos recém-nascidos logo após o parto e na readmissão hospitalar. Desfechos maternos e perinatais negativos foram mais frequentes em gestantes com internação prévia ao parto.

Soapwort extract supplementation alters antioxidant status of serum, liver and heart tissues in growing Japanese quails reared under chronic intermittent cold stress

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Bestami Dalkilic

2017-01-01

Full Text Available Antioxidant effect of dietary soapwort extract supplementation was studied in growing Japanese quails suffering from chronic intermittent cold stress. For this purpose, a total of ninety 15-d-old quails were divided into three groups with three replicates. Chronic intermittent cold stress was applied every night between 22.00 to 06.00 h; starting at 14 °C for the first week, and gradually weekly lowered to 8 °C. Three groups were fed with corn-soy based standard diets supplemented with 0, 50, and 100 ppm soapwort extract for four weeks. At the end of the study, three males and three females were slaughtered to determine total antioxidant and oxidant status of serum, malondialdehyde, glutathione, glutathione peroxidase activity, superoxide dismutase of liver and heart tissues. Although the dietary soapwort extract had no effect on serum total antioxidant capacity, it significantly lowered the total oxidant status of serum in cold stressed quails. Glutathione and superoxide dismutase enzyme activity of liver and heart tissues were similar among groups. While the dietary soapwort extract had no effect on glutathione peroxidase activity of the heart tissue, it significantly increased glutathione peroxidase activity in the liver tissue. In relation to the control group, malondialdehyde concentrations in the liver and heart tissues were significantly lower in soapwort extract groups. These data suggest that dietary soapwort extract could alleviate the detrimental effects of oxidative stress in growing Japanese quails exposed to cold stress.

Uncoupling of Vascular Nitric Oxide Synthase Caused by Intermittent Hypoxia

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Mohammad Badran

2016-01-01

Full Text Available Objective. Obstructive sleep apnea (OSA, characterized by chronic intermittent hypoxia (CIH, is often present in diabetic (DB patients. Both conditions are associated with endothelial dysfunction and cardiovascular disease. We hypothesized that diabetic endothelial dysfunction is further compromised by CIH. Methods. Adult male diabetic (BKS.Cg-Dock7m +/+ Leprdb/J (db/db mice (10 weeks old and their heterozygote littermates were subjected to CIH or intermittent air (IA for 8 weeks. Mice were separated into 4 groups: IA (intermittent air nondiabetic, IH (intermittent hypoxia nondiabetic, IADB (intermittent air diabetic, and IHDB (intermittent hypoxia diabetic groups. Endothelium-dependent and endothelium-independent relaxation and modulation by basal nitric oxide (NO were analyzed using wire myograph. Plasma 8-isoprostane, interleukin-6 (IL-6, and asymmetric dimethylarginine (ADMA were measured using ELISA. Uncoupling of eNOS was measured using dihydroethidium (DHE staining. Results. Endothelium-dependent vasodilation and basal NO production were significantly impaired in the IH and IADB group compared to IA group but was more pronounced in IHDB group. Levels of 8-isoprostane, IL-6, ADMA, and eNOS uncoupling were ≈2-fold higher in IH and IADB groups and were further increased in the IHDB group. Conclusion. Endothelial dysfunction is more pronounced in diabetic mice subjected to CIH compared to diabetic or CIH mice alone. Oxidative stress, ADMA, and eNOS uncoupling were exacerbated by CIH in diabetic mice.

Effects of intermittent fasting and chronic swimming exercise on body composition and lipid metabolism.

Science.gov (United States)

Moraes, Ruan Carlos Macedo de; Portari, Guilherme Vannucchi; Ferraz, Alex Soares Marreiros; da Silva, Tiago Eugênio Oliveira; Marocolo, Moacir

2017-12-01

Intermittent fasting protocol (IFP) has been suggested as a strategy to change body metabolism and improve health. The effects of IFP seem to be similar to aerobic exercise, having a hormetic adaptation according to intensity and frequency. However, the effects of combining both interventions are still unknown. Therefore, the aim of the present study was to evaluate the effects of IFP with and without endurance-exercise training on body composition, food behavior, and lipid metabolism. Twenty-week-old Wistar rats were kept under an inverted circadian cycle of 12 h with water ad libitum and assigned to 4 different groups: control group (ad libitum feeding and sedentary), exercise group (ad libitum feeding and endurance training), intermittent fasting group (IF; intermittent fasting and sedentary), and intermittent fasting and exercise group (IFEX; intermittent fasting and endurance training). After 6 weeks, the body weight of IF and IFEX animals decreased without changes in food consumption. Yet, the body composition between the 2 groups was different, with the IFEX animals containing higher total protein and lower total fat content than the IF animals. The IFEX group also showed increases in total high-density lipoprotein cholesterol and increased intramuscular lipid content. The amount of brown adipose tissue was higher in IF and IFEX groups; however, the IFEX group showed higher expression levels of uncoupling protein 1 in this tissue, indicating a greater thermogenesis. The IFP combined with endurance training is an efficient method for decreasing body mass and altering fat metabolism, without inflicting losses in protein content.

Roles and Mechanisms of Obstructive Sleep Apnea-Hypopnea Syndrome and Chronic Intermittent Hypoxia in Atherosclerosis: Evidence and Prospective.

Science.gov (United States)

Ma, Linqin; Zhang, Jingchun; Liu, Yue

2016-01-01

The morbidity and mortality of obstructive sleep apnea-hypopnea syndrome (OSAHS) are regarded as consequences of its adverse effects on the cardiovascular system. Chronic intermittent hypoxia (CIH) induced by OSAHS can result in vascular endothelial injury, thus promoting development of atherosclerosis (AS). Studies have shown that CIH is an independent risk factor for the occurrence and development of AS, but the underlying mechanism remains unclear. Here, we review clinical and fundamental studies reported during the last 10 years on the occurrence and development of AS mediated by CIH, focusing on inflammation, oxidative stress, insulin resistance, cell apoptosis, vascular endothelial injury, platelet activation, and neuroendocrine disorders. This review will offer current evidence and perspective to researchers for the development of effective intervention strategies for OSAHS-related cardiocerebrovascular diseases.

Glucocorticoids and fetal programming part 1: Outcomes.

Science.gov (United States)

Moisiadis, Vasilis G; Matthews, Stephen G

2014-07-01

Fetal development is a critical period for shaping the lifelong health of an individual. However, the fetus is susceptible to internal and external stimuli that can lead to adverse long-term health consequences. Glucocorticoids are an important developmental switch, driving changes in gene regulation that are necessary for normal growth and maturation. The fetal hypothalamic-pituitary-adrenal (HPA) axis is particularly susceptible to long-term programming by glucocorticoids; these effects can persist throughout the life of an organism. Dysfunction of the HPA axis as a result of fetal programming has been associated with impaired brain growth, altered behaviour and increased susceptibility to chronic disease (such as metabolic and cardiovascular disease). Moreover, the effects of glucocorticoid-mediated programming are evident in subsequent generations, and transmission of these changes can occur through both maternal and paternal lineages.

Physiologic basis for intermittent hypoxic episodes in preterm infants.

Science.gov (United States)

Martin, R J; Di Fiore, J M; Macfarlane, P M; Wilson, C G

2012-01-01

Intermittent hypoxic episodes are typically a consequence of immature respiratory control and remain a troublesome challenge for the neonatologist. Furthermore, their frequency and magnitude are commonly underestimated by clinically employed pulse oximeter settings. In extremely low birth weight infants the incidence of intermittent hypoxia [IH] progressively increases over the first 4 weeks of postnatal life, with a subsequent plateau followed by a slow decline beginning at weeks six to eight. Over this period of unstable respiratory control, increased oxygen-sensitive peripheral chemoreceptor activity has been associated with a higher incidence of apnea of prematurity. In contrast, infants with bronchopulmonary dysplasia [chronic neonatal lung disease] exhibit decreased peripheral chemosensitivity, although the effect on respiratory stability in this population is unclear. Such episodic hypoxia/reoxygenation in early life has the potential to sustain a proinflammatory cascade with resultant multisystem, including respiratory, morbidity. Therapeutic approaches for intermittent hypoxic episodes comprise careful titration of baseline or supplemental inspired oxygen as well as xanthine therapy to prevent apnea of prematurity. Characterization of the pathophysiologic basis for such intermittent hypoxic episodes and their consequences during early life is necessary to provide an evidence-based approach to their management.

Suporte materno mediante o abuso sexual infantil: revisão de literatura

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Patricia Marafon

2017-02-01

Full Text Available O suporte materno é fundamental para minimizar os efeitos traumáticos dos maus-tratos infantis. Objetivou-se com este estudo investigar como as mães se comportam frente à revelação do abuso sexual contra seus filhos. Com base nas diretrizes do guia Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA, foram selecionados artigos publicados entre 1995 e 2015, nas bases de dados SciELO, BVS e ScienceDirect, usando os descritores “maternal support”, “disclosure”, “child sexual abuse” e “psychological assessment”, “suporte materno”, “denúncia”, “abuso sexual infantil”, “avaliação psicológica”. Identificaram-se 80 artigos, sendo 17 incluídos neste estudo. Diante da revelação do abuso: i as mães oferecem apoio às filhas e necessitam de suporte para prestar auxílio; ii o uso de álcool e drogas, as ideias suicidas e homicidas são fatores contribuintes para a falta de assistência das mães. O suporte materno em situação de abuso sexual está relacionado à rede de apoio psicossocial oferecido.

INTERMITTENT ANTIARYTHMIC THERAPY OF ARIOVENTICULAR NODAL REENTRY TACHYCARDIA IN CHILDREN

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Boris Djindjic

2008-04-01

Full Text Available Until recent advances in pharmacology and clinical cardiology regarding farmacodynamics of antiarrhythmic drugs and their efficiency in patients with refractory paroxysmal supraventricular tachycardia, chronic prophylactic therapy was the only treatment option for patients refusing catheter ablation. Another treatment option, also known by eponym “pill in pocket” have been shown to be equally useful and efficacious.The aim of our study was prospective examination of children with refractory atrioventricular nodal reentry tachycardia (AVNRT who were withdrawn from chronic antiarrhythmic prophylactic therapy and started with intermittent oral beta blocker treatment (propranolol at dosage 1 mg/kg - max 80 mg.Twelve children (8 boys and 4 girls with AVNRT were included in the study. Four children did not have arrhythmia during first six months after withdrawal and 7 were successfully treated without complication.Intermittent antiarrhythmic therapy in children with AVNRT could be very efficacious and useful treatment option which significantly improves their quality of life.

Early aggressive eradication therapy for intermittent Pseudomonas aeruginosa airway colonization in cystic fibrosis patients: 15 years experience

DEFF Research Database (Denmark)

Hansen, C.R.; Pressler, T.; Høiby, Niels

2008-01-01

BACKGROUND: Since 1989, CF-patients intermittently colonized with Pseudomonas aeruginosa have been treated with inhaled colistin and oral ciprofloxacin in the Copenhagen CF-centre. The study evaluates 15 years results of this treatment. METHODS: All isolates of P. aeruginosa from CF-patients inte......BACKGROUND: Since 1989, CF-patients intermittently colonized with Pseudomonas aeruginosa have been treated with inhaled colistin and oral ciprofloxacin in the Copenhagen CF-centre. The study evaluates 15 years results of this treatment. METHODS: All isolates of P. aeruginosa from CF......-patients intermittently colonized with P. aeruginosa from 1989 to 2003 were identified All anti-P. aeruginosa treatments were evaluated for antibiotics used, treatment duration, pseudomonas-free interval and development of chronic infection. All P. aeruginosa isolates were assessed for resistance and for non......-mucoid or mucoid phenotype. RESULTS: 146 CF-patients were included in the study (1106 patient-years). 99 patients had first ever isolate during the study period. Median observation time 7 years (0.1-14.9). 12 patients developed chronic infection. A Kaplan Meyer plot showed protection from chronic infection in up...

Consumo alimentar de lactentes com fenilcetonúria em uso de aleitamento materno

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Jacqueline Siqueira Santos

2011-12-01

Full Text Available OBJETIVO: O objetivo deste estudo foi avaliar a ingestão de calorias, fenilalanina, tirosina e proteína de lactentes com fenilcetonúria em uso de aleitamento materno. MÉTODOS: Um grupo de 39 crianças, com até 6 meses de idade, que fazia uso de aleitamento materno (grupo amamentado foi comparado a um grupo-controle que fazia uso de fórmula especial com baixo teor de fenilanina, por meio de um estudo de coorte histórico concorrente. Os grupos foram pareados por sexo e duração da amamentação. Foram revistos 719 recordatórios alimentares de pacientes do grupo amamentado e 628 do grupo-controle. Foi realizada avaliação antropométrica no início e no final do estudo. A análise da ingestão de nutrientes foi feita com a utilização dos programas Minitab e LogXact 4.0, e a avaliação antropométrica foi feita com a utilização do programa Epi Info 6.0. RESULTADOS: O grupo amamentado apresentou ingestão adequada de fenilalanina e tirosina e maior adequação de ingestão proteica e energética. A maioria das crianças dos dois grupos apresentou escore-Z dentro dos limites normais (Z ³-2, com evolução favorável dos indicadores estudados (peso/idade, estatura/idade, peso/estatura e perímetro cefálico. CONCLUSÃO: O aleitamento materno na fenilcetonúria proporcionou ingestão adequada de calorias, fenilalanina, tirosina e proteína. A chance de uma criança do grupo amamentado possuir recordatórios de 24h adequados de ingestão energética foi 10,64 vezes maior que a chance de uma criança do grupo-controle. Em relação à ingestão proteica a chance foi 5,34 vezes maior. O crescimento foi similar nos dois grupos.

Maternal Nutritional Factors and Low Birth Weight in a Health Area Factores nutricionales maternos y el bajo peso al nacer en un área de salud

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Amarelis Rodríguez Fuentes

2013-04-01

Full Text Available Background: low birth weight is multifactorial and is commonly attributed to maternal, fetal and environmental causes. Dietary habits linked to inadequate maternal nutritional factors are decisive. Objective: to identify maternal nutritional factors related to low birth weight in patients of the consultation Area # I in Cienfuegos. Methods: an analytical, retrospective and case-control study was conducted from January 2006 to December 2008. We studied 50 mothers of low birth weight infants (cases and 100 mothers of normal weight children (controls at a rate of 2 per case. They were selected out of birth records in the health area. Obstetric medical records were reviewed and an interview was applied to each patient in order to assess their nutritional habits according to meals frequency and more widely consumed food groups. The data processing was performed using SPSS version 15,0. The results are presented in tables with absolute frequencies, percentages and results of the statistical techniques used. Results: maternal age, nutritional status in early pregnancy, weight gain during pregnancy and hemoglobin in the third quarter emerged as risk factors. Women with unstable and insufficient eating habits were 33 times more likely to have low birth weight infants and women who reported unhealthy diets according to more widely consumed food groups were estimated to be nine times more exposed to risk. Conclusions: maternal nutritional factors influenced the incidence of low birth weight, primarily in the cases of inadequate eating habits.Fundamento: el bajo peso al nacer es multifactorial y se atribuye a causas maternas, fetales y ambientales. Los hábitos alimentarios inadecuados unidos a otros factores nutricionales maternos son determinantes. Objetivo: identificar los factores nutricionales maternos relacionados con el bajo peso al nacer en pacientes del Área I del municipio Cienfuegos. Métodos: se realizó un estudio analítico, retrospectivo, de

Effects of chronic vs. intermittent calorie restriction on mammary tumor incidence and serum adiponectin and leptin levels in MMTV-TGF-α mice at different ages

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DOGAN, SONER; ROGOZINA, OLGA P.; LOKSHIN, ANNA E.; GRANDE, JOSEPH P.; CLEARY, MARGOT P.

2010-01-01

Calorie restriction prevents mammary tumor (MT) development in rodents. Usually, chronic calorie restriction (CCR) has been implemented. In contrast, intermittent calorie restriction (ICR) has been less frequently used. Recent studies indicate that when a direct comparison of the same degree of CCR vs. ICR was made using MMTV-TGF-α mice which develop MTs in the second year of life, ICR provided greater protection than CCR in delaying MT detection and reducing tumor incidence. Adiponectin and leptin are two adipocytokines secreted from adipose tissue which have opposite effects on many physiological functions, including proliferation of human breast cancer cells. A recent study indicated that a low adiponectin/leptin ratio was associated with breast cancer. We evaluated the relationship of adiponectin and leptin to MT development in MMTV-TGF-α calorie-restricted mice at several ages. Mice were enrolled at 10 weeks of age and subjected to 25% caloric reduction implemented either chronically or intermittently. Mice were euthanized at designated time points up to 74 weeks of age. Serum samples were collected to measure adiponectin and leptin concentrations. Both CCR and ICR mice had significantly reduced MT incidence. For the groups studied, serum leptin increased over time, while there was a trend for an increase in serum adiponectin levels in ad libitum and ICR mice, with no change in CCR mice between 10 and 74 weeks of age. The adiponectin/leptin ratio was significantly reduced as mice aged, but this ratio in ICR mice was significantly higher than that for ad libitum and CCR mice. No correlation was noted between serum adiponectin and leptin. These findings demonstrate that intermittent calorie restriction delays the early development of MTs. This delay was associated with reduced serum leptin levels following the restriction phases of the protocol. Additionally, serum leptin levels correlated with body weight and body fat in the groups studied. PMID:22966277

Chronic intermittent ethanol exposure during adolescence: effects on social behavior and ethanol sensitivity in adulthood.

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Varlinskaya, Elena I; Truxell, Eric; Spear, Linda P

2014-08-01

This study assessed long-lasting consequences of repeated ethanol exposure during two different periods of adolescence on 1) baseline levels of social investigation, play fighting, and social preference and 2) sensitivity to the social consequences of acute ethanol challenge. Adult male and female Sprague-Dawley rats were tested 25 days after repeated exposure to ethanol (3.5 g/kg intragastrically [i.g.], every other day for a total of 11 exposures) in a modified social interaction test. Early-mid adolescent intermittent exposure (e-AIE) occurred between postnatal days (P) 25 and 45, whereas late adolescent intermittent exposure (l-AIE) was conducted between P45 and P65. Significant decreases in social investigation and social preference were evident in adult male rats, but not their female counterparts following e-AIE, whereas neither males nor females demonstrated these alterations following l-AIE. In contrast, both e-AIE and l-AIE produced alterations in sensitivity to acute ethanol challenge in males tested 25 days after adolescent exposure. Ethanol-induced facilitation of social investigation and play fighting, reminiscent of that normally seen during adolescence, was evident in adult males after e-AIE, whereas control males showed an age-typical inhibition of social behavior. Males after l-AIE were found to be insensitive to the socially suppressing effects of acute ethanol challenge, suggesting the development of chronic tolerance in these animals. In contrast, females showed little evidence for alterations in sensitivity to acute ethanol challenge following either early or late AIE. The results of the present study demonstrate a particular vulnerability of young adolescent males to long-lasting detrimental effects of repeated ethanol. Retention of adolescent-typical sensitivity to the socially facilitating effects of ethanol could potentially make ethanol especially appealing to these males, therefore promoting relatively high levels of ethanol intake later

Chronic Intermittent Hypoxia Induces the Long-Term Facilitation of Genioglossus Corticomotor Activity

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Ying Zou

2018-01-01

Full Text Available Obstructive sleep apnea (OSA is characterized by the repetitive collapse of the upper airway and chronic intermittent hypoxia (CIH during sleep. It has been reported that CIH can increase the EMG activity of genioglossus in rats, which may be related to the neuromuscular compensation of OSA patients. This study aimed to explore whether CIH could induce the long-term facilitation (LTF of genioglossus corticomotor activity. 16 rats were divided into the air group (n=8 and the CIH group (n=8. The CIH group was exposed to hypoxia for 4 weeks; the air group was subjected to air under identical experimental conditions in parallel. Transcranial magnetic stimulation (TMS was applied every ten minutes and lasted for 1 h/day on the 1st, 3rd, 7th, 14th, 21st, and 28th days of air/CIH exposure. Genioglossus EMG was also recorded at the same time. Compared with the air group, the CIH group showed decreased TMS latency from 10 to 60 minutes on the 7th, 14th, 21st, and 28th days. The increased TMS amplitude lasting for 60 minutes was only observed on the 21st day. Genioglossus EMG activity increased only on the 28th day of CIH. We concluded that CIH could induce LTF of genioglossus corticomotor activity in rats.

Forced swim stress increases ethanol consumption in C57BL/6J mice with a history of chronic intermittent ethanol exposure.

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Anderson, Rachel I; Lopez, Marcelo F; Becker, Howard C

2016-06-01

Stress exposure has been identified as one risk factor for alcohol abuse that may facilitate the transition from social or regulated alcohol use to the development of alcohol dependence. Additionally, stress is a common trigger for relapse and subsequent loss of control of drinking in alcohol-dependent individuals. The present study was designed to characterize effects of repeated forced swim stress (FSS) on ethanol consumption in three rodent drinking models that engender high levels of ethanol consumption. Adult male C57BL/6J mice were exposed to 10-min FSS 4 h prior to each drinking session in three different models of high ethanol consumption: chronic intermittent ethanol (CIE) drinking (a model of dependence-like drinking), drinking-in-the-dark (DID; a model of binge-like drinking), and intermittent vs. continuous access (a model of escalated drinking). In the CIE drinking paradigm, daily FSS facilitated the escalation of ethanol intake that is typically seen in CIE-exposed mice without altering ethanol consumption in control mice exposed to FSS. FSS prior to drinking sessions did not alter ethanol consumption in the DID or intermittent access paradigms, whereas stressed mice in the continuous access procedure consumed less ethanol than their nonstressed counterparts. The CIE drinking paradigm may provide a helpful preclinical model of stress-induced transition to ethanol dependence that can be used to (1) identify underlying neural mechanisms that facilitate this transition and (2) evaluate the therapeutic potential of various pharmacological agents hypothesized to alleviate stress-induced drinking.

Impacto do aleitamento materno no coeficiente de inteligência de crianças de oito anos de idade

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Ana L. M. Fonseca

2013-08-01

Full Text Available OBJETIVO: O objetivo deste estudo foi determinar a influência do aleitamento materno na capacidade intelectual de crianças pertencentes a uma coorte de um país em desenvolvimento, controlando para os principais fatores de confusão. MÉTODOS: Foi realizado um estudo de coorte prospectiva com todos os recém-nascidos nos hospitais de uma cidade de porte médio e acompanhou-se uma amostra aleatória destes aos 30, 90 e 180 dias de vida e aos 8 anos. No acompanhamento foram avaliados diversos aspectos da amamentação e, aos 8 anos, foi realizada avaliação da capacidade intelectual geral aplicando-se o Teste de Raven. As análises estatísticas utilizaram Teste T, ANOVA e regressão linear e logística, considerando como associações estatisticamente significativas aquelas cujo valor de p foi inferior a 0,05. RESULTADOS: Aos 8 anos 560 crianças participaram da avaliação com o Teste de Raven. A média da pontuação das crianças no teste foi de 22,56 pontos com desvio padrão de 5,93. A diferença de médias entre os grupos em aleitamento materno ou não, aos seis meses, foi de 1,33 (p = 0,008. Permaneceram associadas ao desfecho, após regressão linear e logística, a cor materna e da criança, classe socioeconômica, escolaridade e tabagismo maternos e o aleitamento materno aos 6 meses de idade (p = 0,007. CONCLUSÕES: As crianças que mamaram por seis meses ou mais tiveram melhor desempenho na avaliação intelectual geral, mesmo após ajuste para os principais fatores de confundimento.

Roles and Mechanisms of Obstructive Sleep Apnea-Hypopnea Syndrome and Chronic Intermittent Hypoxia in Atherosclerosis: Evidence and Prospective

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Linqin Ma

2016-01-01

Full Text Available The morbidity and mortality of obstructive sleep apnea-hypopnea syndrome (OSAHS are regarded as consequences of its adverse effects on the cardiovascular system. Chronic intermittent hypoxia (CIH induced by OSAHS can result in vascular endothelial injury, thus promoting development of atherosclerosis (AS. Studies have shown that CIH is an independent risk factor for the occurrence and development of AS, but the underlying mechanism remains unclear. Here, we review clinical and fundamental studies reported during the last 10 years on the occurrence and development of AS mediated by CIH, focusing on inflammation, oxidative stress, insulin resistance, cell apoptosis, vascular endothelial injury, platelet activation, and neuroendocrine disorders. This review will offer current evidence and perspective to researchers for the development of effective intervention strategies for OSAHS-related cardiocerebrovascular diseases.

Near miss materno e iniquidades em saúde: análise de determinantes contextuais no Rio Grande do Norte, Brasil

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Tatyana Maria Silva de Souza Rosendo

2016-01-01

Full Text Available Resumo O objetivo deste estudo foi identificar os fatores contextuais socioeconômicos e de assistência à saúde na atenção básica associados ao near miss materno e a suas condições marcadoras. Trata-se de um estudo ecológico que utilizou como unidade de análise os dados agregados de 63 clusters formados pelos municípios do Rio Grande do Norte, Brasil, através do método Skater de regionalização de áreas. A razão de near miss materno e de suas condições marcadoras foram obtidas através do Sistema de Informação Hospitalar do Sistema Único de Saúde. Na análise de regressão linear múltipla, houve associação significativa entre o near miss materno e variáveis relacionadas à pobreza e à pior assistência na atenção básica. As doenças hipertensivas também associaram-se à pobreza e à pior assistência e a ocorrência de hemorragia associou-se à mortalidade infantil. Pôde-se constatar que a ocorrência de near miss materno está relacionada a condições socioeconômicas desfavoráveis e a uma assistência à saúde de pior qualidade que são reflexo de políticas públicas que reforçam a iniquidade em saúde.

Asma na gestação: efeitos na vitalidade fetal, complicações maternas e perinatais Asthma during pregnancy: effects on fetal well-being, and maternal and perinatal complications

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Renata Franco Pimentel Mendes

2013-04-01

impairment of fetal well-being, as well as the related maternal and perinatal complications. METHODS: A retrospective study with 117 pregnancies complicated by maternal asthma and with no other comorbidities, in the period from January, 2005 to December, 2010. Inclusion criteriawere as follows: singleton pregnancy; pregnantwomen diagnosed with asthma prior to pregnancy; initiation of prenatal care before the 28th week of pregnancy; birth at this institution; newborn weighing over 500 g and gestational age at delivery of 22 weeks or more; absence of fetal malformations or chromosomal abnormalities; absence of maternal comorbidities. Asthma was classified as intermittent, mild persistent, moderate persistent, or severe persistent. The results of fetal biophysical profile and of Doppler velocimetry of the umbilical artery performed 14 days prior to birth were analyzed. RESULTS: Of the total of 117 pregnant women with asthma, 41 (35.0% had intermittent, 33 (28.2% mild persistent, 21 (17.9% moderate persistent, and 22 (18.8% severe persistent asthma. There was no significant difference among the groups as to the type of birth: cesarean section was performed in 65.8% of the cases, maternal corticosteroid therapy was used at the moment of birth in 20.5%, the gestational age at birth averaged 38.6 weeks (SD 1.9 weeks, and birth weight averaged 3,056 g (SD 581 g. The fetal biophysical profile performed during the antepartum period (n = 90, 76.9% showed a normal result (8 or 10 in 99% of the cases. Doppler velocimetry of the umbilical artery was assessed in 23.9% (n = 28 of the pregnant women, and delivered normal results in 100% of the cases. The use of systemic corticosteroid therapy was significantly (p < 0.001 different among the intermittent (4.9%, mild persistent (9.1%, moderate persistent (28.6%, and severe persistent (45.5% groups. Regarding the beginning of birth, there was a higher proportion of elective cesarean section in the groups with moderate persistent asthma (52

The efficacy of antihypertensive drugs in chronic intermittent hypoxia conditions

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Diogo, Lucilia N.; Monteiro, Emília C.

2014-01-01

Sleep apnea/hypopnea disorders include centrally originated diseases and obstructive sleep apnea (OSA). This last condition is renowned as a frequent secondary cause of hypertension (HT). The mechanisms involved in the pathogenesis of HT can be summarized in relation to two main pathways: sympathetic nervous system stimulation mediated mainly by activation of carotid body (CB) chemoreflexes and/or asphyxia, and, by no means the least important, the systemic effects of chronic intermittent hypoxia (CIH). The use of animal models has revealed that CIH is the critical stimulus underlying sympathetic activity and hypertension, and that this effect requires the presence of functional arterial chemoreceptors, which are hyperactive in CIH. These models of CIH mimic the HT observed in humans and allow the study of CIH independently without the mechanical obstruction component. The effect of continuous positive airway pressure (CPAP), the gold standard treatment for OSA patients, to reduce blood pressure seems to be modest and concomitant antihypertensive therapy is still required. We focus this review on the efficacy of pharmacological interventions to revert HT associated with CIH conditions in both animal models and humans. First, we explore the experimental animal models, developed to mimic HT related to CIH, which have been used to investigate the effect of antihypertensive drugs (AHDs). Second, we review what is known about drug efficacy to reverse HT induced by CIH in animals. Moreover, findings in humans with OSA are cited to demonstrate the lack of strong evidence for the establishment of a first-line antihypertensive regimen for these patients. Indeed, specific therapeutic guidelines for the pharmacological treatment of HT in these patients are still lacking. Finally, we discuss the future perspectives concerning the non-pharmacological and pharmacological management of this particular type of HT. PMID:25295010

Programas de saúde materno-infantil em Moçambique: marcos evolutivos e a inserção da enfermagem Programas de atención de salud materno-infantil en Mozambique: marcos evolutivos e inserción de la enfermería Programs of maternal and infant health in Mozambique: gradual landmarks and the insertion of nursing

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Maria Acácia Ernesto Lourenço

2009-09-01

Full Text Available Pesquisa centrada nas políticas públicas do governo moçambicano para o setor da saúde, com foco voltado para programas de assistência à saúde materno-infantil. Tem o propósito de apresentar contextos básicos para a reflexão sobre a filosofia da implantação e implementação dos programas e a inserção da Enfermagem, mostrando seus marcos evolutivos. Constatou-se que, na década 70, o Sistema Nacional de Saúde adotou o Programa de Proteção Materno-Infantil, que na década de 80 ficou concebido como Programa de Saúde Materno-Infantil e, posteriormente, na década 90, ficou inserido no Programa Nacional Integrado de Saúde Materno-Infantil e Planejamento Familiar, Programa Alargado de Vacinação, Saúde Escolar e do Adolescente, incluindo Saúde Sexual e Reprodutiva. A inserção da Enfermagem foi evidenciada na implementação das ações assistenciais. Os marcos evolutivos foram: a introdução dos cursos específicos de Enfermagem em saúde materno-infantil do nível básico ao superior e abrangência dos serviços do Programa Nacional Integrado.Pesquisa Centrada en las políticas públicas del gobierno Mozambicano para el setor salud, con foco en los Programas de Asistencia en Salud Materno-infantil, con el propósito de presentar contextos básicos para la reflexión acerca de la filosofia de implantación e implementación de los programas mostrando sus marcos evolutivos e de la inserción de la Enfermería. Se constató que en la década 70, el Sistema Nacional de Salud adoptó el Programa de Protección Materno Infantil, que en la década de 80 se transformó en Programa de Salud Materno-infantil y posteriormente en la década de 90 fue inserido en el Programa Nacional Integrado de Salud Materno- Infantil y Planificación Familia, Programas Ampliado de Vacunación, Salud Escolar y del Adolescente incluyendo la salud Sexual y Reproductiva. La inserción de la Enfermería fue evidenciada en la implantación por medio de

Sex differences in the fetal programming of hypertension.

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Grigore, Daniela; Ojeda, Norma B; Alexander, Barbara T

2008-01-01

Numerous clinical and experimental studies support the hypothesis that the intrauterine environment is an important determinant of cardiovascular disease and hypertension. This review examined the mechanisms linking an adverse fetal environment and increased risk for chronic disease in adulthood with an emphasis on gender differences and the role of sex hormones in mediating sexual dimorphism in response to a suboptimal fetal environment. This review focuses on current findings from the PubMed database regarding animal models of fetal programming of hypertension, sex differences in phenotypic outcomes, and potential mechanisms in offspring of mothers exposed to an adverse insult during gestation. For the years 1988 to 2007, the database was searched using the following terms: fetal programming, intrauterine growth restriction, low birth weight, sex differences, estradiol, testosterone, high blood pressure, and hypertension. The mechanisms involved in the fetal programming of adult disease are multifactorial and include alterations in the regulatory systems affecting the long-tterm control of arterial pressure. Sex differences have been observed in animal models of fetal programming, and recent studies suggest that sex hormones may modulate activity of regulatory systems, leading to a lower incidence of hypertension and vascular dysfunction in females compared with males. Animal models of fetal programming provide critical support for the inverse relationship between birth weight and blood pressure. Experimental models demonstrate that sex differences are observed in the pathophysiologic response to an adverse fetal environment. A role for sex hormone involvement is strongly suggested,with modulation of the renin-angiotensin system as a possible mechanism.

Reconhecimento materno na Unidade de Cuidado Intensivo Neonatal

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Monika Wernet

2015-04-01

Full Text Available RESUMO Objetivo: analisar experiências maternas em Unidade de Cuidado Intensivo Neonatal, com foco nas relações de reconhecimento. Método: estudo qualitativo, desenvolvido na perspectiva da hermenêutica gadameriana, fundamentado no conceito honnethiano de reconhecimento. Foram entrevistadas, em profundidade, dez mães de crianças internadas em Unidade de Cuidado Intensivo Neonatal. Resultados: há comprometimentos no processo de reconhecimento materno na unidade e, como desdobramento, surgem sentimentos de obrigação e insegurança para o cuidado do filho e fragilidades na autoestima. Conclusão: as interações com os profissionais de saúde e as normas e protocolos ali existentes promovem vulnerabilidades e comprometem o reconhecimento e a autonomia materna.

Intermittent search strategies

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Bénichou, O.; Loverdo, C.; Moreau, M.; Voituriez, R.

2011-01-01

This review examines intermittent target search strategies, which combine phases of slow motion, allowing the searcher to detect the target, and phases of fast motion during which targets cannot be detected. It is first shown that intermittent search strategies are actually widely observed at various scales. At the macroscopic scale, this is, for example, the case of animals looking for food; at the microscopic scale, intermittent transport patterns are involved in a reaction pathway of DNA-binding proteins as well as in intracellular transport. Second, generic stochastic models are introduced, which show that intermittent strategies are efficient strategies that enable the minimization of search time. This suggests that the intrinsic efficiency of intermittent search strategies could justify their frequent observation in nature. Last, beyond these modeling aspects, it is proposed that intermittent strategies could also be used in a broader context to design and accelerate search processes.

Atribuições de enfermeiros na orientação de lactantes acerca do aleitamento materno

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Ariele Londres Mesquita

2018-02-01

Full Text Available O aleitamento materno exclusivo é um problema mundial de saúde pública. O enfermeiro como educador e promotor da saúde é quem deve orientar as gestantes no pré-natal, puerpério e pós-parto. São inúmeros os benefícios que existem na amamentação, dentre eles a involução uterina de forma acelerada, benefícios para mãe na prevenção de uma nova gestação e benefícios também para o bebê que receberá todos os nutrientes necessários na fase inicial de sua vida. A partir deste pressuposto o estudo tem como objetivo identificar as atribuições do enfermeiro no processo de conscientização do aleitamento materno para com as gestantes. Este estudo constitui em uma revisão integrativa de literatura científica e para coleta dos materiais foram utilizadas as bases de dados Biblioteca Virtual em Saúde (BVS, os Periódicos Capes e o Google Acadêmico; os critérios de inclusão foram indexação de estudos nas respectivas bases de dados; relação direta com os descritores; pesquisas desenvolvidas no Brasil; idiomas de publicação em português; período de publicação compreendido entre 2011 e 2016. A partir dos fatos extraidos entende-se que a falta de orientação sobre aleitamento materno, os cuidados e os benefícios gerados são ainda os principais motivos de desmame precoce; desta forma o enfermeiro tem um papel importante na prevenção e promoção de saúde a estas nutrizes, estratégias devem ser criadas em conjunto com equipes de saúde para diminuir o índice de intercorrências mamarias e consequentemente garantir um período de amamentação adequado sem prejuízos tanto para a mãe quanto para o bebê. Descritores: Aleitamento materno; Amamentação; Enfermeiro.

Angiotensin II type 1a receptors in subfornical organ contribute towards chronic intermittent hypoxia-associated sustained increase in mean arterial pressure.

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Saxena, Ashwini; Little, Joel T; Nedungadi, T Prashant; Cunningham, J Thomas

2015-03-01

Sleep apnea is associated with hypertension. The mechanisms contributing to a sustained increase in mean arterial pressure (MAP) even during normoxic awake-state remain unknown. Rats exposed to chronic intermittent hypoxia for 7 days, a model of the hypoxemia associated with sleep apnea, exhibit sustained increases in MAP even during the normoxic dark phase. Activation of the renin-angiotensin system (RAS) has been implicated in chronic intermittent hypoxia (CIH) hypertension. Since the subfornical organ (SFO) serves as a primary target for the central actions of circulating ANG II, we tested the effects of ANG II type 1a receptor (AT1aR) knockdown in the SFO on the sustained increase in MAP in this CIH model. Adeno-associated virus carrying green fluorescent protein (GFP) and small-hairpin RNA against either AT1aR or a scrambled control sequence (SCM) was stereotaxically injected in the SFO of rats. After recovery, MAP, heart rate, respiratory rate, and activity were continuously recorded using radiotelemetry. In the normoxic groups, the recorded variables did not deviate from the baseline values. Both CIH groups exhibited significant increases in MAP during CIH exposures (P < 0.05). During the normoxic dark phase in the CIH groups, only the SCM-injected group exhibited a sustained increase in MAP (P < 0.05). The AT1aR-CIH group showed significant decreases in FosB/ΔFosB staining in the median preoptic nucleus and the paraventricular nuclei of the hypothalamus compared with the SCM-CIH group. Our data indicate that AT1aRs in the SFO are critical for the sustained elevation in MAP and increased FosB/ΔFosB expression in forebrain autonomic nuclei associated with CIH. Copyright © 2015 the American Physiological Society.

Role of catecholamines in maternal-fetal stress transfer in sheep.

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Rakers, Florian; Bischoff, Sabine; Schiffner, Rene; Haase, Michelle; Rupprecht, Sven; Kiehntopf, Michael; Kühn-Velten, W Nikolaus; Schubert, Harald; Witte, Otto W; Nijland, Mark J; Nathanielsz, Peter W; Schwab, Matthias

2015-11-01

We sought to evaluate whether in addition to cortisol, catecholamines also transfer psychosocial stress indirectly to the fetus by decreasing uterine blood flow (UBF) and increasing fetal anaerobic metabolism and stress hormones. Seven pregnant sheep chronically instrumented with uterine ultrasound flow probes and catheters at 0.77 gestation underwent 2 hours of psychosocial stress by isolation. We used adrenergic blockade with labetalol to examine whether decreased UBF is catecholamine mediated and to determine to what extent stress transfer from mother to fetus is catecholamine dependent. Stress induced transient increases in maternal cortisol and norepinephrine (NE). Maximum fetal plasma cortisol concentrations were 8.1 ± 2.1% of those in the mother suggesting its maternal origin. In parallel to the maternal NE increase, UBF decreased by maximum 22% for 30 minutes (P Fetal NE remained elevated for >2 hours accompanied by a prolonged blood pressure increase (P fetal NE and blood pressure increase and the shift toward anaerobic metabolism. We conclude that catecholamine-induced decrease of UBF is a mechanism of maternal-fetal stress transfer. It may explain the influence of maternal stress on fetal development and on programming of adverse health outcomes in later life especially during early pregnancy when fetal glucocorticoid receptor expression is limited. Copyright © 2015 Elsevier Inc. All rights reserved.

Influencia del ejercicio físico aeróbico durante el embarazo en los niveles de hemoglobina y de hierro maternos. (Influence of the physical aerobic exercise during pregnancy in the maternal haemoglobin and iron levels.

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James Stirling

2008-04-01

Full Text Available Resumen Son bien conocidos los efectos beneficiosos que el ejercicio físico tiene sobre la salud en general, aunque no se cuenta con la misma información cuando se desarrolla durante el embarazo. La mayor incertidumbre es saber si pueden coexistir ambos procesos, ejercicio y embarazo, sin conflictos materno-fetales y sin resultados del embarazo alterados. Especialmente cuando día a día, son más las mujeres que desean continuar ejercitándose de alguna forma, durante su embarazo. El objetivo de este trabajo es conocer la influencia del ejercicio físico aeróbico moderado desarrollado durante el segundo y tercer trimestres en los niveles de hemoglobina y de hierro maternos. Material y métodos: Se llevó acabo un estudio experimental que incluyó un total de 142 gestantes. Grupo casos: integrado por 72 mujeres. Grupo control: integrado por 70 mujeres. Los parámetros maternos estudiados fueron: niveles de hierro, nivel de hemoglobina previo al parto, edad gestacional, tipo de parto. Fetales: Peso de nacimiento, talla, perímetro craneal, test de Apgar (1´y 5´. Resultados: No se encontraron diferencias significativas a nivel estadístico entre ambos grupos (p menor que 0,05, el grupo de casos (ejercicio presento medias similares en los niveles de hemoglobina: 12.1 ± 0.8 y de hierro: 65.90 ± 7.1; que el grupo de control: hemoglobina: 12.3 ± 0.8 y hierro: 66.42 ± 8.4. El peso de nacimiento fue inferior en el grupo de casos dentro de valores normales (-142.1 grs.. Conclusión: El ejercicio aeróbico moderado desarrollado durante el segundo y tercer trimestre de embarazo parece no alterar los niveles de hierro y hemoglobina maternos. Abstract They are very well-known the beneficial effects that the physical exercise has about the health in general, although it is not had the same information when it refers to a pro- cess of remarkable importance: the pregnancy. The biggest uncertainty is to know if both processes, exercise and pregnancy can

Chronic intermittent hypoxia alters local respiratory circuit function at the level of the preBötzinger complex

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Alfredo J Garcia

2016-02-01

Full Text Available Chronic intermittent hypoxia (CIH is a common state experienced in several breathing disorders, including obstructive sleep apnea (OSA and apneas of prematurity. Unraveling how CIH affects the CNS, and in turn how the CNS contributes to apneas is perhaps the most challenging task. The preBötzinger complex (preBötC is a pre-motor respiratory network critical for inspiratory rhythm generation. Here, we test the hypothesis that CIH increases irregular output from the isolated preBötC, which can be mitigated by antioxidant treatment. Electrophysiological recordings from brainstem slices revealed that CIH enhanced burst-to-burst irregularity in period and/or amplitude. Irregularities represented a change in individual fidelity among preBötC neurons, and changed transmission from preBötC to the hypoglossal motor nucleus (XIIn, which resulted in increased transmission failure to XIIn. CIH increased the degree of lipid peroxidation in the preBötC and treatment with the antioxidant, 5,10,15,20-Tetrakis (1-methylpyridinium-4-yl-21H,23H-porphyrin manganese(III pentachloride (MnTMPyP, reduced CIH-mediated irregularities on the network rhythm and improved transmission of preBötC to the XIIn. These findings suggest that CIH promotes a pro-oxidant state that destabilizes rhythmogenesis originating from the preBötC and changes the local rhythm generating circuit which in turn, can lead to intermittent transmission failure to the XIIn. We propose that these CIH-mediated effects represent a part of the central mechanism that may perpetuate apneas and respiratory instability, which are hallmark traits in several dysautonomic conditions.

Sexual dimorphism in epigenomicresponses of stem cells to extreme fetal growth

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Delahaye, Fabien; Wijetunga, N. Ari; Heo, Hye J.; Tozour, Jessica N.; Zhao, Yong Mei; Greally, John M.; Einstein, Francine H.

2014-01-01

Extreme fetal growth is associated with increased susceptibility to a range of adult diseases through an unknown mechanism of cellular memory. We tested whether heritable epigenetic processes in long-lived CD34+ hematopoietic stem/progenitor cells (HSPCs) showed evidence for re-programming associated with the extremes of fetal growth. Here we show that both fetal growth restriction and over-growth are associated with global shifts towards DNA hypermethylation, targeting cis-regulatory elements in proximity to genes involved in glucose homeostasis and stem cell function. We find a sexually dimorphic response; intrauterine growth restriction (IUGR) is associated with substantially greater epigenetic dysregulation in males, whereas large for gestational age (LGA) growth predominantly affects females. The findings are consistent with extreme fetal growth interacting with variable fetal susceptibility to influence cellular aging and metabolic characteristics through epigenetic mechanisms, potentially generating biomarkers that could identify infants at higher risk for chronic disease later in life. PMID:25300954

Melatonin modulates the fetal cardiovascular defense response to acute hypoxia.

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Thakor, Avnesh S; Allison, Beth J; Niu, Youguo; Botting, Kimberley J; Serón-Ferré, Maria; Herrera, Emilio A; Giussani, Dino A

2015-08-01

Experimental studies in animal models supporting protective effects on the fetus of melatonin in adverse pregnancy have prompted clinical trials in human pregnancy complicated by fetal growth restriction. However, the effects of melatonin on the fetal defense to acute hypoxia, such as that which may occur during labor, remain unknown. This translational study tested the hypothesis, in vivo, that melatonin modulates the fetal cardiometabolic defense responses to acute hypoxia in chronically instrumented late gestation fetal sheep via alterations in fetal nitric oxide (NO) bioavailability. Under anesthesia, 6 fetal sheep at 0.85 gestation were instrumented with vascular catheters and a Transonic flow probe around a femoral artery. Five days later, fetuses were exposed to acute hypoxia with or without melatonin treatment. Fetal blood was taken to determine blood gas and metabolic status and plasma catecholamine concentrations. Hypoxia during melatonin treatment was repeated during in vivo NO blockade with the NO clamp. This technique permits blockade of de novo synthesis of NO while compensating for the tonic production of the gas, thereby maintaining basal cardiovascular function. Melatonin suppressed the redistribution of blood flow away from peripheral circulations and the glycemic and plasma catecholamine responses to acute hypoxia. These are important components of the fetal brain sparing response to acute hypoxia. The effects of melatonin involved NO-dependent mechanisms as the responses were reverted by fetal treatment with the NO clamp. Melatonin modulates the in vivo fetal cardiometabolic responses to acute hypoxia by increasing NO bioavailability. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chronic intermittent ethanol exposure and withdrawal leads to adaptations in nucleus accumbens core postsynaptic density proteome and dendritic spines.

