Control preconcepcional y diabetes gestacional. Revisión sistemática y estado del arte / Preconceptional control and gestational diabetes. Systematic review and state of the art

Introducción: La diabetes mellitus gestacional se manifiesta con una intolerancia a los carbohidratos, ocasionada por una alteración en la secreción de insulina, con descontrol de los niveles de glucosa en sangre, caracterizada por ser una condición temporal y que se desarrolla por primera vez durante el embarazo; suele desaparecer después del parto, pero puede desarrollarse diabetes mellitus en un futuro. Metodología: Se realizó un estudio investigativo tipo documental, sistematizada, descriptiva, prospectiva en un periodo de revisión de cinco años, del 2013 a 2018. Discusión: Entre los trastornos más comunes en el feto esta la macrostomia, posterior al nacimiento se puede desarrollar hipoglu-cemia. Por parte de la madre también se han documentado complicaciones que pueden percutir al momento del parto como la preeclampsia y el síndrome metabólico. Conclusiones: La diabetes gestacional puede cursar asintomática, por lo que se recomienda realizar pruebas de medición de glucosa en sangre durante las semanas 24 y 28 de gestación. Hay factores que pueden incrementar los riesgos de desarrollar diabetes gestacional, como: la edad avanzada de la madre, sobrepeso u obesidad, antecedentes familiares de diabetes mellitus, entre otros. Por lo tanto, someterse a la prueba de tamizaje sigue siendo el método más seguro de detección.

Introduction: Gestational diabetes mellitus manifests itself with a carbohydrate intolerance, caused by an alteration in insulin secretion, with uncontrolled blood glucose levels, characterized by being a temporary condition, which develops for the first time during pregnancy; It usually disappears after childbirth, although diabetes mellitus may develop later. Methodology: A documentary, systematic, descriptive, prospective research study was conducted in a five-year review period, from 2013 to 2018. Discussion: Among the most common disorders in the fetus is macrostomia, hypoglycemia may develop after birth. On the part of the mother complications have also been documented that can affect the moment of delivery such as preeclampsia and metabolic syndrome. Conclusions:Gestational diabetes can be asymptomatic, so it is recommended to perform blood glucose measu-rement tests during weeks 24 and 28 of gestation. There are factors that can increase the risks of developing gestational diabetes, such as: the mother's advanced age, overweight or obesity, family history of diabetes mellitus, among others. Therefore, undergoing the screening test remains the safest method of detection

Current trends in bovine abortion in Argentina / Tendências atuais do aborto bovino na Argentina

Bovine abortion is an important cause of significant economic losses in beef and dairy herds. This syndrome is usually difficult to diagnose. The aim of this study was to characterize bovine abortion causes in Argentina by standard diagnosis procedures (histology, bacterial and viral isolation) and other diagnostic tests like direct fluorescent antibody test (DFAT), fetal serology, immunohistochemistry (IHC), and PCR, showing their specific advantages and limitations. Necropsies were performed in 150 aborted bovine fetuses submitted to the diagnostic laboratories of Instituto Nacional de Tecnología Agropecuaria (INTA) Balcarce, Argentina. Etiological diagnosis was confirmed in 78 fetuses (52% of the cases). Most causes of abortion were of infectious origin, being Neospora caninum (14.67%), Campylobacter fetus sp. (9.33%), Leptospira spp. (7.33%) and Brucella abortus (6.65%) the main microorganisms identified. Bovine viral diarrhea virus (BVDV) and bovine herpes virus (BHV) were diagnosed in 2 (1.33%) and 3 (2%) cases, respectively. This study showed a better characterization of bovine abortion compared with previous researches done on this topic.(AU)

O aborto bovino é uma causa importante de perdas econômicas significativas em rebanhos bovinos e leiteiros. Esta síndrome é geralmente difícil de diagnosticar. O objetivo deste estudo foi caracterizar o aborto bovino na Argentina por procedimentos diagnósticos de rotina (histologia, isolamento viral e bacteriana) e outros testes diagnósticos como ensaio directo de anticorpos fluorescentes (DFAT), sorologia fetal, imuno-histoquica (IHC), e PCR; mostrando suas vantagens e limitações específicas. As necropsias foram realizadas em 150 fetos bovinos abortados submetidos aos laboratórios de diagnóstico do Instituto Nacional de Tecnologia Agropecuária (INTA) de Balcarce, na Argentina. O diagnóstico etiológico foi confirmado em 78 fetos (52% dos casos). A maioria das causas de aborto foram de origem infecciosa, sendo Neospora caninum (14,67%), Campylobacter fetus sp. (9,33%), Leptospira spp. (7,33%) e Brucella abortus (6,65%) os principais microrganismos identificados. O vírus da diarréia viral bovina (BVDV) e o herpesvírus bovino (BHV) foram diagnosticados em 2 (1,33%) e 3 (2%) casos, respectivamente. Este estudo mostrou uma melhor caracterização do aborto bovino em comparação com pesquisas anteriores feita sobre este tema.(AU)

Placentitis bacteriana como causa de aborto en yeguas: reporte de caso / Placentitis Bacterial as a cause of abortion in mares: Case Report / Placentite causa bacteriana de aborto em éguas: relato de caso

Resumen La placentitis en yeguas ocasionada por bacterias es una de las causas más importantes de abortos, en Colombia no existe evidencia escrita de su presentación. En el presente artículo se reporta el caso de una yegua Silla Francesa de 10 años de edad, que abortó a los 9 meses de gestación y fue atendida en la Clínica Veterinaria San Jorge - Escuela de Equitación Ejército Nacional en Bogotá. La paciente presentó signos de lactancia prematura y se observó engrosamiento de la placenta, además en los hallazgos histopatológicos predominan cambios vasculares (congestión, edema y fibrina) lo que indica una placentitis aguda. En la tinción de Gram de la placenta se encontraron cocobacilos gram negativos adheridos a la superficie de las células de las vellosidades corioalantóicas y entremezclados con el material proteináceo, aparentemente algunos se ubican intracelularmente; asociando estos fenómenos a un proceso infeccioso por posibles enterobacterias (E.coli o Salmonella spp).

Abstract Placentitis in mares caused by bacteria is one of the most important causes of abortions, there aren't any documented cases in Colombia as of yet. In this article, we take a look at a particular case of a "Silla Francesa" mare 10 years of age. The Mare had an abortion at 9 months of gestation and was treated at the Veterinary Clinic San Jorge - Army Equitation School from Bogota. The mare suffered from a premature lactation and presented thickening in the placenta which indicated placentitis, showing signs of vascular changes (congestion, edema and fibrin).In gram staining of placenta, It was found a negative gram coccobacilli adhered to the surface of the chorioallantoic villus cells and mixed with the proteinaceous material, apparently some are located intracellularly, confirming the process of infection potentially due to the presence of enterobacteias. (E.coli or Salmonella sp).

Resumo O placentite em éguas causadas por bactérias é uma das mais importantes causas de abortos, na Colômbia não está escrita a apresentação de provas. Este artigo relata o caso de uma égua cadeira francesa de 10 anos de idade, que o aborto aos 9 meses de gestação e foi tratado na Clínica Veterinária São Jorge - Escola de Equitação do Exército em Bogotá. O paciente apresentou sinais de lactação prematura e espessamento foi observado indicando placentite placenta porque predominantemente alterações vasculares agudas (edema, congestão e fibrina). Na coloração de gram da placenta, cocobacilos gram-negativo foi encontrada aderida à superfície das células das vilosidades corioalantóicas e misturado com o material proteico, aparentemente algumas estão localizadas intracelularmente, o que confirma o processo de potencial infeccioso de enterobactérias (E. coli ou Salmonella sp).

