O panorama da produção científica no que concerne à família e estomas é carente de estudos sobre o tema, em especial sobre esta experiência no período neonatal da criança, que é permeada por crenças, sentimentos e expectativas que envolvem o nascimento de um novo membro da família e as mudanças que este evento acarreta na vida familiar. O presente estudo teve como objetivo geral compreender a experiência da mãe que tem um filho estomizado durante o período neonatal ou durante o tempo de internação em UTI Neonatal. Utilizando a História Oral como referencial metodológico, foram realizadas entrevistas com nove mães focalizando o impacto do evento sobre suas histórias. O resgate das memórias individuais permitiu a elaboração das narrativas, que por meio de um processo analítico possibilitaram a construção memória da coletiva, organizada em quatro temas: SONHOS VERSUS REALIDADE, PROTEÇÃO PERDIDA, NA COMPANHIA DO MEDO e É PRECISO EXERCER A MATERNIDADE. Os resultados do estudo revelaram que eventos inesperados e indesejados, dentre eles a criação do estoma no filho, são geradores de profundo impacto na vida das mulheres e de suas famílias, fazendo com que a realidade muito diferente da sonhada seja vivenciada com medo e sofrimento. A mãe vive a experiência acreditando que é dever da mãe cuidar do filho e que é preciso exercer a maternidade, e ao mesmo tempo vendo-se impedida de exercer plenamente o seu papel. Os resultados permitem uma reflexão sobre a importância de medidas mais eficazes que contribuam para autonomia e alívio do sofrimento da mãe na UTI Neonatal, onde a assistência de enfermagem possa ser orientada pelos princípios do Cuidado Centrado na Família que enfatizam a dignidade e o respeito, compartilhamento de informações, participação e colaboração. / The scientific production overview that concerns the family and stomas urges for studies about the subject, especially about the experience in neonatal period that is pervaded with beliefs, feelings and expectations implicated in the birth of a new member of a family and the changes that this event brings along for family life. The present study aimed to comprehend mothers experience about stomized children during neonatal period or the hospitalization period in Neonatal Intensive Care Unit. The methodological approach adopted in this study was Oral History, where interviews were conducted with nine mothers, focusing on the impact of the event on their stories. The rescue of individual memories enabled the elaboration of narratives in an analytical process which consequently resulted in rescuing of collective memory, organized in four themes: DREAMS VERSUS REALITY, LOST PROTECTION, IN FEARS COMPANY and MOTHERHOOD IS NEEDED. The results revealed that unwanted and unexpected events, such as stomas, might generate profound impact in womens and families lives. Such factors turn dreams into a very different reality which are likely to be lived with fear and suffering. Mother lives the experience believing that is her duty care of her child and that motherhood is need, and at the same time perceiving prevented herself from exercising her role. The results allow a reflection about the importance of more effective actions that contribute to the autonomy and relief of suffering of the mother in Neonatal Intensive Care Unit, where nursing care can be guided by the principles of Family Centered Care which emphasize dignity and respect, sharing information, participation and collaboration.

