Hui Sau Lei Raydi. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 71-82). / Abstracts in English and Chinese. / ABSTRACT (English and Chinese) --- p.i / ACKNOWLEDGMENT --- p.1 / LIST OF FIGURES --- p.2 / LIST OF TABLES --- p.3 / LIST OF ABBREVIATIONS --- p.4 / Chapter I. --- Introduction and Objectives --- p.5-8 / Chapter II. --- Literature review --- p.9 / Chapter II.A --- Corticotrophin-releasing hormone --- p.9 / Chapter II.A.1. --- Structure of Corticotrophin-releasing hormone --- p.9-10 / Chapter II.A.2. --- Corticotrophin releasing hormone and normal Physiology --- p.11 / Chapter II.A.2.a. --- Pituitary-adrenal axis --- p.11-12 / Chapter II.A.2.b. --- Role of Pituitary-adrenal axis --- p.12 / Chapter II.A.3. --- Placental Corticotrophin releasing hormone --- p.13 / Chapter II.A.3.a. --- Origin --- p.13 / Chapter II.A.3.b. --- Physiology --- p.14 / Chapter II.A.3.C. --- Normal pregnancy --- p.15 / Chapter II.A.3.d. --- Association with human parturition --- p.16 / Chapter II.A.3.e. --- Association with preterm delivery and other abnormal pregnancy outcomes --- p.17-18 / Chapter II.B. --- Alpha-fetoprotein --- p.19 / Chapter II.B.1. --- Physiology --- p.19-20 / Chapter II.B.2. --- Maternal alpha-fetoprotein levels in the second trimester --- p.21-22 / Chapter III : --- Materials & Method --- p.23 / Chapter III.A. --- Study population --- p.23-24 / Chapter III.B. --- Sample collection and Analysis --- p.25 / Chapter III.C. --- Corticotrophin releasing hormone radioimmunoassay --- p.26 / Chapter III.C.l.a. --- Theoretical basis for radioimmunoassay --- p.26-27 / Chapter III.C.l.b. --- Vycor extraction of maternal plasma samples --- p.28-30 / Chapter III.C.l.c. --- Standard curve --- p.31-32 / Chapter III.C.l.d. --- Antisera --- p.33 / Chapter III.C.1.e. --- Tracer --- p.34-35 / Chapter III.C.l.f. --- HPLC Tracer Purification --- p.36-37 / Chapter III.C.l.g. --- Separation of bound from unbound Cortico- trophin-releasing hormone: second antibody --- p.38 / Chapter III.C.1.h. --- Corticotrophin-releasing hormone radio- immunoassay procedure --- p.39 / Chapter III.C.2. --- Corticotrophin-releasing hormone reagents --- p.40-41 / Chapter III.C.3. --- Estimation of Corticotrophin-releasing hormone extraction recovery --- p.42 / Chapter III.C.4. --- Sample dilution --- p.43 / Chapter III.D. --- Alpha-fetoprotein: microparticle enzyme immunoassay --- p.44 / Chapter III.D.1. --- Principles --- p.44 / Chapter III.D.2. --- Reaction Process --- p.45-46 / Chapter III.D.3. --- MEIA Optical Assembly --- p.47 / Chapter III.D.4. --- Operation --- p.47 / Chapter III.D.5. --- Alpha-fetoprotein reagents --- p.48 / Chapter III.D.6. --- Sample Dilution --- p.49 / Chapter III.D.7. --- Inter-assay and Intra-assay Variation --- p.50-52 / Chapter III.E. --- Data handling --- p.53 / Chapter III.F. --- Statistical Analysis --- p.53 / Chapter IV: --- Results --- p.54 / Chapter IV.A. --- Demographic Data --- p.55-57 / Chapter IV.B. --- Corticotrophin-releasing hormone levels --- p.58 / Chapter IV.B.1. --- Corticotrophin-releasing hormone levels increases as gestation advances --- p.58 / Chapter IV.B.2 --- The association between the plasma Corticotrophin releasing hormone levels and the time to delivery --- p.59 / Chapter IV.B.3 --- Elevated Corticotrophin-releasing hormone levels among the preterm group --- p.60 / Chapter IV.B.4. --- Corticotrophin releasing hormone levels and history of threatened abortion --- p.61 / Chapter IV.C. --- Alpha-fetoprotein levels --- p.62 / Chapter IV.C.1. --- Alpha-fetoprotein levels and gestational age --- p.62 / Chapter IV.C.2. --- Alpha-fetoprotein levels and preterm labour --- p.63 / Chapter V: --- Discussion --- p.64-65 / Chapter V.A. --- Importance of dating --- p.64 / Chapter V.B. --- Diagnosis of preterm labour --- p.64-65 / Chapter V.C.1. --- Corticotrophin-releasing hormone and labour --- p.65-66 / Chapter V.C.2. --- Corticotrophin-releasing hormone and infection --- p.66-67 / Chapter V.C.3. --- Diurnal rhythm of Corticotrophin-releasing hormone --- p.67 / Chapter V.C.4. --- Laboratory assays of Corticotrophin-releasing hormone --- p.68 / Chapter V.D. --- Alpha-fetoprotein and labour --- p.69-70 / Chapter VI. --- Reference --- p.71-82

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 56-62).

