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2.
An Acad Bras Cienc ; 96(2): e20230846, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38808877

RESUMO

Sound speed profiles in the ocean are determined by seawater properties, where horizontal variability of thermal stratification modulates sonar detection distance. This work assesses the impacts of upwelling dynamics on sound speed profile in enclosed coastal areas by means of temperature observations acquired with a low-cost platform in Anjos Cove, Cabo Frio, Brazil. The Integrated Acquisition System for Research in Acoustics (IARA) consists of a customized 10-meter-long chain of smart temperature sensors (±0.1°C accuracy) mounted in an anchored vertical cable and an echo sounder for tide level measurements. From 2021 to 2023 a number of intrusion events of the cold South Atlantic Central Water (SACW) took place along the Cabo Frio continental shelf, some of which were recorded in the inner region of the Anjos Cove by IARA. Sound speed profiles computed by applying TEOS-10 standards indicate that the sound propagation within Anjos Cove varies often, i.e., several orders of magnitude, under the influence of SACW intrusion events. The phenomenon reflects information from deeper waters on a coastal scale, even at small depths.


Assuntos
Acústica , Baías , Monitoramento Ambiental , Água do Mar , Som , Brasil , Monitoramento Ambiental/métodos , Temperatura
3.
Arq Bras Cardiol ; 121(1): e20220469, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38536996

RESUMO

BACKGROUND: This was a 30-year retrospective cohort study that approximates closely to the natural history of cardiac tumors diagnosed in the fetus, since there was no case of pregnancy interruption. OBJECTIVE: To assess morbidity and mortality in the perinatal period and at long term in fetuses diagnosed with cardiac tumor. Our secondary objective was to assess the evaluating factors of perinatal and postnatal results. METHODS: This was a retrospective cohort study with 74 pregnant women with an echocardiographic diagnosis of fetal cardiac tumor at two referral centers between May 1991 and November 2021. A descriptive analysis was performed, and data were expressed as absolute (n) and relative (%) frequencies, median and interquartile range. Fisher's exact test was used to evaluate the association of echocardiographic characteristics and clinical manifestations with perinatal and postnatal results. Global survival was calculated using the Kaplan-Meier method and the curves were compared by the log-rank test. The time of follow-up, calculated in months, corresponded to the time elapsed from hospital discharge to current status (survived/ censoring or death). The level of significance was set at 5% (p<0.05). RESULTS: Rhabdomyoma is the most common type of cardiac tumor (85%), with a high morbidity (79.3%) and overall mortality of 17.4%. The presence of fetal hydrops was a predictor of death. CONCLUSION: The presence of fetal hydrops had an impact on mortality, and hence is an important factor in counselling and determining the prognosis. Most deaths occurred before hospital discharge.


FUNDAMENTO: Seguimento de coorte retrospectiva de 30 anos que se aproxima da história natural dos tumores cardíacos diagnosticados no feto uma vez que nenhum caso foi submetido à interrupção da gestação. OBJETIVO: Avaliar a morbidade e mortalidade perinatal e em longo prazo em fetos com diagnóstico de tumor cardíaco. Como objetivo secundário avaliar os fatores que influenciaram os resultados perinatais e pós-natais. MÉTODO: Estudo de coorte retrospectiva envolvendo 74 gestantes com diagnóstico ecocardiográfico fetal de tumor cardíaco acompanhadas em dois serviços de referência no período de maio de 1991 a novembro de 2021. Foi realizada análise descritiva dos dados por meio de frequências absolutas (n) e relativas (%), mediana e intervalos interquartis. Para avaliar a associação entre as características ecocardiográficas e as manifestações clínicas com os resultados perinatais e pós-natais, foi aplicado o teste exato de Fisher. O cálculo da sobrevida global foi realizado pelo método de Kaplan-Meier e a comparação de curvas pelo teste de log-rank. O tempo de seguimento, calculado em meses, foi definido a partir da data de alta do hospital à data do status atual (vivo/censura ou óbito). O nível de significância considerado foi de 5% (p<0,05). RESULTADOS: o rabdomioma é o tipo mais frequente (85%) de tumor cardíaco; apresenta alta morbidade (79,3%) e mortalidade geral de 17,4%; a presença de hidropisia fetal preditiva de óbito. CONCLUSÃO: A presença de hidropisia fetal teve impacto na mortalidade, sendo fator importante para aconselhamento e estabelecimento de prognóstico. A maioria dos óbitos ocorrem antes da alta hospitalar.


