Resiliência e apoio social em gestantes tardias

The gestation process, in general, is a very important event on a woman’s life and it brings phisical, phisiological and emotional changes, which by itself is an experience full of intense feelings. By late-aged pregnancy we mean those which occurs at the age of 35 or further. The occurance of this type of pregnancy is rising in Brasil and throughout the world, factors such as, better access to birth control resources and the search for financial stability explains the pregnancy delay. Important processes like resilience and social support can help late-aged pregnant women, in a benefical way, to adapt to the gestation process. Resilience is the capacity that a certain individual or group of individuals have to go through an adverse situation, be able to overcome it and become streghtened, transforming it in motivation for its biopsichosocial development. Social support is a complex and dinamic process that involves transactions between individuals and their social networks, meeting the social needs, promoting and complementing the personal resources that they have to face new demands. This research has the intention of raising information about the issues of late-aged pregnant women in the County of Natal- RN, the main objective was to evaluate the resilience indicators and the social support on late-aged pregnant women in the Natal-RN County. A transversal cut, correlational and descriptive research that was done with 150 lateaged pregnant women. The tools that were used were: A form with sociodemographic and gestation info, the scale of resilience and social support. An eletronic spreadsheet sofware (Excel e SPSS 21.0) was used to analize data which helped on the statistics according to its variables and the objective of this work. For the nominal variables, relative frequencies were used and for continuous the Pearson correlation and determination coefficient were used, regarding that; the sample had a normal distribution. The project fulfilled the ethnic aspects prescribed by Resolution 466/12 of the National Health Council, with a favorable decision (356.436/ 2013) of the UFRN Ethics on Research Committee. Most of the pregnant women had a low money income and education level, born in the state of Rio Grande do Norte they had an average age of 37,49 (±2,577), catholic, married, house wives, they had more than one child and were on their third trimester of pregnancy; they also had a low past abortion rate, not having planned their pregnancy, with an average of 4,22 (±2,506) pre-natal appointments, residing with an average of 3,673 (±1,397) people, having used any sort of birth control device and having high indicators of resilience and social support. The correlations kept between resilience, social support and some of the social demographics and gestation variables were considered low. Such data points out the fact that most of these women were in a stable relationship; they hadn’t had a past of abortion, they were involved with some kind of religion, they were not first pregnancy mothers, had an age on which they are not considered inexperienced mothers and even had scored high on the social support scale, these may all possibly be the most contributing factors on development and resilience building on these 35 years or more mothers. We expect that the data and information from this research may add up knowledge, actions and improvements regarding late-aged pregnant women and the pregnancy phenomena in general.

Receptores de citocinas proinflamatórias na pré-eclâmpsia

Preeclampsia is a disease specific of human pregnancy that affects 3-8% of pregnant women, and it is one of the three leading causes of maternal mortality and morbidity. The disease is characterized by hypertension and proteinuria after the 20th week of gestation. The risk factors for this disease are not completely understood but appear to include dysregulation of the immune response arising from defects in placentation, environmental and genetic factors. This study aimed to determine whether the variation in the amount of proinflammatory cytokine receptors IL-1R2, IL-6R and TNF-αR1 would be involved in preeclampsia. They were recruited women with preeclampsia (n=24) and women who evolved during pregnancy without changes in blood pressure (n=12) were recruited. Clinical and laboratory data were collected. The cytokine receptors (IL-1R2, TNF-αR1 and IL-6R) were assessed in mononuclear cells isolated from peripheral blood using flow cytometry (Control = 8; PE = 24). C-reactive protein (CRP) was determined by CRP ultrasensitive method (Control = 7; PE = 18) was performed using sera pregnant women. Women with preeclampsia had higher weight at the beginning of the pregnancy (p=0.0171) and lower gestational age at delivery (0.0008). Classical monocytes were decreased in preeclampsia but not intermediate or non-classical monocytes. The frequency of IL-1R2 pro inflammatory cytokine receptors is decreased in women with PE only in the subpopulation of non-classical monocytes (p = 0.0011). TNF-αR1 receptor and IL-6R, had a decreased frequency in the three subpopulations of monocyte (classic, intermediate and non-classical) when compared to women with normal pregnancy. An increase in IL-1R2 receptor in TCD4+ lymphocytes, but a decrease in TNF-receptor and IL-6R in women with preeclampsia were found. No differences in the frequency of those receptors in CD3+/CD8+ in preeclampsia. There was no difference in C-reactive protein in preeclampsia. The reduction in the amount of IL-1R2, TNF- αR1 and IL-6R monocytes and lymphocytes can be involved in the regulation of inflammation observed in preeclampsia, contributing to disease.

