Fatores determinantes do near miss materno em uma unidade de terapia intensiva obstétrica

OBJETIVO:Avaliar os fatores determinantes da morbimortalidade em unidade de terapia intensiva obstétrica de um hospital universitário.MÉTODOS:Estudo observacional de corte transversal com 492 gestantes ou puérperas. Foram selecionadas pacientes internadas na unidade de terapia intensiva obstétrica no período de um ano, sendo informadas sobre as propostas do estudo e realizada aplicação do questionário. A análise foi feita através do Microsoft Excel 2013 e GraphPad Prism 6. Foram empregados testes do χ2 para verificar associação entre os fatores de risco para morbimortalidade materna grave.RESULTADOS: Foram encontrados como riscos relativos significativamente elevados para desenvolvimento de near missquando comparada à morbidade materna grave, a raça não branca (OR=2,5; RP=2,3); pacientes casadas (OR=7,9; RP=7,1), escolaridade até 2º grau incompleto (OR=3,1; RP=2,8), procedente do interior (OR=4,6; RP=4,0), renda familiar menor que 1 salário mínimo (OR=7,0; RP=5,5), distúrbios hipertensivos gestacionais (OR=16,3; RP=13,2), realização do pré-natal (OR=5,0; RP=4,2) e a via de parto cesárea (OR=39,2; RP=31,2).CONCLUSÕES: Questões socioeconômicas, clínicas e assistenciais mostraram-se relacionados à prevalência de near miss, revelando a importância de intervenções amplas para melhorar esses indicadores. Reforça-se a importância da realização de pré-natal para identificação de riscos potenciais, garantia de um suporte nutricional à gestante, tratamento de doenças e estabelecimento de programa de imunização materna, assim como uma melhor assistência no que tange aos aspectos clínicos das pacientes, objetivando diminuir o risco obstétrico e neonatal.

Normal median near nerve potential

In routine studies of sensory nerve conduction, only fibers e7 µm in diameter are analyzed. The late components which originate from thinner fibers are not detected. This explains why a normal sensory action potential (SAP) may be recorded in patients with peripheral neuropathies and sensory loss. In the present study we investigated the late component of the median SAP with a near nerve needle electrode technique in 14 normal volunteers (7 men and 7 women), aged 34.5 ± 14.8 years. The stimulus consisted of rectangular pulses of 0.2-ms duration at a frequency of 1 Hz with an intensity at least 6 times greater than the threshold value for the main component. Five hundred to 2000 sweep averagings were performed. The duration of analysis was 40 or 50 ms and the wave analysis frequency was 200 (-6 dB/oct) to 3000 Hz (-12 dB/oct). We used an apparatus with a two-channel amplifier system, 200 MW or more of entry impedance and a noise level of 0.7 µVrms or less. The main component mean amplitude, conduction velocity and latency and the late component mean amplitude, conduction velocity and latency were respectively (mean ± SD): 26.5 ± 5.42 µV, 56.8 ± 5.42 m/s, 3.01 ± 0.31 ms, 0.12 ± 0.04 µV, 16.4 ± 2.95 m/s and 10.6 ± 2.48 ms. More sophisticated equipment has an internal noise of 0.6 µVrms. These data demonstrate that the technique can now be employed to study thin fiber neuropathies, like in leprosy, using commercial electromyographs, even in non-academic practices

Regulation of the expression of NADP-malic enzyme by UV-B, red and far-red light in maize seedlings

The induction of nicotinamide adenine dinucleotide phosphate-malic enzyme (NADP-ME) in etiolated maize (Zea mays) seedlings by UV-B and UV-A radiation, and different levels of photosynthetically active radiation (PAR, 400-700 nm) was investigated by measuring changes in activity, protein quantity and RNA levels as a function of intensity and duration of exposure to the different radiations. Under low levels of PAR, exposure to UV-B radiation but not UV-A radiation for 6 to 24 h caused a marked increase in the enzyme levels similar to that observed under high PAR in the absence of UV-B. UV-B treatment of green leaves following a 12-h dark period also caused an increase in NADP-ME expression. Exposure to UV-B radiation for only 5 min resulted in a rapid increase of the enzyme, followed by a more gradual rise with longer exposure up to 6 h. Low levels of red light for 5 min or 6 h were also effective in inducing NADP-ME activity equivalent to that obtained with UV-B radiation. A 5-min exposure to far-red light following UV-B or red light treatment reversed the induction of NADP-ME, and this effect could be eliminated by further treatment with UV-B or red light. These results indicate that physiological levels of UV-B radiation can have a positive effect on the induction of this photosynthetic enzyme. The reducing power and pyruvate generated by the activity of NADP-ME may be used for respiration, in cellular repair processes and as substrates for fatty acid synthesis required for membrane repair.

