929 resultados para Early pregnancy failure, intravaginal, misoprostol, missed abortion, oral, surgical evacuation
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Introducción: La aparición de vasodilatación aislada de la arteria cerebral media en fetos pequeños para la edad gestacional sin otros cambios en el doppler puede interpretarse como fisiológica o podría ser la manifestación inicial de una restricción de crecimiento intrauterino de inicio tardío. Se pretende evaluar la asociación de la disminución del índice de pulsatibilidad de la arteria cerebral media, como predictor de desenlaces perinatales adversos, en fetos con bajo peso para edad gestacional. Metodología: Se realizó un estudio de cohorte analítica de temporalidad histórica para determinar si el hallazgo de disminución de la pulsatibilidad en el doppler de arteria cerebral media se asocia con el pronóstico perinatal adverso, en fetos pequeños para edad gestacional mediante un muestreo no probabilístico. Resultados: Se recolectaron un total de 325 flujometría doppler de fetos pequeños para edad gestacional. El riesgo de parto pretérmino fue RR 2.6 IC95% 1.6-4.1, de hospitalización fue RR 1.4 IC95%1.1-1.9 y de muerte fue 2.1 IC95%1.5-3.2 cuando hay índice de pulsatilidad alterada en la arteria cerebral media. La regresión logística mostró que el riesgo de desenlaces desfavorables con alteraciones en la arteria cerebral media fue de RR 4.2 IC95% 2.5-7.1 ajustado por edad materna, edad gestacional y bajo peso al nacer. Discusión Los pacientes expuestos presentan mayor riesgo de desenlaces desfavorables con diferencias significativas, no así en otros estudios publicados. El presente estudio muestra asociaciones significativas que debe ser evaluada con estudios más amplios.
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Comparar el resultado de la resonancia magnética en el diagnóstico de apendicitis aguda con el patrón de oro (estudio histopatológico o seguimiento clínico del paciente) con el fin de establecer la utilidad de ésta como prueba diagnóstica y poder incluirla dentro del algoritmo de estudio de esta patología cuando hay sospecha clínica y un resultado negativo o dudoso de la ecografía abdominal
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ANTECEDENTES: El aislamiento de células fetales libres o ADN fetal en sangre materna abre una ventana de posibilidades diagnósticas no invasivas para patologías monogénicas y cromosómicas, además de permitir la identificación del sexo y del RH fetal. Actualmente existen múltiples estudios que evalúan la eficacia de estos métodos, mostrando resultados costo-efectivos y de menor riesgo que el estándar de oro. Este trabajo describe la evidencia encontrada acerca del diagnóstico prenatal no invasivo luego de realizar una revisión sistemática de la literatura. OBJETIVOS: El objetivo de este estudio fue reunir la evidencia que cumpla con los criterios de búsqueda, en el tema del diagnóstico fetal no invasivo por células fetales libres en sangre materna para determinar su utilidad diagnóstica. MÉTODOS: Se realizó una revisión sistemática de la literatura con el fin de determinar si el diagnóstico prenatal no invasivo por células fetales libres en sangre materna es efectivo como método de diagnóstico. RESULTADOS: Se encontraron 5,893 artículos que cumplían con los criterios de búsqueda; 67 cumplieron los criterios de inclusión: 49.3% (33/67) correspondieron a estudios de corte transversal, 38,8% (26/67) a estudios de cohortes y el 11.9% (8/67) a estudios casos y controles. Se obtuvieron resultados de sensibilidad, especificidad y tipo de prueba. CONCLUSIÓN: En la presente revisión sistemática, se evidencia como el diagnóstico prenatal no invasivo es una técnica feasible, reproducible y sensible para el diagnóstico fetal, evitando el riesgo de un diagnóstico invasivo.