Análise do perfil imunológico e citohistológico durante a transmissão vertical de Trypanosoma cruzi em diferentes estágios da infecção experimental

Trypanosma cruzi is the causative agent of Chagas disease. This trypanosomiasis has become a global public health problem due to migration of Latin Americans to non-endemic countries. In Latin America with the succesful implementation of control domiciliated vector infestation and blood transfusion, the importance of congenital transmission has recently increased. Considering the tight regulation of immune system during gestation, we aimed to investigate the changes in the immune system caused by T.cruzi infection in the gestation outcome. T cruzi G and Y strain were used to infect female BALB/c mice before or after mating with non-infected male mice. The presence of vaginal plug was used as indicative of mating. Females were euthanized 8 days after confirmation of vaginal plug. We used three female control groups, only infected, only infected and non-infected and non-pregnant females. Two groups were infected before mating and other two were infected 4 days after confirmation of vaginal plug. The uterus and spleen were collected to immunochemistry, qPCR, immunofluorescence and cytokine analysis. Our results showed that despite the MMP’s identification being similarly among groups, T.cruzi higher virulent strain can impaire gestation outcome prior mating; the infection also increased cytokines like IFN-γ, IL-1β and IL-4; and leucocytes in uterine environment was altered, responding locally to systemic changes caused by T.cruzi infection. In conclusion this work suggests that T.cruzi infection can impaire gestation outcome and local response to sistemic infection was able to control the infection allowing pregnancy development in some conditions.

Utilização de peptídeos sintéticos derivados de moléculas imunodominantes de Toxoplasma gondii para diagnóstico sorológico da toxoplasmose em ovinos e galinhas caipiras

Chapter I - The obligate intracellular parasite Toxoplasma gondii is the causative agent of toxoplasmosis, a disease that affects humans and generates economic losses in farm animals. When prevention fails disease refers to the diagnosis and subsequent treatment if the individual is diagnosed as positive. Therefore, the development of new accurate diagnostic tools for detecting T. gondii infection is a need in particular to determine the environmental source of infection which can result in more appropriate public health policies against different routes of infection and prevent potential damage that toxoplasmosis can cause when animals are infected. Chapter II - The domestic chicken (Gallus gallus domesticus) are considered epidemiological sentinels, still representing a major source of recombinant strains when predated by cats, it is common to find them with multiple infections. We evaluate the diagnostic potential of six synthetic peptides (SAG2Y, MIC1, M2AP, GRA10, ROP2 and ROP7) predicted in silico from tachyzoites immunodominant markers of T. gondii in samples from naturally infected chickens, comparing synthetic peptides with antigen total soluble (STAg). In general, our results demonstrated that reactivity rates and positivity for these peptides are similar to the STAg, and the ROP7 peptide and the combination of peptides MIC1+ROP2 have significant sensitivity, confirming them as potential diagnostic tools for the diagnosis of toxoplasmosis in chickens. Chapter III - Sheep (Ovis aries) are commonly infected with Toxoplasma gondii due to his eating habits. Infection in pregnant sheep can have serious consequences such as embryonic death, fetal resorption, mummification, and neonatal death. One concern regarding the infection in these animals is that the meat can be a source of contamination to humans and other carnivores. Therefore perform accurate diagnosis in these animals is of fundamental importance. In the present study we evaluated the potential of new synthetic peptides as a diagnostic tool. Synthetic peptides (SAG2Y, SRS52A, MIC14, GRA4, GRA10 and GRA15) were predicted in silico from immunodominant proteins of T. gondii. We determine the levels of IgG antibodies using sera obtained from two farms in the city of Uberlândia. Analyzing the results together, the peptide combination GRA10+GRA15 (Accuracy = 0,82) showed better characteristics compared with the other mixtures. This preparation could be better analyzed with an antigenic mixture potential use in the diagnosis of toxoplasmosis in sheep and other species.