Thesis (doctoral)--Katholieke Universiteit te Nijmegen. / Bibliography: p. 156-174.

Objective: Unknown ethiology Background: Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and resistant to aminoglycosides. Case Report: A 23-year-old woman presented with lower abdominal pain and was admitted for premature labor at 24-weeks of gestation. At presentation, the cervix was closed and the membrane was intact; however, contractions continued, the membrane subsequently ruptured before receiving any steroids or magnesium, and the mother gave birth to a 540-gram female baby. At birth, Apgar scores were 1 at 5 minutes, 1 at 10 minutes, and 2 at 15 minutes. On the fifth day of life, the blood culture grew Capnocytophaga species. Consequently, Cefotaxime was started and ampicillin continued for a total of 14 days; however, on the 6th day, the head ultrasound showed grade 4 intraventricular hemorrhage and a Do Not Resuscitate (DNR) order was placed in the chart. The patient's health continued to deteriorate, having multiple episodes of bradycardia and desaturation until cardiac arrest on the 17th day. Conclusions: Capnocytophaga ochracea was isolated from the blood culture of a preterm neonate. It was thought to be the cause of the premature labor and subsequent neonatal septicemia. This case report suggests that the prevalence of Capnocytophaga infections is most likely underestimated and that additional premature labors and abortions could have been caused by Capnocytophaga infections that were never detected. Hence, more studies are needed to investigate the route of transmission.

Leung Tse Ngong. / Thesis (M.D.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (p. 169-197). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.

Thesis (Ph. D.)--University of Washington, 1998. / Vita. Includes bibliographical references (leaves [114]-119).

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 80-97).

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-22T13:38:34Z No. of bitstreams: 1 julianafurtadomacedo.pdf: 1425315 bytes, checksum: e539e2a6f2139eef74856ce89f25d9e5 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:28:58Z (GMT) No. of bitstreams: 1 julianafurtadomacedo.pdf: 1425315 bytes, checksum: e539e2a6f2139eef74856ce89f25d9e5 (MD5) / Made available in DSpace on 2016-09-26T20:28:58Z (GMT). No. of bitstreams: 1 julianafurtadomacedo.pdf: 1425315 bytes, checksum: e539e2a6f2139eef74856ce89f25d9e5 (MD5) Previous issue date: 2010-07-30 / Este estudo avaliou a associação entre doença periodontal materna e nascimento prematuro em um grupo de mulheres brasileiras. Um estudo caso-controle foi conduzido com mulheres no pós-parto, com idades entre 18-40 anos. Foram incluídas mães cujos partos ocorreram no setor de obstetrícia de um hospital de Juiz de Fora, Minas Gerais, Brasil, entre janeiro e junho de 2010. Foram coletados dados demográficos e socioeconômicos, informações sobre a história da gestação atual e/ou anterior(es). Avaliação periodontal foi realizada até 48 horas após o parto. A doença periodontal foi avaliada segundo duas definições: definição 1 – presença de quatro ou mais dentes, com pelo menos um sítio com profundidade de sondagem (PS)≥4 mm e perda de inserção periodontal (PIP)≥3 mm; definição 2 – presença de pelo menos um dente com pelo menos um sítio com PS e PIP≥4 mm. Análise de regressão logística multivariada foi realizada para cada uma destas definições. Calculou-se a razão de chance (OR) com um intervalo de confiança (IC) de 95%. As 296 puérperas que preencheram os critérios de inclusão foram divididas em dois grupos: 74 mães de recém-nascidos prematuros (grupo caso) e 222 mães de recémnascidos prematuros (grupo controle). Não houve diferença significativa nos dados demográficos, exceto para o município de origem, nem nos dados obstétricos. Aumento do apetite e número de escovações diárias associaram-se significativamente à prematuridade, independentemente da definição de doença periodontal adotada. A definição 1 da doença periodontal não se associou ao menor número de semanas de gestação (OR=1,62; IC95%: 0,80-3,29; p=0,178). Encontrouse associação significativa entre a definição 2 e nascimento prematuro (OR=1,98; IC95%: 1,14-3,43; p=0,015), resultado que sugere que a doença periodontal pode ser um fator associado para prematuridade e aponta para a necessidade de exame regular da condição periodontal durante a gestação. / This study was designed to address the association between maternal periodontal disease and preterm birth in a group of Brazilian women. A case-control study with post partum women aged 18-40 yrs was conducted. The mothers included those who gave birth between January and June 2010 at the obstetrics clinic of a general hospital in Juiz de Fora, State of Minas Gerais, Brazil. Demographic and socioeconomic data, information on current and anterior pregnancy histories, and periodontal clinical parameters were collected until 48 hrs after childbirth. Periodontal disease was assessed according to two alternative definitions, namely: definition 1 – four or more teeth with at least one site showing probing depth (PD)≥4 mm and clinical attachment loss (CAL)≥3 mm; and definition 2 – at least one site showing PD and CAL≥4 mm. For each of these definitions, multivariate logistic regression analysis was conducted. Odds ratio (OR) was calculated with a 95% confidence interval (CI), to evaluate the association between periodontal disease and prematurity. A total of 296 post partum women met the inclusion criteria and were divided as followed: 74 women who delivered a preterm neonate were assigned to the case group while the other 222 were assigned to the control group. There were no significant differences neither in demographic information, except for origin municipality, nor in obstetric characteristics. Increased appetite and number of daily toothbrushing were associated with prematurity, regardless the definition of periodontal disease used. Definition 1 of periodontal disease was not associated with fewer weeks of gestation (OR=1.62; CI95%: 0.80-3.29; p=0.178). Significant association was found between definition 2 of periodontal disease and preterm birth (OR=1.98; CI95%: 1.14-3.43; p=0.015). The results suggest that periodontal disease may be an associated risk factor for prematurity, as well as point to the necessity of regular investigation on periodontal condition during pregnancy.