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Estudo sobre a problemática da Evasão Escolar na Educação de Jovens e Adultos – EJA da Unidade de Educação Básica Alberto Pinheiro em São Luís – Maranhão. Fundamenta-se na análise da literatura sobre as políticas de Educação de Jovens e Adultos no Brasil, no estado da arte sobre a evasão escolar desse segmento de ensino e ainda na análise dos documentos escolares, relatórios e atas de avaliação, que subsidiaram esta investigação. Aplicaram-se questionários e entrevistas, além de pesquisa de campo através da observação direta. Os sujeitos investigados foram os ex-alunos evadidos, professores e pedagogos desse segmento de ensino. A pesquisa indicou que nesse segmento da EJA existe um percentual consistente de evasão escolar, cujas causas vão desde a necessidade de trabalhar até a baixa escolaridade da família. Os resultados mostram o perfil de uma clientela que em sua maioria deseja estudar, mas é impelida a se evadir por diversos motivos, como: a falta de tempo, distância entre o domicílio e a escola, gravidez precoce e despreparo dos professores que atuam nessa modalidade de ensino. Conclui-se que existe a necessidade de melhora das condições físicas e estruturais da oferta da EJA, o que compreende a valorização do professor e as condições materiais da escola.
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BACKGROUND: Trophoblast invasion is a temporally and spatially regulated scheme of events that can dictate pregnancy outcome. Evidence suggests that the potent mitogen epidermal growth factor (EGF) regulates cytotrophoblast (CTB) differentiation and invasion during early pregnancy. METHODS AND RESULTS: In the present study, the first trimester extravillous CTB cell line SGHPL-4 was used to investigate the signalling pathways involved in the motile component of EGF-mediated CTB migration/invasion. EGF induced the phosphorylation of the phosphatidylinositol 3-kinase (PI3-K)-dependent proteins, Akt and GSK-3β as well as both p42/44 MAPK and p38 mitogen-activated protein kinases (MAPK). EGF-stimulated motility was significantly reduced following the inhibition of PI3-K (P < 0.001), Akt (P < 0.01) and both p42/44 MAPK (P < 0.001) and p38 MAPKs (P < 0.001) but not the inhibition of GSK-3β. Further analysis indicated that the p38 MAPK inhibitor SB 203580 inhibited EGF-stimulated phosphorylation of Akt on serine 473, which may be responsible for the effect SB 203580 has on CTB motility. Although Akt activation leads to GSK-3β phosphorylation and the subsequent expression of β-catenin, activation of this pathway by 1-azakenpaullone was insufficient to stimulate the motile phenotype. CONCLUSION: We demonstrate a role for PI3-K, p42/44 MAPK and p38 MAPK in the stimulation of CTB cell motility by EGF, however activation of β-catenin alone was insufficient to stimulate cell motility.
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In the pregnant mouse uterus, small leucine-rich proteoglycans (SLRPs) are drastically remodeled within a few hours after fertilization, suggesting that ovarian hormone levels modulate their synthesis and degradation. In this study, we followed by immunoperoxidase approach, the presence of four members of the SLRP family (decorin, lumican, biglycan, and fibromodulin) in the uterine tissues along the estrous cycle of the mouse. All molecules except fibromodulin, which predominates in the myometrium, showed a striking modulation in their distribution in the endometrial stroma, following the rise in the level of estrogen. Moreover, notable differences in the distribution of SLRPs were observed between superficial and deep stroma, as well as between the internal and external layers of the myometrium. Only biglycan and fibromodulin were expressed in the luminal and glandular epithelia. All four SLRPs were found in cytoplasmic granules of mononucleated cells. The pattern of distribution of the immunoreaction for these molecules in the uterine tissues was found to be estrous cycle-stage dependent, suggesting that these molecules undergo ovarian hormonal control and probably participate in the preparation of the uterus for decidualization and embryo implantation. In addition, this and previous results from our laboratory suggest the existence of two subpopulations of endometrial fibroblasts that may be related to the centrifugal development of the decidua. Anat Rec, 292:138-153, 2009. (c) 2008 Wiley-Liss, Inc.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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The objective of this study was to evaluate the use of probit and logit link functions for the genetic evaluation of early pregnancy using simulated data. The following simulation/analysis structures were constructed: logit/logit, logit/probit, probit/logit, and probit/probit. The percentages of precocious females were 5, 10, 15, 20, 25 and 30% and were adjusted based on a change in the mean of the latent variable. The parametric heritability (h²) was 0.40. Simulation and genetic evaluation were implemented in the R software. Heritability estimates (ĥ²) were compared with h² using the mean squared error. Pearson correlations between predicted and true breeding values and the percentage of coincidence between true and predicted