Risk Prediction of Cardiovascular Complications in Pregnant Women With Heart Disease

Abstract Background: Heart disease in pregnancy is the leading cause of non- obstetric maternal death. Few Brazilian studies have assessed the impact of heart disease during pregnancy. Objective: To determine the risk factors associated with cardiovascular and neonatal complications. Methods: We evaluated 132 pregnant women with heart disease at a High-Risk Pregnancy outpatient clinic, from January 2005 to July 2010. Variables that could influence the maternal-fetal outcome were selected: age, parity, smoking, etiology and severity of the disease, previous cardiac complications, cyanosis, New York Heart Association (NYHA) functional class > II, left ventricular dysfunction/obstruction, arrhythmia, drug treatment change, time of prenatal care beginning and number of prenatal visits. The maternal-fetal risk index, Cardiac Disease in Pregnancy (CARPREG), was retrospectively calculated at the beginning of prenatal care, and patients were stratified in its three risk categories. Results: Rheumatic heart disease was the most prevalent (62.12%). The most frequent complications were heart failure (11.36%) and arrhythmias (6.82%). Factors associated with cardiovascular complications on multivariate analysis were: drug treatment change (p = 0.009), previous cardiac complications (p = 0.013) and NYHA class III on the first prenatal visit (p = 0.041). The cardiovascular complication rates were 15.22% in CARPREG 0, 16.42% in CARPREG 1, and 42.11% in CARPREG > 1, differing from those estimated by the original index: 5%, 27% and 75%, respectively. This sample had 26.36% of prematurity. Conclusion: The cardiovascular complication risk factors in this population were drug treatment change, previous cardiac complications and NYHA class III at the beginning of prenatal care. The CARPREG index used in this sample composed mainly of patients with rheumatic heart disease overestimated the number of events in pregnant women classified as CARPREG 1 and > 1, and underestimated it in low-risk patients (CARPREG 0).

Efeitos da aplicação de P, B, Zn e calagem no teor de boro e zinco das folhas de mudas de Eucalyptus grandis (Hill, Ex-Maiden) cultivadas em solo de cerrado

Foi desenvolvido em casa de vegetação, na E. S.A."Luiz de Queiroz", em Piracicaba (SP), um experimento, utilizando-se Latossol Vermelho Amarelo, fase arenosa, originalmente sob vegetação de cerrado, do município de Itirapina (SP), cujo objetivo foi estudar os efeitos de níveis de fósforo (0, 16 e 32 ppm), boro (0, 2 e 4 ppm), zinco (0, 3 e 6 ppm) e calagem (0 e 6,0 g CaCO3 + 2,5 g MgCO3) por vaso no teor de micronutrientes de folhas de Eucalyptus grandis (Hill, Ex-Maiden). O delineamento experimental utilizado foi inteiramente casualizado num esquema fatorial 3³ na presença e ausência de calagem. Cada parcela foi constituída de um vaso contendo 8,0 kg de terra e duas plantas. As adubações com boro e zinco aumentaram as concentrações desses micronutrientes nas folhas das plantas. Verificou-se acúmulo de boro nos tecidos das folhas, em níveis considerados tóxicos, quan do se adicionou ao solo 2 e 4 ppm de boro. A calagem diminuiu as concentrações de zinco das folhas das plantas.

Efeitos da aplicação de fósforo, boro, zinco e calagem na altura e na produção de matéria seca em mudas de Eucalyptus grandis (Hill, Ex-Maiden) cultivadas em um solo de cerrado

Foi desenvolvido um experimento em casa de vegetação na Escola Superior de Agricultura "Luiz de Queiroz", em Piracicaba (SP) utilizando-se Latossol Vermelho Amarelo, fase arenosa, originalmente sob vegetação de cerrado, do município de Itirapina (SP), com o objetivo de estudar o efeito de três níveis de P (0, 16 e 32 ppm), três níveis de B (0, 2 e 4 ppm), tres níveis de Zn (0, 3 e 6 ppm) e dois níveis de calagem (0 e 6,0 g CaCO3 + 2,5 g MgC0(3)) por cada vaso no crescimento em altura e na produção de matéria seca de mudas de Eucalyptus grandis (Hill, Ex-Maiden). A adubação fosfatada, provocou aumento no crescimento em altura e na produção de matéria seca das plantas. A adição de 2 e 4 ppm de boro ao solo, provocou efeitos de interação com calagem, fósforo e zinco, ocasionando alterações no crescimento em altura das plantas. A adição de 3 e 6 ppm de zinco ao solo, ocasionou interação com o boro e fósforo adicionados, diminuindo o crescimento em altura das plantas.

