Made available in DSpace on 2014-06-11T19:29:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-27Bitstream added on 2014-06-13T21:00:23Z : No. of bitstreams: 1 volpi_scp_me_botfm.pdf: 576023 bytes, checksum: 7dd3829998229954fc827b11bf062fd2 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / É grande a preocupação com o desenvolvimento motor de prematuros de muito baixo peso, mas as idades de seus marcos motores não estão bem estabelecidas. Determinar as idades cronológica e corrigida dos marcos motores até a marcha, em prematuros de muito baixo peso. Estudo de coorte, em 143 prematuros com menos de 1500g e idade gestacional menor ou igual a 34 semanas, sem alterações neurossensoriais, selecionados no ambulatório de seguimento de recém-nascidos de Unidade de Terapia Intensiva Neonatal do Hospital das Clinicas da Faculdade de Medicina de Botucatu- Universidade Estadual Paulista, no período de 1998 a 2003 e avaliados a cada dois meses de seguimento até a marcha. Dos 155 prematuros incluídos houve perda de 9% da coorte, restando no estudo143 lactentes. A média de idade gestacional foi 30±2 semanas.O peso ao nascimento de 1130±222g, sendo 59% do sexo feminino e 43% pequenos para Idade gestacional. Houve atraso superior a um mês nas idades cronológicas do controle de cabeça, rastejar e engatinhar, mas na idade corrigida todos os marcos foram alcançados no prazo previsto. Não houve diferença entre meninos e meninas. Os pequenos para idade gestacional diferiram dos adequados, mas obtiveram seus marcos dentro da normalidade. Houve correlação significativa entre os marcos motores. Prematuros de muito baixo peso, sem alterações neurossensoriais, apresentam marcos motores no prazo normal: controlam a cabeça no 2o mês, sentam aos sete meses e andam com 12,8 meses de idade corrigida, correspondendo respectivamente ao 4o, 9o e 15o mês de idade cronológica. Os marcos motores são mais tardios nos prematuros pequenos para idade gestacional. / There is great concern regarding to the neurodevelopment of very low birthweight infants, but the ages of gross motor milestone attainement are not well established. To determine the chronological and corrected ages of gross motor milestones until walking attainment in very low birthweight infants. Methods: Prospective cohort study, including 143 preterm infants < 1500g and ≤ 34 weeks of gestation, without neurological and sensorial sequelae, recruited from 1998 to 2003 in the Neonatal High Risk Follow-up Clinic of HC- Botucatu Medical School-UNESP, and bimonthly evaluated up to walking attainment. Of the 155 preterm included, there was loss of 9% of the cohort, and 143 were studied. Mean gestational age was 30±2 weeks, birth weight 1130±222g, 59% were female and 43% small for gestational age. Chronologic ages were delayed more than one month for the head control, creeping, and crawling, however all motor milestones attainment were normal for the correct age. Males did not differ from females. Small for gestational age infants attained their milestones later than those of appropriate size for gestational age, although in the normal range of the expected time. There was a significant correlation between the gross motor milestones. Very low birthweight infants, without neurosensorial sequelae, have a normal profile of the gross motor milestones: head control at 2nd month, siting at 7 months and walking at 12,8 months of corrected age, corresponding to 4th, 9th, and 15th months of chronologic age respectively. Motor milestones are later in the small for getational age infants.