Gemelos unidos (siameses): descripción de hallazgos anatomopatológicos / Conjoined twins (siamese): description of anatomopathological findings

Resumen OBJETIVO: Describir los hallazgos anatomopatológicos y placentarios en una serie de autopsias de 5 siameses. CASOS CLÍNICOS: Serie de casos de autopsias efectuadas entre 2013 y 2018 de pacientes entre 14 y 30 semanas de embarazo, con diagnóstico de gemelos unidos. RESULTADOS: Se encontraron 5 casos de gemelos unidos, hijos de madres multíparas, 3 tuvieron muerte intrauterina y 2 fallecimiento a los pocos minutos de vida. Tres casos correspondieron a uniones ventrales (2 toracoonfalópagos y 1 cefalópago) y dos a uniones laterales de tipo parápagos, dicéfalos. Hubo corazón único en los gemelos toracoonfalópagos y sistemas cardiacos separados en los tres restantes, donde hubo fusión aórtica distal. En 4 casos el hígado se encontró fusionado, con dos vías biliares independientes. Los cordones umbilicales de los casos de unión ventral tenían 5 vasos sanguíneos. Los de unión lateral tenían cordón umbilical trivascular. Los discos placentarios mostraron grados variables de hipoxia preplacentaria y cambios de malperfusión vascular materna. CONCLUSIONES: Las fusiones ventrales tienen grados variables de estructuras compartidas; entre mayor sea la fusión de los órganos internos, menor es el número de vasos umbilicales. De las teorías etiológicas propuestas, la esférica es la que mejor soporta los grados variables de fusión.

Abstract OBJECTIVE: Description of the anatomopathological and placental findings in a series of autopsies of 5 conjoined twins. MATERIALS AND METHODS: Series of cases of autopsies performed between 2013-2018 of patients between 14-30 weeks of gestation, with diagnosis of conjoined twins. RESULTS: Five cases of conjoined twins, product of multiparous mothers, 3 of these presented intrauterine death and 2 deaths within a few minutes of life. Three cases corresponded to ventral junctions (2 thoracoomphalopagus and 1 cephalopagus) and two to lateral junctions of parapagus type. A single heart was observed in the thoracoomphalopagus twins and separated cardiac systems in the remaining three where there was distal aortic fusion. In 4 cases the liver was found fused with two independent bile ducts. The umbilical cords of the cases of ventral union presented 5 blood vessels; those with lateral junction presented a trivascular umbilical cord. The placentas showed varying degrees of preuterine hypoxic pattern and changes of Maternal Vascular malperfusion of the Placental Bed. CONCLUSIONS: Ventral fusions have varying degrees of shared structures; the greater the fusion of the internal organs, the smaller the number of umbilical vessels will be. Of the proposed etiological theories, it is the so-called spherical theory, which best supports the variable degrees of fusion and how it can be saltatory on the vertical axis.

Microcefalia e Zika Vírus: características e associações / Microcephaly and Zika Virus: clinical features and associations / Microcefalia y Virus Zika: características y asociaciones

Objetivo: Discutir a associação entre microcefalia e a infecção materna por Zika Vírus. A microcefalia é o tamanho da cabeça menor do que o esperado em comparação com bebês do mesmo sexo e idade. Entre as causas conhecidas, estão as infecções congênitas. O aumento de casos entre outubro e novembro de 2015 no nordeste brasileiro, que coincidiu com a presença da circulação de novo vírus no país, em maio do mesmo ano, criou a hipótese de associação entre a microcefalia e a infecção materna durante a gravidez. O Zika Vírus é um arbovírus similar ao da Febre Amarela e da Dengue, transmitido principalmente através da picada do Aedes aegypti. A provável transmissão por relação sexual e transfusão de sangue, além de outros vetores como o Aedes albopictus e possivelmente até o pernilongo (Culex sp) aumentam a necessidade de cuidados preventivos em relação à infecção. O exame para detecção viral idealmente é realizado até o quinto dia após o início dos sintomas. Sorologias ainda não são amplamente disponíveis no Brasil. Métodos: Revisão narrativa da literatura. Conclusão: A associação entre casos de microcefalia e o Zika Vírus é embasada nos relatos de relação têmporo-espacial, padrão de alterações neurológicas associado a malformações congênitas, presença do RNA viral no líquido amniótico e nos tecidos de fetos. As respostas definitivas de causalidade serão possíveis após pesquisas e disponibilidade de exames laboratoriais. As evidências até agora apoiam fortemente esta hipótese e todas as medidas preventivas devem ser estimuladas.

Objective: To discuss the association between microcephaly and intrauterine infection by Zika virus. Microcephaly occurs when a child is born with a head smaller than expected when compared to babies of the same sex and age. Known causes of microcephaly include congenital infections. The increase in the number of microcephaly cases in Northeast Brazil between October and November 2015, which coincided with the emergence of Zika virus in the country in May of the same year, led to the hypothesis of an association between microcephaly and intrauterine Zika virus infection. Zika is an arbovirus that is closely related to yellow fever and dengue viruses. Aedes aegypti mosquitoes are the primary vector of transmission. Possible transmission through sexual contact and blood transfusion, as well as the implication of other vectors, such as Aedes albopictus and even Culex sp increases the need for preventive action. The test for viral detection is ideally performed before the 5th day following the onset of symptoms. Serology tests are not yet widely available in Brazil. Methods: We performed a narrative literature review. Conclusion: The hypothesis of an association between microcephaly and Zika virus is based on reports of spatial/temporal relationship, pattern of neurologic alterations associated with congenital malformations, and findings of viral RNA in amniotic fluid and fetal tissue. Definitive conclusions about the causality can only be reached after further research and availability of laboratory tests. The current evidence strongly supports the association between microcephaly and Zika infection, and all preventive measures must be stimulated.

Objetivo: Discutir las asociaciones entre microcefalia e infección materna por Virus Zika. La microcefalia es el tamaño de la cabeza menor de lo esperado en comparación con los bebés del mismo sexo y edad. Entre las causas conocidas están las infecciones congénitas. El aumento de casos entre octubre y noviembre de 2015 en el nordeste de Brasil, que coincidió con la presencia de la nueva circulación del virus en el país en mayo del mismo año, creó la hipótesis de asociación entre la microcefalia y la infección de la madre por Virus Zika durante el embarazo. El virus Zika es un arbovirus similar al dengue y la fiebre amarilla. El virus se transmite a través de la picadura del mosquito Aedes aegypti. La probable transmisión por vía sexual y por la transfusión de sangre - además de otros vectores como el Aedes albopictus y posiblemente el mosquito Culex sp - aumentan la necesidad de atención preventiva contra la infección. El cuadro clínico es benigno, autolimitado, caracterizado por erupción maculopapular asociado con otros síntomas tales como conjuntivitis, artralgia y la inflamación de las articulaciones. El examen para la detección del virus se realiza idealmente por el quinto día después de la aparición de los síntomas. Las pruebas serológicas no están ampliamente disponibles en Brasil. Métodos: Revisión de literatura. Conclusión: La asociación entre los casos de microcefalia y el virus Zika se basa en informes de patrón de relación temporo-espacial de los trastornos neurológicos asociados con malformaciones congénitas, el ARN viral presente en el líquido amniótico y tejidos de fetos. Las respuestas definitivas de causalidad serán posibles después de la investigación y la disponibilidad de pruebas de laboratorio. Hasta ahora, las evidencias apoyan firmemente esta hipótesis y todas las medidas preventivas deben ser estimuladas.

