Prevalencia de lesao do septo nasal em prematuros no uso de prongas nasais

O objetivo do estudo foi investigar a prevalência e os fatores associados à lesão do septo nasal em prematuros sob uso de ventilação não invasiva. Estudo transversal, cujos dados foram coletados entre março e julho de 2012 por meio de busca em prontuários, entrevistas às mães e avaliação nasal de 47 prematuros, na Unidade Neonatal de um Hospital Universitário da cidade do Recife, Pernambuco, região nordeste do Brasil. Realizou-se análise estatística descritiva e bivariada por meio do teste qui-quadrado ou Exato de Fisher, utilizando o software SPSS. A prevalência de lesão nasal foi de 68,1%, associada ao baixo peso ao nascer e à duração do tratamento. A prevalência de lesão nasal na população estudada é elevada e associa-se ao baixo peso ao nascer e ao tempo de permanência em ventilação não invasiva. Infere-se a necessidade de ações preventivas, como cuidados de Enfermagem contínuos, adequação dos dispositivos e educação permanente em serviço.

Role of Chlamydia trachomatis in miscarriage.

To determine the role of Chlamydia trachomatis in miscarriage, we prospectively collected serum, cervicovaginal swab specimens, and placental samples from 386 women with and without miscarriage. Prevalence of immunoglobulin G against C. trachomatis was higher in the miscarriage group than in the control group (15.2% vs. 7.3%; p = 0.018). Association between C. trachomatis-positive serologic results and miscarriage remained significant after adjustment for age, origin, education, and number of sex partners (odds ratio 2.3, 95% confidence interval 1.1-4.9). C. trachomatis DNA was more frequently amplified from products of conception or placenta from women who had a miscarriage (4%) than from controls (0.7%; p = 0.026). Immunohistochemical analysis confirmed C. trachomatis in placenta from 5 of 7 patients with positive PCR results, whereas results of immunohistochemical analysis were negative in placenta samples from all 8 negative controls tested. Associations between miscarriage and serologic/molecular evidence of C. trachomatis infection support its role in miscarriage.

Identification of a new cancer/testis gene family, CT47, among expressed multicopy genes on the human X chromosome.

Cancer/testis (CT) genes are normally expressed in germ cells only, yet are reactivated and expressed in some tumors. Of the approximately 40 CT genes or gene families identified to date, 20 are on the X chromosome and are present as multigene families, many with highly conserved members. This indicates that novel CT gene families may be identified by detecting duplicated expressed genes on chromosome X. By searching for transcript clusters that map to multiple locations on the chromosome, followed by in silico analysis of their gene expression profiles, we identified five novel gene families with testis-specific expression and >98% sequence identity among family members. The expression of these genes in normal tissues and various tumor cell lines and specimens was evaluated by qualitative and quantitative RT-PCR, and a novel CT gene family with at least 13 copies was identified on Xq24, designated as CT47. mRNA expression of CT47 was found mainly in the testes, with weak expression in the placenta. Brain tissue was the only positive somatic tissue tested, with an estimated CT47 transcript level 0.09% of that found in testis. Among the tumor specimens tested, CT47 expression was found in approximately 15% of lung cancer and esophageal cancer specimens, but not in colorectal cancer or breast cancer. The putative CT47 protein consists of 288 amino acid residues, with a C-terminus rich in alanine and glutamic acid. The only species other than human in which a gene homologous to CT47 has been detected is the chimpanzee, with the predicted protein showing approximately 80% identity in its carboxy terminal region.

Biologicals and fetal cell therapy for wound and scar management.

Few biopharmaceutical preparations developed from biologicals are available for tissue regeneration and scar management. When developing biological treatments with cellular therapy, selection of cell types and establishment of consistent cell banks are crucial steps in whole-cell bioprocessing. Various cell types have been used in treatment of wounds to reduce scar to date including autolog and allogenic skin cells, platelets, placenta, and amniotic extracts. Experience with fetal cells show that they may provide an interesting cell choice due to facility of outscaling and known properties for wound healing without scar. Differential gene profiling has helped to point to potential indicators of repair which include cell adhesion, extracellular matrix, cytokines, growth factors, and development. Safety has been evidenced in Phase I and II clinical fetal cell use for burn and wound treatments with different cell delivery systems. We present herein that fetal cells present technical and therapeutic advantages compared to other cell types for effective cell-based therapy for wound and scar management.