Pre-eclampsia is a pregnancy-related disorder characterised by high blood pressure, proteinuria and oedema. The aetiology of the disease is unclear but evidence suggests that endothelial dysfunction is central to the development of the maternal syndrome. Kinins are endogenous peptides released by the endothelium that contribute to the regulation of cardiovascular homeostasis by inducing vasodilation, fibrinolysis and angiogenesis. Given that pre-eclampsia is associated with reduced endotheliumdependent relaxation, coagulation abnormalities and an angiogenic imbalance, it was hypothesised that alterations of kinin receptor-mediated responses may be involved in the pathogenesis of the condition. To investigate whether changes in kinin receptor activity are involved in the impairment of endothelium-dependent relaxation observed in pre-eclampsia, the effects of specific B2 and B1 receptor agonists and antagonists on myometrial vascular tone were tested on arteries from healthy pregnancy and pre-eclampsia. The results demonstrated that in addition to classical bradykinin B2 receptor-mediated relaxation, a subset of healthy patients exhibited nitric oxide-dependent relaxation to the B1 receptor agonist Lys-des- Arg9-BK (LDABK) which could not be inhibited by either B1 or B2 receptor antagonists. Also, vessels that exhibited this novel response to LDABK were more sensitive to bradykinin. Furthermore, this study revealed that patients with pre-eclampsia had an attenuated response to both bradykinin and LDABK. Immunolocalisation and mRNA expression of the kinin receptors in the myometrium revealed no differences between healthy pregnancy and pre-eclampsia suggesting that disturbances of kinin receptor signalling rather than changes in receptor distribution or expression levels may be involved in the reduction of kinin-mediated responses in these patients. The role of kinins in mediating placental angiogenesis in healthy pregnancy and preeclampsia was determined using the endothelial tube formation assay in primary human umbilical vein endothelial cells (HUVECs) isolated from healthy women and women with pre-eclampsia. B2 and B1 receptor agonists induced endothelial tube formation via a VEGF-dependent, nitric oxide-independent mechanism in healthy HUVECs cultured in normoxic conditions. HUVECs isolated from women with pre-eclampsia cultured under normoxia and HUVECs from healthy pregnancies cultured under hypoxia exhibited greater levels of angiogenic branching compared with healthy normoxic cells, but were unresponsive to bradykinin and LDABK. Incubation of these cells with a VEGF receptor inhibitor reduced the elevated levels of tube formation indicating that this effect may be due to hypoxic upregulation of VEGF or an intrinsic difference in their angiogenic capacity. Further studies are required to determine the cause for the differences in angiogenic potential between healthy and pre-eclamptic cells and the impact this could have on placental vascular development and the pathogenesis of preeclampsia.

Orientador: Maria Terezinha Serrão Peraçoli / Resumo: A pré-eclâmpsia é uma complicação grave da gestação, caracterizada por hipertensão e proteinúria. Os sintomas desta síndrome aparecem durante a segunda metade da gestação. A literatura sugere que a pré-eclâmpsia resulta de uma resposta inflamatória excessiva à gestação. O objetivo deste trabalho foi avaliar a atividade de monócitos de sangue periférico através da produção de citocinas, atividade fungicida e liberação de peróxido de hidrogênio por essas células em gestantes normais e com pré-eclâmpsia. Foram estudadas 25 mulheres não-grávidas e normotensas e 50 gestantes sendo 20 normotensas e 30 com pré-eclâmpsia. Monócitos foram cultivados com ou sem 10 ug/mL de lipopolissacáride (LPS) durante 24 h a 37oC e os níveis de fator de necrose tumoral alfa (TNF-a), de Interleucina-10 (IL -10) e de fator transformador do crescimento beta (TGF-b1) foram determinados no sobrenadante de cultura por ensaio imunoenzimático. A atividade fungicida foi avaliada pela recuperação de células viáveis de Candida albicans após plaqueamento e contagem de unidades formadoras de colônias em meio ágar Sabouraud. A liberação de peróxido de hidrogênio (H2O2) foi determinada antes e após estímulo dos monócitos com phorbol 12-myristate 13-acetate (PMA). Os resultados mostraram que os níveis endógenos de TNF-a, IL -10 e de TGF-b1 produzidos por monócitos, cultivados sem estímulo, foram significativamente mais elevados tanto em gestantes normais como nas com pré-eclâmpsia. Resultados semelhantes foram observados com relação à produção de IL-10 e TGF-b1 por monócitos após estímulo com LPS. A liberação de H2O2 após estímulo com PMA foi mais elevada em gestantes normais do que nas com pré-eclâmpsia. Além disso, monócitos de gestantes com... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Pre-eclampsia is a severe complication of pregnancy, characterized by hypertension and proteinuria. The symptoms of this syndrome appear during the second half of the pregnancy. The literature suggests that pre-eclampsia results from an excessive maternal inflammatory response to pregnancy. The objective of this study was to evaluate the activity of peripheral blood monocytes by cytokine production, fungicidal activity and hydrogen peroxide liberation in normotensive pregnant women and with pre-eclampsia. The study included 25 normotensive non-pregnant and 50 pregnant women being 20 normotensive and 30 with preeclampsia. Monocytes from these women were cultivated with or without 10 ug/mL lipopolysaccharide (LPS) during 24h at 37oC, and the levels of tumor necrosis factor-alpha (TNF-a), Interleukin-10 (IL -10) and transforming growth factor beta 1 (TGF-b1) were determined in culture supernatants by enzyme immunoassay. The fungicidal activity was determined by the recovery of viable Candida albicans after co-culture of yeasts with monocyte and plating in Sabouraud medium with enumeration of colony forming units. Hydrogen peroxide (H2O2) liberation was determined before and after monocyte stimulation with phorbol 12-myristate 13- acetate (PMA). The results showed that endogenous levels of TNF-a, IL-10 and TGF-b1 detected in supernatants of monocytes cultivated without stimulus were significantly higher in both normal and pre-eclampsia pregnant patients than in non-pregnant women. Similar results were observed in relation to IL -10 and TGF- b1 production after monocyte stimulation with LPS. Monocytes from normotensive pregnant women released higher levels of H2O2 after PMA stimulation than cells from patients with pre-eclampsia. Besides monocytes from women with preeclampsia produced lower levels of TNF-a suggesting an impairment in the... (Complete abstract click electronic address below) / Mestre

Pre-eclampsia (PE) is a pregnancy disorder that affects roughly 5-7% of all pregnancies and is a leading cause of both maternal and fetal/neonatal morbidity and mortality. With no present cure for the disease, researchers are interested in the lower incidence of PE observed among the cigarette smoking pregnant population. However, women who use smokeless tobacco do not experience the same decreased incidence of PE, leading to hypothesis of protection against PE from the largest combustible product of cigarette smoke, carbon monoxide (CO). Studies evaluated levels of CO in PE women and found that they were statistically lower than those of healthy pregnancy. Researchers have found CO to possess many cytoprotective and regulatory properties and specifically within the placenta, it has been found to increase perfusion pressure, decrease oxidative stress, decreases ischemia/reperfusion induced apoptosis and maintain endothelial functioning. The idea for use of CO as a possible therapeutic for PE has thus become a real possibility. This study determined CO levels in pregnant women ± smoking as well as in PE women±smoking, as to discover a possible therapeutic range for future treatments. The best correlated automated CO measurement device with blood CO levels was determined, for use in future clinical studies. This thesis also sought a possible CO delivery concentration, in order to achieve the CO levels observed in the human correlation study. A threshold level of maternal CO exposure in a murine animal model was found, for which fetal and maternal negative toxicities were not observed. The results of this thesis lend a few more pieces to the complicated puzzle involving CO and PE and offer another step toward the possibility of a therapeutic treatment/prevention using this gaseous molecule. / Thesis (Master, Anatomy & Cell Biology) -- Queen's University, 2009-09-19 08:55:06.548