Assuntos
Neoplasias Cardíacas , Hidropisia Fetal , Gravidez , Humanos , Feminino , Estudos de Coortes , Seguimentos , Estudos Retrospectivos , Feto/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Ultrassonografia Pré-Natal
4.
Arq. bras. cardiol ; 121(1): e20220469, jan. 2024. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1550031

RESUMO

Resumo Fundamento: Seguimento de coorte retrospectiva de 30 anos que se aproxima da história natural dos tumores cardíacos diagnosticados no feto uma vez que nenhum caso foi submetido à interrupção da gestação. Objetivo: Avaliar a morbidade e mortalidade perinatal e em longo prazo em fetos com diagnóstico de tumor cardíaco. Como objetivo secundário avaliar os fatores que influenciaram os resultados perinatais e pós-natais. Método: Estudo de coorte retrospectiva envolvendo 74 gestantes com diagnóstico ecocardiográfico fetal de tumor cardíaco acompanhadas em dois serviços de referência no período de maio de 1991 a novembro de 2021. Foi realizada análise descritiva dos dados por meio de frequências absolutas (n) e relativas (%), mediana e intervalos interquartis. Para avaliar a associação entre as características ecocardiográficas e as manifestações clínicas com os resultados perinatais e pós-natais, foi aplicado o teste exato de Fisher. O cálculo da sobrevida global foi realizado pelo método de Kaplan-Meier e a comparação de curvas pelo teste de log-rank. O tempo de seguimento, calculado em meses, foi definido a partir da data de alta do hospital à data do status atual (vivo/censura ou óbito). O nível de significância considerado foi de 5% (p<0,05). Resultados: o rabdomioma é o tipo mais frequente (85%) de tumor cardíaco; apresenta alta morbidade (79,3%) e mortalidade geral de 17,4%; a presença de hidropisia fetal preditiva de óbito. Conclusão: A presença de hidropisia fetal teve impacto na mortalidade, sendo fator importante para aconselhamento e estabelecimento de prognóstico. A maioria dos óbitos ocorrem antes da alta hospitalar.


Abstract Background: This was a 30-year retrospective cohort study that approximates closely to the natural history of cardiac tumors diagnosed in the fetus, since there was no case of pregnancy interruption Objective: To assess morbidity and mortality in the perinatal period and at long term in fetuses diagnosed with cardiac tumor. Our secondary objective was to assess the evaluating factors of perinatal and postnatal results. Methods: This was a retrospective cohort study with 74 pregnant women with an echocardiographic diagnosis of fetal cardiac tumor at two referral centers between May 1991 and November 2021. A descriptive analysis was performed, and data were expressed as absolute (n) and relative (%) frequencies, median and interquartile range. Fisher's exact test was used to evaluate the association of echocardiographic characteristics and clinical manifestations with perinatal and postnatal results. Global survival was calculated using the Kaplan-Meier method and the curves were compared by the log-rank test. The time of follow-up, calculated in months, corresponded to the time elapsed from hospital discharge to current status (survived/ censoring or death). The level of significance was set at 5% (p<0.05). Results: Rhabdomyoma is the most common type of cardiac tumor (85%), with a high morbidity (79.3%) and overall mortality of 17.4%. The presence of fetal hydrops was a predictor of death. Conclusion: The presence of fetal hydrops had an impact on mortality, and hence is an important factor in counselling and determining the prognosis. Most deaths occurred before hospital discharge.