Correlation between placental bacterial culture results and histological chorioamnionitis: a prospective study on 376 placentas.

OBJECTIVE: To study the correlation between the bacteriological and histopathological findings in placentas from women with suspected or proven chorioamnionitis (CA). METHODS: Over a 1-year period, 376 placentas were prospectively collected and processed for bacteriological and pathological studies in cases of confirmed or suspected maternal or neonatal infection. RESULTS: Histological CA was diagnosed in 26.9% of placentas (101/376), and 27.7% (28/101) of these placentas had positive bacteriological cultures. A monomicrobial culture, mainly represented by Gram-positive cocci and Gram-negative bacilli, was identified in 27% of the positive bacterial cultures. The proportion of positive cultures was higher (p=0.03) when CA was associated with funisitis, as compared with placental samples with early CA. In placentas without histological CA, bacteriological cultures were mostly negative (230/275), although pathogenic bacteria were identified in 16.3% of them (45/275). CONCLUSIONS: The histological and bacteriological results were concordant in about 70% of the examined placentas, with 61.1% negative cases (CA absent and negative bacterial cultures), and only 7.4% placentas with positive histological and bacteriological results. Discordant results (positive histology with negative bacteriology) were obtained in placentas with early CA documented by histology although possibly in relation with antibiotic prophylaxis and the presence of fastidious bacteria. Conversely, negative histology with positive bacteriology could be explained by the presence of an early-stage bacterial infection that has not yet led to detectable microscopic lesions.

Avaliação Patológica da Estrutura de um Edifício Situado na Encosta de Vila Nova

Actualmente existe um grande número de edifícios no mundo em estado de deterioração, visto que, apresentam manifestações patológicas de diferentes tipos, nomeadamente como descolamento e, especialmente, fissuras, nos elementos que constituem os edifícios, como alvenarias e partes das estruturas de betão armado. Acerca destes, os cuidados devem ser específicos, pois os fenómenos patológicos verificados podem comprometer toda a estrutura. Neste trabalho estudou-se a aplicação de metodologias de avaliação do grau de deterioração de edificações, com o objectivo de caracterizar uma edificação a nível estrutural e funcional. Avalia-se com base no diagnóstico à necessidade de intervenção, nos aspectos de desempenho, estética, segurança e funcionalidade da obra como um todo. Foi realizado um levantamento para registo das manifestações patológicas, seguido de análise do histórico da obra, ensaio complementar e diagnóstico das manifestações detectadas. Com este trabalho pretende-se obter conhecimentos a fim de aprofundar na avaliação de estrutura de modo que diminui as patologias na estrutura e também na prevenção das novas patologias.

Automedicação na gravidez

A automedicação é um problema de saúde pública visto que traz várias consequências para a saúde das pessoas principalmente no período da gravidez, nesse sentido torna-se essencial realizar estudo nessa área em Cabo Verde como forma de informar as pessoas sobre os malefícios e assim evitar esse ato. Este trabalho é o resultado de uma pesquisa realizada com as grávidas que frequentam o Centro de Saúde Reprodutiva de Bela Vista cujo tema é “ A Automedicação na gravidez”. Trata-se de um estudo quantitativo, de carácter exploratório cujo objetivo é Identificar as informações que as grávidas têm sobre a automedicação na gravidez. A amostra foi constituída por 55 grávidas que frequentam o Centro de Saúde Reprodutiva de Bela Vista entre os meses de Maio e Junho de 2015, como instrumento de recolha de informações foi utilizado o inquérito por questionário. Com a investigação pode-se concluir que a maioria das grávidas têm informações sobre a automedicação na gravidez, sendo que 78,2% tem informações das consequências que a automedicação acarreta, exemplificando o aborto espontâneo, mal formações congénitas, perda de líquido, atraso mental, reações alérgicas, parto prematuro. No entanto nota-se que apenas 21,8% das grávidas não tem informações, logo a necessidade de mais informações por parte dos enfermeiros de forma a concientiza-las sobre os riscos que a automedicação traz. Também é importante ressaltar que a maioria (90,91%) não praticou a automedicação na gravidez, o que mostra que as informações fornecidas pelos enfermeiros foram bem compreendidas pela maioria das grávidas, sendo que apenas 9,09% das grávidas praticou este ato. Isso evidencia que nem todas as grávidas tiveram informações sobre a automedicação por parte dos enfermeiros ou não as assimilaram como deve ser.Pode-se ver que os enfermeiros têm vindo a trabalhar nessa temática na medida em que 69,1% das grávidas tiveram orientações sobre a automedicação na gravidez, o que ajuda na diminuição da prática da automedicação na medida em que tendo estas informações dos riscos que este ato pode trazer evitam a sua prática.

