Characterization of Portuguese honey from Castelo Branco region according to their pollen spectrum, physicochemical characteristics and mineral contents.

The aim of this work was to evaluate the quality of 16 honey samples from Castelo Branco region (Portugal). Twelve are monofloral from Calluna vulgaris, Erica, Lavandula, Echium and Campanula. The mean values obtained for physicochemical parameters were: 3.82 pH; 16.80% moisture; 81.6°Brix; 0.21% ash; 357.6 µS cm-1 electrical conductivity; 33.7 meq/kg free acidity; 5.7 meq/kg lactonic acidity; 39.3 meq/kg total acidity; 9.11 mg/kg HMF; 21.3 IN invertase and 9.0° Gothe for diastase activities. The results indicate a good quality, adequate processing, good maturity and freshness of honey. Additionally, the determination of mineral contents revealed that the K was the major element. Mean values obtained were (mg/kg): Ca, 28.36; K, 701.87; Mg, 74.00; Na, 31.04; Fe, 097; Cu, 0.65; Zn, 1.23; Mn, 2.78 and P, 48.80. Among the overall determined parameters, CB2 stands out by its high values in minerals, pH, moisture, ash, electrical conductivity and enzyme activity.

European marketable grain legume seeds: Further insight into phenolic compounds profiles.

Twenty-nine mature raw varieties of grain legume seeds (chickpeas, field peas, faba beans, common vetch and lupins) produced in Europe were investigated for their phenolic profile by means of high performance liquid chromatography coupled to diode array detection (HPLC-DAD). To the best of our knowledge, this study reported for the first time the phenolic composition of mature raw seeds of chickpea type Desi, field pea and common vetch. Phenolic acids were predominant compounds in chickpeas, field peas and common vetch compared to flavonoids, whereas the opposite was observed for lupin seeds. Yellow lupins presented the highest levels of total phenolic compounds followed by narrow-leafed lupins (in average 960 and 679mg/kg, dry basis, respectively), whereas Kabuli chickpeas got the lowest ones (in average 47mg/kg, dry basis). Principal component analysis revealed that flavones and total levels of phenolic compounds were responsible for nearly 51% of total data variability.

Digestive Gland from Aplysia depilans Gmelin: Leads for Inflammation Treatment.

The exploitation of marine organisms for human nutritional and pharmaceutical purposes has revealed important chemical prototypes for the discovery of new drugs, stimulating compounds isolation and syntheses of new related compounds with biomedical application. Nowadays, it is well known that inflammatory processes are involved in many diseases and the interest in the search for marine natural products with anti-inflammatory potential has been increasing. The genus Aplysia belongs to the class Gastropoda, having a wide geographical distribution and including several species, commonly known as sea hares. Aplysia depilans Gmelin is usually found in the Mediterranean Sea and in the Atlantic Ocean, from West Africa to the French coast. In these marine organisms, most of the digestion and nutrient absorption occurs in the digestive gland. This work aimed to explore the chemical composition and bioactivity of the methanol extract from A. depilans digestive gland. Therefore, fatty acids and carotenoids were determined by GC-MS and HPLC-DAD, respectively. Twenty-two fatty acids and eight carotenoids were identified for the first time in this species. The A. depilans digestive gland revealed to be essentially composed by polyunsaturated fatty acids (PUFA) and xanthophylls. Regarding the anti-inflammatory potential in RAW 264.7 cells stimulated with lipopolysaccharide, it was observed that this matrix has capacity to reduce nitric oxide (NO) and L-citrulline levels, which suggests that its compounds may act by interference with inducible nitric oxide synthase. Taking into account the results obtained, A. depilans digestive gland may be a good source of nutraceuticals, due to their richness in health beneficial nutrients, such as carotenoids and long-chain PUFA.

Neuroprotective effect of steroidal alkaloids on glutamate-induced toxicity by preserving mitochondrial membrane potential and reducing oxidative stress.