Made available in DSpace on 2014-08-13T14:50:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-02-21Bitstream added on 2014-08-13T18:00:54Z : No. of bitstreams: 1 000750733.pdf: 1281894 bytes, checksum: dc49e77c506e8c2dbd261f5086ca51f7 (MD5) / A pré-eclâmpsia (PE) é uma síndrome específica da gestação humana, caracterizada por uma resposta inflamatória sistêmica, de maior intensidade do que a observada na gestação normal. Nessa patologia, células do sistema imune inato como monócitos e granulócitos encontram-se ativadas endogenamente e secretam níveis elevados de radicais livres e citocinas inflamatórias. 1) Determinar o estado de ativação endógena de monócitos pela expressão de receptores TLR2 e TLR4, bem como a ativação do fator de transcrição nuclear NF-κB nessas células em gestantes portadoras de PE distribuídas quanto à idade gestacional de aparecimento das manifestações clínicas (precoce ou tardia) da doença; 2) Correlacionar a expressão de TLR2 e TLR4 com a produção de fator de necrose tumoral alfa (TNF-), interleucina-10 (IL-10) e IL-12 por monócitos estimulados com lipopolissacáride de Escherichia coli (LPS) e peptidoglicano (PGN) de bactéria Gram-positiva em gestantes com PE precoce ou tardia; 3) Verificar se os parâmetros estudados diferenciam PE precoce e tardia. Foram estudadas 92 gestantes, sendo 32 normotensas e 60 portadoras de PE, pareadas pela idade gestacional. As gestantes pré-eclâmpticas foram classificadas de acordo com o aparecimento das manifestações clínicas em PE precoce (<34 semanas de gestação, n=30) e PE tardia (≥34 semanas de gestação, n=30). Monócitos de sangue periférico obtidos de gestantes normotensas ou com PE foram cultivados por 18 h na ausência ou presença de LPS ou de PGN. A expressão de receptores TLR2 e TLR4, presentes na superfície de monócitos, foi detectada por citometria de fluxo, empregando-se anticorpos monoclonais específicos, marcados com fluorocromos. Para análise da ativação do fator de transcrição nuclear NF-κB os monócitos foram incubados na presença ou ausência de LPS ou PGN por 30 min e o extrato nuclear obtido foi empregado para dosagem de NF-κB. Monócitos ... / Preeclampsia (PE) is a pregnancy-specific human syndrome characterized by a systemic inflammatory response, with higher intensity than the one observed in normal pregnancy. In this pathology, innate immune cells such as monocytes and granulocytes are activated endogenously and secrete high levels of inflammatory cytokines and free radicals. 1) to determine the activation state of monocytes by endogenous expression of TLR2 and TLR4 receptors as well as the nuclear transcription factor (NF-κB) activation in these cells in pregnant women with PE, distributed according to the gestational age of clinical manifestations (early or late-onset) of the disease; 2) to correlate TLR2 and TLR4 expression with TNF-α, IL-10 and IL-12 by monocytes stimulated with lipopolysaccharide (LPS) of Escherichia coli and peptidoglycan (PGN) of Gram-positive bacteria in pregnant women with early-onset or late-onset PE; 3) to verify if the parameters studied may differentiate early-onset or late-onset PE. We studied 92 pregnant women, 32 normotensive and 60 women with PE, paired for gestational age. Preeclamptic pregnant women were classified according to onset of clinical manifestations in early-onset PE (<34 weeks gestation, n=30) and late-onset PE (≥ 34 weeks gestation, n=30). Monocytes from peripheral blood obtained from preeclamptic and normotensive pregnant women were incubated for 18h in the absence or presence of LPS or PGN. Expression of TLR2 and TLR4 receptors present on the surface of monocytes, was detected by flow cytometry, using specific monoclonal antibodies labeled with fluorochromes. To analyze NF-κB, monocytes were incubated with or without LPS or PGN for 30 min and the nuclear extract obtained was employed for NF-κB determination. Monocytes were further cultured in the presence or absence of LPS and PGN and the supernatant obtained after 18h cultivation was aspirated and used for TNF-α, IL-10, IL-12p40 and IL-12p70 determination by ...