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Uys, Joachim D; McGuier, Natalie S; Gass, Justin T; Griffin, William C; Ball, Lauren E; Mulholland, Patrick J

2016-05-01

Alcohol use disorder is a chronic relapsing brain disease characterized by the loss of ability to control alcohol (ethanol) intake despite knowledge of detrimental health or personal consequences. Clinical and pre-clinical models provide strong evidence for chronic ethanol-associated alterations in glutamatergic signaling and impaired synaptic plasticity in the nucleus accumbens (NAc). However, the neural mechanisms that contribute to aberrant glutamatergic signaling in ethanol-dependent individuals in this critical brain structure remain unknown. Using an unbiased proteomic approach, we investigated the effects of chronic intermittent ethanol (CIE) exposure on neuroadaptations in postsynaptic density (PSD)-enriched proteins in the NAc of ethanol-dependent mice. Compared with controls, CIE exposure significantly changed expression levels of 50 proteins in the PSD-enriched fraction. Systems biology and functional annotation analyses demonstrated that the dysregulated proteins are expressed at tetrapartite synapses and critically regulate cellular morphology. To confirm this latter finding, the density and morphology of dendritic spines were examined in the NAc core of ethanol-dependent mice. We found that CIE exposure and withdrawal differentially altered dendrite diameter and dendritic spine density and morphology. Through the use of quantitative proteomics and functional annotation, these series of experiments demonstrate that ethanol dependence produces neuroadaptations in proteins that modify dendritic spine morphology. In addition, these studies identified novel PSD-related proteins that contribute to the neurobiological mechanisms of ethanol dependence that drive maladaptive structural plasticity of NAc neurons. © 2015 Society for the Study of Addiction.

THE EFFECT OF ADRENAL MEDULLECTOMY ON METABOLIC RESPONSES TO CHRONIC INTERMITTENT HYPOXIA

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Shin, Mi-Kyung; Han, Woobum; Bevans-Fonti, Shannon; Jun, Jonathan C.; Punjabi, Naresh M.; Polotsky, Vsevolod Y.

2014-01-01

Obstructive sleep apnea causes intermittent hypoxia (IH) and is associated with insulin resistance and type 2 diabetes. IH increases plasma catecholamine levels, which may increase insulin resistance and suppress insulin secretion. The objective of this study was to determine if adrenal medullectomy (MED) prevents metabolic dysfunction in IH. MED or sham surgery was performed in 60 male C57BL/6J mice, which were then exposed to IH or control conditions (intermittent air) for 6 weeks. IH increased plasma epinephrine and norepinephrine levels, increased fasting blood glucose and lowered basal and glucose-stimulated insulin secretion. MED decreased baseline epinephrine and prevented the IH induced increase in epinephrine, whereas the norepinephrine response remained intact. MED improved glucose tolerance in mice exposed to IH, attenuated the impairment in basal and glucose-stimulated insulin secretion, but did not prevent IH-induced fasting hyperglycemia or insulin resistance. We conclude that the epinephrine release from the adrenal medulla during IH suppresses insulin secretion causing hyperglycemia. PMID:25179887

Motivação de gestantes para o aleitamento materno Motivating breastfeeding among expectant mothers

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Sueli Aparecida Moreira Takushi

2008-10-01

Full Text Available OBJETIVO: Conhecer os motivos de gestantes para o aleitamento materno. MÉTODOS: É um estudo qualitativo realizado com 164 gestantes assistidas no pré-natal em dois Centros de Saúde na região central da cidade de São Paulo. Os dados foram coletados por meio de entrevistas semi-estruturadas sobre motivação para amamentar. As narrativas foram organizadas em planilha eletrônica em busca de categorias. RESULTADOS: As principais categorias identificadas estavam relacionadas à saúde da criança, da mulher e aos benefícios da prática de amamentar e do leite materno. A maioria das mulheres (98,8% foi favorável à amamentação. Benefícios à saúde da criança foi o motivo mais freqüente (73,8%. CONCLUSÃO: A motivação ao aleitamento materno foi centrada nos benefícios à saúde da criança. A amamentação é valorizada independentemente da vontade materna.OBJECTIVE: The present study sought to discover the reasons for expectant mothers to breastfeed. METHODS: This was a qualitative study involving 164 expectant mothers attending prenatal care in two health centers of the city of São Paulo. Semi-structured interviews were done to collect data on the reasons to breastfeed. The information was organized in a spreadsheet to search for categories. RESULTS: The main identified categories regarded the child's and woman's health and the benefits of breastfeeding and breast milk. The majority of the women (98.8% regarded breastfeeding favorably. Benefit to the child's health was the reason mentioned most often (73.8%. CONCLUSION: Motivation to breastfeed was based on benefits to the child's health. Breastfeeding is valued regardless of the mother's will.

Actualización del Programa de Atención Materno Infantil en la disciplina Enfermería

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Nora Helena Martínez-Malo Gutiérrez

2014-12-01

Full Text Available Introducción: el Programa de Atención Materno Infantil tiene como centro la salud de la mujer, los niños y adolescentes y la planificación familiar entre otros aspectos. Su propósito esencial es contribuir a elevar el nivel de salud y el grado de satisfacción de la población mediante acciones de prevención, promoción, protección y recuperación en la mujer embarazada o no, el niño y adolescente. Objetivo: actualizar el Programa Atención Materno Infantil en la disciplina enfermería. Material y métodos: se realizó una investigación de corte pedagógico, que asume el método dialéctico materialista como rector del proceso de investigación; los métodos del nivel teórico como el histórico-lógico, el sistémico-estructural, el de inducción-deducción y el método de la modelación y los métodos del nivel empírico como el análisis documental, las encuestas y entrevistas, observación al proceso docente de enfermería, además de métodos estadísticos. Resultados: existen dificultades en cuanto a la actualización de los contenidos del Programa de Atención Materno Infantil en la disciplina Enfermería, en función del modelo del profesional; todo lo cual afecta el desarrollo del proceso docente educativo, la adquisición de conocimientos y habilidades en la propia disciplina. Se diseñaron acciones validadas por los expertos para la actualización de estos contenidos. Conclusiones: se diseñaron acciones dirigidas a perfeccionar el proceso docente educativo en la disciplina enfermería, a partir de los contenidos relacionados con el Programa de Atención Materno Infantil desde el punto de vista didáctico y metodológico y de superación profesional.

Resultados maternos e perinatais em gestantes portadoras de leucemia Maternal and perinatal outcomes in pregnant women with leukemia

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Roseli Mieko Yamamoto Nomura

2011-08-01

grupo de gestantes com LMC, verificou-se a ocorrência de anemia em quatro casos (44,4% e plaquetopenia em um (11,1%. Quanto aos resultados perinatais, nas gestações complicadas pela leucemia aguda, a média da idade gestacional no parto foi de 32 semanas (desvio padrão - DP=4,4 e a média do peso do recém-nascido foi 1476 g (DP=657 g. Houve 2 (40,0% óbitos perinatais (um fetal e um neonatal. Nas gestações complicadas pela LMC, a média da idade gestacional no parto foi de 37,6 semanas (DP=1,1 e a média do peso do recém-nascido foi 2870 g (DP=516 g; não houve morte perinatal e nenhuma anomalia fetal foi detectada. CONCLUSÕES: É elevada a morbidade materna e fetal nas gestações complicadas pela leucemia aguda; enquanto que, nas complicadas pela LMC, o prognóstico materno e fetal parece ser mais favorável, com maior facilidade no manejo das complicações.PURPOSE: To describe the maternal and perinatal outcomes of pregnant women diagnosed with leukemia who were followed up for prenatal care and delivery at a university hospital. METHODS: A retrospective study of the period from 2001 to 2011, which included 16 pregnant women with a diagnosis of leukemia followed by antenatal care specialists in hematological diseases and pregnancy. For acute leukemia diagnosed after the first trimester, the recommendation was to perform chemotherapy despite the current pregnancy. For chronic leukemia, patients who were controlled in hematological terms were maintained without medication during pregnancy, or chemotherapy was introduced after the first trimester. We analyzed the maternal and perinatal outcome. RESULTS: Acute lymphoblastic leukemia (ALL was diagnosed in five cases (31.3%, acute myeloid leukemia (AML in two cases (12.5% and chronic myeloid leukemia (CML in nine cases (56.3%. Of the cases of acute leukemia, two (28.6% were diagnosed in the first trimester, two (28.6% in the second and three (42.9% in the third. Two patients with ALL diagnosed in the first

Superando o falicismo: sofrimento materno na psicanálise de crianças Superando el falicismo: sufrimiento materno en el psicoanálisis de niños Beyond phallicism: maternal suffering in child psychoanalysis

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Henriqueta Lúcia Arcoverde de Melo

2012-09-01

Full Text Available Interpreta-se, no contexto da psicanálise de uma criança psicótica, o sofrimento materno e suas implicações nos destinos do tratamento. O sofrimento parental interfere negativamente quando compele à repetição fantasmática de traumatismos cujas mensagens, uma vez intrometidas, não são elaboradas pelos pais. Como demonstra o caso clínico, o falicismo materno e a foraclusão da função paterna não necessariamente estão presentes na geração da psicose. Longe de ser falo, originalmente ao paciente foi atribuído o lugar de substituto de um objeto odiado numa cena traumática vivida na infância materna, responsável pela intromissão de mensagens sexuais em torno de experiências de nascimento e morte, revividas fantasmaticamente no contexto da análise de seu filho.Se interpreta, en el contexto del psicoanálisis de un niño psicótico, el sufrimiento materno y sus implicaciones en los objetivos del tratamiento. El sufrimiento parental interfiere negativamente cuando obliga a la repetición fantasmática de traumatismos cuyos mensajes, una vez entrometidos, no han sido procesados por los padres. Como demuestra el caso clínico, el falicismo materno y la foraclusión de la función paterna no están necesariamente presentes en la generación de la psicosis. Originalmente al paciente le fue atribuido el lugar de sustituto de un objeto odiado en una escena traumática vivida en la infancia materna, responsable por la intromisión de mensajes sexuales acerca de experiencias de nacimiento y muerte, revividas fantasmáticamente en el contexto del análisis de su hijo.The article interprets maternal suffering and its implications on a psychotic child's psychoanalysis. Parental suffering interferes with a child's treatment when it induces the repetition of fantasies generated in traumas whose messages, once intruded, were not worked through by the parents. As the clinical case demonstrates, the mother's phallicism and the foreclosure of the

Chronic intermittent hypoxia-hypercapnia blunts heart rate responses and alters neurotransmission to cardiac vagal neurons.

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Dyavanapalli, Jhansi; Jameson, Heather; Dergacheva, Olga; Jain, Vivek; Alhusayyen, Mona; Mendelowitz, David

2014-07-01

Patients with obstructive sleep apnoea experience chronic intermittent hypoxia-hypercapnia (CIHH) during sleep that elicit sympathetic overactivity and diminished parasympathetic activity to the heart, leading to hypertension and depressed baroreflex sensitivity. The parasympathetic control of heart rate arises from pre-motor cardiac vagal neurons (CVNs) located in nucleus ambiguus (NA) and dorsal motor nucleus of the vagus (DMNX). The mechanisms underlying diminished vagal control of heart rate were investigated by studying the changes in blood pressure, heart rate, and neurotransmission to CVNs evoked by acute hypoxia-hypercapnia (H-H) and CIHH. In vivo telemetry recordings of blood pressure and heart rate were obtained in adult rats during 4 weeks of CIHH exposure. Retrogradely labelled CVNs were identified in an in vitro brainstem slice preparation obtained from adult rats exposed either to air or CIHH for 4 weeks. Postsynaptic inhibitory or excitatory currents were recorded using whole cell voltage clamp techniques. Rats exposed to CIHH had increases in blood pressure, leading to hypertension, and blunted heart rate responses to acute H-H. CIHH induced an increase in GABAergic and glycinergic neurotransmission to CVNs in NA and DMNX, respectively; and a reduction in glutamatergic neurotransmission to CVNs in both nuclei. CIHH blunted the bradycardia evoked by acute H-H and abolished the acute H-H evoked inhibition of GABAergic transmission while enhancing glycinergic neurotransmission to CVNs in NA. These changes with CIHH inhibit CVNs and vagal outflow to the heart, both in acute and chronic exposures to H-H, resulting in diminished levels of cardioprotective parasympathetic activity to the heart as seen in OSA patients. © 2014 The Authors. The Journal of Physiology © 2014 The Physiological Society.

Liquid-Diet with Alcohol Alters Maternal, Fetal and Placental Weights and the Expression of Molecules Involved in Integrin Signaling in the Fetal Cerebral Cortex

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Ujjwal K. Rout

2010-11-01

Full Text Available Maternal alcohol consumption during pregnancy causes wide range of behavioral and structural deficits in children, commonly known as Fetal Alcohol Syndrome (FAS. Children with FAS may suffer behavioral deficits in the absence of obvious malformations. In rodents, the exposure to alcohol during gestation changes brain structures and weights of offspring. The mechanism of FAS is not completely understood. In the present study, an established rat (Long-Evans model of FAS was used. The litter size and the weights of mothers, fetuses and placentas were examined on gestation days 18 or 20. On gestation day 18, the effects of chronic alcohol on the expression levels of integrin receptor subunits, phospholipase-Cγ and N-cadherin were examined in the fetal cerebral cortices. Presence of alcohol in the liquid-diet reduced the consumption and decreased weights of mothers and fetuses but increased the placental weights. Expression levels of β1 and α3 integrin subunits and phospholipase-Cγ2 were significantly altered in the fetal cerebral cortices of mothers on alcohol containing diet. Results show that alcohol consumption during pregnancy even with protein, mineral and vitamin enriched diet may affect maternal and fetal health, and alter integrin receptor signaling pathways in the fetal cerebral cortex disturbing the development of fetal brains.

Proteção do leite materno e ética

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Marina Ferreira Rea

2000-08-01

Full Text Available INTRODUÇÃO: A Organização Mundial da Saúde, em 1981, recomendou aos países a adoção do "Código Internacional de Marketing dos Substitutos do Leite Materno" e o Brasil o traduziu em normas desde 1988. Objetivou-se verificar o cumprimento dessa norma entre empresas que devem obedecê-la, especialmente quanto aos profissionais de saúde. MÉTODOS: Realizou-se pesquisa exploratória com amostragem intencional em 30 cidades brasileiras, entrevistando 95 profissionais de saúde. Descrevem-se os resultados referentes à relação profissional de saúde-companhias comercializadoras de leites infantis. RESULTADOS: Foram identificadas práticas promocionais dos produtores de substitutos de leite materno, especialmente com pediatras, que evidenciam conflitos de interesses: o apoio financeiro recebido beneficia o profissional, que passa a ter seu nome ligado aos que apóiam direta ou indiretamente a indústria. DISCUSSÃO: Existe conflito de interesses sempre que um interesse secundário faz com que a atitude profissional se modifique (por exemplo, na metodologia de uma pesquisa, na análise ou na publicação dos resultados, em favor daquele interesse e em detrimento da atitude científica. Tanto o código citado como a Norma Brasileira sobre a Comercialização de Alimentos para Lactentes parecem não ser suficientes para indicar os limites éticos da relação profissional-indústria. Proteger a prática de amamentar dos interesses comerciais passa por políticas públicas que contemplem essas questões.

A musicoterapia pode aumentar os índices de aleitamento materno entre mães de recém-nascidos prematuros: um ensaio clínico randomizado controlado

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Martha N. S Vianna

2011-06-01

Full Text Available OBJETIVO: Avaliar o impacto da musicoterapia nos índices de aleitamento materno entre mães de recém-nascidos prematuros. MÉTODO: Neste ensaio clínico controlado, randomizado e aberto, mães de neonatos prematuros com peso < 1.750 g foram submetidas a sessões de musicoterapia três vezes por semana durante 60 minutos. Os desfechos foram os índices de aleitamento materno na ocasião da alta hospitalar do bebê e em consultas de seguimento (7-15 dias, 30 e 60 dias após a alta. RESULTADOS: Foram avaliadas 94 mães (48 no grupo da musicoterapia e 46 no grupo controle. O aleitamento materno foi significativamente mais frequente no grupo da musicoterapia na primeira consulta de seguimento [risco relativo (RR = 1,26; intervalo de confiança de 95% (IC95% = 1,01-1,57; p = 0,03; número necessário para tratar (NNT = 5,6]. Esse grupo também apresentou índices mais elevados de aleitamento materno na ocasião da alta do bebê (RR = 1,22; IC95% = 0,99-1,51; p = 0,06; NNT = 6,3, e 30 e 60 dias após a alta (RR = 1,21; IC95% = 0,73-5,66; p = 0,13 e RR = 1,28; IC95% = 0,95-1,71; p = 0,09, respectivamente, mas esses resultados não foram estatisticamente significativos. CONCLUSÕES: Este estudo demonstrou que a musicoterapia teve efeito significativo no aumento do índice de aleitamento materno entre mães de recém-nascidos prematuros na primeira consulta de seguimento, e uma influência positiva (embora não significativa que se estendeu até 60 dias depois da alta. A musicoterapia pode ser útil para elevar os índices de aleitamento materno entre mães de prematuros.

Influência regional no consumo precoce de alimentos diferentes do leite materno em menores de seis meses residentes nas capitais brasileiras e Distrito Federal

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Saldiva,Silvia Regina Dias Medici; Venancio,Sonia Isoyama; Gouveia,Ana Gabriela Cepeda; Castro,Ana Lucia da Silva; Escuder,Maria Mercedes Loureiro; Giugliani,Elsa Regina Justo

2011-01-01

Objetivou-se avaliar a influência regional no consumo precoce de alimentos diferentes do leite materno em menores de seis meses residentes nas capitais brasileiras. Analisaram-se dados de 18.929 crianças da II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras - 2008. As frequências do consumo de chá, sucos, leite artificial e mingau/papa foram calculadas para as capitais das cinco regiões brasileiras. Curvas do consumo foram obtidas pela análise de logitos e estimativas ...

Analysis of the stability of housekeeping gene expression in the left cardiac ventricle of rats submitted to chronic intermittent hypoxia

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Guilherme Silva Julian

Full Text Available ABSTRACT Obstructive sleep apnea (OSA has been associated with oxidative stress and various cardiovascular consequences, such as increased cardiovascular disease risk. Quantitative real-time PCR is frequently employed to assess changes in gene expression in experimental models. In this study, we analyzed the effects of chronic intermittent hypoxia (an experimental model of OSA on housekeeping gene expression in the left cardiac ventricle of rats. Analyses via four different approaches-use of the geNorm, BestKeeper, and NormFinder algorithms; and 2−ΔCt (threshold cycle data analysis-produced similar results: all genes were found to be suitable for use, glyceraldehyde-3-phosphate dehydrogenase and 18S being classified as the most and the least stable, respectively. The use of more than one housekeeping gene is strongly advised.

Feto portador de síndrome de turner e tetralogia de fallot associadas à elevação de alfafetoproteína materna Fetal turner syndrome and tetralogy of fallot associated with elevated maternal serum alpha-fetoprotein levels

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Eduardo Vieira Neto

1998-06-01

Full Text Available A síndrome de Turner fetal e suas complicações, a hidropisia e o higroma cístico, podem produzir alteração dos marcadores bioquímicos de soro materno inicialmente utilizados no rastreamento de síndrome de Down e de defeitos de tubo neural (DTN. Os autores relatam o caso de uma gestante de 37 anos, que foi rastreada para síndrome de Down e DTN no início do 2º trimestre. Foi constatado aumento da alfafetoproteína de soro materno (MSAFP e o rastreamento foi considerado positivo para DTN. Foi realizado exame ultra-sonográfico tridimensional, que não demonstrou nenhuma anormalidade fetal ou placentária, caracterizando o caso como elevação idiopática de MSAFP. No 3º trimestre, a gravidez evoluiu com acentuada oligoidrâmnia e alteração do fluxo uteroplacentário, obrigando à instituição de terapia com corticosteróides e parto cesáreo na 34ª semana gestacional. O concepto do sexo feminino foi encaminhado à UTI neonatal, onde foram diagnosticadas tetralogia de Fallot e síndrome de Turner. Esse caso incentivou os autores a rever a literatura sobre marcadores bioquímicos de soro materno na síndrome de Turner e nas malformações cardíacas congênitas. Ao final, propõe-se um protocolo para elevação idiopática de MSAFP.Turner syndrome and its complications, hydrops and cystic hygroma, can produce alterations in maternal serum biochemical markers used in screening for Down's syndrome and neural tube defects (NTD. The authors report the case of a 37-year-old pregnant woman, screened for Down's syndrome and NTD in the second trimester of pregnancy. The maternal serum alpha-fetoprotein (MSAFP level was increased and the test was considered screen positive for NTD. A three-dimensional ultrasound investigation was performed, but no fetal or placental anomalies were found, indicating a case of unexplained increased msafp. In the third trimester severe oligohydramnios and disturbances in uteroplacental arterial circulation

Long-term effects of recurrent intermittent hypoxia and hyperoxia on respiratory system mechanics in neonatal mice.

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Dylag, Andrew M; Mayer, Catherine A; Raffay, Thomas M; Martin, Richard J; Jafri, Anjum; MacFarlane, Peter M

2017-04-01

Premature infants are at increased risk for wheezing disorders. Clinically, these neonates experience recurrent episodes of apnea and desaturation often treated by increasing the fraction of inspired oxygen (FIO 2 ). We developed a novel paradigm of neonatal intermittent hypoxia with subsequent hyperoxia overshoots (CIH O/E ) and hypothesized that CIH O/E elicits long-term changes on pulmonary mechanics in mice. Neonatal C57BL/6 mice received CIH O/E , which consisted of 10% O2 (1 min) followed by a transient exposure to 50% FIO 2 , on 10-min repeating cycles 24 h/d from birth to P7. Baseline respiratory mechanics, methacholine challenge, RT-PCR for pro and antioxidants, radial alveolar counts, and airway smooth muscle actin were assessed at P21 after 2-wk room air recovery. Control groups were mice exposed to normoxia, chronic intermittent hyperoxia (CIH E ), and chronic intermittent hypoxia (CIH O ). CIH O/E and CIH E increased airway resistance at higher doses of methacholine and decreased baseline compliance compared with normoxia mice. Lung mRNA for NOX2 was increased by CIH O/E . Radial alveolar counts and airway smooth muscle actin was not different between groups. Neonatal intermittent hypoxia/hyperoxia exposure results in long-term changes in respiratory mechanics. We speculate that recurrent desaturation with hyperoxia overshoot may increase oxidative stress and contribute to wheezing in former preterm infants.

Fetal echocardiography

International Nuclear Information System (INIS)

Chaubal, Nitin G.; Chaubal, Jyoti

2009-01-01

USG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies. In fetal echocardiography, the four-chamber view and the outflow-tract view are used to diagnose cardiac anomalies. The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram. Associated truncal and chromosomal anomalies need to be identified. This review shows how fetal echocardiography, apart from identifying structural defects in the fetal heart, can be used to look at rhythm abnormalities and other functional aspects of the fetal heart

Alteraciones en el vínculo materno- infantil: prevalencia, factores de riesgo, criterios diagnósticos y estrategias de evaluación

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Bruma Palacios-Hernández

2016-06-01

Full Text Available La interacción temprana entre una madre y su bebé durante el primer año de posparto, se centra en la respuesta emocional materna que determina el vínculo materno-infantil, considerado éste un importante mediador en el desarrollo psicosocial del infante. Alteraciones en esta vinculación temprana se asocian a importantes consecuencias en el infante a nivel cognitivo, social, de salud mental y con riesgo de maltrato, abuso infantil y hasta infanticidio. Los factores de riesgo para una alteración en el vínculo materno-infantil incluyen factores de la madre, del bebé, del embarazo, parto y posparto y del ambiente social. El estudio de los aspectos psicosociales de la relación temprana entre una madre y su infante, ha sido de principal interés en países desarrollados; sin embargo, en Latinoamérica la investigación es aún muy escasa. En la presente revisión se exploran las características del vínculo materno-infantil, sus factores de riesgo y consecuencias negativas más asociadas, así como una identificación de las estrategias de evaluación más usadas en diferentes países. La detección temprana de una problemática del vínculo materno-infantil es una estrategia fundamental para diseñar intervenciones de salud específicas y pertinentes que disminuyan las consecuencias adversas y promuevan el bienestar de la diada madre-bebé y su ámbito familiar.

Tendências temporais e fatores associados à duração do aleitamento materno em Pernambuco Tendencias temporales y factores asociados a la duración del amamantamiento materno en Pernambuco, Noreste de Brasil Time trends and factors associated with breastfeeding in the state of Pernambuco, Northeastern Brazil

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Maria de Fátima Costa Caminha

2010-04-01

Full Text Available OBJETIVO: Analisar as tendências temporais de duração do aleitamento materno exclusivo e os fatores de proteção. MÉTODOS: Foram analisadas as prevalências de amamentação total e o aleitamento materno exclusivo de lactentes aos quatro meses de idade. Os dados foram obtidos de inquéritos populacionais realizados em 1991, 1997 e 2006, com 935, 2.081 e 1.568 crianças, respectivamente. Os dados foram coletados por entrevista realizada com o responsável pela criança. As prevalências foram analisadas por regressão de Poisson em relação a: condições ambientais, comportamentais e socioeconômicas, variáveis maternas e fatores biológicos da criança. RESULTADOS: A duração mediana do aleitamento total elevou-se de 89 dias (1991 para 106 dias (1997 e, finalmente, 183 dias (2006. A mediana do aleitamento materno exclusivo manteve-se estacionária em torno de 30 dias entre 1997 e 2006. Na análise multivariada, das dez variáveis analisadas, apenas a escolaridade e idade maternas, situação do domicílio e a criança ser do sexo feminino se mantiveram no modelo explicativo final. CONCLUSÕES: Apesar do aleitamento total ter tido importante aumento de duração, o mesmo não ocorreu com a duração do aleitamento materno exclusivo.OBJETIVO: Analizar las tendencias temporales de duración del amamantamiento materno exclusivo y los factores de protección. MÉTODOS: Fueron analizadas las prevalencias de amamantamiento total y el amamantamiento materno exclusivo de lactantes a los cuatro meses de edad. Los datos fueron obtenidos de pesquisas poblacionales realizadas en 1991, 1997 y 2006, con 935, 2.081 y 1.568 niños, respectivamente. Los datos fueron colectados por entrevista realizada con el responsable del niño. Las prevalencias fueron analizadas por regresión de Poisson en relación a: condiciones ambientales, de comportamiento y socioeconómicas, variables maternas y factores biológicos del niño. RESULTADOS: La duración mediana

Aleitamento materno: instintivo? Natural? O paradigma biológico x os direitos reprodutivos em discussão

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Kátia Fernanda Alves Moreira

2002-12-01

Full Text Available O objetivo deste ensaio foi refletir sobre a naturalização do aleitamento, inserindo o campo da amamentação na esfera dos direitos da mulher, procurando desconstruir o paradigma que biologiza o corpo feminino para as funções maternas, em especial para a amamentação, à luz dos direitos reprodutivos. Na discussão salientamos a importância das ações de incentivo ao aleitamento materno estarem embasadas na noção de direitos reprodutivos, o que permitirá aos profissionais de saúde compreenderem os significados da amamentação no marco de vida da mulher e de seu cotidiano. Propomos no final que os direitos reprodutivos direcionem as ações de incentivo ao aleitamento materno desenvolvidas pelos profissionais de saúde, na perspectiva de resgatar a visibilidade da mulher enquanto sujeito principal desta prática.

Fetal magnetic resonance: technique applications and normal fetal anatomy

International Nuclear Information System (INIS)

Martin, C.; Darnell, A.; Duran, C.; Mellado, F.; Corona, M

2003-01-01

Ultrasonography is the preferred diagnostic imaging technique for intrauterine fetal examination. Nevertheless, circumstances sometimes dictate the use of other techniques in order to analyze fetal structures. The advent of ultra rapid magnetic resonance (MR) sequencing has led to the possibility of doing MR fetal studies, since images are obtained in an extradordiarily short time and are not affected by either maternal or fetal movements. It does not employ ionizing radiations, it provides high-contrast images and it can obtain such images in any plane of space without being influenced by either the child bearer's physical characteristics of fetal position. MR provides good quality images of most fetal organs. It is extremely useful in analysing distinct structures, as well as permitting an evaluation of cervical structures, lungs, diaphragms, intra-abdominal and retroperitoneal structures, and fetal extremities. It can also provide useful information regarding the placenta,umbilical cord, amniotic fluid and uterus. The objective of this work is to describe MR technique as applied to intrauterine fetal examination, and to illustrate normal fetal anatomy as manifested by MR and its applications. (Author) 42 refs

Fetal organ dosimetry for the Techa River and Ozyorsk offspring cohorts. Pt. 1. A Urals-based series of fetal computational phantoms

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Maynard, Matthew R.; Bolch, Wesley E. [University of Florida, Advanced Laboratory for Radiation Dosimetry Studies (ALRADS), J. Crayton Pruitt Family Department of Biomedical Engineering, Gainesville, FL (United States); Shagina, Natalia B.; Tolstykh, Evgenia I.; Degteva, Marina O. [Urals Research Center for Radiation Medicine, Chelyabinsk (Russian Federation); Fell, Tim P. [Public Health England, Centre for Radiation, Chemical and Environmental Health, Didcot, Chilton, Oxon (United Kingdom)

2015-03-15

The European Union's SOLO (Epidemiological Studies of Exposed Southern Urals Populations) project aims to improve understanding of cancer risks associated with chronic in utero radiation exposure. A comprehensive series of hybrid computational fetal phantoms was previously developed at the University of Florida in order to provide the SOLO project with the capability of computationally simulating and quantifying radiation exposures to individual fetal bones and soft tissue organs. To improve harmonization between the SOLO fetal biokinetic models and the computational phantoms, a subset of those phantoms was systematically modified to create a novel series of phantoms matching anatomical data representing Russian fetal biometry in the Southern Urals. Using previously established modeling techniques, eight computational Urals-based phantoms aged 8, 12, 18, 22, 26, 30, 34, and 38 weeks post-conception were constructed to match appropriate age-dependent femur lengths, biparietal diameters, individual bone masses and whole-body masses. Bone and soft tissue organ mass differences between the common ages of the subset of UF phantom series and the Urals-based phantom series illustrated the need for improved understanding of fetal bone densities as a critical parameter of computational phantom development. In anticipation for SOLO radiation dosimetry studies involving the developing fetus and pregnant female, the completed phantom series was successfully converted to a cuboidal voxel format easily interpreted by radiation transport software. (orig.)

Intermittent degradation and schizotypy

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Matthew W. Roché

2015-06-01

Full Text Available Intermittent degradation refers to transient detrimental disruptions in task performance. This phenomenon has been repeatedly observed in the performance data of patients with schizophrenia. Whether intermittent degradation is a feature of the liability for schizophrenia (i.e., schizotypy is an open question. Further, the specificity of intermittent degradation to schizotypy has yet to be investigated. To address these questions, 92 undergraduate participants completed a battery of self-report questionnaires assessing schizotypy and psychological state variables (e.g., anxiety, depression, and their reaction times were recorded as they did so. Intermittent degradation was defined as the number of times a subject’s reaction time for questionnaire items met or exceeded three standard deviations from his or her mean reaction time after controlling for each item’s information processing load. Intermittent degradation scores were correlated with questionnaire scores. Our results indicate that intermittent degradation is associated with total scores on measures of positive and disorganized schizotypy, but unrelated to total scores on measures of negative schizotypy and psychological state variables. Intermittent degradation is interpreted as potentially derivative of schizotypy and a candidate endophenotypic marker worthy of continued research.

Hígado graso agudo del embarazo: tres primeros casos en el Hospital Materno Infantil

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Ariel I. Ruiz Parra

1986-01-01

Full Text Available We present three cases of acute fatty liver during pregnancy studied at the Hospital Materno Infantil of Bogotá; clinical laboratory and pathological results are discussed and knowledge and hypothesis about the disease entity are resumend, emphasiying the need to consider this diagnostic option when studying icteric patients during the third pregnancy trimester since instauration of support mea sures could contribute to a better prognosis.

Estrés Materno y Configuración Familiar: Estudio comparativo en Familias Chilenas Monoparentales y Nucleares de bajos ingresos / Maternal Stress and Family Constitution: Comparative Study on Chilean, Single-Mother and Nuclear, Low-Income Families

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Marcia Olhaberry

2012-12-01

Full Text Available Los estudios sobre estrés materno durante la crianza infantil han considerado variables contextuales para explicarlo. El nivel socioeconómico, así como la configuración familiar han sido variables relevantes, asociándose monoparentalidad en familias de bajos ingresos a mayores niveles de estrés materno. Se estudian los niveles de estrés materno en familias chilenas nucleares y monoparentales de N.S.E. bajo, considerando el estrés en distintas dimensiones, asociado al rol materno, a la interacción madre-hijo(a y a la percepción de dificultades en el niño(a percibidas por la madre. Se estudia un total de 169 diadas, 80 pertenecientes a familias monoparentales y 89 pertenecientes a familias nucleares con niños(as entre los 4 y 15 meses de edad. Se evaluaron los niveles de estrés materno con el Parental Stress Index, versión abreviada, desarrollado por R. Abidin (1995. Los resultados muestran niveles de estrés significativamente más altos en las madres pertenecientes a familias monoparentales en el estrés asociado al rol materno, a la percepción del niño(a como difícil y en el estrés total.

Analysis of fetal movements by Doppler actocardiogram and fetal B-mode imaging.

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Maeda, K; Tatsumura, M; Utsu, M

1999-12-01

We have presented that fetal surveillance may be enhanced by use of the fetal actocardiogram and by computerized processing of fetal motion as well as fetal B-mode ultrasound imaging. Ultrasonic Doppler fetal actogram is a sensitive and objective method for detecting and recording fetal movements. Computer processing of the actograph output signals enables powerful, detailed, and convenient analysis of fetal physiologic phenomena. The actocardiogram is a useful measurement tool not only in fetal behavioral studies but also in evaluation of fetal well-being. It reduces false-positive, nonreactive NST and false-positive sinusoidal FHR pattern. It is a valuable tool to predict fetal distress. The results of intrapartum fetal monitoring are further improved by the antepartum application of the actocardiogram. Quantified fetal motion analysis is a useful, objective evaluation of the embryo and fetus. This method allows monitoring of changes in fetal movement, as well as frequency, amplitude, and duration. Furthermore, quantification of fetal motion enables evaluation of fetal behavior states and how these states relate to other measurements, such as changes in FHR. Numeric analysis of both fetal actogram and fetal motion from B-mode images is a promising application in the correlation of fetal activity or behavior with other fetal physiologic measurements.

Hypoglycemia and the origin of hypoxia-induced reduction in human fetal growth.

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Stacy Zamudio

2010-01-01

placentally-mediated reduction in glucose transport is an initiating factor for reduced fetal growth under conditions of chronic hypoxemia.

Efectos del bajo peso materno preconcepcional sobre el embarazo y el parto

OpenAIRE

López Montero, Maribel; Trufero Cánovas, Norma

2006-01-01

Se realizó un estudio de cohorte no concurrente pareado 1:1 para investigar los efectos del bajo peso materno preconcepcional (malnutrición materna por defecto) sobre el embarazo, el parto y el recién nacido en el Policlínico Finlay del municipio Camagüey desde octubre de 2002 hasta abril de 2004. Fueron estudiadas 51 gestantes malnutridas por defecto y 51 embarazadas sin riesgo. Los datos fueron tomados a partir de los registros oficiales de la atención perinatal complementados con una encue...

Validez del tacto materno en el reconocimiento de fiebre en niños menores de 36 meses

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María Velásquez-Espíritu

2010-10-01

Full Text Available Objetivo: Determinar la validez del tacto materno como método de detección de la presencia o no de fiebre en los niños. Material y métodos: Se seleccionaron por conveniencia a 269 madres y sus respectivos niños menores de 36 meses que acudieron al Servicio de Emergencias Pediátricas del Hospital Nacional Cayetano Heredia por cualquier molestia. Se preguntó a las madres si su niño presentaba fiebre o no (detectado por tacto, y luego se procedió con la medición de la temperatura rectal de cada niño. Resultados: Se incluyeron 269 participantes. El tacto materno para la detección de fiebre tuvo una sensibilidad de 79,3% (69,6% a 86,5%, especificidad 91,8% (86,8% a 94,9%, VPP 82,1% (72,6% a 88,9% y VPN 90,3% (85,1% a 93,8%; el likelihood ratio positivo fue 9,62 (5,86 a 15,81 y el likelihood ratio negativo fue 0,23 (0,15 a 0,34. La correlación (índice Kappa de fiebre o no fiebre determinada por la madre y la medida por termómetro fue de 0,72 (p:0,0000. Conclusiones: Las madres tienen una buena capacidad discriminativa en la determinación de la presencia o ausencia de fiebre mediante la palpación, por lo que la detección de fiebre por tacto materno es un eficiente método de despistaje.(Rev Med Hered 2010;21:175-179

Intrapartum fetal heart rate profiles with and without fetal asphyxia.

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Low, J A; Pancham, S R; Worthington, D N

1977-04-01

Fetal heart rate profiles for periods up to 12 hours prior to delivery have been reviewed in 515 patients with a fetus at risk. Mechanisms other than fetal asphyxia will cause fetal heart rate decelerations, and fetal asphyxia may in some instances develop in the absence of total or late decelerations. However, an increasing incidence of total decelerations and late decelerations and particularly a marked pattern of total decelerations and late decelerations are of value in the prediction of fetal asphyxia. Fetal heart rate deceleration patterns can predict the probability of fetal asphyxia at the time of initial intervention, while a progression of fetal heart rate deceleration patterns in the individual fetus can be of assistance in the subsequent scheduling of serial acid-base assessments during labor.

[Materno-fetal acid-base equilibrium evaluation in parturients submitted to ketamine anesthesia (author's transl)].

Science.gov (United States)

Mauad Filho, F; Meirelles, R S

1975-01-01

In the present work ketamine was used as anesthetic during the labor in order to evaluate the effect of this anesthetic on the binominal fetus-mother. Two groups of parturients and their fetuses, were studied: 1) The experimental group, with 22 parturients and their fetuses submitted to ketamine anesthesia during the labord, and 2) The control group, with 20 parturients and their fetuses without any analgesic treatment during the labor. In 20 cases of the experimental group the anesthetic was injected during the delivery labor and the other two just before it. It were evaluated in the mother's blood the biochemical parameters of the acid-base balance and others collateral effects of the anesthesia; on the fetus's side the same parameters also and the cardiac frequency. The newborn were evaluated by Apgar Score during the first and fifth minutes of life. The incidence of the spontaneous delivery in the experimental group, was 78%; in 22% of these patients the forceps of relief was used. In 22 cases in which Ketamine was applied it were observed, the following events: elevation of the blood pressure (50%), perineum rigidness (18%), dreams and or hallucinations (18%), increase of the cardiac frequency (9%), apneia (4%) and nausea (4%). It was also observed an increase of uterine tonus an abolishment of abdominal press during the delivery labor, studied through the uterine electromyography register. It was noted after the Ketamine application a fall in the pH of the maternal peripherical venous blood, fetal skull blood and the pH of the blood of the umbilical vein. 22% of the newborns, from the experimental group, presented a depression in the first minute of life (Apgar less than or equals to 6). The pCO2 values in the blood of the umbilical artery were higher in the experimental group than in the control one.

A maior dor do mundo: o luto materno em uma perspectiva fenomenológica

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Joanneliese Lucas de Freitas

2014-06-01

Full Text Available O presente trabalho busca refletir sobre a vivência do luto materno na sociedade brasileira contemporânea, a partir da perspectiva fenomenológico-existencial. Foi realizada uma pesquisa qualitativa com três mães enlutadas. Utilizou-se o método fenomenológico de entrevistas, com uso de pergunta disparadora. A análise dos dados seguiu os quatro passos metodológicos de Giorgi. O relato das mães evidenciou diferentes temáticas, descritas por meio de dez elementos constituintes da vivência de luto materno, a saber: dor; perda de um modo de existir; espiritualidade; culpa; perda do sentido do mundo-da-vida; vontade de morrer; fragmentação dos laços afetivos; engajamento em projetos relacionados ao filho; perpetuação da memória do filho; estreitamento de laços com pessoas significativas para o morto. Os resultados obtidos na pesquisa indicam que, embora o luto se modifique ao longo do tempo, a perda de um filho jamais é superada, sendo este sofrimento compreendido não mais como uma condição patológica, mas como especificidades a serem compreendidas.

Intermittent cardiac overload results in adaptive hypertrophy and provides protection against left ventricular acute pressure overload insult.

Science.gov (United States)

Moreira-Gonçalves, Daniel; Henriques-Coelho, Tiago; Fonseca, Hélder; Ferreira, Rita; Padrão, Ana Isabel; Santa, Cátia; Vieira, Sara; Silva, Ana Filipa; Amado, Francisco; Leite-Moreira, Adelino; Duarte, José Alberto

2015-09-01

The present study aimed to test whether a chronic intermittent workload could induce an adaptive cardiac phenotype Chronic intermittent workload induced features of adaptive hypertrophy This was paralleled by protection against acute pressure overload insult The heart may adapt favourably to balanced demands, regardless of the nature of the stimuli. The present study aimed to test whether submitting the healthy heart to intermittent and tolerable amounts of workload, independently of its nature, could result in an adaptive cardiac phenotype. Male Wistar rats were subjected to treadmill running (Ex) (n = 20), intermittent cardiac overload with dobutamine (ITO) (2 mg kg(-1) , s.c.; n = 20) or placebo administration (Cont) (n = 20) for 5 days week(-1) for 8 weeks. Animals were then killed for histological and biochemical analysis or subjected to left ventricular haemodynamic evaluation under baseline conditions, in response to isovolumetric contractions and to sustained LV acute pressure overload (35% increase in peak systolic pressure maintained for 2 h). Baseline cardiac function was enhanced only in Ex, whereas the response to isovolumetric heartbeats was improved in both ITO and Ex. By contrast to the Cont group, in which rats developed diastolic dysfunction with sustained acute pressure overload, ITO and Ex showed increased tolerance to this stress test. Both ITO and Ex developed cardiomyocyte hypertrophy without fibrosis, no overexpression of osteopontin-1 or β-myosin heavy chain, and increased expression of sarcoplasmic reticulum Ca(2+) protein. Regarding hypertrophic pathways, ITO and Ex showed activation of the protein kinase B/mammalian target of rapamycin pathway but not calcineurin. Mitochondrial complex IV and V activities were also increased in ITO and Ex. Chronic submission to controlled intermittent cardiac overload, independently of its nature, results in an adaptive cardiac phenotype. Features of the cardiac overload, such as the duration and

Costos de la analgesia epidural de parto. Instituto Nacional Materno Perinatal. Enero 2006

OpenAIRE

Arias Lazarte, Silvia E.; Montes Ruiz, Celina H.; Arias Lazarte, Gladys C.

2010-01-01

Objetivo: Determinar el costo unitario y el costo operacional, para identificar los elementos y más importantes variables. Material y método: Diseño: retrospectivo, descriptivo y transversal. Los pacientes fueron 53 mujeres en trabajo de parto. Ellas reciberon analgesia epidural en enero de 2006 en el Instituto Nacional Materno Perinatal INMP. El instrumento utilizado fue una encuesta para analizar los costos. Los tipos de costos fueron calculados por la metodología del sistema de"información...

Prevalência do aleitamento materno em recém-nascidos de baixo peso Prevalence of breast feeding of low birthweight infants

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César C. Xavier

1991-10-01

Full Text Available Estudou-se de forma longitudinal e prospectiva a duração do aleitamento materno no primeira ano de vida de 222 crianças nascidas com peso menor ou igual a 2.500 gramas no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (Brasil, no período de outubro de 1985 a setembro de 1986. A incidência do aleitamento materno foi de 86,5%. A prevalência encontrada para as crianças que foram amamentadas foi de 62,5% aos 3 meses, 38,5% aos 6 meses, 28,7% aos 9 meses e 25,0% aos 12 meses de vida. A mediana da duração do aleitamento materno foi de 4 meses. O peso ao nascer mostrou associação positiva com a incidência e duração do aleitamento materno, O nível de escolaridade materno associou-se positivamente com sua duração. A idade materna, situação conjugal e o número de consultas pré-natais não apresentaram associação com o aleitamento materno. Estes dados mostram índices menores em relação aos de populações de países desenvolvidos, em especial os pré-termos finlandeses nascidos com peso menor do que 1.500 gramas. Programas de ações envolvendo a comunidade e/ou instituições devem resultar em melhoria de nossos índices, se bem implementados.The present situation regarding the breast feeding of children born with a weight of 2,500 grammes or less (LWB at the Hospital das Clínicas of the Medical School of the Universidade de S. Paulo in Ribeirão Preto (Brazil was studied. The study was descriptive and the data were obtained through a longitudinal follow-up carried over the period from October 1985 to September 1986 inclusive. Of the 222 children included in the study, 30 (13.5% infants were not breastfed. Thus the incidence of breast feeding among this population was of 86.5%. At 3 months 62.5% of these infants were still being breastfed. At 6 months this figure fell to 38.5% and only 25.0% were still being breast-fed at the end of 12 months. The average duration of breast feeding for the 192 children that

Investigation of a Potential Protective Mechanism Against Heparin-Induced Thrombocytopenia in Patients on Chronic Intermittent Hemodialysis

Science.gov (United States)

Tanhehco, Yvette C.; Cuker, Adam; Rudnick, Michael; Sachais, Bruce S.