Atherogenic lipid profile of Brazilian near-term newborns

Cardiovascular disease is the primary cause of death in Brazil. Recent studies have shown that low birth weight and preterm birth are linked to a higher prevalence of cardiovascular disease. The aim of the present study was to compare the levels of lipids and apolipoproteins and atherogenic indexes between term and near-term newborn infants. A sample of umbilical cord blood was obtained from 135 newborns (66 males) divided into two groups: 25 near-term neonates (35-36.6 weeks of gestational age) and 110 term neonates (37-42 weeks of gestational age). The total cholesterol concentrations were higher in the near-term neonates than in the term group (94.04 ± 8.02 vs 70.42 ± 1.63 mg/dl, P < 0.01), due to an increase in the LDL-cholesterol fraction in the near-term group (57.76 ± 6.39 vs 34.38 ± 1.29 mg/dl, P < 0.001). The atherogenic indexes (total cholesterol/HDL-cholesterol, LDL-cholesterol/HDL-cholesterol and apolipoprotein B/apolipoprotein A-I) were higher in the near-term group (P < 0.001, P < 0.001, and P < 0.05, respectively). The gestational age of the newborns was inversely correlated with total cholesterol and LDL-cholesterol, and also with the total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol indexes. These findings demonstrate that the lipid profile is worse in the group of near-term neonates compared with the term group. Future studies are needed to determine if this atherogenic profile in near-term neonates can affect body metabolism, increasing the risk for cardiovascular diseases in adult life.

High pressure near infrared study of the mutated light-harvesting complex LH2

The pressure sensitivities of the near infrared spectra of the light-harvesting (LH2) complex and a mutant complex with a simplified BChl-B850 binding pocket were compared. In the mutant an abrupt change in the spectral properties occurred at 250 MPa, which was not observed with the native sample. Increased disorder due to collapse of the chromophore pocket is suggested.

An HPLC-UV method for the measurement of permeability of marker drugs in the Caco-2 cell assay

The Caco-2 cell line has been used as a model to predict the in vitro permeability of the human intestinal barrier. The predictive potential of the assay relies on an appropriate in-house validation of the method. The objective of the present study was to develop a single HPLC-UV method for the identification and quantitation of marker drugs and to determine the suitability of the Caco-2 cell permeability assay. A simple chromatographic method was developed for the simultaneous determination of both passively (propranolol, carbamazepine, acyclovir, and hydrochlorothiazide) and actively transported drugs (vinblastine and verapamil). Separation was achieved on a C18 column with step-gradient elution (acetonitrile and aqueous solution of ammonium acetate, pH 3.0) at a flow rate of 1.0 mL/min and UV detection at 275 nm during the total run time of 35 min. The method was validated and found to be specific, linear, precise, and accurate. This chromatographic system can be readily used on a routine basis and its utilization can be extended to other permeability models. The results obtained in the Caco-2 bi-directional transport experiments confirmed the validity of the assay, given that high and low permeability profiles were identified, and P-glycoprotein functionality was established.

STABILITY OF OILS HEATED BY MICROWAVE: UV - SPECTROPHOTOMETRIC EVALUATION

The effects of microwave heating on the oxidative stability of refined canola, corn and soybean oils were determined by absorptivity in the UV spectrum and by chemical analysis (peroxide and acid values). Samples were heated in a microwave oven (800 W, 2,450 MHz) for 0 to 36 min. Microwave heating produced oxidative degradation in the three oils. Absorptivity at 232 and 270 nm increased gradually with an increase in microwave exposure time (0-36 min) for canola, corn and soybean oils. Values of absorptivity at 232 nm increased from 4.812, 3.568 and 4.183 to 10.579, 12.874 and 15.950 after 36 min of heating canola, corn and soybean oil, respectively. The absorptivity at 232nm, due to the formation of conjugated dienes, was a good index for measuring the degradation of microwaved samples. UV scanning (220 - 320 nm) detected alterations in the spectrum of microwaved samples. Acid value also increased within 36 min of heating for all oils. Peroxide value showed a significant difference (P<0.05) in the initial stage of heating (0-6 min) for all oils. After this period it could not be correlated with absorptivity at 232 nm, due to the instability of hydroperoxides at high temperatures.