Comparison of Two- and Three-dimensional Ultrasonography in the Evaluation of Lesion Level in Fetuses with Spina Bifida / Comparação entre a ultrassonografia bidimensional e a ultrassonografia tridimensional na avaliação do nível da lesão nos fetos com espinha bífida

Purpose To evaluate the precision of both two- and three-dimensional ultrasonography in determining vertebral lesion level (the first open vertebra) in patients with spina bifida. Methods This was a prospective longitudinal study comprising of fetuses with open spina bifida who were treated in the fetal medicine division of the department of obstetrics of Hospital das Clínicas of the Universidade de São Paulo between 2004 and 2013. Vertebral lesion level was established by using both two- and three-dimensional ultrasonography in 50 fetuses (two examiners in each method). The lesion level in the neonatal period was established by radiological assessment of the spine. All pregnancies were followed in our hospital prenatally, and delivery was scheduled to allow immediate postnatal surgical correction. Results Two-dimensional sonography precisely estimated the spina bifida level in 53% of the cases. The estimate error was within one vertebra in 80% of the cases, in up to two vertebrae in 89%, and in up to three vertebrae in 100%, showing a good interobserver agreement. Three-dimensional ultrasonography precisely estimated the lesion level in 50% of the cases. The estimate error was within one vertebra in 82% of the cases, in up to two vertebrae in 90%, and in up to three vertebrae in 100%, also showing good interobserver agreement. Whenever an estimate error was observed, both two- and three-dimensional ultrasonography scans tended to underestimate the true lesion level (55.3% and 62% of the cases, respectively). Conclusions No relevant difference in diagnostic performance was observed between the two- and three-dimensional ultrasonography. The use of three-dimensional ultrasonography showed no additional benefit in diagnosing the lesion level in the fetuses with spina bifida. Errors in both methods showed a tendency to underestimate lesion level.

Objetivo Avaliar a precisão da ultrassonografia bidimensional e tridimensional para a determinação do nível da lesão vertebral em casos de fetos portadores de espinha bífida. Métodos Estudo prospectivo longitudinal, compreendendo fetos portadores de espinha bífida assistidos no setor de medicina fetal de hospital de ensino do Sudeste do Brasil, entre os anos de 2004 e 2013. Foram incluídos 50 fetos portadores de espinha bífida pela ultrassonografia bidimensional e tridimensional (dois examinadores em cadamétodo) comrelação ao nível da lesão. O nível exato da lesão foi verificado usando radiografia após o nascimento. Resultados A ultrassonografia bidimensional estimou corretamente o nível de espinha bífida em 53,0% dos casos. Em 80,0% dos casos a estimativa ocorreu com erro de uma vértebra; 89,0% em até duas vértebras e de 100,0% em até três vértebras. A ultrassonografia tridimensional estimou corretamente o nível de espinha bífida em 50,0% dos casos. Em 82,0% dos casos, a estimativa ocorreu com erro de uma vértebra; 90,0% em até duas vértebras e de 100,0% em até três vértebras. Nos casos em que houve erro na estimativa do nível da lesão, tanto na avaliação bidimensional quanto na tridimensional, observou-se tendência a subestimar o nível da lesão vertebral (55,3% na avaliação bidimensional e 62,0% na tridimensional), ou seja, colocando o nível ultrassonográfico mais baixo que o observado no pós-natal. Conclusões Não houve diferenças relevantes entre o desempenho diagnóstico da ultrassonografia bidimensional e tridimensional para determinação do nível da lesão vertebral nos casos de fetos portadores de espinha bífida. Tendência a subestimação do nível de lesão nos casos em que houve erro tanto na ultrassonografia bidimensional quanto na tridimensional.

End-of-life decisions in perinatal care: A view from health-care providers in Mexico / Decisiones sobre el final de la vida en la atención perinatal: Una visión del equipo de salud en México

Objective. To examine the opinions of a perinatal health team regarding decisions related to late termination of pregnancy and severely ill newborns. Materials and Methods. An anonymous questionnaire was administered to physicians, social workers, and nurses in perinatal care. Differences were evaluated using the chi square and Student's t tests. Results. When considering severely ill fetuses and newborns, 82% and 93% of participants, respectively, opted for providing palliative care, whereas 18% considered feticide as an alternative. Those who opted for palliative care aimed to diminish suffering and those who opted for intensive care intended to protect life or sanctity of life. There was poor knowledge about the laws that regulate these decisions. Conclusions. Although there is no consensus on what decisions should be taken with severely ill fetuses or neonates, most participants considered palliative care as the first option, but feticide or induced neonatal death was not ruled out.

Objetivo. Explorar la opinión del equipo de salud sobre las decisiones relacionadas con la atención de fetos y neonatos gravemente enfermos. Material y métodos. Se aplicó un cuestionario anónimo a médicos, trabajadoras sociales y enfermeras perinatales. Las diferencias se evaluaron con las pruebas chi cuadrada y t de Student. Resultados. Al tratar fetos y neonatos gravemente enfermos, 82 y 93% de los participantes optaron, respectivamente, por atención paliativa. El 18% consideró el feticidio como alternativa. Quienes optaron por atención paliativa, lo hicieron para disminuir el sufrimiento, mientras que los que eligieron cuidados intensivos lo hicieron para proteger la vida o la sacralidad de la vida. Nuestro estudio mostró un pobre conocimiento de las leyes que regulan estas decisiones. Conclusiones. Aun cuando no existe un consenso sobre las decisiones que deben tomarse con fetos o neonatos gravemente enfermos, la mayoría consideró como primera opción los cuidados paliativos, aunque el feticidio y la muerte neonatal inducida no se descartaron.

Estudo morfométrico do músculo latíssimo do dorso em fetos humanos / Morphometric study of the latissimus dorsi muscle in human fetuses

Introdução: O músculo latíssimo do dorso (MLD) é largo, triangular e realiza extensão, adução e rotação medial do braço. É vascularizado pelos vasos toracodorsais e ramos perfurantes das artérias intercostais posteriores e lombares, configurando retalho tipo V de Mathes e Nahai, de grande aplicabilidade em cirurgia plástica. O objetivo é analisar a morfometria e a vascularização do MLD em fetos humanos. Método: Dissecou-se a região axilar e o MLD de oito fetos humanos formolizados (três do sexo feminino e cinco do sexo masculino), entre 20 e 32 semanas gestacionais, em decúbito dorsal e abdução completa do braço. Mensuraram-se os comprimentos dos vasos subescapulares e toracodorsais, e foi realizada a morfometria do músculo. Resultados: Em todos os fetos, os vasos toracodorsais conferiram a vascularização primária do MLD. Em 25%, a veia subescapular era tributária direta da veia axilar; 25% dos casos apresentaram veia circunflexa da escápula dupla. O ramo para o músculo serrátil anterior foi único em todos os casos. Em 50% dos casos, o ramo angular da artéria toracodorsal foi visualizado e, em 25% deles, era proveniente do ramo para o músculo serrátil anterior. A distância entre a inserção do músculo e a entrada do pedículo neurovascular variou entre 1,1 e 1,9 cm em fetos de 21 e 26 semanas, respectivamente. Todos os fetos apresentaram a margem anterior do músculo na linha axilar média. Conclusão: A morfometria constante e a reduzida variação anatômica do pedículo vascular encontradas possibilitam a realização de pesquisas envolvendo o uso do MLD em reconstruções cirúrgicas intraútero.