Efeitos da aplicação de fósforo, boro, zinco e calagem no teor de macronutrientes das folhas de mudas de Eucalyptus grandis (Hill, Ex-Maiden) Cultivadas em solo de cerrado

Utilizando-se um Latossol Vermelho Amarelo fase arenosa, originalmente sob vegetação de Cerrado do município de Itirapina (SP), foi desenvolvido um experimento em vasos, em casa de vegetação, na E. S.A. "Luiz de Queiroz", em Piracicaba (SP), com a finalidade de se verificar o efeito da aplicação de níveis de P (0, 16 e 32 ppm), níveis de B (0, 2 e 4 ppm), níveis de Zn (0, 3 e 6 ppm) e níveis de calagem (0 e 6,0 g CaCO3 + 2,5 g MgCO3) por cada vaso, na concentração de N, P, K, Ca e Mg das folhas de mudas de Eucalyptus grandis (Hill, Ex-Maiden), A calagem e as adubações fosfatadas, com boro ou com zinco, alteraram as concentrações dos macronutrientes dos tecidos foliares das plantas.

Biologia de Rolepa unimoda (Dognin,1923) (Lepidoptera, Lymantriidae) em folhas de Tabebuia avellanedae Lor. ex-griseb (Bignoniaceae) e observações sobre inimigos naturais

Este trabalho trata do estudo da biologia de Rolepa unimoda (Dognin,1923) (Lepidoptera, Lymantriidae), cujas lagartas são desfolhadoras em plantios ornamentais de Tabebuia avellanedae Lor. ex-Griseb (Bignoniaceae). Ataca também T. caraiba (Mart.) Burm. Os insetos foram criados em condições de laboratório (Temperatura 27±2°C; UR: 70 ± 15%, Fotoperíodo de 12 h), na Seção de Entomologia do Centro de Ciências Agrárias da Fundação Universidade Federal de Mato Grosso, em Cuiabá, MT. Foram estudados os seguintes parâmetros: período e viabilidade das fases de ovos,lagarta, pré-pupa e pupa; número e duração dos ínstares larvais e consumo foliar da fase de lagarta; longevidade dos adultos e proporção quanto ao sexo; inimigos naturais; plantas hospedeiras e ocorrência do inseto nos Estados de Mato Grosso e Mato Grosso do Sul.

Efeitos de diferentes níveis de N P K sobre o peso da matéria seca, na produção de mudas por via seminífera, do hedíquio amarelo, Hedychium gardnerianum sheppard ex ker-gawl, zingiberaceae

Estudou-se o efeito de aplicação de diferentes níveis de N P K: N = 0,200, 400; P = 0,400, 800 e K = 0,200, 400 kg/ha, em condições de campo na produção de mudas, por sementes, do hedíquio amarelo, Hedyohium gardnerianum Sheppard ex Ker-Gawl, Zingiberaceae, e sua influência sobre o peso da matéria seca. Através dos dados obtidos concluiu-se que a maior produção da matéria seca total, incluindo-se a parte aérea e o rizoma foram obtidos com os níveis de: a) 20g de N; 80 de P e 20 de K/m² b) 40g de N; 80 de P e 40 de K/m² c) 20g de N; 40 de P e 40 de K/m².

Mechanisms of immune protection in the asexual blood stage infection by Plasmodium falciparum: analysis by in vitro and ex-vivo assays

Mechanisms of immune protection against the asexual blood stage infection by Plasmodium falciparum are reviewed. Recent studies of two independent lines of research developed at the Institute Pasteur, in humans and primate infections clearly indicate an obligatory interaction of antibodies and effector cells to express the anti-parasitic effect.

The consequences of malaria infection in pregnant women and their infants

Preliminary results are presented from this study which indicate that 84.8 of pregnant women present at first antenatal visit with anemia (Hb 11g/dl) an 8.7 of their infants (n = 230) have a hemoglobin at birth below 14g/dl. There is an association between pregnancy anemia and malaria. A case control study in pregnant women and an infant cohort study to 18 months of age, are employed to study the cause and effects of anemia and malaria on women and their infants health.