5.
Equine Vet J ; 54(5): 934-945, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34482568

RESUMO

BACKGROUND: Standing flank laparotomy can be an alternative to ventral midline laparotomy in horses with colic. Standing flank laparotomy avoids general anaesthesia, provides excellent access to some regions of the abdominopelvic cavity and costs less than ventral midline laparotomy. OBJECTIVE: To report a series of cases of peritoneal and intestinal diseases other than SC diseases managed with standing flank laparotomy. STUDY DESIGN: Retrospective case series. METHODS: Records from equids with colic subjected to standing flank laparotomy at five hospitals (2003-2020) were reviewed. Descriptive data analysis was performed. RESULTS: Thirty horses (sixteen survived to discharge), six ponies (four survived) and one donkey (euthanised) were subjected to standing flank laparotomy via the left flank (n = 31), right flank (n = 2) or both flanks (n = 4). The primary disease affected the peritoneum (0/5 survived), SI (5/9 survived) and caecum and/or LC (15/23 survived). Enterotomy was performed in four animals (all survived). Partial typhlectomy was performed in one horse (euthanised). Resection-anastomosis of the SI or LC was performed in three animals (one survived). Three animals had intraoperative complications that negatively affected the outcome: Two ponies had intolerance to abdominopelvic exploration; one mare had spontaneous exteriorisation of a long segment of the SI leading to a large tear in the mesentery. In seven cases, severe/extensive lesions found during standing flank laparotomy warranted immediate euthanasia. The survival rate was 54%. All owners were satisfied with the decision to perform standing flank laparotomy. MAIN LIMITATIONS: The retrospective design, lack of a control group, small number of cases and lack of standardised protocols between hospitals. CONCLUSIONS: Although ventral midline laparotomy is the standard of care for horses with colic, standing flank laparotomy is a viable approach for some types of colic. Systemic administration of analgesics may not produce sufficient peritoneal analgesia, which can lead to intolerance to abdominopelvic exploration during standing flank laparotomy in horses with colic and may negatively affect the outcome.


Assuntos
Cólica , Doenças dos Cavalos , Anestesia Geral/veterinária , Animais , Cólica/cirurgia , Cólica/veterinária , Feminino , Doenças dos Cavalos/cirurgia , Cavalos , Laparotomia/métodos , Laparotomia/veterinária , Estudos Retrospectivos
6.
J Am Vet Med Assoc ; 259(8): 892-898, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34609192

RESUMO

OBJECTIVE: To investigate the effects of a small sensor attached to the pastern region of a forelimb on lameness detection and quantification with a portable inertial sensor-based system (PISBS) for lameness detection and quantification in horses. ANIMALS: 20 adult horses (body weight, 410 to 650 kg) with no visible lameness at the walk. PROCEDURES: In a crossover study design, horses were evaluated at the trot twice using the PISBS with the gyroscope alternately attached to the right forelimb pastern region (as recommended by the manufacturer) or to the left forelimb pastern region (with the sensor flipped 180° on the frontal plane relative to the standard position). Agreement between the 2 instrumentation approaches was investigated graphically and by repeated-measures ANOVA, Pearson correlation analysis, and Bland-Altman analysis. RESULTS: No effects of instrumentation of a forelimb with the gyroscope were detected on the lame limb or limbs or on lameness severity. Attachment of the gyroscope to a forelimb had no effect on forelimb or hind limb lameness (ie, did not cause or mask lameness) as measured with the PISBS. CONCLUSIONS AND CLINICAL RELEVANCE: Instrumentation of a forelimb with a lightweight gyroscope for lameness evaluations with a PISBS had no effects on lameness measurements in horses. Results suggested that, when indicated, the gyroscope can be attached (while flipped 180° on the frontal plane relative to the standard position) to the left forelimb (rather than the right forelimb).


