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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Determinantes gen?ticos e ambientais das doen?as hipertensivas da gravidez

Ferreira, Leonardo Capistrano 06 October 2014 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-01-04T22:02:35Z No. of bitstreams: 1 LeonardoCapistranoFerreira_TESE.pdf: 3396619 bytes, checksum: bffb880b6907328ac1ce5051faaf28fd (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-01-07T21:08:47Z (GMT) No. of bitstreams: 1 LeonardoCapistranoFerreira_TESE.pdf: 3396619 bytes, checksum: bffb880b6907328ac1ce5051faaf28fd (MD5) / Made available in DSpace on 2016-01-07T21:08:47Z (GMT). No. of bitstreams: 1 LeonardoCapistranoFerreira_TESE.pdf: 3396619 bytes, checksum: bffb880b6907328ac1ce5051faaf28fd (MD5) Previous issue date: 2014-10-06 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / O desenvolvimento de doen?as complexas, como a pr?-ecl?mpsia, ? determinado por fatores ambientais e gen?ticos, al?m da poss?vel intera??o entre esses fatores. As doen?as hipertensivas da gravidez (DHGs) apresentam um amplo espectro cl?nico, que pode variar desde pr?-ecl?mpsia leve (hipertens?o e proteinuria) at? formas mais graves, como a ecl?mpsia (convuls?es) e s?ndrome HELLP (hem?lise, eleva??o das enzimas hep?ticas e plaquetopenia). O espectro cl?nico parece estar ligado a diferentes mecanismos patol?gicos. Este trabalho tem como objetivo identificar fatores (gen?ticos e ambientais) envolvidos no desenvolvimento das DHGs. Usando uma abordagem caso-controle, selecionamos um total de 1498 mulheres para os estudos epidemiol?gico e gen?tico, abrangendo 755 gr?vidas normotensas (controle); 518 pr?-ecl?mpsia; 84 eclampsia e 141 HELLP. As mulheres foram genotipados para 18 marcadores distribu?dos em cinco genes candidatos (FLT1, ACVR2A, ERAP1, ERAP2 e LNPEP). Como resultado das an?lises dos fatores ambientais, encontramos idade materna, paridade e o ?ndice de massa corporal pr?-gestacional como importantes fatores de risco associados ?s DHGs. As an?lises gen?ticas mostraram que os genes est?o associados de maneira fen?tipo-espec?fica: ACVR2A com pr?-ecl?mpsia precoce (rs1424954, p=0,002); FLT1 com s?ndrome HELLP (rs9513095, p=0,003), e ERAP1 com ecl?mpsia (rs30187, p=0,03). Nossos resultados sugerem que diferentes mecanismos gen?ticos, juntamente com fatores ambientais espec?ficos, contribuem na determina??o do espectro cl?nico das DHGs. Al?m disso, o refinamento fenot?pico parece ser um passo essencial na busca por genes de doen?as complexas / The development of complex diseases such as preeclampsia are determined by both environmental and genetic factors, but there is also interaction among these factors. Preeclampsia is a pregnancy-specific disorder characterized by de-novo hypertension and proteinuria after 20th week of gestation. There is a broad spectrum of clinical presentations related to hypertensive disorders of pregnancy (HDP) that can range from mild preeclampsia to eclampsia (seizures) or HELLP syndrome (Hemolysis, Elevation of Liver enzymes, Low Platelets). Those clinical outcomes might be linked to different pathological mechanisms. Our work aims to identify factors (i.e. genes and environmental) associated with the HDP?s clinical spectrum. Using a case-control approach, we selected a total of 1498 pregnant women for epidemiological and genetic studies, encompassing 755 normotensive (control); 518 preeclampsia; 84 eclampsia; and 141 HELLP. Women were genotyped for 18 SNPs across 5 candidate genes (FLT1, ACVR2A, ERAP1, ERAP2 and LNPEP). For the environmental factors, we found maternal age, parity status and pre-gestational body mass index as important risk factors associated with disease. Genes were associated in a phenotype-specific manner: ACVR2A with early preeclampsia (rs1424954, p=0.002); FLT1 with HELLP syndrome (rs9513095, p=0.003); and ERAP1 with eclampsia (rs30187, p=0.03). Our results suggest that different genetic mechanisms along with specific environmental factors might determine the clinical spectrum of HDP. In addition, phenotype refinement seems to be an essential step in the search for complex disease genes
22

