Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 33
Filtrar
Mais filtros

Tipo de documento
Intervalo de ano de publicação
1.
Int J Obes (Lond) ; 41(1): 159-169, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27569686

RESUMO

BACKGROUND/OBJECTIVES: Elevated prepregnancy body mass index (pBMI) and excess gestational weight gain (GWG) constitute important prenatal exposures that may program adiposity and disease risk in offspring. The objective of this study is to investigate the influence of pBMI and GWG on the maternal metabolomic profile across pregnancy, and to identify associations with birth weight. SUBJECTS/METHODS: This is a longitudinal prospective study of 167 nondiabetic women carrying a singleton pregnancy. Women were recruited between March 2011 and December 2013 from antenatal clinics affiliated to the University of California, Irvine, Medical Center. Seven women were excluded from analyses because of a diagnosis of diabetes during pregnancy. A total of 254 plasma metabolites known to be related to obesity in nonpregnant populations were analyzed in each trimester using targeted metabolomics. The effects of pBMI and GWG on metabolites were tested through linear regression and principle component analysis, adjusting for maternal sociodemographic factors, diet, and insulin resistance. A Bonferroni correction was applied for multiple comparison testing. RESULTS: pBMI was significantly associated with 40 metabolites. Nonesterified fatty acids (NEFA) showed a strong positive association with pBMI, with specificity for mono-unsaturated and omega-6 NEFA. Among phospholipids, sphingomyelins with two double bonds and phosphatidylcholines containing 20:3 fatty acid chain, indicative of omega-6 NEFA, were positively associated with pBMI. Few associations between GWG, quality and quantity of the diet, insulin resistance and the maternal metabolome throughout gestation were detected. NEFA levels in the first and, to a lesser degree, in the second trimester were positively associated with birth weight percentiles. CONCLUSIONS: Preconception obesity appears to have a stronger influence on the maternal metabolic milieu than gestational factors such as weight gain, dietary intake and insulin resistance, highlighting the critical importance of preconception health. NEFA in general, as well as monounsaturated and omega-6 fatty acid species in particular, represent key metabolites for a potential mechanism of intergenerational transfer of obesity risk.


Assuntos
Peso ao Nascer/fisiologia , Índice de Massa Corporal , Metabolômica , Gestantes , Adulto , California , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Gravidez , Estudos Prospectivos , Fatores de Risco , Aumento de Peso
2.
Int J Obes (Lond) ; 41(9): 1434-1439, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28487552

RESUMO

BACKGROUND: The importance of energy homeostasis brain circuitry in the context of obesity is well established, however, the developmental ontogeny of this circuitry in humans is currently unknown. Here, we investigate the prospective association between newborn gray matter (GM) volume in the insula, a key brain region underlying energy homeostasis, and change in percent body fat accrual over the first six months of postnatal life, an outcome that represents among the most reliable infant predictors of childhood obesity risk. METHODS: A total of 52 infants (29 male, 23 female, gestational age at birth=39(1.5) weeks) were assessed using structural MRI shortly after birth (postnatal age at MRI scan=25.9(12.2) days), and serial Dual X-Ray Absorptiometry shortly after birth (postnatal age at DXA scan 1=24.6(11.4) days) and at six months of age (postnatal age at DXA scan 2=26.7(3.3) weeks). RESULTS: Insula GM volume was inversely associated with change in percent body fat from birth to six-months postnatal age and accounted for 19% of its variance (ß=-3.6%/S.D., P=0.001). This association was driven by the central-posterior portion of the insula, a region of particular importance for gustation and interoception. The direction of this effect is in concordance with observations in adults, and the results remained statistically significant after adjusting for relevant covariates and potential confounding variables. CONCLUSIONS: Altogether, these findings suggest an underlying neural basis of childhood obesity that precedes the influence of the postnatal environment. The identification of plausible brain-related biomarkers of childhood obesity risk that predate the influence of the postnatal obesogenic environment may contribute to an improved understanding of propensity for obesity, early identification of at-risk individuals, and intervention targets for primary prevention.