Assuntos
Doenças dos Cavalos , Coxeadura Animal , Animais , Fenômenos Biomecânicos , Estudos Cross-Over , Membro Anterior , Marcha , Membro Posterior , Doenças dos Cavalos/diagnóstico , Cavalos , Coxeadura Animal/diagnóstico
7.
Nutrients ; 13(6)2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34071239

RESUMO

The aim of this study was to evaluate the Diet Quality Index (DQI) and the Physical Activity (PA) levels associated with adequacy of gestational weight gain in pregnant women with gestational diabetes mellitus (GDM). A total of 172 pregnant women with a single fetus and a diagnosis of GDM participated. Food intake was self-reported on the food frequency questionnaire and DQI was quantified using the index validated and revised for Brazil (DQI-R). To assess PA, the Pregnancy Physical Activity Questionnaire was administered. Gestational weight gain was classified, following the criteria of the Institute of Medicine, into adequate (AWG), insufficient (IWG), or excessive (EWG) weight gain. A multinomial logistic regression analysis was performed, with level of significance <0.05. The participants were divided into 3 groups: AWG (33.1%), IWG (27.3%), and EWG (39.5%). The analysis indicated that if the pregnant women PA fell into tertile 1 or 2, then they had a greater chance of having IWG, whereas those with the lowest scores on the DQI-R, whose PA fell into tertile 2, and pregestational obesity women had the greatest chance of having EWG. This study has shown that low PA levels may contribute towards IWG. On the other hand, a low final DQI-R score, representing inadequate food habits, low PA levels, and pregestational obesity may increase the chance of EWG in patients with GDM.


Assuntos
Diabetes Gestacional/epidemiologia , Dieta/estatística & dados numéricos , Exercício Físico/fisiologia , Ganho de Peso na Gestação/fisiologia , Adolescente , Adulto , Brasil , Inquéritos sobre Dietas , Feminino , Humanos , Gravidez , Estudos Prospectivos , Adulto Jovem
8.
Vet Surg ; 49(4): 778-786, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32031290

RESUMO

OBJECTIVE: To describe subchondral lucencies (SCL) in the equine proximal tibia, several treatment options, and clinical outcomes. STUDY DESIGN: Retrospective study. ANIMALS: Seventeen horses with proximal tibial SCL. METHODS: Medical record and radiograph review. Follow-up was obtained via examination and radiography when possible and by telephone and race records when required. The median duration of follow-up was 20 months (range, 0-48). RESULTS: Proximal tibial SCL were associated with lameness in 14 of 17 horses. Subchondral lucencies were primary in 11 horses and secondary to an ipsilateral medial femoral condyle SCL in six horses. One foal with a primary SCL was euthanized because of osteomyelitis. Six horses ≤1 year old with primary SCL were managed with exercise restrictions only; SCL in three horses without lameness decreased in size, whereas three horses with lameness did not improve. One young horse treated with surgical debridement failed to improve and was euthanized. Lameness resolved in three horses with primary tibial SCL treated with screw fixation. Screw fixation of secondary SCL in five horses led to a reduction in SCL size and degree of lameness. CONCLUSION: Primary tibial SCL healed with rest in 3 non-lame young horses with small SCL, but was not successful in lame horses with larger SC. Radiographic size and associated lameness improved or resolved with screw fixation in primary and secondary proximal tibial SCL. CLINICAL SIGNIFICANCE: Primary tibial SCL that did not cause lameness healed with conservative management, but persistent primary and secondary tibial SCL required screw fixation to reduce lameness.


Assuntos
Densidade Óssea , Doenças dos Cavalos/cirurgia , Cavalos/fisiologia , Coxeadura Animal/cirurgia , Radiografia/veterinária , Tíbia/fisiopatologia , Animais , Parafusos Ósseos/veterinária , Desbridamento/veterinária , Cavalos/cirurgia , Estudos Retrospectivos , Tíbia/cirurgia
9.
J Laparoendosc Adv Surg Tech A ; 30(1): 40-43, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31368842