IFRS 9 inom bilfinansieringsbranchen : En kvalitativ studie som blickar närmare på IFRS 9 inverkan på redovisningen på Sveriges ledande bilfinansieringsföretag

Nicklasson, Albin, Gourie, Joakim January 2024 (has links)
SAMMANFATTNING Datum:  2024-05-28 Nivå:   Kandidatuppsats i Företagsekonomi, 15 hp Institution:  Akademin för Ekonomi, Samhälle och Teknik, Mälardalens Universitet Författare:  Albin Nicklasson & Joakim Gourie Titel:   IFRS 9 inom bilfinansieringsbranschen Handledare:  Angelina Sundström Nyckelord:  IFRS 9, ECL-modell, ICL-modell, transparens, kreditreserveringar  Forskningsfråga: Hur har IFRS 9 inverkat på redovisningen inom       bilfinansieringsbranschen  Syfte:   Syftet med denna studie är att ge en fördjupad förståelse kring hur det   nya ramverket IFRS 9 har påverkat redovisningen för     bilfinansieringsbolag.  Metod:  För att besvara forskningsfrågan valdes en kvalitativ forskningsmetod   som genomfördes med fyra intervjuer.  Slutsats:  Studien resulterar i att införandet av IFRS 9 har förbättrat      redovisningen för bilfinansieringsbolag.
23

Ger IFRS 9 bättre beslutsunderlag? : En dokumentstudie ur en investerares perspektiv / Does IFRS 9 provide a better basis for decision making? : A document analysis from an investor´s perspective

Lysér, Oskar, Sylvén, Viktor January 2020 (has links)
IFRS 9 är en ny standard som avser att förbättra redovisningen av finansiella instrument. Detta grundade sig i finanskrisen 2008 då föregångaren IAS 39 fick motstå kritik för att redovisa kreditförluster för sent. Med IFRS 9 introducerades därför en ny framåtblickande nedskrivningsmodell där företagen blivit tvungna att ta hänsyn till framtida makroekonomiska faktorer. Tidigare forskning har främst studerat banker eller avsett att beräkna framtida effekter av IFRS 9 innan standarden implementerades 2018. Det har inte påvisats några väsentliga effekter av IFRS 9 inom banksektorn. Det som skiljer vår studie från tidigare studier är att vi försöker tyda effekter av implementeringen på olika sektorer samt att analysera om effekten av IFRS 9 har påverkat investerares beslutsfattande. För att uppnå syftet har en dokumentstudie på olika företag inom diverse branscher genomförts utifrån ett investerarperspektiv som grundar sig i IASB:s kvalitativa egenskaper. Resultatet av studien blir att det inte har skett några väsentliga förändringar i de finansiella rapporterna hos de olika företagen när det gäller värderingen. Utifrån de kvalitativa egenskaperna har informationen för en investerare blivit mer användbar samtidigt som relevansen i de finansiella rapporterna ökat. Detta har påverkat en investerares beslutsfattande positivt. Den skillnad som går att utläsa är att företagen har efter implementeringen ökat den årliga avsättningen till reserven för förväntade kreditförluster. Dock anser vi att den stora skillnaden med IFRS 9 först kan tydas i en lågkonjunktur. / IFRS 9 is a new standard which intend to improve accounting of financial instruments. The precursor IAS 39 was heavily criticized during the financial crises in 2008 because of its late recognition of credit loss. IFRS 9 introduces a new forward-looking approach that considers future macroeconomic factors. Previous research has mainly been studying banks and future effects of the standards implementation. No essential effects have been shown in previous research. What distinguishes our study is that we try to interpret the effects of implementation in different sectors and to analyze whether the effect of IFRS 9 has affected investors’ decision-making. To achieve the purpose of this thesis, a document analysis of different companies in various industries has been conducted. This thesis has been analyzed from an investors point of view which is based on IASB’s conceptual framework. This thesis has not seen any essential effects from the implementation of IFRS 9 in the financial reports. From the qualitative characteristics the financial information for an investor has improved and its relevance has increased, which has affected the investors’ decision-making, in a positive manner. After the implementation the big difference is that the annual deposition to the reserve for credit loss has increased for companies in all industries. Although, we believe that the big differences with IFRS 9 can first be interpreted in a recession.
24

