990 resultados para Preeclampsia (PE)


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对半结晶的聚合物PE和PP而言,当结晶不满足Bragg取向时,靠散射反差几乎不可能区分非晶区和结晶区。所以,对大多数多相聚合物体系,相差是一种很重要的成像技术。在PP/PE共混体系中,如何区分PP和PE是聚合物透射电子显微学中的难点。本文采用相差成像技术成功地揭示出PP和PP/PE超薄膜中的片晶结构,而无需借助重金属修饰或化学染色技术。理论计算表明,只要样品足够薄,利用位相反差区分HDPE和PP的晶区是切实可行的。实验像证实了上述理论预测。

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用TEM研究了(NR+SBR)/PE共混体系经动、静态硫化后的形态结构及其与力学性能的关系。未硫化和静态硫化体系的形态结构与其组成有关,均以含量大的组份为连续相;对动态硫化体系,当(NR=SBR)/PE<70/30时,均以PE为连续相,其性能主要依赖于构成连续相组份的性质。 动态硫化体系的T_g值低于静态体系,随PE组份含量的增加变化不大,而静态硫化体系的T_g值则随PE含量增加向高温方向迁移。用DSC测得动态硫化体系的结晶度比静态体系的大。前者的应力-应变性能也低于后者。

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我们以张新时用Thornthwaite植被的PE(可能蒸散)指标所作出的可能蒸散的多元回归模型和他对Holdridge的修正系统对柴达木地区的植被-气候关系初步分析,二者在柴达木地区植被一气候相关性规律较好,这两种方法基本上适用于柴达木地区的自然条件。二者相比较,只是用Thornthwaite的方法所估算的可能蒸散(PE)要比实际中的较小一些,Holdridge的方法相对比较精细一些。

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Descrição sumária da área; metodologia da espacialização geoambiental; subunidades e segmentos geoambientais; diagnóstico e potencial de uso agrícola das terras e subunidades e segmentos geoambientais; Bacia do Jatobá - chapadas arenosas baixas; tabuleiros interioranos dissecados isolados; superfícies avermelhadas do cristalino relacionadas ao sopé de serras e serrotes; pediplanos do Alto Pageú; terraços aluviais - baixios; serras, serrotes e elevações residuais; campos de aplicação do diagnóstico ambiental.

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A gestao inadequada dos recursos naturais tem causado forte degradacao ambiental, despertando preocupacoes para controlar ou amenizar este processo. Na Regiao Nordeste, cresce a consciencia do desenvolvimento sustentavel. A Embrapa Semi-Arido, atraves de sua Unidade de Execucao de Pesquisa e Desenvolvimento - UEP Recife, posteriormente UEP Recife da Embrapa Solos e atual Escritorio Regional de Pesquisa e Desenvolvimento Nordeste (ERP/NE) da Embrapa Solos, preocupada com a necessidade de promover o desenvolvimento sustentavel dos municipios da regiao, no que diz respeito ao setor primario, lancou o Projeto de Zoneamento Agroecologico de Municipios do Estado de Pernambuco. O "Diagnostico Ambiental do Municipio de Mirandiba, PE" identifica e espacializa os ecossistemas que constituem seu territorio, visando utiliza-los em suas verdadeiras vocacoes agroecologicas. O modelo de diagnostico ambiental baseia-se na caracterizacao de ofertas e restricoes fisicas e bioticas. Orienta a ocupacao, uso e manejo ambiental, de forma integrada. Neste sentido, podera contribuir para a organizacao espacial das atividades agropecuarias, florestais e de conservacao dos sistemas naturais. O trabalho, realizado na escala 1:100.000, contou com o apoio da Prefeitura Municipal de Mirandiba e constitui um destaque antecipado do Zoneamento Agroecologico do Estado de Pernambuco - ZAPE, que esta sendo realizado pela Embrapa, atraves de convenio com o Governo do Estado de Pernambuco.

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O municipio de Iguaraci, com uma area de 770,96 km2, localiza-se na regiao semi-arida de Pernambuco, na Zona do Alto Pajeu. O estudo, na escala 1:100.000, identifica os diversos ambientes do municipio, com suas principais vocacoes, potencialidades e limitacoes. Pode, entao, subsidiar o planejamento de atividades agricolas, pecuarias, florestais ou outros tipos de atividades nao agricolas, incluindo recomendacoes de areas para preservacao ambiental. O municipio foi dividido em 15 segmentos geoambientais em funcao do arranjo e distribuicao dos diferentes solos em topossequencias, do grau xerofitico da caatinga (hiper e hipoxerofila) e, no caso das Serras e Serrotes, tambem foram consideradas suas dimensoes e diferencas geologicas. Estes segmentos geoambientais foram agrupados em 5 subunidades geoambientais em funcao de diferenciacoes geologicas, aspectos morfoestruturais, e de combinacoes de caracteristicas de geologia e relevo. As subunidades geoambientais identificadas foram as seguintes: (1) Tabuleiros Interioranos Dissecados Isolados - TD (com o segmento geoambiental TD1); (2) Superficies Avermelhadas do Cristalino - SA (com o segmento geoambiental SA1); (3) Pediplanos do Alto Pajeu - PD (com os segmentos geoambientais PD1 a PD6); (4) Terracos Aluviais - Baixios - TA (com os segmentos geoambientais TA1 e TA2); e (5) Serras, Serrotes e Elevacoes Residuais - SS (com os segmentos geoambientais SS1 a SS5). Os segmentos geoambientais indicados preferencialmente para lavouras sao TD1, SA1, TA1, TA2, PD1 e PD2, que perfazem uma area de 76,48 km2. Os segmentos indicados para lavouras e/ou pastagens (plantadas ou naturais) sao PD3 e PD4, abrangendo uma area de 206,74 km2. Os segmentos geoambientais recomendados para pecuaria extensiva, pastagem natural e/ou plantada e apicultura, sao PD5 e PD6, perfazendo uma area de 359,56 km2. Os segmentos indicados para preservacao ambiental sao os SS1 a SS5, perfazendo uma area de 18,18 km2.