RESUMO

Background: Most of the obese patients undergoing an anti-reflux operation experience recurrence of gastroesophageal reflux disease (GERD). Laparoscopic Roux-en-Y gastric bypass (LRNYGB) has been accepted as the bariatric surgery of choice for a previous GERD-operated obese patients. Methods: We present 85 consecutive patients from a single institution, previously submitted to antireflux surgery and then to LRNYGB. Preoperative endoscopy was carried out in all patients; 49 (57.64%) patients had findings of fundoplication failure or signs of persistent GERD, of those 20 (40.81%) with esophagitis. Results: From the bypass, per or postoperative minor to moderate complications occurred in 12 patients (14.11%): 2 (2.35%) conversions to laparotomy, 1 (1.17%) melena, 8 (9.41%) stenosis of gastrojejunostomy, treated by a simple endoscopic dilatation with a balloon, and 1 (1.17%) gastrogastric fistula. A follow-up endoscopy of 79 of 85 (92.9%) patients was carried out after 6 months of LRNYGB. Eight of 79 (10.12%) patients had persistent esophagitis that represented 40% (8 of 20 patients) of persistent reflux esophagitis even after LRNYGB. All of them were men. Conclusion: LRNYGB after laparoscopic fundoplication is a feasible procedure with an excepted higher rate of complications because of the complexity of the procedure. Nevertheless esophagitis still persisted in many of those patients.


Assuntos
Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Refluxo Gastroesofágico/cirurgia , Obesidade/cirurgia , Adulto , Idoso , Conversão para Cirurgia Aberta , Endoscopia Gastrointestinal , Esofagite Péptica/etiologia , Feminino , Fundoplicatura , Refluxo Gastroesofágico/complicações , Humanos , Complicações Intraoperatórias/etiologia , Laparoscopia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Período Pré-Operatório
10.
Cephalalgia ; 40(3): 255-265, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31530007

RESUMO

BACKGROUND: Migraine attacks are unpredictable, precluding preemptive interventions and leading to lack of control over individuals' lives. Although there are neurophysiological changes 24-48 hours before migraine attacks, so far, they have not been used in patients' management. This study evaluates the applicability and the ability to identify pre-attack changes of daily "at home" electroencephalography obtained with a portable system for migraine patients. METHODS: Patients with episodic migraine fulfilling ICHD-3 beta criteria used a mobile system composed of a wireless EEG device (BrainStation®, Neuroverse®, Inc., USA) and mobile application (BrainVitalsM®, Neuroverse®, Inc., USA) to self-record their neural activity daily at home while resting and while performing an attention task, over the course of 2 weeks. Standard EEG spectral analysis and event-related brain potentials (ERP) methods were used and recordings were grouped by time from migraine attacks (i.e. "Interictal day", "24 h Before Migraine", "Migraine day" and "Post Migraine"). RESULTS: Twenty-four patients (22 women) recorded an average of 13.3 ± 1.9 days and had 2 ± 0.9 attacks. Twenty-four hours before attack onset, there was a statistically significant modulation of relative power in the delta (decrease) and beta (increase) frequency bands, at rest, and a significant reduction of the amplitude and inter-trial coherence measures of an attention event-related brain potential (P300). CONCLUSIONS: This proof-of-concept study shows that brain state monitoring, utilising an easy-to-use wearable EEG system to track neural modulations at home, can identify physiological changes preceding a migraine attack enabling valuable pre-symptom prediction and subsequent early intervention.


Assuntos
Eletroencefalografia/métodos , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/fisiopatologia , Monitorização Ambulatorial/métodos , Tecnologia sem Fio , Adulto , Eletroencefalografia/instrumentação , Eletroencefalografia/tendências , Feminino , Previsões , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Monitorização Ambulatorial/instrumentação , Monitorização Ambulatorial/tendências , Projetos Piloto , Valor Preditivo dos Testes , Estudo de Prova de Conceito , Estudos Prospectivos , Tecnologia sem Fio/instrumentação , Tecnologia sem Fio/tendências , Adulto Jovem
13.
Genet Mol Biol ; 41(3): 545-554, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30043834