2015-01-01

BACKGROUND Heparin-induced thrombocytopenia (HIT) develops as a result of platelet (PLT) activation by anti-platelet factor 4 (PF4)/heparin complex antibodies. Despite repeated exposure to heparin, patients undergoing chronic intermittent hemodialysis (HD) rarely develop HIT. We investigated the possibility that HD decreases/removes PF4 from PLT surfaces and/or plasma, thereby disfavoring immune complex formation as a mechanism of protection against HIT. MATERIALS AND METHODS We enrolled 20 patients undergoing chronic HD at the Penn Presbyterian Medical Center. Blood samples were drawn before, during and after treatment in the presence and absence of heparin. PF4, PF4/heparin antibody, heparin, and P-selectin levels were measured. RESULTS No patients demonstrated clinical symptoms of HIT. PLT surface PF4 levels decreased and plasma PF4 levels increased concurrently with increase in plasma heparin concentration. In the absence of heparin, PLT surface and plasma PF4 levels were unchanged. Anti-PF4/heparin antibodies, which were non-functional by the serotonin release assay, were detectable in 8 patients. PLT surface P-selectin levels did not change during treatment. CONCLUSIONS Removal of PLT surface and/or plasma PF4 as a mechanism of protection against HIT in patients undergoing HD is not supported by the results of our study, although the transient decrease in PLT surface PF4 in the presence of large amounts of heparin remains a candidate mechanism. The small sample size, single type of dialyzer membrane, and early sampling time points may have led to the inability to detect changes in PF4 levels. Future studies should explore other potential protective mechanisms. PMID:23305841

[Effects of intermittent hypoxia on the responses of genioglossus motor cortex to transcranial magnetic stimulation in rats].

Science.gov (United States)

Li, Ting; Wang, Wei; Kong, De-lei; Su, Jiao; Kang, Jian

2012-04-01

To explore the influence of intermittent hypoxia on the responses of genioglossus motor cortex to transcranial magnetic stimulation. Male Sprague-Dawley rats were randomly divided into a control group and a chronic intermittent hypoxia group. Transcranial magnetic stimulation was applied in genioglossus motor cortex of the 2 groups. The responses of transcranial magnetic stimulation were recorded and analyzed by single factor analysis of variance. The anterolateral area provided an optimal motor evoked potential response to transcranial magnetic stimulation in the genioglossus motor cortex of the rats. Genioglossus motor evoked potential latency and amplitude were significantly modified by intermittent hypoxic exposure, with a significant decrease in latency (F = 3.294, P motor cortex in rats.

The effect of fetal sex on customized fetal growth charts.

Science.gov (United States)

Rizzo, Giuseppe; Prefumo, Federico; Ferrazzi, Enrico; Zanardini, Cristina; Di Martino, Daniela; Boito, Simona; Aiello, Elisa; Ghi, Tullio

2016-12-01

To evaluate the effect of fetal sex on singleton pregnancy growth charts customized for parental characteristics, race, and parity Methods: In a multicentric cross-sectional study, 8070 ultrasonographic examinations from low-risk singleton pregnancies between 16 and 40 weeks of gestation were considered. The fetal measurements obtained were biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Quantile regression was used to examine the impact of fetal sex across the biometric percentiles of the fetal measurements considered together with parents' height, weight, parity, and race. Fetal gender resulted to be a significant covariate for BDP, HC, and AC with higher values for male fetuses (p ≤ 0.0009). Minimal differences were found among sexes for FL. Parity, maternal race, paternal height and maternal height, and weight resulted significantly related to the fetal biometric parameters considered independently from fetal gender. In this study, we constructed customized biometric growth charts for fetal sex, parental, and obstetrical characteristics using quantile regression. The use of gender-specific charts offers the advantage to define individualized normal ranges of fetal biometric parameters at each specific centile. This approach may improve the antenatal identification of abnormal fetal growth.

Fetal MRI; Fetales MRT

Energy Technology Data Exchange (ETDEWEB)

Blondin, D. [Inst. fuer Diagn. Radiologie, Uniklinikum Duesseldorf (Germany); Turowski, B. [Inst. fuer Diagn. Radiologie, Neuroradiologie, Uniklinikum Duesseldorf (Germany); Schaper, J. [Inst. fuer Diagn. Radiologie, Kinderradiologie, Uniklinikum Duesseldorf (Germany)

2007-02-15

Ultrasonography is the method of choice for prenatal malformation screening, but it does not always provide sufficient information for correct diagnosis or adequate abnormality evaluation. Fetal MRI is increasingly being used to complete sonographic findings. It was initially used for evaluation of cerebral abnormalities but is increasingly being applied to other fetal areas. In vivo investigation of fetal brain maturation has been enhanced by MRI. An adequate analysis of fetal chest and abdomen can be achieved with fast T2-, T1-weighted and diffusion-weighted imaging (DWI). The advantages include the great field of view and the excellent soft tissue contrast. This allows correct diagnosis of congenital diaphragmatic hernia and evaluation of the consequences on pulmonary growth. Other pulmonary malformations, such as cystic adenomatoid malformation, sequestration and brochogenic cysts, can also be easily identified. Renal position can be quickly determined using DWI sequences and renal agenesia can be easily diagnosed with only one sequence. Prenatal MRI is virtually as effective as postnatal examination, dispenses with transport of a potentially very ill newborn, and provides logistic advantages. Therefore, prenatal MRI is useful for adequate postnatal treatment of newborns with malformations. (orig.)

A placenta clinic approach to the diagnosis and management of fetal growth restriction.

Science.gov (United States)

Kingdom, John C; Audette, Melanie C; Hobson, Sebastian R; Windrim, Rory C; Morgen, Eric

2018-02-01

Effective detection and management of fetal growth restriction is relevant to all obstetric care providers. Models of best practice to care for these patients and their families continue to evolve. Since much of the disease burden in fetal growth restriction originates in the placenta, the concept of a multidisciplinary placenta clinic program, managed primarily within a maternal-fetal medicine division, has gained popularity. In this context, fetal growth restriction is merely one of many placenta-related disorders that can benefit from an interdisciplinary approach, incorporating expertise from specialist perinatal ultrasound and magnetic resonance imaging, reproductive genetics, neonatal pediatrics, internal medicine subspecialties, perinatal pathology, and nursing. The accurate diagnosis and prognosis for women with fetal growth restriction is established by comprehensive clinical review and detailed sonographic evaluation of the fetus, combined with uterine artery Doppler and morphologic assessment of the placenta. Diagnostic accuracy for placenta-mediated fetal growth restriction may be enhanced by quantification of maternal serum biomarkers including placenta growth factor alone or combined with soluble fms-like tyrosine kinase-1. Uterine artery Doppler is typically abnormal in most instances of early-onset fetal growth restriction and is associated with coexistent preeclampsia and underlying maternal vascular malperfusion pathology of the placenta. By contrast, rare but potentially more serious underlying placental diagnoses, such as massive perivillous fibrinoid deposition, chronic histiocytic intervillositis, or fetal thrombotic vasculopathy, may be associated with normal uterine artery Doppler waveforms. Despite minor variations in placental size, shape, and cord insertion, placental function remains, largely normal in the general population. Consequently, morphologic assessment of the placenta is not currently incorporated into current screening

Fetal Origins of Mental Health: The Developmental Origins of Health and Disease Hypothesis.

Science.gov (United States)

O'Donnell, Kieran J; Meaney, Michael J

2017-04-01

The quality of fetal growth and development predicts the risk for a range of noncommunicable, chronic illnesses. These observations form the basis of the "developmental origins of health and disease" hypothesis, which suggests that the intrauterine signals that compromise fetal growth also act to "program" tissue differentiation in a manner that predisposes to later illness. Fetal growth also predicts the risk for later psychopathology. These findings parallel studies showing that antenatal maternal emotional well-being likewise predicts the risk for later psychopathology. Taken together, these findings form the basis for integrative models of fetal neurodevelopment, which propose that antenatal maternal adversity operates through the biological pathways associated with fetal growth to program neurodevelopment. The authors review the literature and find little support for such integrated models. Maternal anxiety, depression, and stress all influence neurodevelopment but show modest, weak, or no associations with known stress mediators (e.g., glucocorticoids) or with fetal growth. Rather, compromised fetal development appears to establish a "meta-plastic" state that increases sensitivity to postnatal influences. There also remain serious concerns that observational studies associating either fetal growth or maternal mental health with neurodevelopmental outcomes fail to account for underlying genetic factors. Finally, while the observed relation between fetal growth and adult health has garnered considerable attention, the clinical relevance of these associations remains to be determined. There are both considerable promise and important challenges for future studies of the fetal origins of mental health.

Critical Role of Endoplasmic Reticulum Stress in Chronic Intermittent Hypoxia-Induced Deficits in Synaptic Plasticity and Long-Term Memory.

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Xu, Lin-Hao; Xie, Hui; Shi, Zhi-Hui; Du, Li-Da; Wing, Yun-Kwok; Li, Albert M; Ke, Ya; Yung, Wing-Ho

2015-09-20

This study examined the role of endoplasmic reticulum (ER) stress in mediating chronic intermittent hypoxia (IH)-induced neurocognitive deficits. We designed experiments to demonstrate that ER stress is initiated in the hippocampus under chronic IH and determined its role in apoptotic cell death, impaired synaptic structure and plasticity, and memory deficits. Two weeks of IH disrupted ER fine structure and upregulated ER stress markers, glucose-regulated protein 78, caspase-12, and C/EBP homologous protein, in the hippocampus, which could be suppressed by ER stress inhibitors, tauroursodeoxycholic acid (TUDCA) and 4-phenylbutyric acid. Meanwhile, ER stress induced apoptosis via decreased Bcl-2, promoted reactive oxygen species production, and increased malondialdehyde formation and protein carbonyl, as well as suppressed mitochondrial function. These effects were largely prevented by ER stress inhibitors. On the other hand, suppression of oxidative stress could reduce ER stress. In addition, the length of the synaptic active zone and number of mature spines were reduced by IH. Long-term recognition memory and spatial memory were also impaired, which was accompanied by reduced long-term potentiation in the Schaffer collateral pathway. These effects were prevented by coadministration of the TUDCA. These results show that ER stress plays a critical role in underlying memory deficits in obstructive sleep apnea (OSA)-associated IH. Attenuators of ER stress may serve as novel adjunct therapeutic agents for ameliorating OSA-induced neurocognitive impairment.

Effect of acute intermittent hypoxia on motor function in individuals with chronic spinal cord injury following ibuprofen pretreatment: A pilot study.

Science.gov (United States)

Lynch, Meaghan; Duffell, Lynsey; Sandhu, Milap; Srivatsan, Sudarshan; Deatsch, Kelly; Kessler, Allison; Mitchell, Gordon S; Jayaraman, Arun; Rymer, William Zev

2017-05-01

Acute intermittent hypoxia (AIH) enhances lower extremity motor function in humans with chronic incomplete spinal cord injury (SCI). AIH-induced spinal plasticity is inhibited by systemic inflammation in animal models. Since SCI is frequently associated with systemic inflammation in humans, we tested the hypothesis that pretreatment with the anti-inflammatory agent ibuprofen enhances the effects of AIH. A randomized, double-blinded, placebo-controlled crossover design was used. Nine adults (mean age 51.1 ± 13.1 years) with chronic motor-incomplete SCI (7.7 ± 6.3 years post-injury) received a single dose of ibuprofen (800 mg) or placebo, 90 minutes prior to AIH. For AIH, 9% O 2 for 90 seconds was interspersed with 21% O 2 for 60 seconds. Maximal voluntary ankle plantar flexion isometric torque was assessed prior to, and at 0, 30, and 60 minutes post-AIH. Surface electromyography (EMG) of plantar flexor muscles was also recorded. Torque increased significantly after AIH at 30 (P = 0.007; by ∼20%) and 60 (P Ibuprofen did not augment the effects of AIH. EMG activity did not increase significantly after AIH; however, there was a significant association between increases in torque and EMG in both gastrocnemius (R 2  = 0.17, P ibuprofen pretreatment. Our study re-confirms the ability of AIH to enhance leg strength in persons with chronic incomplete SCI.

Hipertireoidismo na gravidez: repercussões materno-fetais Hyperthyroidism during pregnancy: maternal-fetal outcomes

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Amanda Tavares Pinheiro

2008-09-01

Full Text Available OBJETIVO: avaliar a experiência do Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista "Júlio de Mesquita Filho", no acompanhamento de gestantes com hipertireoidismo. MÉTODOS: foram estudadas, retrospectivamente, 60 pacientes, divididas em grupos com hipertireoidismo compensado (GHC=24 e com hipertireoidismo descompensado (GHD=36 e comparadas quanto a características clínico-laboratoriais e intercorrências. Para análise dos resultados, foram utilizados o teste t de Student, as tabelas de contingência, regressão linear múltipla e regressão logística múltipla, com nível de significância de 5,0%. RESULTADOS: propiltiouracil (PTU foi usado por 94,0% do GHD e 42,0% do GHC (pPURPOSE: to evaluate the experience of Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista "Júlio de Mesquita Filho", in the follow-up of pregnant women with hyperthyroidism. METHODS: Sixty patients, divided in groups with compensated hyperthyroidism (CHG=24 and with uncompensated hyperthyroidism (UHG=36 were retrospectively studied and compared concerning clinical-laboratorial characteristics and intercurrences. The t-Student test, contingency tables, multiple linear regression and multiple logistic regression with significance level at 5.0% were used. RESULTS: propylthiouracil (PTU was used by 94.0% of UHG and by 42.0% of CHG (p<0.0001; maternal complications close to delivery have occurred in 20.6% of UHG and in 11.8% of CHG, and UHG presented three fetal deaths, influenced by the mother age, higher level of T4L (lT4L and of PTU dose (PTUd in the third trimester (p=0.007; restriction of intra-uterine growth, influenced by lT4L and PTUd in the third trimester has occurred in nine UHG and in three CHG cases, and oligoamnios has occurred in 12 patients (83.3% of UGH and 16.7% of CGH, influenced by age and lT4L in the third trimester (p=0.04; the gestational age at delivery was 34.4�

Fetal exposure to a diabetic intrauterine environment resulted in a failure of cord blood endothelial progenitor cell adaptation against chronic hypoxia

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Dincer UD

2014-12-01

Full Text Available U Deniz Dincer Department of Basic and Clinical Pharmacology, School of Medicine, Bezmialem Vakif University (BAVU, Fatih/Istanbul, Turkey Abstract: Gestational diabetes mellitus (GDM has long-term health consequences, and fetal exposure to a diabetic intrauterine environment increases cardiovascular risk for her adult offspring. Some part of this could be related to their endothelial progenitor cells (EPCs. Understanding the vessel-forming ability of human umbilical cord blood (HUCB-derived endothelial colony-forming cells (ECFCs against pathological stress such as GDM response to hypoxia could generate new therapeutic strategies. This study aims to investigate the role of chronic hypoxia in EPCs functional and vessel-forming ability in GDM subjects. Each ECFC was expressed in endothelial and pro-angiogenic specific markers, namely endothelial nitric oxide synthase (eNOS, platelet (PECAM-1 endothelial cell adhesion molecule 1, vascular endothelial-cadherin CdH5 (Ca-dependent cell adhesion molecule, vascular endothelial growth factor A, (VEGFA and insulin-like growth factor 1 (IGF1. Chronic hypoxia did not affect CdH5, but PECAM1 MRNA expressions were increased in control and GDM subjects. Control hypoxic and GDM normoxic VEGFA MRNA expressions and hypoxia-inducible factor 1-alpha (HIF1α protein expressions were significantly increased in HUCB ECFCs. GDM resulted in most failure of HUCB ECFC adaptation and eNOS protein expressions against chronic hypoxia. Chronic hypoxia resulted in an overall decline in HUCB ECFCs' proliferative ability due to reduction of clonogenic capacity and diminished vessel formation. Furthermore, GDM also resulted in most failure of cord blood ECFC adaptation against chronic hypoxic environment. Keywords: endothelial progenitor cells, gestational diabetes mellitus, chronic hypoxia, human cord blood

Intermittent ileocoecal intususception in adult

International Nuclear Information System (INIS)

Cambal, M.; Zonca, P.; Maly, T.

2013-01-01

Aim: Aim of our paper is to present a case-report of chronic invagination in adult patient. Material: 28-years old woman with one year history of intermittent abdominal pain with symptoms of subileus state. She has underwent abdominal ultrasonography, abdominal X-ray, colonoscopy, irigography and abdominal CT. Appendectomy indicated for diagnosis of chronic appendicitis did not improve symptoms. Consecutively during acute problems were irigography and CT performed and diagnosis of an incomplete colon transversum obstruction of uncertain origin was established. There was stated suspicion of an intususception and patient was due to a repeated gastrointestinal passage indicated for an explorative laparotomy. During operation there was identified threefold invagination – colo-colonic, ileo-colonic and ileo-ileal. As a leading point of invagination was found in terminal ileum intraluminal polypous tumor 5 cm in diameter. Because of the secondary chronic changes of right colon wall and terminal ileum wall, after partial desinvagination right hemicolectomy was performed. Results: Patient was primary healed and now is without any subjective problems. Conclusion: Invagination is an acute abdominal event of obturative-strangulative type and it mainly occurs in infantile age. It is astonishing how long were patient´s difficulties lasting without obvious acute ileus. It is necessary in clinical practice to think on these rare reasons of gastrointestinal passage disorders. (author)

Fetal organ dosimetry for the Techa River and Ozyorsk Offspring Cohorts. Pt. 2. Radionuclide S values for fetal self-dose and maternal cross-dose

International Nuclear Information System (INIS)

Maynard, Matthew R.; Bolch, Wesley E.; Shagina, Natalia B.; Tolstykh, Evgenia I.; Degteva, Marina O.; Fell, Tim P.

2015-01-01

One of the many objectives of the European Union's SOLO (Epidemiological Studies of Exposed Southern Urals Populations) project is to quantify the radiation dose-response following chronic in utero exposures to ionizing radiation. The project is presently conducting a pooled analysis of two cohorts of individuals born to exposed mothers - the Techa River Offspring Cohort (TROC) and the Ozyorsk Offspring Cohort (OOC). The TROC includes the offspring of mothers with external exposures to contaminated riverbanks and internal ingestions of 89 Sr, 90 Sr/ 90 Y, and 137 Cs/ 137m Ba, while the OOC includes the offspring of mothers with external exposures seen within the Mayak plutonium production facilities and internal inhalation of 239 Pu and possibly 131 I. In the present study, a newly created Urals-based series of fetal and maternal models is employed to assess S values for all seven radionuclides. Among all fetal ages, S values ranged in magnitude from 10 -14 to 10 -10 Gy per Bq-s for fetal source organs and from 10 -18 to 10 -14 Gy per Bq-s from maternal source organs, depending upon particle type, particle energy, and fetal age. For a given radionuclide and fetal age, S values for fetal source organs were approximately two orders of magnitude higher than for maternal source organs. Little variation in S values was observed among fetal source organs, while variations of over 100 % with respect to the mean were observed for maternal source organs near the fetus. S value variations from maternal cross-fire were highly dependent on fetal position and separation distance from the maternal source organ. These radionuclide S values have been coupled with biokinetic models for use in cohort dose assessment within the SOLO project. (orig.)

Chronic and acute inspiratory muscle loading augment the effect of a 6-week interval program on tolerance of high-intensity intermittent bouts of running.

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Tong, Tom K; Fu, Frank H; Eston, Roger; Chung, Pak-Kwong; Quach, Binh; Lu, Kui

2010-11-01

This study examined the hypothesis that chronic (training) and acute (warm-up) loaded ventilatory activities applied to the inspiratory muscles (IM) in an integrated manner would augment the training volume of an interval running program. This in turn would result in additional improvement in the maximum performance of the Yo-Yo intermittent recovery test in comparison with interval training alone. Eighteen male nonprofessional athletes were allocated to either an inspiratory muscle loading (IML) group or control group. Both groups participated in a 6-week interval running program consisting of 3-4 workouts (1-3 sets of various repetitions of selected distance [100-2,400 m] per workout) per week. For the IML group, 4-week IM training (30 inspiratory efforts at 50% maximal static inspiratory pressure [P0] per set, 2 sets·d-1, 6 d·wk-1) was applied before the interval program. Specific IM warm-up (2 sets of 30 inspiratory efforts at 40% P0) was performed before each workout of the program. For the control group, neither IML was applied. In comparison with the control group, the interval training volume as indicated by the repeatability of running bouts at high intensity was approximately 27% greater in the IML group. Greater increase in the maximum performance of the Yo-Yo test (control: 16.9 ± 5.5%; IML: 30.7 ± 4.7% baseline value) was also observed after training. The enhanced exercise performance was partly attributable to the greater reductions in the sensation of breathlessness and whole-body metabolic stress during the Yo-Yo test. These findings show that the combination of chronic and acute IML into a high-intensity interval running program is a beneficial training strategy for enhancing the tolerance to high-intensity intermittent bouts of running.

Increasing fetal ovine number per gestation alters fetal plasma clinical chemistry values.

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Zywicki, Micaela; Blohowiak, Sharon E; Magness, Ronald R; Segar, Jeffrey L; Kling, Pamela J

2016-08-01

Intrauterine growth restriction (IUGR) is interconnected with developmental programming of lifelong pathophysiology. IUGR is seen in human multifetal pregnancies, with stepwise rises in fetal numbers interfering with placental nutrient delivery. It remains unknown whether fetal blood analyses would reflect fetal nutrition, liver, and excretory function in the last trimester of human or ovine IUGR In an ovine model, we hypothesized that fetal plasma biochemical values would reflect progressive placental, fetal liver, and fetal kidney dysfunction as the number of fetuses per gestation rose. To determine fetal plasma biochemical values in singleton, twin, triplet, and quadruplet/quintuplet ovine gestation, we investigated morphometric measures and comprehensive metabolic panels with nutritional measures, liver enzymes, and placental and fetal kidney excretory measures at gestational day (GD) 130 (90% gestation). As anticipated, placental dysfunction was supported by a stepwise fall in fetal weight, fetal plasma glucose, and triglyceride levels as fetal number per ewe rose. Fetal glucose and triglycerides were directly related to fetal weight. Plasma creatinine, reflecting fetal renal excretory function, and plasma cholesterol, reflecting placental excretory function, were inversely correlated with fetal weight. Progressive biochemical disturbances and growth restriction accompanied the rise in fetal number. Understanding the compensatory and adaptive responses of growth-restricted fetuses at the biochemical level may help explain how metabolic pathways in growth restriction can be predetermined at birth. This physiological understanding is important for clinical care and generating interventional strategies to prevent altered developmental programming in multifetal gestation. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

Effect of Simulated Intermittent Altitude on the Metabolic and Hematologic Parameters in Streptozotocin Induced Diabetic Rats

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mehdi Faramoushi

2016-04-01

Full Text Available Background & objectives: Type II diabetes is a metabolic disorder accompanied with insulin resistance of the whole body cells and is considered be the fifth cause of death in the world. Adaptation to altitude can lead to tolerance to many diseases. Therefore, the aim of this study was to determine the effect of simulated intermittent altitude on the metabolic and hematologic parameters and liver function in streptozotocin induced diabetic rats. Methods: In the current experimental study, twenty four male Wistar rats weighing 220±20 gr were randomly divided into three groups; normal control group (NC, n=8, diabetic control group (D, n=8 received fat diet for 2 weeks then were injected with streptozotocin (37 mg/kg and diabetic+hypoxia group (D+H, n=8 including diabetic rat exposed to chronic intermittent hypoxia (PiO2≈106 mm Hg, simulated altitude≈3400 m, 14% oxygen for 8 weeks. Diabetic, hematologic and lipid parameters as well as ALT and AST activities were measured in peripheral blood. Results: Our findings showed that intermittent hypoxia significantly decreased serum total cholesterol, LDL ,VLDL and triglyceride in D+H group compared to D group (p<0.05. Serum levels of fasting blood glucose and homeostatic model assessment-insulin resistance HOMA-IR( index and ALT were decreased in D+H group vs. D group p<0.05. Also, hemoglubin and hematocrite level increased in D+H group in comparison to D group p<0.05. No significant difference was detected in red blood cell count in D+H vs. D group. Conclusion: Based on resultant data, it seems that intermittent exposure to hypoxia (simulated to chronic and intermittent lodgement in altitude can be used to control of type 2 diabetes by increasing hemoglobin, decreasing insulin resistance and improving liver function as well as lipid parameters.

Aleitamento e parasitismo intestinal materno-infantil

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Costa-Macedo Lêda Maria

2000-01-01

Full Text Available Entre março e maio de 1991, a prevalência das enteroparasitoses e o aleitamento materno foram determinados simultaneamente em 208 crianças menores de dois anos de idade e suas mães, atendidas em Instituição Pública de Saúde no Rio de Janeiro. Através da técnica de sedimentação, detectou-se positividade geral de 12,7% para as crianças, e 37,3% para as mães. Ascaris lumbricoides foi o parasito mais prevalente nas mulheres (12,7% e nos lactentes (4,3%. A distribuição dos parasitos entre os grupos de aleitamento não variou para as mulheres, mas foi estatisticamente significativa em relação às crianças (p < 0,05. Nenhuma criança em aleitamento exclusivo apresentou parasitose. Verificou-se correlação positiva entre parasitismo e desmame. Cerca de 60% das crianças parasitadas eram filhas de mães também parasitadas, sendo detectado um risco 1,7 vezes maior destas crianças virem a apresentar algum parasito intestinal. Acreditamos que a mãe parasitada possa influenciar na freqüência do parasitismo infantil.

Effect of maternal exercises on biophysical fetal and maternal parameters: a transversal study.

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Santos, Caroline Mombaque Dos; Santos, Wendel Mombaque Dos; Gallarreta, Francisco Maximiliano Pancich; Pigatto, Camila; Portela, Luiz Osório Cruz; Morais, Edson Nunes de

2016-01-01

To evaluate the acute effects of maternal and fetal hemodynamic responses in pregnant women submitted to fetal Doppler and an aerobic physical exercise test according to the degree of effort during the activity and the impact on the well-being. Transversal study with low risk pregnant women, obtained by convenience sample with gestational age between 26 to 34 weeks. The participants carry out a progressive exercise test. After the exercise session, reduced resistance (p=0.02) and pulsatility indices (p=0.01) were identified in the umbilical artery; however, other Doppler parameters analyzed, in addition to cardiotocography and fetal biophysical profile did not achieve significant change. Maternal parameters obtained linear growth with activity, but it was not possible to establish a standard with the Borg scale, and oxygen saturation remained stable. A short submaximal exercise had little effect on placental blood flow after exercise in pregnancies without complications, corroborating that healthy fetus maintains homeostasis even in situations that alter maternal hemodynamics. Avaliar os efeitos agudos de respostas hemodinâmicas maternas e fetais em gestantes submetidas a Doppler fetal e a um teste de exercício físico aeróbio, de acordo com o grau de esforço durante a atividade e o impacto sobre o bem-estar. Estudo transversal desenvolvido com gestantes de baixo risco, por amostra de conveniência com idade gestacional entre 26 e 34 semanas. As participantes realizam um teste de esforço progressivo. Na artéria umbilical, após sessão de exercício físico, identificou-se a redução do índice de resistência (p=0,02) e do índice de pulsatilidade (p=0,01), mas os demais parâmetros Doppler analisados, além da cardiotocografia e do perfil biofísico fetal, não obtiveram alteração significativa. Os parâmetros maternos obtiveram crescimento linear com a atividade, mas não foi possível estabelecer padrão com a escala de Borg, e a saturação de oxig

High fetal plasma adenosine concentration: a role for the fetus in preeclampsia?

LENUS (Irish Health Repository)

Espinoza, Jimmy

2012-02-01

OBJECTIVE: Clinical observations suggest a role for the fetus in the maternal manifestations of preeclampsia, but the possible signaling mechanisms remain unclear. This study compares the fetal plasma concentrations of adenosine from normal pregnancies with those from preeclampsia. STUDY DESIGN: This secondary data analysis included normal pregnancies (n = 27) and patients with preeclampsia (n = 39). Patients with preeclampsia were subclassified into patients with (n = 25) and without (n = 14) abnormal uterine artery Doppler velocimetry (UADV). RESULTS: Fetal plasma concentrations of adenosine were significantly higher in patients with preeclampsia (1.35 +\\/- 0.09 mumol\\/L) than in normal pregnancies (0.52 +\\/- 0.06 mumol\\/L; P < .0001). Fetal plasma concentrations of adenosine in patients with preeclampsia with abnormal UADV (1.78 +\\/- 0.15 mumol\\/L), but not with normal UADV (0.58 +\\/- 0.14 mumol\\/L), were significantly higher than in normal pregnancies (P < .0001). CONCLUSION: Patients with preeclampsia with sonographic evidence of chronic uteroplacental ischemia have high fetal plasma concentrations of adenosine.

Impaired hypoxic ventilatory response following neonatal sustained and subsequent chronic intermittent hypoxia in rats.

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Mayer, C A; Ao, J; Di Fiore, J M; Martin, R J; MacFarlane, P M

2013-06-15

Neonatal chronic intermittent hypoxia (CIH) enhances the ventilatory sensitivity to acute hypoxia (acute hypoxic ventilatory response, HVR), whereas sustained hypoxia (SH) can have the opposite effect. Therefore, we investigated whether neonatal rats pre-treated with SH prior to CIH exhibit a modified HVR. Rat pups were exposed to CIH (5% O2/5min, 8h/day) between 6 and 15 days of postnatal age (P6-15) after pre-treatment with either normoxia or SH (11% O2; P1-5). Using whole-body plethysmography, the acute (5min, 10% O2) HVR at P16 (1 day post-CIH) was unchanged following CIH (67.9±6.7% above baseline) and also SH (58.8±10.5%) compared to age-matched normoxic rats (54.7±6.3%). In contrast, the HVR was attenuated (16.5±6.0%) in CIH exposed rats pre-treated with SH. These data suggest that while neonatal SH and CIH alone have little effect on the magnitude of the acute HVR, their combined effects impose a synergistic disturbance to postnatal development of the HVR. These data could provide important insight into the consequences of not maintaining adequate levels of oxygen saturation during the early neonatal period, especially in vulnerable preterm infants susceptible to frequent bouts of hypoxemic events (CIH) that are commonly associated with apnea of prematurity. Copyright © 2013 Elsevier B.V. All rights reserved.

Fissuras labiopalatinas, ganho de peso e cirurgias: leite materno versus fórmulas lácteas

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Marcos Roberto Tovani Palone

2015-10-01

Full Text Available As fissuras labiopalatinas são as anomalias craniofaciais mais comuns na espécie humana. Por sua vez, com o propósito de ganho de peso corporal necessário para realização das cirurgias reabilitadoras, uma alternativa rotineiramente utilizada para crianças com fissuras consiste no uso de fórmulas lácteas industrializadas, como um substituto do leite materno ou mesmo uma suplementação alimentar. Contudo, é imprescindível a conscientização das mães e demais cuidadores desse grupo de crianças sobre a importância do aleitamento materno e seus benefícios adicionais, os quais inclusive colocam em questionamento a necessidade e viabilidade da prescrição dessas fórmulas nos casos em que a amamentação natural é possível. Ademais, o tipo de alimentação, aleitamento natural ou artificial é de notória importância, com influência direta na composição da microbiota gastrintestinal e possibilidades de impactos sobre a imunomodulação destes indivíduos.

Intermittent Explosive Disorder

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Lut Tamam

2011-09-01

Full Text Available Intermittent explosive disorder is an impulse control disorder characterized by the occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property. Though the prevalence intermittent explosive disorder has been reported to be relatively rare in frontier studies on the field, it is now common opinion that intermittent explosive disorder is far more common than previously thought especially in clinical psychiatry settings. Etiological studies displayed the role of both psychosocial factors like childhood traumas and biological factors like dysfunctional neurotransmitter systems and genetics. In differential diagnosis of the disorder, disorders involving agression as a symptom such as alcohol and drug intoxication, antisocial and borderline personality disorders, personality changes due to general medical conditions and behavioral disorder should be considered. A combination of pharmacological and psychotherapeutic approaches are suggested in the treatment of the disorder. This article briefly reviews the historical background, diagnostic criteria, epidemiology, etiology and treatment of intermittent explosive disorder.

Uso de medicamentos por nutrizes em Itaúna-MG: caracterização e associação com o tempo de aleitamento materno

OpenAIRE

Roberto Gomes Chaves

2007-01-01

O aleitamento materno é uma prática associada a valiosos benefícios para a criança, a mãe, a família e a sociedade, recomendada pela Organização Mundial de Saúde até pelo menos dois anos de idade. Contudo, as crianças raramente são amamentadas até esse período considerado ideal. Assim, torna-se necessária a realização de pesquisa para identificar os fatores associados à duração do aleitamento materno. Entre eles, o uso de medicamentos tem sido apontado como responsável por menos tempo de a...

Intermittent hypoxia in obese Zucker rats: cardiometabolic and inflammatory effects.

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Briançon-Marjollet, Anne; Monneret, Denis; Henri, Marion; Joyeux-Faure, Marie; Totoson, Perle; Cachot, Sandrine; Faure, Patrice; Godin-Ribuot, Diane

2016-11-01

What is the central question of this study? This study addresses the relative impact of obesity and intermittent hypoxia in the pathophysiological process of obstructive sleep apnoea by investigating the metabolic, inflammatory and cardiovascular consequences of intermittent hypoxia in lean and obese Zucker rats. What is the main finding and its importance? We found that obesity and intermittent hypoxia have mainly distinct consequences on the investigated inflammatory and cardiometabolic parameters in Zucker rats. This suggests that, for a given severity of sleep apnea, the association of obesity and obstructive sleep apnoea may not necessarily be deleterious. Obstructive sleep apnoea is associated with obesity with a high prevalence, and both co-morbidities are independent cardiovascular risk factors. Intermittent hypoxia (IH) is thought to be the main factor responsible for the obstructive sleep apnoea-related cardiometabolic alterations. The aim of this study was to assess the respective impact of obesity and IH on the inflammatory and cardiometabolic state in rats. Lean and obese Zucker rats were exposed to normoxia or chronic IH, and we assessed metabolic and inflammatory parameters, such as plasma lipids and glucose, serum leptin and adiponectin, liver cytokines, nuclear factor-κB activity and cardiac endothelin-1 levels. Myocardial infarct size was also evaluated following in vitro ischaemia-reperfusion. Circulating lipids, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), leptin and adiponectin levels were higher in obese versus lean rats. Chronic IH did not have a significant impact on metabolic parameters in lean rats. In obese rats, IH increased glycaemia and HOMA-IR. Liver interleukin-6 and tumour necrosis factor-α levels were elevated in lean rats exposed to IH; obesity prevented the increase in interleukin-6 but not in tumour necrosis factor-α. Finally, IH exposure enhanced myocardial sensitivity to infarction in both lean and

[Perinatal complications in patients with chronic renal insufficiency on hemodialysis].

Science.gov (United States)

Vázquez-Rodríguez, Juan Gustavo; del Angel-García, Guadalupe

2010-09-01

Pregnant patients with chronic renal insufficiency treated with hemodialysis experience adverse perinatal results. To compare perinatal complications of patients with chronic renal insufficiency undergoing hemodialysis who become pregnant vs. the complications of women with chronic renal insufficiency not undergoing dialysis but who then require dialysis during gestation. Transversal and retrospective study that included three patients with chronic renal insufficiency on chronic hemodialysis who became pregnant (group A) and three patients with chronic renal insufficiency without hemodialysis at the time of conception but who required dialysis during gestation (group B). Perinatal results were compared. Statistical analysis was performed with measures of central tendency and dispersion and Student t-test. Group A had 25 sessions vs. group B with 29 hemodialysis sessions (p = 0.88). Maternal complications were anemia 100% (six cases), Cesarean delivery 83.3% (group A 2 cases vs. group B 2 cases), preeclampsia 50% (group A 2 cases vs. group B 1 case), uncontrolled hypertension 50% (group A 2 cases vs. group B 1 case), preterm delivery 50% (group A 2 cases vs. group B 1 case), transfusion 33.3% (group A 2 cases), polyhydramnios 33.3% (group A 1 case vs. group B 1 case) and abortion 16.6% (group A 1 case). Fetal complications included fetal loss 16.6% (group A 1 case), neonatal mortality 33.3% (group A 1 cases vs. group B 1 case), prematurity 50% (group A2 cases vs. group B 1 case), fetal distress 50% (group A 1 case vs. group B 2 cases), respiratory failure 33.3% (group A 2 cases) and fetal growth restriction 16.6% (group A 1 case). Frequency of perinatal complications is elevated in both groups.

O aleitamento materno no tratamento de crianças com fenilcetonúria Breastfeeding in the treatment of children with phenylketonuria

Directory of Open Access Journals (Sweden)

Viviane C. Kanufre

2007-10-01

Full Text Available OBJETIVO: Avaliar o efeito do leite materno como fonte de fenilalanina (phe nos níveis sangüíneos desse aminoácido e no crescimento de fenilcetonúricos. MÉTODOS: Foram estudados 35 fenilcetonúricos que mantiveram leite materno, e os resultados foram comparados com os de 35 lactentes que usaram fórmula láctea comercial. Os grupos foram pareados por sexo e por idade à suspensão do aleitamento materno. Os dados foram analisados até a suspensão do leite materno ou durante 12 meses de acompanhamento. O grupo amamentado recebeu "fórmula especial" isenta em phe, em mamadeira a cada 3 horas, e leite materno em livre demanda nos intervalos. Os níveis sangüíneos de phe, coletados semanalmente até 6 meses e quinzenalmente até 1 ano de idade, foram analisados durante a amamentação. Foram comparados o tempo necessário para adequação dos níveis sangüíneos de phe, após o início do tratamento, utilizando o teste de Wilcoxon e os dados antropométricos, pelo teste t de Student pareado, utilizando o escore z. As dosagens de phe foram analisadas durante a amamentação. RESULTADOS: O tempo mediano para adequação dos níveis de phe no sangue foi de 8 dias para o grupo amamentado e de 7 dias para o grupo controle. As dosagens de phe estavam adequadas em 87% das vezes para o grupo amamentado e em 74,4% para o grupo controle. Na avaliação antropométrica, a maioria das crianças, de ambos os grupos, apresentou escore z > -2. CONCLUSÃO: A manutenção do aleitamento materno, durante o tratamento, mostrou-se adequada no controle metabólico e no crescimento das crianças fenilcetonúricas.OBJECTIVE: To evaluate the effect of breastmilk as a source of phenylalanine (phe on levels of this amino acid and on growth in phenylketonuric infants. METHODS: The study recruited 35 breastfed phenylketonuric infants and compared their results with those of 35 infants fed on commercial, milk-based formula. The groups were paired for sex and age at

STREPTOCOQUE BETA HEMOLYTIQUE DU GROUPE B ET ...

African Journals Online (AJOL)

hémolytic streptococcus during pregnancy and its materno-fetal ..... and their newborns. Medscape Women's Health. 1996 Mar; 1(3):2. 21. Centers for Disease Control and Prevention (CDC). Perinatal Group B streptococcal disease after universal ...

Acute behavioral effects of intrapleural OK-432 (Picibanil) administration in preterm fetal sheep.

Science.gov (United States)

Cowie, Rosalind V; Stone, Peter R; Parry, Emma; Jensen, Ellen C; Gunn, Alistair J; Bennet, Laura

2009-01-01

To develop a model to study the fetal effects of intrapleural infusion of OK-432 (Picibanil), a pleurodesis agent derived from killed Gram-positive streptococci. OK-432 (0.1 mg, n = 5), or normal saline (n = 5) were infused over 20 min into the pleural space of chronically instrumented preterm fetal sheep at 0.7 gestation. Fetal physiological parameters, including breathing and nuchal activity were monitored in utero from 6 h before infusion until 12 h afterward, and fetuses were killed after 7 days recovery. OK-432 was associated with transient suppression of fetal EEG activity, breathing and body movements from 3-6 h after infusion. Hypotension and hypoxia did not occur. At postmortem, local pleural adhesions were seen around the site of OK-432 infusion but not in saline treated fetuses. Intrapleural administration of OK-432 is associated with marked but transient fetal behavioral effects. This model will enable preclinical investigation of the neural and cardiovascular safety of OK-432 at a clinical relevant stage of development. Copyright 2009 S. Karger AG, Basel.

Temporal slice registration and robust diffusion-tensor reconstruction for improved fetal brain structural connectivity analysis.

Science.gov (United States)

Marami, Bahram; Mohseni Salehi, Seyed Sadegh; Afacan, Onur; Scherrer, Benoit; Rollins, Caitlin K; Yang, Edward; Estroff, Judy A; Warfield, Simon K; Gholipour, Ali

2017-08-01

Diffusion weighted magnetic resonance imaging, or DWI, is one of the most promising tools for the analysis of neural microstructure and the structural connectome of the human brain. The application of DWI to map early development of the human connectome in-utero, however, is challenged by intermittent fetal and maternal motion that disrupts the spatial correspondence of data acquired in the relatively long DWI acquisitions. Fetuses move continuously during DWI scans. Reliable and accurate analysis of the fetal brain structural connectome requires careful compensation of motion effects and robust reconstruction to avoid introducing bias based on the degree of fetal motion. In this paper we introduce a novel robust algorithm to reconstruct in-vivo diffusion-tensor MRI (DTI) of the moving fetal brain and show its effect on structural connectivity analysis. The proposed algorithm involves multiple steps of image registration incorporating a dynamic registration-based motion tracking algorithm to restore the spatial correspondence of DWI data at the slice level and reconstruct DTI of the fetal brain in the standard (atlas) coordinate space. A weighted linear least squares approach is adapted to remove the effect of intra-slice motion and reconstruct DTI from motion-corrected data. The proposed algorithm was tested on data obtained from 21 healthy fetuses scanned in-utero at 22-38 weeks gestation. Significantly higher fractional anisotropy values in fiber-rich regions, and the analysis of whole-brain tractography and group structural connectivity, showed the efficacy of the proposed method compared to the analyses based on original data and previously proposed methods. The results of this study show that slice-level motion correction and robust reconstruction is necessary for reliable in-vivo structural connectivity analysis of the fetal brain. Connectivity analysis based on graph theoretic measures show high degree of modularity and clustering, and short average

Soluble Receptor for Advanced Glycation End Product Ameliorates Chronic Intermittent Hypoxia Induced Renal Injury, Inflammation, and Apoptosis via P38/JNK Signaling Pathways

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Xu Wu

2016-01-01

Full Text Available Obstructive sleep apnea (OSA associated chronic kidney disease is mainly caused by chronic intermittent hypoxia (CIH triggered tissue damage. Receptor for advanced glycation end product (RAGE and its ligand high mobility group box 1 (HMGB1 are expressed on renal cells and mediate inflammatory responses in OSA-related diseases. To determine their roles in CIH-induced renal injury, soluble RAGE (sRAGE, the RAGE neutralizing antibody, was intravenously administered in a CIH model. We also evaluated the effect of sRAGE on inflammation and apoptosis. Rats were divided into four groups: (1 normal air (NA, (2 CIH, (3 CIH+sRAGE, and (4 NA+sRAGE. Our results showed that CIH accelerated renal histological injury and upregulated RAGE-HMGB1 levels involving inflammatory (NF-κB, TNF-α, and IL-6, apoptotic (Bcl-2/Bax, and mitogen-activated protein kinases (phosphorylation of P38, ERK, and JNK signal transduction pathways, which were abolished by sRAGE but p-ERK. Furthermore, sRAGE ameliorated renal dysfunction by attenuating tubular endothelial apoptosis determined by immunofluorescence staining of CD31 and TUNEL. These findings suggested that RAGE-HMGB1 activated chronic inflammatory transduction cascades that contributed to the pathogenesis of the CIH-induced renal injury. Inhibition of RAGE ligand interaction by sRAGE provided a therapeutic potential for CIH-induced renal injury, inflammation, and apoptosis through P38 and JNK pathways.

Fetal thrombocytopenia in pregnancies with fetal human parvovirus-B19 infection.

Science.gov (United States)

Melamed, Nir; Whittle, Wendy; Kelly, Edmond N; Windrim, Rory; Seaward, P Gareth R; Keunen, Johannes; Keating, Sarah; Ryan, Greg

2015-06-01

Fetal infection with human parvovirus B19 (hParvo-B19) has been associated mainly with fetal anemia, although data regarding other fetal hematologic effects are limited. Our aim was to assess the rate and consequences of severe fetal thrombocytopenia after fetal hParvo-B19 infection. We conducted a retrospective study of pregnancies that were complicated by fetal hParvo-B19 infection that underwent fetal blood sampling (FBS). The characteristics and outcomes of fetuses with severe thrombocytopenia (B19 infection. A total of 37 pregnancies that were affected by fetal hParvo-B19 infection were identified. Of the 29 cases that underwent FBS and had information regarding fetal platelets, 11 cases (38%) were complicated by severe fetal thrombocytopenia. Severely thrombocytopenic fetuses were characterized by a lower hemoglobin concentration (2.6 ± 0.9 g/dL vs 5.5 ± 3.6 g/dL; P = .01), lower reticulocyte count (9.1% ± 2.8% vs 17.3% ± 10.6%; P = .02), and lower gestational age at the time of diagnosis (21.4 ± 3.1 wk vs 23.6 ± 2.2 wk; P = .03). Both the fetal death rate within 48 hours of FBS (27.3% vs 0%; P = .02) and the risk of prematurity (100.0% vs 13.3%; P B19 infection, can be further worsened by IUT, and may be associated with an increased risk of procedure-related fetal loss after either FBS or IUT. Copyright © 2015. Published by Elsevier Inc.

Avaliação da vitalidade fetal e resultados perinatais em gestações após gastroplastia com derivação em Y de Roux Assessment of fetal vitality and perinatal results in pregnancies after gastroplasty with Roux-en-Y gastric bypass

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Roseli Mieko Yamamoto Nomura

2010-01-01

Full Text Available OBJETIVO: Analisar os resultados da avaliação da vitalidade fetal de gestações após gastroplastia com derivação em Y de Roux, verificando as complicações maternas e os resultados perinatais. MÉTODOS: No período de julho de 2001 a setembro de 2009, foram analisados, retrospectivamente, dados de prontuário de pacientes com gestação após gastroplastia com derivação em Y de Roux, acompanhadas em pré-natal especializado e cujo parto foi realizado na instituição. Foram analisados os exames de avaliação da vitalidade fetal (cardiotocografia, perfil biofísico fetal e dopplervelocimetria das artérias umbilicais realizada na semana anterior ao parto. As variáveis maternas investigadas foram: dados demográficos, complicações clínicas maternas, tipo de parto, complicações no parto e pós-parto, exames hematimétricos maternos e resultados perinatais. RESULTADOS: Trinta gestações após gastroplastia com derivação em Y de Roux foram identificadas e 24 delas foram submetidas à avaliação da vitalidade fetal. Todas as pacientes apresentaram resultados normais na cardiotocografia, no perfil biofísico fetal e na dopplervelocimetria das artérias umbilicais. Houve um caso de oligohidrâmnio. A principal complicação observada foi anemia materna (Hb OBJECTIVE: To study fetal vitality assessed in pregnancies after gastroplasty with Roux-en-Y gastric bypass'and verify maternal complications and perinatal results. METHODS: Hospital charts of all pregnancies after gastroplasty with Roux-en-Y gastric bypass were reviewed retrospectively. All cases followed at the specialized prenatal care that gave birth in this institution, between July 2001 and September 2009, were reviewed. The assessment of fetal vitality (cardiotocography, fetal biophysical profile and umbilical artery Doppler velocimetry performed in the last week before delivery were analyzed. The maternal variables investigated were: demographic data, maternal complications

Intermittent heating of buildings

Energy Technology Data Exchange (ETDEWEB)

Kohonen, K

1983-02-01

Conditions for intermittent heating of buildings are considered both theoretically and experimentally. Thermal behaviour of buildings adn rooms in intermittent heating is simulated by a program based on the convective heat balance equation and by simplified RC-models. The preheat times and the heating energy savings compared with continuous heating are presented for typical lightweight, mediumweight and heavyweight classroom and office modules. Formulaes for estimating the oversizing of the radiator network, the maximum heat output of heat exchangers in district heating and the efficiency of heating boilers in intermittent heating are presented. The preheat times and heating energy savings with different heating control systems are determined also experimentally in eight existing buildings. In addition some principles for the planning and application of intermittent heating systems are suggested.

