Exames de imagem na avaliação de anomalias urológicas em lactentes com hidronefrose fetal: avanços e controvérsias

Avanços recentes no diagnóstico pré-natal têm permitido o aprimoramento da detecção e o manejo das anormalidades do trato urinário. A ultrassonografia pré-natal permite o reconhecimento de anormalidades urológicas que somente seriam identificadas tardiamente, após o aparecimento de sintomas ou complicações. A uretrocistografia miccional pode ser reservada para casos selecionados. Exames de medicina nuclear devem ser realizados em casos de hidronefrose moderada e grave. O estudo consistiu de uma revisão da literatura atual sobre a abordagem pós-natal da hidronefrose fetal. Os dados obtidos foram confrontados com a experiência da Unidade de Nefrologia Pediátrica do HC/UFMG na conduta e no seguimento de crianças com diagnóstico de uropatias detectadas na investigação de hidronefrose fetal.

Human fetal malformations associated with the use of an angiotensin II receptor antagonist: Case Report

Introduction: The potential risks related to drug exposure during pregnancy represent a vast chapter in modern obstetrics and data regarding the safety of antihypertensive drugs during pregnancy are relatively scarce. Case report: A 37-year-old patient discovered her fifth pregnancy at our hospital after 26 weeks and 4 days of gestation. She reported a history of hypertension and was currently being treated with Losartan. Hospitalization was recommended for the patient and further evaluation of fetal vitality was performed. On the fourth day an ultrasound was performed, resulting in a severe oligohydramnios, fetal centralization and abnormal ductus venosus. After 36 hours, the newborn died. Pathologic evaluation: At autopsy, the skullcap had large fontanels and deficient ossification. The kidneys were slightly enlarged. A microscopic examination detected underdevelopment of the tubules and the presence of some dilated lumens. Immunohistochemical detection of epithelial membrane antigen was positive. Immunoreactivity of CD 15 was also assayed to characterize the proximal tubules, and lumen collapse was observed in some regions. Discussion: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor antagonists (ARAs) are among the most widely prescribed drugs for hypertension. They are often used by hypertensive women who are considering become pregnant. While their fetal toxicity in the second or third trimesters has been documented, their teratogenic effect during the first trimester has only recently been demonstrated. Conclusion: Constant awareness by physicians and patients should be encouraged, particularly in regard to the prescription of antihypertensive drugs in women of childbearing age who are or intend to become pregnant.

Biomarkers, medical treatment and fetal intrapartum surveillance in intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific disorder characterized by maternal pruritus and elevated liver enzymes. It usually begins in the third trimester of pregnancy and resolves spontaneously after delivery. ICP is considered benign for the pregnant woman, but it is associated with an increased risk for unexplained term stillbirth and preterm delivery. There are no specific laboratory markers to diagnose ICP. The diagnosis is currently based on the presence of maternal pruritus and elevated values of alanine aminotransaminases (ALT) and serum bile acids (BA). Recently, ursodeoxycholic acid (UDCA) has been used for treatment. Mechanisms leading to intrauterine fetal death (IUFD) may be multifactorial and are unknown at present. For this thesis, 415 pregnant women with ICP were studied. The aim was to evaluate the value of the liver enzyme glutathione S-transferase alpha (GSTA) as a specific marker of ICP and to assess the effect of maternal UDCA therapy on maternal laboratory values and fetal outcome. The specific markers predisposing the fetus to heart arrhythmia were studied by comparing waveform analysis of fetal electrocardiograms (FECG) during labor in pregnancies complicated by ICP with controls. The levels of maternal GSTA were high and the values correlated with the value of ALT in patients with ICP. UDCA therapy reduced the values of the liver enzymes and alleviated maternal pruritus, but it did not influence maternal hormonal values. Although the newborns experienced an uneventful perinatal outcome, severe ICP was still associated with preterm birth and admission to the neonatal intensive care unit (NICU). There were no significant differences in intrapartum FECG findings between fetuses born to ICP women and controls.

