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1.
Am J Physiol Regul Integr Comp Physiol ; 326(1): R10-R18, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37955129

RESUMO

Maternal obesity increases the risk of adverse pregnancy outcomes. The mechanisms that contribute to this elevated risk are unclear but may be related to greater activity of the sympathetic nervous system, which is associated with hypertensive disorders of pregnancy. We hypothesized that resting muscle sympathetic nerve activity (MSNA) would be greater in women with obesity during pregnancy when compared with normal-weight women. Blood pressure, heart rate, and MSNA were recorded during 5 min of supine rest in 14 normal-weight women [body mass index (BMI) 22.1 ± 2.1 (SD) kg/m2] and 14 women with obesity (BMI 33.9 ± 3.5 kg/m2) during (early and late) pregnancy and postpartum. All women had uncomplicated pregnancies. Resting MSNA burst frequency was not different between groups during early (normal weight 17 ± 10 vs. obesity 22 ± 15 bursts/min, P = 0.35) but was significantly greater in the obesity group during late pregnancy (23 ± 13 vs. 35 ± 15 bursts/min, P = 0.031) and not different postpartum (10 ± 6 vs. 9 ± 7 bursts/min, P = 0.74). These findings were also apparent when comparing burst incidence and total activity. Although still within the normotensive range, systolic blood pressure was greater in the obesity group across all time points (P = 0.002). Diastolic blood pressure was lower during pregnancy compared with postpartum (P < 0.001) and not different between groups (P = 0.488). Heart rate increased throughout pregnancy in both groups (P < 0.001). Our findings suggest that maternal obesity is associated with greater increases in sympathetic activity even during uncomplicated pregnancy. Future research is needed to determine if this is linked with an increased risk of adverse outcomes or is required to maintain homeostasis in pregnancy.NEW & NOTEWORTHY The impact of maternal obesity on resting muscle sympathetic nerve activity was examined during (early and late) and after uncomplicated pregnancy. Resting muscle sympathetic nerve activity is not different during early pregnancy or postpartum but is significantly elevated in women with obesity during late pregnancy when compared with normal-weight women. Future research is needed to determine if this is linked with an increased risk of adverse outcomes or is required to maintain homeostasis in pregnancy.


Assuntos
Obesidade Materna , Humanos , Feminino , Gravidez , Masculino , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Músculo Esquelético/inervação , Obesidade/diagnóstico , Sistema Nervoso Simpático
2.
Arch. venez. pueric. pediatr ; 70(4): 126-129, oct.-dic. 2007. tab, graf
Artigo em Espanhol | LILACS | ID: lil-589301

RESUMO

El PRISM es una escala de predicción del riesgo de mortalidad pediátrica, basada en la inestabilidad fisiológica, la cual refleja directamente el riesgo de mortalidad. Determinar si esta escala es un buen predictor de mortalidad en los pacientes ingresados en la Unidad de Cuidados Intensivos Pediátricos del Hospital Dr. Miguel Pérez Carreño. En el período de un año fueron recogidas las variables fisiológicas al ingreso. Se aplicó el PRISM, obteniéndose el puntaje y el porcentaje de riesgo de mortalidad. Se utilizó estadística básica descriptiva, la prueba de diferencia de medias t de Student y la de contraste chi cuadrado. Fueron ingresados 119 pacientes de ambos sexos con edades compredidas entre 1 y 144 meses. La mortalidad observada fue de 18.5 por ciento. La media del PRISM fue de 14.92. Se encontró asociación entre la mortalidad observada y la esperada. El PRISM es una buena escala de predicción de mortalidad en nuestra población pediátrica.


PRISM is a pediatric mortality risk prediction scale based on the fact that physiologic instability directly reflects the risk of mortality. We used PRISM in all the patients admitted to our pediatric intensive care unit in order to determine if this scale is applicable to our pediatric population. All physiologic parameters were recorded on admission for a period of one year. PRISM was used to determine the number of points in the scale as well as the mortality risk percentage. Basic descriptive statistics was used to calculate the means, t Student and chi square. 119 patients with ages between 1 and 144 months and of both genders were admitted. Observed mortality was 18,5%. PRISM mean was 14,92. There was a association between the observed and predicted mortality. PRISM is a good mortality risk prediction scale in our pediatric population.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Doenças Respiratórias/patologia , Escala de Coma de Glasgow , Reanimação Cardiopulmonar/métodos , Reanimação Cardiopulmonar/mortalidade , Sepse/patologia , Sepse/terapia , Cuidados Críticos , Intoxicação/complicações , Mortalidade Infantil , Pediatria
3.
Arch. venez. pueric. pediatr ; 66(4): 27-32, oct.-dic. 2003. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-396061

RESUMO

La Fasceitis Necrotizante (FN) y la Púrpura Fulminate (PF) son un grupo de patologías potencialmente incapacitantes y amenazadoras de la vida. Se presenta el caso de un preescolar masculino de 2 años de edad, con varicela, quien presentó signos de flogosis en la región lumbar, de rápida progresión a tórax con centro necrótico, concomitante con necrosis de párpado superior derecho y deterioro del estado general. En los paraclínicos presentó leucocitosis con neutrofilia, trombocitopenia y tiempos de coagulación prolongados. Se realizó necrectomía amplia e ingresó a la Unidad de Terapia Intensiva Pediátrica (UTIP), donde evolucionó a disfunción multiorgánica. A las 72 horas aparecen lesiones purpúricas en dedos de los pies y mano derecha, compatible con FP asociada a sepsis. La biopsia de piel reveló hallazgos compatibles con FN. Se hace una revisión de la FN y PF por Estreptococo del grupo A secundario a varicela


Assuntos
Humanos , Pré-Escolar , Varicela , Pré-Escolar , Fasciite Necrosante , Vasculite por IgA/etiologia , Vasculite por IgA/patologia , Streptococcus pyogenes , Pediatria , Venezuela
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