Fetal cerebral responses to ventilation and oxygenation in utero

International Nuclear Information System (INIS)

Gleason, C.A.; Jones, M.D. Jr.; Traystman, R.J.; Notter, R.H.

1988-01-01

Previous studies have shown that cerebral oxygen consumption (CMRO 2 ) increases by nearly 50% at birth. The perinatal factors responsible for this increase are unknown; however, one possibility is that fetal CMRO 2 is constrained by the normal intrauterine arterial Po 2 (Pa 0 2 ) of ∼20 mmHg. The authors investigated this possibility in seven near-term chronically instrumented fetal sheep (131-138 days gestation) in which they inserted vascular catheters and an endotracheal tube. After 1-3 days recovery, they measured cerebral blood flow (CBF) with radiolabeled microspheres and calculated CMRO 2 . Measurements were made in utero under three conditions for each fetus: (1) nonventilated control; (2) ventilation with 3% O 2 -5% CO 2 -92% N 2 ; and (3) ventilation with an inspired oxygen concentration sufficient to raise fetal Pa 0 2 to normal newborn levels. The results showed that increasing fetal arterial Po 2 to postnatal levels did not consistently increase CMRO 2 . CBF decreased as arterial O 2 content (Ca 0 2 ) rose, with an inverse hyperbolic response similar to that previously found to relate CBF to Ca 0 2 during fetal hypoxic hypoxia. This indicates that the normally low intrauterine Pa 0 2 does not intrinsically limit CMRO 2 and implies that the rapid increase in CMRO 2 at birth reflects the activation of specific cellular and physiological processes at (or near) this unique developmental event

Reflexões sobre a prática do aleitamento materno Reflexions about breastfeeding's practices

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Isilia Aparecida Silva

1996-04-01

Full Text Available O trabalho traz uma análise sobre o aleitamento materno, fazendo reflexões sobre os indicadores determinantes da situação atual, buscando identificar os elementos fins e meios para atingir o cenário idealizado para o futuro da prática do amamentar.The autor makes analises of breast feeding, doing a reflexion about the mainly indicators who has determined the atual situation, looking for identify ways for win the ideal cenary to future of breast feeding.

Terapia nutricional no diabetes gestacional

OpenAIRE

Padilha,Patricia de Carvalho; Sena,Ana Beatriz; Nogueira,Jamile Lima; Araújo,Roberta Pimenta da Silva; Alves,Priscila Dutra; Accioly,Elizabeth; Saunders,Cláudia

2010-01-01

Trata-se de uma revisão da literatura científica sobre a terapia nutricional no Diabetes Mellitus Gestacional, sem restrição de data e com fontes primárias indexadas nas bases de dados SciELO, PubMed, Medline. Os resultados desta revisão apontam a intervenção nutricional como uma importante aliada no controle do Diabetes Mellitus Gestacional, trazendo potenciais benefícios à saúde materno-fetal. Na avaliação do estado nutricional materno devem ser empregados os indicadores antropométricos, di...

Modelo de rol materno en la alimentación del lactante: Teoría del rango medio

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Rosario Edith Ortiz-Félix

Full Text Available Las interacciones madre-hijo durante la alimentación en el primer año de vida tienen impacto duradero en la regulación del apetito y el desarrollo de obesidad actual y futura del individuo. Para los profesionales de enfermería es un reto y una nueva función prevenir problemas nutricionales en los lactantes. Contar con teorías de rango medio propias de enfermería que guíen el cuidado diario resulta indispensable. El presente trabajo presenta el desarrollo de la teoría de rango medio Modelo de rol materno en la alimentación del lactante, mediante el método de derivación teórica de Fawcett. Este modelo tiene como objetivo explicar cómo características maternas y del lactante influyen en el rol materno de alimentación y estado nutricional del hijo en el primer año de vida. Mediante este modelo se ofrece sustento teórico para la investigación e intervenciones de enfermería enfocadas a prevenir problemas de nutrición en el lactante.

Conducta médica posnatal ante la dilatación del tracto urinario superior fetal Postnatal medical behavior in face a dilatation of fetal high urinary tract

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Sandalio Durán Álvarez

2012-03-01

Full Text Available El seguimiento sistemático del embarazo normal mediante el estudio ultrasonográfico materno-fetal ha demostrado que por cada 500 embarazos debemos esperar una anomalía importante del tracto urinario. La anomalía detectada con mayor frecuencia es la dilatación del tracto urinario superior, que si bien la mayoría de las veces no se traduce en una alteración importante, obliga a su estudio posnatal para poder valorar su significación. Una dilatación del tracto urinario superior puede ser la traducción de una hidronefrosis obstructiva por estenosis ureteropiélica, una hidronefrosis no obstructiva, un reflujo vesicoureteral o una pielectasia, y menos frecuentemente, puede ser la imagen de un doble sistema excretor con el superior obstruido, un megauréter obstructivo o no obstructivo, o una valva de uretra posterior en el sexo masculino. En esta revisión se presentan los criterios diagnósticos y el tratamiento clínico de las hidronefrosis y pielectasias, así como el estudio de los casos en que se sospecha reflujo vesicoureteral, y se relatan las anomalías encontradas en 318 niños en que el ultrasonido materno-fetal detectó alguna alteración del tracto urinario. Aunque no tan frecuente como las pielectasias y las hidronefrosis no obstructivas, las estenosis pieloureterales que producen obstrucción, pueden traer serias consecuencias sobre la función renal, que obligan a tomar decisiones médicas, y, en ocasiones, quirúrgicas, para mejorar la calidad de vida de estos niños.The systematic follow-up of the normal pregnancy by means of a mother-fetus ultrasonography study has demonstrated that for each 500 pregnancies, we must to expect a significant anomaly of urinary tract. The more frequent anomaly detected is the high urinary tract dilatation, which if not always it is a significant alteration, leads to a postnatal study to assess its significance. A high urinary tract dilatation may to give rise to an obstructive hydronephrosis

Multidimensional intermittency in hadronic collisions

International Nuclear Information System (INIS)

Pan, J.; Hwa, R.C.

1992-06-01

The study of intermittency in high-energy hadronic collisions by the Monte Carlo code ECCO is extended to 3-dimensional phase space. Strong intermittency is found in agreement with the data. Fluctuation in the impact parameter is responsible for the intermittency in lnp T , and the transverse-momentum conservation leads to negative intermittency slopes in the azimuthal angle φ. The Ochs-Wosiek plots are linear in all dimensions having universal slopes. An exponent ν = 1.448 emerges to characterize multiparticle production in pp collisions. The properties of G moments are also examined, and the fractal dimensions determined

Fetal adaptations in insulin secretion result from high catecholamines during placental insufficiency.

Science.gov (United States)

Limesand, Sean W; Rozance, Paul J

2017-08-01

Placental insufficiency and intrauterine growth restriction (IUGR) of the fetus affects approximately 8% of all pregnancies and is associated with short- and long-term disturbances in metabolism. In pregnant sheep, experimental models with a small, defective placenta that restricts delivery of nutrients and oxygen to the fetus result in IUGR. Low blood oxygen concentrations increase fetal plasma catecholamine concentrations, which lower fetal insulin concentrations. All of these observations in sheep models with placental insufficiency are consistent with cases of human IUGR. We propose that sustained high catecholamine concentrations observed in the IUGR fetus produce developmental adaptations in pancreatic β-cells that impair fetal insulin secretion. Experimental evidence supporting this hypothesis shows that chronic elevation in circulating catecholamines in IUGR fetuses persistently inhibits insulin concentrations and secretion. Elevated catecholamines also allow for maintenance of a normal fetal basal metabolic rate despite low fetal insulin and glucose concentrations while suppressing fetal growth. Importantly, a compensatory augmentation in insulin secretion occurs following inhibition or cessation of catecholamine signalling in IUGR fetuses. This finding has been replicated in normally grown sheep fetuses following a 7-day noradrenaline (norepinephrine) infusion. Together, these programmed effects will potentially create an imbalance between insulin secretion and insulin-stimulated glucose utilization in the neonate which probably explains the transient hyperinsulinism and hypoglycaemia in some IUGR infants. © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society.

Chronic intermittent hypoxia promotes expression of 3-mercaptopyruvate sulfurtransferase in adult rat medulla oblongata.

Science.gov (United States)

Li, Mingqiang; Nie, Lihong; Hu, Yajie; Yan, Xiang; Xue, Lian; Chen, Li; Zhou, Hua; Zheng, Yu

2013-12-01

The present experiments were carried out to investigate the expression of 3-mercaptopyruvate sulfurtransferase (3MST) in medulla oblongata of rats and effects of chronic intermittent hypoxia (CIH) on its expression. Sprague Dawley adult rats were randomly divided into two groups, including control (Con) group and CIH group. The endogenous production of hydrogen sulfide (H2S) in medulla oblongata tissue homogenates was measured using the methylene blue assay method, 3MST mRNA and protein expression were analyzed by RT-PCR and Western blotting, respectively, and the expression of 3MST in the neurons of respiratory-related nuclei in medulla oblongata of rats was investigated with immunohistochemical technique. CIH elevated the endogenous H2S production in rat medulla oblongata (Pmedulla oblongata of rats and CIH promoted their expression (P<0.01). Immunohistochemical staining indicated that 3MST existed in the neurons of pre-Bötzinger complex (pre-BötC), hypoglossal nucleus (12N), ambiguous nucleus (Amb), facial nucleus (FN) and nucleus tractus solitarius (NTS) in the animals and the mean optical densities of 3MST-positive neurons in the pre-BötC, 12N and Amb, but not in FN and NTS, were significantly increased in CIH group (P<0.05). In conclusion, 3MST exists in the neurons of medullary respiratory nuclei and its expression can be up-regulated by CIH in adult rat, suggesting that 3MST-H2S pathway may be involved in regulation of respiration and protection on medullary respiratory centers from injury induced by CIH. © 2013.

Estratificación socioeconómica y salud materno infantil en México

OpenAIRE

Carlos Javier Echarri Cánovas

2004-01-01

El objetivo del artículo es el estudio de la salud de los niños en México, mediante un análisis que tenga como eje la diferenciación social, la atención a la salud materno infantil y la estructura familiar. Se argumenta la necesidad de prestar mas atención al análisis de los determinantes que de los indicadores de salud, en virtud de las características de información disponible y de los niveles de mortalidad infantil. Un aspecto metodológico importante es que lo...

Pasado y esperanza de un hospital Instituto Materno Infantil hospital universitario monumento nacional

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Manuel Mercado Pedroza

2002-07-01

Full Text Available El Instituto Materno Infantil (IMI ha sido fundamentalmente una casa de educación en la cultura del respeto por la mujer, el recién nacido y la familia, en un país asolado por la muerte es un centro de vida y esperanza de un futuro mejor para todos. Ha sido un hospital comprometido con la misión de atender a la mujer y al binomio madre - recién nacido, especialmente aquellos de escasos recursos. El IMI es un hospital por el Género femenino, para el género humano.

Average fetal depth in utero: data for estimation of fetal absorbed radiation dose

International Nuclear Information System (INIS)

Ragozzino, M.W.; Breckle, R.; Hill, L.M.; Gray, J.E.

1986-01-01

To estimate fetal absorbed dose from radiographic examinations, the depth from the anterior maternal surface to the midline of the fetal skull and abdomen was measured by ultrasound in 97 pregnant women. The relationships between fetal depth, fetal presentation, and maternal parameters of height, weight, anteroposterior (AP) thickness, gestational age, placental location, and bladder volume were analyzed. Maternal AP thickness (MAP) can be estimated from gestational age, maternal height, and maternal weight. Fetal midskull and abdominal depths were nearly equal. Fetal depth normalized to MAP was independent or nearly independent of maternal parameters and fetal presentation. These data enable a reasonable estimation of absorbed dose to fetal brain, abdomen, and whole body

Lipid peroxidation and antioxidant activity in patients in labor with nonreassuring fetal status.

Science.gov (United States)

Dede, F S; Guney, Yildiz; Dede, Hulya; Koca, Cemile; Dilbaz, Berna; Bilgihan, Ayse

2006-01-01

The aim of our study was to evaluate lipid peroxidation products and antioxidant enzyme activity in placental tissue and umbilical cord blood, as a marker for fetal hypoxia in patients in labor with nonreassuring fetal status. Umbilical cord arterial blood and placental tissue samples were collected from 24 patients with term pregnancies in labor and nonreassuring fetal heart rate (FHR) patterns (study) and 24 women with normal pregnancies in labor and normal FHR tracings (controls) for determination of malondialdehyde (MDA) as a marker for lipid peroxidation and superoxide dismutase (SOD) for the antioxidant activity. Measured values were compared statistically between two groups using independent samples t-test or Mann-Whitney U-test. The median 1min Apgar score was 8 (range 4-9) in the study group and 9 (range 8-10) in the control group, respectively (p 0.05). Placental MDA levels in patients with nonreassuring fetal status were found to be significantly elevated compared to the control group (12.14 nmol/g tissue versus 9.75 nmol/g tissue; p < 0.01). The placental SOD activity in the study group was significantly higher (p < 0.01) compared to controls (3.57 U/mg protein versus 2.63 U/mg protein). The umbilical cord blood MDA levels in the study group were higher than in normal pregnancies (4.99 nmol/mL, 3.88 nmol/mL; p < 0.05). The activity of SOD in umbilical cord blood was significantly higher (p < 0.001) in patients with nonreassuring fetal status when compared with the control group (11.62 versus 6.95 U/mL). Lipid peroxidation products and antioxidant functions were elevated in the umbilical cord blood and placenta of patients having nonreassuring FHR tracings during labor. These findings indicate that lipid peroxidation products in placenta and umbilical cord blood can be used as a possible marker for fetal hypoxia during labor and SOD levels may discriminate acute from chronic hypoxia. Further investigations are needed with large number of series to

Late gestational intermittent hypoxia induces metabolic and epigenetic changes in male adult offspring mice.

Science.gov (United States)

Khalyfa, Abdelnaby; Cortese, Rene; Qiao, Zhuanhong; Ye, Honggang; Bao, Riyue; Andrade, Jorge; Gozal, David

2017-04-15

Late gestation during pregnancy has been associated with a relatively high prevalence of obstructive sleep apnoea (OSA). Intermittent hypoxia, a hallmark of OSA, could impose significant long-term effects on somatic growth, energy homeostasis and metabolic function in offspring. Here we show that late gestation intermittent hypoxia induces metabolic dysfunction as reflected by increased body weight and adiposity index in adult male offspring that is paralleled by epigenomic alterations and inflammation in visceral white adipose tissue. Fetal perturbations by OSA during pregnancy impose long-term detrimental effects manifesting as metabolic dysfunction in adult male offspring. Pregnancy, particularly late gestation (LG), has been associated with a relatively high prevalence of obstructive sleep apnoea (OSA). Intermittent hypoxia (IH), a hallmark of OSA, could impose significant long-term effects on somatic growth, energy homeostasis, and metabolic function in offspring. We hypothesized that IH during late pregnancy (LG-IH) may increase the propensity for metabolic dysregulation and obesity in adult offspring via epigenetic modifications. Time-pregnant female C57BL/6 mice were exposed to LG-IH or room air (LG-RA) during days 13-18 of gestation. At 24 weeks, blood samples were collected from offspring mice for lipid profiles and insulin resistance, indirect calorimetry was performed and visceral white adipose tissues (VWAT) were assessed for inflammatory cells as well as for differentially methylated gene regions (DMRs) using a methylated DNA immunoprecipitation on chip (MeDIP-chip). Body weight, food intake, adiposity index, fasting insulin, triglycerides and cholesterol levels were all significantly higher in LG-IH male but not female offspring. LG-IH also altered metabolic expenditure and locomotor activities in male offspring, and increased number of pro-inflammatory macrophages emerged in VWAT along with 1520 DMRs (P < 0.0001), associated with 693�

Fetal behavioral teratology.

Science.gov (United States)

Visser, Gerard H A; Mulder, Eduard J H; Tessa Ververs, F F

2010-10-01

Ultrasound studies of fetal motor behavior provide direct – in vivo – insight in the functioning of the motor component of the fetal central nervous system. In this article, studies are reviewed showing changes in the first timetable of appearance of fetal movements, changes in quality and/or quantity of movements and disturbances in the development of fetal behavioral states in case of endogenous malfunctions, maternal diseases and exogenous behavioral teratogens.

Influenciadores da intenção do comportamento do aleitamento materno – um estudo exploratório no âmbito do Marketing Social

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Oliva Dourado Martins

2012-12-01

Full Text Available Ao considerando as Teorias do Comportamento do Consumidor, esta investigação visa explorar as principais variáveis no âmbito do Marketing Social, para desenvolver um modelo de análise para descrever e explicar a intenção da mãe no comportamento do aleitamento materno. Pelo facto de o comportamento do aleitamento materno ter sido pouco referenciado no âmbito do marketing social, optou-se por utilizar uma investigação exploratória qualitativa através de 10 entrevistas em profundidade sustentadas por um roteiro de questões semi-abertas. A unidade de estudo da investigação exploratória foi o profissional de saúde envolvido na proteção, promoção e suporte ao aleitamento materno em Portugal. Alguns dos actuais modelos de análise da intenção do comportamento existentes na literatura utilizam o conhecimento como uma variável exógena para influenciar a atitude. Porém, nos estudos mais recentes, concluiu-se que o conhecimento tem pouca significância no processo de intenção do aleitamento materno. Como resultado desta investigação, verificou-se que a auto-estima, que ainda não se encontrava presente nos actuais modelos de análise da intenção do comportamento, foi confirmada nas entrevistas como uma possível variável a ser testada. Como principais limitações, além de ser uma investigação de natureza qualitativa exploratória fundamentada num modelo específico de análise da intenção, pode ressaltar-se o facto de o modelo ter sido desenvolvido especificamente para o comportamento em questão e ainda não ter sido testado. Propõe-se então um novo modelo de análise da intenção do comportamento.

Intermittency in branching models

International Nuclear Information System (INIS)

Chiu, C.B.; Texas Univ., Austin; Hwa, R.C.; Oregon Univ., Eugene

1990-01-01

The intermittency properties of three branching models have been investigated. The factorial moments show power-law behavior as function of small rapidity width. The slopes and energy dependences reveal different characteristics of the models. The gluon model has the weakest intermittency. (orig.)

Deficits in the extinction of ethanol-seeking behavior following chronic intermittent ethanol exposure are attenuated with positive allosteric modulation of mGlu5.

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Gass, J T; McGonigal, J T; Chandler, L J

2017-02-01

Alcoholism is a chronic relapsing disorder characterized by periods of heavy alcohol consumption and unsuccessful attempts at abstinence. Relapse is one of the most problematic aspects in the treatment of alcoholism and is triggered by ethanol-associated cues. Extinction-based cue exposure therapies have proven ineffective in the treatment of alcoholism. However, positive allosteric modulation of mGlu5 with CDPPB enhances the extinction learning of alcohol-seeking behavior. The current study investigated the impact of chronic alcohol exposure on the extinction of ethanol-seeking behavior. Adult Wistar rats were trained to self-administer alcohol with a light/tone stimulus serving as the alcohol cue. After training, one group of rats was exposed to chronic intermittent ethanol (CIE) daily for a period of 2 weeks to induce ethanol dependence. Control rats were exposed to air for the same period of time. Both groups were then retrained to self-administer ethanol and subsequently tested for changes in extinction learning. CIE exposed rats consumed more ethanol compared to their pre-CIE levels and to control rats. During extinction training, CIE rats responded significantly more on the previously active lever and required more sessions to reach extinction criteria compared to control rats. Treatment with CDPPB facilitated extinction in control rats and attenuated the increased resistance to extinction in CIE-exposed rats. These results demonstrate that chronic ethanol exposure not only alters ethanol intake, but also the extinction of ethanol-seeking behaviors. The ability to attenuate deficits through modulation of mGlu5 provides a potential target for pharmacological manipulation that could ultimately reduce relapse in alcoholics. Copyright © 2016 Elsevier Ltd. All rights reserved.

Apoio paterno ao aleitamento materno: uma revisão integrativa Fathers support on breastfeeding: an integrative review

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Bruna Turaça Silva

2012-01-01

Full Text Available OBJETIVO: Identificar, na literatura científica, publicações sobre a participação do pai ou companheiro no aleitamento materno. FONTES DE DADOS: Realizou-se uma revisão integrativa no período de 1995 a 2010, utilizando-se os unitermos "pai" e "aleitamento materno" nas bases de dados LILACS, SciELO, BDENF e PubMed/MEDLINE. Os dados obtidos foram organizados em três categorias: o pai como suporte para a amamentação; percepções paternas sobre a amamentação; e o impacto da intervenção educativa sobre aleitamento para os pais. SÍNTESE DOS DADOS: Foram identificadas 44 publicações que mostraram que o apoio social, profissional e familiar foi imprescindível para o sucesso do aleitamento materno. O pai foi destacado como suporte fundamental pela forte influência na decisão da mulher em amamentar e na sua continuidade. Contudo, a participação do pai exibe sentimentos ambivalentes: competitividade com a mãe vs. proteção; exclusão vs. aumento do vínculo familiar; apoio vs. preconceitos. Os profissionais de saúde, apontados como referência na busca de informações, mostram-se despreparados para atender aos pais. CONCLUSÕES: Foram encontradas várias produções científicas ressaltando a relevância do apoio paterno para o sucesso do aleitamento materno. Contudo, a maioria das pesquisas apresenta abordagem descritiva, havendo poucos estudos com intervenções educativas.OBJECTIVE: To identify publications regarding the role of the father or partner in the breastfeeding practice. DATA SOURCE: An integrative review of the literature was performed searching for articles published between 1995 and 2010, using the key-words "father" and "breastfeeding" in following databases: LILACS, SciELO, BDENF e PubMed/MEDLINE. Data were organized in three categories: the supporting role of the father on breastfeeding; paternal perceptions about breastfeeding; and the impact of educational intervention on breastfeeding for parents. DATA

Cardiac Response to Chronic Intermittent Hypoxia with a Transition from Adaptation to Maladaptation: The Role of Hydrogen Peroxide

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Xia Yin

2012-01-01

Full Text Available Obstructive sleep apnea (OSA is a highly prevalent respiratory disorder of sleep, and associated with chronic intermittent hypoxia (CIH. Experimental evidence indicates that CIH is a unique physiological state with potentially “adaptive” and “maladaptive” consequences for cardio-respiratory homeostasis. CIH is also a critical element accounting for most of cardiovascular complications of OSA. Cardiac response to CIH is time-dependent, showing a transition from cardiac compensative (such as hypertrophy to decompensating changes (such as failure. CIH-provoked mild and transient oxidative stress can induce adaptation, but severe and persistent oxidative stress may provoke maladaptation. Hydrogen peroxide as one of major reactive oxygen species plays an important role in the transition of adaptive to maladaptive response to OSA-associated CIH. This may account for the fact that although oxidative stress has been recognized as a driver of cardiac disease progression, clinical interventions with antioxidants have had little or no impact on heart disease and progression. Here we focus on the role of hydrogen peroxide in CIH and OSA, trying to outline the potential of antioxidative therapy in preventing CIH-induced cardiac damage.

Metabolic Effects of Intermittent Fasting.

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Patterson, Ruth E; Sears, Dorothy D

2017-08-21

The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved health outcomes. A MEDLINE search was performed using PubMed and the terms "intermittent fasting," "fasting," "time-restricted feeding," and "food timing." Modified fasting regimens appear to promote weight loss and may improve metabolic health. Several lines of evidence also support the hypothesis that eating patterns that reduce or eliminate nighttime eating and prolong nightly fasting intervals may result in sustained improvements in human health. Intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on (a) circadian biology, (b) the gut microbiome, and (c) modifiable lifestyle behaviors, such as sleep. If proven to be efficacious, these eating regimens offer promising nonpharmacological approaches to improving health at the population level, with multiple public health benefits.

The effects of smoking and hypertensive disorders on fetal growth

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Irgens Lorentz M

2006-04-01

Full Text Available Abstract Background It is well known that smoking and pregnancy induced hypertension (PIH are associated with decreased fetal growth. It has been reported that in preeclampsia the fetal growth deficit attributable to smoking is higher, which has been contradicted in other studies. We therefore evaluated the effects on fetal growth of early- and late onset PIH and chronic hypertension and how cigarette smoking modify these effects. We also quantified the proportion of small for gestational age (SGA cases attributable to PIH, chronic hypertension, and smoking. Methods Population-based study based on record of 215598 singleton pregnancies from the Medical Birth Registry of Norway. Results In severe preeclampsia, mild preeclampsia, transient hypertension, and normotension in term birth, odds ratios (ORs of SGA in smokers compared with non-smokers were 1.4 (95% confidence interval 0.9, 2.2, 1.6 (1.3, 1.9, 2.3 (1.8, 3.1, and 2.0 (1.9, 2.1, respectively. For preterm births, corresponding ORs were 1.3 (0.9, 2.0, 1.8 (1.1, 3.0, 4.1 (1.9, 9.0, and 1.7 (1.4, 2.0, respectively. The effect of early onset PIH was stronger than that in term births, while the effect of smoking was equal in preterm and term newborns. Only in non-smokers who delivered at term, the rates of SGA significantly increased with the severity of PIH (ORs = 1.3 (1.1, 1.5, 1.8 (1.7, 2.0, and 2.5 (2.2, 3.0 for transient hypertension, mild-, and severe preeclampsia, respectively. The combined effects of smoking and hypertension were generally not synergistic. The effect of smoking was not stronger in women who had chronic hypertension. Nor were the effects of chronic hypertension stronger in smokers. PIH explained 21.9 and 2.5% of preterm and term cases of SGA, respectively, while smoking explained 12% of SGA cases. Conclusion The effects of hypertensive disorder and smoking were generally not synergistic, which suggest that they may exert their main actions on separate sites or work through

[Electronic fetal monitoring and management of adverse outcomes: how to perform and improve a training program for clinicians?].

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Secourgeon, J-F

2012-10-01

Electronic fetal monitoring during labor is the most commonly used method to evaluate the fetal status, but it remains exposed to some criticism. By comparison with intermittent auscultation and in the light of the results of the great studies in the last 30 years, it may be accused its failure to improve the neonatal outcome and its responsibility in the increase on operative deliveries. Actually, the electronic fetal monitoring is a tool whose effectiveness is linked to the accuracy of the analysis developed by the clinician. Studies on assessment of the tracing interpretation indicate that there is always a lack of quality, which may be improved through training programs. It also reveals the benefit of the fetal blood sampling to reduce operative deliveries and the generalization of this method, in addition to electronic fetal monitoring, is recommended by referral agencies. More generally, the continuous monitoring is only a part of the patient safety strategy in the labour ward and we are currently observing, in some European countries and in the United States, the development of training programs concerning the management of the adverse outcomes in obstetrics. The good performances related to the quality of care are demonstrated by the findings of the studies performed in the centers that have implemented an active training policy. In France, the professionals directly involved in the field of the perinatology should benefit from such educational programs that could be organized within the care networks under the authority of referral agencies. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Estado nutricional materno, ganho de peso gestacional e peso ao nascer Maternal nutritional status, gestational weight gain and birth weight

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Adriana Suely de Oliveira Melo

2007-06-01

Full Text Available INTRODUÇÃO: Tanto o estado nutricional materno como o ganho de peso gestacional vem sendo estudado em relação ao papel determinante que desempenham sobre o crescimento fetal e o peso ao nascer. O peso inadequado ao nascer é uma das grandes preocupações da saúde pública devido ao aumento da morbimortalidade no primeiro ano de vida e ao maior risco de desenvolver doenças na vida adulta, tais como a síndrome metabólica, nos casos de baixo peso, e diabetes e obesidade, nos casos de macrossomia. O objetivo deste trabalho foi descrever uma coorte de gestantes, classificando-as de acordo com o estado nutricional inicial, o ganho ponderal gestacional, a resistência nas artérias uterinas e o peso dos recém-nascidos. MÉTODOS: foi acompanhada, a cada quatro semanas gestacionais, uma coorte de 115 gestantes atendidas pelo Programa de Saúde da Família do município de Campina Grande, PB. O estado nutricional inicial foi determinado através do índice de massa corporal (kg/m² para a idade gestacional, e as gestantes classificadas de acordo com os critérios de Atalah. Na 20ª semana, foi estudada a resistência das artérias uterinas, através da dopplervelocimetria. RESULTADOS: o estado nutricional inicial mostrou uma alta prevalência de sobrepeso e obesidade (27%, e uma prevalência significante de desnutrição (23%. Um alto percentual de gestantes ganhou peso excessivo tanto no segundo (44% como no terceiro trimestre (45%. A distribuição do peso ao nascer, indicou uma incidência de 10% de baixo peso e de 9% de macrossomia. Observou-se ainda, uma alta prevalência de incisuras nas artérias uterinas.INTRODUCTION: Maternal nutritional status and gestational weight gain have been addressed because of their importance to fetal growth and birth weight. Inadequate birth weight is a major concern to public health given it has been associated with increasing morbidity-mortality during the first year of life and with increased risks of

Fetal echocardiography

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... page: //medlineplus.gov/ency/article/007340.htm Fetal echocardiography To use the sharing features on this page, please enable JavaScript. Fetal echocardiography is a test that uses sound waves ( ultrasound ) ...

Fetal electrocardiogram (ECG) for fetal monitoring during labour.

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Neilson, James P

2015-12-21

Hypoxaemia during labour can alter the shape of the fetal electrocardiogram (ECG) waveform, notably the relation of the PR to RR intervals, and elevation or depression of the ST segment. Technical systems have therefore been developed to monitor the fetal ECG during labour as an adjunct to continuous electronic fetal heart rate monitoring with the aim of improving fetal outcome and minimising unnecessary obstetric interference. To compare the effects of analysis of fetal ECG waveforms during labour with alternative methods of fetal monitoring. The Cochrane Pregnancy and Childbirth Group's Trials Register (latest search 23 September 2015) and reference lists of retrieved studies. Randomised trials comparing fetal ECG waveform analysis with alternative methods of fetal monitoring during labour. One review author independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. One review author assessed the quality of the evidence using the GRADE approach. Seven trials (27,403 women) were included: six trials of ST waveform analysis (26,446 women) and one trial of PR interval analysis (957 women). The trials were generally at low risk of bias for most domains and the quality of evidence for ST waveform analysis trials was graded moderate to high. In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no obvious difference to primary outcomes: births by caesarean section (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.96 to 1.08; six trials, 26,446 women; high quality evidence); the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (average RR 0.72, 95% CI 0.43 to 1.20; six trials, 25,682 babies; moderate quality evidence); or babies with neonatal encephalopathy (RR 0.61, 95% CI 0.30 to 1.22; six trials, 26,410 babies; high quality evidence). There were, however, on average

Cosmic Rays in Intermittent Magnetic Fields

International Nuclear Information System (INIS)

Shukurov, Anvar; Seta, Amit; Bushby, Paul J.; Wood, Toby S.; Snodin, Andrew P.

2017-01-01

The propagation of cosmic rays in turbulent magnetic fields is a diffusive process driven by the scattering of the charged particles by random magnetic fluctuations. Such fields are usually highly intermittent, consisting of intense magnetic filaments and ribbons surrounded by weaker, unstructured fluctuations. Studies of cosmic-ray propagation have largely overlooked intermittency, instead adopting Gaussian random magnetic fields. Using test particle simulations, we calculate cosmic-ray diffusivity in intermittent, dynamo-generated magnetic fields. The results are compared with those obtained from non-intermittent magnetic fields having identical power spectra. The presence of magnetic intermittency significantly enhances cosmic-ray diffusion over a wide range of particle energies. We demonstrate that the results can be interpreted in terms of a correlated random walk.

Cosmic Rays in Intermittent Magnetic Fields

Energy Technology Data Exchange (ETDEWEB)

Shukurov, Anvar; Seta, Amit; Bushby, Paul J.; Wood, Toby S. [School of Mathematics and Statistics, Newcastle University, Newcastle Upon Tyne NE1 7RU (United Kingdom); Snodin, Andrew P., E-mail: a.seta1@ncl.ac.uk, E-mail: amitseta90@gmail.com [Department of Mathematics, Faculty of Applied Science, King Mongkut’s University of Technology North Bangkok, Bangkok 10800 (Thailand)

2017-04-10

The propagation of cosmic rays in turbulent magnetic fields is a diffusive process driven by the scattering of the charged particles by random magnetic fluctuations. Such fields are usually highly intermittent, consisting of intense magnetic filaments and ribbons surrounded by weaker, unstructured fluctuations. Studies of cosmic-ray propagation have largely overlooked intermittency, instead adopting Gaussian random magnetic fields. Using test particle simulations, we calculate cosmic-ray diffusivity in intermittent, dynamo-generated magnetic fields. The results are compared with those obtained from non-intermittent magnetic fields having identical power spectra. The presence of magnetic intermittency significantly enhances cosmic-ray diffusion over a wide range of particle energies. We demonstrate that the results can be interpreted in terms of a correlated random walk.

Pulmonary Hypoplasia Caused by Fetal Ascites in Congenital Cytomegalovirus Infection Despite Fetal Therapy

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Kazumichi Fujioka

2017-11-01

Full Text Available We report two cases of pulmonary hypoplasia due to fetal ascites in symptomatic congenital cytomegalovirus (CMV infections despite fetal therapy. The patients died soon after birth. The pathogenesis of pulmonary hypoplasia in our cases might be thoracic compression due to massive fetal ascites as a result of liver insufficiency. Despite aggressive fetal treatment, including multiple immunoglobulin administration, which was supposed to diminish the pathogenic effects of CMV either by neutralization or immunomodulatory effects, the fetal ascites was uncontrollable. To prevent development of pulmonary hypoplasia in symptomatic congenital CMV infections, further fetal intervention to reduce ascites should be considered.

Fetal scalp pH testing

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Fetal scalp blood; Scalp pH testing; Fetal blood testing - scalp; Fetal distress - fetal scalp testing; Labor - fetal scalp testing ... a baby. In these cases, testing the scalp pH can help the doctor decide whether the fetus ...

[Incidence of fetal macrosomia: maternal and fetal morbidity].

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Rodríguez-Rojas, R R; Cantú-Esquivel, M G; Benavides-de la Garza, L; Benavides-de Anda, L

1996-06-01

The macrosomia is an obstetric eventuality associated to high maternal-fetal morbidity-mortality. This assay was planned in order to know the incidence of macrosomia in our institution, the relation between vaginal and abdominal deliveries and the fetal-maternal morbidity we reviewed 3590 records and we found 5.6% incidence of macrosomia in the global obstetric population. There was 58% of vaginal deliveries, 68% of the newborn were male. The main complications were in the C. sections, 2 laceration of the hysterectomy, and 2 peroperative atonias. In the vaginal deliveries, the lacerations of III and IV grade were 9 of each grade. The main fetal complications were 5 slight to severe asphyxia and 4 shoulder dystocias. This assay concludes that the macrosomia in our service is similar to the already published ones, a 42% were C. section and the maternal-fetal morbidity was low.

The use of non-invasive fetal electrocardiography in diagnosing second-degree fetal atrioventricular block.

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Lakhno, Igor; Behar, Joachim A; Oster, Julien; Shulgin, Vyacheslav; Ostras, Oleksii; Andreotti, Fernando

2017-01-01

Complete atrioventricular block in fetuses is known to be mostly associated with autoimmune disease and can be irreversible if no steroids treatment is provided. Conventional methods used in clinical practice for diagnosing fetal arrhythmia are limited since they do not reflect the primary electrophysiological conduction processes that take place in the myocardium. The non-invasive fetal electrocardiogram has the potential to better support fetal arrhythmias diagnosis through the continuous analysis of the beat to beat variation of the fetal heart rate and morphological analysis of the PQRST complex. We present two retrospective case reports on which atrioventricular block diagnosis could have been supported by the non-invasive fetal electrocardiogram. The two cases comprised a 22-year-old pregnant woman with the gestational age of 31 weeks and a 25-year-old pregnant woman with the gestational age of 41 weeks. Both women were admitted to the Department of Maternal and Fetal Medicine at the Kyiv and Kharkiv municipal perinatal clinics. Patients were observed using standard fetal monitoring methods as well as the non-invasive fetal electrocardiogram. The non-invasive fetal electrocardiographic recordings were analyzed retrospectively, where it is possible to identify the presence of the atrioventricular block. This study demonstrates, for the first time, the feasibility of the non-invasive fetal electrocardiogram as a supplementary method to diagnose of the fetal atrioventricular block. Combined with current fetal monitoring techniques, non-invasive fetal electrocardiography could support clinical decisions.

Prevalência de práticas educativas acerca do aleitamento materno exclusivo (AME em Cuiabá - MT

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Luma Natalia Barbosa

2015-03-01

Full Text Available Objetivo: Descrever a prevalência das práticas educativas em saúde sobre o aleitamento materno exclusivo (AME no Município de Cuiabá - MT nos meses de julho a dezembro de 2012. Métodos: Trata-se de um estudo descritivo transversal, realizado junto a mulheres internadas em um hospital. A amostra foi composta por 306 mulheres no período pós-parto imediato. Os dados foram coletados por meio de um questionário semiestruturado. Resultados: Ter oito anos ou mais de estudo (RP = 1,77; ter renda até dois salários mínimos (RP = 1,22; ter planejado a gravidez (RP = 1,31; ter iniciado o atendimento no serviço de pré-natal no primeiro trimestre (RP = 1,65 e serem primíparas (RP = 1,21 são características que aparecem associadas com uma maior chance de receber orientações sobre aleitamento materno do que as demais mulheres. Conclusão: Faz-se necessário repensar mudanças dessas práticas, a fim de se realizar ações educativas que busquem efetivar transformações na relação profissional/usuário, visando o acolhimento das gestantes.

Fetal magnetic resonance imaging: methods and techniques; Fetale Magnetresonanztomographie: Methoden und Technik

Energy Technology Data Exchange (ETDEWEB)

Brugger, P.C. [Zentrum fuer Anatomie und Zellbiologie, Medizinische Universitaet Wien (Austria). Arbeitsgruppe Integrative Morphologie; Stuhr, F.; Lindner, C.; Prayer, D. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik

2006-02-15

Since the introduction of fetal magnetic resonance imaging (MRI) into prenatal diagnostics, advances in coil technology and development of ultrafast sequences have further enhanced this technique. At present numerous sequences are available to visualize the whole fetus with high resolution and image quality, even in late stages of pregnancy. Taking into consideration the special circumstances of examination and adjusting sequence parameters to gestational age, fetal anatomy can be accurately depicted. The variety of sequences also allows further characterization of fetal tissues and pathologies. Fetal MRI not only supplies additional information to routine ultrasound studies, but also reveals fetal morphology and pathology in a way hitherto not possible. (orig.) [German] Seit Einfuehrung der fetalen Magnetresonanztomographie (MRT) in die praenatale Diagnostik wurde das Verfahren durch neue Spulentechniken und die Entwicklung ultraschneller Sequenzen kontinuierlich weiter entwickelt. Gegenwaertig steht eine Vielzahl von Sequenzen zur Verfuegung, die es erlauben, mit hoher Bildqualitaet und raeumlicher Aufloesung selbst in fortgeschrittenen Schwangerschaftsstadien den gesamten Feten darzustellen. Unter Beruecksichtigung der speziellen Untersuchungsbedingungen und des Schwangerschaftsalters kann so die fetale Anatomie genau abgebildet werden. Die Vielfalt an Sequenzen und deren gezielter Einsatz ermoeglichen es weiter, fetale Gewebe und Pathologien naeher zu charakterisierten. Auf diese Weise liefert die fetale MRT nicht nur Zusatzinformationen zur Routineultraschalluntersuchung, sie gibt auch Aufschluss ueber bestimmte fetale Morphologien und Pathologien, die bisher nicht darstellbar waren. (orig.)

Choriodecidual group B streptococcal inoculation induces fetal lung injury without intra-amniotic infection and preterm labor in Macaca nemestrina.

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Kristina M Adams Waldorf

Full Text Available BACKGROUND: Early events leading to intrauterine infection and fetal lung injury remain poorly defined, but may hold the key to preventing neonatal and adult chronic lung disease. Our objective was to establish a nonhuman primate model of an early stage of chorioamnionitis in order to determine the time course and mechanisms of fetal lung injury in utero. METHODOLOGY/PRINCIPAL FINDINGS: Ten chronically catheterized pregnant monkeys (Macaca nemestrina at 118-125 days gestation (term=172 days received one of two treatments: 1 choriodecidual and intra-amniotic saline (n=5, or 2 choriodecidual inoculation of Group B Streptococcus (GBS 1×10(6 colony forming units (n=5. Cesarean section was performed regardless of labor 4 days after GBS or 7 days after saline infusion to collect fetal and placental tissues. Only two GBS animals developed early labor with no cervical change in the remaining animals. Despite uterine quiescence in most cases, blinded review found histopathological evidence of fetal lung injury in four GBS animals characterized by intra-alveolar neutrophils and interstitial thickening, which was absent in controls. Significant elevations of cytokines in amniotic fluid (TNF-α, IL-8, IL-1β, IL-6 and fetal plasma (IL-8 were detected in GBS animals and correlated with lung injury (p<0.05. Lung injury was not directly caused by GBS, because GBS was undetectable in amniotic fluid (~10 samples tested/animal, maternal and fetal blood by culture and polymerase chain reaction. In only two cases was GBS cultured from the inoculation site in low numbers. Chorioamnionitis occurred in two GBS animals with lung injury, but two others with lung injury had normal placental histology. CONCLUSIONS/SIGNIFICANCE: A transient choriodecidual infection can induce cytokine production, which is associated with fetal lung injury without overt infection of amniotic fluid, chorioamnionitis or preterm labor. Fetal lung injury may, thus, occur silently without

Automedicación en gestantes que acuden al Instituto Nacional Materno Perinatal, Perú 2011 Self-medication behavior among pregnant women user of the Instituto Nacional Materno Perinatal, Peru 2011

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Elsy Miní

2012-06-01

Full Text Available Con el objetivo de determinar la prevalencia de automedicación en gestantes y sus características, se realizó un estudio descriptivo transversal. Se entrevistó a 400 gestantes que acudían a control prenatal en el Instituto Nacional Materno Perinatal de Lima. El 10,5% (42 pacientes se automedicó durante la gestación, el 64,6% opinó que la automedicación puede producir malformaciones congénitas a sus bebes. Los medicamentos consumidos por las gestantes estuvieron en categoría A y B de la clasificación de la Administración de Alimentos y Drogas de EUA (FDA; principalmente, consumieron paracetamol (47,6% y amoxicilina (16,7%. Todas las mujeres que se automedicaron durante la gestación lo habían hecho antes de estar embarazadas. De acuerdo con estos resultados concluimos que la prevalencia de automedicación en gestantes del estudio es baja, comparado con la literatura internacional.We aim to determine the prevalence of self prescribing behaviour during pregnancy and its characteristics. For this purpose, we designed a cross sectional study and interviewed 400 pregnant women who had their prenatal care at Instituto Nacional Materno Perinatal, Lima. We found that 10.5% of the patients (42 patients had a self prescribing behavior during pregnancy, 64.5% think that self prescribing behavior can produce congenital malformations. The medications used were classified as type A and B according to the Food and Drug Administration (FDA. Paracetamol was used more frequently (47.6% followed by amoxicillin (16.7%. All the women who self-prescribed have had this behavior before pregnancy. According to these results, we conclude there is a low prevalence of self-prescribing behavior during pregnancy compared to the international literature.

Intrauterine Intervention for the Treatment of Fetal Growth Restriction.

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Spiroski, A-M; Oliver, M H; Harding, J E; Bloomfield, F H

2016-01-01

Fetal growth restriction (FGR) is associated with an increased incidence of fetal and neonatal death, and of neonatal morbidity. Babies born following FGR also are at risk of a range of postnatal complications, which may contribute to an increased incidence of disease later in life. There currently are no effective clinical interventions which improve perinatal survival, intrauterine growth and later outcomes of the FGR baby. Postnatal interventions aimed at promoting or accelerating growth in FGR babies to improve outcome, particularly neurodevelopmental outcomes, may further increase the risk of metabolic dysregulation and, therefore, the risk of developing chronic disease in adulthood. An intrauterine intervention to improve nutrition and growth in the FGR fetus may have the potential to decrease mortality and improve long-term outcomes by delaying preterm delivery and mitigating the need for and risks of accelerated postnatal growth.

Effects of L-glutamine supplementation on maternal and fetal hemodynamics in gestating ewes exposed to alcohol.