RESUMO

Our aim was to develop and apply a comprehensive noninvasive prenatal test (NIPT) by using high-coverage targeted next-generation sequencing to estimate fetal fraction, determine fetal sex, and detect trisomy and monogenic disease without parental genotype information. We analyzed 45 pregnancies, 40 mock samples, and eight mother-child pairs to generate 35 simulated datasets. Fetal fraction (FF) was estimated based on analysis of the single nucleotide polymorphism (SNP) allele fraction distribution. A Z-score was calculated for trisomy of chromosome 21 (T21), and fetal sex detection. Monogenic disease detection was performed through variant analysis. Model validation was performed using the simulated datasets. The novel model to estimate FF was robust and accurate (r2= 0.994, p-value < 2.2e-16). For samples with FF > 0.04, T21 detection had 100% sensitivity (95% CI: 63.06 to 100%) and 98.53% specificity (95% CI: 92.08 to 99.96%). Fetal sex was determined with 100% accuracy. We later performed a proof of concept for monogenic disease diagnosis of 5/7 skeletal dysplasia cases. In conclusion, it is feasible to perform a comprehensive NIPT by using only data from high coverage targeted sequencing, which, in addition to detecting trisomies, also make it possible to identify pathogenic variants of the candidate genes for monogenic diseases.

15.
J. vasc. bras ; 17(1): 26-33, jan.-mar. 2018. ilus, tab
Artigo em Português | LILACS | ID: biblio-904898

RESUMO

Contexto: A cirurgia bariátrica é considerada a melhor opção para o tratamento da obesidade, cujos pacientes são considerados de alto risco para fenômenos tromboembólicos. Objetivos: Comparar o uso de doses diferentes de heparina de baixo peso molecular (HBPM) na profilaxia da trombose venosa profunda (TVP) em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, alteração na dosagem do fator anti-Xa e sangramento pré ou pós-operatório. Métodos: Estudo comparativo transversal em pacientes submetidos à cirurgia bariátrica distribuídos em dois grupos, que receberam doses de HBPM de 40 mg (grupo controle, GC) e 80 mg (grupo de estudo, GE). Foram avaliados por ultrassonografia vascular e dosagem de KPTT, TAP, plaquetas e fator anti-Xa. Resultados: Foram avaliados 60 pacientes, sendo 34 no GC e 26 no GE. Foi observada diferença significativa somente no peso (p = 0,003) e índice de massa corporal (p = 0,018) no GE em relação ao GC. Não houve diferença na dosagem de KPTT, TAP, plaquetas e fator anti-Xa entre os grupos. Não foram detectados TVP ou sangramentos significativos em ambos os grupos. Conclusões: Não houve diferença estatisticamente significativa na utilização de doses maiores de HBPM na profilaxia da TVP em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, dosagem do fator anti-Xa e sangramento pré ou pós-operatório


Background: Bariatric surgery is considered the best treatment option for patients with obesity who are classed as high risk for thromboembolic events. Objectives: To compare two different doses of low weight molecular heparin (LWMH) for prevention of deep venous thrombosis (DVT) in candidates for bariatric surgery, in terms of DVT risk, abnormal anti-Xa levels, and preoperative and/or postoperative bleeding. Methods: A cross-sectional comparative study of bariatric surgery patients divided into two groups given different doses of LWMH; 40 mg of LWMH (control group, CG) and 80 mg of LWMH (study group, SG), both evaluated by vascular ultrasonography (VU) and according to the results of PTT, PT, platelets, and anti-Xa factor assays. Results: Sixty patients were evaluated, 34 in the CG and 26 in the SG. The only significant differences between the patients in the SG and the CG were weight (p = 0.003) and body mass index (p = 0.018). There were no differences between the groups in PTT, PT, platelets, or anti-Xa factor levels. There was no DVT or significant bleeding in either group. Conclusions: There were no statistical differences when higher doses of LWMH were used for prevention of DVT in bariatric surgery patients, in terms of DVT risk, anti-Xa factor levels, or preoperative and postoperative bleeding


