Background: The postnatal failures of expression of the hepatic glucose-6-phosphatase system suggest there are developmental deficiencies in the mechanism to ‘switch-on’ this key enzyme of gluconeogenesis at the time of birth in both preterm and term infants. The evidence for hormonal regulation of this critical enzyme system in animal studies, in adult humans, and studies of cell lines make the possible failure of hormonal control around the time of birth an important hypothesis to test, but before this can be done, further studies of perinatal metabolism and its hormonal control need to be undertaken. Objective: To describe the hormonal and metabolic profiles of ‘unstressed’ term infants delivered by elective caesarean section. Methods: One hundred and fifty three women who had an elective caesarean section for a singleton pregnancy at term in Ninewells Hospital and Medical School, Dundee were recruited between July 2004 and April 2006. Maternal venous blood was taken for glucose and lactate estimations. Umbilical venous cord blood was obtained for the measurement of glucose, lactate, 3-hydroxybutyrate, free fatty acids, amino acids (alanine, arginine, citruline, cystine, GABA, glutamic acid, glutamine, glycine, histidine, isoleucine, leucine, lysine, methionine ornithine, phenyalanine, serine,taurine, threonine, tyrosine and valine), insulin, glucagon, human growth hormone, cortisol, catechols (EPI, NE, DA, DOPA, DHPG, DOPAC) and their sulfated conjugates (EPI sulfate, NE sulfate, DA sulfate, DOPA sulfate, DHPG sulfate, DOPAC sulfate), and blood gas and acid-base profiles. Results The mean maternal glucose and lactate levels were 4.28 mmol/l and 1.8 mmol/l respectively. Three infants were hypoglycaemic with umbilical blood glucose levels of less than 2.6 mmol/l. The mean infant glucose and lactate levels were as expected for full term infants at 3.3 mmol/l and 2.2 mmol/l respectively. High mean levels of insulin and catechols were noted at birth. There was a significant positive association between umbilical venous cord glucose levels and maternal venous glucose levels (p=<0.001) but no association of umbilical venous cord glucose levels with amino acids, insulin, glucagon, human growth hormone, cortisol and catechols. Conclusions: This extensive data set of levels of metabolites and hormones in infants at birth acts as a reference source and will be valuable for evaluating any effects of antenatal or intrapartum factors on the hormonal and metabolic profiles of infants at birth as well as to investigate the mechanisms to ‘switch-on’ the key enzyme glucose-6-phosphatase. Objective: To describe the hormonal and metabolic profiles of ‘unstressed’ term infants delivered by elective caesarean section. Methods: One hundred and fifty three women who had an elective caesarean section for a singleton pregnancy at term in Ninewells Hospital and Medical School, Dundee were recruited between July 2004 and April 2006. Maternal venous blood was taken for glucose and lactate estimations. Umbilical venous cord blood was obtained for the measurement of glucose, lactate, 3-hydroxybutyrate, free fatty acids, amino acids (alanine, arginine, citruline, cystine, GABA, glutamic acid, glutamine, glycine, histidine, isoleucine, leucine, lysine, methionine ornithine, phenyalanine, serine, taurine, threonine, tyrosine and valine), insulin, glucagon, human growth hormone, cortisol, catechols (EPI, NE, DA, DOPA, DHPG, DOPAC) and their sulfated conjugates (EPI sulfate, NE sulfate, DA sulfate, DOPA sulfate, DHPG sulfate, DOPAC sulfate), and blood gas and acid-base profiles. Results: The mean maternal glucose and lactate levels were 4.28 mmol/l and 1.8 mmol/l respectively. Three infants were hypoglycaemic with umbilical blood glucose levels of less than 2.6 mmol/l. The mean infant glucose and lactate levels were as expected for full term infants at 3.3 mmol/l and 2.2 mmol/l respectively. High mean levels of insulin and catechols were noted at birth. There was a significant positive association between umbilical venous cord glucose levels and maternal venous glucose levels (p=<0.001) but no association of umbilical venous cord glucose levels with amino acids, insulin, glucagon, human growth hormone, cortisol and catechols.