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Made available in DSpace on 2014-06-11T19:26:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-11-24Bitstream added on 2014-06-13T19:54:31Z : No. of bitstreams: 1 souza_co_me_botfm.pdf: 403996 bytes, checksum: 1bf83541f86766588143610433c5d720 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Silibinina é um flavonóide quimicamente definido e o principal componente ativo da silimarina, um complexo polifenólico obtido de frutos e sementes de Silybum marianum, que possui propriedades anti-inflamatória, hepatoprotetora e anti-carcinogênica. Objetivo: O objetivo deste trabalho foi avaliar os efeitos da silibinina sobre a performance reprodutiva de ratas prenhes Wistar e as anomalias e/ou malformações de seus fetos. Métodos: Foram utilizadas ratas Wistar prenhes estratificadas em quatro grupos experimentais: controle (n = 6), ratas tratadas com 50mg/kg/dia de silibinina (Grupo I, n = 6), ratas tratadas com 100mg/kg/dia de silibinina (Grupo II, n = 6) e ratas tratadas com 200mg/kg/dia de silibinina (Grupo III, n = 6). Os animais receberam tratamento por via oral (gavage). Durante toda a prenhez, o consumo de ração e a ingestão de água, bem como o ganho de peso corporal foram avaliados. No dia 21 de prenhez as ratas foram anestesiadas A cesárea foi realizada no 21º dia, quando os recém-nascidos foram mortos e processados para análise das variações e/ou malformações. Resultados: os grupos controle e tratados não apresentaram diferenças significativas em relação aos parâmetros fetais, não se observando sinais de toxicidade materna com as diferentes concentrações de silibinina empregadas. Conclusão: O tratamento com silibinina não determinou efeitos deletérios na performance reprodutiva das ratas, mesmo quando utilizada em altas doses (200 mg/Kg/dia). / Silibinin is a chemically defined flavonoid and the main active component of silymarin, a polyphenolic complex from fruits and seeds of Silybum marianum, which has anti-inflammatory, hepatoprotective and anticarcinogenic properties. Objective: The aim of the present study was to evaluate the dose-dependent effect of silibinin treatment on maternal reproductive performance and on abnormalities and/or fetal malformations. Methods: Pregnant Wistar rats were distributed in four experimental groups: control, not treated with silibinin (n=6), rats treated with silibinin 50mg/kg/day (Group I, n = 6), rats treated with silibinin 100mg/kg/day (Group II, n = 6) and rats treated with silibinin 200mg/kg/day (Group III, n = 6). Silibinin was administrated by gavage from day 0 to 20 of pregnancy. During the period of pregnancy food and water intake, as well as weight gain were evaluated. On day 21 of pregnancy, the rats were anesthetized and submitted to cesarean section to analyse maternal reproductive performance and fetal malformations. Results: The control and silibinin-treated groups did not show significant differences in relation to the fetal parameters evaluated and no maternal toxicity effects of silibinin were detected in the concentrations employed. Conclusion: Silibinin treatment did not determined deleterious effect on the maternal reproductive performance and fetal outcome even when employed in high dose (200 mg/Kg).