Introduction: The latissimus dorsi muscle (LDM) is a flat triangular muscle which extends, adducts and draws the arm medially. Its blood supply is from the thoracodorsal vessels and the perforating branches of the posterior intercostal and lumbar arteries, therefore, it is a type V flap variety, which has great applicability in plastic surgery. This study aims to analyze the morphometry and the vascularization of MLD in human fetuses. Methods: The axillary region and LDM of eight human fetuses (3 females, 5 males), between 20 and 32 weeks of gestational ages, were dissected in supine position with complete abduction of the arm. The subscapular and thoracodorsal vessels lengths were measured and the morphology of the muscle was studied. Results: In all fetuses, the dominant vascular pedicle of LDM was the thoracodorsal vessels. In 25% of cases the subscapular vein was tributary of the axillary vein. Double circumflex scapular vein were found in 25% of the cases. In all fetuses, the serratus anterior branch was unique. In 50% of the cases the angular branch of the thoracodorsal artery was found, 25% of them were from the serratus anterior branch. The length between its insertion and the entry of the neurovascular pedicle was 1.1 to 1.9 cm in fetuses of 21 and 26 weeks, respectively. In all fetuses, the anterior border of the muscle was at the mid-axillary line. Conclusion: The constant morphometry and reduced anatomical variation of the vascular pedicle enables new studies regarding the use of LDM in surgical reconstructions in utero.

Echobiometrics kidney and renal artery triplex doppler of canine fetuses / Ecobiometria renal e Doppler Triplex da artéria renal de fetos caninos

The aim of this study was to assess the sogographic parameters and biometry of canine fetal kidneys using the B mode, and to determinate the vascular index of the fetal renal arteries using the Doppler Triplex. Twenty four Shi-tzu and Pug, weighting between 4 and 10kg, aging between 4 and 6 years old were evaluated. The B mode, the fetal renal echobiometry and regularity of the renal surface, echotexture and cortex:medular ratio were evaluated during the 5th, 6th, 7th and 8th weeks of pregnancy. At the same time point of the B mode evaluation, the Doppler Triplex was carried out to assess the sistolic peak velocity (SPV), end diastolic velocity (EDV), vascular resistive (RI) and pulsatility index (PI). B mode revealed no fetal renal abnormalities and echobiometry showed important measurements during fetal development (P<0.0001). The values of the fetal renal arteries index (PSV and EDV) increased during the course of the pregancy (P<0.05) and remained constant for PI and RI (P>0.05). B mode and Doppler Triplex were important tools for the assessment of fetal renal development, using echobiometry and renal arterial index in canie fetuses...

O objetivo deste estudo foi avaliar, por meio da ultrassonografia convencional modo B, as características sonográficas e a biometria dos rins de fetos caninos, bem como determinar os índices vasculares da artéria renal dos conceptos ao Doppler Triplex. Foram utilizadas 24 fêmeas Shi-tzu e Pugs pesando de quatro a 10 kg e com idade entre quatro e seis anos. Ao modo B, a ecobiometria renal fetal, a regularidade da superfície renal, a ecotextura e a relação córtico-medular foram avaliadas durante a quinta, sexta, sétima e oitava semanas gestacionais. Ao Doppler Triplex, durante o mesmo período em que se realizou o exame convencional, foram determinados o pico de velocidade sistólica (PVS), a velocidade diastólica final (EDV) e o índice de resistência vascular (RI) e de pulsatividade (PI). Ao modo B, não foram detectadas alterações em rins fetais, e à ecobiometria renal dos fetos, foi possível determinar medidas renais importantes, verificando-se aumento das biometrias no decorrer do desenvolvimento fetal (P<0,0001). Ao Doppler Triplex, determinaram-se os índices vasculares da artéria renal fetal, sendo que os valores para PSV e EDV aumentaram no decorrer das semanas gestacionais (P<0,05) e permaneceram constantes para PI e RI (P>0,05). Concluiu-se que o modo B e o Doppler Triplex são ferramentas importantes para a avaliação do desenvolvimento renal fetal, com a utilização da ecobiometria renal e avaliação dos indices vasculares da artéria renal de fetos caninos...

Desenvolvimento do abomaso de bovinos no período pré-natal / Development of bovine abomasum in prenatal period

Para esta pesquisa, amostras de abomaso de fetos da raça Nelore (Bos taurus indicus) foram divididos em cinco grupos: 1º – fetos com 9 a 15 semanas (8 a 21cm) de gestação, 2º – fetos com 16 a 22 semanas (23 a 37 cm), 3º – fetos com 23 a 29 semanas (40 a 58 cm), 4º – fetos com 30 a 36 semanas (61 a 77 cm) e 5º – fetos com 37 a 43 semanas (79 a 88 cm). Os cortes histológicos foram corados com Hematoxilina e Eosina, picrossirius e Tricrômico de Mallory e examinados ao microscópio de luz. No feto de 11 cm, observaram-se pregas mucosas largas, vilosidades revestidas por epitélio simples cilíndrico, lâmina própria, tela submucosa, túnica muscular com estratos interno e externo e serosa. Aos 13,5 cm, as vilosidades eram evidentes com formação da lâmina muscular da mucosa. Aos 16,5 cm, houve aumento em número e tamanho das glândulas mucosas. No feto de 26 cm, observou-se aumento das túnicas e ramificações das glândulas. Aos 29 cm, observou-se aumento no tamanho das pregas. Com 37 cm, houve aumento do epitélio glandular, lâmina muscular da mucosa e túnica muscular. Com 42 cm, as glândulas eram profundas com células mucosas e lâmina pró- pria delgada. Concluiu-se que as os valores histomorfométricos da túnica muscular e parede total do abomaso foram crescentes para todos os grupos, com exceção dos grupos 4 e 5 para os quais houve queda dos valores, sem diferença significante e não houve crescimento contínuo para os demais constituintes da parede do abomaso.

For this purpose, samples of Nelore fetus abomasum (Bos taurus indicus) were classified into five groups: 1 – fetuses with 9 to 15 weeks (8 to 21 cm) of gestation, 2 – fetuses with 16 to 22 weeks (23 to 37 cm), 3 – fetuses at 23 to 29 weeks (40 to 58 cm) 4 – fetuses with 30 to 36 weeks (61 to 77 cm) and 5 – fetuses with 37 to 43 weeks (79 to 88 cm). Histologic sections were stained with Hematoxylin and eosin, picrosirius and Mallory’s trichrome methods and examined underlight microscopy. In fetus with 11 cm of length showed deep mucosa, wide folds and villi lined by single cylindrical epithelium, lamina propria, submucosa, muscular sublayers and serosa. Fetus with 13.5 cm, villi were evident and muscular layer of the mucosa was formed. At 16.5 cm, could be seen an increase in mucosa glands size and number. In fetus of 26 cm, showed gastric mucous glands at great number and ramifications. At 29 cm large folds, were observed.At 37 cm, showed glandular epithelium, muscular layer of the mucosa and muscular layer well development. Fetus with 42 cm, showed deep glands with corresponding mucous cells surrounding by thin lamina propria. It was concluded that the histomorphometric values of muscular layer and total abomasum wall were increased for all groups except for groups 4 and 5 which there was a decline of values, without presenting a significant difference and there was no continuous pattern of growth for other components of abomasum wall.