Impact of Forward-Looking Macroeconomic Information on Expected Credit Losses According to IFRS 9 / Effekten av Framåtblickande Makroekonomisk Information på Förväntade Kreditförluster i Enlighet med IFRS 9

Corfitsen, Christian January 2021 (has links)
In this master thesis, the impact of forward-looking macroeconomic information under IFRS 9 is studied using fictional data from a Swedish mortgage loan portfolio. The study employs a time series analysis approach and employs vector autoregression models to model expected credit loss parameters with multiple incorporated macroeconomic parameters. The models are analyzed using impulse response functions to study the impact of macroeconomic shocks and the results show that the unemployment rate, USD/SEK exchange rate and 3-month interest rates have a significant impact on expected credit losses. / I detta examensarbete studeras effekterna av framåtblickande makroekonomisk information enligt IFRS 9 med fiktiv data baserad på en svensk bolåneportfölj. Studien använder sig av tidsserieanalys och vektorautoregressionsmodeller för att modellera förväntade kreditförlust-parametrar med flera inkorporerade makroekonomiska parametrar. Modellerna analyseras med hjälp av impulsresponsfunktioner för att studera effekterna av makroekonomiska chocker. Resultaten visar att arbetslöshet, USD/SEK växelkurs och 3-månaders räntor har en signifikant inverkan på förväntade kreditförluster.
25

Arquitetura campestre na obra de Ramos de Azevedo. A arquitetura rural campineira: a Fazenda S?o Vicente em Campinas

Amoroso, Maria Rita Silveira de Paula 19 February 2009 (has links)
Made available in DSpace on 2016-04-04T18:21:52Z (GMT). No. of bitstreams: 1 Maria Rita Silveira de Paula Amoroso-1.pdf: 21515567 bytes, checksum: 47d8d8520567aa789d73c5f94cfc65d9 (MD5) Previous issue date: 2009-02-19 / L?ing?niuer-architecte Francisco de Paula Ramos de Azevedo a produit une oeuvre urbaine qui a re?u ces dernni?res ann?es l?atention des historiens de l?architecture. Cependant, dans la production t?cnique de ce professionnel nous trouvons aussi des maisons de campagne, comme c?est le cas da la maison principale de la Fazenda S?o Vicente ? Campinas, ?tat de S?o Paulo. Cette maison a subi une restauration qui a ?t? achev?e en 2007 et qui est l?objet de cette communication. Notre objectif est celui de metre en evidence les rapports entre une architecture urbaine et une architecture rural dans l?ouvrage de cet architecte. / O engenheiro-arquiteto Francisco de Paula Ramos de Azevedo produziu uma obra essencialmente urbana que recebeu nos ?ltimos anos uma significativa aten??o por parte dos historiadores da arquitetura. Todavia, a produ??o t?cnica deste profissional tamb?m possuiu uma dimens?o rural, como ? o caso da sede do antigo complexo cafeeiro da Fazenda S?o Vicente, em Campinas-SP, a qual passou por uma restaura??o conclu?da no ano de 2007, e que ? objeto de estudo da presente disserta??o. Objetiva-se colocar em evid?ncia as rela??es entre o que seria uma arquitetura urbana e uma arquitetura rural, destacando como os saberes t?cnicos s?o apropriados por agentes sociais no contexto de uma cultura burguesa no auge do ciclo econ?mico do caf? no estado de S?o Paulo.
26