Made available in DSpace on 2015-03-26T13:47:21Z (GMT). No. of bitstreams: 1 texto completo.pdf: 238713 bytes, checksum: 7e42918a5e51d885e8e4ce32bf3cf3bc (MD5) Previous issue date: 2003-04-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The caesarean section is an emergency procedure that should depend upon safe anaesthetic techniques for both the mother and foetus and, at the same time, allow the realization of the surgery in due time, freeing the puppies in a vigorous state. All of the anaesthetic drugs used in caesarians quickly cross through the placenta which can affect the foetus. Foetal and neonatal depression of a variable degree occurs following the anaesthetic induction, depending upon the induction agent used, its dosage and the time passed since the induction until the freeing of the foetus. On this study there is a comparison of the foetal and maternal effects of propofol, etomidate and thiopental used as anaesthesia induction drugs for the maintenance with halothane as well as a verification of the possible advantages in substituting these inducting drugs by epidural anesthesia, following direct induction with halotane administered through mask, in caesarean section in bitches. For so, 20 bitches and 129 puppies were used distributed in four groups. In group 1 ( 5 bitches and 39 newborns) the anaesthetic induction was made with propofol, in group 2 (5 bitches and 25 newborns) with etomidate, in group 3 (5 bitches and 26 newborns) with thiopental and in group 4 (5 bitches and 39 newborns) epidural anesthesia and induction with halothane through mask were used. In all the cases the pre-anaesthetic medication was made with midazolam in a dosage of 0,22 mg/kg IM, and the anaesthetic maintenance with halothane in a semiclosed circuit and a initial concentration of 3%. The evaluated variables on the bitches were: rectal temperature, heart rate, breath rate, oxi-hemoglobin (SpO2) saturation, sistolic, mean and diastolic blood arterial pressure. For the effect evaluation of the different techniques of anaesthetic induction, the newborns were measured for cardiac frequency, respiratory effort, muscular movement, mucosa coloration and reflex irritability, and interpreted through the modified Apgar score . Besides these variables, there was also the evaluation of the newborn's SpO2. The results showed that all of the protocols were adequate for the mothers with minimal systemic effects. For the newborn, epidural anaesthesia usage followed by induction and maintance with halothane was superior to the protocols that used injectable agents in the unaesthetic induction. / A cesariana, geralmente um procedimento de emergência, deve contar com técnicas anestésicas seguras para mãe e fetos, que ao mesmo tempo, possibilite a realização da cirurgia em tempo hábil, liberando os filhotes em estado vigoroso. Todos os fármacos anestésicos utilizados em cesarianas atravessam rapidamente a placenta, podendo de alguma forma afetar o feto, Ocorrendo depressão fetal e neonatal de grau variável seguindo a indução anestésica, dependendo do agente utilizado, de sua dose e do tempo transcorrido desde a indução até a retirada do feto. Neste trabalho foi comparado o efeito fetal e materno do propofol, etomidato e tiopental, utilizados como fármacos indutores de anestesia para a manutenção com halotano, e verificado as possíveis vantagens da substituição dessas drogas indutoras, por anestesia epidural lombossacra, seguida de indução direta com halotano administrado através de máscara, em cesarianas de cadelas. Para tanto, foram utilizadas 20 cadelas e 129 filhotes distribuídos em quatro grupos. No grupo 1 ( 5 cadelas e 39 neonatos) a indução anestésica foi feita com propofol, no grupo 2 (5 cadelas e 25 neonatos) com etomidato, no grupo 3 (5 cadelas e 26 neonatos) com tiopental e no grupo 4 (5 cadelas e 39 neonatos) utilizou-se anestesia epidural e indução com halotano através de máscara. Em todos os casos, a medicação pré-anestésica foi feita com midazolam na dose de 0,22 mg/kg via IM, e a manutenção anestésica com halotano em circuito semifechado e concentração inicial de 3%. As variáveis avaliadas nas cadelas foram: temperatura retal, freqüência cardíaca, freqüência respiratória, saturação da oxi-hemoglobina (SpO2), pressão arterial sistólica, média e diastólica. Para avaliação dos efeitos das diferentes técnicas de indução anestésica, foram mensurados nos recém-nascidos, a freqüência cardíaca, o esforço respiratório, os movimentos musculares a coloração das mucosas e a irritabilidade reflexa, e interpretados através do escore de Apgar modificado . Além destas variáveis, foi avaliada também a SpO2 do neonato. Os resultados mostraram que todos os protocolos foram adequados para as mães com mínimos efeitos sistêmicos. Para o neonato, a utilização de anestesia epidural seguida de indução e manutenção com halotano foi superior aos protocolos que usaram agentes injetáveis na indução anestésica.

Made available in DSpace on 2015-03-26T13:46:47Z (GMT). No. of bitstreams: 1 texto completo.pdf: 86037 bytes, checksum: e4f697c00d41650b873d456f7d47cced (MD5) Previous issue date: 2005-04-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In the veterinarian medicine daily routine the caesarian is a highly used technique. Despite the anesthetic protocol chosen, the drug will act direct or indirectly on the fetus, causing neonates vital function depression and contributing to a hazard in their adaptation to the extra-uterine life. Trying to revert in neonates the depressor effects of the anesthesia used on mothers, the application of doxapram chloridate and/or aminofiline is recommended. This work aimed to study the doxapram chloridate and aminofiline, associated or not, efficiency, as well as to compare the sub-lingual and subcutaneous administration of these drugs. A total of 64 puppies were evaluated, distributed in eight groups of eight animals each. Four of these groups received the drugs via subcutaneous (sC) and the other four via sub-lingual (sL). Two groups (G1sC and G1sL) received only placebo; another two (G2sC and G2sL) received aminofiline; in other two groups (G3sC and G3sL) doxapram was administered and the last two (G4sC and G4sL) received aminofiline associated to doxapram. According to the results obtained in the present experiment it was possible to conclude that the aminofiline was more effective than the doxapram and, that the via sub-lingual was more efficient than the subcutaneous in the neonates reanimation. / No cotidiano da medicina veterinária a cesariana é uma técnica cirúrgica bastante empregada. Qualquer que seja o protocolo anestésico escolhido, a droga atuará direta ou indiretamente sobre os fetos, causando depressão das funções vitais do neonato e contribuindo para dificultar sua adaptação à vida extra-uterina. Na tentativa de reverter no neonato os efeitos depressores da anestesia usada na mãe, recomenda-se a aplicação do cloridrato de doxapram e/ou aminofilina. Este trabalho objetivou estudar a eficácia do cloridrato de doxapram e da aminofilina associados ou não, na reanimação de neonatos caninos após cesariana eletiva, bem como comparar a via sublingual com a subcutânea para a administração dessas drogas. Foram avaliados um total de 64 filhotes, distribuídos em oito grupos de oito animais cada. Quatro destes grupos receberam as drogas por via subcutânea (sC) e os outros quatro via sublingual (sL). Dois grupos (G1sC e G1sL) receberam apenas placebo; outros dois (G2sC e G2sL) receberam aminofilina; em outros dois (G3sC e G3sL) administrou-se doxapram e os dois últimos (G4sC e G4sL) receberam aminofilina associada ao doxapram. De acordo com os resultados obtidos no presente experimento foi possível concluir que a aminofilina foi mais eficaz que o doxapram e a via sublingual mais eficiente que a subcutânea na reanimação dos neonatos.