Searching for Accommodations within the Ontario Criminal Justice System for Persons with Fetal Alcohol Spectrum Disorder: Views of Social Service Agency and Justice Professionals

Although persons with intellectual disabilities have been conceptualized as having rights to equality in Canada and internationally, there continue to be gaps in the delivery of justice when they are involved within the criminal process. The literature consistently reported that individuals with Fetal Alcohol Spectrum Disorder (FASDs) often experienced challenges within the justice system, such as difficulty understanding abstract legal concepts (Conry & Fast, 2009). In the Canadian legal system, accommodations are available to enable persons with disabilities to receive equal access to justice; however, how these are applied to persons with FASDs had not been fully explored in the literature. In this study, in-depth interviews were conducted with social service agency workers (n=10) and justice professionals (n=10) regarding their views of the challenges persons with FASDs experience in the justice system and their suggestions on the use of accommodations. The findings showed that while supports have been provided for individuals with intellectual disabilities, there has been a lack of specialized accommodations available specifically for individuals with FASDs in accessing their right to justice.

Chute Losses Aren't Accidents! Most Injuries can be Avoided. Here's How to Rate the Performance of Your Chute and Crew

The conclusion of the article reads "good handling during processing and re-implanting could mean the difference between a going operation and financial disaster. But it's up to you to make certain your crew understands and follows proper chute practices. When they do, it will mean more money in your pocket."

Estudio inmunohistoquímico de los receptores estrogénicos en el pulmón fetal del ratón albino Mus-musculus

Tesis (Maestría en Ciencias con Especialidad en Morfología) UANL

Efecto de la dexametasona sobre las fibras del tejido conectivo pulmonar fetal del ratón albino (Mus musculus)

Tesis (Maestría en Ciencias con Especialidad en Morfología) UANL

Dimorfismo sexual durante el desarrollo del pulmón fetal del ratón albino : estudio morfológico y bioquímico (por) Rosa Patricia Penilla Navarro

Tesis (Maestría en Ciencias, con especialidad en Morfología)U.A.N.L.

The mexican war : a history of its origen, and a detailed account of the victories wich terminated in the surrender of the capital ; with the official despatches of the generals. To which is added, the Treaty of Peace, and valuable tables of the strength and losses of the United States Army.

UANL

A Reinforcement Learning Algorithm to Economic Dispatch Considering Transmission Losses

Reinforcement Learning (RL) refers to a class of learning algorithms in which learning system learns which action to take in different situations by using a scalar evaluation received from the environment on performing an action. RL has been successfully applied to many multi stage decision making problem (MDP) where in each stage the learning systems decides which action has to be taken. Economic Dispatch (ED) problem is an important scheduling problem in power systems, which decides the amount of generation to be allocated to each generating unit so that the total cost of generation is minimized without violating system constraints. In this paper we formulate economic dispatch problem as a multi stage decision making problem. In this paper, we also develop RL based algorithm to solve the ED problem. The performance of our algorithm is compared with other recent methods. The main advantage of our method is it can learn the schedule for all possible demands simultaneously.

Gaseous and leaching losses of carbon and nitrogen in irrigated organic farming of a coastal oasis in Oman

In der Dissertation wurden die Effekte verschiedener C/N-Verhältnisse und verschiedener Verhältnisse von strukturellen zu löslichen Kohlenhydraten (NDF/SC) von Dung, der in bewässerten Gemüsekulturen im Norden Omans appliziert wurde, untersucht. Im auf sandigen Böden durchgeführten Experiment wurden zwei Büffeldungvarianten zum einen mit einem C/N-Verhältnis von 19 und einem NDF/SC-Verhältnis von 17 (ORG1) und zum anderen mit einem C/N-Verhältnis von 25 und einem NDF/SC-Verhältnis von 108 (ORG2) verwendet. Das relevante faktorielle Anbausystem war eine zweijährige Rotation, bestehend aus Rettich gefolgt von Blumenkohl und Karotte. Eine signifikante Zunahme der Erträge, des Sproßdurchmessers und der Pflanzenhöhe von Blumenkohl (P<0,001) sowie der Konzentration von Askorbinsäure in den Wurzeln von Rettich (P<0,01) mit erhöhter Verfügbarkeit von N, P und K von ORG2 über ORG1 bis hin zur Mineraldünger-Kontrollbehandlung (MIN) konnte festgestellt werden. Innerhalb von 260 Tagen wurden für die gesamte Anbauperiode mit einem photoakustischen Infrarot-Multigasmonitor und einer damit verbundenen Haube bodenbürtige Gasemissionen gemessen. Die errechneten Nettobilanzen zeigten Überschüsse von N und P, welche von Defiziten für K begleitet waren. Die Kohlenstoff Nettobilanzen waren während des Untersuchungszeitraums negativ oder nicht konsistent. Die Ergebnisse zeigen, dass unter extremen klimatischen Bedingungen bewässerter sandiger Böden organische Kultivierung zuerst durch den Kohlenstoffgehalt von Dung und Boden und erst dann durch die applizierten Mengen an N, P und K limitiert wird. Es konnte festgestellt werden, dass Gasemissionen den größten Teil der N und C Verluste von bewässerten sandigen Böden im Norden Omans darstellen. Die Reduzierung von Treibhausgasen und Sickerverlusten sollte weiterhin im Fokus zukünftiger Untersuchungen stehen, um zur Entwicklung von nachhaltigen organischen Anbausystemen im Oman und anderen ariden tropischen Ländern beizutragen.