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The aim of this study was to compare time-domain waveform analysis of second-trimester uterine artery Doppler using the resistance index (RI) with waveform analysis using a mathematical tool known as wavelet transform for the prediction of pre-eclampsia (PE). This was a retrospective, nested case-cohort study of 336 women, 37 of whom subsequently developed PE. Uterine artery Doppler waveforms were analysed using both RI and waveform analysis. The utility of these indices in screening for PE was then evaluated using receiver operating characteristic curves. There were significant differences in uterine artery RI between the PE women and those with normal pregnancy outcome. After wavelet analysis, significant difference in the mean amplitude in wavelet frequency band 4 was noted between the 2 groups. The sensitivity for both Doppler RI and frequency band 4 for the detection of PE at a 10% false-positive rate was 45%. This small study demonstrates the application of wavelet transform analysis of uterine artery Doppler waveforms in screening for PE. Further prospective studies are needed in order to clearly define if this analytical approach to waveform analysis may have the potential to improve the detection of PE by uterine artery Doppler screening.

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Objective The phenotype of the antioxidant and pro-angiogenicprotein haptoglobin (Hp) predicts cardiovascular disease risk andtreatment response to antioxidant vitamins in individuals withdiabetes. Our objective was to determine whether Hp phenotypeinfluences pre-eclampsia risk, or the efficacy of vitamins C and Ein preventing pre-eclampsia, in women with type-1 diabetes.
Design This is a secondary analysis of a randomised controlledtrial in which women with diabetes received daily vitamins C andE, or placebo, from 8 to 22 weeks of gestation until delivery.
Setting Twenty-five antenatal metabolic clinics across the UK (innorth-west England, Scotland, and Northern Ireland).
Population Pregnant women with type-1 diabetes.
Methods Hp phenotype was determined in white women whocompleted the study and had plasma samples available (n = 685).
Main outcome measure Pre-eclampsia.
Results Compared with Hp 2-1, Hp 1-1 (OR 0.59, 95% CI 0.30–1.16) and Hp 2-2 (OR 0.93, 95% CI 0.60–1.45) were notassociated with significantly decreased pre-eclampsia risk afteradjusting for treatment group and HbA1c at randomisation. Ourstudy was not powered to detect an interaction between Hpphenotype and treatment response; however, our preliminaryanalysis sugge sts that vitamins C and E did not prevent pre-eclampsia in women of any Hp phenotype (Hp 1-1, OR 0.77, 95%CI 0.22–2.71; Hp 2-1, OR 0.81, 95% CI 0.46–1.43; Hp 2-2, 0.67,95% CI 0.34–1.33), after adjusting for HbA1c at randomisation.
Conclusions The Hp phenotype did not significantly affect pre-eclampsia risk in women with type-1 diabetes.


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Objective Increased advanced glycation end-products (AGEs) and their soluble receptors (sRAGE) have been implicated in the pathogenesis of pre-eclampsia (PE). However, this association has not been elucidated in pregnancies complicated by diabetes. We aimed to investigate the serum levels of these factors in pregnant women with Type 1 diabetes mellitus (T1DM), a condition associated with a four-fold increase in PE. Design Prospective study in women with T1DM at 12.2 ± 1.9, 21.6 ± 1.5 and 31.5 ± 1.7 weeks of gestation [mean ± standard deviation (SD); no overlap] before PE onset. Setting Antenatal clinics. Population Pregnant women with T1DM (n = 118; 26 developed PE) and healthy nondiabetic pregnant controls (n = 21). Methods Maternal serum levels of sRAGE (total circulating pool), N -(carboxymethyl)lysine (CML), hydroimidazolone (methylglyoxal-modified proteins) and total AGEs were measured by immunoassays. Main outcome measures Serum sRAGE and AGEs in pregnant women with T1DM who subsequently developed PE (DM PE+) versus those who remained normotensive (DM PE-). Results In DM PE+ versus DM PE-, sRAGE was significantly lower in the first and second trimesters, prior to the clinical manifestation of PE (P <0.05). Further, reflecting the net sRAGE scavenger capacity, sRAGE:hydroimidazolone was significantly lower in the second trimester (P <0.05) and sRAGE:AGE and sRAGE:CML tended to be lower in the first trimester (P <0.1) in women with T1DM who subsequently developed PE versus those who did not. These conclusions persisted after adjusting for prandial status, glycated haemoglobin (HbA1c), duration of diabetes, parity and mean arterial pressure as covariates. Conclusions In the early stages of pregnancy, lower circulating sRAGE levels, and the ratio of sRAGE to AGEs, may be associated with the subsequent development of PE in women with T1DM. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