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Sawant, Onkar B; Ramadoss, Jayanth; Hankins, Gary D; Wu, Guoyao; Washburn, Shannon E

2014-08-01

Not much is known about effects of gestational alcohol exposure on maternal and fetal cardiovascular adaptations. This study determined whether maternal binge alcohol exposure and L-glutamine supplementation could affect maternal-fetal hemodynamics and fetal regional brain blood flow during the brain growth spurt period. Pregnant sheep were randomly assigned to one of four groups: saline control, alcohol (1.75-2.5 g/kg body weight), glutamine (100 mg/kg body weight) or alcohol + glutamine. A chronic weekend binge drinking paradigm between gestational days (GD) 99 and 115 was utilized. Fetuses were surgically instrumented on GD 117 ± 1 and studied on GD 120 ± 1. Binge alcohol exposure caused maternal acidemia, hypercapnea, and hypoxemia. Fetuses were acidemic and hypercapnic, but not hypoxemic. Alcohol exposure increased fetal mean arterial pressure, whereas fetal heart rate was unaltered. Alcohol exposure resulted in ~40 % reduction in maternal uterine artery blood flow. Labeled microsphere analyses showed that alcohol induced >2-fold increases in fetal whole brain blood flow. The elevation in fetal brain blood flow was region-specific, particularly affecting the developing cerebellum, brain stem, and olfactory bulb. Maternal L-glutamine supplementation attenuated alcohol-induced maternal hypercapnea, fetal acidemia and increases in fetal brain blood flow. L-Glutamine supplementation did not affect uterine blood flow. Collectively, alcohol exposure alters maternal and fetal acid-base balance, decreases uterine blood flow, and alters fetal regional brain blood flow. Importantly, L-glutamine supplementation mitigates alcohol-induced acid-base imbalances and alterations in fetal regional brain blood flow. Further studies are warranted to elucidate mechanisms responsible for alcohol-induced programming of maternal uterine artery and fetal circulation adaptations in pregnancy.

Lung regeneration by fetal lung tissue implantation in a mouse pulmonary emphysema model.

Science.gov (United States)

Uyama, Koh; Sakiyama, Shoji; Yoshida, Mitsuteru; Kenzaki, Koichiro; Toba, Hiroaki; Kawakami, Yukikiyo; Okumura, Kazumasa; Takizawa, Hiromitsu; Kondo, Kazuya; Tangoku, Akira

2016-01-01

The mortality and morbidity of chronic obstructive pulmonary disease are high. However, no radical therapy has been developed to date. The purpose of this study was to evaluate whether fetal mouse lung tissue can grow and differentiate in the emphysematous lung. Fetal lung tissue from green fluorescent protein C57BL/6 mice at 16 days' gestation was used as donor material. Twelve-month-old pallid mice were used as recipients. Donor lungs were cut into small pieces and implanted into the recipient left lung by performing thoracotomy under anesthesia. The recipient mice were sacrificed at day 7, 14, and 28 after implantation and used for histological examination. Well-developed spontaneous pulmonary emphysema was seen in 12-month-old pallid mice. Smooth and continuous connection between implanted fetal lung tissue and recipient lung was recognized. Air space expansion and donor tissue differentiation were observed over time. We could clearly distinguish the border zones between injected tissue and native tissue by the green fluorescence of grafts. Fetal mouse lung fragments survived and differentiated in the emphysematous lung of pallid mice. Implantation of fetal lung tissue in pallid mice might lead to further lung regeneration research from the perspective of respiratory and exercise function. J. Med. Invest. 63: 182-186, August, 2016.

Conhecimento de mulheres com diabetes mellitus sobre cuidados pré-concepcionais e riscos materno-fetais

OpenAIRE

Escolástica Rejane Ferreira Moura; Danielle Rosa Evangelista; Ana Kelve de Castro Damasceno

2012-01-01

Objetivou-se descrever o perfil reprodutivo de mulheres com diabetes mellitus (DM) e verificar o nível de conhecimento destas quanto aos riscos maternos e fetais e os cuidados pré-concepcionais. Estudo exploratório, que contou com a participação de 106 mulheres, realizado no Centro Integrado de Hipertensão e Diabetes, de março a julho de 2009. As variáveis reprodutivas foram: número de gestações, partos e abortos e planejamento da gravidez. Os dados foram coletados por meio de entrevista que ...

Cytomegalovirus infection in pregnancy.

Science.gov (United States)

Kagan, Karl Oliver; Hamprecht, Klaus

2017-07-01

Due to the severe risk of long-term sequelae, prenatal cytomegalovirus infection is of particular importance amongst intrauterine viral infections. This review summarizes the current knowledge about CMV infection in pregnancy. A search of the Medline and Embase database was done for articles about CMV infection in pregnany. We performed a detailed review of the literature in view of diagnosis, epidemiology and management of CMV infection in pregnancy. The maternal course of the infection is predominantly asymptomatic; the infection often remains unrecognized until the actual fetal manifestation. Typical ultrasound signs that should arouse suspicion of intrauterine CMV infection can be distinguished into CNS signs such as ventriculomegaly or microcephaly and extracerebral infection signs such as hepatosplenomegaly or hyperechogenic bowel. Current treatment strategies focus on hygienic measures to prevent a maternal CMV infection during pregnancy, on maternal application of hyperimmunoglobulines to avoid materno-fetal transmission in case of a maternal seroconversion, and on an antiviral therapy in case the materno-fetal transmission have occurred. CMV infection in pregnancy may result in a severe developmental disorder of the newborn. This should be taken into account in the treatment of affected and non-affected pregnant women.

EPIGENETIC RISK FACTORS OF FETAL SENSITIZATION TO ALLERGENS IN THE SYSTEM «MOTHER-FETUS-NEWBORN»

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L. A. Lityaeva

2017-01-01

Full Text Available A comparative study of the state of health of 110 women with allergopathology at the stage of pregnancy and their newborn children, with an assessment of the influence of factors burdening fetal fetal development and contributing to the implementation of allergopathology in the first months of life.Trigger factors of disturbances in the formation of the intestinal microbiota, immune system and congenital decrease in the resistance of the child's organism — gestosis (c2 = 5.2, p = 0.022, Feto-placental insufficiency (c2 = 6.2, p = 0.012, chronic intrauterine fetal hypoxia (c2 = 5.7, p = 0.017, due to the presence in a woman with an allergic disease of combined somatic pathology and pathology of the genitals, malnutrition and microecological status.Such women should be classified as a high-risk group for intrauterine fetal sensitization and taken from the first days of pregnancy for primary prevention of allergopathology already at the stage of intrauterine development of the fetus. 

Fetal cardiology

International Nuclear Information System (INIS)

Meijboom, E.J.; Rijsterborgh, N.; Bom, N.

1986-01-01

Doppler echocardiography makes it possible to diagnose congenital heart disease in early pregnancy. It allows us to study the anatomical configuration of the fetal heart, and additionally, to evaluate the physiological conditions of the fetus. Evaluation of the direction, velocity, wave form pattern, and quantification of blood flow at the various sites in the fetal heart helps us to assess the characteristics of the fetal circulation and condition of the fetal heart. In order to use this technique in pathological situations, an initial study of the developing normal human fetal circulation was necessary. The authors studied 34 uncomplicated pregnancies by serial Doppler echocardiography. The studies were performed every 4 weeks from 16-weeks gestation to term. The pulsed Doppler sector scanner provided cardiac cross-sectional images, mitral and tricuspid blood velocities were obtained from apical four-chamber views. Angle corrected maximal and mean temporal velocities were calculated by digitizing the Doppler frequency shift recording on a graphic tablet computed with a minicomputer. The angle between the Doppler interrogation beam and the direction of blood flow was kept as small as possible in order to minimize the error

Enhancement of Na/K pump activity by chronic intermittent hypobaric hypoxia protected against reperfusion injury.

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Guo, Hui-Cai; Guo, Fang; Zhang, Li-Nan; Zhang, Rong; Chen, Qing; Li, Jun-Xia; Yin, Jian; Wang, Yong-Li

2011-06-01

Chronic intermittent hypobaric hypoxia (CIHH) has been shown to attenuate intracellular Na(+) accumulation and Ca(2+) overload during ischemia and reperfusion (I/R), both of which are closely related to the outcome of myocardial damage. Na/K pump plays an essential role in maintaining the equilibrium of intracellular Na(+) and Ca(2+) during I/R. It has been shown that enhancement of Na/K pump activity by ischemic preconditioning may be involved in the cardiac protection. Therefore, we tested whether Na/K pump was involved in the cardioprotection by CIHH. We found that Na/K pump current in cardiac myocytes of guinea pigs exposed to CIHH increased 1.45-fold. The K(1) and f(1), which reflect the portion of α(1)-isoform of Na/K pump, dramatically decreased or increased, respectively, in CIHH myocytes. Western blot analysis revealed that CIHH increased the protein expression of the α(1)-isoform by 76%, whereas the protein expression of the α(2)-isoform was not changed significantly. Na/K pump current was significantly suppressed in simulated I/R, and CIHH preserved the Na/K pump current. CIHH significantly improved the recovery of cell length and contraction during reperfusion. Furthermore, inhibition of Na/K pump by ouabain attenuated the protective effect afforded by CIHH. Collectively, these data suggest that the increase of Na/K pump activity following CIHH is due to the upregulating α(1)-isoform of Na/K pump, which may be one of the mechanisms of CIHH against I/R-induced injury.

Impact of Chronic Neonatal Intermittent Hypoxia on Severity of Retinal Damage in a Rat Model of Oxygen-Induced Retinopathy.

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Beharry, Kay D; Cai, Charles L; Ahmad, Taimur; Guzel, Sibel; Valencia, Gloria B; Aranda, Jacob V

2018-01-01

Neonatal intermittent hypoxia (IH) followed by re-oxygenation in normoxia or supplemental oxygen (IHR) increases the risk for severe retinopathy of prematurity (ROP). The exact timing for the onset of retinal damage which may guide strategic interventions during retinal development, is unknown. We tested the hypothesis that chronic exposure of the immature retina to neonatal IH induces early manifestations of retinal damage that can be utilized as key time points for strategic pharmacologic intervention. Newborn rats were exposed to IH within 2 hours of birth (P0) until P14, or allowed to recover in room air (RA) from P14 to P21 (IHR). Retinal integrity and angiogenesis biomarkers were progressively assessed before (P0), during IH, and post IH (recovery in RA), or IHR, and compared to normoxic age-matched controls. Retinal damage occurred as early as day 3 of neonatal IH, consistent with vascular abnormalities and disturbances in the astrocytic template. These abnormalities worsened during IHR. Pharmacologic and non-pharmacologic interventions to identify, prevent, or minimize neonatal IH should be implemented shortly after birth in high risk preterm newborns. This strategy may lead to a reduction in the outcome of severe ROP requiring later invasive treatments.

A crucial role for maternal dietary methyl donor intake in epigenetic programming and fetal growth outcomes.

Science.gov (United States)

McGee, Meghan; Bainbridge, Shannon; Fontaine-Bisson, Bénédicte

2018-06-01

The fetal origins of health and disease framework has identified extremes in fetal growth and birth weight as factors associated with the lifelong generation of chronic diseases such as obesity, diabetes, cardiovascular disease, and hypertension. Maternal nutrition plays a critical role in fetal and placental development, in part by providing the methyl groups required to establish the fetus's genome structure and function, notably through DNA methylation. The goal of this narrative review is to describe the role of maternal dietary methyl donor (methionine, folate, and choline) and cofactor (zinc and vitamins B2, B6, and B12) intake in one-carbon metabolism and DNA methylation in the fetus and placenta, as well as their impacts on fetal growth and lifelong health outcomes, with specific examples in animals and humans. Based on the available evidence, it is concluded that intake of different amounts of dietary methyl donors and cofactors during pregnancy may alter fetal growth and development, thus establishing a major link between early environmental exposure and disease development in the offspring later in life.

Randomized, controlled trial comparing synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in preterm infants.

Science.gov (United States)

Reyes, Zenaida C; Claure, Nelson; Tauscher, Markus K; D'Ugard, Carmen; Vanbuskirk, Silvia; Bancalari, Eduardo

2006-10-01

Prolonged mechanical ventilation is associated with lung injury in preterm infants. In these infants, weaning from synchronized intermittent mandatory ventilation may be delayed by their inability to cope with increased respiratory loads. The addition of pressure support to synchronized intermittent mandatory ventilation can offset these loads and may facilitate weaning. The purpose of this work was to compare synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in weaning from mechanical ventilation and the duration of supplemental oxygen dependency in preterm infants with respiratory failure. Preterm infants weighing 500 to 1000 g at birth who required mechanical ventilation during the first postnatal week were randomly assigned to synchronized intermittent mandatory ventilation or synchronized intermittent mandatory ventilation plus pressure support. In both groups, weaning followed a set protocol during the first 28 days. Outcomes were assessed during the first 28 days and until discharge or death. There were 107 infants enrolled (53 synchronized intermittent mandatory ventilation plus pressure support and 54 synchronized intermittent mandatory ventilation). Demographic and perinatal data, mortality, and morbidity did not differ between groups. During the first 28 days, infants in the synchronized intermittent mandatory ventilation plus pressure support group reached minimal ventilator settings and were extubated earlier than infants in the synchronized intermittent mandatory ventilation group. Total duration of mechanical ventilation, duration of oxygen dependency, and oxygen need at 36 weeks' postmenstrual age alone or combined with death did not differ between groups. However, infants in synchronized intermittent mandatory ventilation plus pressure support within the 700- to 1000-g birth weight strata had a shorter oxygen dependency. The results of this study suggest that the addition of

Studies by radioiodination of normal adult, fetal and leukemic cell membranes

Energy Technology Data Exchange (ETDEWEB)

Kannourakis, G; Cauchi, M N [Department of Pathology and Immunology, Monash Medical School, Melbourne, Australia

1978-01-01

A comparison was made between cord blood lymphocytes, normal adult lymphocytes and leukemic cells after membrane iodination with lactoperoxidase. A double-labeling technique using lactoperoxidase iodination with /sup 125/I and /sup 131/I followed by analysis on polyacrylamide gel electrophoresis revealed a number of membrane differences between leukemic, normal and fetal cells. There was a reduction in the 70,000 molecular weight component in cord blood cells compared to adult lymphocytes, and an increase in membrane peptides with molecular weights of 35,000, 20,000, 9,000 and 4,000. Although smaller molecular weight peptides were also present in chronic lymphatic leukemia as well as acute myeloid leukemia, these were shown to be distinct from fetal type membrane components.

Repeated episodes of chronic intermittent ethanol promote insensitivity to devaluation of the reinforcing effect of ethanol.

Science.gov (United States)

Lopez, M F; Becker, H C; Chandler, L J

2014-11-01

Studies in animal models have shown that repeated episodes of alcohol dependence and withdrawal promote escalation of drinking that is presumably associated with alterations in the addiction neurocircuitry. Using a lithium chloride-ethanol pairing procedure to devalue the reinforcing properties of ethanol, the present study determined whether multiple cycles of chronic intermittent ethanol (CIE) exposure by vapor inhalation also alters the sensitivity of drinking behavior to the devaluation of ethanol's reinforcing effects. The effect of devaluation on operant ethanol self-administration and extinction was examined in mice prior to initiation of CIE (short drinking history) and after repeated cycles of CIE or air control exposure (long drinking history). Devaluation significantly attenuated the recovery of baseline ethanol self-administration when tested either prior to CIE or in the air-exposed controls that had experienced repeated bouts of drinking but no CIE. In contrast, in mice that had undergone repeated cycles of CIE exposure that promoted escalation of ethanol drinking, self-administration was completely resistant to the effect of devaluation. Devaluation had no effect on the time course of extinction training in either pre-CIE or post-CIE mice. Taken together, these results are consistent with the suggestion that repeated cycles of ethanol dependence and withdrawal produce escalation of ethanol self-administration that is associated with a change in sensitivity to devaluation of the reinforcing properties of ethanol. Copyright © 2014 Elsevier Inc. All rights reserved.

Intermittency in 197Au fragmentation

International Nuclear Information System (INIS)

Dabrowska, A.; Holynski, R.; Olszewski, A.; Szarska, M.; Wilczynska, B.; Wolter, W.; Wosiek, B.; Cherry, M.L.; Deines-Jones, P.; Jones, W.V.; Sengupta, K.; Wefel, B.

1995-07-01

The concept of factorial moments was applied to an analysis of the dynamical fluctuations in the charge distributions of the fragments emitted from gold nuclei with energies 10.6 and < 1.0 GeV/n interacting with emulsion nuclei. Clear evidence for intermittent fluctuations has been found in an analysis using all the particles released from the gold projectile, with a stronger effect observed below 1 GeV/n than at 10.6 GeV/n. For the full data sets, however, the intermittency effect was found to be very sensitive to the singly charged particles, and neglecting these particles strongly reduces the intermittency signal. When the analysis is restricted to the multiply charged fragments, an intermittency effect is revealed only for multifragmentation events, although one that is enhanced as compared to the analysis of all, singly and multiply charged, particles. The properties of the anomalous fractal dimensions suggest a sequential decay mechanism, rather than the existence of possible critical behaviour in the process of nuclear fragmentation. The likely influence of the charge conservation effects and the finite size of decaying systems on the observed intermittency signals was pointed out. (author). 37 refs, 9 figs, 5 tabs

Intermittent Hypoxia Increases the Severity of Bleomycin-Induced Lung Injury in Mice

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Thomas Gille

2018-01-01

Full Text Available Background. Severe obstructive sleep apnea (OSA with chronic intermittent hypoxia (IH is common in idiopathic pulmonary fibrosis (IPF. Here, we evaluated the impact of IH on bleomycin- (BLM- induced pulmonary fibrosis in mice. Methods. C57BL/6J mice received intratracheal BLM or saline and were exposed to IH (40 cycles/hour; FiO2 nadir: 6%; 8 hours/day or intermittent air (IA. In the four experimental groups, we evaluated (i survival; (ii alveolar inflammation, pulmonary edema, lung oxidative stress, and antioxidant enzymes; (iii lung cell apoptosis; and (iv pulmonary fibrosis. Results. Survival at day 21 was lower in the BLM-IH group (p<0.05. Pulmonary fibrosis was more severe at day 21 in BLM-IH mice, as assessed by lung collagen content (p=0.02 and histology. At day 4, BLM-IH mice developed a more severe neutrophilic alveolitis, (p<0.001. Lung oxidative stress was observed, and superoxide dismutase and glutathione peroxidase expression was decreased in BLM-IH mice (p<0.05 versus BLM-IA group. At day 8, pulmonary edema was observed and lung cell apoptosis was increased in the BLM-IH group. Conclusion. These results show that exposure to chronic IH increases mortality, lung inflammation, and lung fibrosis in BLM-treated mice. This study raises the question of the worsening impact of severe OSA in IPF patients.

Transcranial Magnetic Stimulation with Intermittent Theta Burst Stimulation Alters Corticospinal Output in Patients with Chronic Incomplete Spinal Cord Injury

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Hunter J. Fassett

2017-08-01

Full Text Available Intermittent theta burst stimulation (iTBS is intended primarily to alter corticospinal excitability, creating an attractive opportunity to alter neural output following incomplete spinal cord injury (SCI. This study is the first to assess the effects of iTBS in SCI. Eight individuals with chronic incomplete SCI were studied. Sham or real iTBS was delivered (to each participant over primary motor and somatosensory cortices in separate sessions. Motor-evoked potential (MEP recruitment curves were obtained from the flexor carpi radialis muscle before and after iTBS. Results indicate similar responses for iTBS to both motor and somatosensory cortex and reduced MEPs in 56.25% and increased MEPs in 25% of instances. Sham stimulation exceeded real iTBS effects in the remaining 18.25%. It is our opinion that observing short-term neuroplasticity in corticospinal output in chronic SCI is an important advance and should be tested in future studies as an opportunity to improve function in this population. We emphasize the need to re-consider the importance of the direction of MEP change following a single session of iTBS since the relationship between MEP direction and motor function is unknown and multiple sessions of iTBS may yield very different directional results. Furthermore, we highlight the importance of including sham control in the experimental design. The fundamental point from this pilot research is that a single session of iTBS is often capable of creating short-term change in SCI. Future sham-controlled randomized trials may consider repeat iTBS sessions to promote long-term changes in corticospinal excitability.

Choriodecidual infection downregulates angiogenesis and morphogenesis pathways in fetal lungs from Macaca nemestrina.

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Ryan M McAdams

Full Text Available Intrauterine exposure to amniotic fluid (AF cytokines is thought to predispose to bronchopulmonary dysplasia (BPD. We evaluated the effects of GBS exposure on RNA expression in fetal lung tissue to determine early molecular pathways associated with fetal lung injury that may progress to BPD.Ten chronically catheterized pregnant monkeys (Macaca nemestrina at 118-125 days gestation (term = 172 days received choriodecidual inoculation of either: 1 Group B Streptococcus (n = 5 or 2 saline (n = 5. Cesarean section and fetal necropsy was performed in the first week after GBS or saline inoculation regardless of labor. RNA was extracted from fetal lungs and profiled by microarray. Results were analyzed using single gene, Gene Set, and Ingenuity Pathway Analysis. Validation was by RT-PCR and immunohistochemistry.Despite uterine quiescence in most cases, fetal lung injury occurred in four GBS cases (intra-alveolar neutrophils, interstitial thickening and one control (peri-mortem hemorrhage. Significant elevations of AF cytokines (TNF-α, IL-8, IL-1β, IL-6 were detected in GBS versus controls (p<0.05. Lung injury was not directly caused by GBS, because GBS was undetectable by culture and PCR in the AF and fetal lungs. A total of 335 genes were differentially expressed greater than 1.5 fold (p<0.05 with GBS exposure associated with a striking upregulation of genes in innate and adaptive immunity and downregulation of pathways for angiogenesis, morphogenesis, and cellular growth and development.A transient choriodecidual infection may induce fetal lung injury with profound alterations in the genetic program of the fetal lung before signs of preterm labor. Our results provide a window for the first time into early molecular pathways disrupting fetal lung angiogenesis and morphogenesis before preterm labor occurs, which may set the stage for BPD. A strategy to prevent BPD should target the fetus in utero to attenuate alterations in the fetal lung

Human fetal anatomy: MR imaging.

Science.gov (United States)

Weinreb, J C; Lowe, T; Cohen, J M; Kutler, M

1985-12-01

Twenty-four pregnant women carrying 26 fetuses (two sets of twins) were imaged with magnetic resonance (MR) imaging at 0.35 T following sonographic evaluation. Each study was retrospectively evaluated to determine which of 33 normal fetal structures were visible on the images and which imaging parameters were most useful for depicting fetal anatomy. Fetal motion degraded fetal images in all but two cases, both with oligohydramnios and in the third trimester of gestation. Nevertheless, many fetal structures were identifiable, particularly in the third trimester. Visualization of fetal anatomy improved with intravenous maternal sedation in five cases. Relatively T1-weighted images occasionally offered the advantage of less image degradation owing to fetal motion and improved contrast between different fetal structures. More T2 weighting was believed to be advantageous in one case for outlining the fetal head and in one case for delineation of the brain. In many cases, structures were similarly identifiable (though with different signal intensities) regardless of the parameters selected. The authors conclude that MR imaging of many fetal structures is currently unsatisfactory and is probably of limited value, particularly in the first and second trimesters. However, the relative frequency and detail with which the fetal head and liver can be depicted indicate that these may be areas for further investigation, and the potential utility of imaging fetal fat warrants further investigation.

Caffeine reduces apnea frequency and enhances ventilatory long-term facilitation in rat pups raised in chronic intermittent hypoxia.

Science.gov (United States)

Julien, Cécile A; Joseph, Vincent; Bairam, Aida

2010-08-01

The mechanisms underlying the therapeutic function of caffeine on apneas in preterm neonates are not well determined. To better understand these effects, we exposed rat pups from postnatal d 3-12 to chronic intermittent hypoxia (5% O2/100 s every 10 min; 6 cycles/h followed by 1 h at 21% O2, 24 h/d), a model mimicking hypoxemic exposure in apneic neonates. Then, using whole-body plethysmography, we evaluated minute ventilation, apnea frequency, and duration after i.p injection of caffeine citrate (20 mg/kg) or saline under normoxia and in response to either sustained (FiO2 12%, 20 min) or brief (FiO2 5%, 60 s, total 10 episodes of 8 min each) hypoxia. These tests were used to assess peripheral and central components of hypoxic response. The latter also assessed the ventilatory long-term facilitation during recovery (2 h). Caffeine injection increased minute ventilation under baseline and during recovery. This effect was correlated with a decrease in apnea frequency (not duration). On the contrary, caffeine did not change the ventilatory response to sustained or brief hypoxic exposure. These results suggest that the effects of caffeine on apnea depend on increased central normoxic respiratory drive and enhancement of ventilatory long-term facilitation rather than on higher hypoxic ventilatory response.

O perfil de portadores de diabetes tipo 1 considerando seu histórico de aleitamento materno El perfil de los portadores de Diabetes tipo 1 considerando su histórico de amamantamiento materno The profile of people with Type 1 Diabetes considering their history of breast feeding

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Dalila Teixeira Leal

2011-03-01

Full Text Available Trata-se de um estudo que teve como objetivo descrever o perfil dos usuários de um Serviço de Controle de Hipertensão, Diabetes e Obesidade e discutir a relação entre a história de aleitamento materno da criança ou adolescente portador de diabetes tipo 1 e o desenvolvimento desta patologia. A coleta de dados foi realizada por meio de um questionário estruturado, aplicado aos pais ou responsáveis de crianças ou adolescentes portadoras de diabetes mellitus tipo 1, durante o segundo semestre de 2007. Os dados foram analisados com uma abordagem quantitativa, em que se utilizou a estatística descritiva. Como resultados foram apresentados dados referentes à caracterização da amostra, ocorrência do desmame precoce, período de aleitamento materno exclusivo, dieta oferecida após o desmame, entre outros. Na conclusão é evidenciada a significativa relação entre desmame precoce, com a consequente introdução de substitutos do leite materno e o desenvolvimento do diabetes mellitus tipo 1.Es un estudio que tuvo como objetivo describir el perfil de los usuarios del Servicio de Control de Hipertensión, Diabetes y Obesidad y discutir la relación entre la historia de amamantamiento materno del niño o del adolescente portador de diabetes tipo 1 y el desenvolvimiento de esta enfermedad. La colecta de los datos fue realizada por medio de un cuestionario estructurado, aplicado en los padres o responsables de estos niños, durante el 2º semestre de 2007. Los datos fueron analizados en un abordaje cuantitativo en que se utilizó la estadística descriptiva. Como resultados fueron presentados datos referentes a la caracterización de la muestra, ocurrencia de la interrupción del amamantamiento precoz, período de amamantamiento materno exclusivo, dieta ofrecida después de la interrupción del amamantamiento y otros. En la conclusión es presentada la significativa relación entre la interrupción del amamantamiento precoz, con la consecuente

Intermittent control: a computational theory of human control.

Science.gov (United States)

Gawthrop, Peter; Loram, Ian; Lakie, Martin; Gollee, Henrik

2011-02-01

The paradigm of continuous control using internal models has advanced understanding of human motor control. However, this paradigm ignores some aspects of human control, including intermittent feedback, serial ballistic control, triggered responses and refractory periods. It is shown that event-driven intermittent control provides a framework to explain the behaviour of the human operator under a wider range of conditions than continuous control. Continuous control is included as a special case, but sampling, system matched hold, an intermittent predictor and an event trigger allow serial open-loop trajectories using intermittent feedback. The implementation here may be described as "continuous observation, intermittent action". Beyond explaining unimodal regulation distributions in common with continuous control, these features naturally explain refractoriness and bimodal stabilisation distributions observed in double stimulus tracking experiments and quiet standing, respectively. Moreover, given that human control systems contain significant time delays, a biological-cybernetic rationale favours intermittent over continuous control: intermittent predictive control is computationally less demanding than continuous predictive control. A standard continuous-time predictive control model of the human operator is used as the underlying design method for an event-driven intermittent controller. It is shown that when event thresholds are small and sampling is regular, the intermittent controller can masquerade as the underlying continuous-time controller and thus, under these conditions, the continuous-time and intermittent controller cannot be distinguished. This explains why the intermittent control hypothesis is consistent with the continuous control hypothesis for certain experimental conditions.

Fetal MSCs

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Derived from extra embryonic tissues (amniotic fluid, placenta, cord blood, Wharton's Jelly) and fetal tissues (aborted fetuses). Derived from extra embryonic tissues (amniotic fluid, placenta, cord blood, Wharton's Jelly) and fetal tissues (aborted fetuses). In comparison ...

Long-Term Intermittent Work at High Altitude: Right Heart Functional and Morphological Status and Associated Cardiometabolic Factors.

Science.gov (United States)

Brito, Julio; Siques, Patricia; López, Rosario; Romero, Raul; León-Velarde, Fabiola; Flores, Karen; Lüneburg, Nicole; Hannemann, Juliane; Böger, Rainer H

2018-01-01

Background: Living at high altitude or with chronic hypoxia implies functional and morphological changes in the right ventricle and pulmonary vasculature with a 10% prevalence of high-altitude pulmonary hypertension (HAPH). The implications of working intermittently (day shifts) at high altitude (hypobaric hypoxia) over the long term are still not well-defined. The aim of this study was to evaluate the right cardiac circuit status along with potentially contributory metabolic variables and distinctive responses after long exposure to the latter condition. Methods: A cross-sectional study of 120 healthy miners working at an altitude of 4,400-4,800 m for over 5 years in 7-day commuting shifts was designed. Echocardiography was performed on day 2 at sea level. Additionally, biomedical and biochemical variables, Lake Louise scores (LLSs), sleep disturbances and physiological variables were measured at altitude and at sea level. Results: The population was 41.8 ± 0.7 years old, with an average of 14 ± 0.5 (range 5-29) years spent at altitude. Most subjects still suffered from mild to moderate symptoms of acute mountain sickness (mild was an LLS of 3-5 points, including cephalea; moderate was LLS of 6-10 points) (38.3%) at the end of day 1 of the shift. Echocardiography showed a 23% mean pulmonary artery pressure (mPAP) >25 mmHg, 9% HAPH (≥30 mmHg), 85% mild increase in right ventricle wall thickness (≥5 mm), 64% mild right ventricle dilation, low pulmonary vascular resistance (PVR) and fairly good ventricle performance. Asymmetric dimethylarginine (ADMA) (OR 8.84 (1.18-66.39); p Working intermittently at high altitude involves a distinctive pattern. The most relevant and novel characteristics are a greater prevalence of elevated mPAP and HAPH than previously reported at chronic intermittent hypobaric hypoxia (CIHH), which is accompanied by subsequent morphological characteristics. These findings are associated with cardiometabolic factors (insulin and ADMA

Prenatal programming of postnatal obesity: fetal nutrition and the regulation of leptin synthesis and secretion before birth.

Science.gov (United States)

McMillen, I C; Muhlhausler, B S; Duffield, J A; Yuen, B S J

2004-08-01

Exposure to either an increased or decreased level of intrauterine nutrition can result in an increase in adiposity and in circulating leptin concentrations in later life. In animals such as the sheep and pig in which fat is deposited before birth, leptin is synthesised in fetal adipose tissue and is present in the fetal circulation throughout late gestation. In the sheep a moderate increase or decrease in the level of maternal nutrition does not alter fetal plasma leptin concentrations, but there is evidence that chronic fetal hyperglycaemia and hyperinsulinaemia increase fetal fat mass and leptin synthesis within fetal fat depots. Importantly, there is a positive relationship between the relative mass of the 'unilocular' component of fetal perirenal and interscapular adipose tissue and circulating fetal leptin concentrations in the sheep. Thus, as in the neonate and adult, circulating leptin concentrations may be a signal of fat mass in fetal life. There is also evidence that leptin can act to regulate the lipid storage, leptin synthetic capacity and potential thermogenic functions of fat before birth. Thus, leptin may act as a signal of energy supply and have a 'lipostatic' role before birth. Future studies are clearly required to determine whether the intrauterine and early postnatal nutrient environment programme the endocrine feedback loop between adipose tissue and the central and peripheral neuroendocrine systems that regulate energy balance, resulting in an enhanced risk of obesity in adult life.

Fetal abdominal magnetic resonance imaging

International Nuclear Information System (INIS)

Brugger, Peter C.; Prayer, Daniela

2006-01-01

This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages

Fetal abdominal magnetic resonance imaging

Energy Technology Data Exchange (ETDEWEB)

Brugger, Peter C. [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, 1090 Vienna (Austria)]. E-mail: peter.brugger@meduniwien.ac.at; Prayer, Daniela [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria)

2006-02-15

This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages.

Fetal tachycardia : diagnosis and treatment

NARCIS (Netherlands)

Oudijk, Martijn Alexander

2003-01-01

Part I: Fetal tachyarrhythmias Diagnosis Fetal tachycardia is a serious condition warranting specialized evaluation. In chapter 2, methods of diagnosis of fetal tachycardia are described, including doppler and M-mode echocardiography and fetal magnetocardiography. The study presented in chapter 3

Fetal short time variation during labor: a non-invasive alternative to fetal scalp pH measurements?

Science.gov (United States)

Schiermeier, Sven; Reinhard, Joscha; Hatzmann, Hendrike; Zimmermann, Ralf C; Westhof, Gregor

2009-01-01

To determine whether short time variation (STV) of fetal heart beat correlates with scalp pH measurements during labor. From 1279 deliveries, 197 women had at least one fetal scalp pH measurement. Using the CTG-Player, STVs were calculated from the electronically saved cardiotocography (CTG) traces and related to the fetal scalp pH measurements. There was no correlation between STV and fetal scalp pH measurements (r=-0.0592). Fetal STV is an important parameter with high sensitivity for antenatal fetal acidosis. This study shows that STV calculations do not correlate with fetal scalp pH measurements during labor, hence are not helpful in identifying fetal acidosis.

CONDITIONED ANALYSIS OF HIGH-LATITUDE SOLAR WIND INTERMITTENCY

International Nuclear Information System (INIS)

D'Amicis, R.; Consolini, G.; Bavassano, B.; Bruno, R.

2012-01-01

The solar wind is a turbulent medium displaying intermittency. Its intermittent features have been widely documented and studied, showing how the intermittent character is different in fast and slow wind. In this paper, a statistical conditioned analysis of the solar wind intermittency for a period of high-latitude fast solar wind is presented. In particular, the intermittent features are investigated as a function of the Alfvénic degree of fluctuations at a given scale. The results show that the main contribution to solar wind intermittency is due to non-Alfvénic structures, while Alfvénic increments are found to be characterized by a smaller level of intermittency than the previous ones. Furthermore, the lifetime statistics of Alfvénic periods are discussed in terms of a multiscale texture of randomly oriented flux tubes.

Repercussão da monitorização fetal intraparto sobre os índices de operação cesariana Impact of intrapartum fetal monitoring on cesarean section rates

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Edson N. Morais

1998-03-01

Full Text Available A monitorização fetal eletrônica (MFE tem sido o método mais amplamente utilizado para a vigilância fetal direta, especialmente durante o trabalho de parto. Na tentativa de elucidar o efeito da MFE sobre os índices de cesárea (IC, um estudo retrospectivo foi realizado no Hospital Universitário de Santa Maria (HUSM. Estudamos dois grupos de pacientes perfazendo um total de 2.114 gestantes: um grupo (n=517 com MFE e outro (n=1.597 com ausculta intermitente (AI. No grupo MFE observamos um IC de 38,0%, contra 27,2% do grupo AI. Para todas as pacientes, o IC foi de 29,9%. O sofrimento fetal agudo foi a indicação mais comum de cesárea no grupo MFE (40,6%, ao passo que a cesárea prévia foi a terceira causa (10,1%. No grupo AI, o sofrimento fetal foi a terceira causa de cesárea (14,3%, ao passo que a cesárea prévia foi a indicação mais comum (32,4%. Baseados no presente estudo, acreditamos que a MFE não tem efeito, por si só, sobre as taxas de cesárea, se considerados todos os nascimentos no HUSM. Com uma educação adequada dos obstetras e uma correta interpretação dos traçados, a MFE não aumenta os índices de cesárea, ao contrário permite mais acuracidade na descrição das condições fetais intraparto.Electronic fetal heart rate monitoring (EFM is the most widely used method of direct fetal surveillance especially during labor. In an attempt to elucidate the effect of EFM on cesarean section (CS rates, a retrospective study was performed at the University Hospital of Santa Maria (HUSM. We studied two groups of patients, consisting of 2114 pregnant women: EFM group (n=517 and intermittent auscultation (IA group (n=1597. In the EFM group we observed 38.0% of CS vs. 27.2% in the IA group. For all patients, the CS rate was 29.9%. Fetal distress was the most common indication for CS in the EFM group (40.6%, while previous CS was the third cause (10.1%. On the IA group, fetal distress was the third cause in CS (14.3%, while

Who's the patient? : ethics in and around maternal-fetal surgery

NARCIS (Netherlands)

Rodrigues, Helena Catarina Misarela Loureiro

2012-01-01

Het complex van chirurgische handelingen en andere prenatale interventies die reeds voor de geboorte van de foetus worden uitgevoerd wordt ook wel Materno-Foetale chirurgie genoemd (MFS). Doel van deze handelingen is om levensbedreigende of met een ernstige handicap gepaard gaande afwijkingen reeds

Intermittency '93

International Nuclear Information System (INIS)

Bialas, A.

1993-01-01

The existing data definitely indicate the existence of intermittency, i.e. of self similar structures in the systems of particles created in high-energy collisions. The effect seems universal: it was found in most of the processes investigated and its measures parameters depend only weakly (if at all) on the process in question. Strong HBT effect was found, suggesting that intermittency is related to space-time structure of the pion source rather than to detailed momentum structure of the production amplitudes. There are indications that this space time structure may be fractal, but more data is needed to establish this. The theoretical explanation remains obscure: it seems that both parton cascade and hadronization play an important role. Their interrelation, however, remains a mystery. 5 figs., 19 refs

PATTERN OF CHOLINESTERASE INHIBITION IN ADULT, MALE RATS CHRONICALLY EXPOSED TO DIETARY CHLORPYRIFOS.

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Very little is known about the effects of chronic exposure to relatively low levels of anticholinesterase insecticides or how the effects of chronic exposure compare to higher, intermittent exposure of the same compound for the same duration. To that end, we exposed adult male ra...

Repetitive reduction of uterine blood flow and its influence on fetal transcutaneous PO2 and cardiovascular variables.

Science.gov (United States)

Jensen, A; Künzel, W; Kastendieck, E

1985-04-01

The influence of repeated asphyxia on fetal transcutaneous PO2, relative local skin perfusion, heart rate, blood gases and pH was investigated in 15 experiments on 8 acutely instrumented sheep fetuses in utero between 125 and 145 days gestation (term is 147 days). Uterine blood flow was intermittently arrested (11 times within 33 min) by intra-vascular maternal aortic occlusion, exposing the fetuses to repeated episodes of asphyxia of 30 (n = 3), 60 (n = 9) and 90 (n = 3) s duration. The fetal transcutaneous PO2 fell as the duration of asphyxia (2 alpha less than 0.01), heart rate deceleration area (2 alpha less than 0.01) and acidaemia (2 alpha less than 0.01) increased. With decreasing skin perfusion, which was dependent on the duration of asphyxia (2 alpha less than 0.001) and acidaemia (2 alpha less than 0.001), a discrepancy developed between transcutaneous and arterial PO2. The increase (delta) in transcutaneous-arterial PO2 difference was related linearly to the duration of asphyxia (2 alpha less than 0.01), the mean haemoglobin oxygen saturation (2 alpha less than 0.001), acidaemia (2 alpha less than 0.001) and relative local skin flow (2 alpha less than 0.05). It was highest after severe episodes of asphyxia (90 s), when O2 saturation, skin blood flow and arterial blood pH values were low. Fetal heart rate deceleration area was only correlated with the cutaneous-arterial PO2 difference when the mean fetal haemoglobin oxygen saturation was below 35%. Thus, a discrimination of heart rate decelerations that are significant for the fetus seems to be possible, when associated with low transcutaneous PO2 values. We conclude that in the sheep fetus transcutaneous PO2 measurements during repeated asphyxial episodes yield information on fetal oxygenation and on the skin vasomotor response.

Review: Adiponectin – The Missing Link between Maternal Adiposity, Placental Transport and Fetal Growth?

Science.gov (United States)

Aye, Irving L. M. H.; Powell, Theresa L.; Jansson, Thomas

2012-01-01

Adiponectin has well-established insulin-sensitizing effects in non-pregnant individuals. Pregnant women who are obese or have gestational diabetes typically have low circulating levels of adiponectin, which is associated with increased fetal growth. Lean women, on the other hand, have high circulating levels of adiponectin. As a result, maternal serum adiponectin is inversely correlated to fetal growth across the full range of birth weights, suggesting that maternal adiponectin may limit fetal growth. In the mother, adiponectin is predicted to promote insulin sensitivity and stimulate glucose uptake in maternal skeletal muscle thereby reducing nutrient availability for placental transfer. Adiponectin prevents insulin-stimulated amino acid uptake in cultured primary human trophoblast cells by modulating insulin receptor substrate phosphorylation. Furthermore, chronic administration of adiponectin to pregnant mice inhibits placental insulin and mammalian target of rapamycin complex 1 (mTORC1) signaling, down-regulates the activity and expression of key placental nutrient transporters and decreases fetal growth. Preliminary findings indicate that adiponectin binds to the adiponectin receptor-2 on the trophoblast cell and activates p38 MAPK and PPAR-α, which inhibits the insulin/IGF-1 signaling pathway. In contrast to maternal adiponectin, recent reports suggest that fetal adiponectin may promote expansion of adipose tissue and stimulate fetal growth. Regulation of placental function by adiponectin constitutes a novel physiological mechanism by which the endocrine functions of maternal adipose tissue influence fetal growth. These findings may help us better understand the factors determining birth weight in normal pregnancies and in pregnancy complications associated with altered maternal adiponectin levels such as obesity and gestational diabetes. PMID:23245987

The relationship between maternal and fetal vitamin D, insulin resistance, and fetal growth.

LENUS (Irish Health Repository)

Walsh, Jennifer M

2013-05-01

Evidence for a role of vitamin D in maintaining normal glucose homeostasis is inconclusive. We sought to clarify the relationship between maternal and fetal insulin resistance and vitamin D status. This is a prospective cohort study of 60 caucasian pregnant women. Concentrations of 25-hydroxyvitamin D (25-OHD), glucose, insulin, and leptin were measured in early pregnancy and at 28 weeks. Ultrasound at 34 weeks assessed fetal anthropometry including abdominal wall width, a marker of fetal adiposity. At delivery birth weight was recorded and fetal 25-OHD, glucose, C-peptide, and leptin measured in cord blood. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA) equation. We found that those with lower 25-OHD in early pregnancy had higher HOMA indices at 28 weeks, (r = -.32, P = .02). No significant relationship existed between maternal or fetal leptin and 25-OHD, or between maternal or fetal 25-OHD and fetal anthropometry or birth weight. The incidence of vitamin D deficiency was high at each time point (15%-45%). These findings lend support to routine antenatal supplementation with vitamin D in at risk populations.

Influência das intercorrências maternas e fetais nos diferentes graus de corioamnionite Influence of maternal and fetal intercurrences on the different degrees of chorioamnionitis

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Juliana Reis Machado

2012-04-01

Full Text Available OBJETIVO: Avaliar a influência das complicações maternas, da prematuridade, dos parâmetros antropométricos do feto e de condições do recém-nascido nos diferentes graus de corioamnionite. MÉTODOS: Foram analisadas 90 placentas provenientes de partos realizados no Hospital de Clinicas da Universidade Federal do Triângulo Mineiro com diagnóstico de inflamação no exame anatomopatológico. A revisão dos prontuários foi realizada para adquirir informações materno-fetais relevantes. A infecção foi classificada em: grau I - deciduíte; grau II - corioamnionite; grau III - corioamnionite e vasculite; grau IV - sepse neonatal; e grau V - morte fetal e pneumonite. RESULTADOS: Dentre as gestantes analisadas, 50,0% não apresentaram intercorrências, 15,0% apresentaram amniorrexe prematura, 15,0% infecção do trato urinário, 7,5% síndromes hipertensivas, 7,5% infecção transvaginal, 5,0% infecção hematogênica e 11,1% outras complicações. Mais da metade dos neonatos eram do sexo masculino e 72,2% a termo. Analisando o grau de corioamnionite, 56,7% apresentaram o grau I, 22,2 % grau II, 4,4% grau III, 10,0% grau IV e 6,7% grau V. Na análise estatística foi utilizado o Teste Χ2 para a análise de variáveis qualitativas e o Teste de Spearman para a análise das correlações. Os graus mais elevados de corioamnionite foram observados nos casos que apresentaram intercorrências maternas. Foram observadas correlações negativas entre todos os parâmetros fetais e o grau de corioamnionite, sendo significativa em relação ao peso, ao comprimento, à circunferência torácica e ao Apgar no primeiro e quinto minuto. CONCLUSÕES: Os diferentes padrões de corioamnionite estão relacionados a diferentes manifestações clínicas materno-fetais, influenciando nas condições de vida do recém-nascido e na gravidade de lesões morfológicas encontradas em natimortos.PURPOSE: To evaluate the influence of maternal complications, prematurity

Milk--the promoter of chronic Western diseases.

Science.gov (United States)

Melnik, Bodo C

2009-06-01

Common chronic diseases of Western societies, such as coronary heart disease, diabetes mellitus, cancer, hypertension, obesity, dementia, and allergic diseases are significantly influenced by dietary habits. Cow's milk and dairy products are nutritional staples in most Western societies. Milk and dairy product consumption is recommended by most nutritional societies because of their beneficial effects for calcium uptake and bone mineralization and as a source of valuable protein. However, the adverse long-term effects of milk and milk protein consumption on human health have been neglected. A hypothesis is presented, showing for the first time that milk protein consumption is an essential adverse environmental factor promoting most chronic diseases of Western societies. Milk protein consumption induces postprandial hyperinsulinaemia and shifts the growth hormone/insulin-like growth factor-1 (IGF-1) axis to permanently increased IGF-1 serum levels. Insulin/IGF-1 signalling is involved in the regulation of fetal growth, T-cell maturation in the thymus, linear growth, pathogenesis of acne, atherosclerosis, diabetes mellitus, obesity, cancer and neurodegenerative diseases, thus affecting most chronic diseases of Western societies. Of special concern is the possibility that milk intake during pregnancy adversely affects the early fetal programming of the IGF-1 axis which will influence health risks later in life. An accumulated body of evidence for the adverse effects of cow's milk consumption from fetal life to childhood, adolescence, adulthood and senescence will be provided which strengthens the presented hypothesis.

MALFORMAÇÕES CONGÊNITAS E FATORES DE RISCO MATERNO EM CAMPINA GRANDE - PARAÍBA

OpenAIRE

Virgínia Rossana de Sousa Brito; Francisco Stélio de Sousa; Francisco Henrique Gadelha; Rafaella Queiroga Souto; Ana Raquel de Figueiredo Rego; Inacia Sátiro Xavier de França

2010-01-01

n el siguiente artículo se realiza un estudio para verificar el predominio de niños nacidos con malformaciones congénitas en las maternidades de Campina Grande–PB y los factores de riesgo asociados. Los datos recolectados se refieren a tres cen- tros maternos a través de las Declaraciones de Nacido Vivo — DNV emitidos en el período del 2003 al 2005. La asociación entre los tipos de malformaciones y las variables fue avalorada por el Chi-cuadrado y las Odds Ratio, fueron calculadas para cada v...