Acur?cia dos testes ultrassonogr?ficos para predi??o de pr?-ecl?mpsia

Cunha Filho, Edson Vieira da 24 March 2015 (has links)
Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-07-07T12:46:56Z No. of bitstreams: 1 471709 - Texto Completo.pdf: 1964920 bytes, checksum: 322c3402ce4feed16d4833fcbeb64c63 (MD5) / Made available in DSpace on 2015-07-07T12:46:56Z (GMT). No. of bitstreams: 1 471709 - Texto Completo.pdf: 1964920 bytes, checksum: 322c3402ce4feed16d4833fcbeb64c63 (MD5) Previous issue date: 2015-03-24 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Objective : To develop a meta-analysis on ultrasonographic methods for preecalmpsia prediction.Methods : The databases MEDLINE, EMBASE, LILACS and SCIELO were searched for selecting studies and data extraction. We assessed study validity by QUADAS II. The statistical analysis was performed using summary operating point for qualitative variables and using summary ROC curves for quantitative variables.Results : In the gestation?s first trimester, ultrasound methods are not applicable for preeclampsia prediction due to low sensitivity. In the second trimester there are three feasible tests. For early preeclampsia prediction (birth < 34 weeks) the uterine arteries mean pulsatility index above 95th centile plus bilateral notching have a low negative likelihood ratio (0.28) and high sensitivity (89%). For preeclampsia prediction at any time of gestation, resistance index may be used. Mean resistance index > 0.58 is applicable for high risk pregnant women with an AUC of 0.804. For pregnant women without risk for preeclampsia, the specificity of the bilateral resitance index > 0.70 was 97%.Conclusion : In the first trimester ultrasound methods can not be used to predict preeclampsia. During the second trimester, the mean pulsatility index above 95th centile has the best predictive power. This test is applicable for low risk patients to predict preeclampsia below 34 weeks. The mean resistance index > 0.58, with sensitivity and specificity around 74%, to predict preeclampsia at any time of gestation in high risk patients, can also be used. For low risk patients and preeclampsia prediction at any time of gestation , all tests had low sensitivities. / Objetivo : Realizar uma metan?lise para testar a acur?cia dos m?todos ultrassonogr?ficos para predi??o de pr?-ecl?mpsia.M?todos : Foi efteuada pesquisa nas bases de dados MEDLINE, EMBASE, LILACS e CIELO, onde os estudos foram selecionados. A validade dos estudos foi acessada pela ferramenta QUADAS II. A an?lise estat?stica foi feita utilizando summary operating point para vari?veis qualitativas e summary ROC curve para vari?veis quantitativas.Resultados : No primeiro trimestre da gesta??o, os m?todos ultrassonogr?ficos n?o t?m aplicabilidade para predi??o de pr?-ecl?mpsia devido ? sua baixa sensibilidade. No segundo trimestre, encontramos tr?s testes que podem ser utilizados. Para predi??o de pr?-ecl?mpsia precoce (que culmina com nascimento abaixo das 34 semanas) o ?ndice de Pulsatilidade m?dio das art?rias uterinas acima do percentil 95 associado ? incisura protodiast?lica bilateral teve uma baixa raz?o de verossimilhan?a negativa (0,28) e uma alta sensibilidade (89%). Para predi??o de pr?-ecl?mpsia a qualquer momento da gravidez, o ?ndice de resist?ncia pode ser usado. ?ndice de Resist?ncia m?dio > 0,58 ? aplic?vel para pacientes de alto risco, tendo uma ?rea abaixo da curva de 0,804. Para gr?vidas de baixo risco de pr?-ecl?mpsia, a especificidade do ?ndice de Resist?ncia bilateral > 0,70 foi de 97%.Conclus?o : No primeiro trimestre n?o encontramos bons resultados com m?todos ultrassonogr?ficos para predi??o de pr?-ecl?mpsia. No segundo trimestre o ?ndice de pulsatilidade m?dio acima do percentil 95 teve o melhor poder preditivo. Este teste ? aplic?vel para pacientes de baixo risco e para predizer pr?-ecl?mpsia abaixo de 34 semanas. Podemos utilizar tamb?m o ?ndice de Resist?ncia maior que 0,58, com sensibilidade e especificidade pr?ximas as 74%, para predizer pr?-ecl?mpsia em pacientes de alto risco, com a doen?a ocorrendo em qualquer momento da gravidez. Para pacientes de baixo risco e predi??o de pr?-ecl?mpsia a qualquer momento da gesta??o os testes t?m baixa sensibilidades.
27