hShroom1 links a membrane bound protein to the actin cytoskeleton.

hShroom1 (hShrm1) is a member of the Apx/Shroom (Shrm) protein family and was identified from a yeast two-hybrid screen as a protein that interacts with the cytoplasmic domain of melanoma cell adhesion molecule (MCAM). The characteristic signature of the Shrm family is the presence of a unique domain, ASD2 (Apx/Shroom domain 2). mRNA analysis suggests that hShrm1 is expressed in brain, heart, skeletal muscle, colon, small intestine, kidney, placenta and lung tissue, as well a variety of melanoma and other cell lines. Co-immunoprecipitation and bioluminescence resonance energy transfer (BRET) experiments indicate that hShrm1 and MCAM interact in vivo and by immunofluorescence microscopy some co-localization of these proteins is observed. hShrm1 partly co-localises with beta-actin and is found in the Triton X-100 insoluble fraction of melanoma cell extracts. We propose that hShrm1 is involved in linking MCAM to the cytoskeleton.

Differentiation of trophoblast giant cells and their metabolic functions are dependent on peroxisome proliferator-activated receptor beta/delta.

Mutation of the nuclear receptor peroxisome proliferator-activated receptor beta/delta (PPARbeta/delta) severely affects placenta development, leading to embryonic death at embryonic day 9.5 (E9.5) to E10.5 of most, but not all, PPARbeta/delta-null mutant embryos. While very little is known at present about the pathway governed by PPARbeta/delta in the developing placenta, this paper demonstrates that the main alteration of the placenta of PPARbeta/delta-null embryos is found in the giant cell layer. PPARbeta/delta activity is in fact essential for the differentiation of the Rcho-1 cells in giant cells, as shown by the severe inhibition of differentiation once PPARbeta/delta is silenced. Conversely, exposure of Rcho-1 cells to a PPARbeta/delta agonist triggers a massive differentiation via increased expression of 3-phosphoinositide-dependent kinase 1 and integrin-linked kinase and subsequent phosphorylation of Akt. The links between PPARbeta/delta activity in giant cells and its role on Akt activity are further strengthened by the remarkable pattern of phospho-Akt expression in vivo at E9.5, specifically in the nucleus of the giant cells. In addition to this phosphatidylinositol 3-kinase/Akt main pathway, PPARbeta/delta also induced giant cell differentiation via increased expression of I-mfa, an inhibitor of Mash-2 activity. Finally, giant cell differentiation at E9.5 is accompanied by a PPARbeta/delta-dependent accumulation of lipid droplets and an increased expression of the adipose differentiation-related protein (also called adipophilin), which may participate to lipid metabolism and/or steroidogenesis. Altogether, this important role of PPARbeta/delta in placenta development and giant cell differentiation should be considered when contemplating the potency of PPARbeta/delta agonist as therapeutic agents of broad application.

Diagnostic value of MRI for the detection of suspected placental invasion: Does it depend on observers' experience?

Purpose: To evaluate the diagnostic value of specific MR features for detection of suspected placental invasion according to observers' experience.Methods and Materials: Our study population included 25 pregnant women (mean age 35.16) investigated by prenatal MRI. In twelve out of them placental invasion was histopathologically proven, the 13 other women (52%) without placental invasion served as control group. Multiplanar T1- and T2-weighted sequences had been performed mostly without IV contrast injection (1.5 T). MR examinations of the two groups were rendered anonymous, mixed, then independently and retrospectively reviewed by two senior and two junior radiologists in view of 8 MR features indicating placentar invasion including the degree. Results were compared with surgical diagnosis (placenta normal/increta/accreta/percreta). Interobserver agrement between senior and junior readers were calculated. Stepwise logistic regression and receiver operating (ROC) curvers were performed.Results: Demographics between the two groups were not statistically different. Overall sensitivity and specificity for detecting placentar invasion was 90.9% and 75.0% for senior readers, and 81.8% and 61.8% for junior readers respectively. The most significant MR features indicating placentar invasion were T2 hypointense placental bands, followed by placenta praevia, focally interrupted myometrial border, posterior placental insertion, and heterogeneous placental signal. For each of the evaluated MR features the interobserver agreement kappa between the two senior readers was superior than that between the junior readers, ranging from bad (<0.4) to good (0.4-0.75).Conclusions: MRI can be a reliable and reproducible tool for detection of suspected placentar invasion, however very variable according to the observers' experience.