A radiologia dentária na gravidez

Aborda-se a biossegurança aplicada a radiologia dentária relativa à radiação ionizante e a exposição aos agentes biológicos, a que pacientes, grávidas / feto e profissionais são submetidos durante os procedimentos radiológicos. As diferentes doses de radiação emitidas, pelos equipamentos utilizados em radiologia oral, quer nos sistemas analógicos, como digitais. As diversas formas de propagação de micro-organismos, durante a obtenção de imagens radiográficas. As medidas de biossegurança, para prevenção desses riscos em radiologia dentária, através da radioprotecção e do controlo da infeção. A radiação ionizante pela sua elevada energia, é capaz de penetrar na matéria, ionizar os átomos, romper ligações químicas e causar danos nos tecidos biológicos. A exposição a doses elevadas de radiação ionizante pode ainda resultar, na destruição de células ou na indução de cancro. Atualmente a biossegurança em radiologia dentária, tem como principais objetivos, a redução da dose de radiação e evitar a infeção cruzada entre os diferentes agentes envolvidos.

Expectativas da grávida em relação ao parto

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Enfermagem

Intervenção Precoce com Jovens Mães

A Formação Parental poderá ser a chave para o sucesso de muitas famílias, principalmente para aquelas que se encontram menos preparadas para este novo papel, que é ser mãe ou pai, sobretudo quando ainda são jovens. Desta forma, o presente estudo tem como objetivos identificar quais as necessidades de formação de mães com filhos com idades compreendidas entre os 3 e 6 anos apoiadas pelo Centro da Mãe do Funchal; aplicar um programa de formação parental adequado às necessidades das mães; avaliar a evolução das competências e estilos parentais e comparar os resultados com outros estudos. Como já supramencionado, este estudo desenvolveu-se no Centro de Mãe do Funchal, Instituição Particular de Solidariedade Social, que tem como objetivo apoiar e/ou acolher grávidas adolescentes e jovens mães, com os seus filhos, em situação de risco. As participantes do estudo foram três assistentes sociais, uma psicóloga e seis jovens mães de crianças em idade pré-escolar, apoiadas pelo Centro de Mãe. A identificação das necessidades de formação das mães foi concretizada recorrendo a entrevistas semiestruturadas. Posteriormente, procedemos à adaptação de um programa de formação parental, baseando-o no programa “Escola de Mães” do estudo de Bernardo (2013). Após as alterações necessárias ao programa de formação parental, este foi aplicado às mães. Com o objetivo de avaliar a evolução das competências e estilos parentais, foi efetuada também uma entrevista antes e após a frequência da formação parental. De forma a consubstanciar esta avaliação foram utilizados três instrumentos validados para a população portuguesa, designadamente o Questionário de Estilos Parentais – Pais adaptado de Parental Authority Questionnaire PAQ, de Buri (1991, cit in Pires et al.,2011), a Escala de Estima de Si - S.E.R.T.H.U.A.L. adaptado de Tap et al., (2009) e a Escala de Autoeficácia Parental de Brites (2010). As alterações do estilo parental praticado antes e após a frequência do programa indicam que o Programa de formação parental teve um impacto positivo junto da maioria das participantes neste estudo. É de realçar ainda a evolução das competências parentais das mães, manifestadas na sua autoestima e na relação com os seus filhos.

Biologia reprodutiva, crescimento corporal e parâmetros demográficos de Cavia magna em uma ilha estuarina do extremo sul do Brasil