Determinação simultânea de amarelo tartrazina e amarelo crepúsculo em alimentos via espectrofotometria UV-VIS e métodos de calibração multivariada

Os corantes sintéticos são usualmente adicionados a alimentos industrializados para conferir e restaurar a cor obtendo-se a qualidade estética desejada. Em função destes aspectos e do potencial toxicológico que alguns corantes podem apresentar, o controle de qualidade destes compostos é de fundamental importância. Neste trabalho, foi estudado o potencial das metodologias matemáticas como o princípio da aditividade, espectrofotometria derivativa e técnica multivariada (Regressão por Mínimos Quadrados Parciais - PLSR) na determinação simultânea de dois corantes alimentícios: Amarelo Crepúsculo (AC) e Amarelo Tartrazina (AT), extraídos com lã natural. Estas metodologias foram avaliadas e comparadas em função das suas capacidades de previsão, sendo que o modelo PLSR otimizado (faixa espectral de 305 a 645 nm, empregando-se 1ª derivada como transformação dos dados e 2 componentes principais) apresentou o menor valor de Raiz Quadrada da Soma dos Erros de Previsão (RMSEP) (AT = 0,191 e AC = 0,102). A faixa de concentração estudada foi de 1,0 a 16,0 mg.L-1 para AC e de 2,0 a 22,0 mg.L-1 para AT. O conjunto de validação externa apresentou erros relativos médios de 1,97% para AC e 1,39% para AT. A aplicação desta metodologia em amostras reais mostrou que em todas as amostras analisadas as concentrações destes corantes estavam de acordo com os limites estabelecidos pela legislação brasileira

Biochemical and color changes of fresh-cut melon (Cucumis melo L. cv. Galia) treated with UV-C

The importance of minimally processed commodities in the retail groceries of most developed countries has been rising continuously during the last decades. Cantaloupe melon is used more than any other fruit in fresh-cut processing. Ultraviolet (UV) light has been extensively used to simulate biological stres in plants and for determining resistance mechanisms of plant tissues. In this study the effect of ultraviolet irradiation on some properties of fresh-cut cantalope melon was determined during storage. Freshly cut cantalope melons cubes treated with ultraviolet irradiation at the doses of 1, 2 or 3 min before storage, and then placed in a cold room at 5±1°C temperature and 85-90% RH. Hue angle values of control group is low compared to UV-C treated samples, whereas L values of is high. EL of UV treated samples higher than those of control group. Total soluble solids of fresh-cut melon samples in UC3 treatment increased during storage. The results indicate that UV-C treatments on fresh-cut cantaloupe melon cubes increased total soluble solids independently from water loss.

Postharvest UV-B treatments increased fructose content of tomato (Solanum lycopersicon L. cv. Tayfun F1) harvested at different ripening stages

Abstract In the postharvest stage, taste and flavor are the key components of the marketability of tomato. Therefore, greater emphasis is now being placed on improving traits such as sugar content. In this study postharvest ultraviolet-B (UV-B) treatments on sugar, total soluble solids, and color of tomatoes harvested at different stages were investigated. Tomatoes harvested at turning, pink, and red stages were treated with two different doses of UV-B irradiation: UVB4 and UVB8. Color L* and hue angle values of tomatoes treated with UV-B were found to be high, which means the red color of tomatoes was improved. UVB4 treatments increased the color a* and saturation index values of tomatoes at pink and red harvest stage, although it did not affect at the turning stage. Additionally, UV-B irradiation treatments had no effect on sucrose content of the tomatoes. Fructose, glucose, and TSS content of tomatoes treated with UVB8 at red harvest stage were found to be high. Hence, the results obtained from this study are of great importance in terms of providing an increase in the amount of sugar without the need for breeding, and also consumer satisfaction.

Comparison of baseline data between chronic kidney disease patients starting hemodialysis who live near and far from the dialysis center

Introduction: The treatment offered to chronic kidney disease (CKD) patients before starting hemodialysis (HD) impacts prognosis. Objective: We seek differences among incident HD patients according to the distance between home and the dialysis center. Methods: We included 179 CKD patients undergoing HD. Patients were stratified in two groups: "living near the dialysis center" (patients whose hometown was in cities up to 100 km from the dialysis center) or as "living far from the dialysis center" (patients whose hometown was more than 100 km from the dialysis center). Socioeconomic status, laboratory results, awareness of CKD before starting HD, consultation with nephrologist before the first HD session, and type of vascular access when starting HD were compared between the two groups. Comparisons of continuous and categorical variables were performed using Student's t-test and the Chi-square test, respectively. Results: Ninety (50.3%) patients were classified as "living near the dialysis center" and 89 (49.7%) as "living far from the dialysis center". Patients living near the dialysis center were more likely to know about their condition of CKD than those living far from the dialysis center, respectively 46.6% versus 28.0% (p = 0.015). Although without statistical significance, patients living near the dialysis center had more frequent previous consultation with nephrologists (55.5% versus 42.6%; p = 0.116) and first HD by fistula (30.0% versus 19.1%; p = 0.128) than those living far from the dialysis center. Conclusion: There are potential advantages of CKD awareness, referral to nephrologists and starting HD through fistula among patients living near the dialysis center.