Identification of CT46/HORMAD1, an immunogenic cancer/testis antigen encoding a putative meiosis-related protein.

Transcripts with ESTs derived exclusively or predominantly from testis, and not from other normal tissues, are likely to be products of genes with testis-restricted expression, and are thus potential cancer/testis (CT) antigen genes. A list of 371 genes with such characteristics was compiled by analyzing publicly available EST databases. RT-PCR analysis of normal and tumor tissues was performed to validate an initial selection of 20 of these genes. Several new CT and CT-like genes were identified. One of these, CT46/HORMAD1, is expressed strongly in testis and weakly in placenta; the highest level of expression in other tissues is &lt;1% of testicular expression. The CT46/HORMAD1 gene was expressed in 31% (34/109) of the carcinomas examined, with 11% (12/109) showing expression levels &gt;10% of the testicular level of expression. CT46/HORMAD1 is a single-copy gene on chromosome 1q21.3, encoding a putative protein of 394 aa. Conserved protein domain analysis identified a HORMA domain involved in chromatin binding. The CT46/HORMAD1 protein was found to be homologous to the prototype HORMA domain-containing protein, Hop1, a yeast meiosis-specific protein, as well as to asy1, a meiotic synaptic mutant protein in Arabidopsis thaliana.

Insertion vélamenteuse du cordon et grossesse gémellaire

Problématique : L'insertion vélamenteuse du cordon ombilical est reportée dans environ 1% des grossesses uniques et semble associée à de sévères complications obstétricales. Mais l'étude de cette insertion reste encore lacunaire en ce qui concerne les grossesses gémellaires. Depuis quelques années, ces dernières sont en augmentation et doivent être considérées comme des grossesses à risque. En effet, les jumeaux occupent une place toujours plus importante dans les unités de néonatologie, du fait de la morbidité particulière de ces grossesses. Ces dernières peuvent de plus s'accompagner d'autres anomalies qui peuvent influencer la croissance des jumeaux déjà prétérités par rapport aux bébés uniques. Parmi celles-ci, l'insertion vélamenteuse du cordon. Existe-il une association entre grossesse gémellaire et insertion vélamenteuse ? Quelles seraient les conséquences de ce type d'insertion sur l'évolution de la grossesse ?¦Objectifs : Evaluer l'incidence de la survenue d'une insertion vélamenteuse du cordon ombilical dans les grossesses gémellaires par rapport aux grossesses uniques et la différence de cette incidence entre placentas monochoriaux et bichoriaux. Analyser les conséquences majeures qui peuvent lui être associées.¦Méthode : Analyse rétrospective de tous les placentas de grossesses gémellaires reçus pour examen à l'institut universitaire de pathologie anatomique (IUPA) de Lausanne entre janvier 2000 et septembre 2010, ainsi que du suivi périnatal des enfants issus de ces grossesses.¦Résultats : 722 placentas issus de grossesses gémellaires ont été reçus et analysés à l'IUPA. L'insertion vélamenteuse du cordon est rencontrée dans plus de 17% des grossesses gémellaires. Elle représente plus de 9% de toutes les insertions lors de ces grossesses. Elle est retrouvée dans 35% des cas lorsque le placenta est monochorial et dans 10% des cas lorsque le placenta est bichorial.¦Notre étude a démontré une influence significative de l'insertion vélamenteuse sur l'âge gestationnel, le poids du placenta, la croissance foetale (poids > taille > PC), la durée d'hospitalisation et la mortalité. La monochorialité est le seul facteur de risque à avoir été mis en évidence.¦Conclusion : Avec l'augmentation de l'âge maternel et le recours de plus en plus fréquent aux traitements de fertilité, le nombre de grossesses gémellaires devrait s'accroitre dans les années à venir et, avec elles, le nombre d'insertions vélamenteuses du cordon. Cependant, le diagnostic d'une telle insertion ne peut être que suspecté lors d'un examen ultrasonographique en cours de grossesse. Il est donc difficile de l'identifier avant la naissance et ainsi de prévoir ses conséquences. Mais en étant conscient des complications éventuelles que peut engendrer cette insertion, nous serions plus à même d'y faire face.