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OBJECTIVE To assess the association between circulating angiogenic and antiangiogenic factors in the second trimester and risk of preeclampsia in women with type 1 diabetes.

RESEARCH DESIGN AND METHODS Maternal plasma concentrations of placental growth factor (PlGF), soluble fms-like tyrosine kinase 1 (sFlt-1), and soluble endoglin (sEng) were available at 26 weeks of gestation in 540 women with type 1 diabetes enrolled in the Diabetes and Preeclampsia Intervention Trial.

RESULTS Preeclampsia developed in 17% of pregnancies (n = 94). At 26 weeks of gestation, women in whom preeclampsia developed later had significantly lower PlGF (median [interquartile range]: 231 pg/mL [120–423] vs. 365 pg/mL [237–582]; P < 0.001), higher sFlt-1 (1,522 pg/mL [1,108–3,393] vs. 1,193 pg/mL [844–1,630] P < 0.001), and higher sEng (6.2 ng/mL [4.9–7.9] vs. 5.1 ng/mL[(4.3–6.2]; P < 0.001) compared with women who did not have preeclampsia. In addition, the ratio of PlGF to sEng was significantly lower (40 [17–71] vs. 71 [44–114]; P < 0.001) and the ratio of sFlt-1 to PlGF was significantly higher (6.3 [3.4–15.7] vs. 3.1 [1.8–5.8]; P < 0.001) in women who later developed preeclampsia. The addition of the ratio of PlGF to sEng or the ratio of sFlt-1 to PlGF to a logistic model containing established risk factors (area under the curve [AUC], 0.813) significantly improved the predictive value (AUC, 0.850 and 0.846, respectively; P < 0.01) and significantly improved reclassification according to the integrated discrimination improvement index (IDI) (IDI scores 0.086 and 0.065, respectively; P < 0.001).

CONCLUSIONS These data suggest that angiogenic and antiangiogenic factors measured during the second trimester are predictive of preeclampsia in women with type 1 diabetes. The addition of the ratio of PlGF to sEng or the ratio of sFlt-1 to PlGF to established clinical risk factors significantly improves the prediction of preeclampsia in women with type 1 diabetes.

Preeclampsia is characterized by the development of hypertension and new-onset proteinuria during the second half of pregnancy (1,2), leading to increased maternal morbidity and mortality (3). Women with type 1 diabetes are at increased risk for development of preeclampsia during pregnancy, with rates being two-times to four-times higher than that of the background maternity population (4,5). Small advances have come from preventive measures, such as low-dose aspirin in women at high risk (6); however, delivery remains the only effective intervention, and preeclampsia is responsible for up to 15% of preterm births and a consequent increase in infant mortality and morbidity (7).

Although the etiology of preeclampsia remains unclear, abnormal placental vascular remodeling and placental ischemia, together with maternal endothelial dysfunction, hemodynamic changes, and renal pathology, contribute to its pathogenesis (8). In addition, over the past decade accumulating evidence has suggested that an imbalance between angiogenic factors, such as placental growth factor (PlGF), and antiangiogenic factors, such as soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sEng), plays a key role in the pathogenesis of preeclampsia (8,9). In women at low risk (10–13) and women at high risk (14,15), concentrations of angiogenic and antiangiogenic factors are significantly different between women who later develop preeclampsia (lower PlGF, higher sFlt-1, and higher sEng levels) compared with women who do not.

Few studies have specifically focused on circulating angiogenic factors and risk of preeclampsia in women with diabetes, and the results have been conflicting. In a small study, higher sFlt-1 and lower PlGF were reported at the time of delivery in women with diabetes who developed preeclampsia (16). In a longitudinal prospective cohort of pregnant women with diabetes, Yu et al. (17) reported increased sFlt-1 and reduced PlGF in the early third trimester as potential predictors of preeclampsia in women with type 1 diabetes, but they did not show any difference in sEng levels in women with preeclampsia compared with women without preeclampsia. By contrast, Powers et al. (18) reported only increased sEng in the second trimester in women with pregestational diabetes who developed preeclampsia.

The aim of this study, which was significantly larger than the previous studies highlighted, was to assess the association between circulating angiogenic (PlGF) and antiangiogenic (sFlt-1 and sEng) factors and the risk of preeclampsia in women with type 1 diabetes. A further aim was to evaluate the added predictive ability and clinical usefulness of angiogenic factors and established risk factors for preeclampsia risk prediction in women with type 1 diabetes.