A incompetência istmo cervical é uma importante causa de prematuridade. Atualmente, o componente genético está relacionado ao parto prematuro, dentre os quais os polimorfismos de nucleotídeo único (SNPs) de alguns genes candidatos estão associados. Os SNPs nos genes do colágeno, da matrix extracelular e das de interleucinas têm relação direta com o comprimento do colo uterino podendo relacionar-se com o encurtamento do colo uterino, como também ocorre na incompetência cervical. Este estudo tem o objetivo de associar a frequência dos SNPs dos genes do COL1 A1, COL 4A3, TGF-B e TIMP2 à história de incompetência cervical. Foi realizado estudo de caso controle com grupo de pacientes, que realizaram cerclagem do colo uterino na última gestação e o grupo de pacientes com antecedente de gestação a termo (controle). Em sangue periférico, foi extraído DNA, realizadas reações de PCR com primers específicos para os SNPs de interesse em 62 amostras preparadas para sequenciamento de última geração pelo Ion Torrent. Houve leitura satisfatória em 57 amostras, sendo 28 casos e 29 controles. A frequência do SNPS do COL1A1 no grupo caso foi de 70,4% versus 33,3% no grupo controle (p=0,03). Os SNPs do COL4A3 e do TIMP2 apresentaram associação com o antecedente de abortos totais (p=0,02 e p=0,023) e abortos tardios (p=0,001 e p=0,034); para os demais SNPs não houve diferença em frequência entre os grupos caso e controle. Foram identificados SNPs exônicos ainda não descritos na literatura. O presente estudo observou uma maior taxa de homozigoze T/T para o SNP COL1A1 no grupo caso, que é um gene associado ao metabolismo do colágeno, além de identificar SNPs ainda não descritos na literatura, que poderão ser objeto de estudo no futuro para conhecimento da sua repercussão na composição do colágeno / Cervical incompetence is one of the most important causes of prematurity. It has already been suggested that genetic factors plays a significant hole in determining the risk of preterm birth and the single nucleotide polimofisms (SNPS) from candidate genes are associated. Polymorfisms in several genes such as the collagen, the extracelular matrix and the interleucins, are related to abnormal cervical length, as it occurs in cervical incompetence. The aim of this study, was to associate the frequency of the SNPs in the COL1A1, COL4A3, TGF-B and TIMP2 genes to the cervical incompetence. We conduced a case control study with patients submitted to cervical cerclage and a control group with women who delivery at term. DNA was isolated from blood samples and amplifications of the genomic DNA were performed by PCR protocol with specific primers for the SNPs. DNA sequencing of 62 samples, was obtained from next generation sequencing on the Ion Torrent. A total of 57 samples, including 28 cases and 29 controls had results available. The frequency of the SNP in COL1A1 in the case group was 70,4% versus 33% in the control group (p=0,03). The SNPS in COL4A3 and TIMP2 were significant related to the history of miscarriages (p=0,2 and p=0,023) and fetal losses (p=0,001 and p=0,034) No significant differences were observed in the frequencies for the others SNPs in the two groups. In the present study, non described exonic SNPs were discovered. Higher frequencies of the homozygous T/T genotype in COL1A1 were observed in the case group involving the collagen metabolism and the non described exonic SNPs might be associated to collagen abnormalities in future studies