Fetal Echocardiography and Indications

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Melih Atahan Güven

2008-09-01

Full Text Available Congenital heart diseases are encountered in 0.8% of live births and are among the most frequently diagnosed malformations. At least half of these anomalies end up with death or require surgical interventions and are responsible for 30% of the perinatal mortality. Fetal echocardiography is the sum of knowledge, skill and orientation rather than knowing the embryologic details of the fetal heart. The purpose of fetal echocardiography is to document the presence of normal fetal cardiac anatomy and rhythm in high risk group and to define the anomaly and arrhythmia if present. A certain sequence should be followed during the evaluation of fetal heart. Sequential segmental analysis (SSA and basic definition terminology made it possible to determine a lot of complex cardiac anomalies during prenatal period. By the end of 1970’s, Shinebourne started using sequential segmental analysis for fetal cardiac evaluation and today, prenatal diagnosis of congenital heart disease is possible without any confusion. In this manner, whole fetal heart can be evaluated as the relation of three segments (atria, ventricles and the great arteries with each other, irrelevant of complexity of a possible cardiac anomaly. Presence of increased nuchal thickness during early gestation and abnormal four-chamber-view during ultrasonography by the obstetrician presents a clear indication for fetal echocardiography,however, one should keep in mind that 80-90% of the babies born with a congenital heart disease do not have a familial or maternal risk factor. In addition, it should be remembered that expectant mothers with diabetes mellitus pose an indication for fetal echocardiography.

Value of amniocentesis versus fetal tissue for cytogenetic analysis in cases of fetal demise.

Science.gov (United States)

Bryant Borders, Ann E; Greenberg, Jessica; Plaga, Stacey; Shepard-Hinton, Megan; Yates, Carin; Elias, Sherman; Shulman, Lee P

2009-01-01

Use of fetal tissue for cytogenetic analysis in cases of second- and third-trimester fetal demise frequently results in unacceptably high failure rates. We reviewed our ongoing use of amniocentesis prior to uterine evacuation to determine if this provided a better source of cells for cytogenetic analysis. We compared cytogenetic results using fetal tissues obtained following uterine evacuation to our ongoing use of amniotic fluid cell obtained by transabdominal amniocentesis prior to uterine evacuation from 2003 to 2008. In 49 of the 63 cases evaluated by fetal tissue biopsies performed after uterine evacuation, a karyotypic analysis was obtained (77.8%). Among the 38 cases evaluated by amniocentesis, an amniotic fluid sample and fetal cytogenetic results were obtained in all 38 (100%) cases. Our findings indicate that amniocentesis is a more reliable source of cytogenetic information than fetal tissue in cases of second- and third-trimester fetal demise.

High-dose phenobarbital with intermittent short-acting barbiturates for acute encephalitis with refractory, repetitive partial seizures.

Science.gov (United States)

Uchida, Takashi; Takayanagi, Masaru; Kitamura, Taro; Nishio, Toshiyuki; Numata, Yurika; Endo, Wakaba; Haginoya, Kazuhiro; Ohura, Toshihiro

2016-08-01

Acute encephalitis with refractory, repetitive partial seizures (AERRPS) is characterized by repetitive seizures during the acute and chronic phases and has a poor neurological outcome. Burst-suppression coma via continuous i.v. infusion of a short-acting barbiturate is used to terminate refractory seizures, but the severe side-effects of short-acting barbiturates are problematic. We report on a 9-year-old boy with AERRPS who was effectively treated with very-high-dose phenobarbital (VHDPB) combined with intermittent short-acting barbiturates. VHDPB side-effects were mild, especially compared with those associated with continuous i.v. infusion of short-acting barbiturates (dosage, 40-75 mg/kg/day; maximum blood level, 290 μg/mL). Using VHDPB as the main treatment, short-acting barbiturates were used intermittently and in small amounts. This is the first report to show that VHDPB, combined with intermittent short-acting barbiturates, can effectively treat AERRPS. After treatment, convulsions were suppressed and daily life continued, but intellectual impairment and high-level dysfunction remained. © 2016 Japan Pediatric Society.

Fetal body weight and the development of the control of the cardiovascular system in fetal sheep.

Science.gov (United States)

Frasch, M G; Müller, T; Wicher, C; Weiss, C; Löhle, M; Schwab, K; Schubert, H; Nathanielsz, P W; Witte, O W; Schwab, M

2007-03-15

Reduced birth weight predisposes to cardiovascular diseases in later life. We examined in fetal sheep at 0.76 (n = 18) and 0.87 (n = 17) gestation whether spontaneously occurring variations in fetal weight affect maturation of autonomic control of cardiovascular function. Fetal weights at both gestational ages were grouped statistically in low (LW) and normal weights (NW) (P fetal sheep not constituting a major malnutritive condition. Mean fetal blood pressure (FBP) of all fetuses was negatively correlated to fetal weight at 0.76 but not 0.87 gestation (P fetal heart rate depended on fetal weight (P fetal weight within the normal weight span is accompanied by a different trajectory of development of sympathetic blood pressure and vagal heart rate control. This may contribute to the development of elevated blood pressure in later life. Examination of the underlying mechanisms and consequences may contribute to the understanding of programming of cardiovascular diseases.

Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers.

Science.gov (United States)

Gaccioli, Francesca; Aye, Irving L M H; Sovio, Ulla; Charnock-Jones, D Stephen; Smith, Gordon C S

2018-02-01

Fetal growth restriction is a major determinant of perinatal morbidity and mortality. Screening for fetal growth restriction is a key element of prenatal care but it is recognized to be problematic. Screening using clinical risk assessment and targeting ultrasound to high-risk women is the standard of care in the United States and United Kingdom, but the approach is known to have low sensitivity. Systematic reviews of randomized controlled trials do not demonstrate any benefit from universal ultrasound screening for fetal growth restriction in the third trimester, but the evidence base is not strong. Implementation of universal ultrasound screening in low-risk women in France failed to reduce the risk of complications among small-for-gestational-age infants but did appear to cause iatrogenic harm to false positives. One strategy to making progress is to improve screening by developing more sensitive and specific tests with the key goal of differentiating between healthy small fetuses and those that are small through fetal growth restriction. As abnormal placentation is thought to be the major cause of fetal growth restriction, one approach is to combine fetal biometry with an indicator of placental dysfunction. In the past, these indicators were generally ultrasonic measurements, such as Doppler flow velocimetry of the uteroplacental circulation. However, another promising approach is to combine ultrasonic suspicion of small-for-gestational-age infant with a blood test indicating placental dysfunction. Thus far, much of the research on maternal serum biomarkers for fetal growth restriction has involved the secondary analysis of tests performed for other indications, such as fetal aneuploidies. An exemplar of this is pregnancy-associated plasma protein A. This blood test is performed primarily to assess the risk of Down syndrome, but women with low first-trimester levels are now serially scanned in later pregnancy due to associations with placental causes of

The effects of intermittent fasting during the month of Ramadan in chronic haemodialysis patients in a tropical climate country.

Science.gov (United States)

Wan Md Adnan, Wan Ahmad Hafiz; Zaharan, Nur Lisa; Wong, Mun Hoe; Lim, Soo Kun

2014-01-01

Chronic kidney disease is an emerging problem in the majority Muslim countries. Despite the uncertainties of the risks involved, some Muslim patients undergoing chronic haemodialysis choose to observe intermittent fasting during the month of Ramadan. This study aims to investigate the effect of Ramadan fasting in haemodialysis patients residing in a tropical climate country. This prospective cross sectional study recruited Muslim patients on regular haemodialysis from three haemodialysis centres in Kuala Lumpur from 15th July 2011 to 29th August 2011. Patients who fasted for any number of days were included (n = 35, 54% female, age 54±11 years). 89% of patients fasted for more than 15 days and 49% were diabetics. Dialysis parameters and blood samples were obtained one week prior to Ramadan and during the last week of Ramadan. The differences in dialysis parameters and biochemical values pre- and end-Ramadan were examined using paired t-test. Both pre- and post-dialysis weight were significantly decreased during Ramadan fasting compared to the month prior (p = <0.001). There was a significant decrease in the amount of ultrafiltration (p = 0.002). There were no significant differences in dry weight, inter-dialytic weight gain, mean urea reduction ratio or blood pressure measurements comparing pre- and end of Ramadan fasting. There was a significant increase in serum albumin level (p = 0.006) and decrease in serum phosphate level (p = 0.02) at the end of Ramadan. Ramadan fasting is associated with reduced weight, improved serum albumin and phosphate level in our population of haemodialysis patients. A larger multi-centre study will allow us to understand more about the effects of fasting in this population.

The effects of intermittent fasting during the month of Ramadan in chronic haemodialysis patients in a tropical climate country.

Directory of Open Access Journals (Sweden)

Wan Ahmad Hafiz Wan Md Adnan

Full Text Available BACKGROUND: Chronic kidney disease is an emerging problem in the majority Muslim countries. Despite the uncertainties of the risks involved, some Muslim patients undergoing chronic haemodialysis choose to observe intermittent fasting during the month of Ramadan. This study aims to investigate the effect of Ramadan fasting in haemodialysis patients residing in a tropical climate country. METHODS: This prospective cross sectional study recruited Muslim patients on regular haemodialysis from three haemodialysis centres in Kuala Lumpur from 15th July 2011 to 29th August 2011. Patients who fasted for any number of days were included (n = 35, 54% female, age 54±11 years. 89% of patients fasted for more than 15 days and 49% were diabetics. Dialysis parameters and blood samples were obtained one week prior to Ramadan and during the last week of Ramadan. The differences in dialysis parameters and biochemical values pre- and end-Ramadan were examined using paired t-test. RESULTS: Both pre- and post-dialysis weight were significantly decreased during Ramadan fasting compared to the month prior (p = <0.001. There was a significant decrease in the amount of ultrafiltration (p = 0.002. There were no significant differences in dry weight, inter-dialytic weight gain, mean urea reduction ratio or blood pressure measurements comparing pre- and end of Ramadan fasting. There was a significant increase in serum albumin level (p = 0.006 and decrease in serum phosphate level (p = 0.02 at the end of Ramadan. CONCLUSION: Ramadan fasting is associated with reduced weight, improved serum albumin and phosphate level in our population of haemodialysis patients. A larger multi-centre study will allow us to understand more about the effects of fasting in this population.

Intermittent Auscultation in Labor: Could It Be Missing Many Pathological (Late) Fetal Heart Rate Decelerations? Analytical Review and Rationale for Improvement Supported by Clinical Cases

Science.gov (United States)

Sholapurkar, Shashikant L.

2015-01-01

Intermittent auscultation (IA) of fetal heart rate (FHR) is recommended/preferred in low risk labors. Its usage even in developed countries is poised to increase because of perceived benefit of reduction in operative intervention and some disillusionment with the cardiotocography (CTG). Many national guidelines have stipulated regimes (frequency/timing) of IA based on level IV evidence. These tend to get faithfully and exactingly followed. It was observed that deliveries of many unexpectedly asphyxiated infants occurred despite rigorously performed and documented IA compliant with the guidelines. This triggered a reappraisal of the robustness of IA leading to this focused review supplemented by two anonymized cases. It concludes that the current methodology of IA may be flawed in that it poses a risk of missing many or most late (pathological) FHR decelerations, one of the foremost goals of IA. This is because many late decelerations reach their nadir before the end of the contraction. Thus the currently recommended auscultation of FHR for 60 seconds after the contraction by all national guidelines seemed to encompass their “recovery” phase and appeared to be misinterpreted as normal FHR or even as a reassuring accelerative pattern in the clinical practice. A recent recommendation of recording of the FHR as a single figure (rather than a range) does not remedy this anomaly and seems even less informative. It would be better to auscultate FHR before and after the contractions (or contraction to contraction) and take the FHR just before the contraction as the baseline FHR and interpret the FHR after contraction in the context of this baseline. This relatively simple improvement would detect most late FHR decelerations thus ameliorating the risk and significantly enhancing the patient safety. PMID:26566404

Prevalência do aleitamento materno na região noroeste de Campinas, São Paulo, Brasil, 2001 Breast-feeding prevalence, northwest region of Campinas, São Paulo, Brazil, 2001

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Daniel Felipe Alves Cecchetti

2005-04-01

Full Text Available OBJETIVO: Calcular a prevalência do aleitamento materno entre crianças menores de dois anos de idade, residentes na região Noroeste de Campinas, São Paulo. MÉTODOS: Estudo transversal foi conduzido, em 2001, junto a 4 103 crianças, questionando sobre data de nascimento, sexo, alimentação e serviço de saúde utilizado. O questionário foi aplicado em 42 postos de vacinação durante a Campanha Nacional de Vacinação contra Poliomielite (Campólio. A dieta foi classificada em amamentação exclusiva, predominante, continuada e aleitamento artificial. RESULTADOS: No primeiro semestre, a prevalência de aleitamento materno exclusivo foi de 31,6% e a de aleitamento total 74,5%. Das crianças com idade entre 6 e 12 meses, 38,0% recebiam leite materno. No segundo ano, a prevalência de aleitamento materno foi reduzida para 22,1%. O aleitamento materno exclusivo passou de 72,2% aos 7 dias de idade para 53,8% aos 15 dias, 33,3% aos 3 meses, 10,0% aos 4 meses e 5,7% aos 6 meses. A prevalência do aleitamento materno total foi de 100,0% aos 7 dias; 79,1% aos 3 meses; 54,3% aos 6; 34,4% aos 12 meses; 26,1% aos 18 e zero aos 24 meses. A mediana de amamentação exclusiva foi de 67 dias e a de amamentação total foi de 6,6 meses. Das crianças vinculadas ao Sistema Único de Saúde, 42,2% receberam aleitamento materno, em contraste com 34,4% das usuárias de serviços privados (pOBJECTIVE: To calculate the prevalence of breast-feeding among children less than two years old, in the northwest region of the city of Campinas, São Paulo, Brazil. METHODS: A survey was conducted in 2001, with 4 103 children, querying about birth date, gender, feeding practices and health services routinely used. The questionnaire was applied at the 42 public immunization centers during the 2001 National Campaign against Polyomielites. The child's diet was categorized as exclusive breast-feeding, predominant breast-feeding, continued breast-feeding and bottle

Pressure Autoregulation Measurement Techniques in Adult Traumatic Brain Injury, Part I: A Scoping Review of Intermittent/Semi-Intermittent Methods.

Science.gov (United States)

Zeiler, Frederick A; Donnelly, Joseph; Calviello, Leanne; Menon, David K; Smielewski, Peter; Czosnyka, Marek

2017-12-01

The purpose of this study was to perform a systematic, scoping review of commonly described intermittent/semi-intermittent autoregulation measurement techniques in adult traumatic brain injury (TBI). Nine separate systematic reviews were conducted for each intermittent technique: computed tomographic perfusion (CTP)/Xenon-CT (Xe-CT), positron emission tomography (PET), magnetic resonance imaging (MRI), arteriovenous difference in oxygen (AVDO 2 ) technique, thigh cuff deflation technique (TCDT), transient hyperemic response test (THRT), orthostatic hypotension test (OHT), mean flow index (Mx), and transfer function autoregulation index (TF-ARI). MEDLINE ® , BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library (inception to December 2016), and reference lists of relevant articles were searched. A two tier filter of references was conducted. The total number of articles utilizing each of the nine searched techniques for intermittent/semi-intermittent autoregulation techniques in adult TBI were: CTP/Xe-CT (10), PET (6), MRI (0), AVDO 2 (10), ARI-based TCDT (9), THRT (6), OHT (3), Mx (17), and TF-ARI (6). The premise behind all of the intermittent techniques is manipulation of systemic blood pressure/blood volume via either chemical (such as vasopressors) or mechanical (such as thigh cuffs or carotid compression) means. Exceptionally, Mx and TF-ARI are based on spontaneous fluctuations of cerebral perfusion pressure (CPP) or mean arterial pressure (MAP). The method for assessing the cerebral circulation during these manipulations varies, with both imaging-based techniques and TCD utilized. Despite the limited literature for intermittent/semi-intermittent techniques in adult TBI (minus Mx), it is important to acknowledge the availability of such tests. They have provided fundamental insight into human autoregulatory capacity, leading to the development of continuous and more commonly applied techniques in the intensive care unit (ICU). Numerous methods of

Clinical significance of perceptible fetal motion.

Science.gov (United States)

Rayburn, W F

1980-09-15

The monitoring of fetal activity during the last trimester of pregnancy has been proposed to be useful in assessing fetal welfare. The maternal perception of fetal activity was tested among 82 patients using real-time ultrasonography. All perceived fetal movements were visualized on the scanner and involved motion of the lower limbs. Conversely, 82% of all visualized motions of fetal limbs were perceived by the patients. All combined motions of fetal trunk with limbs were preceived by the patients and described as strong movements, whereas clusters of isolated, weak motions of the fetal limbs were less accurately perceived (56% accuracy). The number of fetal movements perceived during the 15-minute test period was significantly (p fetal motion was present (44 of 45 cases) than when it was absent (five of 10 cases). These findings reveal that perceived fetal motion is: (1) reliable; (2) related to the strength of lower limb motion; (3) increased with ruptured amniotic membranes; and (4) reassuring if considered to be active.

Cistoadenocarcinoma mucinoso de ovario en estadio terminal, en embarazo complicado con muerte fetal tardía. Presentación de un caso.

Directory of Open Access Journals (Sweden)

Hansy Díaz Pérez

2007-06-01

Full Text Available Presentamos un caso de Cistoadenocarcinoma mucinoso de ovario en un embarazo de 36.4 semanas de gestación complicado con muerte fetal tardía. que ingresó en el Hospital Materno Provincial “Isabel María de Valdivia y Salas de Sancti-Spíritus” diagnosticándose el tumor de ovario en un estadío avanzado de la enfermedad con un cuadro clínico florido y múltiples hallazgos al exámen físico que motivó varios planteamientos y dudas en el diagnóstico ,no realizándose el mismo durante la vigilancia prenatal habitual ni durante la ecografía pélvica que se realiza durante esta, siendo un hallazgo durante la laparotomía exploradora ya cuando la paciente se encontraba en la fase final del cuadro que la lleva al fallecimiento en la Unidad de cuidados intensivos al tercer día del ingreso con asistencia ventilatoria y múltiples complicaciones.

Healthcare professional versus patient goal setting in intermittent allergic rhinitis.

Science.gov (United States)

O'Connor, J; Seeto, C; Saini, B; Bosnic-Anticevich, S; Krass, I; Armour, C; Smith, L

2008-01-01

To examine the impact of healthcare professional versus patient goal setting for the self-management of intermittent allergic rhinitis (AR) on symptom severity and quality of life. This was a 6 week, parallel group study. Group A participants, with pharmacist facilitation, nominated personally relevant goals and strategies relating to their AR. Group B participants had their goals and strategies set by the pharmacist. The main outcome measures used included perceived symptom severity and quality of life. In addition, goals and strategies data from participants of both groups were collected and analysed. Both groups demonstrated significant improvements in symptom severity and quality of life scores however Group B symptom severity scores improved more. Group B set a greater number of goals and strategies which were better structured and more task specific. This is the first study to investigate the impact of goal setting on patient behaviour in a chronic yet episodic illness. Our results suggest that self-management goals set by the healthcare professional which are clinically indicated but tailored to the patient's nominated symptoms yields better outcomes than goals nominated by the patient. A brief, structured intervention, tailored to patient symptoms, can enhance self-management of intermittent allergic rhinitis.

[Maternal-placental interactions and fetal programming].

Science.gov (United States)

Kadyrov, M; Moser, G; Rath, W; Kweider, N; Wruck, C J; Pufe, T; Huppertz, B

2013-06-01

Pregnancy-related complications not only represent a risk for maternal and fetal morbidity and mortality, but are also a risk for several diseases later in life. Many epidemiological studies have shown clear associations between an adverse intrauterine environment and an increased risk of diabetes, hypertension, cardiovascular disease, depression, obesity, and other chronic diseases in the adult. Some of these syndromes could be prevented by avoiding adverse stimuli or insults including psychological stress during pregnancy, intake of drugs, insufficient diet and substandard working conditions. Hence, all of these stimuli have the potential to alter health later in life. The placenta plays a key role in regulating the nutrient supply to the fetus and producing hormones that control the fetal as well as the maternal metabolism. Thus, any factor or stimulus that alters the function of the hormone producing placental trophoblast will provoke critical alterations of placental function and hence could induce programming of the fetus. The factors that change placental development may interfere with nutrient and oxygen supply to the fetus. This may be achieved by a direct disturbance of the placental barrier or more indirectly by, e. g., disturbing trophoblast invasion. For both path-ways, the respective pathologies are known: while preeclampsia is caused by alterations of the villous trophoblast, intra-uterine growth restriction is caused by insufficient invasion of the extravillous trophoblast. In both cases the effect can be undernutrition and/or fetal hypoxia, both of which adversely affect organ development, especially of brain and heart. However, the mechanisms responsible for disturbances of trophoblast differentiation and function remain elusive. © Georg Thieme Verlag KG Stuttgart · New York.

Impact of age on intermittent hypoxia in obstructive sleep apnea: a propensity-matched analysis.

Science.gov (United States)

Bostanci, Asli; Bozkurt, Selen; Turhan, Murat

2018-05-01

To determine independent relationship of aging with chronic intermittent hypoxia, we compared hypoxia-related polysomnographic variables of geriatric patients (aged ≥ 65 years) with an apnea-hypopnea index (AHI)-, gender-, body mass index (BMI)-, and neck circumference-matched cohort of non-geriatric patients. The study was conducted using clinical and polysomnographic data of 1280 consecutive patients who underwent complete polysomnographic evaluation for suspected sleep-disordered breathing (SDB) at a single sleep disorder center. A propensity score-matched analysis was performed to obtain matched cohorts of geriatric and non-geriatric patients, which resulted in successful matching of 168 patients from each group. Study groups were comparable for gender (P = 0.999), BMI (P = 0.940), neck circumference (P = 0.969), AHI (P = 0.935), and severity of SDB (P = 0.089). The oximetric variables representing the duration of chronic intermittent hypoxia such as mean (P = 0.001), the longest (P = 0.001) and total apnea durations (P = 0.003), mean (P = 0.001) and the longest hypopnea durations (P = 0.001), and total sleep time with oxygen saturation below 90% (P = 0.008) were significantly higher in the geriatric patients as compared with younger adults. Geriatric patients had significantly lower minimum (P = 0.013) and mean oxygen saturation (P = 0.001) than non-geriatric patients. The study provides evidence that elderly patients exhibit more severe and deeper nocturnal intermittent hypoxia than the younger adults, independent of severity of obstructive sleep apnea, BMI, gender, and neck circumference. Hypoxia-related polysomnographic variables in geriatric patients may in fact reflect a physiological aging process rather than the severity of a SDB.

Differential diagnosis between fetal extrarenal pelvis and obstructive uropathy on fetal ultrasonogram

Energy Technology Data Exchange (ETDEWEB)

Han, Byoung Hee; Cho, Jeong Yeon; Cho, Byung Jae; Lee, Kyung Sang [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2003-03-15

To establish the standard guideline for differentiating the extrarenal pelvis from obstructive uropathy on fetal ultrasonogram (US) to avoid unnecessary postnatal follow-up and other additional examinations. From July 2000 to July 2001, Thirty-four kidneys with hydronephrosis diagnosed on fetal ultrasonogram performed during the third trimester of pregnancy were included in this study. Hydronephrosis was defined as the pelvic anteroposterior (AP) diameter being 4 mm or greater before 33 weeks of gestation while 7 mm or greater at or after 33 weeks of gestation. The size of the renal pelvis was measured at intrarenal, intra-extrarenal junctional and extrarenal portions in every kidney on the transverse view of the fetal renal hiluin. Postnatally, all neonates underwent renal ultrasonogram 2 to 8 days after birth, and renal pelvic diameters were measured using the same method as the fetal US in 28 kidneys. We then compared the extrarenal-intrarenal ratio (E/I ratio) of pelvic diameter between fetal and neoatal kidneys. We presumed that the extrarenal pelvis in fetal US was the pelvis showing the normal intrarenal pelvic diameter accompanied by the most dilated exrtarenal pelvic diameter. Follow-up ultrasonograms were measured using the same method as the fetal US in 28 kidneys. We then compared the extrarenal intrarenal ratio (E/I ratio) of pelvic diameter between fetal and neonatal kidneys. We presumed that the extrarenal pelvis on fetal US was the pelvis showing the normal intrarenal pelvic diameter accompanied by the most dilated extrarenal pelvic diameter. Follow-up ultrasonograms were performed in 12 of 17 neonates who had the maximal diameter at extrarenal portion on fetal ultrasonogram. VCUG and IVU were taken in 2 patients with a persistent dilatation of the renal pelvis on follow-up ultrasonograms. On fetal US, 17/34 kidneys showed the extrarenal portion with the most dilatation while in 12/34 kidneys, the intra-extra renal junction portion was the most

Differential diagnosis between fetal extrarenal pelvis and obstructive uropathy on fetal ultrasonogram

International Nuclear Information System (INIS)

Han, Byoung Hee; Cho, Jeong Yeon; Cho, Byung Jae; Lee, Kyung Sang

2003-01-01

To establish the standard guideline for differentiating the extrarenal pelvis from obstructive uropathy on fetal ultrasonogram (US) to avoid unnecessary postnatal follow-up and other additional examinations. From July 2000 to July 2001, Thirty-four kidneys with hydronephrosis diagnosed on fetal ultrasonogram performed during the third trimester of pregnancy were included in this study. Hydronephrosis was defined as the pelvic anteroposterior (AP) diameter being 4 mm or greater before 33 weeks of gestation while 7 mm or greater at or after 33 weeks of gestation. The size of the renal pelvis was measured at intrarenal, intra-extrarenal junctional and extrarenal portions in every kidney on the transverse view of the fetal renal hiluin. Postnatally, all neonates underwent renal ultrasonogram 2 to 8 days after birth, and renal pelvic diameters were measured using the same method as the fetal US in 28 kidneys. We then compared the extrarenal-intrarenal ratio (E/I ratio) of pelvic diameter between fetal and neoatal kidneys. We presumed that the extrarenal pelvis in fetal US was the pelvis showing the normal intrarenal pelvic diameter accompanied by the most dilated exrtarenal pelvic diameter. Follow-up ultrasonograms were measured using the same method as the fetal US in 28 kidneys. We then compared the extrarenal intrarenal ratio (E/I ratio) of pelvic diameter between fetal and neonatal kidneys. We presumed that the extrarenal pelvis on fetal US was the pelvis showing the normal intrarenal pelvic diameter accompanied by the most dilated extrarenal pelvic diameter. Follow-up ultrasonograms were performed in 12 of 17 neonates who had the maximal diameter at extrarenal portion on fetal ultrasonogram. VCUG and IVU were taken in 2 patients with a persistent dilatation of the renal pelvis on follow-up ultrasonograms. On fetal US, 17/34 kidneys showed the extrarenal portion with the most dilatation while in 12/34 kidneys, the intra-extra renal junction portion was the most

Ten-minute umbilical cord occlusion markedly reduces cerebral blood flow and heat production in fetal sheep.

NARCIS (Netherlands)

Lotgering, F.K.; Bishai, J.M.; Struijk, P.C.; Blood, A.B.; Hunter, C.J.; Power, G.G.; Longo, L.D.

2003-01-01

OBJECTIVE: The study was undertaken to determine to what extent a 10-minute total umbilical cord occlusion affects autoregulation of cerebral blood flow and cerebral heat production in the fetus. STUDY DESIGN: In seven chronically catheterized late-gestation fetal sheep (127-131 days' gestation), we

Cardiovascular function in term fetal sheep conceived, gestated and studied in the hypobaric hypoxia of the Andean altiplano.

Science.gov (United States)

Herrera, Emilio A; Rojas, Rodrigo T; Krause, Bernardo J; Ebensperger, Germán; Reyes, Roberto V; Giussani, Dino A; Parer, Julian T; Llanos, Aníbal J

2016-03-01

High-altitude hypoxia causes intrauterine growth restriction and cardiovascular programming. However, adult humans and animals that have evolved at altitude show certain protection against the effects of chronic hypoxia. Whether the highland fetus shows similar protection against high altitude gestation is unclear. We tested the hypothesis that high-altitude fetal sheep have evolved cardiovascular compensatory mechanisms to withstand chronic hypoxia that are different from lowland sheep. We studied seven high-altitude (HA; 3600 m) and eight low-altitude (LA; 520 m) pregnant sheep at ∼90% gestation. Pregnant ewes and fetuses were instrumented for cardiovascular investigation. A three-period experimental protocol was performed in vivo: 30 min of basal, 1 h of acute superimposed hypoxia (∼10% O2) and 30 min of recovery. Further, we determined ex vivo fetal cerebral and femoral arterial function. HA pregnancy led to chronic fetal hypoxia, growth restriction and altered cardiovascular function. During acute superimposed hypoxia, LA fetuses redistributed blood flow favouring the brain, heart and adrenals, whereas HA fetuses showed a blunted cardiovascular response. Importantly, HA fetuses have a marked reduction in umbilical blood flow versus LA. Isolated cerebral arteries from HA fetuses showed a higher contractile capacity but a diminished response to catecholamines. In contrast, femoral arteries from HA fetuses showed decreased contractile capacity and increased adrenergic contractility. The blunting of the cardiovascular responses to hypoxia in fetuses raised in the Alto Andino may indicate a change in control strategy triggered by chronic hypoxia, switching towards compensatory mechanisms that are more cost-effective in terms of oxygen uptake. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

Optimal intermittent search strategies

International Nuclear Information System (INIS)

Rojo, F; Budde, C E; Wio, H S

2009-01-01

We study the search kinetics of a single fixed target by a set of searchers performing an intermittent random walk, jumping between different internal states. Exploiting concepts of multi-state and continuous-time random walks we have calculated the survival probability of a target up to time t, and have 'optimized' (minimized) it with regard to the transition probability among internal states. Our model shows that intermittent strategies always improve target detection, even for simple diffusion states of motion

Maternal high fat diet is associated with decreased plasma n-3 fatty acids and fetal hepatic apoptosis in nonhuman primates.

Directory of Open Access Journals (Sweden)

Wilmon F Grant

2011-02-01

Full Text Available To begin to understand the contributions of maternal obesity and over-nutrition to human development and the early origins of obesity, we utilized a non-human primate model to investigate the effects of maternal high-fat feeding and obesity on breast milk, maternal and fetal plasma fatty acid composition and fetal hepatic development. While the high-fat diet (HFD contained equivalent levels of n-3 fatty acids (FA's and higher levels of n-6 FA's than the control diet (CTR, we found significant decreases in docosahexaenoic acid (DHA and total n-3 FA's in HFD maternal and fetal plasma. Furthermore, the HFD fetal plasma n-6:n-3 ratio was elevated and was significantly correlated to the maternal plasma n-6:n-3 ratio and maternal hyperinsulinemia. Hepatic apoptosis was also increased in the HFD fetal liver. Switching HFD females to a CTR diet during a subsequent pregnancy normalized fetal DHA, n-3 FA's and fetal hepatic apoptosis to CTR levels. Breast milk from HFD dams contained lower levels of eicosopentanoic acid (EPA and DHA and lower levels of total protein than CTR breast milk. This study links chronic maternal consumption of a HFD with fetal hepatic apoptosis and suggests that a potentially pathological maternal fatty acid milieu is replicated in the developing fetal circulation in the nonhuman primate.

Análisis de la tasa de detección de fetos macrosómicos mediante ecografía

OpenAIRE

Teva G,María Jesús; Redondo A,Rosario; Rodríguez G,Isabel; Martínez C,Sara; Abulhaj M,Mariam

2013-01-01

Antecedentes: La macrosomía fetal es clínicamente relevante debido a que se asocia a un incremento significativo de la morbilidad materno-fetal. La ecografía es el estándar dorado para la estimación del peso fetal y la valoración de su crecimiento. Tiene una sensibilidad de 21,6%, por tanto la probabilidad de detectar ma-crosomía es baja para todas las fórmulas. El error entre el peso real y el estimado es 7,5-10%, y en el caso de RN macrosomas éste puede llegar al 15%. Objetivo: Analizar las...

Fetal Alcohol Syndrome and Fetal Alcohol Effects in Child Development.

Science.gov (United States)

Pancratz, Diane R.

This literature review defines Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) and considers their causes, diagnoses, prevalence, and educational ramifications. Effects of alcohol during each of the trimesters of pregnancy are summarized. Specific diagnostic characteristics of FAS are listed: (1) growth deficiency, (2) a…

Intermittency in {sup 197}Au fragmentation

Energy Technology Data Exchange (ETDEWEB)

Dabrowska, A; Holynski, R; Olszewski, A; Szarska, M; Wilczynska, B; Wolter, W; Wosiek, B [Institute of Nuclear Physics, Cracow (Poland); Cherry, M L; Deines-Jones, P; Jones, W V; Sengupta, K; Wefel, B [Louisiana State Univ., Baton Rouge, LA (United States). Dept. of Physics and Astronomy; Waddington, C J [Minnesota Univ., Minneapolis, MN (United States). School of Physics and Astronomy; Pozharova, E A; Skorodko, T Yu [Inst. of Theoretical and Experimental Physics, Moscow (Russian Federation); KLMM Collaboration

1995-07-01

The concept of factorial moments was applied to an analysis of the dynamical fluctuations in the charge distributions of the fragments emitted from gold nuclei with energies 10.6 and < 1.0 GeV/n interacting with emulsion nuclei. Clear evidence for intermittent fluctuations has been found in an analysis using all the particles released from the gold projectile, with a stronger effect observed below 1 GeV/n than at 10.6 GeV/n. For the full data sets, however, the intermittency effect was found to be very sensitive to the singly charged particles, and neglecting these particles strongly reduces the intermittency signal. When the analysis is restricted to the multiply charged fragments, an intermittency effect is revealed only for multifragmentation events, although one that is enhanced as compared to the analysis of all, singly and multiply charged, particles. The properties of the anomalous fractal dimensions suggest a sequential decay mechanism, rather than the existence of possible critical behaviour in the process of nuclear fragmentation. The likely influence of the charge conservation effects and the finite size of decaying systems on the observed intermittency signals was pointed out. (author). 37 refs, 9 figs, 5 tabs.

Trabajo y salud de las docentes de la Universidad Nacional de Córdoba: uso de medicamentos/sustancias lícitas y plan materno infantil

Directory of Open Access Journals (Sweden)

Giacone Marta Susana

2004-01-01

Full Text Available Este trabajo tuvo como objetivo investigar condiciones de existencia, proceso de trabajo y salud y consumo de medicamentos de docentes universitarias en edad reproductiva. Además, intentó conocer uso, opiniones y sugerencias de usuarias del Plan Materno Infantil de la Obra Social Universitaria. El estudio se encaminó desde la perspectiva teórico-metodológica del materialismo histórico y dialéctico, se delineó como investigación social desarrollada a través de un estudio de campo descriptivo-correlativo e estratégico en una muestra total de 50 personas. Los resultados indican presencia de condiciones de existencia y trabajo deterioradas, afectando el perfil de salud de las docentes y el consumo de medicamentos. Alto porcentaje de las entrevistadas consideró el Plan Materno Infantil muy bueno o bueno y enfatizó la necesidad de mejor información a cerca de ella.

Fetal scalp blood sampling during labor

DEFF Research Database (Denmark)

Chandraharan, Edwin; Wiberg, Nana

2014-01-01

Fetal cardiotocography is characterized by low specificity; therefore, in an attempt to ensure fetal well-being, fetal scalp blood sampling has been recommended by most obstetric societies in the case of a non-reassuring cardiotocography. The scientific agreement on the evidence for using fetal...... scalp blood sampling to decrease the rate of operative delivery for fetal distress is ambiguous. Based on the same studies, a Cochrane review states that fetal scalp blood sampling increases the rate of instrumental delivery while decreasing neonatal acidosis, whereas the National Institute of Health...... and Clinical Excellence guideline considers that fetal scalp blood sampling decreases instrumental delivery without differences in other outcome variables. The fetal scalp is supplied by vessels outside the skull below the level of the cranial vault, which is likely to be compressed during contractions...

Optimal intermittent search strategies

Energy Technology Data Exchange (ETDEWEB)

Rojo, F; Budde, C E [FaMAF, Universidad Nacional de Cordoba, Ciudad Universitaria, X5000HUA Cordoba (Argentina); Wio, H S [Instituto de Fisica de Cantabria, Universidad de Cantabria and CSIC E-39005 Santander (Spain)

2009-03-27

We study the search kinetics of a single fixed target by a set of searchers performing an intermittent random walk, jumping between different internal states. Exploiting concepts of multi-state and continuous-time random walks we have calculated the survival probability of a target up to time t, and have 'optimized' (minimized) it with regard to the transition probability among internal states. Our model shows that intermittent strategies always improve target detection, even for simple diffusion states of motion.

Evaluación del tamizaje selectivo de errores innatos del metabolismo en el instituto materno infantil en colombia

OpenAIRE

Bermúdez, M.; Arteaga, C.; Cifuentes, Y.

2011-01-01

El programa de detección de Errores Innatos del metabolismo del Instituto Materno Infantil (IMI) de Bogotá, en un periodo de cinco años ha estudiado 1.147 pacientes de alto riesgo (nacidos y remitidos al IMI como también procedentes de otras Instituciones) con:
1.Antecedentes en la historia familiar
2.Alteraciones neurológicas.
3.Sepsis sin respuesta al tratamiento.
4.Asfixia perinatal severa, falla cardiaca, dificultada respiratoria sin causa evide...

Chronic intermittent hypoxia from pedo-stage decreases glucose transporter 4 expression in adipose tissue and causes insulin resistance.

Science.gov (United States)

Chen, Lin; Cao, Zhao-long; Han, Fang; Gao, Zhan-cheng; He, Quan-ying

2010-02-20

The persistence of sleep disordered breathing (SDB) symptoms after tonsil and/or adenoid (T&A) surgery are common in children with obstructive sleep apnea (OSA). We tested the hypothesis that disturbances of glucose transporters (GLUTs) in intraabdominal adipose tissue caused by chronic intermittent hypoxia (CIH) from the pedo-period could facilitate the appearance of periphery insulin resistance in Sprague-Dawley (SD) rats. We tested the hypothesis that the changes of GLUTs in adipose tissue may be one of the reasons for persistent SDB among clinical OSA children after T&A surgery. Thirty 21-day-old SD rats were randomly divided into a CIH group, a chronic continuous hypoxia (CCH) group, and a normal oxygen group (control group) and exposed for 40 days. The changes of weight, fasting blood glucose and fasting blood insulin levels were measured. Hyperinsulinemic-euglycemic clamp techniques were used to measure insulin resistance in each animal. Real-time quantitative PCR and Western blotting were used to measure GLUT mRNA and proteins in intraabdominal adipose tissue. Additional intraabdomial white adipose tissue (WAT) was also processed into paraffin sections and directly observed for GLUTs1-4 expression. When compared with control group, CIH increased blood fasting insulin levels, (245.07 +/- 53.89) pg/ml vs. (168.63 +/- 38.70) pg/ml, P = 0.038, and decreased the mean glucose infusion rate (GIR), (7.25 +/- 1.29) mg x kg(-1) x min(-1) vs. (13.34 +/- 1.54) mg x kg(-1) x min(-1), P < 0.001. GLUT-4 mRNA and protein expression was significantly reduced after CIH compared with CCH or normal oxygen rats, 0.002 +/- 0.002 vs. 0.039 +/- 0.009, P < 0.001; 0.642 +/- 0.073 vs. 1.000 +/- 0.103, P = 0.035. CIH in young rats could induce insulin resistance via adverse effects on glycometabolism. These findings emphasize the importance of early detection and treatment of insulin insensitivity in obese childhood OSA.

Intrapartum fetal monitoring by ST-analysis of the fetal ECG

NARCIS (Netherlands)

Westerhuis, M.E.M.H.

2010-01-01

Objective Intrapartum fetal monitoring aims to identify fetuses at risk for neonatal and long-term injury due to asphyxia. To serve this purpose, cardiotocography (CTG) combined with ST-analysis of the fetal electrocardiogram (ECG), which is a relatively new method, may be used. The main aim of this

Chronic mesenteric volvulus in a dog

Science.gov (United States)

Spevakow, Andrea B.; Nibblett, Belle Marie D.; Carr, Anthony P.; Linn, Kathleen A.

2010-01-01

A chronic, partial mesenteric volvulus was found on laparotomy of an adult Bernese mountain dog with a 4-month history of intermittent vomiting, diarrhea, and weight loss. The dog had elevated cholestatic and hepatocellular leakage enzymes, increased bile acids, azotemia, isosthenuria, and a hypokalemic, hypochloremic, metabolic alkalosis. The dog recovered fully following reduction of the volvulus. PMID:20357947

Satisfacción sobre la educación en salud materno infantil de las madres en Huelva

OpenAIRE

Tierra Burguillo, María del Pilar

2016-01-01

Objetivos Conocer el nivel de satisfacción sobre educación en salud materno infantil que tienen las madres de Huelva es el principal objetivo del estudio. Los específicos son: 1. Describir si existe relación entre el grado de satisfacción y las características sociodemográficas maternas y otras variables relacionadas con la crianza. 2. Determinar las principales redes sociales de información materna durante el embarazo. 3. Identificar los principales obstáculos con los que se encu...

Avaliação da contratilidade da vesícula biliar com leite materno e leite de vaca em lactentes Gallbladder contractility after breast milk and cow's milk meals in infants

Directory of Open Access Journals (Sweden)

Marise Silva Teixeira

2004-06-01

Full Text Available As múltiplas características distintas do leite materno e do leite de vaca fazem com que o esvaziamento gástrico seja mais rápido após ingestão do primeiro. Esta rapidez do esvaziamento gástrico pode estar associada ao esvaziamento da vesícula biliar, também mais rápido. O objetivo do trabalho foi determinar se há diferença na velocidade de esvaziamento da vesícula biliar, por método ultra-sonográfico, após ingestão de leite materno e leite de vaca. Estudamos 47 crianças menores de dois anos, 22 após uma refeição com leite materno e 25 após uma refeição com leite de vaca. A vesícula biliar foi medida após um período de quatro a seis horas de jejum e uma hora após uma refeição (leite materno ou leite de vaca, e a contração da vesícula biliar foi avaliada, em porcentagem, pela diferença de volume da vesícula biliar entre as duas medidas e expressa em porcentagem do volume inicial. As medianas das porcentagens do volume inicial para as crianças alimentadas com leite materno e leite de vaca foram, respectivamente, 92,25% e 53,8%, diferença estatisticamente significativa. Portanto, a contração da vesícula biliar após uma refeição com leite de vaca é muito mais lenta do que aquela após uma refeição com leite materno.Breast milk and cow's milk differ in multiple characteristics that account for a faster gastric emptying time after breast feeding. This faster gastric emptying may be associated with a faster gallbladder emptying. Our aim was to compare gallbladder contraction after breast milk meal and cow's milk meal using ultrasound examination. We studied 22 infants after a breast milk meal and 25 infants after a cow's milk meal. Gallbladder volume was measured after a 4-6 hours fasting and one hour after the meal (breast milk or cow's milk. Gallbladder contractility was calculated by determining the difference between gallbladder volume one hour after the meal and the fasting volume, and expressed as a

Long-Term Intermittent Work at High Altitude: Right Heart Functional and Morphological Status and Associated Cardiometabolic Factors

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Julio Brito

2018-03-01

Full Text Available Background: Living at high altitude or with chronic hypoxia implies functional and morphological changes in the right ventricle and pulmonary vasculature with a 10% prevalence of high-altitude pulmonary hypertension (HAPH. The implications of working intermittently (day shifts at high altitude (hypobaric hypoxia over the long term are still not well-defined. The aim of this study was to evaluate the right cardiac circuit status along with potentially contributory metabolic variables and distinctive responses after long exposure to the latter condition.Methods: A cross-sectional study of 120 healthy miners working at an altitude of 4,400–4,800 m for over 5 years in 7-day commuting shifts was designed. Echocardiography was performed on day 2 at sea level. Additionally, biomedical and biochemical variables, Lake Louise scores (LLSs, sleep disturbances and physiological variables were measured at altitude and at sea level.Results: The population was 41.8 ± 0.7 years old, with an average of 14 ± 0.5 (range 5–29 years spent at altitude. Most subjects still suffered from mild to moderate symptoms of acute mountain sickness (mild was an LLS of 3–5 points, including cephalea; moderate was LLS of 6–10 points (38.3% at the end of day 1 of the shift. Echocardiography showed a 23% mean pulmonary artery pressure (mPAP >25 mmHg, 9% HAPH (≥30 mmHg, 85% mild increase in right ventricle wall thickness (≥5 mm, 64% mild right ventricle dilation, low pulmonary vascular resistance (PVR and fairly good ventricle performance. Asymmetric dimethylarginine (ADMA (OR 8.84 (1.18–66.39; p < 0.05 and insulin (OR: 1.11 (1.02–1.20; p < 0.05 were associated with elevated mPAP and were defined as a cut-off. Interestingly, the correspondence analysis identified association patterns of several other variables (metabolic, labor, and biomedical with higher mPAP.Conclusions: Working intermittently at high altitude involves a distinctive pattern. The most relevant and

Hepatic cholesterol metabolism following a chronic ingestion of cesium-137 starting at fetal stage in rats

International Nuclear Information System (INIS)

Racine, R.; Grandcolas, L.; Blanchardon, E.; Gourmelon, P.; Souidi, M.; Veyssiere, G.