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estudo Comparativo , Heparina/administração & dosagem , Trombose Venosa/cirurgia , Trombose Venosa/terapia , Prevenção de Doenças , Cirurgia Bariátrica/métodos , Hemorragia/complicações , Coagulantes/administração & dosagem , Índice de Massa Corporal , Estudos de Casos e Controles , Grupos Controle , Interpretação Estatística de Dados , Fatores de Risco , Laparoscopia/métodos , Diabetes Mellitus , Hipertensão
16.
Clinics (Sao Paulo) ; 72(6): 325-332, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28658431

RESUMO

OBJECTIVES:: To analyze the influence of lying in prone position on a specially designed stretcher on the maternal-fetal hemodynamic parameters and comfort of pregnant women. METHODS:: A randomized, controlled trial with 33 pregnant women divided into 2 groups: pregnant group sequence 1 and pregnant group sequence 2. The order of positions used in sequence 1 was Fowler's position, prone position, supine position, left lateral, Fowler's position 2, supine position 2, prone position 2 and left lateral 2. The order of positions used in sequence 2 was Fowler's position, prone position, left lateral, supine position, Fowler's position 2, left lateral 2, prone position 2 and supine position 2. Each woman remained in each position for 6 minutes. For the statistical analyses, we used Wilcoxon's test for 2 paired samples when comparing the prone position with the other positions. The variables are presented in graphs showing the means and 95% confidence intervals. Trial Registration: Clinical Trial No. ISRCTN41359519. RESULTS:: All the parameters were within the standards of normality. There were no differences between positions in terms of maternal heart rate, diastolic blood pressure, oxygen saturation and fetal heart rate. However, there were significant decreases in respiratory rate and systolic blood pressure in prone position 2 compared with left lateral 2. There was an increase in oxygen saturation in prone position compared with Fowler's position and supine position 2 in both sequences. All the women reported feeling comfortable in the prone position. CONCLUSIONS:: The prone position was considered safe and comfortable and could be advantageous for improving oxygen saturation and reducing the systolic blood pressure and respiratory rate.


Assuntos
Hemodinâmica/fisiologia , Gravidez/fisiologia , Decúbito Ventral/fisiologia , Macas , Adulto , Feminino , Humanos , Conforto do Paciente , Adulto Jovem
17.
Clinics ; 72(6): 325-332, June 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-840090

RESUMO

OBJECTIVES: To analyze the influence of lying in prone position on a specially designed stretcher on the maternal-fetal hemodynamic parameters and comfort of pregnant women. METHODS: A randomized, controlled trial with 33 pregnant women divided into 2 groups: pregnant group sequence 1 and pregnant group sequence 2. The order of positions used in sequence 1 was Fowler’s position, prone position, supine position, left lateral, Fowler’s position 2, supine position 2, prone position 2 and left lateral 2. The order of positions used in sequence 2 was Fowler’s position, prone position, left lateral, supine position, Fowler’s position 2, left lateral 2, prone position 2 and supine position 2. Each woman remained in each position for 6 minutes. For the statistical analyses, we used Wilcoxon’s test for 2 paired samples when comparing the prone position with the other positions. The variables are presented in graphs showing the means and 95% confidence intervals. Trial Registration: Clinical Trial No. ISRCTN41359519 RESULTS: All the parameters were within the standards of normality. There were no differences between positions in terms of maternal heart rate, diastolic blood pressure, oxygen saturation and fetal heart rate. However, there were significant decreases in respiratory rate and systolic blood pressure in prone position 2 compared with left lateral 2. There was an increase in oxygen saturation in prone position compared with Fowler’s position and supine position 2 in both sequences. All the women reported feeling comfortable in the prone position. CONCLUSIONS: The prone position was considered safe and comfortable and could be advantageous for improving oxygen saturation and reducing the systolic blood pressure and respiratory rate.