The diversity of postharvest losses in cassava value chains in selected developing countries

The extent of physical and economic postharvest losses at different stages of cassava value chains has been estimated in four countries that differ considerably in the way cassava is cultivated, processed and consumed and in the relationships and linkages among the value chain actors. Ghana incurs by far the highest losses because a high proportion of roots reach the consumers in the fresh form. Most losses occur at the last stage of the value chain. In Nigeria and Vietnam processors incur most of the losses while in Thailand most losses occur during harvesting. Poorer countries incur higher losses despite their capacity to absorb sub-standard products (therefore transforming part of the physical losses into economic losses) and less strict buyer standards. In monetary terms the impact of losses is particularly severe in Ghana and estimated at about half a billion US dollar per annum while in the other countries it is at the most about USD 50 million. This comparison shows that there are no “one-size-fits-all" solutions for addressing postharvest losses but rather these must be tailor-made to the specific characteristics of the different value chains.

Efecto de la glicemia materna en la monitoría electrónica fetal

Introducción: Después del ingreso de la monitoría fetal electrónica como estudio de bienestar fetal, se ha considerado por décadas que un aporte de carbohidratos a la gestante antes de la realización de la monitoría fetal influye en el reporte pero existen estudios que consideran que los niveles de glicemia materna no afecta la variabilidad de la monitoría fetal. Metodología: Se realizó un estudio de corte transversal, para evaluar el efecto de la glicemia materna en la monitoría fetal electrónica comparando los valores de glicemia materna con su resultado, según la categorización del ACOG. Las principales variables fueron las horas de ayuno, valores de glicemia, variabilidad de la monitoría fetal y presencia de aceleraciones. Resultados: Se incluyeron un total de 60 pacientes, que ingresaron al servicio de obstetricia y ginecología del Hospital Universitario Mayor Méderi en el periodo de estudio. No se encontraron diferencias estadísticamente significativas entre los resultados de monitoría fetal y los valores de glicemia materna. Ninguna paciente presentó monitoría categoría III (según categorización de la ACOG). Discusión Se requieren estudios analíticos más amplios para evaluar el papel de la glicemia en el resultado de la monitoría, pero el presente estudio sugiere que no existe relación entre la glicemia materna y el resultado de la monitoría fetal electrónica en la categorización del Colegio Americano De Ginecología Y Obstetricia (ACOG).

Secuencia acinesia/hipocinesia fetal

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Sobrepeso y obesidad como causas de óbito fetal: revisión sistemática de literatura

La obesidad es una de las causas de óbito fetal documentadas en la literatura, pero actualmente no hay datos conclusivos sobre el efecto del sobrepeso como causa de óbito. Con la presente revisión sistemática se pretendió evaluar la evidencia relacionada con las alteraciones de peso como causa de óbito fetal. Se realizó una revisión sistemática de la literatura en múltiples bases de datos incluyendo la mejor evidencia relacionada con el tema en un periodo de cinco años. El sobrepeso/obesidad es un factor de riesgo modificable en toda mujer que planea una gestación; la intervención oportuna durante la valoración preconcepcional puede modificar todos los factores en cuanto a patrones de alimentación, ejercicio y hábitos de vida saludable.