2010-01-01

The Chernobyl accident released many radionuclides in the environment. Some are still contaminating the ground and thus the people through dietary intake. The long-term sanitary consequences of this disaster are still unclear and several biological systems remain to be investigated. Cholesterol metabolism is of particular interest, with regard to the link established between atherosclerosis and exposure to high-dose ionizing radiations. This study assesses the effect of cesium-137 on cholesterol metabolism in rats, after a chronic exposure since fetal life. To achieve this, rat dams were contaminated with cesium-137-supplemented water from two weeks before mating until the weaning of the pups. Thereafter, the weaned rats were given direct access to the contaminated drinking water until the age of 9 months. After the sacrifice, cholesterol metabolism was investigated in the liver at gene expression and protein level. The cholesterolemia was preserved, as well as the cholesterol concentration in the liver. At molecular level, the gene expressions of ACAT 2 (a cholesterol storage enzyme), of Apolipoprotein A-I and of RXR (a nuclear receptor involved in cholesterol metabolism) were significantly decreased. In addition, the enzymatic activity of CYP27A1, which catabolizes cholesterol, was increased. The results indicate that the rats seem to adapt to the cesium-137 contamination and display modifications of hepatic cholesterol metabolism only at molecular level and within physiological range. (author)

Metodologia das Pesquisas Populacionais de Saúde Materno-Infantil: uma série transversal realizada no Estado do Ceará de 1987 a 2007

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Luciano Lima Correia

2014-12-01

Full Text Available Objectivo: descrever os métodos utilizados nas Pesquisas de Saúde Materno-Infantil (PESMIC no Ceará, durante 20 anos. Métodos: a série de inquéritos realizados no período de 20 anos foi analisada nos seguintes aspectos: a Estudos transversais em série de base populacional, com amostra representativa de 8000 famílias; b Utilizou-se questionários e medições antropométricas, estudando-se níveis e causas de mortalidade infantil, prevalência de desnutrição da mãe e da criança, duração da amamentação, cobertura vacinal, prevalência e manejo da diarreia e acesso aos serviços de saúde materno-infantil; c Obteve-se como resultado as variáveis desfechos (principal mortalidade infantil e diversos determinantes materno-infantis e socioeconómicos. Resultados: o índice de resposta foi de quase 100% nos cinco inquéritos realizados (1986-2007, e ocorreram importantes mudanças nos indicadores sociodemográficos e de saúde; redução de 81% da taxa de mortalidade infantil, aumento de 43% da taxa de amamentação; índice de imunização de 95%. Observou-se aumento de 243% do índice de sobrepeso. Foram entrevistados no total somado dos cinco estudos: 177.132 residentes, sendo 47.508 mulheres e 13.049 crianças. Conclusões: recomenda-se a continuidade desses estudos utilizando-se a mesma metodologia, possibilitando analises de variações temporais.

Fetal short time variation during labor: a non-invasive alternative to fetal scalp pH measurements?

OpenAIRE

Schiermeier, Sven; Reinhard, Joscha; Hatzmann, Hendrike; Zimmermann, Ralf C.; Westhof, Gregor

2009-01-01

Objective: To determine whether short time variation (STV) of fetal heart beat correlates with scalp pH measurements during labor. Patients and methods: From 1279 deliveries, 197 women had at least one fetal scalp pH measurement. Using the CTG-Player®, STVs were calculated from the electronically saved cardiotocography (CTG) traces and related to the fetal scalp pH measurements. Results: There was no correlation between STV and fetal scalp pH measurements (r=−0.0592). Conclusions: Fetal ST...

Non-invasive pulsed cavitational ultrasound for fetal tissue ablation: feasibility study in a fetal sheep model.

Science.gov (United States)

Kim, Y; Gelehrter, S K; Fifer, C G; Lu, J C; Owens, G E; Berman, D R; Williams, J; Wilkinson, J E; Ives, K A; Xu, Z

2011-04-01

Currently available fetal intervention techniques rely on invasive procedures that carry inherent risks. A non-invasive technique for fetal intervention could potentially reduce the risk of fetal and obstetric complications. Pulsed cavitational ultrasound therapy (histotripsy) is an ablation technique that mechanically fractionates tissue at the focal region using extracorporeal ultrasound. In this study, we investigated the feasibility of using histotripsy as a non-invasive approach to fetal intervention in a sheep model. The experiments involved 11 gravid sheep at 102-129 days of gestation. Fetal kidney, liver, lung and heart were exposed to ultrasound pulses (bones. Histological assessment confirmed lesion locations and sizes corresponding to regions where cavitation was monitored, with no lesions found when cavitation was absent. Inability to generate cavitation was primarily associated with increased depth to target and obstructing structures such as fetal limbs. Extracorporeal histotripsy therapy successfully created targeted lesions in fetal sheep organs without significant damage to overlying structures. With further improvements, histotripsy may evolve into a viable technique for non-invasive fetal intervention procedures. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

Fetal blood drawing.

Science.gov (United States)

Hobbins, J C; Mahoney, M J

1975-07-19

A small sample of fetal blood suitable for studies of haemoglobin synthesis was obtained from a placental vessel under endoscopic visualisation in 23 of 26 patients in whom the procedure was attempted prior to second-trimester abortion. Fetal blood loss, calculated in 23 cases, was between 0-2 ml. and 2-5 ml., and fetal blood-volume depletion varied from 0-5% to 15%. No short-term ill-effects were demonstrated in mother or fetus in any of 16 patients in whom the injection of aborti-facient was postponed for between 16 and 24 hours after the procedure.

The effect of prolonged intrauterine hyperinsulinemia on iron utilization in fetal sheep.

Science.gov (United States)

Georgieff, M K; Widness, J A; Mills, M M; Stonestreet, B S

1989-11-01

Newborn infants of poorly controlled insulin-dependent diabetic mothers demonstrate a redistribution of iron from serum and tissue stores into red blood cells. These changes may be due to increases in iron utilization during augmented Hb synthesis, which compensates for chronic intrauterine hypoxemia induced by prolonged fetal hyperinsulinemia. We tested this hypothesis by measuring plasma iron, total iron-binding capacity, percent iron-binding capacity saturation (total iron-binding capacity saturation), Hb concentration, total red cell Hb, and total red cell iron in the arterial blood of 11 chronically instrumented fetal sheep after 7-12 d of infusion with 15 U/day of insulin (n = 5) or placebo (n = 6). The insulin-infused fetal sheep had higher mean +/- SD plasma insulin concentrations (448 +/- 507 versus 11 +/- 8 mU/L; p less than 0.001) and lower arterial oxygen saturations (38 +/- 7 versus 54 +/- 9%; p less than 0.02). The insulin-infused group had a lower mean plasma iron concentration (20.8 +/- 10.9 versus 42.1 +/- 14.7 microM/L; p less than 0.02) and total iron-binding capacity saturation (36 +/- 20 versus 64 +/- 22%; p less than 0.02) and a higher total red cell Hb (45.4 +/- 8.7 versus 32.6 +/- 8.8 g; p less than 0.02) and total red cell iron content (154 +/- 29 versus 111 +/- 29 mg; p less than 0.02) when compared with the placebo group. Seven to 12 d of intrauterine hyperinsulinemia decreases serum iron and increases total red cell iron, most likely by stimulating increased Hb synthesis in response to low arterial oxygen saturation.(ABSTRACT TRUNCATED AT 250 WORDS)

Intermittent Rivers and Biodiversity. Large scale analyses between hydrology and ecology in intermittent rivers

OpenAIRE

Blanchard, Q.

2014-01-01

Intermittent rivers are characterized by a temporary interruption of their flow which can manifest in a variety of ways, as much on a spatial scale as on a temporal one. This particular aspect of intermittent river hydrology gives rise to unique ecosystems, combining both aquatic and terrestrial habitats. Neglected for a long time by scientists and once considered biologically depauperate and ecologically unimportant, these fragile habitats are nowadays acknowledged for their rendered service...

Glucoregulatory consequences and cardiorespiratory parameters in rats exposed to chronic-intermittent hypoxia: Effects of the duration of exposure and losartan

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Victor B Fenik

2012-04-01

Full Text Available Background: Obstructive sleep apnea (OSA is associated with glucose intolerance. Both chronic sleep disruption and recurrent blood oxygen desaturations (chronic-intermittent hypoxia – CIH may cause, or exacerbate, metabolic derangements. Methods: To assess the impact of CIH alone, without accompanying upper airway obstructions, on the counter-regulatory response to glucose load and cardiorespiratory parameters, we exposed adult male Sprague-Dawley rats to CIH or sham room air exchanges for 10 h/day for 7, 21 or 35 days and then, one day after conclusion of CIH exposure, conducted intravenous glucose tolerance tests (ivgtt under urethane anesthesia. Additional rats underwent 35 days of CIH followed by 35 days of regular housing, or had 35 day-long CIH exposure combined with daily administration of the type 1 angiotensin II receptor antagonist, losartan (15 mg/kg, p.o., and then were also subjected to ivgtt. Results: Compared with the corresponding control groups, CIH rats had progressively reduced glucose-stimulated insulin release and impaired glucose clearance, only mildly elevated heart rate and/or arterial blood pressure and slightly reduced respiratory rate. The differences in insulin release between the CIH and sham-treated rats disappeared in the rats normally housed for 35 days after 35 days of CIH/sham exposure. The losartan-treated rats had improved insulin sensitivity, with no evidence of suppressed insulin release in the CIH group. Conclusions: In adult rats, the glucose-stimulated insulin release is gradually suppressed with the duration of exposure to CIH, but the effect is reversible. Elimination of the detrimental effect of CIH on insulin release by losartan suggests that CIH disrupts glucoregulation through angiotensin/catecholaminergic pathways. Accordingly, treatment with continuous positive airway pressure may ameliorate pre-diabetic conditions in OSA patients, in part, by reducing sympathoexcitatory effects of recurrent

Fetal and neonatal thyrotoxicosis

Science.gov (United States)

Batra, Chandar Mohan

2013-01-01

Fetal thyrotoxicosis is a rare disease occurring in 1 out of 70 pregnancies with Grave's disease or in 1 out of 4000-50,000 deliveries. The mortality is 12-20%, usually from heart failure, but other complications are tracheal compression, infections and thrombocytopenia. It results from transfer of thyroid stimulating immunoglobulins from mother to fetus through the placenta. This transplacental transfer begins around 20th week of pregnancy and reaches its maximum by 30th week. These autoantibodies bind to the fetal thyroid stimulating hormone (TSH) receptors and increase the secretion of the thyroid hormones. The mother has an active autoimmune thyroid disease or has been treated for it in the past. She may be absolutely euthyroid due to past treatment by drugs, surgery or radioiodine ablation, but still have active TSH receptor stimulating autoantibodies, which can cause fetal thyrotoxicosis. The other features of this disease are fetal tachycardia, fetal goiter and history of spontaneous abortions and findings of goiter, ascites, craniosyntosis, fetal growth retardation, maceration and hydrops at fetal autopsy. If untreated, this disease can result in intrauterine death. The treatment for this disease consists of giving carbimazole to the mother, which is transferred through the placenta to the fetus. The dose of carbimazole is titrated with the fetal heart rate. If the mother becomes hypothyroid due to carbimazole, thyroxine is added taking advantage of the fact that very little of thyroxine is transferred across the placenta. Neonatal thyrotoxicosis patients are very sick and require emergency treatment. The goal of the treatment is to normalize thyroid functions as quickly as possible, to avoid iatrogenic hypothyroidism while providing management and supportive therapy for the infant's specific signs and symptoms. PMID:24251220

Fetal MRI of pathological brain development; Fetale MRT der pathologischen Hirnentwicklung

Energy Technology Data Exchange (ETDEWEB)

Brugger, P.C. [Medizinische Universitaet Wien (Austria). Arbeitsgruppe Integrative Morphologie, Zentrum fuer Anatomie und Zellbiologie; Prayer, D. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik

2006-02-15

Because of the superior tissue contrast, high spatial resolution, and multiplanar capabilities, fetal magnetic resonance imaging (MRI) can depict fetal brain pathologies with high accuracy. Pathological fetal brain development may result from malformations or acquired conditions. Differentiation of these etiologies is important with respect to managing the actual pregnancy or counseling future pregnancies. As a widened ventricular system is a common hallmark of both maldevelopment and acquired conditions, it may cause problems in the differential diagnosis. Fetal MRI can provide detailed morphological information, which allows refinement of the diagnosis of ventricular enlargement in a large number of cases. Systematic work-up of morphological details that may be recognized on MR images provides an approach for achieving a correct diagnosis in cases of ventricle enlargement. (orig.) [German] Aufgrund des hervorragenden Gewebekontrastes, der hohen raeumlichen Aufloesung und multiplanaren Moeglichkeiten erlaubt die fetale Magnetresonanztomographie (MRT) eine detaillierte Darstellung fetaler Hirnpathologien. Eine pathologische Hirnentwicklung kann sowohl auf Fehlbildungen als auch waehrend der Schwangerschaft erworbenen Stoerungen beruhen. Nachdem die weiteren Konsequenzen fuer die bestehende, aber auch fuer folgende Schwangerschaften zu einem grossen Teil von einer Differenzierung dieser Aetiologien abhaengig sein kann, ist ein Erkennen der jeweiligen Pathologie wesentlich. Die morphologische Praesentation erworbener und fehlbildungsbedingter Veraenderungen auf MR-Bildern ist u. U. sehr aehnlich. Besondere differenzialdiagnostische Probleme bereitet dabei das Vorliegen eines erweiterten Ventrikelsystems, das als Symptom unterschiedlichster Veraenderungen vorliegen kann. Anhand einer systematischen Darstellung mittels MR-erfassbarer morphologischer Details wird eine Anleitung gegeben, bei Bestehen dieses Leitsymptoms zu einer moeglichst genauen Diagnose zu kommen

Aleitamento materno exclusivo entre trabalhadoras com creche no local de trabalho Exclusive breastfeeding among working women with free daycare available at workplace

Directory of Open Access Journals (Sweden)

Maria José Duarte Osis

2004-04-01

Full Text Available OBJETIVO: Investigar os fatores relacionados à decisão das mulheres em amamentar e a duração planejada e, de fato observada, do aleitamento exclusivo entre trabalhadoras que dispõem de creche na empresa. MÉTODOS: Estudo qualitativo no qual se comparou um grupo de 15 trabalhadoras cujos bebês estavam sendo alimentados apenas com leite materno quando começaram a freqüentar a creche da empresa com outro similar que incluía mulheres cujos bebês que, ao ingressar, já estavam recebendo, além do leite materno, outros alimentos. Foram realizadas entrevistas semi-estruturadas e grupos focais. RESULTADOS: Evidenciaram-se como fatores relacionados à decisão de iniciar a amamentação e mantê-la ao retornar ao trabalho: o desejo de amamentar, embasado no valor que as mulheres dos dois grupos atribuíam ao aleitamento materno, bem como seus maridos e outras pessoas significativas (por exemplo: mãe, irmã, amigas. A duração do aleitamento exclusivo relacionou-se principalmente à orientação do pediatra que cuidava do bebê, que foi distinta em cada um dos grupos estudados. CONCLUSÃO: A existência da creche no local de trabalho aparece como elemento relevante para a manutenção do aleitamento após a licença de maternidade, especialmente o materno exclusivo. A decisão sobre quanto tempo amamentar de forma exclusiva esteve relacionada às informações recebidas acerca do assunto antes e durante a gestação, e no pós-parto. A diferença entre os dois grupos estudados foi que as mulheres que mantiveram o aleitamento exclusivo por quase seis meses acreditavam que quanto mais tempo dessem somente o leite materno, mais benefícios o bebê teria, enquanto as mulheres do outro grupo acreditavam que três meses de aleitamento exclusivo eram suficientes.OBJECTIVE: To investigate factors related to the decision of exclusive breastfeeding, and the planned and the actual duration among working women with free daycare available at workplace

Antithyroid drug-induced fetal goitrous hypothyroidism

DEFF Research Database (Denmark)

Bliddal, Sofie; Rasmussen, Ase Krogh; Sundberg, Karin

2011-01-01

Maternal overtreatment with antithyroid drugs can induce fetal goitrous hypothyroidism. This condition can have a critical effect on pregnancy outcome, as well as on fetal growth and neurological development. The purpose of this Review is to clarify if and how fetal goitrous hypothyroidism can...... be prevented, and how to react when prevention has failed. Understanding the importance of pregnancy-related changes in maternal thyroid status when treating a pregnant woman is crucial to preventing fetal goitrous hypothyroidism. Maternal levels of free T(4) are the most consistent indication of maternal...... and fetal thyroid status. In patients with fetal goitrous hypothyroidism, intra-amniotic levothyroxine injections improve fetal outcome. The best way to avoid maternal overtreatment with antithyroid drugs is to monitor closely the maternal thyroid status, especially estimates of free T(4) levels....

Acute Effects of Carbohydrate Supplementation on Intermittent Sports Performance.

Science.gov (United States)

Baker, Lindsay B; Rollo, Ian; Stein, Kimberly W; Jeukendrup, Asker E

2015-07-14

Intermittent sports (e.g., team sports) are diverse in their rules and regulations but similar in the pattern of play; that is, intermittent high-intensity movements and the execution of sport-specific skills over a prolonged period of time (~1-2 h). Performance during intermittent sports is dependent upon a combination of anaerobic and aerobic energy systems, both of which rely on muscle glycogen and/or blood glucose as an important substrate for energy production. The aims of this paper are to review: (1) potential biological mechanisms by which carbohydrate may impact intermittent sport performance; (2) the acute effects of carbohydrate ingestion on intermittent sport performance, including intermittent high-intensity exercise capacity, sprinting, jumping, skill, change of direction speed, and cognition; and (3) what recommendations can be derived for carbohydrate intake before/during exercise in intermittent sports based on the available evidence. The most researched intermittent sport is soccer but some sport-specific studies have also been conducted in other sports (e.g., rugby, field hockey, basketball, American football, and racquet sports). Carbohydrate ingestion before/during exercise has been shown in most studies to enhance intermittent high-intensity exercise capacity. However, studies have shown mixed results with regards to the acute effects of carbohydrate intake on sprinting, jumping, skill, change of direction speed, and cognition. In most of these studies the amount of carbohydrate consumed was ~30-60 g/h in the form of a 6%-7% carbohydrate solution comprised of sucrose, glucose, and/or maltodextrin. The magnitude of the impact that carbohydrate ingestion has on intermittent sport performance is likely dependent on the carbohydrate status of the individual; that is, carbohydrate ingestion has the greatest impact on performance under circumstances eliciting fatigue and/or hypoglycemia. Accordingly, carbohydrate ingestion before and during a game

MR evaluation of fetal demise

International Nuclear Information System (INIS)

Victoria, Teresa; Chauvin, Nancy Anne; Johnson, Ann M.; Kramer, Sandra Sue; Epelman, Monica; Capilla, Elena

2011-01-01

Fetal demise is an uncommon event encountered at MR imaging. When it occurs, recognition by the interpreting radiologist is important to initiate appropriate patient management. To identify MR findings of fetal demise. Following IRB approval, a retrospective search of the radiology fetal MR database was conducted searching the words ''fetal demise'' and ''fetal death.'' Fetuses with obvious maceration or no sonographic confirmation of death were excluded. Eleven cases formed the study group. These were matched randomly to live fetuses of similar gestational age. Images were reviewed independently by three pediatric radiologists. The deceased fetus demonstrates decreased MR soft-tissue contrast and definition of tissue planes, including loss of gray-white matter differentiation in the brain. The signal within the cardiac chambers, when visible, is bright on HASTE sequences from the stagnant blood; the heart is small. Pleural effusions and decreased lung volumes may be seen. Interestingly, the fetal orbits lose their anatomical round shape and become smaller and more elliptical; a dark, irregular rim resembling a mask may be seen. Although fetal demise is uncommonly encountered at MR imaging, radiologists should be aware of such imaging findings so prompt management can be instituted. (orig.)

21 CFR 884.2900 - Fetal stethoscope.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fetal stethoscope. 884.2900 Section 884.2900 Food... Fetal stethoscope. (a) Identification. A fetal stethoscope is a device used for listening to fetal heart... conventional stethoscopes. (b) Classification. Class I (general controls). The device is exempt from the...

Coherent Structures and Intermittency in Plasma Turbulence

International Nuclear Information System (INIS)

Das, Amita; Kaw, Predhiman; Sen, Abhijit

2008-01-01

The paper discusses some fundamental issues related to the phenomenon of intermittency in plasma turbulence with particular reference to experimental observations in fusion devices. Intermittency is typically associated with the presence of coherent structures in turbulence. Since coherent structures can play an important role in governing the transport properties of a system they have received a great deal of attention in fusion research. We review some of the experimental measurements and numerical simulation studies on the presence and formation of coherent structures in plasmas and discuss their relevance to intermittency. Intermittency, as widely discussed in the context of neutral fluid turbulence, implies multiscaling behaviour in contrast to self-similar scaling patterns observed in self organized criticality (SOC) phenomenon. The experimental evidence from plasma turbulence measurements reveal a mixed picture--while some observations support the SOC model description others indicate the presence of multiscaling behaviour. We discuss these results in the light of our present understanding of plasma turbulence and in terms of certain unique aspects of intermittency as revealed by fluid models of plasmas.

The impact of intermittent or sustained carbon dioxide on intermittent hypoxia initiated respiratory plasticity. What is the effect of these combined stimuli on apnea severity?

Science.gov (United States)

Mateika, Jason H; Panza, Gino; Alex, Raichel; El-Chami, Mohamad

2017-10-31

The following review explores the effect that intermittent or sustained hypercapnia coupled to intermittent hypoxia has on respiratory plasticity. The review explores published work which suggests that intermittent hypercapnia leads to long-term depression of respiration when administered in isolation and prevents the initiation of long-term facilitation when administered in combination with intermittent hypoxia. The review also explores the impact that sustained hypercapnia alone and in combination with intermittent hypoxia has on the magnitude of long-term facilitation. After exploring the outcomes linked to intermittent hypoxia/hypercapnia and intermittent hypoxia/sustained hypercapnia the translational relevance of the outcomes as it relates to breathing stability during sleep is addressed. The likelihood that naturally induced cycles of intermittent hypoxia, coupled to oscillations in carbon dioxide that range between hypocapnia and hypercapnia, do not initiate long-term facilitation is addressed. Moreover, the conditions under which intermittent hypoxia/sustained hypercapnia could serve to improve breathing stability and mitigate co-morbidities associated with sleep apnea are considered. Published by Elsevier B.V.

Diagnóstico precoce da restrição do crescimento fetal pela estimativa ultra-sonográfica do peso fetal Early diagnosis of intra-uterine growth restriction by ultrasonographic estimation of fetal weight

Directory of Open Access Journals (Sweden)

Maria Marta Martins

2005-02-01

Full Text Available OBJETIVOS: Com a finalidade da atuação pré-natal oportuna e diminuição da morbiletalidade perinatal e tardia, este estudo se propôs a avaliar a evolução do peso fetal determinado pela ecografia entre a 25ª e 27ª semanas de gestação, estabelecer valores de corte de peso fetal úteis no diagnóstico do pequeno para esta época da gestação e propor modelo matemático para reconhecer a probabilidade de ocorrência de recém-nascido pequeno para a idade gestacional (PIG. MÉTODOS: Avaliaram-se 85 recém-nascidos, 35 pequenos e 50 adequados para a idade gestacional (AIG. As mães haviam feito o pré-natal no serviço, eram hígidas ou apresentavam hipertensão arterial crônica como única doença, sem história de vícios, fetos gemelares ou malformados. Todas realizaram exames ultra-sonográficos na 25ª e 27ª semanas para cálculo do peso fetal. RESULTADOS: O ganho de peso ecográfico fetal entre a 25ª e a 27ª semanas de gestação foi menor no grupo PIG havendo desaceleração do crescimento em relação ao grupo AIG. Os valores de corte de pesos ecográficos fetais foram de 775 gramas e 1015 gramas para a 25ª e 27ª semanas, respectivamente Obteve-se modelo matemático útil para quantificar a probabilidade de crescimento intra-uterino inadequado.OBJECTIVE: Aiming to reduce the perinatal and late morbidity and lethality through opportune prenatal intervention, this study proposed to sequentially evaluate the echographic fetal weight at the 25th and 27th weeks of gestation, establishing cut-off values for echographic fetal weight useful in the diagnosis of small-for-gestational-age at this gestation time, and developing a mathematical model able to recognize the probability of a newborn small-for- gestational-age. METHODS: Eighty-five newborns were evaluated, 35 small and 50 adequate for gestational age. The mothers who underwent prenatal care at our Instituition were healthy or presented chronic arterial hypertension as the only

CUIDADO MATERNO AOS FILHOS NASCIDOS EXPOSTOS AO HIV/AIDS

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Léa Maria Moura Barroso

2009-01-01

Full Text Available La finalidad fue evaluar el cuidado materno a hijos menores de seis meses, nacidos expuestos al VIH/SIDA con la meta de reducir la transmisión vertical. En un ambulatorio especializado en Fortaleza/CE, 18 madres fueron entrevistadas en el segundo semestre de 2007. Estudio exploratorio y descriptivo con planteo cuantitativo. Preguntas evaluaron las recomendacio- nes para cuidado en salud bajo la perspectiva de la prevención de la transmisión vertical. Ninguna madre ofreció lactancia natural al hijo; el 94,4% ofreció Zidovudina® en jarabe de manera adecuada; el 27,8% no llevó a su hijo para acompañamiento especializado, ni tampoco realizó análisis específicos; el 53,9% tuvo frecuencia inadecuada en las consultas; el 55,6% de los niños no recibió profilaxis para pulmonía y estaba con el calendario de vacunas atrasado. Todos los niños recibieron lactancia artificial, aunque con dilución, frecuencia y cantidad inadecuadas, y alimentación complementaria incorrecta. Se concluye que los cuidados proporcionados a los hijos nacidos expuestos al VIH no están en total consonancia con normas preestablecidas para reducción de la transmisión vertical en Brasil.

Intermittent hypoxia increases insulin resistance in genetically obese mice.

Science.gov (United States)

Polotsky, Vsevolod Y; Li, Jianguo; Punjabi, Naresh M; Rubin, Arnon E; Smith, Philip L; Schwartz, Alan R; O'Donnell, Christopher P

2003-10-01

Obstructive sleep apnoea, a syndrome that leads to recurrent intermittent hypoxia, is associated with insulin resistance in obese individuals, but the mechanisms underlying this association remain unknown. We utilized a mouse model to examine the effects of intermittent hypoxia on insulin resistance in lean C57BL/6J mice and leptin-deficient obese (C57BL/6J-Lepob) mice. In lean mice, exposure to intermittent hypoxia for 5 days (short term) resulted in a decrease in fasting blood glucose levels (from 173 +/- 11 mg dl-1 on day 0 to 138 +/- 10 mg dl-1 on day 5, P obese mice, short-term intermittent hypoxia led to a decrease in blood glucose levels accompanied by a 607 +/- 136 % (P intermittent hypoxia was completely abolished by prior leptin infusion. Obese mice exposed to intermittent hypoxia for 12 weeks (long term) developed a time-dependent increase in fasting serum insulin levels (from 3.6 +/- 1.1 ng ml-1 at baseline to 9.8 +/- 1.8 ng ml-1 at week 12, P intermittent hypoxia is dependent on the disruption of leptin pathways.

Chronic high fat diet induces cardiac hypertrophy and fibrosis in mice.

Science.gov (United States)

Wang, Zhi; Li, Liaoliao; Zhao, Huijuan; Peng, Shuling; Zuo, Zhiyi

2015-08-01

Obesity can cause pathological changes in organs. We determined the effects of chronic high fat diet (HFD) and intermittent fasting, a paradigm providing organ protection, on mouse heart. Seven-week old CD1 male mice were randomly assigned to control, HFD and intermittent fasting groups. Control mice had free access to regular diet (RD). RD was provided every other day to mice in the intermittent fasting group. Mice in HFD group had free access to HFD. Their left ventricles were harvested 11 months after they had been on these diet regimens. HFD increased cardiomyocyte cross-section area and fibrosis. HFD decreased active caspase 3, an apoptosis marker, and the ratio of microtubule-associated protein 1A/1B-light chain 3 (LC3) II/LC3I, an autophagy marker. HFD increased the phospho-glycogen synthase kinase-3β (GSK-3β) at Ser9, a sign of GSK-3β inhibition. Nuclear GATA binding protein 4 and yes-associated protein, two GSK-3β targeting transcription factors that can induce hypertrophy-related gene expression, were increased in HFD-fed mice. Mice on intermittent fasting did not have these changes except for the increased active caspase 3 and decreased ratio of LC3II/LC3I. These results suggest that chronic HFD induces myocardial hypertrophy and fibrosis, which may be mediated by GSK-3β inhibition. Copyright © 2015 Elsevier Inc. All rights reserved.

The Yo-Yo intermittent recovery test

DEFF Research Database (Denmark)

Bangsbo, Jens; Iaia, F. Marcello; Krustrup, Peter

2008-01-01

The two Yo-Yo intermittent recovery (IR) tests evaluate an individual's ability to repeatedly perform intense exercise. The Yo-Yo IR level 1 (Yo-Yo IR1) test focuses on the capacity to carry out intermittent exercise leading to a maximal activation of the aerobic system, whereas Yo-Yo IR level 2...

Dynamic characterizers of spatiotemporal intermittency

OpenAIRE

Gupte, Neelima; Jabeen, Zahera

2006-01-01

Systems of coupled sine circle maps show regimes of spatiotemporally intermittent behaviour with associated scaling exponents which belong to the DP class, as well as regimes of spatially intermittent behaviour (with associated regular dynamical behaviour) which do not belong to the DP class. Both types of behaviour are seen along the bifurcation boundaries of the synchronized solutions, and contribute distinct signatures to the dynamical characterizers of the system, viz. the distribution of...

Efectos de los RNAm maternos sobre la maduración del ovocito y el desarrollo embrionario temprano en mamíferos. Revisión

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M. Eduviges Burrola-Barraza

2015-01-01

Full Text Available Obtener o vocitos madurados in vitro , que sean competentes para fertilizarse y originar un porcentaje superior al 50 % de blastocitos viables, es una de las principales metas que existen en el desarrollo in vitro de embriones bovinos. Es por ello necesario entender los procesos celulares, que desembocan en la maduración del ovocito durante la foliculogénesis y su subsecuente transición al embrión. La transición del ovocito al embrión es un p roceso complejo que involucra la inactivación genómica del ovocito y la activación del genoma embrionario. Este proceso se da en bovinos en la etapa de 8 a 16 células y presenta una degradación selectiva de RNAm maternos, que fueron almacenados durante la ovogénesis y son la fuente para la codificación de proteínas en las etapas iníciales del desarrollo embrionario. La acción de los RNAm maternos es clave para que la activación del genoma embrionario se realice en tiempo y forma adecuados. Entender la participación de estos transcritos en la activación del genoma embrionario, es esencial para esclarecer los procesos celulares que fallan en los protocolos de maduración de ovocitos in vitro . Es por esto que el objetivo de esta revisión fue recopilar la información de los principales RNAm maternos que han sido identificados tanto en el modelo murino como el bovino, esto con el fin de integrar el conocimiento relacionado con los procesos genómicos que permiten el desarrollo del embrión en el bovino, y diseñar nuevas estrategias que permitan mejorar los protocolos de fertilización in vitro.

En Alto Riesgo: La Crisis De La Salud Pública En El Instituto Materno Infantil De Bogotá.

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César ernesto abadía barrero.

2006-12-01

Full Text Available This article examinesthe impact of the economic crisis of the instituto materno infantil, colombia, on patients and workers. Families comment on the quality and warmth of health care provided; however, healthcare workers act as buffers protecting patients from the full impact of the crisis. in addition, delays in workers' payments have worsened their quality of life and forced them to look for additional income. We discuss connections between the economic crisis of public hospitals and structural adjustment and conclude that the "problem" of financial viability of the hospitals needs to be analyzed with a political economy framework.

La formación docente desde lo asistencial en el especialista en enfermería materno infantil

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Mur Villar, Norma

2010-01-01

La formación, preparación y actualización docente de la enfermería en Cuba es una necesidad para cumplir con el encargo social de este profesional. La presente tesis: “La Formación Docente desde lo Asistencial en el Especialista de Enfermería Materno Infantil, tiene como objeto el proceso de formación de este especialista y como objetivo la elaboración de una propuesta en que la formación docente se concibe como la integración del desempeño docente, asistencial y comunitario en las diferentes...

Enhanced carotid body chemosensory activity and the cardiovascular alterations induced by intermittent hypoxia

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Rodrigo eIturriaga

2014-12-01

Full Text Available The carotid body (CB plays a main role in the maintenance of the oxygen homeostasis. The hypoxic stimulation of the CB increases the chemosensory discharge, which in turn elicits reflex sympathetic, cardiovascular and ventilatory adjustments. An exacerbate carotid chemosensory activity has been associated with human sympathetic-mediated diseases such as hypertension, insulin resistance, heart failure and obstructive sleep apnea (OSA. Indeed, the CB chemosensory discharge becomes tonically hypereactive in experimental models of OSA and heart failure. Chronic intermittent hypoxia (CIH, a main feature of OSA, enhances CB chemosensory baseline discharges in normoxia and in response to hypoxia, inducing sympathetic overactivity and hypertension. Oxidative stress, increased levels of ET-1, Angiotensin II and pro-inflammatory cytokines, along with a reduced production of NO in the CB, have been associated with the enhanced carotid chemosensory activity. In this review, we will discuss new evidence supporting a main role for the CB chemoreceptor in the autonomic and cardiorespiratory alterations induced by intermittent hypoxia, as well as the molecular mechanisms involved in the CB chemosensory potentiation.

Enhanced carotid body chemosensory activity and the cardiovascular alterations induced by intermittent hypoxia

Science.gov (United States)

Iturriaga, Rodrigo; Andrade, David C.; Del Rio, Rodrigo

2014-01-01

The carotid body (CB) plays a main role in the maintenance of the oxygen homeostasis. The hypoxic stimulation of the CB increases the chemosensory discharge, which in turn elicits reflex sympathetic, cardiovascular, and ventilatory adjustments. An exacerbate carotid chemosensory activity has been associated with human sympathetic-mediated diseases such as hypertension, insulin resistance, heart failure, and obstructive sleep apnea (OSA). Indeed, the CB chemosensory discharge becomes tonically hypereactive in experimental models of OSA and heart failure. Chronic intermittent hypoxia (CIH), a main feature of OSA, enhances CB chemosensory baseline discharges in normoxia and in response to hypoxia, inducing sympathetic overactivity and hypertension. Oxidative stress, increased levels of ET-1, Angiotensin II and pro-inflammatory cytokines, along with a reduced production of NO in the CB, have been associated with the enhanced carotid chemosensory activity. In this review, we will discuss new evidence supporting a main role for the CB chemoreceptor in the autonomic and cardiorespiratory alterations induced by intermittent hypoxia, as well as the molecular mechanisms involved in the CB chemosensory potentiation. PMID:25520668

Value of fetal skeletal radiographs in the diagnosis of fetal death

International Nuclear Information System (INIS)

Bourliere-Najean, B.; Russel, A.S.; Petit, P.; Devred, P.; Panuel, M.; Piercecchi-Marti, M.D.; Fredouille, C.; Sigaudy, S.; Philip, N.

2003-01-01

The aim of this study was to assess the value of fetal skeletal radiographs in determining the etiology of fetal death. A total of 1193 post-mortem fetal skeletal radiographs were analysed. Fetuses were classified into one of three groups (group I: abnormality diagnosed during pregnancy; group II: maternal pathology; group III: spontaneous abortion of pregnancy, IIIa before 26 weeks of gestation (WG), IIIb after 26 weeks of gestation). Face, supine and lateral skeletal views were performed. Skeletal abnormalities were detected in 33.9% of the fetuses, including 22.7% with minor abnormalities (abnormal rib number, no nasal bone ossification, amesophalangia or P2 hypoplasia of the fifth digit) and 14.5% with major abnormalities (other skeletal abnormalities). Among the fetuses with major abnormalities, 98.8% came from group I, 2.9% came from group II, 2.3% came from group IIIa and none came from group IIIb. Fetal skeletal radiographs are not useful in fetuses arising from spontaneous abortion of pregnancy without abnormality on ultrasound screening, abnormality clinical examination or in fetuses with prenatal diagnosis of chromosomal abnormality. This practice is valuable only if there is a multidisciplinary team, with all the participants (pathologists, radiologists, geneticists) knowledgeable about fetal pathology. In the absence of this multidisciplinary approach, it is easier to X-ray all fetuses to avoid misdiagnosis and the important consequences for genetic counselling. (orig.)

Value of fetal skeletal radiographs in the diagnosis of fetal death

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Bourliere-Najean, B.; Russel, A.S.; Petit, P.; Devred, P. [Department of Pediatric Radiology, CHU Timone, 264 rue St. Pierre, 13385 Marseille cedex 5 (France); Panuel, M. [Department of Radiology, Hopital Nord, chemin Bourrelys, 13915 Marseille cedex 20 (France); Piercecchi-Marti, M.D.; Fredouille, C. [Department of Pathology, CHU Timone, 264 rue St. Pierre, 13385 Marseille cedex 5 (France); Sigaudy, S.; Philip, N. [Department of Genetics, CHU Timone, 264 rue St. Pierre, 13385 Marseille cedex 5 (France)

2003-05-01

The aim of this study was to assess the value of fetal skeletal radiographs in determining the etiology of fetal death. A total of 1193 post-mortem fetal skeletal radiographs were analysed. Fetuses were classified into one of three groups (group I: abnormality diagnosed during pregnancy; group II: maternal pathology; group III: spontaneous abortion of pregnancy, IIIa before 26 weeks of gestation (WG), IIIb after 26 weeks of gestation). Face, supine and lateral skeletal views were performed. Skeletal abnormalities were detected in 33.9% of the fetuses, including 22.7% with minor abnormalities (abnormal rib number, no nasal bone ossification, amesophalangia or P2 hypoplasia of the fifth digit) and 14.5% with major abnormalities (other skeletal abnormalities). Among the fetuses with major abnormalities, 98.8% came from group I, 2.9% came from group II, 2.3% came from group IIIa and none came from group IIIb. Fetal skeletal radiographs are not useful in fetuses arising from spontaneous abortion of pregnancy without abnormality on ultrasound screening, abnormality clinical examination or in fetuses with prenatal diagnosis of chromosomal abnormality. This practice is valuable only if there is a multidisciplinary team, with all the participants (pathologists, radiologists, geneticists) knowledgeable about fetal pathology. In the absence of this multidisciplinary approach, it is easier to X-ray all fetuses to avoid misdiagnosis and the important consequences for genetic counselling. (orig.)

Scheduled Intermittent Screening with Rapid Diagnostic Tests and Treatment with Dihydroartemisinin-Piperaquine versus Intermittent Preventive Therapy with Sulfadoxine-Pyrimethamine for Malaria in Pregnancy in Malawi: An Open-Label Randomized Controlled Trial.

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Mwayiwawo Madanitsa

2016-09-01

Full Text Available In Africa, most plasmodium infections during pregnancy remain asymptomatic, yet are associated with maternal anemia and low birthweight. WHO recommends intermittent preventive therapy in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP. However, sulfadoxine-pyrimethamine (SP efficacy is threatened by high-level parasite resistance. We conducted a trial to evaluate the efficacy and safety of scheduled intermittent screening with malaria rapid diagnostic tests (RDTs and treatment of RDT-positive women with dihydroartemisinin-piperaquine (DP as an alternative strategy to IPTp-SP.This was an open-label, two-arm individually randomized superiority trial among HIV-seronegative women at three sites in Malawi with high SP resistance. The intervention consisted of three or four scheduled visits in the second and third trimester, 4 to 6 wk apart. Women in the IPTp-SP arm received SP at each visit. Women in the intermittent screening and treatment in pregnancy with DP (ISTp-DP arm were screened for malaria at every visit and treated with DP if RDT-positive. The primary outcomes were adverse live birth outcome (composite of small for gestational age, low birthweight [<2,500 g], or preterm birth [<37 wk] in paucigravidae (first or second pregnancy and maternal or placental plasmodium infection at delivery in multigravidae (third pregnancy or higher. Analysis was by intention to treat. Between 21 July 2011 and 18 March 2013, 1,873 women were recruited (1,155 paucigravidae and 718 multigravidae. The prevalence of adverse live birth outcome was similar in the ISTp-DP (29.9% and IPTp-SP (28.8% arms (risk difference = 1.08% [95% CI -3.25% to 5.41%]; all women: relative risk [RR] = 1.04 [95% CI 0.90-1.20], p = 0.625; paucigravidae: RR = 1.10 [95% CI 0.92-1.31], p = 0.282; multigravidae: RR = 0.92 [95% CI 0.71-1.20], p = 0.543. The prevalence of malaria at delivery was higher in the ISTp-DP arm (48.7% versus 40.8%; risk difference = 7.85%, [95% CI 3

FATORES DE RISCO MATERNOS E INFANTIS ASSOCIADOS À MORTALIDADE NEONATAL

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Maria Aparecida Munhoz Gaiva

2016-01-01

Full Text Available En este trabajo se estudiaron los factores materno-infantiles relacionados con la mortalidad neonatal, a partir de datos obtenidos de los Sistemas de Información de Nacidos Vivos y Mortalidad integrados por vinculación. Se analizaron 9.349 nacidos vivos en Cuiabá-MT, en 2010, 78 de los cuales murieron en el período neonatal. Se realizó análisis univariado y multivariado empleando la regresión logística. En el modelo múltiple, se mantuvo asociada con la mortalidad neonatal: la edad materna menor de 20 años; la prematuridad; bajo peso al nacer; Apgar menor a siete en el 1 y 5 minutos; y la presencia de anomalías congénitas. Los resultados indicaron la necesidad de mejorar la calidad de la atención prenatal, para la prevención del bajo peso al nacer y la prematuridad. La asociación entre la muerte neonatal y baja puntuación de Apgar en el 1 y 5 minutos indica, a su vez, la importancia de la atención del parto.

Chronic intermittent hypoxia exerts CNS region-specific effects on rat microglial inflammatory and TLR4 gene expression.

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Stephanie M C Smith

Full Text Available Intermittent hypoxia (IH during sleep is a hallmark of sleep apnea, causing significant neuronal apoptosis, and cognitive and behavioral deficits in CNS regions underlying memory processing and executive functions. IH-induced neuroinflammation is thought to contribute to cognitive deficits after IH. In the present studies, we tested the hypothesis that IH would differentially induce inflammatory factor gene expression in microglia in a CNS region-dependent manner, and that the effects of IH would differ temporally. To test this hypothesis, adult rats were exposed to intermittent hypoxia (2 min intervals of 10.5% O2 for 8 hours/day during their respective sleep cycles for 1, 3 or 14 days. Cortex, medulla and spinal cord tissues were dissected, microglia were immunomagnetically isolated and mRNA levels of the inflammatory genes iNOS, COX-2, TNFα, IL-1β and IL-6 and the innate immune receptor TLR4 were compared to levels in normoxia. Inflammatory gene expression was also assessed in tissue homogenates (containing all CNS cells. We found that microglia from different CNS regions responded to IH differently. Cortical microglia had longer lasting inflammatory gene expression whereas spinal microglial gene expression was rapid and transient. We also observed that inflammatory gene expression in microglia frequently differed from that in tissue homogenates from the same region, indicating that cells other than microglia also contribute to IH-induced neuroinflammation. Lastly, microglial TLR4 mRNA levels were strongly upregulated by IH in a region- and time-dependent manner, and the increase in TLR4 expression appeared to coincide with timing of peak inflammatory gene expression, suggesting that TLR4 may play a role in IH-induced neuroinflammation. Together, these data indicate that microglial-specific neuroinflammation may play distinct roles in the effects of intermittent hypoxia in different CNS regions.

Acute Effects of Carbohydrate Supplementation on Intermittent Sports Performance

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Lindsay B. Baker

2015-07-01

Full Text Available Intermittent sports (e.g., team sports are diverse in their rules and regulations but similar in the pattern of play; that is, intermittent high-intensity movements and the execution of sport-specific skills over a prolonged period of time (~1–2 h. Performance during intermittent sports is dependent upon a combination of anaerobic and aerobic energy systems, both of which rely on muscle glycogen and/or blood glucose as an important substrate for energy production. The aims of this paper are to review: (1 potential biological mechanisms by which carbohydrate may impact intermittent sport performance; (2 the acute effects of carbohydrate ingestion on intermittent sport performance, including intermittent high-intensity exercise capacity, sprinting, jumping, skill, change of direction speed, and cognition; and (3 what recommendations can be derived for carbohydrate intake before/during exercise in intermittent sports based on the available evidence. The most researched intermittent sport is soccer but some sport-specific studies have also been conducted in other sports (e.g., rugby, field hockey, basketball, American football, and racquet sports. Carbohydrate ingestion before/during exercise has been shown in most studies to enhance intermittent high-intensity exercise capacity. However, studies have shown mixed results with regards to the acute effects of carbohydrate intake on sprinting, jumping, skill, change of direction speed, and cognition. In most of these studies the amount of carbohydrate consumed was ~30–60 g/h in the form of a 6%–7% carbohydrate solution comprised of sucrose, glucose, and/or maltodextrin. The magnitude of the impact that carbohydrate ingestion has on intermittent sport performance is likely dependent on the carbohydrate status of the individual; that is, carbohydrate ingestion has the greatest impact on performance under circumstances eliciting fatigue and/or hypoglycemia. Accordingly, carbohydrate ingestion before

Prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent hemodialysis: a systematic review

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Brkovic T

2016-06-01

Full Text Available Tonci Brkovic,1 Eliana Burilovic,2 Livia Puljak3 1Department of Internal Medicine, Division of Nephrology, 2Department of Psychiatry, University Hospital Split, 3Department of Anatomy, Histology and Embryology, Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Objectives: Understanding the epidemiology of pain in patients on hemodialysis (HD is crucial for further improvement in managing pain. The aim of this study was to systematically review available evidence on the prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent HD. Materials and methods: We carried out a systematic review of the literature and developed a comprehensive search strategy based on search terms on pain and HD. We searched the databases MEDLINE, Scopus, PsycINFO, and CINAHL from the earliest date of each database to July 24, 2014. Manuscripts in all languages were taken into consideration. Two authors performed each step independently, and all disagreements were resolved after discussion with the third author. The quality of studies was estimated using the STROBE checklist and Cochrane risk-of-bias tool.Results: We included 52 studies with 6,917 participants. The prevalence of acute and chronic pain in HD patients was up to 82% and 92%, respectively. A considerable number of patients suffered from severe pain. Various locations and causes of pain were described, with most of the studies reporting pain in general, pain related to arteriovenous access, headache, and musculoskeletal pain.Conclusion: The findings of this systematic review indicate high prevalence of pain in HD patients and considerable gaps and limitations in the available evidence. Pain in this population should be recognized as a considerable health concern, and the nephrology community should promote pain management in HD patients as a clinical and research priority to improve patients’ quality of life and pain

Cuidados maternos a crianças de baixo peso ao nascer Cuidados maternos a niños con bajo peso al nacer Mothers' care to the low birth weight infant

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Débora Falleiros de Mello

2002-09-01

Full Text Available Este estudo é descritivo exploratório e teve por objetivo caracterizar os relatos maternos sobre o cuidado à saúde de crianças de baixo peso ao nascer no primeiro e segundo ano de vida, através de entrevistas domiciliares com um grupo de onze mães de crianças procedentes de Ribeirão Preto - SR De modo geral, as mães apontam dificuldades no cuidado de amamentar o bebê, alimentação e uso de medicação, referem preocupações com as intercorrências, reinternações e desenvolvimento psicomotor, implicando na necessidade de suporte profissional para avaliar e acompanhar o processo de crescimento e desenvolvimento infantil no cotidiano das famílias.Este estudio es descriptivo exploratório y tuvo por objetivo caracterizar los relatos maternos sobre el cuidado a la salud de niños con bajo peso al nacer en el primero y segundo ano de vida, a través de entrevistas domiciliares con un grupo de once madres de niños procedentes de Ribeirão Preto - SR De modo general, las madres apuntan dificultades en el cuidado relacionados a la lactancia del bebé, alimentación y uso de medicación. Refieren preocupaciones con las intercurrencias, reinternaciones y desarrollo psicomotor, implicando en la necesidad de soporte profesional para evaluar y acompañar el proceso de crecimiento y desarrollo infantil en el cotidiano de las familias.This is an exploratory and descriptive study which aimed at characterizing mothers' accounts on the care given to the health of children with low weight at birth during their first and second years of life by means of home interviews with a group of eleven mothers of children from Ribeirão Preto - SR The mothers pointed to difficulties with breastfeeding, the babies' diet and medication use. They also referred to concerns about intercurrences, re-hospitalizations and psychomotor development, which results in the need for professional support in order to evaluate and follow the growth and development process of

Placental Origins of Chronic Disease

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Burton, Graham J.; Fowden, Abigail L.; Thornburg, Kent L.