Desenvolvimento do omaso de bovinos da raça Nelore (Bos taurus indicus) durante o período pré-natal / Development of the omasum of Nelore cattle (Bos taurus indicus) during the prenatal period

O desenvolvimento do estômago de mamíferos domésticos é um processo complexo, especialmente em ruminantes. Essa pesquisa analisou o desenvolvimento desse órgão durante o período pré-natal. Foram utilizadas amostras de omaso de fetos da raça Nelore (Bos taurus indicus) divididos em cinco grupos com seis amostras cada: 1º – fetos com 9 a 15 semanas (8 a 21cm) de gestação, 2º – fetos com 16 a 22 semanas (23 a 37cm), 3º – fetos com 23 a 29 semanas (40 a 58cm), 4º – fetos com 30 a 36 semanas (61 a 77cm) e 5º– fetos com 37 a 43 semanas (79 a 88cm). Os cortes histológicos foram corados com Hematoxilina e Eosina e Picrossirius e examinados ao microscópio de luz. No feto de 11 cm, foi observado mucosa com lâminas primárias, secundárias e terciárias uniformes e demais camadas presentes. No feto de 13,5 cm surgiram as lâminas quaternárias, papilas nas lâminas primárias e secundárias e a formação da muscular da mucosa. Aos 28 cm, as papilas estavam em pleno desenvolvimento, assim como as lâminas, principalmente as quaternárias. No feto de 42 cm houve início de queratinização epitelial e, no de 56 cm, estava totalmente queratinizado. No feto de 60 cm, as lâminas possuíam papilas grandes e afiladas no ápice e, aos 65 cm, houve diminuição do epitélio e aumento da camada muscular. O feto de 83 cm apresentou lâminas delgadas, muscular da mucosa discreta e papilas por toda a superfície. Concluiu-se que as lâminas e papilas foram as estruturas que mais apresentaram modificações durante o desenvolvimento fetal.

The development of the stomach of domestic mammals is a complex process, especially in ruminants. The aim of this study was to analyze this organ during prenatal period. Omasum samples of Nelore fetuses (Bos taurus indicus) were divided into five groups of six samples each: 1- fetuses from 9 to 15 weeks (8 to 21cm) of gestation, 2 - fetuses from 16 to 22 weeks (23 to 37cm), 3 - fetuses from 23 to 29 weeks (40 to 58cm), 4 - fetuses from 30 to 36 weeks (61 to 77cm) and 5 - fetuses from 37 to 43 weeks (79 to 88cm). The histological sections were stained with Hematoxylin and Eosin and Picrossirius and examined by light microscopy. In fetuses of 11 cm it was observed mucosa with uniform primary, secondary and tertiary blades and all layers present. The fetus with 13.5 cm presented quaternary blades emergence, papillae on primary and secondary blades and formation of the muscularis mucosae. At 28 cm it were observed papillae in development, as well as the blades, especially the quaternary. In 42 cm fetuses was early epithelial keratinization and at 56 cm it was fully keratinized. In 60 cm fetuses the blades presented large papillae with tapered apex and at 65 cm there was decreased epithelium and increase of the muscle layer. In the fetus of 83 cm it were observed thin sections, discrete muscularis mucosa and papillae over the entire organ surface. It was concluded that the blades and papillae were structures that presented more changes during fetal development.

Pathological findings in fetuses of goats and cattle poisoned by Sida carpinifolia (Malvaceae) / Achados patológicos em fetos de caprinos e bovinos intoxicados por Sida carpinifolia (Malvaceae)

In Brazil, the consumption of Sida carpinifolia by livestock has been associated with neurological diseases linked to lysosomal storage disorders. This paper describes the pathological findings in two caprine fetuses from dams that were experimentally poisoned with S. carpinifolia. The goats were orally dosed with 10 and 13g/kg of a paste of green chopped S. carpinifolia for 30 days and were observed for an additional 15 days period after the last dosage with the plant; thereafter they were euthanized and necropsied. The dams showed only slight clinical signs. The study also includes the findings in one bovine fetus from a naturally S. carpinifolia poisoned cow which showed mild incoordination, generalized tremors, staggering, and frequent falls. The cow was euthanized and necropsied. While there were no significant histopathological changes in the goats, in the cow vacuolation of Purkinje neurons of the cerebellum, pancreatic acinar cells, and thyroid follicular cells were observed. The main microscopic changes observed in the caprine and bovine fetuses were vacuolation in the epithelium of renal tubules, thyroid follicular cells, and Purkinje neurons of the cerebellum. Transmission electron microscopy of sections from CNS of the cow and its fetus revealed vacuoles containing fine granular material surrounded by membrane. Lectin-histochemistry of CNS sections from goat fetuses marked lightly to sWGA lectins, WGA, and Con-A.

No Brasil, o consumo de Sida carpinifolia por animais de produção tem sido associada a doenças neurológicas relacionadas com doença de depósito lisossômico. Este trabalho descreve os achados patológicos observados em dois fetos caprinos de mães que foram experimentalmente intoxicadas por S. carpinifolia. As cabras foram intoxicadas experimentalmente com S. carpinifolia nas doses de 10 e 13g/kg durante 30 dias e foram acompanhadas durante 15 dias após o consumo da planta. Após este período foram eutanasiadas e necropsiadas. O estudo também inclui os achados patológicos encontrados em um feto de uma fêmea bovina intoxicada naturalmente pela planta, que mostrou leve incoordenação, tremores generalizados, andar desequilibrado e quedas frequentes. A vaca foi eutanasiada e necropsiada. Embora não houvesse alterações histológicas significativas nas cabras, vacuolização dos neurônios de Purkinje do cerebelo, das células acinares do pâncreas e nas células foliculares da tireoide foram observadas na vaca. As principais alterações histológicas observadas nos fetos caprinos e no feto bovino foram vacuolização no epitélio dos túbulos renais, nas células foliculares da tireoide e nos neurônios de Purkinje do cerebelo. Na microscopia eletrônica de transmissão do sistema nervoso central da vaca e de seu feto revelaram-se vacúolos contendo material finamente granulado e delimitado por membrana. Na técnica de lectina-histoquímica dos fetos caprinos houve marcação leve no SNC para as lectinas sWGA, WGA e para Con-A.

The great auricular nerve in fetuses / El nervio auricular mayor en fetos

The great auricular nerve (GAN) is the largest branch of the superficial cervical plexus that winds around the posterior border of the sternocleidomastoid muscle, accompanied by the external jugular vein. Forty fetuses (right side: 40/80; left: 40/80) with gestational ages between 15 to 28 weeks were microdissected to document the anatomy of the GAN. The results obtained were classified as: i) Incidence and morphometry: GAN was present in 100 percent of the fetal specimens with average length on the right and left sides recorded as 12.65 +/- 2.14 mm and 12.55 +/- 2.82 mm respectively. ii) Course: GAN was located parallel to the transverse cervical nerve and the external jugular vein. Duplicate external jugular veins were observed in 5 percent (4/80) with GAN located anterior to one of the tributaries; iii) Branching Pattern: 16 percent (13/80) of specimens depicted a single branch. Duplicate branches in 67 percent (54/80) (referred to as Type I: anterior and posterior branches and 33 percent (26/80) referred to as Type II: anterior and posterior branches; iv) Variation: the transverse cervical nerve formed a communication with GAN, inferior to the parotid gland in 1 percent. The anatomical knowledge of the course, bifurcation pattern and variations of GAN may prevent complications during surgical procedures such as parotidectomies.