Several evidences suggest that enhanced oxidative stress is involved in the pathogenesis and/or progression of several neurodegenerative diseases. The aim of this study was to investigate for the first time whether both extracts from tomato plant (Lycopersicon esculentum Mill.) leaves and their isolated steroidal alkaloids (tomatine and tomatidine) afford neuroprotective effect against glutamate-induced toxicity in SH-SY5Y neuroblastoma cells and to elucidate the mechanisms underlying this protection. Steroidal alkaloids from tomato are well known for their cholinesterases' inhibitory capacity and the results showed that both purified extracts and isolated compounds, at non-toxic concentrations for gastric (AGS), intestinal (Caco-2) and neuronal (SH-SY5Y) cells, have the capacity to preserve mitochondria membrane potential and to decrease reactive oxygen species levels of SH-SY5Y glutamate-insulted cells. Moreover, the use of specific antagonists of cholinergic receptors allowed observing that tomatine and tomatidine can interact with nicotinic receptors, specifically with the α7 type. No effect on muscarinic receptors was noticed. In addition to the selective cholinesterases' inhibition revealed by the compounds/extracts, these results provide novel and important insights into their neuroprotective mechanism. This work also demystifies the applicability of these compounds in therapeutics, by demonstrating that their toxicity was overestimated for long time.

Fast determination of bioactive compounds from Lycopersicon esculentum Mill. leaves.

Lycopersicon esculentum leaves, usually considered as a by-product of tomato production, present several bioactive compounds of interest for industries like food, pharmaceutical and cosmetics. Nevertheless, before industrial application, suitable methods to identify and quantify those metabolites should be developed. In this study agitation with aqueous methanol was used for phenolic compounds extraction. Solid-phase extraction (SPE) was performed as the purification step before alkaloids analysis. Among the SPE sorbents tested, sulphonic acid bonded silica with H(+) counterion (SCX) proved to be the most efficient one for removing interfering components. Fifteen phenolics and four steroidic alkaloids were identified in 35 and 20 min analysis, respectively. The optimised methods were validated, revealing to be accurate, fast, simple and sensitive. Thus, these methods represent an easy and fast analytical approach, using equipment available in almost laboratory, which render them to be appropriate for routine analysis.

High-performance liquid chromatography-diode array detection-electrospray ionization multi-stage mass spectrometric screening of an insect/plant system: the case of Spodoptera littoralis/Lycopersicon esculentum phenolics and alkaloids.

High-performance liquid chromatography-diode array detection-electrospray ionization multi-stage mass spectrometry (HPLC-DAD-ESI-MS(n)) is considered to be a very valuable tool for the characterization of compounds found in trace amounts in natural matrices, as their previous isolation and clean-up steps can be avoided. Micro-scale separation increases the potential of this analytical technique, allowing the determination of compounds in reduced samples. Spodoptera littoralis represents a major challenge to Solanaceae plants, as it is one of the most deleterious pests. The S. littoralis/Lycopersicon esculentum system was studied for the first time concerning glycoalkaloids and phenolics. Using HPLC-DAD-ESI-MS(n) we were able to characterize 15 phenolic compounds in L. esculentum leaves. Nine of them are reported for the first time. Some differences were found between leaves of cerasiforme and 'Bull's heart' varieties. However, in the materials of S. littoralis (larvae, adults, exuviae and excrements) reared in both L. esculentum leaves no phenolics were identified. α-Tomatine was the main glycoalkaloid in the host plant. The glycoalkaloid composition of the different S. littoralis materials was distinct, with α-tomatine and dehydrotomatine being the main detected compounds in larvae and excrements. These results add knowledge to the ecological interaction in this insect/plant duo, for which it is hard to obtain considerable sample amounts.

Lycopersicon esculentum seeds: an industrial byproduct as an antimicrobial agent.