Made available in DSpace on 2014-06-11T19:32:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-07-18Bitstream added on 2014-06-13T19:03:48Z : No. of bitstreams: 1 magalhaes_cg_dr_botfm.pdf: 216705 bytes, checksum: 881a08a914c86cba7e794e4008028006 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Fundação para o Desenvolvimento da UNESP (FUNDUNESP) / Verificar se o coração é órgão-alvo da pré-eclâmpsia (PE) e identificar as alterações hemodinâmicas, estruturais e de função diastólica e sistólica do ventrículo esquerdo, por estudos Doppler-ecocardiográficos. Sujeitos e métodos: Foram avaliadas 29 gestantes com PE e 29 normotensas, pareadas por idades materna e gestacional, e paridade. O exame foi realizado no momento diagnóstico de PE, antes da administração de anti-hipertensivos, avaliando-se as variáveis: resistência periférica (RP), rigidez vascular (RV), diâmetro do átrio esquerdo (AE), diâmetro diastólico do ventrículo esquerdo (VE) (DDVE), diâmetro sistólico do VE (DSVE), septo interventricular (SIVd), parede posterior do VE (PPVEd), espessura relativa da parede posterior do VE (ERP), massa do VE (MVE), índice de massa do VE (iMVE), débito cardíaco (DC), volume sistólico (VS), fração de ejeção (FE%), porcentagem de variação do diâmetro VE (%HD), onda E (E), Onda A (A), relação E/A, tempo de relaxamento isovolumétrico do VE (TRIV). Os dados foram avaliados por média ± desvio-padrão e a análise estatística, pelo teste t de Student, considerando-se p < 0,05. Resultados: Gestantes com PE apresentaram aumento significativo de RV (0.86 ± 0.34 v 0.65 ± 0.17mmHg/mL, p = 0.006), RP (1900.75 ± 439.53 v 1388.14 ± 336.90dyn/s/cm-5, p < 0.001) , SIVd (9.66 ± 1.67 v 7.40 ± 0.86mm, p < 0.001), PPVEd (9.45 ± 1.63 v 7.52 ± 0.81mm, p < 0.001), ERP (0.40 ± 0.09 v 0.31 ± 0.04, p < 0.001),MVE (187.36 ± 43.89 v 132.78 ± 32.66g, p < 0.001), iMVE (52.01 ± 11.29 v 45.33 ± 11.69g/m2,7, p < 0.001), FE% (0.79 ± 0.04 v 0.74 ± 0.06%, p = 0.001), %HD (40.73 ± 4.43 v 36.69 ± 5.27%, p = 0.002) e A (62.34 ± 18.78 v 50.37 ± 10.93cm/s, p < 0.004). Gestantes normotensas apresentaram significativamente maiores valores de DSVE (30.61 ± 3.39 v 28.48 ± 4.09mm, p = 0.032) e relação E/A (1.71 ± 0.50 v 1.42 ± 0.40, p = 0.018). / Being PE a systemic disease which affects multiple organs, it is possible to infer that it also affects the heart, even in the absence of symptoms. This study proposed to verify if the heart is a target organ in PE by analyzing structural and functional variables. Methods: Left ventricular geometry and function were compared among 29 PE women and 29 normotensive pregnant women (grouped according to maternal and gestational age and parity) using Doppler-echocardiography performed when PE was diagnosed. The parameters included systemic vascular resistance (SVR), Stiffness (S), left atrial dimension (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septal thickness in diastole (IVSD), left ventricular posterior wall thickness in diastole (LVPWD), relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMi), cardiac output (CO), stroke volume (SV), ejection fraction (EF), fractional shortening (FS), peak velocity of the mitral E wave (E), peak velocity of the mitral A wave (A), E/A ratio and isovolumetric relaxation time (IVRT). Data were expressed as mean ± SD. Comparison between groups was made using the Student’s t-test. A p value of < 0.05 was considered as significant. Results: PE women showed increased: Stifnness (0.86 ± 0.34 mmHg/mL v 0.65 ± 0.17mmHg/mL, p = 0.006), SVR (1900.75 ± 439.53dyn/s/cm-5 v 1388.14 ± 336.90dyn/s/cm-5, p < 0.001), IVSD (9.66 ± 1.67 mm v 7.40 ± 0.86mm, p < 0.001), LVPWD (9.45 ± 1.63mm v 7.52 ± 0.81mm, p < 0.001), RWT (0.40 ± 0.09 v 0.31 ± 0.04, p < 0.001), LVM (187.36 ± 43.89g v 132.78 ± 32.66g, p < 0.001), LVMi (52.01 ± 11.29g/m2,7 v 45.33 ± 11.69g/m2,7, p < 0.001), EF (0.79 ± 0.04% v 0.74 ± 0.06%, p = 0.001), FS (40.73 ± 4.43% v 36.69 ± 5.27%, p = 0.002) A (62.34 ± 18.78 v 50.37 ± 10.93, p < 0.004) Normotensive women showed increased:...(Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-08-28Bitstream added on 2014-06-13T21:07:53Z : No. of bitstreams: 1 silva_eg_dr_botfm.pdf: 973178 bytes, checksum: 4a8313adf342022e0a48ef10b96e7f10 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Analisar possíveis associações entre resistência e reactância, avaliadas pela análise de impedância bioelétrica (BIA), no primeiro, segundo e terceiro trimestres de gestação, e ocorrência de pré-eclâmpsia; identificar qual o momento mais precoce da associação. Coorte prospectiva. Hospital das Clinicas da Faculdade de Medicina de Botucatu/Unesp. 