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1.
BMC pregnancy childbirth ; 23(1): 605, 2023.
Artigo em Inglês | LILACS, BNUY, MMyP, UY-BNMED | ID: biblio-1518570

RESUMO

Background: Latin America has the highest Cesarean Section Rates (CSR) in the world. Robson's Ten Group Classification System (RTGCS) was developed to enable understanding the CSR in different groups of women, classified according to obstetric characteristics into one of ten groups. The size of each CS group may provide helpful data on quality of care in a determined region or setting. Data can potentially be used to compare the impact of conditions such as maternal morbidity on CSR. The objective of this study is to understand the impact of Severe Maternal Morbidity (SMM) on CSR in ten different groups of RTGCS. Methods: Secondary analysis of childbirth information from 2018 to 2021, including 8 health facilities from 5 Latin American and Caribbean countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic), using a surveillance database (SIP-Perinatal Information System, in Spanish) implemented in different settings across Latin America. Women were classified into one of RTGCS. The frequency of each group and its respective CSR were described. Furthermore, the sample was divided into two groups, according to maternal outcomes: women without SMM and those who experienced SMM, considering Potentially Life-threatening Conditions, Maternal Near Miss and Maternal Death as the continuum of morbidity. Results: Available data were obtained from 92,688 deliveries using the Robson Classification. Overall CSR was around 38%. Group 5 was responsible for almost one-third of cesarean sections. SMM occurred in 6.7% of cases. Among these cases, the overall CSR was almost 70% in this group. Group 10 had a major role (preterm deliveries). Group 5 (previous Cesarean section) had a very high CSR within the group, regardless of the occurrence of maternal morbidity (over 80%). Conclusion: Cesarean section rate was higher in women experiencing SMM than in those without SMM in Latin America. SMM was associated with higher Cesarean section rates, especially in groups 1 and 3. Nevertheless, group 5 was the major contributor to the overall CSR. (AU)


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Cesárea , Tetranitrato de Pentaeritritol , Parto , América Latina/epidemiologia
2.
Braz. j. med. biol. res ; 38(6): 959-966, June 2005. ilus, tab
Artigo em Inglês | LILACS | ID: lil-402665

RESUMO

Discrepancy was found between enhanced hypotension and attenuated relaxation of conduit arteries in response to acetylcholine (ACh) and bradykinin (BK) in nitric oxide (NO)-deficient hypertension. The question is whether a similar phenomenon occurs in spontaneously hypertensive rats (SHR) with a different pathogenesis. Wistar rats, SHR, and SHR treated with NO donors [molsidomine (50 mg/kg) or pentaerythritol tetranitrate (100 mg/kg), twice a day, by gavage] were studied. After 6 weeks of treatment systolic blood pressure (BP) was increased significantly in experimental groups. Under anesthesia, the carotid artery was cannulated for BP recording and the jugular vein for drug administration. The iliac artery was used for in vitro studies and determination of geometry. Compared to control, SHR showed a significantly enhanced (P < 0.01) hypotensive response to ACh (1 and 10 æg, 87.9 ± 6.9 and 108.1 ± 5.1 vs 35.9 ± 4.7 and 64.0 ± 3.3 mmHg), and BK (100 æg, 106.7 ± 8.3 vs 53.3 ± 5.2 mmHg). SHR receiving NO donors yielded similar results. In contrast, maximum relaxation of the iliac artery in response to ACh was attenuated in SHR (12.1 ± 3.6 vs 74.2 ± 8.6 percent in controls, P < 0.01). Iliac artery inner diameter also increased (680 ± 46 vs 828 ± 28 æm in controls, P < 0.01). Wall thickness, wall cross-section area, wall thickness/inner diameter ratio increased significantly (P < 0.01). No differences were found in this respect among SHR and SHR treated with NO donors. These findings demonstrated enhanced hypotension and attenuated relaxation of the conduit artery in response to NO activators in SHR and in SHR treated with NO donors, a response similar to that found in NO-deficient hypertension.


Assuntos
Animais , Masculino , Ratos , Acetilcolina/farmacologia , Bradicinina/farmacologia , Hipotensão/metabolismo , Artéria Ilíaca/efeitos dos fármacos , Doadores de Óxido Nítrico/farmacologia , Vasodilatadores/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Artérias Carótidas/efeitos dos fármacos , Artérias Carótidas/fisiologia , Hipotensão/induzido quimicamente , Artéria Ilíaca/patologia , Artéria Ilíaca/fisiologia , Molsidomina/farmacologia , Óxido Nítrico Sintase/efeitos dos fármacos , Tetranitrato de Pentaeritritol/farmacologia , Ratos Endogâmicos SHR , Ratos Wistar
3.
Rev. cuba. cardiol. cir. cardiovasc ; 1(2): 51-8, jul.-dic. 1987. tab
Artigo em Espanhol | LILACS | ID: lil-53718

RESUMO

Se estudiaron 18 pacientes (13 hombres) con una edad promedio de 57 años, los cuales presentaron angina de esfuerzo estable. Se realizó la prueba ergométrica sin tratamiento y después se administró un ciclo de tetranitrato de pentaeritritol y otro de propranolol durante 14 días; al finalizar cada uno se repitió la prueba de esfuerzo. La dosis de tetranitrato de pentaeritritol fluctuó entre 120 y 240 mg y la dosis media de propranolol fue de 122 mg. Ambos medicamentos prolongaron el tiempo total de ejercicio, redujeron el desnivel del segmento RS-T y el doble producto. No hubo diferencias significativas al comparar las 2 drogas. Los resultados sugieren que el tetranitrato de pentaeritritol mejora la capoacidad de esfuerzo físico en pacientes con angina de esfuerzo estable, por lo que se considera útil en el tratamiento de esta afección


Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Angina Pectoris/tratamento farmacológico , Teste de Esforço , Tetranitrato de Pentaeritritol/uso terapêutico , Propranolol/uso terapêutico
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