El nervio auricular mayor (NAM) es el ramo más grande del plexo cervical superficial que gira alrededor del margen posterior del músculo esternocleidomastoideo, acompañado de la vena yugular externa. Cuarenta fetos (lado derecho: 40/80; izquierdo: 40/80), con edades gestacionales de 15 a 28 semanas fueron microdisecados para describir la anatomía del NAM. Los resultados obtenidos se clasificaron en: i) Incidencia y morfometría: NAM estaba presente en el 100 por ciento de las muestras fetales con una longitud media de los lados derecho e izquierdo de 12,65+/-2,14mm y 12,55+/-2,82mm, respectivamente. ii) Curso: NAM se encuentra paralelo al nervio cervical transverso y la vena yugular externa. Duplicación de las venas yugulares externas se observaron en el 5 por ciento (4/80) con el NAM situado por delante de uno de los afluentes, iii) Patrón de ramificación: 16 por ciento (13/80) de las muestras presentaba una solo ramo. Ramos duplicados en el 67 por ciento (54/80) de Tipo I, ramos anterior y posterior y, el 33 por ciento (26/80) Tipo II, ramos anterior y posterior, y iv) Variación: el nervio cervical transverso formando una comunicación con NAM, inferior a la glándula parótida en el 1 por ciento. El conocimiento anatómico del curso, patrón de bifurcación y variaciones del NAM pueden prevenir las complicaciones durante los procedimientos quirúrgicos como la parotidectomía.

Absorption levels and morphological features of fetal organs in wistar rats treated with lead acetate / Niveles de absorción y características morfológicas de los órganos fetales en ratas wistar tratadas con acetato de plomo

Lead is one of the heavy metals most used in industry. Poisoning due to long-term lead exposure is known as saturnism, and is an occupational illness that has been known for many years. Lead is highly toxic and can compromise the structural and functional patterns of organs and systems. The aim of this study was to examine the lungs and kidneys of fetuses from female Wistar rats exposed to lead acetate. In this study, the lungs and kidneys of 20 fetuses from female rats that had previously been treated with lead acetate were dissected, fixed, embedded in paraffin and stained with hematoxylin and eosin. Macroscopic changes to the shape, color and consistency of organs from fetuses treated with this heavy metal were observed, in comparison with organs from control fetuses. Microscopic lesions characterized by vascular sclerosis, cell atrophy or hyperplasia, progressive interstitial fibrosis, inclusion bodies containing lead acetate and glomerular sclerosis were found in the kidneys. The lesions found in the lungs consisted of destructuring of the parenchyma, impregnation with lead acetate, formation of fibrosis, extravasation of vascular fluids, reduction of the alveolar spaces and formation of alveolar edema. These changes were correlated with the level of lead acetate absorption, as determined using atomic spectrophotometry.

El plomo es un metal pesado utilizado en la industria. El envenenamiento debido a la exposición prolongada por plomo es una enfermedad profesional conocida por muchos años. La toxicidad del plomo es muy expresiva y puede poner en peligro el modelo estructural y funcional de los órganos y sistemas. El objetivo de este estudio fue examinar los pulmones y riñones de fetos de ratas Wistar expuestos al acetato de plomo. En este estudio, 20 fetos de ratas Wistar previamente tratados con acetato de plomo durante la gestación, tuvieron sus órganos disecados, fijados, incluidos en parafina y teñidos con hematoxilina y eosina. Macroscópicamente, los órganos fetales tratados por este metal fueron comparados con los órganos de fetos controles en relación a forma, color y consistencia. Microscópicamente, se encontraron lesiones en el riñón que se caracterizaron por esclerosis vascular, atrofia o hiperplasia de células, fibrosis intersticial progresiva, presencia de cuerpos de inclusión que contenían acetato de plomo y esclerosis glomerular. En el pulmón se observó desorganización del parénquima impregnado con acetato de plomo, formación de fibrosis, líquido intersticial, reducción de los espacios alveolares y edema alveolar. Estos cambios se correlacionaron con el nivel de absorción de acetato de plomo, determinado por espectrometría atómica.

Morphometric changes in talus of club foot A gross observation in human foetuses / Cambios morfométricos en talus del pie zambo, una observación macroscópica en fetos humanos

Both the feet of six human foetuses of different age groups having unilateral club feet, were dissected for morphological study. Six morphometric parameters considered for comparing gross anatomical changes in normal and deformed feet, were 1-Maximum length of the talus, 2-Longitudinal dimension of head of talus, 3-Anterior trochlear breadth, 4-Maximum medial talar height, 5-Talar neck and calcaneal angle, 6-Talocalcaneal angle. All the foetuses with congenital club feet have almost similar deformity of foot skeleton. The gross anomalies observed were the smaller size of club foot talus and increased medial and planter deviation of a stunted, misshapen head and neck region. A medial plantar subluxation of the navicular bone with a consequent deformity of the articular facets of the talar head was also observed. Uniformity and consistency of anatomical abnormalities were striking features in present study.

Para su estudio morfológico fueron disecados ambos pies de seis fetos humanos de distintas edades, uno de los pies era zambo. Seis parámetros morfométricos fueron considerados para la comparación de graves alteraciones anatómicas en los pies normales y deformes; estos fueron: 1. Longitud máxima del talus, 2. Dimensión longitudinal de la cabeza del talus, 3. Ancho troclear anterior, 4. Altura medial máxima del talus, 5. Cuello talar y ángulo calcáneo, 6. Ángulo talocalcáneo. Todos los fetos con pie zambo congénito tienen una deformidad similar del esqueleto del pie. Las anomalías graves observadas fueron el menor tamaño del talus del pie zambo, aumento de la desviación media y retraso en el crecimiento plantar, deformación de la cabeza y región del cuello talar. También se observó una subluxación medial plantar del hueso navicular, con un consecuente deformidad de las facetas articulares de la cabeza del talus. La uniformidad y consistencia de las anomalías anatómicas fueron los rasgos más llamativos en este estudio.

Morphometric analysis of lumbosacral canal in human foetuses / Análisis morfométrico del canal lumbosacro en fetos humanos

Lumbosacral part of the spinal canal requires special attention because this is the site commonly involved in spina bifida, tethered cord syndrome and some other pathologies like fatty tumours in the spine, cysts and syrinxes. The diagnosis as well as the treatment of neural tube defects mandates an accurate knowledge of morphometry of lumbosacral vertebral canal. There are various reports on radiological morphometric measurements in human foetuses by various authors but these possess inherent variability due to imaging techniques, patient positioning, observer's measuring techniques and normal and pathological variations. To overcome all these limitations, direct measurements by vernier calliper were preferred. 30 Formalin preserved human foetuses, of all age groups and both sexes, free of congenital craniovertebral anomalies, were obtained from the museum of Dept. of Anatomy, J. N. Medical College AMU Aligarh for the present study. Foetuses were divided into five groups (I-V) based on their gestational ages. Group I foetuses were of less than 17 weeks, II of 17-20 weeks, III of 21-25 weeks, IV of 26-30 weeks and V of more than 30 weeks. Each group contained 6 foetuses having both male and female, 3 each. Morphometric parameters taken into account were length of lumbar canal, maximum transverse diameters of lumbar vertebral canal at different vertebral levels, heights of the posterior surfaces of bodies of all lumbar vertebrae and length of sacral canal. Readings of adjacent groups were compared and results were analyzed by using Student's 't' test. Lumbar canal starts growing in length significantly in group III foetuses onward. There was consistency in the growth of lumbar canal diameters with gestational age at all levels. Heights of vertebral bodies of Ist two lumbar vertebrae showed variability in some adjacent groups. The same in the next three grew constantly with the growth of foetuses. Sacral canal showed variable growth in lengths in different grou...