Assuntos
Humanos , Feminino , Adulto , Adulto Jovem , Hemodinâmica/fisiologia , Gravidez/fisiologia , Decúbito Ventral/fisiologia , Macas , Conforto do Paciente
18.
PLoS One ; 11(11): e0166523, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27846295

RESUMO

Horses are exquisitely sensitive to non-specific gastrointestinal disturbances as well as systemic and extraintestinal conditions related to gut health, yet minimal data are available regarding the composition of the microbiota present in the equine stomach, small intestine, and cecum and their relation to fecal microbiota. Moreover, there is minimal information regarding the concordance of the luminal and mucosal microbial communities throughout the equine gut. Illumina-based 16S rRNA gene amplicon sequencing of the luminal and mucosal microbiota present in seven regions of the gastrointestinal tract of nine healthy adult horses revealed a distinct compositional divide between the small and large intestines. This disparity in composition was more pronounced within the luminal contents, but was also detected within mucosal populations. Moreover, the uniformity of the gut microbiota was much higher in the cecum and colon relative to that in the stomach, jejunum and ileum, despite a significantly higher number of unique sequences detected in the colon. Collectively, the current data suggest that while colonic samples (a proxy for feces) may provide a reasonable profile of the luminal contents of the healthy equine large intestine, they are not informative with regard to the contents of the stomach or small intestine. In contrast to the distinct difference between the highly variable upper gastrointestinal tract microbiota and relatively uniform large bowel microbiota present within the lumen, these data also demonstrate a regional continuity present in mucosal microbial communities throughout the length of the equine gut.


Assuntos
Bactérias/genética , Microbioma Gastrointestinal/genética , Cavalos/microbiologia , RNA Ribossômico 16S/genética , Animais , Bactérias/classificação , Técnicas de Tipagem Bacteriana , Ceco/microbiologia , Colo/microbiologia , Duodeno/microbiologia , Feminino , Variação Genética , Íleo/microbiologia , Jejuno/microbiologia , Masculino , Especificidade de Órgãos , Análise de Componente Principal , Estômago/microbiologia , Simbiose/fisiologia
19.
Am J Vet Res ; 77(10): 1121-31, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27668584

RESUMO

OBJECTIVE To evaluate head, pelvic, and limb movement to detect lameness in galloping horses. ANIMALS 12 Thoroughbreds. PROCEDURES Movement data were collected with inertial sensors mounted on the head, pelvis, and limbs of horses trotting and galloping in a straight line before and after induction of forelimb and hind limb lameness by use of sole pressure. Successful induction of lameness was determined by measurement of asymmetric vertical head and pelvic movement during trotting. Differences in gallop strides before and after induction of lameness were evaluated with paired-sample statistical analysis and neural network training and testing. Variables included maximum, minimum, range, and time indices of vertical head and pelvic acceleration, head rotation in the sagittal plane, pelvic rotation in the frontal plane, limb contact intervals, stride durations, and limb lead preference. Difference between median standardized gallop strides for each limb lead before and after induction of lameness was calculated as the sum of squared differences at each time index and assessed with a 2-way ANOVA. RESULTS Head and pelvic acceleration and rotation, limb timing, stride duration measurements, and limb lead preference during galloping were not significantly different before and after induction of lameness in the forelimb or hind limb. Differences between limb leads before induction of lameness were similar to or greater than differences within limb leads before and after lameness induction. CONCLUSIONS AND CLINICAL RELEVANCE Galloping horses maintained asymmetry of head, pelvic, and limb motion between limb leads that was unrelated to lameness.


Assuntos
Marcha/fisiologia , Doenças dos Cavalos/diagnóstico , Coxeadura Animal/diagnóstico , Tecnologia sem Fio/instrumentação , Animais , Fenômenos Biomecânicos , Feminino , Membro Anterior/fisiopatologia , Membro Posterior/fisiopatologia , Doenças dos Cavalos/fisiopatologia , Cavalos , Coxeadura Animal/fisiopatologia , Masculino , Movimento , Condicionamento Físico Animal , Processamento de Sinais Assistido por Computador
20.
Rev Bras Ginecol Obstet ; 38(3): 120-6, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27022783

RESUMO

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.


Assuntos
Imageamento Tridimensional , Disrafismo Espinal/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Feminino , Feto , Humanos , Estudos Longitudinais , Gravidez , Estudos Prospectivos
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