Altera??es do timo fetal secund?rias ao uso de cortic?ide para matura??o pulmonar

Steibel, Gustavo 29 August 2011 (has links)
Made available in DSpace on 2015-04-14T13:32:51Z (GMT). No. of bitstreams: 1 433664.pdf: 556146 bytes, checksum: f1547b214dce555fdf116d5fa8243c45 (MD5) Previous issue date: 2011-08-29 / Objetivo: Avaliar as medidas do timo fetal atrav?s da ultrassonografia 24 e 48 horas ap?s o uso de Betametasona para matura??o pulmonar em gesta??es entre 24 e 34 semanas. M?todos: estudo prospectivo com 25 gestantes que receberam Betametasona intramuscular para matura??o pulmonar fetal antes de 34 semanas de gesta??o. As medidas do per?metro e do di?metro do timo foram realizadas antes, 24 e 48 horas ap?s o uso do corticoide. Resultados: o di?metro e o per?metro do timo diminu?ram ap?s 24 e 48 horas da administra??o de Betametasona. As m?dias do di?metro foram 25,5 ? 3,7; 21, 7 ? 3,6 e 20,2 ? 5,5 mm e do per?metro foram 89,8 ? 9,5; 78,6 ? 8,6 e 76,6 ? 15,0 mm para 0, 24h e 48 h, respectivamente (P < 0.001). Conclus?o: O uso de Betametasona para matura??o pulmonar fetal pode estar associada com a diminui??o do di?metro e do per?metro do timo fetal. Este fato pode aumentar falsamente o n?mero de fetos com timos considerados abaixo do percentil 5, caso a medida seja realizada ap?s o uso de corticoide
28

N?veis da quimiocina RANTES na placenta, plasma materno e plasma do cord?o umbilical em gestantes normais e com s?ndrome de pr?-ecl?mpsia