O desenvolvimento de vacinas imunogênicas em mucosas é essencial na prevenção da infecção pelo HIV. A vacina LAMP/gag associa o gene LAMP murino com o gene gag do HIV-1, possibilitando a apresentação antigênica no contexto das moléculas de classe II do MHC. Os resultados mostraram que a imunização com vacina quimérica LAMP/gag induziu produção de anticorpos sIgA e IgG anti-GAG e associação das vias intrasanal e intradérmica possibilitou a geração de resposta humoral de mucosa e sistêmica anti-GAG. Ambas as vacinas LAMP/gag e gag induziram resposta de células T CD8+ similares. Entretanto, a resposta T CD4+ foi mais pronunciada nos animais LAMP/gag, que reconheceram o dobro do número de pools de peptídeos da GAG e aumento da SFC de IFN-<font face=\"symbol\">g e IL-4. A associação do adjuvante ODN CpG A às vacinas regulou negativamente a resposta medida por células T CD4+ e a produção de anticorpos IgG2a. Os dados evidenciaram que apenas a vacina quimérica LAMP/gag foi capaz de induzir resposta imune celular e humoral e memória imunológica, por ativar mais eficazmente as células T CD4+. / The development of mucosal immunogenic vaccines is essential to prevent HIV infection. The LAMP/gag vaccine strategy associates the murine LAMP gene and the HIV-1 gag gene, allowing antigenic presentation in the context of MHC class II molecules. The results showed that the immunization with LAMP/gag chimera DNA vaccine induced anti-GAG sIgA and IgG antibodies and the association of intradermal injection to the intranasal immunization protocol induced anti-GAG antibodies. Both LAMP/gag and gag vaccines generated a strong CD8+ T-cell response. However, the CD4+ T cells response was more pronounced in LAMP/gag mice, able to recognized twice the number of GAG peptide pools and increasing the amplitude of IFN-<font face=\"symbol\">g and IL-4 SFC. The association of the CpG ODN adjuvant to the DNA vaccines downregulated the CD4+ T cells response and the IgG2a antibodies production. The data showed that only the LAMP/gag chimera DNA vaccine was able of inducing cellular and humoral immune responses and immunological memory due to the adequate CD4+ T cells activation.

Os recém-nascidos possuem o sistema antioxidante imaturo, por haver baixa tensão de oxigênio no ambiente intrauterino durante a vida fetal. Logo após o nascimento, as alterações súbitas das condições fisiológicas e ambientais causam significativo aumento no consumo de oxigênio, desencadeando, assim, a produção de radicais livres. Tais condições promovem vulnerabilidade dos neonatos ao efeito negativo do estresse oxidativo, o que potencialmente podem prejudicar a vitalidade neonatal. O presente estudo teve como objetivo comparar o perfil antioxidante e estresse oxidativo de neonatos e fêmeas caninas no periparto eutócico vaginal ou cesariana eletiva, e avaliar a influência da condição obstétrica para o estado oxidativo. Foram selecionadas 21 cadelas gestantes, as quais, constituíram dois grupos amostrais, de acordo com a condição obstétrica: Eutocia Vaginal (n = 10) e Cesariana Eletiva (n = 11); e seus respectivos neonatos foram alocados em subgrupos de acordo com a condição obstétrica e momento do nascimento: Eutocia Vaginal Inicial (n=10), Eutocia Vaginal Final (n = 9), Cesariana Eletiva Inicial (n = 11) e Cesariana Eletiva final (n= 10). As cadelas foram avaliadas no período pródromo do parto, intraparto; uma hora e três dias pós-parto, quando amostras de sangue foram colhidas para análise do perfil antioxidante [dosagem das enzimas superóxido dismutase (SOD), glutationa peroxidase (GPx), dosagem da concentração de tióis totais e determinação do status antioxidante total(TAC)] e do estresse oxidativo [dosagem da peroxidação lipídica (TBARS) e da oxidação de proteínas]. Os neonatos foram avaliados quanto ao escore Apgar aos 0 e 60 minutos do nascimento; avaliação clínica (frequências cardíaca e respiratória; escore de tônus muscular, irritabilidade reflexa e coloração de mucosa, aferição da temperatura corporal), lactatemia sanguínea, oximetria de pulso, determinação do perfil antioxidante e do estresse oxidativo e aferição do peso corporal aos 0, 60 minutos, às 12, 24 horas e ao 3º dia pós nascimento. As cadelas do Grupo Eutocia Vaginal apresentaram maior peroxidação lipídica, oxidação de proteínas e atividade de SOD e menor atividade de GPx e concentração de tióis totais em comparação ao Grupo Cesariana Eletiva. A capacidade antioxidante total elevou-se após 1h do parto em comparação aos outros momentos de avaliação no Grupo Cesariana Eletiva. Embora os neonatos do Grupo Eutocia Vaginal tenham apresentado melhores parâmetros de vitalidade neonatal, em comparação ao