Effets de l'amnioinfusion en présence de liquide amniotique méconial épais sur les anomalies du rythme cardiaque foetal

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Anomalies de la tolérance au glucose secondaires à la fibrose kystique : relations avec le statut clinique

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies: a European register-based study

Evidence of an association between early pregnancy exposure to selective serotonin reuptake inhibitors (SSRI) and congenital heart defects (CHD) has contributed to recommendations to weigh benefits and risks carefully. The objective of this study was to determine the specificity of association between first trimester exposure to SSRIs and specific CHD and other congenital anomalies (CA) associated with SSRI exposure in the literature (signals). A population-based case-malformed control study was conducted in 12 EUROCAT CA registries covering 2.1 million births 1995-2009 including livebirths, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly. Babies/fetuses with specific CHD (n = 12,876) and non-CHD signal CA (n = 13,024), were compared with malformed controls whose diagnosed CA have not been associated with SSRI in the literature (n = 17,083). SSRI exposure in first trimester pregnancy was associated with CHD overall (OR adjusted for registry 1.41, 95% CI 1.07-1.86, fluoxetine adjOR 1.43 95% CI 0.85-2.40, paroxetine adjOR 1.53, 95% CI 0.91-2.58) and with severe CHD (adjOR 1.56, 95% CI 1.02-2.39), particularly Tetralogy of Fallot (adjOR 3.16, 95% CI 1.52-6.58) and Ebstein's anomaly (adjOR 8.23, 95% CI 2.92-23.16). Significant associations with SSRI exposure were also found for ano-rectal atresia/stenosis (adjOR 2.46, 95% CI 1.06-5.68), gastroschisis (adjOR 2.42, 95% CI 1.10-5.29), renal dysplasia (adjOR 3.01, 95% CI 1.61-5.61), and clubfoot (adjOR 2.41, 95% CI 1.59-3.65). These data support a teratogenic effect of SSRIs specific to certain anomalies, but cannot exclude confounding by indication or associated factors.

Impacts of Recent Climate Anomalies: Losers and Winners

Illinois State Water Survey

Resting energy expenditure, macronutrient utilization, and body composition in term infants after corrective surgery of major congenital anomalies: a case-study

Introduction - Knowledge on the metabolic changes and nutritional needs during the postsurgical anabolic phase in infants is scarce. This analysis explores the associations of resting energy expenditure (REE) and macronutrient utilization with body composition of full-term infants, during catch-up growth after corrective surgery of major congenital anomalies. Methods - A cohort of full-term appropriate for-gestational-age neonates subjected to corrective surgery of major congenital anomalies were recruited after gaining weight for at least one week. REE and macronutrient utilization, measured by respiratory quotient (RQ), were assessed by indirect calorimetry using the Deltatrac II Metabolic Monitor ®. Body composition, expressed as fat-free mass (FFM), fat mass (FM) and adiposity defined as percentage of FM (% FM), was measured by air displacement plethysmography using the Pea Pod ®. Results - Four infants were included at 3 to 5 postnatal weeks. Recommended energy and macronutrient intakes for healthy term infants were provided. Through the study, the median (min-max) REE (Kcal/Kg FFM/d) was 70.8 (60.6-96.1) and RQ was 0.99 (0.72-1.20). Steady increases in both body weight and FFM were associated with initial decrease in FM and adiposity followed by their increase. Low RQ preceded decrease in adiposity. Conclusion - The marked adiposity depletion, not expected during steady weight gain in the postsurgical period, prompts us to report this finding. The subsequent adiposity catch-up was associated with relatively high REE and RQ, suggesting preferential oxidation of carbohydrates and preservation of lipids for fat storage.

Primary prevention of neural tube defects: data from the portuguese national registry of congenital anomalies (RENAC)

Background: In Portugal folic acid supplementation is recommended to start at least 2-3 months before conception for primary prevention of Neural Tube Defects. The aim of this study was to evaluate, within gestations with at least one congenital anomaly, possible association between maternal socio-demographic factors and the use of folic acid. Methods: Using data from the Portuguese national registry of congenital anomalies, for the 2004-2013 period, the association between folic acid use during pregnancy and maternal characteristics was studied using the chi-square test. Results: Considering all reported cases with congenital anomaly, the use of folic acid before conception was reported by 12.7% (n = 1233) of the women; 47.8% (n = 4623) started supplementation during the 1st trimester, 7% (n = 680) did not take folic acid and 32.5% (3143) of the records had no information on folic acid use. Women with professions that require higher academic differentiation started the use of supplements before pregnancy (p <0.001); women under 19 years old and with Arab ethnicity (p <0.001) did not take folic acid. Mothers with a previous pregnancy reported less use of folic acid (11.5% versus 14.7%) than mothers without a previous pregnancy (p <0.001). Conclusions: The results suggest some degree of association between maternal characteristics and use of folic acid. To increase the consumption of folic acid before pregnancy new measures are need to promote this primary prevention, among couples and health professionals. This study highlights some maternal characteristics and subgroups of mothers for who the measures should be reinforced.