La porción lumbosacra del canal espinal requiere una atención especial; es un sitio frecuentemente implicado en la espina bífida, el síndrome de médula anclada y algunas otras patologías como tumores de grasa en la columna vertebral, quistes y siringomelia. El diagnóstico y el tratamiento de los defectos del tubo neural requieren de un conocimiento preciso de la morfometría del canal vertebral lumbosacro. Existen diversos informes radiológicos sobre mediciones morfométricas en fetos humanos por parte de diversos investigadores, pero estos poseen una variabilidad inherente debido a las técnicas de imagen, posicionamiento del paciente, técnicas de medición del observador y, las variaciones normales y patológicas. Para superar todas estas limitaciones, para las mediciones directas se utilizó un caliper vernier. 30 fetos humanos conservados en formalina, de todas las edades y de ambos sexos, sin anomalías congénitas craneovertebrales, fueron obtenidos del museo del Departamento de Anatomía, J. N. Facultad de Medicina de la UMA, Aligarh. Los fetos fueron divididos en cinco grupos (I-V) sobre la base de su edad gestacional. El grupo I de fetos fueron los menores de 17 semanas, el II de 17-20 semanas, el III de 21-25 semanas, IV de 26 a 30 semanas, V de más de 30 semanas. Cada grupo contenía 6 fetos de ambos sexos (1:1/H:M)). Los parámetros morfométricos tomados en cuenta fueron la longitud del canal lumbar, el diámetro transversal máximo del canal vertebral lumbar en diferentes niveles, la altura de las superficies posteriores de los cuerpos de todas las vértebras lumbares y la longitud del canal sacro. Las mediciones de los grupos fueron comparadas y analizadas mediante el uso de la prueba de "t". El canal lumbar comenzó a aumentar en longitud significativamente desde el grupo de fetos III en adelante. No hubo consistencia en el crecimiento de los diámetros del canal lumbar con la edad gestacional en todos los niveles. Las alturas de los primeros dos cuerpos verte...

La infección por Trypanosoma cruzi en ratones gestantes induce una respuesta inmune celular con producción de citocinas en sus fetos / Trypanosoma cruzi infection in pregnant mice induces a cellular immune response with citokines production in their fetuses

El objetivo del presente estudio fue detectar las citocinas IFN-g, IL-4 e IL-10 expresadas por células T CD4+ en tejidos de fetos de ratones con infección chagásica aguda. Para ello, se examinaron fetos de ratones NMRI cuyas madres fueron infectadas con 22×10³ tripomastigotes metacíclicos de la cepa M/HOM/BRA/53/Y de T. cruzi y preñadas durante la fase aguda de la infección. Para la detección y localización de infiltrados inflamatorios, nidos de parásitos, antígenos de T. cruzi y citocinas se emplearon las técnicas de hematoxilina-eosina, peroxidasa-anti-peroxidasa e inmunofluorescencia indirecta. Se detectaron infiltrados inflamatorios y antígenos con nidos de amastigotes en el músculo esquelético fetal. Células T CD4+ productoras de IFN-g así como depósitos de IFN-g e IL-10 fueron detectados en las secciones de placenta, corazón y músculo esquelético de fetos de ratones infectadas, mientras que células CD4+/IL-10+ se encontraron sólo en músculo esquelético, adicionalmente se detectaron depósitos de IL-4 sólo en placentas de ratones sanas. Estos resultados indican que el feto es capaz de generar una respuesta inmune propia frente a antígenos transmitidos por su madre, lo cual induce la secreción de citocinas que actuando en sinergia con los anticuerpos maternos le confieren un estado de protección contra la infección, y que la transmisión del parásito depende de factores específicos de cada madre, la cual puede modificar su capacidad de controlar tal transmisión ya sea a nivel placentario o sistémico.

The objective of this study was to detect the cytokines IFN-g, IL-4 and IL-10 expressed by CD4+ T cells in tissues of fetal mice with acute chagasic infection. For this, we examined the fetuses of NMRI mice whose mothers were infected with 22×10³ metacyclic trypomastigotes of the M/HOM/BRA/53/Y strain of T. cruzi and made pregnant during the acute phase of infection. For the detection and localization of inflammatory infiltrates, nest parasites, antigens of T. cruzi and cytokines we used hematoxylin-eosin techniques, peroxidase-anti-peroxidase and immunofluorescence. The immunohistochemical study revealed the presence of inflammatory infiltrates and antigens with amastigote nests in fetal skeletal muscle. CD4 + T cells producing IFN-g, as well as deposits of IFN-g and IL-10, were detected in sections of placenta, heart and skeletal muscle of fetuses of mice infected, while CD4+/IL-10+ was found only in skeletal muscle; in addition, deposits of IL-4 were detected only in placentas of healthy mice. These results indicate that fetuses are capable of generating their own immune response to antigens transmitted by their mother, which induces the secretion of cytokines and that, acting in synergy with the maternal antibodies, confer them a state of protection against infection; and that the transmission of the parasite depends on factors specific to each mother, which may modify its ability to control such transmission at the placental or systemic levels.

Utilidad de la espectroscopia por resonancia magnética en fetos con resistencias arteriales normales y resistencias arteriales elevadas / Usefulness of magnetic resonance spectroscopy in fetuses with normal arterial resistence and elevated arterial resistance

Determinar si la espectroscopia por resonancia magnética puede utilizarse en la evaluación del desarrollo cerebral de fetos con resistencias arteriales normales y resistencias arteriales elevadas y predecir daño neuronal. Unidad de Perinatología del Hospital Universitario de Caracas. Estudio prospectivo. Se midieron las resistencias arteriales del cordón umbilical y de la arteria cerebral media a nivel del segmento M2 a sesenta embarazadas de edad de gestación entre 26 y 36 semanas. Imágenes sagitales coronales y axiales del cuerpo y cerebro se obtuvieron de todos los fetos. La espectroscopia cerebral se realizó con la técnica del univoxel, con tiempo de eco corto e intermedio. Se analizaron las relaciones N-acetil aspartato/creatina, N-acetil aspartato/colina, colina/creatina, colina/N-acetil aspartato, mioInositol/N-acetil aspartato e mioInositol/creatina. La prueba estadística se realizó mediante frecuencias absolutas, porcentajes, medias, desviaciones estándar y el test de Fisher. Treinta presentaron resistencias arteriales normales (fetos control) y treinta presentaron resistencias elevadas. Las resistencias del cordón umbilical fueron significativamente mayores en fetos con resistencias arteriales elevadas que en fetos control. La morfo-anatomía fue normal en todos los fetos. En los fetos control, N-acetil aspartato/colina y N-acetil aspartato/creatina aumentaron con la edad gestacional y colina/N-acetil aspartato, mioInositol/N-acetil aspartato y mioinositol/creatina disminuyeron. Las relaciones en fetos con resistencias arteriales elevadas presentaron mucha variabilidad y un 69 por ciento de los espectros presentaron lactato. La espectroscopia por resonancia magnética puede evaluar el desarrollo cerebral de fetos y la presencia de lactato cerebral refleja una condición de hipoxia que puede predecir daño neurológico