Lycopersicon esculentum (tomato) fruit is a widely studied matrix. However, only few works focus their attention on its seeds, which constitute a major byproduct of the tomato processing industry. In this study the antimicrobial potential of ten different tomato seed extracts from "Bull's heart" and "Cherry" varieties were analyzed against Gram-positive (Staphylococcus aureus, Staphylococcus epidermidis, Micrococcus luteus, Enterococcus faecalis and Bacillus cereus) and Gram-negative (Proteus mirabilis, Escherichia coli, Pseudomonas aeruginosa and Salmonella typhimurium) bacteria and fungi (Candida albicans, Aspergillus fumigatus and Trichophyton rubrum). Regarding antibacterial capacity, the different extracts were revealed to be active only against Gram-positive bacteria, E. faecalis being the most susceptible one (MIC: 2.5-10 mg/mL). Concerning antifungal activity, "Bull's heart" extracts were the most active. In a general way C. albicans was the most susceptible species (MIC: 5-10 mg/mL). The chemical composition of the extracts was also pursued, concerning organic acids, phenolics and fatty acids, in order to establish a possible relationship with the observed antimicrobial effect.

Tomato ( Lycopersicon esculentum ) seeds: new flavonols and cytotoxic effect.

In this study, seeds of Lycopersicon esculentum Mill. were analyzed by HPLC/UV-PAD/MS(n)-ESI. Fourteen flavonoids were identified, including quercetin, kaempferol, and isorhamnetin derivatives, with 13 of them being reported for the first time in tomato seeds. The major identified compounds were quercetin-3-O-sophoroside, kaempferol-3-O-sophoroside, and isorhamnetin-3-O-sophoroside. A significant cell proliferation inhibition (>80%), against rat basophile leukemia (RBL-2H3) cell line, was observed with this extract (IC(50) = 5980 microg/mL). For acetylcholinesterase inhibitory activity, a concentration-dependent effect was verified (IC(20) = 2400 microg/mL). The same behavior was noted regarding antioxidant capacity, evaluated against DPPH (IC(10) = 284 microg/mL), nitric oxide (IC(25) = 396 microg/L), and superoxide radicals (IC(25) = 3 microg/mL).

Screening of antioxidant phenolic compounds produced by in vitro shoots of Brassica oleracea L. var. costata DC.

The phenolic compounds produced by in vitro shoots of Brassica oleracea L. var. costata DC were screened by HPLC-DAD-MS/MS. Thirty seven compounds were characterized, which included chlorogenic acids, flavonoids (the majority of them were hydroxycinnamic acid esters of kaempferol and quercetin glycosides) and hydroxycinnamic acyl glycosides (with predominance of synapoyl gentiobiosides). The antioxidant capacity of the shoots was assessed against DPPH radical and two reactive oxygen species (superoxide radical and hypochlorous acid). A strong concentration-dependent antioxidative capacity was verified in the DPPH and superoxide radicals assays, but a reduced effect was noticed against hypochlorous acid. The results obtained indicate that the in vitro production of B. oleracea var. costata shoots can become important in the obtention of a noticeable dietary source of compounds with health protective potential.

In vitro cultures of Brassica oleracea L. var. costata DC: potential plant bioreactor for antioxidant phenolic compounds.

In this work were studied the phenolic composition of in vitro material (shoots, calli, and roots) of Brassica oleracea var. costata and its antioxidant capacity. Samples were obtained in different culture medium, with distinct supplementations to verify their influence on those parameters. Phenolic determination was achieved by HPLC-DAD. Antioxidant activity was assessed against DPPH. In calli and roots no phenolic compound was identified. In shoots was verified the presence of 36 compounds, which included hydroxycinnamic acids, flavonoids (kaempferol and quercetin derivatives), and hydroxycinnamic acyl glycosides (with a predominance of synapoyl gentiobiosides). MS liquid medium supplemented with 2 mg/L benzylaminopurine (BAP) and 0.1 mg/L naphthaleneacetic acid (NAA) revealed to be the best in vitro condition to produce shoot material with highest phenolic compound contents and stronger antioxidant potential, thus with a possible increase of health benefits.

Inflorescences of Brassicacea species as source of bioactive compounds: A comparative study.