Genital manifestations of schistosomiasis mansoni in women: important but neglected

Egg-induced lesions in the upper and the lower female reproductive tract are important complications of the infection with Schistosoma mansoni. The understanding of the pathophysiology and pathology of genital lesions is only rudimentary, simple and reliable diagnostic tools are not at hand, epidemiological data do not exist and how to treat best the women affected, is not known. In view of recent advances in the understanding of genital lesions induced by S. haematobium the existing literature is critically analysized and possible consequences of female genital schistosomiasis are outlined. We estimate that 6 to 27 % girls and women with intestinal schistosomiasis, at least temporarily, suffer from pathology induced by eggs sequestered somewhere in their genital organs. This is a mattern of concern and warrants more research into the epidemiology, pathology, diagnosis and therapy of this disease entity.

Plasmodium/intestinal helminth co-infections among pregnant Nigerian women

Hospital based studies were conducted to investigate the occurrence of Plasmodium/intestinal helminth co-infections among pregnant Nigerian women, and their effects on birthweights, anaemia and spleen size. From 2,104 near-term pregnant women examined, 816 (38.8%) were found to be infected with malaria parasites. Among the 816 parasitaemic subjects, 394 (48.3%) were also infected with intestinal helminths, 102 (12.5%) having mixed helminth infections. The prevalence of the helminth species found in stool samples of parasitaemic subjects examined was, Ascaris lumbricoides (19.1%), hookworm (14.2%), Trichuris trichiura (7%) Schistosoma mansoni (3.4%), Enterobius vermicularis (2%), Hymenolepis sp. (1.6%) and Taenia sp. (1%). Mothers with Plasmodium infection but without intestinal helminth infection had neonates of higher mean birthweights than those presenting both Plasmodium and intestinal helminth infections and this effect was more pronounced in primigravids. The mean haemoglobin values of malarial mothers with intestinal helminth infections were lower than those with Plasmodium infection but without intestinal helminth infections but these were not statistically significant. Severe splenomegaly was predominant among parasitaemic gravidae who also harboured S. mansoni infection in two of the hospitals studied.

Viral Hepatitis Markers in Antepartum and Postpartum Women in Rio de Janeiro, Brazil

A seroprevalence study was carried out among a group of women in Rio de Janeiro to determine the prevalence of different markers for viral hepatitis given the limited data among healthy populations. Blood samples collected and tested from 874 women before or after delivery in a public county maternity hospital demonstrated age to be directly related to markers for hepatitis A virus and hepatitis B virus (HBV) infection. The prevalence of HBV and hepatitis C virus infection were lower than that observed in the blood donor population and might be explained by the younger age group and gender.

First characterization of Candida albicans by random amplified polymorphic DNA method in Nicaragua and comparison of the diagnosis methods for vaginal candidiasis in Nicaraguan women

A total of 106 women with vaginitis in Nicaragua were studied. The positive rate for the identification of Candida species was 41% (44 positive cultures out of 106 women with vaginitis). The sensitivity of microscopic examination of wet mount with the potassium hydroxide (KOH) was 61% and 70% with Gram's stain when using the culture of vaginal fluid as gold standard for diagnosis of candidiasis. Among the 44 positives cultures, isolated species of yeast from vaginal swabs were C. albicans (59%), C. tropicalis (23%), C. glabrata (14%) and C. krusei (4%). This study reports the first characterization of 26 C. albicans stocks from Nicaragua by the random amplified polymorphic DNA method. The genetic analysis in this small C. albicans population showed the existence of linkage disequilibrium, which is consistent with the hypothesis that C. albicans undergoes a clonal propagation.

Prevalence of Chlamydia trachomatis in human immunodeficiency virus-infected women in Cuba

To determine the prevalence rates and serovar distribution of Chlamydia trachomatis cervical infections in Cuban women, two different groups were selected. Group I consisted of 60 human immunodeficiency virus (HIV-1) seropositive women from different regions of Cuba and group II of 60 randomly selected women HIV seronegative and apparently healthy. C. trachomatis was detected in cervical scrapes by mean of nested polymerase chain reaction (PCR) specific for major out membrane protein. The overall prevalence rate of C. trachomatis in cervical scrapes determined by nested PCR was 10% in group I and the estimated prevalence was 6.6% for group II; 83.3% of HIV seropositive women with C. trachomatis infection reported history of pelvic inflammatory disease followed by cervicitis (50%). The control group C. trachomatis-infected women referred a history of cervicitis in 75% of cases. Other reports in the latter group included infertility and pelvic inflamatory disease in 50%. The present study is the first report of C. trachomatis prevalence in Cuba. It showed that there was not significantly difference in the prevalence rate of C. trachomatis between both groups.