A teoria da história de vida tem como objetivo compreender os fatores que produzem variações na taxa de sobrevivência, tamanho no nascimento, idade de maturação, sazonalidade na reprodução, longevidade, razão sexual da prole. O gênero Cavia pallas 1776 apresenta a maior distribuição dentro da subfamília Cavinae, sendo composto por seis espécies, dentre elas Cavia magna, a qual habita regiões de restinga próximas a estuários ou lagos do norte do Uruguai ao sul do Brasil. Durante esse trabalho avaliamos os padrões da história de vida de uma população de Cavia magna da Ilha dos Marinheiros, RS, Brasil, devido ao fato de se tratar de uma espécie com baixa taxa reprodutiva, distribuição geográfica restrita, e estar exposta a alta pressão de predação. Para isso foi realizado um programa de captura-marcação-recaptura, durante 13 meses no qual foram capturados 129 animais, sendo 63 fêmeas e 66 machos. As longevidades máximas registradas, foram 233 dias para uma fêmea e 321 dias para um macho. Foram encontradas 13 fêmeas grávidas ou lactantes, dentre elas 9 estavam grávidas, sendo que 6 estavam prenhas de 2 filhotes e 3 estavam prenhas de 1 filhote apenas. Vários parâmetros foram testados, para estimar a taxa de sobrevivência e captura ,utilizamos o programa Mark, o método jacknife um modelo probabilístico, que permite heterogeneidade individual nas taxas de captura também foi utilizado. Não houve diferenças significativas no número de machos e fêmeas, a razão sexual foi 1:1. Em relação a estrutura etária, a população foi composta por adultos (82%) e a densidade populacional foi de 30 animais por hectare.

Cannabinoids impact on pregnancy: effects in trophoblast cells

Cannabinoids (CBs) can be classified as: phytocannabinoids, the constituents of the Cannabis sativa plant; synthetic cannabinoids lab-synthesized and the endocannabinoids that are endogenous lipid mediators. Cannabinoid compounds activate cannabinoid receptors – CB1 and CB2. The most prevalent psychoactive phytocannabinoid is Δ9tetrahydrocannabinol (THC), but more than 60 different CBs were already identified in the plant. The best characterized endocannabinoids (eCBs) are anandamide (AEA) and 2arachidonoylglycerol (2-AG), that are involved in several physiological processes including synaptic plasticity, pain modulation, energy homeostasis and reproduction. On the other hand, some synthetic cannabinoids that were initially designed for medical research, are now used as drugs of abuse. During the period of placental development, highly dynamic processes of remodeling occur, involving proliferation, apoptosis, differentiation and invasion of trophoblasts. It is known that a tight control of eCBs levels is required for normal pregnancy progression and that eCBs are involved in trophoblast cells turnover. Therefore, by sharing activation of the same receptors, exposure to exocannabinoids either by recreational or medicinal use may lead to alterations in the eCBs levels and in the endocannabinoid system homeostasis In this work, it was studied the impact of CBs in BeWo trophoblastic cells and in primary cultures of human cytotrophoblasts. Cells were treated for 24 hours with different concentrations of THC, the synthetic cannabinoid WIN‐55,212 (WIN) and 2-AG. Treatment with THC did not affect BeWo cells viability while WIN and 2-AG caused a dose-dependent viability loss. Morphological studies together with biochemical markers indicate that 2-AG is able to induce apoptosis in cytotrophoblasts. On the other hand, morphological studies after acridine orange staining suggest that autophagy may take part in WIN-induced loss of cell viability. All cannabinoids caused a decrease in mitochondrial membrane potential (Δψm) but only 2-AG led to ROS/RNS generation, though no changes in glutathione levels were observed. In addition, ER-stress may be involved in the 2-AG induced-oxidative stress, as preliminary results point to an increase in CCAAT-enhancer-binding protein homologous protein (CHOP) expression. Besides the decrease in cell viability, alterations in cell cycle progression were observed. WIN treatment induced a cell cycle arrest in G0/G1 phase, whereas 2-AG induced a cell cycle arrest in G2/M phase. Here it is reinforced the relevance of cannabinoid signaling in fundamental processes of cell proliferation and cell death in trophoblast cells. Since cannabis-based drugs are the most consumed illicit drugs worldwide and some of the most consumed recreational drugs by pregnant women, this study may contribute to the understanding of the impact of such substances in human reproduction.