Two Brassica oleracea varieties (B. oleracea L. var. costata DC and B. oleracea L. var. acephala) and Brassica rapa L. var. rapa inflorescences were studied for their chemical composition and antioxidant capacity. Phenolic compounds and organic acids profiles were determined by HPLC-DAD and HPLC-UV, respectively. B. oleracea var. costata and B. oleracea L. var. acephala inflorescences presented a similar qualitative phenolic composition, exhibiting several complex kaempferol derivatives and 3-p-coumaroylquinic acid, while B. rapa var. rapa was characterized by kaempferol and isorhamnetin glycosides and several phenolic acids derivatives. B. oleracea L. var. costata and B. rapa var. rapa showed the highest phenolics content. The three Brassica exhibited the same six organic acids (aconitic, citric, pyruvic, malic, shikimic and fumaric acids), but B. oleracea L. var. acephala presented a considerably higher amount. Each inflorescence was investigated for its capacity to act as a scavenger of DPPH radical and reactive oxygen species (superoxide radical, hydroxyl radical and hypochlorous acid), exhibiting antioxidant capacity in a concentration dependent manner against all radicals. These samples were also studied for its antimicrobial potential against Gram-positive and Gram-negative bacteria and fungi, displaying antimicrobial capacity only against Gram-positive bacteria.

Screening of antioxidant compounds during sprouting of Brassica oleracea L. var. costata DC.

The changes in antioxidant compounds of Brassica oleracea L. var. costata DC seeds were monitored during the first twelve days of seedling development. Sprouts were screened at time intervals of two days for phenolic compounds and organic acids. The identified phenolic compounds included esters of sinapic acid with glucose, gentiobiose and kaempferol, as well as sinapoylcholine. The organic acids were oxalic, aconitic, citric, pyruvic, malic, shikimic, and fumaric acids. During germination, a depletion of phenolic compounds was observed, although no qualitative changes were seen. Among individual compounds, kaempferol, choline and glucose esters of sinapic acid showed a marked decrease between days two and six, whereas the changes in gentiobiose esters of sinapic acid were smaller. The total organic acids content increased rapidly during the first four days, with less significant variations thereafter. Malic acid, the major organic acid found in sprouts, greatly contributed to this result though oxalic, pyruvic, and fumaric acids also increased in the same manner. In contrast, aconitic, citric and shikimic acids showed decreases between days two and twelve of germination.

[Assessment of the correlation between hemoglobin concentration and the echographic measurement of biventricular outer diameter in anemic fetuses of isoimmunized women]. / Avaliar a correlação entre a concentração da hemoglobina e a medida ecográfica do diâmetro biventricular externo em fetos anêmicos de gestantes isoimunizadas.

OBJECTIVE: To assess whether a significant correlation exists between the echographic measurement of biventricular outer diameter and the pretransfusional serum concentration of fetal hemoglobin and whether that echographic measurement can be used as a noninvasive marker of fetal anemia. METHODS: A prospective cross-sectional study was carried out comprising 65 cordocenteses performed in 36 anemic fetuses of mothers with isoimmunization to the Rh antigen. The biventricular outer diameter (BOD) was obtained by M-mode evaluation. Previous to the transfusion, a 0.5-mL fetal blood sample was obtained for hemoglobin measurement with spectrophotometry in the Hemocue device. The minimum square regression was used with p < 0.05 and multivariate analysis were used as statistical analysis. RESULTS: An inverse correlation was observed between the fetal hemoglobin concentration before transfusion and the BOD measurement, and a direct correlation was observed between the BOD measurement and gestational age. In addition, multivariate analysis showed that fetal hemoglobin concentration decreases as BOD increases, independently of the influence of gestational age on that parameter. CONCLUSION: An inverse correlation exists between fetal hemoglobin concentration and BOD measurement, regardless of gestational age. The findings suggest that BOD may become an echographic predictor of the hemoglobin level of fetuses of isoimmunized pregnant women.