Cell therapies for tendons: old cell choice for modern innovation.

Although tissue engineering and cell therapies are becoming realistic approaches for medical therapeutics, it is likely that musculoskeletal applications will be among the first to benefit on a large scale. Cell sources for tissue engineering and cell therapies for tendon pathologies are reviewed with an emphasis on small defect tendon injuries as seen in the hand which could adapt well to injectable cell administration. Specifically, cell sources including tenocytes, tendon sheath fibroblasts, bone marrow or adipose-derived stem cells, amniotic cells, placenta cells and platelet-derivatives have been proposed to enhance tendon regeneration. The associated advantages and disadvantages for these different strategies will be discussed and evolving regulatory requirements for cellular therapies will also be addressed. Human progenitor tenocytes, along with their clinical cell banking potential, will be presented as an alternative cell source solution. Similar cell banking techniques have already been described with other progenitor cell types in the 1950's for vaccine production, and these "old" cell types incite potentially interesting therapeutic options that could be improved with modern innovation for tendon regeneration and repair.

Waddlia, Parachlamydia and Chlamydiaceae in bovine abortion.

The etiology remains unknown in many cases of bovine abortion in Switzerland. Bacteria of the Chlamydiales order are known abortive agents, therefore cases of bovine abortion from three representative regions of Switzerland were investigated in this study. Particularly Chlamydiaceae as well as the Chlamydia-like organisms Waddlia and Parachlamydia were of interest, especially because of their possible zoonotic potential. Placenta samples (n=343) were tested for these bacteria by different PCR-methods, immunohistochemistry and serology for Chlamydia abortus. Additionally an attempt for the isolation of Waddlia and Parachlamydia was made by co-cultivation in amoebae. In 67.3% of the 343 cases a necrotizing and/or purulent placentitis was found histologically. By real-time PCR, 0.9% (3/343) of the cases were positive for Waddlia, 13.4% (46/343) positive for Parachlamydia and 14.6% (50/343) positive or questionable positive for Chlamydiaceae. Of these samples, confirmation by immunohistochemistry was possible in 2/3 cases for Waddlia, 25/46 for Parachlamydia and 4/50 for Chlamydiaceae. Of the 50 cases positive or questionable positive for Chlamydiaceae, species-identification by ArrayTube Microarray or 16S rRNA PCR resulted in 41 cases positive for C. abortus whereas the presence of Chlamydia suis was confirmed in four and Chlamydia pecorum in one case. This study brought evidence for the importance of different members of Chlamydiales in different regions of Switzerland although Waddlia is not occurring in a high prevalence. On the other hand mixed infections with different Chlamydiales as well as with other abortigenic agents could be found.

Intrauterine growth restriction is associated with structural alterations in human umbilical cord and decreased nitric oxide-induced relaxation of umbilical vein.

INTRODUCTION: Intrauterine growth restriction (IUGR) affects ∼8% of all pregnancies and is associated with major perinatal mortality and morbidity, and with an increased risk to develop cardiovascular diseases in adulthood. Despite identification of several risk factors, the mechanisms implicated in the development of IUGR remain poorly understood. In case of placental insufficiency, reduced delivery of oxygen and/or nutrients to the fetus could be associated with alterations in the umbilical circulation, contributing further to the impairment of maternal-fetal exchanges. We compared the structural and functional properties of umbilical cords from growth-restricted and appropriate for gestational age (AGA) term newborns, with particular attention to the umbilical vein (UV). METHODS: Human umbilical cords were collected at delivery. Morphological changes were investigated by histomorphometry, and UV's reactivity by pharmacological studies. RESULTS: Growth-restricted newborns displayed significantly lower growth parameters, placental weight and umbilical cord diameter than AGA controls. Total cross-section and smooth muscle areas were significantly smaller in UV of growth-restricted neonates than in controls. Maximal vasoconstriction achieved in isolated UV was lower in growth-restricted boys than in controls, whereas nitric oxide-induced relaxation was significantly reduced in UV of growth-restricted girls compared to controls. CONCLUSION: IUGR is associated with structural alterations of the UV in both genders, and with a decreased nitric oxide-induced relaxation in UV of newborn girls, whereas boys display impaired vasoconstriction. Further investigations will allow to better understand the regulation of umbilical circulation in growth-restricted neonates, which could contribute to devise potential novel therapeutic strategies to prevent or limit the development of IUGR.