Silveira, Ilson Dias da 28 August 2012 (has links)
Made available in DSpace on 2015-04-14T13:35:35Z (GMT). No. of bitstreams: 1 443353.pdf: 1896369 bytes, checksum: 19ecf303e539b93de8c9bda585ba0ebd (MD5) Previous issue date: 2012-08-28 / Objective: To estimate RANTES levels at maternal plasma, umbilical cord blood plasma and placenta in preeclampsia syndrome and normal pregnancy. Methods: A cross-sectional study was conducted to estimate RANTES levels in maternal plasma, placenta and cord blood plasma in preeclampsia syndrome (n=33) compared to a control group of women with normal pregnancy (n=36) attended at S?o Lucas Hospital/PUCRS, Porto Alegre, RS Brazil. Concentrations of RANTES were measured using a human RANTES ELISA assay. Results: Women with preeclampsia syndrome showed significantly higher RANTES levels in plasma and placenta in comparison to women with normal pregnancy (P<0.01). The cord blood plasma of infants born from women with preeclampsia syndrome had a significantly decreased RANTES levels compared to infants born from a normal pregnancy (P<0.01). The concentration of placental RANTES was positively correlated with RANTES in the maternal plasma (Pearson?s correlation r= 0.697; p<0.001), and negatively with the cord blood plasma (r= -0.818; p<0.001). A strong negative correlation was also demonstrated between maternal plasma and cord blood plasma RANTES (r= -0.751, p<0.001). Conclusion: This study shows a distinct inflammatory response between mother and new born in preeclampsia syndrome and normal pregnancy. In preeclampsia syndrome maternal plasma and placenta displayed increased pro-inflammatory RANTES cytokine concentration, however a reduced levels were detected in the umbilical cord plasma from women with preeclampsia syndrome, suggesting a fetal antiflammatory response. / Objetivo: O objetivo deste trabalho foi estimar os n?veis de RANTES na placenta e nos plasmas materno e do cord?o umbilical na s?ndrome de pr?-ecl?mpsia e gesta??o normal. M?todos: Estudo transversal e observacional estimou os n?veis de RANTES na placenta e nos plasmas materno e do cord?o umbilical na s?ndrome de pr?-ecl?mpsia (n=33) comparando com um grupo controle de gestantes normais (n=36) atendidas no Hospital S?o Lucas/PUCRS, Porto Alegre, RS, Brasil. As concentra??es de RANTES foram verificadas atrav?s do m?todo de enzima imuno ensaio (ELISA) espec?fico para humanos. Resultados: Mulheres com s?ndrome de pr?-ecl?mpsia apresentaram n?veis significativamente maiores de RANTES no plasma e placenta quando comparadas a gestantes normais (P<0,01). O plasma do cord?o umbilical de rec?m-nascidos de gestantes com pr?-ecl?mpsia mostraram n?veis de RANTES significativamente menores que o plasma do cord?o umbilical de rec?m-nascidos de gestantes normais (P<0,01). A concentra??o de RANTES placent?rio correlacionou-se positivamente com a concentra??o de RANTES no plasma materno (r= 0,697; P<0,001) e negativamente com o plasma do cord?o umbilical (r= - 0,818; P< 0,001). Forte correla??o negativa na concentra??o de RANTES foi demonstrada entre plasma materno e plasma do cord?o umbilical (r= - 0,751; P<0,001). Conclus?o: Este estudo mostra uma resposta inflamat?ria distinta entre a m?e e o rec?m-nascido em ambas as condi??es, gesta??o normal e s?ndrome de pr?-ecl?mpsia. A placenta e o plasma materno demonstraram uma concentra??o da citocina inflamat?ria RANTES aumentada na s?ndrome de pr?-ecl?mpsia, entretanto, no plasma do cord?o umbilical dos rec?m-nascidos dessas gestantes estava reduzida, sugerindo uma resposta fetal anti-inflamat?ria.
29