Grupo Cesariana Eletiva, todos os neonatos apresentaram adequada evolução do escore Apgar, coloração de mucosa, irritabilidade reflexa, tônus muscular e oxigenação periférica após 1h do nascimento. A lactatemia sanguínea foi maior no Grupo Eutocia Vaginal, bem como nos neonatos nascidos ao final do parto. A peroxidação lipídica foi superior nos neonatos nascidos por eutocia vaginal em comparação aos nascidos por cesariana eletiva, enquanto a oxidação de proteínas mostrou-se maior nos primeiros neonatos nascidos por eutocia vaginal em comparação aos nascidos ao final do parto. Porém, resultado contrário foi verificado para o Grupo Cesariana Eletiva, pois os neonatos nascidos ao final da cirurgia apresentaram maior valor de oxidação de proteínas. Ademais, para os neonatos nascidos ao final do parto, o Grupo Cesariana Eletiva apresentou maior oxidação proteica em comparação ao Grupo Eutocia Vaginal. A atividade da GPx foi superior nos neonatos nascidos por cesariana eletiva. Em conclusão, a condição obstétrica impõe diferenças no perfil oxidativo e antioxidante em cadelas e neonatos, os quais apresentam estado oxidativo semelhante, denotando influência materna sobre o equilíbrio oxidativo dos recém-nascidos. / Newborns have an immature antioxidant system, due to low oxygen exposure in intrauterine environment during fetal life. Immediately after birth, sudden changes of physiological and environmental conditions cause a significant increase in oxygen consumption, resulting in the production of free radicals. These conditions turn the newborn vulnerable to the negative effects of oxidative stress, which potentially can impair neonatal vitality. This study aimed to compare the antioxidant profile and oxidative stress of neonates and canine females during vaginal labour or elective cesarean section, and to evaluate whether the obstetric condition influences their oxidative status. For this purpose, 21 pregnant bitches were subjected to two experimental groups, according to the obstetric condition: Vaginal Eutocia (n = 10) and Elective Cesarian Section (n = 11) and their respective newborns were allocated into subgroups according to the obstetric condition and moment of birth: Inicial Vaginal Eutocia (n=10), Final Vaginal Eutocia (n = 9), Inicial Elective Cesarian Section (n = 11) and Final Elective Cesarian Section (n= 10). Bitches were evaluated during the preparatory phase of whelping, intrapartum; one and 72 hours postpartum, when blood samples were collected for analysis of the antioxidant profile [Superoxide Dismutase (SOD) and Glutathione Peroxidase (GPx) activity enzymes assays, Total Antioxidant Capacity (TAC) assay and Total Thiols Concentration assay] and oxidative stress [lipid peroxidation (TBARS) and protein oxidation assays]. Neonates were evaluated for the Apgar score at 0 and 60 minutes of birth; clinical evaluation (heart and respiratory rates; muscle tone, irritability reflex and mucous color score; and body temperature), blood lactate, pulse oximetry, determination of antioxidant profile and oxidative stress, and body weight measurement at 0, 60 minutes, 12, 24 and 72 hours after birth. The Vaginal Eutocia bitches had higher lipid peroxidation, protein oxidation and SOD activity and lower GPx activity and total thiols concentration in comparison to the Elective Cesarian Section Group. Total antioxidant capacity was higher 1 hour postpartum compared to the others evaluation moments in the Elective Cesarian Section Group. Although neonates from the Vaginal Eutocia Group presented better neonatal vitality than those from the Elective Cesarian Section, all neonates presented adequate evolution of the Apgar score, mucous color, irritability reflex, muscle tone and pulse oximetry 1 hour postpartum. Blood lactatemia was higher in the Vaginal Eutocia Group, as well as for the last neonates. Lipid peroxidation was higher in neonates born by vaginal eutocia compared to those born by elective cesarean section, whereas protein oxidation was higher in the first neonates born by vaginal eutocia compared to those born at the end of delivery. Conversely, Elective Cesarian Section neonates born at the end of surgery had higher protein oxidation. In addition, for those neonates born at the end of delivery, the Elective Cesarian Section group presented higher protein oxidation compared to the Vaginal Eutocia group. Furthermore, GPx activity was higher in neonates born by elective caesarean section. In conclusion, the obstetric condition imposes differences in the oxidative and antioxidant profile in bitches and neonates with similar oxidative status, denoting maternal influence on the oxidative balance of the newborns.

Trata-se de um estudo quantitativo descritivo, exploratório e observacional cujo objetivo foi determinar os níveis de ruído ambiente na unidade de cuidado intermediário neonatal de um hospital universitário de Ribeirão Preto-SP e dimensionar os níveis de pressão sonora (NPS) gerados em decorrência de ar condicionado, lâmpadas da enfermaria e monitor de apnéia ligados; alarme acionado; torneira da pia aberta; manejo da lixeira; conversas entre profissionais (visita médica e passagem de plantão da enfermagem) e ruídos externos (abrir e fechar a porta de acesso à unidade neonatal e conversação na ante-sala). O ruído ambiente foi dimensionado na enfermaria de manipulação mínima da unidade de cuidado intermediário neonatal, em duas semanas consecutivas, sendo 12 horas por dia no período diurno das 7 às 19 horas na primeira semana e 12 horas no noturno, diariamente das 19 às 7 horas, na segunda semana. Utilizou-se o medidor de NPS, o dosímetro Quest-400, posicionado na área central da enfermaria e suspenso a 70 cm do teto. Para dimensionar cada ruído interno e externo, discriminado no segundo objetivo, mantiveram-se na enfermaria os mesmos bebês ali internados e somente a pesquisadora, evitando-se a presença de outros ruídos audíveis. Mensurou-se os NPS por três minutos consecutivos, exceto a passagem de plantão da enfermagem que incluiu três momentos de medida, sendo uma para cada final de turno de trabalho. Para análise dos dados utilizou-se o programa QuestSuiteMR para processar os NPS em respostas numéricas e transportar em planilhas no software Excel 2003 e SPSS (Statiscal Package for the Social Sciences). O nível médio de ruído na unidade foi de 60,8dBA. A variabilidade do Leq na semana foi de 20,8dBA (51,8 a 72,6dBA), Lpeak 23,6dBA (90,1 a 113,7dBA), Lmax 42,8dBA (52,1 a 90,9dBA) e do Lmin foi de 1,4dBA (50,7 a 52,1dBA). As hipóteses de que mesmo em enfermaria de manipulação mínima o ruído é intenso e que a fonte de ruído mais intensa é o abrir e fechar a tampa da lixeira (Leq médio de 59,3dBA) foram confirmadas. A porta aberta da enfermaria permitiu maior entrada de ruído externo gerado na ante-sala, em especial aquele decorrente de abrir e fechar a porta de correr de acesso à unidade neonatal (57,3dBA). Assim, confirmou-se a terceira hipótese, que o ruído ambiente diminui ao fechar a porta de acesso à enfermaria. Confirmou-se também a quarta hipótese, que a conversa entre os profissionais na passagem de plantão da enfermagem e visita médica constitui fonte de ruído intenso, sendo que os maiores Leq foram de 63,8dBA em ambas situações. Concluiu-se que os NPS foram intensos em todos os turnos e dias da semana da coleta de dados, estando acima das recomendações e normas técnicas para níveis de ruído adequados em unidades neonatais. Com base nos resultados e na literatura elaborou-se um protocolo para controlar o excesso de estímulos sonoros ambientais, incluindo um conjunto de ações intersetoriais dirigidas à infra-estrutura física, aos recursos tecnológicos e humanos (profissionais e familiares). / This descriptive, exploratory and observational quantitative study aimed to determine ambient noise levels at the intermediary neonatal care unit of a university hospital in Ribeirão Preto-SP and dimension sound pressure levels (SPL) produced by air-conditioning, lamps at the nursing ward and the functioning of apnea monitors; alarms going off; open water taps; handling of garbage cans; conversations among professionals (medical visit and nursing shift change) and external noise (opening and closing the access door of the neonatal unit and conversation in the antechamber). Ambient noise was dimensioned at the minimal manipulation nursing ward in the intermediary neonatal care unit of the university hospital in Ribeirão Preto-SP for two consecutive weeks. In the first week, ambient noise levels were measured every day for 12 hours, from 7 a.m. to 7 p.m. In the second, ambient noise was measured every night for 12 hours, from 7 p.m. to 7 a.m. A Quest-400 dosimeter was used to measure SPL, placed in the center of the ward and hung from the roof at 70 cm. To dimension each internal and external noise distinguished in the second objective, only the hospitalized babies and the researcher continued at the ward, avoiding the presence of other audible noise. Sound pressure levels were measured for three consecutive minutes, except during nursing shift changes, including three measurement moments, one at the end of each shift. For data analysis, QuestSuiteMR was used to process SPL in numerical answers and move them to Excel 2003 and SPSS (Statistical Package for the Social Sciences) worksheets. The mean sound level at the unit was 60.8dBA. A variability of 20.8dBA (from 51.8 to 72.6dBA) was found for Leq, 23.6dBA (90.1 to 113.7dBA) for Lpeak, 42.8dBA (52.1 to 90.9dBA) for Lmax and 1.4dBA (50.7 to 52.1dBA) for Lmin. The results confirmed the hypotheses that noise is intense, even at a minimal manipulation ward, and that opening and closing the garbage can is the most intense noise source (mean Leq 59.3dBA). The open door of the nursing ward allowed more external noise from the antechamber to enter, especially noise produced by opening and closing the running door that gave access to the neonatal unit (57.3dBA). This confirmed the third hypothesis, that is, that environmental noise decreases when the door of the nursing ward is closed. The fourth hypothesis was also confirmed, i.e. that conversations between professionals during shift changes and medical visits were a source of intense noise. The highest Leq corresponded to 63.8dBA in both situations. Sound pressure levels were intense across all shifts and days of the data collection period, exceeding recommendations and technical standards for adequate noise levels at neonatal units. Based on these results and on literature, a protocol was elaborated to control the excess of ambient noise stimuli, including a set of intersectorial actions directed at physical infrastructure, technological and human resources (professionals and family members).

Propõe uma intervenção após uma longa observação neonatal de risco, de um hospital escola na cidade de São Paulo, verificando se as modificações efetuadas na sala de pré-termo, tiveram influência em relação ao neonato, à equipe da unidade neonatal e no retorno dos pais ao ambulatório após a alta. Os Ss do estudo são 59 neonatos pré-termo, sendo 32 do grupo controle e 27 do grupo experimental. Realiza a intervenção através de um conjunto sitemático de medidas ao ambiente, às manipulações no neonato (dentro do conceito neuro-evolutivo Bobath) e à orientação aos pais. Faz a avaliação através de: tempo de permanência na unidade, de uso de sonda e de permanência na incubadora; escala de Brazelton; questionário de avaliação respondido pela equipe neonatal e frequência de retorno ambulatórial. Conclui pela validação das medidas propostas, dado que os neonatos do grupo experimental permaneceram menos tempo internados, com menos permanência na incubadora e no uso da sonda. Também mostraram um controle significativamente maior dos estados e da estabilidade autonôma, indicando prontidão para um amadurecimento mais uniforme, decorrente de uma maior estabilidade fisiológica e comportamental. O estudo indica a validade do uso de técnicas de baixo custo, adaptavéis ao meio brasileiro, facilitando a integração do bebê em seu meio / This study aimed to observe whether changes made in the premature roam of a special care neonatal unit could have influence on the baby, on the neonatal unit\'s staff and on the return of the parents to the ambulatory, after discharge. 59 premature babies, 32 of the control group and 27 of the experimental group, from a neonatal unit of a school hospital in the city of São Paulo were involved in this study. lt was done in two steps: observation and intervention with subsequent assessment. The intervention was done through a systematic set of measurements in relation to the environment, to the baby\'s handling (in the neuro-developmental Bobath concept)) and to the parents\' guidance. The survey was made by assessing the number of days the baby stayed in the unit and in the incubator, as well as the number of days he/she was tube fed; by assessing the babies with Brazelton\'s scale; by the survey of a questionnaire answered by the neonatal unit\'s staff and finally by assessing the frequency of the ambulatory return. The validity of the proposed means were confirmed due to the fact that the babies from the experimental group stayed significantly less time in the hospital as well as in the incubator and were tube fed for less time. They also showed a significantly better state controle as well as autonomic stability, showing readiness towards a more steady maturation due to a larger physiological and behavioral stability. This study shows the validity of using low cost techniques, adaptable to the Brazilian surrounding, enabling the baby\'s integration in his/her environment

O desenvolvimento da alergia pode ter início precoce, durante os primeiros meses de vida ou ainda durante a gestação. Em camundongos, é descrita uma predisposição ao desenvolvimento de resposta Th2 no período neonatal, contribuindo para o desenvolvimento da resposta alérgica. A maturação das funções relacionadas à resposta Th1 pelo uso de adjuvantes imunológicos no período pós-natal pode contribuir na profilaxia da asma e outras doenças alérgicas. Neste trabalho, investigamos o efeito dos oligodeoxinucleotídeos CpG na imunização com ovalbumina (OVA) e extrato do ácaro Blomia tropicalis (Bt) em camundongos nos períodos neonatal e adulto. Os resultados obtidos mostram que o ODN-CpG é capaz de diminuir a produção de anticorpos IgE, um isótipo dependente de citocinas Th2, e aumentar os níveis de anticorpos IgG2a nas imunização com OVA e Bt, inclusive na imunização com os dois alérgenos associados. Além disso, a associação do ODN-CpG na imunização neonatal com OVA promove um aumento da produção in vitro de IFN-<font face=\"symbol\">g e diminuiu a produção de IL-10. Ao compararmos a eficiência modulatória do CpG nas imunizações com OVA em camundongos adultos e neonatos, observamos um maior efeito modulatório na produção de anticorpos em adultos. Os resultados mostraram que linfócitos B de camundongos jovens não aumentam a expressão do TLR-9 mesmo após 72 horas de estímulo com CpG, enquanto nos linfócitos de adultos já é possível observar um aumento em 48 horas. Além da menor ativação dos linfócitos B, evidenciamos uma produção de IL-10 e MCP-1 significantemente aumentada na cultura de células de neonatos após estímulo in vitro com CpG. Ao avaliarmos a influência do CpG na ativação antígeno específica dos linfócitos T CD4+, mostramos que linfócitos T CD4+ de neonatos expressam mais intensamente moléculas B7 do que células de adultos após estímulo antigênico in vitro, o que sugere uma característica supressora nestas células. Esse aumento foi inibido pela adição de CpG na cultura. A indução de células Treg (CD4+CD25+Foxp3+) in vitro também foi suprimida pela adição de CpG. Nossos resultados mostram um potencial modulatório do CpG no período neonatal e adulto nas respostas a OVA e Bt. Evidenciamos, também, diferenças qualitativas e quantitativas no efeito do CpG em relação às imunizações neonatal e adulta. Considerando a suscetibilidade dos neonatos às infecções e ao desenvolvimento de alergia, torna-se importante estabelecer estratégias imunomodulatórias que potencializem as respostas inata e adaptativa e possam ser profiláticas no desenvolvimento de doenças alérgicas. / The allergy development may occur in the early life, during the pregnancy or postnatally at the first months of life. In mice, it is described a predisposition to Th2 biased response in the neonatal period, favoring the development of allergic response. The maturation of functions related to Th1 response by the use of immune adjuvants may be beneficial to the allergy prophylaxis. In this work, we evaluated the effect of CpGcontaining oligodeoxynucleotides (CpG-ODN) in the neonatal and adult immunization with ovalbumin (OVA) or the extract of house dust mite Blomia tropicalis (Bt). The results show CpG-ODN is able to decrease IgE antibody production, an isotype related to Th2 response, and increase IgG2a antibody levels in OVA or Bt immunization of A/Sn mice, even when mice were co-immunized with both allergens. Moreover, CpG-ODN association in neonate immunization with OVA increases in vitro IFN-<font face=\"symbol\">g production and decreases IL-10. Comparing the modulatory efficiency of CpG in OVA immunization of neonate and adult mice, we observed a stronger effect on antibody production in adults. Results show that B cells from young mice do not increase the TLR-9 expression upon CpG stimulation for 72 hours whereas the increase of TLR-9 in adult B cells occurs within 48 hours. Besides the lower B cell activation, we found a significant increase of IL-10 and MCP-1 secretion levels by the neonatal cells stimulated by CpG. When we evaluated the influence of CpG on CD4+ T cell activation upon antigenic stimulation, we verified an upregulation of B7 molecules expression on neonate cells than adult cells. This high expression was inhibited by the addition of CpG in the culture. The induction of regulatory T cells (CD4+CD25+Foxp3+) in vitro was also suppressed by CpG. Our results show a modulatory potential of CpG in the immune response to OVA and Bt in both neonatal and adult periods. We also evidenced qualitative and quantitative differences in the CpG effect between neonates and adults. Considering the susceptibility to infections and allergy development in newborns, it becomes important to establish immunomodulatory strategies that enhance innate and adaptive responses and are prophylactic to the development of allergic disorders.

This thesis reports the effects of an altered intrauterine environment on the offspring???s renal, cardiovascular and renin angiotensin systems. After a midgestational asphyxial episode in fetal sheep (30 min total umbilical cord occlusion at 90 days; term 150 days) the hydrops that resulted had not completely resolved by 130 days. While the heart and kidneys were apparently unaffected, the brain and lung weights were 37% and 50% lower than sham values, respectively and there were joint contractures. The effects of maternal renal disease on the offspring were investigated. Although in utero fetuses of subtotally nephrectomised ewes (STNx) had altered urine flow rates, sodium excretion, haematocrits, plasma chloride and plasma renin levels, by 1-2 weeks after birth these values in the lambs (STNxL) were similar to controls (ConL) under baseline conditions. Body weight and the weights of most organs were similar, including the kidney, in which glomerular number was normal. In the neonatal period, the lambs were subjected to four challenges: furosemide (2 mg/kg intravenous bolus), infusion of angiotensin II and phenylephrine, intravenous infusion of 0.15M saline (50 ml/kg over 30 min) and haemorrhage (20% estimated blood volume over 10 min). These challenges revealed evidence of programming of several aspects of the renal, cardiovascular and renin angiotensin systems in the STNx offspring. As young adults at 6 months of age, male and female offspring of STNx ewes were normotensive and had normal renal function. On a high salt diet (HSD, 0.17M NaCl in 8L water for 5-7days), female offspring of both groups did not become hypertensive. However, the STNx offspring must have retained salt and water as plasma sodium was increased and haematocrit was decreased. In the STNx offspring only, there was a relationship between glomerular filtration rate (GFR) and mean arterial pressure, indicating an inability to maintain a constant GFR in response to changes in arterial pressure.

This thesis reports the effects of an altered intrauterine environment on the offspring???s renal, cardiovascular and renin angiotensin systems. After a midgestational asphyxial episode in fetal sheep (30 min total umbilical cord occlusion at 90 days; term 150 days) the hydrops that resulted had not completely resolved by 130 days. While the heart and kidneys were apparently unaffected, the brain and lung weights were 37% and 50% lower than sham values, respectively and there were joint contractures. The effects of maternal renal disease on the offspring were investigated. Although in utero fetuses of subtotally nephrectomised ewes (STNx) had altered urine flow rates, sodium excretion, haematocrits, plasma chloride and plasma renin levels, by 1-2 weeks after birth these values in the lambs (STNxL) were similar to controls (ConL) under baseline conditions. Body weight and the weights of most organs were similar, including the kidney, in which glomerular number was normal. In the neonatal period, the lambs were subjected to four challenges: furosemide (2 mg/kg intravenous bolus), infusion of angiotensin II and phenylephrine, intravenous infusion of 0.15M saline (50 ml/kg over 30 min) and haemorrhage (20% estimated blood volume over 10 min). These challenges revealed evidence of programming of several aspects of the renal, cardiovascular and renin angiotensin systems in the STNx offspring. As young adults at 6 months of age, male and female offspring of STNx ewes were normotensive and had normal renal function. On a high salt diet (HSD, 0.17M NaCl in 8L water for 5-7days), female offspring of both groups did not become hypertensive. However, the STNx offspring must have retained salt and water as plasma sodium was increased and haematocrit was decreased. In the STNx offspring only, there was a relationship between glomerular filtration rate (GFR) and mean arterial pressure, indicating an inability to maintain a constant GFR in response to changes in arterial pressure.

This thesis reports the effects of an altered intrauterine environment on the offspring???s renal, cardiovascular and renin angiotensin systems. After a midgestational asphyxial episode in fetal sheep (30 min total umbilical cord occlusion at 90 days; term 150 days) the hydrops that resulted had not completely resolved by 130 days. While the heart and kidneys were apparently unaffected, the brain and lung weights were 37% and 50% lower than sham values, respectively and there were joint contractures. The effects of maternal renal disease on the offspring were investigated. Although in utero fetuses of subtotally nephrectomised ewes (STNx) had altered urine flow rates, sodium excretion, haematocrits, plasma chloride and plasma renin levels, by 1-2 weeks after birth these values in the lambs (STNxL) were similar to controls (ConL) under baseline conditions. Body weight and the weights of most organs were similar, including the kidney, in which glomerular number was normal. In the neonatal period, the lambs were subjected to four challenges: furosemide (2 mg/kg intravenous bolus), infusion of angiotensin II and phenylephrine, intravenous infusion of 0.15M saline (50 ml/kg over 30 min) and haemorrhage (20% estimated blood volume over 10 min). These challenges revealed evidence of programming of several aspects of the renal, cardiovascular and renin angiotensin systems in the STNx offspring. As young adults at 6 months of age, male and female offspring of STNx ewes were normotensive and had normal renal function. On a high salt diet (HSD, 0.17M NaCl in 8L water for 5-7days), female offspring of both groups did not become hypertensive. However, the STNx offspring must have retained salt and water as plasma sodium was increased and haematocrit was decreased. In the STNx offspring only, there was a relationship between glomerular filtration rate (GFR) and mean arterial pressure, indicating an inability to maintain a constant GFR in response to changes in arterial pressure.

This thesis reports the effects of an altered intrauterine environment on the offspring???s renal, cardiovascular and renin angiotensin systems. After a midgestational asphyxial episode in fetal sheep (30 min total umbilical cord occlusion at 90 days; term 150 days) the hydrops that resulted had not completely resolved by 130 days. While the heart and kidneys were apparently unaffected, the brain and lung weights were 37% and 50% lower than sham values, respectively and there were joint contractures. The effects of maternal renal disease on the offspring were investigated. Although in utero fetuses of subtotally nephrectomised ewes (STNx) had altered urine flow rates, sodium excretion, haematocrits, plasma chloride and plasma renin levels, by 1-2 weeks after birth these values in the lambs (STNxL) were similar to controls (ConL) under baseline conditions. Body weight and the weights of most organs were similar, including the kidney, in which glomerular number was normal. In the neonatal period, the lambs were subjected to four challenges: furosemide (2 mg/kg intravenous bolus), infusion of angiotensin II and phenylephrine, intravenous infusion of 0.15M saline (50 ml/kg over 30 min) and haemorrhage (20% estimated blood volume over 10 min). These challenges revealed evidence of programming of several aspects of the renal, cardiovascular and renin angiotensin systems in the STNx offspring. As young adults at 6 months of age, male and female offspring of STNx ewes were normotensive and had normal renal function. On a high salt diet (HSD, 0.17M NaCl in 8L water for 5-7days), female offspring of both groups did not become hypertensive. However, the STNx offspring must have retained salt and water as plasma sodium was increased and haematocrit was decreased. In the STNx offspring only, there was a relationship between glomerular filtration rate (GFR) and mean arterial pressure, indicating an inability to maintain a constant GFR in response to changes in arterial pressure.