380 gestantes acompanhadas no Serviço. As gestantes foram submetidas à BIA, no primeiro (até 14 semanas), segundo (15 a 28 semanas) e terceiro (29 a41 semanas) trimestres, para avaliação dos valores de resistência e reactância. Considerou-se o desenvolvimento de hipertensão arterial, após a 20ª semana, com ou sem proteinúria, respectivamente, Pré-eclâmpsia (PE) e Hipertensão Gestacional (HG). Foi realizada a análise estatística através teste T de student e do Odds-Ratio considerando p<0,05. No primeiro trimestre a média da resistência e reactância do grupo PE (508Ω;57Ω) foi significativamente menor que a observada no grupo normotenso (580Ω;66Ω). No segundo trimestre as médias de resistência e reactância no grupo PE, respectivamente, (502Ω e 53Ω), foram menores significativamente do que as encontradas no grupo normotenso (566Ω e 57Ω). No terceiro trimestre foram também significativamente menores quando comparadas com o grupo normotenso (452 Ω e 47 Ω). No primeiro trimestre o Odds ratio (OR) para a resistência foi de 0,99 (IC 0,98 – 1,0) com p=0,002 e reactância foi de 0,93 (IC 0,85- 1,01) com p=0,07. No Segundo trimestre o OR foi de 0,99 (IC 0,98-0,99) e p=0,001 e a reactância o OR foi de 0,95 (IC=0,9-1,00) com p=0,05. No terceiro trimestre o OR foi de foi de 0,99 (IC 0,98-0,99) e p=0,0010 para resistência e de 0,93 (IC 0,88 – 0,98) e p=0,01 para reactância. A bioimpedância mostrou associação através da resistência tanto no primeiro quanto no segundo... / To analyze possible associations between resistance and reactance, as evaluated by electrical impedance analysis (BIA) in the first, second and third pregnancy trimesters, and preeclampsia occurrence; to identify the earliest moment of association. Prospective cohort. Botucatu School of Medicine University Hospital/Unesp. Population: 380 pregnant women attended to by the Service. The pregnant women underwent BIA in the first (up to 14 weeks), second (15 to 28 weeks) and third (29 to 41 weeks) trimesters for evaluation of resistance and reactance values. The development of arterial hypertension, after the 20th week, with or without proteinuria, respectively, Preeclampsia (PE) and Gestational Hypertension (GH) was considered. Statistical analysis by Odds-Ratio was performed considering p<0.05. In the first trimester, the resistance and reactance means in the PE group (508Ω;57Ω) were significantly lower than those observed in the healthy group (580Ω;66Ω). In the second trimester, the resistance and reactance means in the PE group, respectively (502Ω and 53Ω), were lower than those found in the healthy group (566Ω and 57Ω). In the third trimester were lower than than those found in the healthy group (452 Ω e 47 Ω). In the first trimester, the Odds ratio (OR) for resistance was 0.99 (CI 0.98 – 1.0) with p=0.002, and reactance was 0.93 (CI 0.85-1.01) with p=0.07. In the second trimester, OR was 0.99 (CI 0.98-0.99) and p=0.001, and for reactance, OR was 0.95 (CI=0.9-1.00) with p=0.05. In the third trimester, the Odds ratio (OR) for resistance was (IC 0,98-0,99) with p=0,0010 and 0,93 (IC 0,88 – 0,98) with p=0,01 for reactance. Bioimpedance showed association by means of resistance both in the first... (Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-27Bitstream added on 2014-06-13T19:25:00Z : No. of bitstreams: 1 silva_eg_dr_botfm.pdf: 959345 bytes, checksum: 6ef2475219297629c565247c6d4f26c2 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Financiadora de Estudos e Projetos (FINEP) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Avaliar