Is there a relation between environmental exposure to teratogenic substances during pregnancy and congenital anomalies in the newborn? A pilot study in Portugal

Background: Maternal occupation as a proxy of environmental exposure has been consistently associated with specific congenital anomalies (CA) in the foetus and newborn. On the other hand, geographical location of the mother such as place of residence and place of work have not been used as proxy for environmental exposures during pregnancy. We designed a pilot study aiming to investigate the association between maternal place of residence and workplace during pregnancy and CA in Portugal. Methods: Cases and controls are identified in the maternity unit. Cases are all live births with at least one CA delivered in the Barreiro hospital located in a heavy industrial area near Lisboa. Controls are the two normal births following each case. Residents outside the study area, stillbirths and women who decline to participate or are incapable of giving consent are excluded. A health professional interviews the mothers using a questionnaire adapted from the registry form of the Portuguese national registry of CA and includes information on places during pregnancy (residence, workplace, leisure), and demographic characterization as place of birth, infant sex, weight, description of CA, age of mother, ethnicity, maternal birth place. Maternal health and obstetric history, education, smoking, alcohol, drugs and medication use is also collected as potential confounders. Results: The pilot study started in January 2016 and at the moment two cases and four controls have been recruited without refusals. The study will continue to be implemented and it is proposed to start in other hospital units during 2016.

Absence of prenatal ultrasound surveillance: Data from the Portuguese congenital anomalies registry

In Portugal, prenatal care guidelines advocate two prenatal ultrasound scans for all pregnant women. Not following this recommendation is considered inadequate prenatal surveillance. The National Registry of Congenital Anomalies (RENAC in Portuguese) is an active population-based registry and an important instrument for the epidemiological surveillance of congenital anomalies (CA) in Portugal. Regarding pregnancies with CA, this study aims to describe the epidemiology of absent prenatal ultrasound scans and factors associated with this inadequate surveillance.

Reading Performance in Children with Visual Function Anomalies

Aims: To compare reading performance in children with and without visual function anomalies and identify the influence of abnormal visual function and other variables in reading ability. Methods: A cross-sectional study was carried in 110 children of school age (6-11 years) with Abnormal Visual Function (AVF) and 562 children with Normal Visual Function (NVF). An orthoptic assessment (visual acuity, ocular alignment, near point of convergence and accommodation, stereopsis and vergences) and autorefraction was carried out. Oral reading was analyzed (list of 34 words). Number of errors, accuracy (percentage of success) and reading speed (words per minute - wpm) were used as reading indicators. Sociodemographic information from parents (n=670) and teachers (n=34) was obtained. Results: Children with AVF had a higher number of errors (AVF=3.00 errors; NVF=1.00 errors; p<0.001), a lower accuracy (AVF=91.18%; NVF=97.06%; p<0.001) and reading speed (AVF=24.71 wpm; NVF=27.39 wpm; p=0.007). Reading speed in the 3rd school grade was not statistically different between the two groups (AVF=31.41 wpm; NVF=32.54 wpm; p=0.113). Children with uncorrected hyperopia (p=0.003) and astigmatism (p=0.019) had worst reading performance. Children in 2nd, 3rd, or 4th grades presented a lower risk of having reading impairment when compared with the 1st grade. Conclusion: Children with AVF had reading impairment in the first school grade. It seems that reading abilities have a wide variation and this disparity lessens in older children. The slow reading characteristics of the children with AVF are similar to dyslexic children, which suggest the need for an eye evaluation before classifying the children as dyslexic.

The Southeast Indian Ridge between 88°E and 118°E: Gravity anomalies and crustal accretion at intermediate spreading rates