Diagnóstico laboratorial de casos de importação de infeções por vírus Zika

O vírus Zika (Flavivirus) é um arbovírus transmitido sobretudo por mosquitos, mas também, por transmissão materno-fetal e sexual. Existem evidências que as infeções por vírus Zika podem estar associadas à síndrome de Guillian-Barré e a casos congénitos de microcefalia e outras malformações do sistema nervoso central. As infeções por vírus Zika, Dengue e Chikungunya partilham, atualmente, os mosquitos vetores, a sintomatologia e a distribuição geográfica. O Centro de Estudos de Vetores e Doenças Infeciosas do Instituto Nacional de Saúde Doutor Ricardo Jorge no seu Laboratório Nacional de Referência de Vírus Transmitidos por Vetores tem desenvolvido o diagnóstico e estudos epidemiológicos de vírus transmitidos por artrópodes desde o princípio dos anos 90. O diagnóstico de Zika foi desenvolvido e padronizado em 2007. O laboratório desenvolveu testes de diagnóstico molecular e serológico tendo identificado vários casos de importação para o território português e feito o diagnóstico diferencial com Dengue e Chikungunya e o despiste de infeção em grávidas e em casos de transmissão sexual.

Avaliação das concentrações hepáticas e séricas de retinol em bovinos e do consumo habitual de fígado por gestantes

The vitamin A is essential to animals because of its participation in a great number of biological functions. The investigation of this vitamin s concentrations is important to serve as reference to normality parameters. This study had as aim to analyse the serics and hepatics concentrations of vitamin A in two groups of bovines and to compare the hepatics concentrations to the present requeriments of vitamin A for pregnant women. It was also appraised the consume habit of bovine liver by pregnant women through of the alimentary frequency quest. Two groups of bovine were studied and the first was formad by Nelore bovine breed and the second by bovine without defined breed (WDB). It was analysed 120 samples: 60 of liver and 60 of serum. The method used to dose retinol was High Performance Liquid Cromatography (HPLC). The average (+ sd) of retinol concentrations in Nelore breed bovine and WDB liver were 16947,8 + 6866,9 and 5213,1 + 2517,2 µg of retinol/100g and at serum 39,6 + 17,9 e 28,6 + 9,4 µg of retinol/dL, respectively. No statistically significant correlation was found between hepatic and the serum retinol. The bovines in this study had adequate vitamin A levels. Independently of animal breed, the daily ingestion of bovine liver is not advised for pregnant women who show adequate support of vitamin A. The consume of bovine liver by pregnant women consulted on school maternity hospital Januário Cicco, UFRN, Natal RN, was considered high

Acolhimento institucional de mães adolescentes na ilha Terceira : entendimento, práticas e estruturas

Dissertação de Mestrado, Ciências Sociais, 16 de Setembro de 2016, Universidade dos Açores.

Segurança Alimentar - um trabalho de equipa

O esforço coletivo para disponibilizar a nível mundial alimentos em quantidade suficiente e com qualidade, é fundamental para a garantia da nossa existência enquanto ser humano. A Organização das Nações Unidas para a Alimentação e a Agricultura define que “existe Segurança Alimentar quando todas as pessoas têm, em todo o momento, acesso físico e económico a uma quantidade suficiente de alimentos seguros e nutritivos para satisfazer as suas necessidades alimentares e as suas preferências em relação aos alimentos a fim de levar uma vida ativa e saudável”. Por esta razão a produção de alimentos seguros requer um controlo de perigos em todas as fases da produção alimentar. Muitas vezes devido à utilização de água contaminada, falta de higiene, condições inadequadas de produção e armazenamento de alimentos, falta de legislação sobre segurança alimentar o risco de doenças transmitidas por alimentos é maior, sendo os perigos biológicos os que apresentam o maior risco relativo à inocuidade dos alimentos. As doenças infecciosas de origem alimentar podem estar na origem de doenças crónicas, afetando com mais gravidade idosos, crianças, grávidas e imunocomprometidos. A nível mundial, 1 em cada 10 pessoas adoecem anualmente devido ao consumo de alimentos contaminados, e 30% de todas as mortes por doença de origem alimentar ocorrem em crianças com idade inferior a 5 anos. A livre circulação de pessoas e bens tornou a investigação de um surto de toxinfeção alimentar mais complicada – agora, um prato de comida pode conter ingredientes de vários países, pelo que "Um problema de segurança alimentar local pode rapidamente tornar-se uma situação de emergência internacional". A OMS sublinha a ameaça global representada pelas doenças transmitidas por alimentos, reforça a necessidade de os governos, a indústria alimentar e população fazerem mais para tornar os alimentos seguros, e insiste na necessidade de educação e formação sobre a prevenção de doenças de origem alimentar.