Avaliar a correlação entre a concentração da hemoglobina e a medida ecográfica do diâmetro biventricular externo em fetos anêmicos de gestantes isoimunizadas / Assessment of the correlation between hemoglobin concentration and the echographic measurement of biventricular outer diameter in anemic fetuses of isoimmunized women

OBJETIVO: Verificar se existe correlação significativa entre a medida ecográfica do diâmetro biventricular externo e a concentração sérica da hemoglobina fetal pré-transfusional e se essa medida ecográfica poderá vir a ser utilizada como marcador não invasivo da anemia fetal. MÉTODOS: Estudo transversal prospectivo, no qual foram selecionadas 65 cordocenteses realizadas em 36 fetos anêmicos de mães portadoras de isoimunização pelo fator Rh. Obteve-se a medida do diâmetro biventricular externo (DBVE), por meio do modo M, utilizando-se aparelho de ultra-som convencional. Anterior à transfusão foi obtida amostra de 0,5ml de sangue fetal, para dosagem da hemoglobina, sendo a medida imediatamente realizada através de espectrofotometria, no equipamento Hemocue®. Como análise estatística foi utilizada a regressão dos mínimos quadrados, aceitando-se p<0,05 e análise multivariada. RESULTADOS: Foram observadas correlação inversa entre a concentração da hemoglobina no sangue fetal no momento prévio à transfusão e a medida do DBVE e correlação direta entre a medida do DBVE e a idade gestacional, e, também, através da análise multivariada que, à medida que a concentração de hemoglobina fetal cai, o DBVE aumenta, independentemente da influência da idade gestacional nesse parâmetro. CONCLUSAO: Existe correlação inversa entre a concentração da hemoglobina no sangue fetal e a medida do DBVE, independente da idade gestacional. Os achados sugerem que o DBVE poderá vir a ser um marcador ecográfico de predição do nível de hemoglobina de fetos de gestantes isoimunizadas.

Estudo das causas da isoimunização materna por antígenos eritrocitáros entre gestantes acompanhadas no Serviço de Medicina Fetal do HC-UFMG / Study of the causes of maternal erithrocytic antigen isoimmunization among pregnant women followed at the Fetal Medicine Service - HC-UFMG

Objetivo: Analisar as causas da isoimunização materna por antígenos entrocitários entre as gestantes acompanhadas no Serviço de Medicina Fetal do HC-UFMG, no período de junho de 1996 a junho /2003. Pacientes e Método: Trata-se de estudo prospectivo, qual 256 gestantes sensibilizadas por antígenos eritrocitários foram acompanhadas no Centro de Medicina Fetal do HC-UFMG. As pacientes foram avaliadas quanto ao passado obstétrico, visando identificar as causas de isoimunização. Resultados: Entre os 256 casos acompanhados, em 185(72,3%) a causa de isoimunização foi a ausência de profilaxia pós-parto; a transfusão sangüínea incompatível foi a responsável por 34 casos (13,3%) e a falta de profilaxia pós-aborto, por 29 casos (11,3%). Os oito casos restantes (3,1%) ocorreram durante o período gestacional. Conclusão: As principais causas de isoimunização materno-fetal continuam se relacionando à etiologia obstétrica, principalmente à falta de imunoprofilaxia no pás-parto e no pós-aborto. Portanto, a isoimunização, em nosso meio, pode ser facilmente prevenível com o uso da imunoglobulina anti-Rh (D), conforme rotina já estabelecida há décadas.

Objective: To analyze the causes of maternal erithrocytic antigen isoimmunization among pregnant women followed at the Fetal Medicine Service Hospital das Clínicas - Universidade Federal de Minas Gerais (FMSHC), from June/1996 to June/2003. Methods and Material: A prospective study, consisting of 256 pregnant women with sensitization by erithrocytic antigen were followed at the FMSHC. These patients were evaluated regarding the obstetric history, in order to identify the causes of isoimmunization. Results: In 185 cases (72.3%), isoimmunization was caused by lack of postpartum prophilaxy. Incompatibility in blood transfusion and absence of post-abortion prophilaxy were responsible for 34 (13.3%) and 29 cases (11.3%), respectively. The remaining eight cases (3.1%) occurred during gestational period. Conclusion: The main cause of fetal-maternal isoimmunization is still related to obstetric etiology, mainly to absence of postpartum or post-abortion immunoprophilaxy. Therefore, isoimmunization, in our population, can be easily prevented by the use of anti-Rh (D) immune globulin according to established routines.