Although slow spreading ridges characterized by a deep axial valley and fast spreading ridges characterized by an axial bathymetric high have been extensively studied, the transition between these two modes of axial morphology is not well understood. We conducted a geophysical-survey of the intermediate spreading rate Southeast Indian Ridge between 88 degrees E and 118 degrees E, a 2300-km-long section of the ridge located between the Amsterdam hot spot and the Australian-Antarctic Discordance where satellite gravity data suggest that the Southeast Indian Ridge (SEIR) undergoes a change from an axial high in the west to an axial valley in the east. A basic change in axial morphology is found near 103 degrees 30'E in the shipboard data; the axis to the west is marked by an axial high, while a valley is found to the east. Although a well-developed axial high, characteristic of the East Pacific Rise (EPR), is occasionally present, the more common observation is a rifted high that is lower and pervasively faulted, sometimes with significant (> 50 m throw) faults within a kilometer of the axis. A shallow axial valley (< 700 m deep) is observed from 104 degrees E to 114 degrees E with a sudden change to a deep (>1200 m deep) valley across a transform at 114 degrees E. The changes in axial morphology along the SEIR are accompanied by a 500 m increase in near-axis ridge flank depth from 2800 m near 88 degrees E to 3300 m near 114 degrees E and by a 50 mGal increase in the regional level of mantle Bouguer gravity anomalies over the same distance, The regional changes in depth and mantle Bouguer anomaly (MBA) gravity can be both explained by a 1.7-2.4 km change in crustal thickness or by a mantle temperature change of 50 degrees C-90 degrees C. In reality, melt supply (crustal thickness) and mantle temperature are linked, so that changes in both may occur simultaneously and these estimates serve as upper bounds. The along-axis MBA gradient is not uniform. Pronounced steps in the regional level of the MBA gravity occur at 103 degrees 30'E-104 degrees E and at 114 degrees E-116 degrees E and correspond to the changes in the nature of the axial morphology and in the amplitude of abyssal hill morphology suggesting that the different forms of morphology do not grade into each other but rather represent distinctly different forms of axial (s)tructure and tectonics with a sharp transition between them. The change from an axial high to an axial valley requires a threshold effect in which the strength of the lithosphere changes quickly. The presence or absence of a quasi-steady state magma chamber may provide such a mechanism. The different forms of axial morphology are also associated with different intrasegment MBA gravity patterns. Segments with an axial high have an MBA low located at a depth minimum near the center of the segment, At EPR-like segments, the MBA low is about 10 mGal with along-axis gradients of 0.15-0.25 mGal/km, similar to those observed at the EPR, Rifted highs have a shallower low and lower gradients suggesting an attenuated composite magma chamber and a reduced and perhaps episodic melt supply. Segments with a shallow axial valley have very flat along-axis MBA profiles with little correspondence between axial depth and axial MBA gravity.

Thinning of the Goban Spur continental margin and formation of early oceanic crust: Constraints from forward modelling and inversion of marine magnetic anomalies

The deep seismic reflection profile Western Approaches Margin (WAM) cuts across the Goban Spur continental margin, located southwest of Ireland. This non-volcanic margin is characterized by a few tilted blocks parallel to the margin. A volcanic sill has been emplaced on the westernmost tilted block. The shape of the eastern part of this sill is known from seismic data, but neither seismic nor gravity data allow a precise determination of the extent and shape of the volcanic body at depth. Forward modelling and inversion of magnetic data constrain the shape of this volcanic sill and the location of the ocean-continent transition. The volcanic body thickens towards the ocean, and seems to be in direct contact with the oceanic crust. In the contact zone, the volcanic body and the oceanic magnetic layer display approximately the same thickness. The oceanic magnetic layer is anomalously thick immediately west of the volcanic body, and gradually thins to reach more typical values 40 km further to the west. The volcanic sill would therefore represent the very first formation of oceanic crust, just before or at the continental break-up. The ocean-continent transition is limited to a zone 15 km wide. The continental magnetic layer seems to thin gradually oceanwards, as does the continental crust, but no simple relation is observed between their respective thinnings.

Size anomalies in EU bank stock returns

Mestrado em Finanças

Geochemistry Of Acid Mine Drainage From A Coal Mining Area And Processes Controlling Metal Attenuation In Stream Waters, Southern Brazil.

Acid drainage influence on the water and sediment quality was investigated in a coal mining area (southern Brazil). Mine drainage showed pH between 3.2 and 4.6 and elevated concentrations of sulfate, As and metals, of which, Fe, Mn and Zn exceeded the limits for the emission of effluents stated in the Brazilian legislation. Arsenic also exceeded the limit, but only slightly. Groundwater monitoring wells from active mines and tailings piles showed pH interval and chemical concentrations similar to those of mine drainage. However, the river and ground water samples of municipal public water supplies revealed a pH range from 7.2 to 7.5 and low chemical concentrations, although Cd concentration slightly exceeded the limit adopted by Brazilian legislation for groundwater. In general, surface waters showed large pH range (6 to 10.8), and changes caused by acid drainage in the chemical composition of these waters were not very significant. Locally, acid drainage seemed to have dissolved carbonate rocks present in the local stratigraphic sequence, attenuating the dispersion of metals and As. Stream sediments presented anomalies of these elements, which were strongly dependent on the proximity of tailings piles and abandoned mines. We found that precipitation processes in sediments and the dilution of dissolved phases were responsible for the attenuation of the concentrations of the metals and As in the acid drainage and river water mixing zone. In general, a larger influence of mining activities on the chemical composition of the surface waters and sediments was observed when enrichment factors in relation to regional background levels were used.