2016-01-01

Epidemiological evidence links an individual's susceptibility to chronic disease in adult life to events during their intrauterine phase of development. Biologically this should not be unexpected, for organ systems are at their most plastic when progenitor cells are proliferating and differentiating. Influences operating at this time can permanently affect their structure and functional capacity, and the activity of enzyme systems and endocrine axes. It is now appreciated that such effects lay the foundations for a diverse array of diseases that become manifest many years later, often in response to secondary environmental stressors. Fetal development is underpinned by the placenta, the organ that forms the interface between the fetus and its mother. All nutrients and oxygen reaching the fetus must pass through this organ. The placenta also has major endocrine functions, orchestrating maternal adaptations to pregnancy and mobilizing resources for fetal use. In addition, it acts as a selective barrier, creating a protective milieu by minimizing exposure of the fetus to maternal hormones, such as glucocorticoids, xenobiotics, pathogens, and parasites. The placenta shows a remarkable capacity to adapt to adverse environmental cues and lessen their impact on the fetus. However, if placental function is impaired, or its capacity to adapt is exceeded, then fetal development may be compromised. Here, we explore the complex relationships between the placental phenotype and developmental programming of chronic disease in the offspring. Ensuring optimal placentation offers a new approach to the prevention of disorders such as cardiovascular disease, diabetes, and obesity, which are reaching epidemic proportions. PMID:27604528

Down-regulation of vascular PPAR-γ contributes to endothelial dysfunction in high-fat diet-induced obese mice exposed to chronic intermittent hypoxia.

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Zhang, Yanan; Zhang, Chunlian; Li, Haiou; Hou, Jingdong

2017-10-14

Obstructive sleep apnea (OSA), characterized by chronic intermittent hypoxia (CIH), is associated with endothelial dysfunction. The prevalence of OSA is linked to an epidemic of obesity. CIH has recently been reported to cause endothelial dysfunction in diet-induced obese animals by exaggerating oxidative stress and inflammation, but the underlying mechanism remains unclear. PPAR-γ, a ligand-inducible transcription factor that exerts anti-oxidant and anti-inflammatory effects, is down-regulated in the peripheral tissues in diet-induce obesity. We tested the hypothesis that down-regulation of vascular PPAR-γ in diet-induced obesity enhances inflammation and oxidative stress in response to CIH, resulting in endothelial dysfunction. Male C57BL/6 mice were fed either a high-fat diet (HFD) or a low-fat diet (LFD) and simultaneously exposed to CIH or intermittent air for 6 weeks. An additional HFD group received a combination of CIH and PPAR-γ agonist pioglitazone for 6 weeks. Endothelial-dependent vasodilation was impaired only in HFD group exposed to CIH, compared with other groups, but was restored by concomitant pioglitazone treatment. Molecular studies revealed that vascular PPAR-γ expression and activity were reduced in HFD groups, compared with LFD groups, but were reversed by pioglitazone treatment. In addition, CIH elevated vascular expression of NADPH oxidase 4 and dihydroethidium fluorescence, and increased expression of proinflammatory cytokines TNF-α and IL-1β in both LFD and HFD groups, but these increases was significantly greater in HFD group, along with decreased vascular eNOS activity. Pioglitazone treatment of HFD group prevented CIH-induced changes in above molecular markers. The results suggest that HFD-induced obesity down-regulates vascular PPAR-γ, which results in exaggerated oxidative stress and inflammation in response to CIH, contributing to endothelial dysfunction. This finding may provide new insights into the mechanisms by which OSA

Dual congenital transmission of Toxoplasma gondii and Sarcocystis neurona in a late-term aborted pup from a chronically infected southern sea otter (Enhydra lutris nereis).

Science.gov (United States)

Shapiro, Karen; Miller, Melissa A; Packham, Andrea E; Aguilar, Beatriz; Conrad, Patricia A; Vanwormer, Elizabeth; Murray, Michael J

2016-03-01

Toxoplasma gondii and Sarcocystis neurona are protozoan parasites with terrestrial definitive hosts, and both pathogens can cause fatal disease in a wide range of marine animals. Close monitoring of threatened southern sea otters (Enhydra lutris nereis) in California allowed for the diagnosis of dual transplacental transmission of T. gondii and S. neurona in a wild female otter that was chronically infected with both parasites. Congenital infection resulted in late-term abortion due to disseminated toxoplasmosis. Toxoplasma gondii and S. neurona DNA was amplified from placental tissue culture, as well as from fetal lung tissue. Molecular characterization of T. gondii revealed a Type X genotype in isolates derived from placenta and fetal brain, as well as in all tested fetal organs (brain, lung, spleen, liver and thymus). This report provides the first evidence for transplacental transmission of T. gondii in a chronically infected wild sea otter, and the first molecular and immunohistochemical confirmation of concurrent transplacental transmission of T. gondii and S. neurona in any species. Repeated fetal and/or neonatal losses in the sea otter dam also suggested that T. gondii has the potential to reduce fecundity in chronically infected marine mammals through parasite recrudescence and repeated fetal infection.

Fetal pancreatic beta-cell function in pregnancies complicated by maternal diabetes mellitus: relationship to fetal acidemia and macrosomia.

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Salvesen, D R; Brudenell, J M; Proudler, A J; Crook, D; Nicolaides, K H

1993-05-01

Our purpose was to investigate the relationship between fetal pancreatic beta-cell function and fetal acidemia and macrosomia in pregnancies complicated by maternal diabetes mellitus. A cross-sectional study at the Harris Birthright Research Centre for Fetal Medicine, London, was performed. In 32 pregnancies complicated by maternal diabetes mellitus cordocentesis was performed at 36 to 39 weeks' gestation for the measurement of umbilical venous blood pH, PO2, PCO2, lactate, and glucose concentration; plasma insulin immunoreactivity; and insulin/glucose ratio. A reference range for plasma insulin and insulin/glucose ratio was constructed by studying fetal blood samples from 80 women who did not have diabetes mellitus. Mean umbilical venous blood pH was significantly lower and plasma insulin immunoreactivity and insulin/glucose ratio were significantly higher than the appropriate normal mean for gestation. There were significant associations between (1) maternal and fetal blood glucose concentrations (r = 0.95, p < 0.0001), (2) fetal blood glucose and plasma insulin immunoreactivity (r = 0.57, p < 0.01), (3) fetal plasma insulin immunoreactivity and blood pH (r = -0.39, p < 0.05), and (4) fetal insulin/glucose ratio and degree of macrosomia (r = 0.76, p < 0.0001). Fetal pancreatic beta-cell hyperplasia is implicated in the pathogenesis of both fetal acidemia and macrosomia.

Forces and energetics of intermittent swimming

Science.gov (United States)

Floryan, Daniel; Van Buren, Tyler; Smits, Alexander J.

2017-08-01

Experiments are reported on intermittent swimming motions. Water tunnel experiments on a nominally two-dimensional pitching foil show that the mean thrust and power scale linearly with the duty cycle, from a value of 0.2 all the way up to continuous motions, indicating that individual bursts of activity in intermittent motions are independent of each other. This conclusion is corroborated by particle image velocimetry (PIV) flow visualizations, which show that the main vortical structures in the wake do not change with duty cycle. The experimental data also demonstrate that intermittent motions are generally energetically advantageous over continuous motions. When metabolic energy losses are taken into account, this conclusion is maintained for metabolic power fractions less than 1.

Fetal magnetic resonance imaging of thoracic and abdominal malformations; Fetale Magnetresonanztomographie thorakaler und abdomineller Malformationen

Energy Technology Data Exchange (ETDEWEB)

Woitek, R.; Asenbaum, U.; Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Brugger, P.C. [Medizinische Universitaet Wien, Zentrum fuer Anatomie und Zellbiologie, Wien (Austria)

2013-02-15

Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations. Ultrasound and magnetic resonance imaging (MRI). In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process. Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences. Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field. In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning. (orig.) [German] Diagnose und Differenzialdiagnose fetaler thorakaler und abdomineller Malformationen. Ultraschall, MRT. MRT zur weiteren Abklaerung und genaueren Differenzierung bei vielen im Ultraschall gestellten Verdachtsdiagnosen. Verbesserte anatomische Darstellung mittels MRT und Darstellung unterschiedlicher Gewebezusammensetzung mittels verschiedener MR-Sequenzen. Die fetale MRT ist bei der angegebenen Fragestellung in die klinische Routine eingegangen und liefert weiterhin die Basis fuer wissenschaftliche Untersuchungen in diesem Bereich. Die fetale MRT liefert beim Vorliegen thorakaler oder abdomineller Malformationen komplementaer zum Ultraschall wichtige Zusatzinformationen, um die diagnostische Genauigkeit zu erhoehen, die Prognoseabschaetzung zu verbessern und ggf. eine bessere chirurgische Planung zu ermoeglichen. (orig.)

Frecuencia cardiaca y movimientos fetales posterior a la administracion de betametasona para maduración pulmonar fetal

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Yolima Ruiz Lopez

2013-05-01

Full Text Available El objetivo de la investigación fue demostrar las modificaciones de la frecuencia cardiaca y los movimientos fetales producidas por la administración de betametasona para maduración pulmonar fetal. Se realizó una investigación de tipo explicativa, prospectiva y longitudinal con un diseño cuasi-experimental y una muestra no probabilística de 106 gestantes entre 24 y 34 semanas, con diagnóstico de amenaza de parto pretérmino tratadas con betametasona (12 mg intramuscular cada 24 horas por dos dosis que acudieron al Hospital Central “Dr. Urquinaona”. Se evaluaron los movimientos fetales y frecuencia cardiaca materna y fetal. No se encontraron diferencias significativas en la frecuencia cardiaca materna comparado con los valores iniciales (p = ns. Se observó que el valor inicial de la frecuencia cardiaca fetal fue de 135,1±9,7 latidos por minuto para aumentar luego a 137,2±8,9 latidos por minuto (p = ns para presentar un nuevo aumento hasta (142,9±9,9 latidos por minuto que fue significativo comparado con los valores iniciales (p < 0,05. Se observó una disminución significativa de movimientos fetales medidos en 30 minutos después de la primera inyección (23,1±6,0 movimientos comparado con 14,8±7,0 movimientos, para aumentar después de la segunda inyección pero aun presentando valores significativamente más bajos comparado con los valores iniciales (20,0 ±6,7 movimientos; p < 0,05. Se concluye que la administración de betametasona para maduración pulmonar fetal produce incremento significativo en la frecuencia cardiaca y reducción marcada de los movimientos fetales. Abstract Fetal heart rate and movements after betamethasone administration for fetal lung maturity The objective of research was to demonstrate fetal heart rate and movements modifications by the use of betamethasone for fetal lung maturity. An explicative, prospective and longitudinal research was done with a quasi-experimental design and a non

Effects of creatine supplementation on high-intensity intermittent exercise: discrepancies and methodological appraisals

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Bruno Gualano

2008-07-01

Full Text Available http://dx.doi.org/10.5007/1980-0037.2008v10n2p189 After a brief review of the literature on the effects of creatine supplementation on high-intensity intermittent exercise performance, the main aim of this study was to discuss methodological differences between studies which could explain the discrepancies observed in the literature. The effects of creatine supplementation on high-intensity intermittent exercise performance have been investigated in depth. Although the results of much research demonstrates the effi cacy of this supplement, there is just as much evidence that does not support this ergogenic effect. The explanation for this divergence appears to be multifactorial, although it is always linked to methodological characteristics. Study design (crossover or parallel groups, individual variability of muscular creatine content, chronic high meat intake, sample size, exercise protocol characteristics (body weight dependence and time between series, and gender and age all differ between studies and are potentially the variables responsible, to differing extents, for the discrepancies observed in the literature. Studies involving young males, with parallel group design, adequate statistical power, control of the incorporation of creatine into muscles, food intake assessment and intermittent exercise protocols in which performance is independent of body weight and with rest-recovery intervals of 1 to 6 minutes, usually produce positive results. The many methodological factors which can contribute to divergence on the ergogenic effects of creatine should be considered in futures studies, as well as when prescribing creatine supplementation.

Metallothionein as a compensatory component prevents intermittent hypoxia-induced cardiomyopathy in mice

Energy Technology Data Exchange (ETDEWEB)

Yin, Xia; Zhou, Shanshan [The First Hospital of Jilin University, Changchun, 130021 (China); KCHRI at the Department of Pediatrics, School of Medicine, University of Louisville, Louisville, 40202 (United States); Zheng, Yang, E-mail: zhengyang@jlu.edu.cn [The First Hospital of Jilin University, Changchun, 130021 (China); Tan, Yi [KCHRI at the Department of Pediatrics, School of Medicine, University of Louisville, Louisville, 40202 (United States); Chinese–American Research Institute for Diabetic Complications, Wenzhou Medical College School of Pharmacy, Wenzhou, 325035 (China); Kong, Maiying [Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY 40202 (United States); Wang, Bo [KCHRI at the Department of Pediatrics, School of Medicine, University of Louisville, Louisville, 40202 (United States); Department of Pathology, Inner Mongolia Forestry General Hospital, Yakeshi, 022150 (China); Feng, Wenke [Department of Medicine, School of Medicine, University of Louisville, Louisville, 40202 (United States); Epstein, Paul N. [KCHRI at the Department of Pediatrics, School of Medicine, University of Louisville, Louisville, 40202 (United States); Cai, Jun, E-mail: j0cai002@louisville.edu [KCHRI at the Department of Pediatrics, School of Medicine, University of Louisville, Louisville, 40202 (United States); Cai, Lu [KCHRI at the Department of Pediatrics, School of Medicine, University of Louisville, Louisville, 40202 (United States); Chinese–American Research Institute for Diabetic Complications, Wenzhou Medical College School of Pharmacy, Wenzhou, 325035 (China); Department of Medicine, School of Medicine, University of Louisville, Louisville, 40202 (United States)

2014-05-15

Obstructive sleep apnea (OSA) causes chronic intermittent hypoxia (IH) to induce cardiovascular disease, which may be related to oxidative damage. Metallothionein (MT) has been extensively proved to be an endogenous and highly inducible antioxidant protein expressed in the heart. Therefore, we tested the hypotheses that oxidative stress plays a critical role in OSA induced cardiac damage and MT protects the heart from OSA-induced cardiomyopathy. To mimic hypoxia/reoxygenation events that occur in adult OSA patients, mice were exposed to IH for 3 days to 8 weeks. The IH paradigm consisted of alternating cycles of 20.9% O{sub 2}/8% O{sub 2} F{sub I}O{sub 2} (30 episodes per hour) with 20 s at the nadir F{sub I}O{sub 2} for 12 h a day during daylight. IH significantly increased the ratio of heart weight to tibia length at 4 weeks with a decrease in cardiac function from 4 to 8 weeks. Cardiac oxidative damage and fibrosis were observed after 4 and 8 weeks of IH exposures. Endogenous MT expression was up-regulated in response to 3-day IH, but significantly decreased at 4 and 8 weeks of IH. In support of MT as a major compensatory component, mice with cardiac overexpression of MT gene and mice with global MT gene deletion were completely resistant, and highly sensitive, respectively, to chronic IH induced cardiac effects. These findings suggest that chronic IH induces cardiomyopathy characterized by oxidative stress-mediated cardiac damage and the antioxidant MT protects the heart from such pathological and functional changes. - Highlights: • The effect of intermittent hypoxia (IH) on cardiac metallothionein (MT) • Cardiac MT expression was up-regulated in response to 3-day IH. • Exposure to 4- or 8-week IH downregulated cardiac MT expression. • Overexpression of cardiac MT protects from IH-induced cardiac damage. • Global deletion of MT gene made the heart more sensitive to IH damage.

Metallothionein as a compensatory component prevents intermittent hypoxia-induced cardiomyopathy in mice

International Nuclear Information System (INIS)

Yin, Xia; Zhou, Shanshan; Zheng, Yang; Tan, Yi; Kong, Maiying; Wang, Bo; Feng, Wenke; Epstein, Paul N.; Cai, Jun; Cai, Lu

2014-01-01

Obstructive sleep apnea (OSA) causes chronic intermittent hypoxia (IH) to induce cardiovascular disease, which may be related to oxidative damage. Metallothionein (MT) has been extensively proved to be an endogenous and highly inducible antioxidant protein expressed in the heart. Therefore, we tested the hypotheses that oxidative stress plays a critical role in OSA induced cardiac damage and MT protects the heart from OSA-induced cardiomyopathy. To mimic hypoxia/reoxygenation events that occur in adult OSA patients, mice were exposed to IH for 3 days to 8 weeks. The IH paradigm consisted of alternating cycles of 20.9% O 2 /8% O 2 F I O 2 (30 episodes per hour) with 20 s at the nadir F I O 2 for 12 h a day during daylight. IH significantly increased the ratio of heart weight to tibia length at 4 weeks with a decrease in cardiac function from 4 to 8 weeks. Cardiac oxidative damage and fibrosis were observed after 4 and 8 weeks of IH exposures. Endogenous MT expression was up-regulated in response to 3-day IH, but significantly decreased at 4 and 8 weeks of IH. In support of MT as a major compensatory component, mice with cardiac overexpression of MT gene and mice with global MT gene deletion were completely resistant, and highly sensitive, respectively, to chronic IH induced cardiac effects. These findings suggest that chronic IH induces cardiomyopathy characterized by oxidative stress-mediated cardiac damage and the antioxidant MT protects the heart from such pathological and functional changes. - Highlights: • The effect of intermittent hypoxia (IH) on cardiac metallothionein (MT) • Cardiac MT expression was up-regulated in response to 3-day IH. • Exposure to 4- or 8-week IH downregulated cardiac MT expression. • Overexpression of cardiac MT protects from IH-induced cardiac damage. • Global deletion of MT gene made the heart more sensitive to IH damage

Chromosome 11-linked determinant controls fetal globin expression and the fetal-to-adult globin switch

International Nuclear Information System (INIS)

Melis, M.; Demopulos, G.; Najfeld, V.; Zhang, J.W.; Brice, M.; Papayannopoulou, T.; Stamatoyannopoulos, G.

1987-01-01

Hybrids formed by fusing mouse erythroleukemia (MEL) cells with human fetal erythroid cells produce human fetal globin, but they switch to adult globin production as culture time advances. To obtain information on the chromosomal assignment of the elements that control γ-to-β switching, the authors analyzed the chromosomal composition of hybrids producing exclusively or predominantly human fetal globin and hybrids producing only adult human globin. No human chromosome was consistently present in hybrids expressing fetal globin and consistently absent in hybrids expressing adult globin. Subcloning experiments demonstrated identical chromosomal compositions in subclones displaying the fetal globin program and those that had switched to expression of the adult globin program. These data indicate that retention of only one human chromosome -- i.e., chromosome 11 -- is sufficient for expression of human fetal globin and the subsequent γ-to-β switch. The results suggest that the γ-to-β switch is controlled either cis to the β-globin locus of by a trans-acting mechanism, the genes of which reside on human chromosome 11

Fetal Echocardiography/Your Unborn Baby's Heart

Science.gov (United States)

... Artery Disease Venous Thromboembolism Aortic Aneurysm More Fetal Echocardiography / Your Unborn Baby's Heart Updated:Oct 6,2016 ... Your Risk • Symptoms & Diagnosis Introduction Common Tests Fetal Echocardiography/Your Unborn Baby's Heart - Fetal Echocardiogram Test - Detection ...

Intermittency in the particle production and in the nuclear multifragmentation

International Nuclear Information System (INIS)

Bozek, P.; Ploszajczak, M.

1991-01-01

Intermittency is a manifestation of scale invariance and randomness in physical systems. Intermittency in relativistic heavy-ion collisions and, in particular, the projectile dependence, multiplicity dependence and source-size dependence are discussed in the frame of the model of spatio-temporal intermittency. Moreover, recent theoretical results in intermittency studies of the nuclear multifragmentation are presented. (author) 35 refs., 4 figs., 1 tab

Beneficial effects of intermittent suction and pressure treatment in intermittent claudication

DEFF Research Database (Denmark)

Mehlsen, J; Himmelstrup, H; Himmelstrup, Bodil

1993-01-01

administration. The treatment caused significant increments in the ADP thresholds for platelet aggregation, while the effects on fibrinolysis were uncertain. It is concluded that intermittent suction and pressure treatment offers a new approach for conservative treatment of intermittent claudication....... participated in an open trial investigating the possible effects of the treatment on platelet aggregation and fibrinolysis. Pain-free and maximal walking distances were measured on a treadmill, and systolic blood pressure was measured on the upper limb, the ankle, and the first toe bilaterally. The threshold...... for adenosine diphosphate (ADP)-induced platelet aggregation was tested, and the fibrinolytic activity was estimated from the euglobulin clot lysis time. Active treatment resulted in significant improvements in pain-free and maximal walking distances, whereas no changes could be found during placebo...

Diversão em movimento: um projeto lúdico para crianças hospitalizadas no Serviço de Oncologia Pediátrica do Instituto Materno Infantil Prof. Fernando Figueira, IMIP Ludotherapy for hospitalized children: a ludotherapy program for hospitalized children in the Pediatrics Oncology Unit of the Instituto Materno Infantil Prof. Fernando Figueira, IMIP

Directory of Open Access Journals (Sweden)

Arli Melo Pedrosa

2007-03-01

Full Text Available O presente trabalho descreve as atividades lúdicas desenvolvidas na enfermaria de oncologia pediátrica do Instituto Materno Infantil Prof. Fernando Figueira (IMIP, com 60 pacientes portadores de neoplasias malignas, no período de janeiro de 2004 a janeiro de 2005. Descreve também as etapas do Projeto e apresenta os resultados obtidos, correlacionando as etapas do desenvolvimento da aprendizagem com os instrumentos lúdicos utilizados como recurso minimizador do processo de hospitalização, através dos itens mais solicitados, considerando, para essa análise, as idéias de Jean Piaget e Bruno Bettelheim.This paper describes a ludotherapy program implemented in the pediatrics oncology ward of the Instituto Materno Infantil Prof. Fernando Figueira (IMIP with 60 malignant neoplasia patients from January 2004 to January 2005. It describes the phases of the project, demonstrates results obtained, relating learning development phases and ludic tools used as a resource to mitigate hospitalization hardships through the most requested items. Jean Piaget and Bruno Bettelheim concepts were used in this assessment.

Intermittency and random matrices

Science.gov (United States)

Sokoloff, Dmitry; Illarionov, E. A.

2015-08-01

A spectacular phenomenon of intermittency, i.e. a progressive growth of higher statistical moments of a physical field excited by an instability in a random medium, attracted the attention of Zeldovich in the last years of his life. At that time, the mathematical aspects underlying the physical description of this phenomenon were still under development and relations between various findings in the field remained obscure. Contemporary results from the theory of the product of independent random matrices (the Furstenberg theory) allowed the elaboration of the phenomenon of intermittency in a systematic way. We consider applications of the Furstenberg theory to some problems in cosmology and dynamo theory.

[Delivery after a previous cesarean in the Gyneco-Obsteric Hospital Garza Garcia, N.L].

Science.gov (United States)

de la Garza Quintanilla, C; Celaya Juárez, J A; Hernández Escobar, C

1997-04-01

One hundred and four patients who delivered after a previous cesarean section, at Hospital de Ginecoobstetricia de Garza García, N.L., from February 1, 1994 to January 31, 1995, were reviewed. The objective for this study was to know materno-fetal morbi-mortality at our hospital. Age, parity weeks of gestation, cause for previous section, delivery culmination, weight and Apgar of products, as well as, materno-fetal morbi-mortality, were analyzed. Average age group was 21 to 30 years with 68.5%. As to parity nulliparae predominated with 48.1%. As to weeks of gestation, the most frequent was 37 to 40 weeks, 85.5%. Previous section indication was: 1. Pelvic presentation, 2. Fetal stress, 3. Cefalo-pelvic disproportion, 4. Premature rupture of membranes, 5. Toxemia. As to deliveries outcome, there was dystocia in 86.5%, by profilactic low forceps application in 81.7%; and mid low in 4.8%. Eutocic delivery, 13.5%. Product weight was 3,000 to 3,500 g, with 51%. Apgar in 94 products was 8 and 9 at one minute. Maternal morbidity was 15.3% being most frequent vaginal tears. There was one case of uterine atonia, and one case of dura mater adverted puncture. There were no uterine dehiscence nor rupture. Perinatal morbidity was 5.6%. There was no perinatal death.

Maternal hemodynamics, fetal biometry and Dopplers in pregnancies followed up for suspected fetal growth restriction.

Science.gov (United States)

Roberts, Llinos A; Ling, Hua Zen; Poon, Liona; Nicolaides, Kypros H; Kametas, Nikos A

2018-04-01

To assess whether in a cohort of patients with small for gestational age (SGA) foetuses with estimated fetal weight ≤10 th percentile, maternal hemodynamics, fetal biometry and Dopplers at presentation, can predict the subsequent development of abnormal fetal Dopplers or delivery with birthweight Cheetah), mean arterial pressure, fetal biometry, umbilical artery (UA), middle cerebral artery (MCA) and uterine artery (UT) pulsatility index (PI) and the deepest vertical pool (DVP) of amniotic fluid. Z-scores of these variables were calculated based on reported reference ranges and the values were compared between those with evidence of abnormal fetal Dopplers at presentation (group 1), those that developed abnormal Dopplers in subsequent visits (group 2) and those who did not develop abnormal Dopplers throughout pregnancy (group 3). Abnormal fetal Dopplers were defined as UAPI >95 th percentile, or MCA PI <5 th percentile. Differences in measured variables at presentation were also compared between pregnancies delivering a baby with birthweight <3 rd and ≥3 rd percentile. Multivariate logistic regression analysis was used to determine significant predictors of birthweight <3 rd percentile and evolution from normal fetal Dopplers to abnormal fetal Dopplers in groups 2 and 3. In the study population 14 (16%) cases were in group 1, 19 (22%) in group 2 and 53 (62%) in group 3. The birthweight was <3 rd percentile in 39 (45%) cases and ≥3 rd percentile in 47 (55%). In the study groups, compared to normal populations, there was decreased cardiac output and stroke volume and increased peripheral vascular resistance and mean arterial pressure (MAP) and the deviations from normal were most marked in group 1. Pregnancies with a birthweight <3 rd , compared to those ≥3 rd percentile, had higher deviations from normal in fetal biometry, maternal cardiac output, stroke volume, heart rate and peripheral vascular resistance and UT-PI. Multivariate logistic regression

Digital atlas of fetal brain MRI.

Science.gov (United States)

Chapman, Teresa; Matesan, Manuela; Weinberger, Ed; Bulas, Dorothy I

2010-02-01

Fetal MRI can be performed in the second and third trimesters. During this time, the fetal brain undergoes profound structural changes. Interpretation of appropriate development might require comparison with normal age-based models. Consultation of a hard-copy atlas is limited by the inability to compare multiple ages simultaneously. To provide images of normal fetal brains from weeks 18 through 37 in a digital format that can be reviewed interactively. This will facilitate recognition of abnormal brain development. T2-W images for the atlas were obtained from fetal MR studies of normal brains scanned for other indications from 2005 to 2007. Images were oriented in standard axial, coronal and sagittal projections, with laterality established by situs. Gestational age was determined by last menstrual period, earliest US measurements and sonogram performed on the same day as the MR. The software program used for viewing the atlas, written in C#, permits linked scrolling and resizing the images. Simultaneous comparison of varying gestational ages is permissible. Fetal brain images across gestational ages 18 to 37 weeks are provided as an interactive digital atlas and are available for free download from http://radiology.seattlechildrens.org/teaching/fetal_brain . Improved interpretation of fetal brain abnormalities can be facilitated by the use of digital atlas cataloging of the normal changes throughout fetal development. Here we provide a description of the atlas and a discussion of normal fetal brain development.

Intermittent behavior of the logistic system

Science.gov (United States)

Mayer-Kress, G.; Haken, H.

1981-03-01

In the discrete logistic model a transition to chaotic behavior via intermittency occurs in a neighborhood of periodic bands. Intermittent behavior is also induced if a stable periodic orbit is perturbed by low-level external noise, whereas alterations due to computer digitalisation produce remarkable periodicities. We compare our numerical results with the predictions of Pomeau and Manneville for the Lorenz system.

Maternal protein-energy malnutrition during early pregnancy in sheep impacts the fetal ornithine cycle to reduce fetal kidney microvascular development.

Science.gov (United States)

Dunford, Louise J; Sinclair, Kevin D; Kwong, Wing Y; Sturrock, Craig; Clifford, Bethan L; Giles, Tom C; Gardner, David S

2014-11-01

This paper identifies a common nutritional pathway relating maternal through to fetal protein-energy malnutrition (PEM) and compromised fetal kidney development. Thirty-one twin-bearing sheep were fed either a control (n=15) or low-protein diet (n=16, 17 vs. 8.7 g crude protein/MJ metabolizable energy) from d 0 to 65 gestation (term, ∼ 145 d). Effects on the maternal and fetal nutritional environment were characterized by sampling blood and amniotic fluid. Kidney development was characterized by histology, immunohistochemistry, vascular corrosion casts, and molecular biology. PEM had little measureable effect on maternal and fetal macronutrient balance (glucose, total protein, total amino acids, and lactate were unaffected) or on fetal growth. PEM decreased maternal and fetal urea concentration, which blunted fetal ornithine availability and affected fetal hepatic polyamine production. For the first time in a large animal model, we associated these nutritional effects with reduced micro- but not macrovascular development in the fetal kidney. Maternal PEM specifically impacts the fetal ornithine cycle, affecting cellular polyamine metabolism and microvascular development of the fetal kidney, effects that likely underpin programming of kidney development and function by a maternal low protein diet. © FASEB.

[Effects of chronic intermittent hypoxia on oxidative stress and inflammatory response and the interventional roles of adiponectin].

Science.gov (United States)

Pan, Guoyu; Su, Mei; Ding, Wenxiao; Ding, Ning; Huang, Hanpeng; Zhang, Xilong

2015-04-28

To explore the effects of chronic intermittent hypoxia (CIH) on oxidative stress and inflammatory response and the interventional roles of adiponectin (Ad). A total of 45 male Wistar rats were randomly divided into three groups of control group, CIH and CIH+Ad (n = 15 each). The control group breathed room air while the CIH and CIH+Ad groups received CIH 8 h/d for 5 successive weeks. The CIH+Ad group Ad had an injection of 10 µg once a week through tail vein. At the end of experiment (Day 35), comparison was performed among three groups about Ad, tumor necrosis factor α (TNF-α), C-reactive protein (CRP) and interleukin (IL) 6 from serum as well as malondialdehyde, superoxide dismutase (SOD), myeloperoxidase (MPO), reactive oxygen spieces (ROS) and nuclear factor (NF) κB from genioglossus. Serum Ad level in CIH group was lower than those in control and CIH+Ad groups ((4 208 ± 2 239) vs (7 051 ± 2 432) and (6 405 ± 2 384) ng/ml, all P statistic difference between control and CIH+Ad groups. Both serum levels of TNF-α and CRP were higher in CIH group than those in control and CIH+Ad groups ((70.87 ± 35.16) vs (26.54 ± 20.32) and (29.50 ± 22.54) pg/ml, as well as (31.84 ± 11.48) vs (22.68 ± 9.63), (25.32 ± 8.34) mg/L, all P statistical difference with CIH+Ad group (1.04 ± 0.27). CIH may induce oxidative stress and inflammation possibly through NF κB pathway while a supplement of Ad attenuates the above CIH-induced responses.

Symptoms of postpartum depression and early interruption of exclusive breastfeeding in the first two months of life Sintomas de depressão pós-parto e interrupção precoce do aleitamento materno exclusivo nos dois primeiros meses de vida

Directory of Open Access Journals (Sweden)

Maria Helena Hasselmann

2008-01-01

Full Text Available This study evaluates the association between postpartum depression and interruption of exclusive breastfeeding in the first two months of life. Cohort study of 429 infants Avaliou-se a associação entre depressão pós-parto e interrupção precoce do aleitamento materno exclusivo nos dois primeiros meses de vida. Estudo de coorte com 429 crianças < 20 dias de idade em quatro unidades de saúde no Rio de Janeiro, Brasil. Considerou-se como interrupção precoce do aleitamento materno exclusivo a introdução de chá, água, suco, leite artificial ou qualquer outro alimento. Na avaliação da depressão pós-parto utilizou-se a Edinburgh Post-natal Depression Scale. Associações foram expressas como razões de prevalências (linha de base e riscos relativos (primeiro e segundo meses de vida e respectivos intervalos de 95% de confiança estimados via regressão de Poisson com variância robusta. Filhos de mulheres com sintomas de depressão pós-parto apresentam maior risco de interrupção precoce do aleitamento materno exclusivo nos dois meses de seguimento (RR = 1,46; IC95%: 0,98-2,17 e RR = 1,21; IC95%: 1,02-1,45, respectivamente. Entre mães que amamentam exclusivamente até o primeiro mês de vida, depressão pós-parto não se associou à interrupção precoce do aleitamento materno exclusivo (RR = 1,44; IC95%: 0,68-3,06. Esses achados apontam para a importância da saúde mental materna no sucesso do aleitamento materno exclusivo.

Intermittent hydronephrosis

International Nuclear Information System (INIS)

Knop, J.; Vogel, H.; Hupe, W.

1981-01-01

An intermittent hydronephrosis was observed in a 40-year old patient. This disease pattern is due to an incongruity between the formation of urine and the transport capacity in the ureteropelvic junction. The latent impediment of flow becomes manifest with increased urine secretion. Irreversible renal damage can be the result of the repeatedly occurring hydronephrotic crises. (orig.) [de

Complicações obstétricas em gestações com feto portador de anomalia incompatível com a sobrevida neonatal Complicaciones obstétricas en gestaciones con feto portador de anomalía incompatible con la sobrevivencia neonatal Obstetric complications in pregnancies with fetal anomalies incompatible with neonatal survival

Directory of Open Access Journals (Sweden)

Danila Cristina Paquier Sala

2010-10-01

Full Text Available OBJETIVO: Descrever as complicações obstétricas mais comuns encontradas nos períodos gestacional, parto e puerpério imediato de gestantes com fetos portadores de anomalias incompatíveis com a vida. MÉTODOS: Estudo descritivo, onde avaliou-se 78 prontuários de pacientes atendidas no pré-natal da Disciplina de Medicina Fetal da Universidade Federal de São Paulo que tiveram partos nessa mesma instituição, entre 2000 e 2006. RESULTADOS: As principais complicações obstétricas identificadas foram:variação do volume de líquido amniótico em 68%; abortamento, parto pré-termo e a gravidez prolongada estiveram presentes em 6,4%, 55,1% e 3,8% das gestações, respectivamente; óbito fetal intra-uterino em 17,9%; descolamento prematuro da placenta ocorreu em 6,4% e histerectomia em 2,6%. CONCLUSÃO: Estes resultados sugerem aumento de risco materno em gestações com fetos portadores de anomalias graves, fato que demonstra necessidade de avaliação especializada caso a caso.OBJETIVO: Describir las complicaciones obstétricas más comunes encontradas en los períodos de gestación, parto y puerperio inmediato de embarazadas con fetos portadores de anomalías incompatibles con la vida. MÉTODOS: Se trata de un estudio descriptivo, que evaluó 78 fichas médicas de pacientes atendidos en el prenatal de la Disciplina de Medicina Fetal de la Universidad Federal de Sao Paulo que tuvieron partos en esa misma institución, entre 2000 y 2006. RESULTADOS: Las principales complicaciones obstétricas identificadas fueron: variación del volumen de líquido amniótico en 68%; abortamiento, parto pre-término y embarazo prolongado estuvieron presentes en 6,4%, 55,1% y 3,8% de las gestaciones, respectivamente; muerte fetal intra-uterina en 17,9%; desprendimiento prematuro de la placenta ocurrió en 6,4% e histerectomía en 2,6%. CONCLUSIÓN: Éstos resultados sugieren un aumento del riesgo materno en gestaciones con fetos portadores de anomal

Two-year home-based nocturnal noninvasive ventilation added to rehabilitation in chronic obstructive pulmonary disease patients : A randomized controlled trial

NARCIS (Netherlands)

Duiverman, Marieke L.; Wempe, Johan B.; Bladder, Gerrie; Vonk, Judith M.; Zijlstra, Jan G.; Kerstjens, Huib A. M.; Wijkstra, Peter J.

2011-01-01

Background: The use of noninvasive intermittent positive pressure ventilation (NIPPV) in chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnic respiratory failure remains controversial as long-term data are almost lacking. The aim was to compare the outcome of 2-year

Accounting for Fetal Origins

DEFF Research Database (Denmark)

Dalgaard, Carl-Johan Lars; Hansen, Casper Worm; Strulik, Holger

2017-01-01

The Fetal Origins hypothesis has received considerable empirical support, both within epidemiology and economics. The present study compares the ability of two rival theoretical frameworks in accounting for the kind of path dependence implied by the Fetal Origins Hypothesis. We argue that while...

Angiotensin-(1-7 relieved renal injury induced by chronic intermittent hypoxia in rats by reducing inflammation, oxidative stress and fibrosis

Directory of Open Access Journals (Sweden)

W. Lu

Full Text Available We aimed to study the renal injury and hypertension induced by chronic intermittent hypoxia (CIH and the protective effects mediated by angiotensin 1-7 [Ang(1-7]. We randomly assigned 32 male Sprague-Dawley rats (body weight 180-200 g to normoxia control, CIH, Ang(1-7-treated normoxia, and Ang(1-7-treated CIH groups. Systolic blood pressure (SBP was monitored at the start and end of each week. Renal sympathetic nerve activity (RSNA was recorded. CTGF and TGF-β were detected by immunohistochemistry and western blotting. Tissue parameters of oxidative stress were also determined. In addition, renal levels of interleukin-6, tumor necrosis factor-α, nitrotyrosine, and hypoxia-inducible factor-1α were determined by immunohistochemistry, immunoblotting, and ELISA. TUNEL assay results and cleaved caspase 3 and 12 were also determined. Ang(1-7 induced a reduction in SBP together with a restoration of RSNA in the rat model of CIH. Ang(1-7 treatment also suppressed the production of reactive oxygen species, reduced renal tissue inflammation, ameliorated mesangial expansion, and decreased renal fibrosis. Thus, Ang(1-7 treatment exerted renoprotective effects on CIH-induced renal injury and was associated with a reduction of oxidative stress, inflammation and fibrosis. Ang(1-7 might therefore represent a promising therapy for obstructive sleep apnea-related hypertension and renal injury.

The number of fetal cells in maternal blood is associated to exercise and fetal gender

DEFF Research Database (Denmark)

Schlütter, Jacob Mørup; Kirkegaard, Ida; Christensen, Connie Britta

Introduction: We have established a robust method to specifically identify and isolate a placental fetal cell in maternal blood (fcmbs) at a gestational age of 12 weeks. The concentration of these cells, however, varies considerably among pregnant women (median 3 fcmbs/30 mL blood, range 0...... activity was obtained by a questionnaire and a structured interview. The number of fcmbs was assessed in 30 mL blood processed by a proprietary method developed in-house. Fetal cells in the blood, binding to fetal cell specific antibodies, were initially isolated by magnetic cell sorting. The fetal cells...... vs. 4, p=0.06) decreased the number of fcmbs, whereas coitus the evening before increased the number (4 vs. 3, p=0.11). Conclusion: The number of fcmbs is affected by normal activities. This should be taken into account when planning collection of fetal cells in connection for prenatal diagnosis...

Postoperative intermittent fasting prevents hippocampal oxidative stress and memory deficits in a rat model of chronic cerebral hypoperfusion.

Science.gov (United States)

Hu, Yuan; Zhang, Miao; Chen, Yunyun; Yang, Ying; Zhang, Jun-Jian

2018-01-11

Whether intermittent fasting (IF) treatment after stroke can prevent its long-term detrimental effects remains unknown. Here, we investigate the effects of postoperative IF on cognitive deficits and its underlying mechanisms in a permanent two-vessel occlusion (2VO) vascular dementia rat model. Rats were subjected to either IF or ad libitum feeding 1 week after 2VO surgery. The cognition of rats was assessed using the novel object recognition (NOR) task and Morris water maze (MWM) 8 weeks after surgery. After behavioral testing, hippocampal malondialdehyde (MDA) and glutathione (GSH) concentrations, superoxide dismutase (SOD) activity, gene expression of antioxidative enzymes, inflammatory protein levels, and microglia density were determined. Postoperative IF significantly ameliorated the cognitive performance of 2VO rats in the NOR and MWM tests. Cognitive enhancement paralleled preservation of the PSD95 and BDNF levels in the 2VO rat hippocampus. Mechanistically, postoperative IF mitigated hippocampal oxidative stress in 2VO rats, as indicated by the reduced MDA concentration and mRNA and the protein levels of the reactive oxygen species-generating enzyme nicotinamide adenine dinucleotide phosphate oxidase 1. IF treatment also preserved the GSH level and SOD activity, as well as the levels of their upstream regulating enzymes, resulting in preserved antioxidative capability. In addition, postoperative IF prevented hippocampal microglial activation and elevation of sphingosine 1-phosphate receptor 1 and inflammatory cytokines in 2VO rats. Our results suggest that postoperative IF suppresses neuroinflammation and oxidative stress induced by chronic cerebral ischemia, thereby preserving cognitive function in a vascular dementia rat model.

Fetal response to maternal hunger and satiation - novel finding from a qualitative descriptive study of maternal perception of fetal movements.

Science.gov (United States)

Bradford, Billie; Maude, Robyn

2014-08-26

Maternal perception of decreased fetal movements is a specific indicator of fetal compromise, notably in the context of poor fetal growth. There is currently no agreed numerical definition of decreased fetal movements, with the subjective perception of a decrease on the part of the mother being the most significant definition clinically. Both qualitative and quantitative aspects of fetal activity may be important in identifying the compromised fetus.Yet, how pregnant women perceive and describe fetal activity is under-investigated by qualitative means. The aim of this study was to explore normal fetal activity, through first-hand descriptive accounts by pregnant women. Using qualitative descriptive methodology, interviews were conducted with 19 low-risk women experiencing their first pregnancy, at two timepoints in their third trimester. Interview transcripts were later analysed using qualitative content analysis and patterns of fetal activity identified were then considered along-side the characteristics of the women and their birth outcomes. This paper focuses on a novel finding; the description by pregnant women of fetal behaviour indicative of hunger and satiation. Full findings will be presented in later papers. Most participants (74% 14 of 19) indicated mealtimes were a time of increased fetal activity. Eight participants provided detailed descriptions of increased activity around meals, with seven (37% 7 of 19) of these specifying increased fetal activity prior to meals or in the context of their own hunger. These movements were interpreted as a fetal demand for food often prompting the mother to eat. Interestingly, the women who described increased fetal activity in the context of hunger subsequently gave birth to smaller infants (mean difference 364 gm) than those who did not describe a fetal response to hunger. Food seeking behaviour may have a pre-birth origin. Maternal-fetal interaction around mealtimes could constitute an endocrine mediated

Digital atlas of fetal brain MRI

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Chapman, Teresa; Weinberger, E. [Department of Radiology, Seattle Children' s Hospital, Seattle, WA (United States); Matesan, Manuela [University of Washington, Department of Radiology, Seattle, WA (United States); Bulas, Dorothy I. [Division of Diagnostic Imaging and Radiology, Children' s National Medical Center, Washington, DC (United States)

2010-02-15

Fetal MRI can be performed in the second and third trimesters. During this time, the fetal brain undergoes profound structural changes. Interpretation of appropriate development might require comparison with normal age-based models. Consultation of a hard-copy atlas is limited by the inability to compare multiple ages simultaneously. To provide images of normal fetal brains from weeks 18 through 37 in a digital format that can be reviewed interactively. This will facilitate recognition of abnormal brain development. T2-W images for the atlas were obtained from fetal MR studies of normal brains scanned for other indications from 2005 to 2007. Images were oriented in standard axial, coronal and sagittal projections, with laterality established by situs. Gestational age was determined by last menstrual period, earliest US measurements and sonogram performed on the same day as the MR. The software program used for viewing the atlas, written in C, permits linked scrolling and resizing the images. Simultaneous comparison of varying gestational ages is permissible. Fetal brain images across gestational ages 18 to 37 weeks are provided as an interactive digital atlas and are available for free download. Improved interpretation of fetal brain abnormalities can be facilitated by the use of digital atlas cataloging of the normal changes throughout fetal development. Here we provide a description of the atlas and a discussion of normal fetal brain development. (orig.)