Diagnóstico não invasivo da anemia fetal pela medida do pico de velocidade sistólica na dopplervelocimetria da artéria cerebral média / Noninvasive fetal anemia diagnosis by middle cerebral artery peak systolic velocity waveform measurement

OBJETIVO: avaliar se existe associação entre a medida do pico de velocidade sistólica (PVS) na dopplervelocimetria da artéria cerebral média (ACM) e a concentração de hemoglobina fetal e determinar a sua capacidade diagnóstica. MÉTODOS: entre janeiro de 2000 e maio de 2003, 44 gestantes isoimunizadas foram submetidas a transfusão intra-uterina. Realizou-se estudo dopplervelocimétrico da ACM antes de cada transfusão fetal, sempre com intervalo inferior a 3 horas, antecedendo o procedimento. O PVS da ACM foi considerado alterado quando seu valor era superior a 1,5 múltiplo da mediana para a respectiva idade gestacional. A concentração de hemoglobina do cordão foi aferida antes de se iniciar a infusão de sangue, realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden). O estudo estatístico foi feito pelo teste do chi2 e também foram calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. RESULTADOS: foram realizados 83 procedimentos, sendo que em 33 a hemoglobina fetal era inferior a 10,0 g/dL. Houve associação significativa entre as variáveis estudadas, p<0,001. Fetos com hemoglobina menor ou igual a 10 g/dL apresentaram aumento significativo na medida do PVS na ACM, com valores superiores a 1,5 múltiplo da mediana. O PVS na ACM apresentou sensibilidade de 75,7 por cento para a detecção de hemoglobina do cordão menor ou igual a 10 g/dL. CONCLUSAO: o pico de velocidade sistólica na artéria cerebral média pode ser utilizado como método complementar no diagnóstico da anemia fetal.

Correlação entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentração de hemoglobina do cordão em fetos de gestantes isoimunizadas / Correlation between the Doppler indices of inferior vena cava and ductus venosus and fetal umbilical cord blood concentration of hemoglobin in pregnant women with isoimmunization

OBJETIVO: o objetivo principal desse estudo foi verificar se existe correlaçäo entre os índices dopplervelocimétricos da veia cava inferior e do ducto venoso e a concentraçäo sérica da hemoglobina fetal. MÉTODOS: estudo transversal e prospectivo, realizado entre janeiro de 1998 e junho de 2001. Foram acompanhadas 31 gestantes isoimunizadas com resultado do teste de Coombs indireto maior que 1:8, que foram submetidas à pesquisa de hemólise fetal. Quando foram indicadas as transfusöes intra-uterinas intravasculares, a hemoglobina do cordäo foi dosada no início do procedimento. Nos demais casos, a hemoglobina do cordäo foi mensurada no momento do parto, sempre por cesariana eletiva. Obteve-se um total de 74 procedimentos estudados, definidos como sendo cada transfusäo intra-uterina precedida pela dopplervelocimetria venosa. A mensuraçäo da concentraçäo da hemoglobina fetal foi realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden), dispositivo usado para a determinaçäo quantitativa de hemoglobina no sangue. A dopplervelocimetria da cava inferior e do ducto venoso foi realizada antecedendo a coleta do sangue fetal, sempre em intervalo de tempo inferior a 24 horas. Os índices dopplervelocimétricos estudados foram o índice de pulsatilidade para veias (IPV), o índice do pico de velocidade para veias (IPVV) e a relaçäo entre o pico de velocidade durante a fase de contraçäo atrial e o pico de velocidade na sístole ventricular (relaçäo CA/SV ou índice de pré-carga), na veia cava inferior, e o IPV, IPVV e a relaçäo entre os picos de velocidade da sístole ventricular e da contraçäo atrial (relaçäo SV/CA), no ducto venoso. Foi realizado estudo de correlaçäo entre a dopplervelocimetria da veia cava inferior e do ducto venoso e a hemoglobina do cordäo, pela técnica de regressäo linear simples. Realizou-se também estudo de associaçäo entre os índices dopplervelocimétricos do compartimento venoso e a hemoglobina fetal inferior a 10 g/dL, por meio do teste do c². RESULTADOS: foi efetuado um total de 74 procedimentos. Em 23 desses a hemoglobina fetal era inferior a 7,0 g/dL. Houve correlaçäo negativa significativa entre todos os índices dopplerfluxométricos estudados e a concentraçäo de hemoglobina fetal (p<0,05), ou seja, os valores mais elevados dos índices dopplervelocimétricos foram observados nos fetos com anemia mais acentuada...