o sistema cardiorrespiratório e sua influência na capacidade funcional de exercício em gestantes com pré-eclâmpsia. Estudo transversal com 50 gestantes portadoras de pré-eclâmpsia e 50 gestantes normotensas, estimado pelo tamanho amostral. Foi realizado espirometria, dopplerecocardiografia e teste de caminhada de seis minutos. Na análise estatística foi usado o teste t e Mann-Whitney para as variáveis com distribuição simétrica e assimétrica, respectivamente, e regressão múltipla linear. As variáveis espirométricas mostraram redução significativa da capacidade vital forçada (L) [3,35 (2,95; 3,74) ν 3,62 (3,31; 3,88) p=0,012], do volume expirado forçado no primeiro segundo (L) [2,85 (2,58; 3,16) ν 3,06 (2,83; 3,27) p=0,034] e da capacidade vital lenta (L) [3,34 (2,87; 3,91) ν 3,65 (3,32; 4,07) p=0,039], no grupo pré-eclâmpsia comparado com o grupo controle, respectivamente. Os valores do diâmetro sistólico (cm) [2,90 (2,7; 3) ν 2,7(2,65; 2,9) p=0,048] e diastólico do ventrículo esquerdo (cm) [4,8 (4,7; 5) ν 4,7 (4,55; 4,8) p=0,016], índice de massa do ventrículo esquerdo (g/m2,7) [48,65 (45,27; 52,12) ν 34,34 (31,57; 38,05) p<0,001], espessura relativa da parede ventricular esquerda (cm) [0,40 (0,38; 0,45) ν 0,34 (0,34; 0,35) p<0,001], volume sistólico (mL) [62,4 (58,57; 67,66) ν 58,19 (55,24; 63,18) p=0,014], tempo de relaxamento isovolumétrico do ventrículo esquerdo (ms) [88 (80; 92) ν 80 (76;84) p<0,001], tempo de desaceleração da onda E (ms) [196 (192;208) ν 192 (188;196) p=0,002] e onda A (cm/s) [64 (54;75) ν 49 (54;54) p<0,001] foram estatisticamente maiores no grupo préeclâmpsia que no controle. Enquanto que a razão E/A foi significativamente menor no grupo pré-eclâmpsia [1,40 (1,21; 1,63) ν 1,72 (1,55; 1,94) p<0,001]. A distância percorrida (m) no teste de caminhada de seis minutos foi significativamente menor... / To evaluate the cardio respiratory system and its influence on the functional exercise capacity of pregnant women with preeclampsia. Cross-sectional trial on 50 pregnant women with preeclampsia and 50 normotensive pregnant women, estimated by sample size. Spirometry, Doppler echocardiography and the six-minute walk test were performed. In statistical analysis, the t test and the Mann-Whitney test were respectively used for variables with symmetrical and asymmetrical distribution, in addition to multiple linear regression. Results: The spirometric variables showed significant reduction in forced vital capacity (L) 3.35 (2.95; 3.74) 3.62 (3.31; 3.88) p=0.012 , in forced expired volume in the first second (L) 2.85 (2.58; 3.16) 3.06 (2.83; 3.27) p=0.034 and in slow vital capacity (L) 3.34 (2.87; 3.91) 3.65 (3.32; 4.07) p=0.039 as compared to the control group, respectively. The values for systolic (cm) 2.90 (2.7; 3) 2.7(2.65; 2.9) p=0.048 and diastolic diameter of the left ventricle (cm) 4.8 (4.7; 5) 4.7 (4.55; 4.8) p=0.016 , mass index of the left ventricle (g/m2,7) 48.65 (45.27; 52.12) 34.34 (31.57; 38.05) p<0.001 , relative thickness of the left ventricular wall (cm) 0.40 (0.38; 0.45) 0.34 (0.34; 0.35) p<0.001 , systolic volume (mL) 62.4 (58.57; 67.66) 58.19 (55.24; 63.18) p=0.014 , isovolumetric relaxation time of the left ventricle (ms) 88 (80;92) 80 (76;84) p<0.001 , deceleration time of the E wave (ms) 196 (192;208) 192 (188;196) p=0.002 and the A wave (cm/s) 64 (54;75) 49 (54;54) p<0.001 were statistically larger in the preeclampsia group than in control while the E/A ratio was significantly smaller in the preeclampsia group 1.40 (1.21; 1.63) 1.72 (1.55; 1.94) p<0.001 . The distance walked (m) in the six-minute walk test was significantly smaller in the preeclampsia group (465± 61) than in the control group (534± 44) p<0.001. Linear multiple regression showed that, in the presence... (Complete abstract click electronic access below)