To determine if proton magnetic resonance spectroscopy could be used to evaluate fetal brain development with normal and high arterial resistances, and to predict neurological damage. Unidad de Perinatología del Hospital Universitario de Caracas.Umbilical cord and brain median artery at M2 segment level arterial resistances were measured to sixty pregnant women with gestation age of 26 to 36 weeks. Thirty had normal arterial resistances (control fetuses) and thirty had high arterial resistances. Body and cerebral axial, coronal and sagittal images were obtained from all fetuses. Cerebral spectroscopy was performed with short and medium-length eco time. Single voxel was located in the basal ganglia. N-acetylaspartate/creatine, N-acetylaspartate/choline, choline/creatine, choline/N-acetylaspartate, mio-inositol/N-acetilaspartate and mio-inositol/creatine ratios were analyzed. Absolute frequencies, percentages, median, standard deviations and Fisher test were used for statistical analysis. Fetuses with high umbilical cord arterial resistances were significant higher than the obtained for control fetuses. Anatomical images were normal in all fetuses. N-acetylaspartate/choline and N-acetylaspartate/creatine increased and choline/N-acetylaspartate, myo-inositol/N-acetylaspartate and myo-inositol/creatine decreased with gestational age in control fetuses. Large variability resulted on metabolite ratios of fetuses with high umbilical cord arterial resistances. No significant differences on metabolites ratios were found between control fetuses and fetuses with high umbilical cord arterial resistances. Lactate was detected in 68 percent of brain fetuses with high umbilical cord arterial resistances. Conclusion: Proton magnetic resonance spectroscopy is able to evaluate fetal brain development and brain lactate, which is indicative of hypoxia, might predict neurological damage

Estudo estrutural do pênis de fetos humanos normais e anencéfalos no segundo trimestre de gestação / Structural study of the penis of normal and anencephalic human fetuses in the second trimester of pregnancy

A anecencefalia é o Defeito do Tubo Neural (DTN) mais severo em fetos humanos. Há uma demanda crescente para reposição tissular em doenças crônicas e cirurgias reconstrutoras. Tecidos fetais têm sido utilizados como substitutos para órgãos sólidos. Comparar a estrutura e morfologia do corpo cavernoso e corpo esponjoso de pênis de fetos humanos anencéfalos e de controle a fim de propor um novo modelo para estudos biológicos e transplantes teciduais. Foram estudados 11 pênis de fetos de controle de 14 a 23 Semanas Pós Concepção (SPC), e cinco pênis de fetos anencéfalos de 18 a 22 SPC. Os órgãos foram removidos e processados pelas técnicas histo e imunohistoquímicas rotineiras. A análise do tecido conjuntivo, células musculares lisas e fibras elásticas foram realizadas em lâminas dos espécimes. Os dados foram expressos em Densidade de àrea (Da) utilizando-se um software de processamento digital. As médias foram comparadas utilizando-se o Teste - T não pareado e quando aplicável, a regressão linear simples foi utilizada. Foi considerada significância estatística se p<0,05. O septo intercavernoso encontrava-se presente em todas as amostras. Não foram observadas diferenças da Da do tecido colágeno e musculatura lisa dos pênis de fetos anencéfalos quando comparados aos normais. A regressão linear simples sugere que durante o desenvolvimento humano há um aumen2to gradual do tecido colágeno (R2=0,45) e uma diminuição da musculatura lisa (R =0,62) no corpo cavernoso de ambos os grupos. A elastina encontrava-se presente apenas em fetos a partir da 20ª SPC. Não houve diferença na estrutura da genitália entre fetos normais e enencéfalos. Apresença da elastina em fetos a partir da 20ª SPC é um dado objetivo da manutenção da capacidade de ereção nestes grupos. A histo e imunohistoquímica sugerem que o desenvolvimento do pênis destes fetos encontra-se inalterado. Futuros estudos deverão ser realizados com o objetivo de avaliar fetos anencéfalos como um potencial ...

Anencephaly is the most severe neural tube defect (NTD) in human fetuses. There is an increasing need for tissue replacement in chronic diseases and reconstructive surgeries. Fetal tissues have been used as a substitute for native organs. Compare the structure and morphology of the corpora cavernosa and spongiosum of penises from anencephalic and normal human fetuses to propose a new model for biological studies and tissue transplantation. We studied 11 penises from normal human fetuses, aged 14 to 23 weeks post-conception (WPC), and 5 penises from anencephalic fetuses, aged 18 to 22 WPC. The organs were removed and processed by routine histological and immunolabeling techniques. Analysis of connective tissue (Cot), smooth muscle (SMC) and elastic fibers (EF) were performed in sections. Data were expressed as area density (Ad) using digital processing and software. Means were statistically compared using the unpaired t test and linear regression was performed. Statistical significance was considered if p < 0.05. The Intracavernosal septum was present in all samples. We did not observe differences in the Ad of Cot and SMC in the penises of anencephalic fetuses when compared to normal ones. The simple linear regression suggested that during human development there is a gradual increase in Cot (R2= +0.45) and a decrease of SMC (R2=- 0.62) in the corpora cavernosa in both groups studied. Elastin was observed only in fetuses from 20th WPC. There was no difference in the structure of the corpora cavernosa and corpus spongiosum of anencephalic fetuses compared to normal ones. Elastin was documented from 20th WPC, which suggests the maintenance of erectile function. Histochemistry and immunolabeling suggested that penile shaft development is maintained and unaltered in anencephalic fetuses. Further studies should be performed to analyze anencephalic fetuses as a potential tissue donating group and a model for biological studies

Teratogenic effect of ethylene glycol-methyl cellosolve mixture in rats: I: reproductive damage / Teratogénesis por etilenglicol-metilcelosolve en ratas: I: daño reproductivo

We investigated the reproductive damage and teratogenic effect of an ethylene glycol-methyl cellosolve mixture on gestating Wistar rats, which received a daily intraperitoneal dose of different concentration of the mixture on day 8 of gestation until day 20. In rats treated with the mixture the number of live fetuses decreased and reabsorptions increased with increasing concentrations of the mixture, as well as the number of abnormal fetuses. We conclude that the ethylene glycol-methyl cellosolve mixture possesses a higher teratogenic potential than each of its constituents separately, producing reproductive damage, external fetal abnormalities, growth delay, and increased fetal death.

Se investigó el daño reproductivo y efecto teratogénico de una mezcla de etilenglicol y metilcelosolve en ratas gestantes, las cuales recibieron por vía intraperitoneal una dosis diaria, a diferentes concentraciones de la mezcla, del día 8 al día 20 de gestación. En las ratas tratadas con la mezcla el número de fetos vivos disminuyó y las reabsorciones y el número de fetos anormales aumentaron a mayor concentración de los solventes. Concluimos que la mezcla de etilenglicol-metilcelosolve tiene mayor efecto teratogénico que cuando actúan cada uno de los solventes por separado, produciendo daño reproductivo, anormalidades fetales externas, retraso del crecimiento y aumento de muerte fetal.