Avaliaçäo da velocidade média na aorta torácica descendente em fetos com anemia / Measurement of the mean blood velocity in the descending thoracic aorta in anemic fetuses

Objetivo: verificar se existe correlaçäo significativa entre a velocidade média na dopplerfluxometria da artéria aorta torácica descendente e o grau de anemia fetal. Métodos: estudo prospectivo, transversal, no qual foram analisados 66 fetos de gestantes isoimunizadas, em que se realizou a cordocentese para a realizaçäo de transfusöes intra-uterinas pela via intravascular (66,7 por cento). Nos fetos que foram submetidos à transfusäo intra-uterina pela via intraperitoneal, ou naqueles casos em que näo houve necessidade de tratamento intra-uterino (33,3 por cento), a determinaçäo da concentraçäo de hemoglobina do cordäo foi realizada pela punçäo do cordäo umbilical, no momento da interrupçäo da gestaçäo. Neste grupo de fetos estudados, foi realizado exame dopplerfluxométrico da artéria aorta torácica descendente, sendo calculada a velocidade média de fluxo. Foi realizado estudo de associaçäo entre as variáveis. Foram também calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. Resultados: observou-se correlaçäo significativa e inversa entre a velocidade média na artéria aorta torácica descendente e o nível de hemoglobina fetal. A velocidade média na dopplerfluxometria da artéria aorta torácica descendente apresentou sensibilidade de 47,5 por cento para anemia fetal moderada (Hg<10 g/dL), com o teste exato de Fisher apresentando valor de p<0,01, e de 54,5 por cento para anemia fetal grave (Hg<7,0 g/dL), com um valor de p=0,01. Conclusöes: houve associaçäo significativa entre a velocidade média na aorta torácica descendente e o grau de diagnóstico de anemia fetal

Transfusão intra-uterina na isoimunização materna pelo fator Rh / Intrauterine tranfusion in maternal Rh immunization

Objetivos: avaliar os resultados do tratamento intra-útero de fetos anêmicos devido a isoimunização materna pelo fator Rh. Pacientes e métodos: foram acompanhados 61 fetos submetidos a transfusão intra-uterina seja por via intraperitoneal, intravascular ou combinada. Os casos de fetos hidrópicos corresponderam a 19,7 por cento do total, sendo que nestes a via de tratamento sempre foi a intravascular. Foram realizadas em média 2,7 transfusões por feto, com um total de 163 procedimentos. A indicação para a transfusão se baseou na espectrofotometria do líquido amniótico (método de Liley) ou quando a dosagem de hemoglobina em sangue de cordão obtido por cordocentese fosse menor que 10 g/dL. Resultados: em metade dos casos submetidos a transfusão intra-uterina, empregou-se a via intravascular. Em relação aos casos de fetos hidrópicos a sobrevida foi de 46 por cento e nos fetos não-hidrópicos, de 84 por cento. Não ocorreram complicações maternas relacionadas ao procedimento. A idade média da interrupção da gestação foi de 34,8 semanas. Conclusões: apesar da melhora do resultado com a transfusão intra-uterina guiada pelo ultra-som e da cordocentese, a isoimunização materna pelo fator Rh permanece como causa de elevada morbimortalidade perinatal.