ranking, considering the 10% of bulls with the highest breeding values (TOP10) were calculated. The mean ĥ² values were under- and overestimated for all percentages of precocious females when logit/probit and probit/logit models used. In addition, the mean squared errors of these models were high when compared with those obtained with the probit/probit and logit/logit models. Considering ĥ², probit/probit and logit/logit were also superior to logit/probit and probit/logit, providing values close to the parametric heritability. Logit/probit and probit/logit presented low Pearson correlations, whereas the correlations obtained with probit/probit and logit/logit ranged from moderate to high. With respect to the TOP10 bulls, logit/probit and probit/logit presented much lower percentages than probit/probit and logit/logit. The genetic parameter estimates and predictions of breeding values of the animals obtained with the logit/logit and probit/probit models were similar. In contrast, the results obtained with probit/logit and logit/probit were not satisfactory. There is need to compare the estimation and prediction ability of logit and probit link functions.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Purpose: To evaluate the placental glycogen storage and fetal development in the pregnancy of neonatally streptozocin-induced diabetic rats and to establish relation with glycemia and insulin levels. Methods: At the birth day, 147 female rats were randomly distributed in two experimental groups: 1) Non-diabetic Group (Control, n=45) - received the vehicle; 2) Diabetic Group (STZ, n=102) received 100 mg streptozocin/kg in neonatal period. At day 0 of pregnancy, adult female rats were included in the control group when presented glycemia below 120 mg/dL and, in the group STZ with glycemia between 120 and 300 mg/dL. At day 21 of pregnancy, blood samples were collected for glycemia and insulin determination, and placentas withdrawn for placental glycogen determination. The newborns (NB) were classified in small (SGA), appropriate (AGA) and large (LGA) for gestational age. Results: Rats STZ presented higher glycemia at days 0 and 14 of pregnancy. At end of pregnancy, rats STZ showed higher proportion of NB SGA and LGA; reduced rate of NB AGA and unaltered glycemia, insulin and placental glycogen determinations. Conclusion: Mild diabetes altered the maternal glycemia in the early pregnancy, impairing future fetal development, but it caused no alteration on insulin and placental glycogen determination, confirming that this glycemic intensity was insufficient to change glycogen metabolism.
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The main objectives of this work were to determine the physiological patterns of progesterone on pregnancy and lactation in ewes, and to verify whether the hormone presents a 24h secretion rhythm. Serum levels of progesterone increased during gestation with an abrupt decrease by two days preterm. The autocorrelation analysis showed that this hormone, had a more evident circadian rhythm on preterm, than during early pregnancy and lactation.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Guinea pig related rodents possess numerous derived placental characters. We attempt to identify diversity within the visceral yolk sac and its association with the chorioallantoic placenta in three species of caviids, two of them possessing a capsule formed by the decidua that covers the chorioallantoic placenta. The results verify that in early pregnancy all three species have in inverted yolk sac placenta. In advanced pregnancy the species differ: Galea spixii, as representative without a capsule, bear a yolk sac in apposition to the chorioallantoic placenta with signs of exchange activity until term. Galea is similar to other caviomorphs in this respect. In Dasyprocta leporina and Cuniculus paca, the representatives possessing a capsule, the yolk sac endoderm lacks signs of substance exchange. Evidently, the presence of a capsule prevents such ail interaction. The variations established here must be considered if animal models for human placentation are required which have restricted access to the chorioallantoic placenta from the outside. (C) 2008 Elsevier Ltd. All rights reserved.
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This study aimed to use the generalized linear models with probit and logit link function to evaluate early pregnancy, and to observe the effects on genetic variability and on sire selection when different ages are adopted in the definition of this trait. Early pregnancy was studied at 15 (EP15), and 21 (EP21) months. The analysis was done in R software. Pearson correlations (PC), between genetic predicted values and percentage of bulls in common considering only 10% of bulls with higher genetic values (TOP 10), between classification by logit and probit models and in each model among EP15 and EP21, were calculated. The heritability for EP15 and EP21 were close between models, except for EP15 using probit link function. PC and TOP10 among models were high. The Akaike and Bayesian criteria reported was similar between models. TOP10, considering the same model, among EP15-EP21 were moderated between EP15-EP21.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)