Pr?-ecl?mpsia : avalia??o de aspectos fisiopatol?gicos e cl?nicos

Hentschke, Marta Ribeiro 24 February 2014 (has links)
Made available in DSpace on 2015-04-14T13:35:54Z (GMT). No. of bitstreams: 1 457551.pdf: 12875247 bytes, checksum: 7692e146a26179178ba4309a48e59226 (MD5) Previous issue date: 2014-02-24 / Pre-eclampsia is one of the leading cause of maternal mortality worldwide. Although some etiological factors such as poor placentation, endothelial dysfunction, excessive maternal inflammation, poor angiogenesis, and placental hypoxia have been proposed, the etiology of pre-eclampsia has not been fully understood. An immune maladaptation theory suggests that pre-eclampsia might be envolved in an inappropriate regulation of normally Th2-deviated maternal immune response, leading to a shift toward harmful Th1 immunity, delivering a large amount of cytokines and growth factor molecues throw maternal circulation. The presence of these mediators seems to play a role in the pathophysiology of pre-eclampsia, resulting in the clinical signs of the disease: hypertension and protein?ria. Thus, this study pretended to analize different pathways during gestation in order to try to elucidate a biomarcar for the disease. We hypothesize that moleculas related to inflammatory system would be up-regulated in maternal plasma and placenta from women with pre-eclampisa and down regulated in fetal plasma. The study was performed at Hospital S?o Lucas of PUCRS, Brazil, where we made Mediating molecules and pre-eclampsia , and at St Thomas&#8223; Hospital, London, UK, where Lipoproteins and pre-eclampsia and Caveola proteins and pre-eclampsia projects were developed. At HSL/PUCRS, maternal/fetal plasma and placenta samples were collected from 117 pre-eclampsia and normal pregnant women in third trimester pregnancy, after informed written consent. The cytokines (Endocan-1, PlGF, IL-6, TNF&#945;, MCP-1, NGF, LIGHT, Leptina) were measured by multiplex detecting assay. In London, a study with 51 pregnant women was conducted analising placenta expression of the following molecules: lipoproteins pathway (LRP-1, LDL-R, SRB1, ABCA1, MTTP and PDIA2) and protein caveolae complex (Caveolin-1-3, cavins 1-4, eNOS and iNOS) which were performed by PCR-RT e immunohistochemistry. Briefly we found high levels of Endocan-1 and TNF&#945; in pre-eclamptic maternal plasma, low levels of IL-6 in fetal plasma in cytokines assay. Also a correlation between LRP-1 gene and small for gestational age infants in lipoproteins receptor assay was found. Finally, a reduction expression of Caveolin-1 found in pre-eclampstic placenta seems to result in a compensatory chronic activation of eNOS to attenuate vasoconstriction seen in pre-eclampsia. In conclusion, our results showed new data in relation to pre-eclampsia, which might be helpful for the understanding of its pathofisiology. / A pr?-ecl?mpsia ? uma das principais causas de mortalidade materna no mundo. Embora alguns fatores etiol?gicos, tais como m? placenta??o, disfun??o endotelial, inflama??o materna exacerbada, angiog?nese deficiente e hipoxia placent?ria t?m sido propostos, a etiologia da pr?-ecl?mpsia ainda n?o foi completamente compreendida. A teoria da m? adapta??o imune sugere que a pr?-ecl?mpsia pode estar envolvida com um desbalan?o Th1/Th2 prejudicial ? gesta??o, com libera??o de citocinas e fatores de crescimento na circula??o materna. A presen?a desses mediadores parece desempenhar um papel na fisiopatologia da pr?-ecl?mpsia, resultando nos sinais cl?nicos da doen?a: a hipertens?o e a protein?ria. Assim, este estudo pretendeu analisar diferentes vias metab?licas durante a gesta??o, a fim de tentar elucidar um biomarcar para a doen?a. Nossa hip?tese ? a de que mol?culas relacionadas ao sistema inflamat?rio estariam aumentadas no plasma materno e na placenta de mulheres com pr?-eclampsia e diminu?das no plasma fetal. O estudo foi realizado no Hospital S?o Lucas da PUCRS, Brasil, onde fizemos a coleta das amostras para o projeto Mol?culas mediadoras e a pr?-ecl?mpsia, e no St Thomas Hospital, em Londres, Reino Unido, onde os projetos Lipoprote?nas e a pr?-eclampsia e Prote?nas das cav?olas e a pr?-ecl?mpsia foram desenvolvidos. No HSL/PUCRS, amostras de plasma materno-fetal e placenta foram coletadas de 117 gestantes com e sem pr?-ecl?mpsia no terceiro trimestre da gesta??o. As mol?culas (Endocan-1, PIGF, IL-6, TNF&#945;, MCP-1, NGF, LIGHT e Leptina) foram dosadas por ensaio de detec??o multiplex. Em Londres, um estudo com 51 gestantes foi realizado analisando express?o placent?ria das seguintes mol?culas: receptores e mediadores de lipoprote?nas (LRP-1, LDL-R, SRB1, ABCA1, MTTP e PDIA2) e prote?nas do complexo das cav?olas (Caviolina-1-3, Cavins 1-4, eNOS e iNOS ), que foram analisadas por PCR-TR e imuno-histoqu?mica. Resumidamente, encontramos altos n?veis de Endocan-1 e TNF&#945; no plasma materno, baixos n?veis de IL-6 no plasma fetal de pacientes com pr?-eclampsia, no ensaio de citocinas. Ainda, foi encontrada uma correla??o entre o gene LRP-1 e rec?m-nascidos pequenos para a idade gestacional, no grupo com pr?-ecl?mpsia, no ensaio de receptor de lipoprote?nas. E, por fim, uma redu??o da express?o de Caveolina-1 na placenta pr?-ecl?mptica foi observada e parece ter resultado numa ativa??o compensat?ria cr?nica da eNOS para tentar atenuar a vasoconstri??o observada na pr?-eclampsia. Concluindo, nossos resultados mostraram novos dados em rela??o ? pr?-ecl?mpsia, que podem ser ?teis para o entendimento de sua fisiopatologia.
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Avalia??o dos ?ndices plaquet?rios e contagem total de plaquetas em gestantes normotensas, com S?ndrome de Pr?-Ecl?mpsia e outros dist?rbios hipertensivos da gesta??o