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2016-07-07T17:27:31Z No. of bitstreams: 1 gustavohenriquedeoliveira_dissert.pdf: 920807 bytes, checksum: dd35cbbf5e85078e466e6f5bcd2d444e (MD5) / Made available in DSpace on 2016-07-07T17:27:31Z (GMT). No. of bitstreams: 1 gustavohenriquedeoliveira_dissert.pdf: 920807 bytes, checksum: dd35cbbf5e85078e466e6f5bcd2d444e (MD5) Previous issue date: 2010-12-09 / Aim: To evaluate the importance of cervical gland area (CGA) to predict spontaneous preterm birth (SPB). Method: A prospective study was performed from October 2008 to September 2009 of 102 singleton pregnancies at 20 and 24 weeks. A transvaginal ultrasound during the routine morphological scan investigated: the cervical length, CGA, its thickness and signs of cervical funneling. A preterm birth is defined as one that occurs at less than 37 weeks gestation. Ultrasound and clinical variables were submitted to univariate analysis by calculations of descriptive statistics, the Student t-test, percentages, and two-dimensional associative arrays evaluated using the Fisher exact test and odds ratio. The level of significance was set at 5%. Results: Of the 102 patients, four were lost in the follow up and seven were excluded as delivery was induced prematurely; ten patients presented spontaneous preterm births and 81 at term. The mean maternal age was 28.8 years old (18-41 years) without significant difference between the spontaneous preterm birth and term groups. There were statistical differences in the mean (33.9 vs. 36.1 cm), median (33.5 vs. 37.0 cm) and spread (standard deviation: 9.6 vs. 7.0) of the cervical length between the two groups. Risk factors for SPB gave an odds ratio of 15.06. All patients presented a CGA with a mean thickness of 8.4 mm (5.1 to 15 mm – SD: 3.1) for SPB and 8.9 mm (3.0 to 13.9 mm – SD: 2.3) for term individuals. Conclusion: The results suggest that the presence or absence and thickness of CGA are not correlated to SPB even in clinically or ultrasonographically high-risk patients. Further studies are necessary to reevaluate the parameters used to predict SPB. / Objetivo: Avaliar a importância do eco glandular endocervical (EGE) na predição de parto prematuro espontâneo (PPE). Método: Estudo prospectivo de 102 gestações únicas, entre 20-24 semanas, de outubro/2008 a setembro/2009. Na ecografia morfológica, o exame transvaginal avaliou: comprimento do colo uterino, EGE, espessura e sinal do afunilamento. Foi considerado PPE interrupção antes de 37 semanas de gestação. As avaliações ultrassonográfica e clínica foram submetidas à análise univariada pelos cálculos de estatísticas descritivas, teste t de Student, distribuições percentuais, tabelas associativas para análises bidimensionais, teste exato de Fisher e odds ratio no nível de significância de 5%. Resultados: Das 102 pacientes, quatro perderam seguimento, sete foram excluídas por parto prematuro induzido, dez pacientes apresentaram PPE e 81 parto a termo (PT). A idade materna média foi de 28,8 anos (18-41 anos), sem diferença nos dois grupos (PPE e PT). No comprimento do colo observaram-se diferenças na média (33,9 x 36,1 cm), mediana (33,5 x 37,0 cm) e na dispersão (desvio–padrão 9,6 x 7,0). Fatores de risco para PPE mostraram odds ratio de 15,06. Todas as pacientes apresentaram EGE, com espessura média de 8,4 mm (5,1 a 15 mm - desvio padrão 3,1) para PPE, e de 8,9 mm (3,0 a 13,9 mm - desvio padrão de 2,3) para PT. Conclusão: Os resultados indicam que a presença, ausência ou espessura do EGE não se correlacionou com PPE, mesmo naquelas pacientes com alto risco clínico e/ou ultrassonográfico de PPE. São necessárias novas pesquisas para reavaliação dos parâmetros indicadores de PPE.