690 resultados para Perinatal
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Includes bibliography
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Preeclampsia (PE) is the most common medical complication in pregnancy and a major cause of maternal and fetal morbidity and mortality. This disease is a great challenge for obstetricians because there are no effective interventions to treat or prevent it, and antenatal care involves a difficult balance between the risks for women to continue pregnancy and the risks for the baby's early birth. Fetal complications in PE are directly related to gestational age and the severity of maternal disease and include increased rates of preterm delivery, intrauterine growth restriction, placental abruption, and perinatal death. The major complications for the newborn are related to prematurity, although the data on the morbidity and outcome for preterm infants of women who have PE are conflicting, and few studies address this issue. The pathogenesis of PE involves abnormal placentation associated with immune and vascular events that result in endothelial dysfunction and clinical manifestations of PE. This disease has been associated with imbalance in angiogenic factors and oxidative stress. Nevertheless, only a limited number of studies have been carried out on fetuses and newborns that suggest that infants born from women who have PE are exposed to increased oxidative stress. Because oxidative stress and free radicals may play roles in several neonatal diseases, a direct effect of maternal disease on neonatal outcome is expected, and further research on such neonates, in the short- and long-term, is urgently needed. © 2011 by the American Academy of Pediatrics.
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Objective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.Study Design: Prospective cohort of 484 infants with 23 0/7 to 266/7 weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ≥1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.Result: Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.Conclusion: In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. © 2012 Nature America, Inc.
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The purpose of this study was to identify the influence of physiological state, season, breed, number of lactations, dairy productivity, and stocking rate on infestation by Rhipicephalus microplus in dairy cows. Two hundred cows were selected through proportional representative sampling at the Seropédica Experimental Station (Pesagro-Rio), Brazil. Fully or partially engorged R. microplus females measuring between 4.5 and 8.0. mm were counted on the right side of each animal. The tick infestation prevalence data were analyzed in relation to the risk factors, using multiple logistic regression. Associations between prevalence and its possible influencing determinants were measured using odds ratios. The average tick count of cows during the peripartum and lactation periods was significantly higher (p<0.05; OR=4.82) than the count in dry cows. Taurine animals showed significantly higher infestation (p<0.05; OR=3.28) than pure zebuine animals. Among cross-bred animals, the infestation was higher (p<0.05) in F1 animals (1/2 taurine × 1/2 zebuine) than in Girolando animals (5/8 zebuine × 3/8 taurine). Primiparous cows (p<0.05) had significantly heavier infestations than multiparous cows. Dairy production showed a positive correlation with tick infestation (p<0.03; OR=2.94), such that the most productive animals were the most parasitized ones. Animals kept at high densities were significantly more heavily infested (p<0.05, OR=6.32) than animals kept at low density. First-lactation and high-productivity taurine animals were more vulnerable to R. microplus, thus comprising a high-risk group in dairy herds. © 2012 Elsevier GmbH.
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Obese Black women are at increased risk for development of gestational diabetes mellitus and have worse perinatal outcomes than do obese women of other ethnicities. Since hsp72 has been associated with the regulation of obesity-induced insulin resistance, we evaluated associations between glucose ingestion, hsp72 release and insulin production in Black pregnant women. Specifically, the effect of a 50-g glucose challenge test (GCT) on heat shock protein and insulin levels in the circulation 1 h later was evaluated. Hsp27 and hsp60 levels remained unchanged. In contrast, serum levels of hsp72 markedly increased after glucose ingestion (p = 0.0054). Further analysis revealed that this increase was limited to women who were not obese (body mass index <30). Insulin levels pre-GCT were positively correlated with body mass index (p = 0.0189). Median insulin concentrations also increased post GCT in non-obese women but remained almost unchanged in obese women. Post-GCT serum hsp72 concentrations were inversely correlated with post GCT insulin concentrations (p = 0.0111). These observations suggest that glucose intake during gestation in Black women rapidly leads to an elevation in circulating hsp72 only in non-obese Black women. The release of hsp72 may regulate the extent of insulin production in response to a glucose challenge and, thereby, protect the mother and/or fetus from development of hyperglycemia, hyperinsulinemia, and/or immune system alterations. © 2013 Cell Stress Society International.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Biologia Geral e Aplicada - IBB
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El estudio proporciona un panorama general sobre la situación de salud-enfermedad y del acceso a recursos y servicios de atención médica presentes en la comuna de Concepción. Previo el planteamiento del marco conceptual, el análisis se centra en: a) el diagnóstico regional local, incluyendo un examen en la calidad de vida de la población con énfasis en la morbilidad y los servicios de salud; b) diagnóstico del nivel institucional de salud de la región; c) la gestión administrativa y técnica del consultorio Tucapel a nivel de los recursos humanos y materiales, el clima organizacional y los programas de atención materna y perinatal, de planificación familiar, de alimentación complementaria, del adulto mayor, de atención infantil, de inmunizaciones y el programa odontológico; d) evaluación de la gestión y desarrollo de los programas; problemas identificados, consultas de especialidad y productividad del servicio
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Pós-graduação em Ciências Biológicas (Farmacologia) - IBB
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Patologia - FMB
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Pós-graduação em Pediatria - FMB
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB