Made available in DSpace on 2013-08-07T19:03:36Z (GMT). No. of bitstreams: 1 000449039-Texto+Completo-0.pdf: 2035926 bytes, checksum: 76ba03094b12ab30e63451e8308ea5c3 (MD5) Previous issue date: 2013 / Objectives: to evaluate the association between brachial artery Flow Mediated Dilatation (FMD) and preeclampsia morbidity.Methods: Sixty-four pregnant women at the diagnosis of preeclampsia were selected. FMD and routine preeclampsia markers were assessed at enrollment and followed until delivery. Women were grouped and compared according to their outcomes (26 developed complications and 38 did not).Results: Median FMD is impaired in women with complicated preeclampsia (7. 44%; IQR 2. 20-13. 34%) compared to those without complications (11. 80%; IQR 5. 36-16. 66%) (p=0,03). The cutoff value of FMD ≤4. 5% was associated with approximately four-fold odds increment of any complication (OR 3. 79; IC95% 1. 23-11. 70), similar to the protein to creatinine ratio >2,0 (OR 4. 50; IC95% 1. 21-16. 74). Systolic and diastolic blood pressure were not associated with risk for complication and uric acid had a borderline significance (OR 3. 38; IC95% 0,98-11,72). Moreover, when major complications (eclampsia, HELLP syndrome or stillbirth) were selected as a composite outcome FMD was even lower (2. 84%; IQR 0. 00–7. 22%) and FMD ≤4. 5% was associated with a marked 15 fold increased risk for these specific events (OR 15. 55; IC95% 3. 55-68. 16). Although FMD seems to have a weak accuracy to predict any preeclampsia complications (AUC=0. 66; IC95% 0. 52-0. 79), ROC curve analysis showed that it may be a prognostic marker for major complications (AUC=0. 84; IC95% 0. 73-0. 96).Conclusion: FMD is associated with morbidity of preeclampsia, markedly in women with eclampsia, HELLP syndrome or stillbirth. FMD at preeclampsia diagnostic moment may be used as a prognostic marker of these poor outcomes. / Objetivos: avaliar a associação entre a Dilatação Mediada por Fluxo (DMF) da artéria braquial e morbidade por pré-eclâmpsia.Métodos: Foram selecionados sessenta e quatro grávidas com pré-eclâmpsia. A DMF e marcadores de pré-eclâmpsia foram avaliados no no momento do diagnóstico da doença a as pacientes foram seguidas até o parto. As mulheres foram agrupados e comparadas de acordo com os seus desfechos (26 com complicações e 38 sem complicação).Resultados: A DMF está comprometida em mulheres com pré-eclâmpsia complicada (7,44%; IQR 2,20-13,34%) comparada com aqueles sem complicações (11,80%; IQR 5,36- 16,66%) (p = 0,03). O valor de corte de DMF ≤ 4,5% foi associada com aproximadamente quatro vezes mais risco de qualquer complicação (OR 3,79 IC95% 1,23-11,70), semelhante à relação proteína/creatinina > 2,0 (OR 4,50 IC95% 1,21-16,74). Pressão arterial sistólica e diastólica não foram associados com risco de complicação e o ácido úrico teve uma significância limítrofe (OR 3,38, IC95% 0,98-11,72). Além disso, quando as principais complicações (eclâmpsia, síndrome HELLP ou morte fetal) foram selecionadas como um desfecho composto a DMF foi ainda mais baixa (2,84%; IQR 0,00-7,22%) e o valor da DMF ≤ 4,5% foi associado com um acentuado aumento de 15 vezes no risco destes eventos específico (OR 15,55; IC95% 3,55-68,16). Embora a DMF tenha pouca capacidade de predição de quaisquer complicações pela pré-eclâmpsia (AUC = 0,66, IC95% 0,52-0,79), análise da curva ROC mostrou que pode ser um bom marcador de prognóstico para complicações graves (AUC = 0,84, IC95% 0,73-0,96).Conclusão: a DMF está associada com morbidade da pré-eclâmpsia, notadamente em mulheres com eclâmpsia, síndrome HELLP ou morte fetal. DMF no momento do diagnóstico da pré-eclâmpsia pode ser usado como marcador prognóstico destes desfechos desfavoráveis.

Submitted by (edna.saturno@ufrpe.br) on 2016-10-06T15:36:45Z No. of bitstreams: 1 Fabio Cordeiro Oliveira Santos.pdf: 1229695 bytes, checksum: e64a6f6820a3cecf726e491693035bbd (MD5) / Made available in DSpace on 2016-10-06T15:36:45Z (GMT). No. of bitstreams: 1 Fabio Cordeiro Oliveira Santos.pdf: 1229695 bytes, checksum: e64a6f6820a3cecf726e491693035bbd (MD5) Previous issue date: 2011-02-08 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / The objective of this work is to perform a clinical epidemiological study on the occurrence of pregnancy toxemia in ewes treated in Bovine Clinic, Campus Garanhuns / UFRPE in the period January 2006 to December 2010. The assessments in epidemiological studies (included factors such as time of year, race, age, number of calving, breeding system, gestational period, number of offspring at birth, power and presence of intercurrent diseases) related to the onset of the disease.We evaluated the hematologic profile, and hormone metabolite in 77 sheep. The clinical manifestation of disease was observed in the ante-partum in 100% of animals, these 66.2% were discharged from clinic and 33.8% died. At birth multiple pregnancy was found in 57.1% of cases, while 42.9% had only one fetus. Most of these animals were kept in intensive farming systems corresponding to 61.0% and body condition were observed between four and five (49.3%). On clinical examination the main clinical signs were anorexia, weakness, dehydration, mucous congestion, depression, attitude ulcers, swelling of limbs and ruminal stasis. The clinical course ranged from five to 14 days in animals that died or were discharged from the clinic, respectively. In hematological profile showed a picture of leukocytosis, neutrophilia, lymphopenia and eosinopenia. Found hyperglycemia (46.9%), normoglycemia (39.4%) and hypoglycemia (13.6%). There was an increase in plasma glucose concentrations (x = 94.5), albumin (x = 3.02), urea (x = 59.8), creatinine (x = 2.3), ß-hidroxubutirato (x = 0 , 9), fructosamine (x = 206.4), lactate (x = 47.6), cortisol (x = 76.1) and non-esterified fatty acid (x = 1.00) in sheep affected. Analyzing the behavior between groups of animals that received high clinic and who died indicators for lymphocytes, cortisol, urea, aspartate aminotransferase and creatinine kinase was observed that significant differences existed (P <0.05), where the animals came the death had higher values.The research on ketone dipstick positivity was observed in urine 66.2% and for the Rothera test was 79.2%. This study confirms that pregnancy toxemia is a metabolic disorder and hormonal causes serious economic losses in sheep production, caused by the mortality of sheep and lambs. / Objetivou-se com este trabalho realizar um estudo clínico-epidemiológico sobre a ocorrência da toxemia da prenhez em ovelhas atendidas na Clínica de Bovinos, Campus Garanhuns/UFRPE, no período de Janeiro de 2006 a Dezembro de 2010. As avaliações no estudo epidemiológico (compreenderam os fatores como época do ano, raça, idade, número de parições, sistema de criação, período gestacional, número de crias no parto, alimentação e presença de doenças intercorrentes) relacionados com o surgimento da doença. Avaliou-se o perfil hematológico, metabólito e hormonal em 77 ovelhas. A manifestação clinica da doença foi observada no período do pré-parto em 100% dos animais, destes 66,2 % receberam alta clínica e 33,8 % vieram a óbito. No momento do parto foi verificada gestação múltipla em 57,1% dos casos, enquanto que em 42,9% havia apenas um feto. A maioria destes animais eram mantidos em sistemas de criação intensivo correspondendo a 61,0 % e foram observados escore corporal entre quatro a cinco (49,3%). No exame clínico os principais sinais observados foram anorexia, fraqueza, desidratação, congestão de mucosa, depressão, atitude de decúbito, edema de membros e atonia ruminal. A evolução clínica variou de cinco a 14 dias nos animais que vieram a óbito ou receberam alta clínica, respectivamente. No perfil hematológico apresentou um quadro de leucocitose, neutrofilia, linfopenia e eosinopenia. Foi encontrada hiperglicemia (46,9%), normoglicemia (39,4%) e hipoglicemia (13,6%). Houve um aumento nas concentrações de glicose plasmática (x=94,5), albumina (x=3,02), uréia (x=59,8), creatinina (x=2,3), ß-hidroxubutirato (x=0,9), frutosamina (x=206,4), lactato (x=47,6), cortisol (x= 76,1) e ácido graxo não esterificado (x= 1,00) nas ovelhas acometidas. Analisando os comportamentos entre grupos dos animais que receberam alta clínica e os que vieram a óbito os indicadores para linfócitos, cortisol, uréia, aspartato aminotransferase e creatinina quinase foi observada que diferenças significativas existiram (P<0,05), onde os animais que vieram a óbito tiveram valores mais elevados. A pesquisa de corpos cetônicos na fita reagente foi observada positividade na urina em 66,2 % e para o teste Rothera foi de 79,2%. Este trabalho confirma que a toxemia da prenhez é um distúrbio metabólico e hormonal que acarreta perdas econômicas importantes a produção de ovinos, causadas pela mortalidade das ovelhas e borregos.

Simultaneous maternal indirect blood pressure measurements, electronic fetal heart rate monitoring, and ultrasonographic biophysical profile testing were used to assess maternal-fetal homeostasis in gravid ewes during gestational days 127 to 134 (term 146), during a 72-hour fast, and during treatment with thromboxane synthetase inhibitors CGS13080 and CGS12970. Seventy-five percent of the ewes (12 of 16) developed clinical signs of ovine pregnancy-induced hypertension, including maternal hypertension and fetal depression. In three untreated hypertensive ewes, pregnancy was terminated by spontaneous premature delivery, and one maternal death occurred after an eclamptic seizure. All nine ewes treated with one of the two thromboxane synthetase inhibitors responded to therapy with decreases in blood pressure and resolution of fetal depression. These nine ewes completed gestation, and were delivered at term. These data indicate that therapy with thromboxane synthetase inhibitors in this animal model of preeclampsia results in profoundly beneficial effects and suggest that further studies of thromboxane synthetase inhibitors are warranted in preeclampsia.

Made available in DSpace on 2015-04-14T13:35:42Z (GMT). No. of bitstreams: 1 449039.pdf: 2035926 bytes, checksum: 76ba03094b12ab30e63451e8308ea5c3 (MD5) Previous issue date: 2013-03-21 / Objectives: to evaluate the association between brachial artery Flow Mediated Dilatation (FMD) and preeclampsia morbidity. Methods: Sixty-four pregnant women at the diagnosis of preeclampsia were selected. FMD and routine preeclampsia markers were assessed at enrollment and followed until delivery. Women were grouped and compared according to their outcomes (26 developed complications and 38 did not). Results: Median FMD is impaired in women with complicated preeclampsia (7.44%; IQR 2.20-13.34%) compared to those without complications (11.80%; IQR 5.36-16.66%) (p=0,03). The cutoff value of FMD &#8804;4.5% was associated with approximately four-fold odds increment of any complication (OR 3.79; IC95% 1.23-11.70), similar to the protein to creatinine ratio >2,0 (OR 4.50; IC95% 1.21-16.74). Systolic and diastolic blood pressure were not associated with risk for complication and uric acid had a borderline significance (OR 3.38; IC95% 0,98-11,72). Moreover, when major complications (eclampsia, HELLP syndrome or stillbirth) were selected as a composite outcome FMD was even lower (2.84%; IQR 0.00 7.22%) and FMD &#8804;4.5% was associated with a marked 15 fold increased risk for these specific events (OR 15.55; IC95% 3.55-68.16). Although FMD seems to have a weak accuracy to predict any preeclampsia complications (AUC=0.66; IC95% 0.52-0.79), ROC curve analysis showed that it may be a prognostic marker for major complications (AUC=0.84; IC95% 0.73-0.96). Conclusion: FMD is associated with morbidity of preeclampsia, markedly in women with eclampsia, HELLP syndrome or stillbirth. FMD at preeclampsia diagnostic moment may be used as a prognostic marker of these poor outcomes. / Objetivos: avaliar a associa??o entre a Dilata??o Mediada por Fluxo (DMF) da art?ria braquial e morbidade por pr?-ecl?mpsia. M?todos: Foram selecionados sessenta e quatro gr?vidas com pr?-ecl?mpsia. A DMF e marcadores de pr?-ecl?mpsia foram avaliados no no momento do diagn?stico da doen?a a as pacientes foram seguidas at? o parto. As mulheres foram agrupados e comparadas de acordo com os seus desfechos (26 com complica??es e 38 sem complica??o). Resultados: A DMF est? comprometida em mulheres com pr?-ecl?mpsia complicada (7,44%; IQR 2,20-13,34%) comparada com aqueles sem complica??es (11,80%; IQR 5,36- 16,66%) (p = 0,03). O valor de corte de DMF &#8804; 4,5% foi associada com aproximadamente quatro vezes mais risco de qualquer complica??o (OR 3,79 IC95% 1,23-11,70), semelhante ? rela??o prote?na/creatinina > 2,0 (OR 4,50 IC95% 1,21-16,74). Press?o arterial sist?lica e diast?lica n?o foram associados com risco de complica??o e o ?cido ?rico teve uma signific?ncia lim?trofe (OR 3,38, IC95% 0,98-11,72). Al?m disso, quando as principais complica??es (ecl?mpsia, s?ndrome HELLP ou morte fetal) foram selecionadas como um desfecho composto a DMF foi ainda mais baixa (2,84%; IQR 0,00-7,22%) e o valor da DMF &#8804; 4,5% foi associado com um acentuado aumento de 15 vezes no risco destes eventos espec?fico (OR 15,55; IC95% 3,55-68,16). Embora a DMF tenha pouca capacidade de predi??o de quaisquer complica??es pela pr?-ecl?mpsia (AUC = 0,66, IC95% 0,52-0,79), an?lise da curva ROC mostrou que pode ser um bom marcador de progn?stico para complica??es graves (AUC = 0,84, IC95% 0,73-0,96). Conclus?o: a DMF est? associada com morbidade da pr?-ecl?mpsia, notadamente em mulheres com ecl?mpsia, s?ndrome HELLP ou morte fetal. DMF no momento do diagn?stico da pr?-ecl?mpsia pode ser usado como marcador progn?stico destes desfechos desfavor?veis.

Thesis (Ph. D.)--University of Virginia, 2008. / Title from title page. Includes bibliographical references. Also available online through Digital Dissertations.

Thesis (M.S.)--University of Michigan, 1995. / Thesis date on spine.

Thesis (M.S.)--University of Michigan, 1995. / Thesis date on spine.

Thesis (Ph. D.)--University of Virginia, 2008. / Title from title page. Includes bibliographical references. Also available online as viewed 8/06/2009 through Digital Dissertations.

No description available.

No description available.