Moraes, Daniela 24 February 2014 (has links)
Made available in DSpace on 2015-04-14T13:35:57Z (GMT). No. of bitstreams: 1 458594.pdf: 1623070 bytes, checksum: 141e39e7200c7e85ea7cf51cf01083c9 (MD5) Previous issue date: 2014-02-24 / Imbalance in hemostatic mechanisms can occur during pregnancy with a tendency for hypercoagulability and increased thrombosis risk. Pregnant women with a hypertensive disorder, especially preeclampsia, may disclose alterations in total platelet count and the platelet indexes, mean platelet volume (MPV) and immature platelet fraction (IPF). The IPF has been suggested as a sensitive index for monitoring changes in platelet production and destruction. An automated technique for obtaining this parameter has been used. The aim of the present study was to evaluate the immature platelet fraction behavior in patients diagnosed with a gestational hypertensive disorder (GHD), using fluorescent flow cytometry. A crosssectional study conducted at the S?o Lucas Hospital, Porto Alegre, Brazil to estimate IPF levels in the maternal blood of 99 pregnant women, divided into 3 groups: normotensive controls (NP), preeclampsia syndrome (PES) and non-proteinuric hypertensive pregnancy (nPHP). Following ethical approval and written informed consent, samples were collected from 33 NP, 34 PES, and 32 nPHP women. IPF levels were measured by fluorescent flow cytometry using the XE-5000? (Sysmex Corporation, Kobe, Japan). The IPF and MPV count in pregnant women with a GHD was significantly higher than the control group. No significant difference was detected between the PES and nPHP groups. The MPV for the NP group was normal. A distinct profile in platelet indexes was detected in hypertensive pregnancies. It is suggested that these markers could be used in daily routine as an additional tool in the management of hypertensive pregnant women. / Um desequil?brio nos mecanismos hemost?ticos pode ocorrer durante a gesta??o com tend?ncia ? hipercoagulabilidade e aumento do risco de trombose. Nas gestantes com dist?rbio hipertensivo, principalmente nas pr?-ecl?mpticas, h? dados na literatura que indicam haver altera??o no n?mero total de plaquetas e nos ?ndices plaquet?rios, volume plaquet?rio m?dio (VPM) e fra??o de plaquetas imaturas(IPF). A IPF tem sido sugerida como um ?ndice sens?vel para monitorar mudan?as na produ??o e destrui??o plaquet?ria. Uma t?cnica automatizada para a obten??o deste par?metro tem sido utilizada. O objetivo do presente estudo ? avaliar o comportamento da IPF utilizando citometria de fluxo fluorescente em pacientes com diagn?stico de doen?a hipertensiva gestacional. Foi realizado estudo transversal controlado com 99 gestantes a fim de estimar os n?veis de IPF no sangue materno das pacientes com s?ndrome de pr?-ecl?mpsia (SPE) comparando com hipertensas gestacionais sem protein?ria (HGsP) e gestantes normais normotensas (NT) atendidas no Hospital S?o Lucas/PUCRS, Porto Alegre, Brasil. O termo de consentimento livre e esclarecido foi empregado nas 34 gestantes com SPE, 32 com GHsP e nas 33 NT. A IPF foi contada atrav?s do equipamento XE-5000 (Sysmex Corporation, Kobe, Japan), utilizando citometria de fluxo fluorescente. A contagem de IPF e VPM em gestantes com doen?a hipertensiva gestacional (DHG) foi significativamente maior que no grupo controle. N?o houve diferen?a estat?stica entre os grupos SPE e HGsP. O VPM foi normal em todas as gestantes do grupo controle. Detectou-se um distinto perfil dos ?ndices plaquet?rios em gestantes hipertensas, e sugere-se que esses marcadores possam ser utilizados na rotina cl?nica di?ria como uma ferramenta adicional no aux?lio do diagn?stico precoce da DHG.

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