Assuntos
Adiposidade/fisiologia , Córtex Cerebral/anatomia & histologia , Metabolismo Energético/fisiologia , Substância Cinzenta/fisiologia , Obesidade Infantil/etiologia , Absorciometria de Fóton , Córtex Cerebral/fisiologia , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Estudos Prospectivos , Transdução de Sinais/fisiologia , Aumento de Peso/fisiologia
3.
Psychoneuroendocrinology ; 144: 105868, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35853381

RESUMO

BACKGROUND: Mitochondria are multifunctional energy-producing and signaling organelles that support life and contribute to stress adaptation. There is a growing understanding of the dynamic relationship between stress exposure and mitochondrial biology; however, the influence of stress on key domains of mitochondrial biology during early-life, particularly the earliest phases of intra-uterine/prenatal period remains largely unknown. Thus, the goal of this study was to examine the impact of fetal exposure to stress (modeled as the biological construct allostatic load) upon mitochondrial biology in early childhood. METHODS: In n = 30 children (range: 3.5-6 years, 53% male), we quantified mitochondrial content via citrate synthase (CS) activity and mtDNA copy number (mtDNAcn), and measured mitochondrial bioenergetic capacity via respiratory chain enzyme activities (complexes I (CI), II (CII), and IV (CIV)) in platelet-depleted peripheral blood mononuclear cells (PBMCs). In a cohort of healthy pregnant women, maternal allostatic load was operationalized as a latent variable (sum of z-scores) representing an aggregation of early-, mid- and late-gestation measures of neuroendocrine (cortisol), immune (interleukin-6, C-reactive protein), metabolic (homeostasis model assessment of insulin resistance, free fatty acids), and cardiovascular (aggregate systolic and diastolic blood pressure) systems, as well as an anthropometric indicator (pre-pregnancy body mass index [BMI]). RESULTS: An interquartile increase in maternal allostatic load during pregnancy was associated with higher mitochondrial content (24% and 15% higher CS and mtDNAcn), and a higher mitochondrial bioenergetic capacity (16%, 23%, and 25% higher CI, CII and CIV enzymatic activities) in child leukocytes. The positive association between maternal allostatic load during pregnancy and child mitochondrial content and bioenergetic capacity remained significant after accounting for the effects of key pre- and post-natal maternal and child covariates (p's < 0.05, except CI p = 0.073). CONCLUSION: We report evidence that prenatal biological stress exposure, modeled as allostatic load, was associated with elevated child mitochondrial content and bioenergetic capacity in early childhood. This higher mitochondrial content and bioenergetic capacity (per leukocyte) may reflect increased energetic demands at the immune or organism level, and thus contribute to wear-and-tear and pathophysiology, and/or programmed pro-inflammatory phenotypes. These findings provide potential mechanistic insight into the cellular processes underlying developmental programming, and support the potential role that changes in mitochondrial content and bioenergetic functional capacity may play in altering life-long susceptibility for health and disease.


Assuntos
Alostase , Alostase/fisiologia , DNA Mitocondrial , Metabolismo Energético , Feminino , Humanos , Leucócitos Mononucleares/metabolismo , Masculino , Mitocôndrias/metabolismo , Gravidez
4.
Stress ; 14(6): 665-76, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21995526

RESUMO

Because fetal brain development proceeds at an extremely rapid pace, early life experiences have the potential to alter the trajectory of neurodevelopment, which may increase susceptibility for developmental and neuropsychiatric disorders. There is evidence that prenatal maternal stress and anxiety, especially worries specifically related to being pregnant, influence neurodevelopmental outcomes. In the current prospective longitudinal study, we included 89 women for whom serial data were available for pregnancy-specific anxiety, state anxiety, and depression at 15, 19, 25, 31, and 37 weeks gestation. When the offspring from the target pregnancy were between 6 and 9 years of age, their executive function was assessed. High levels of mean maternal pregnancy-specific anxiety over the course of gestation were associated with lower inhibitory control in girls only and lower visuospatial working memory performance in boys and girls. Higher-state anxiety and depression also were associated with lower visuospatial working memory performance. However, neither state anxiety nor depression explained any additional variance after accounting for pregnancy-specific anxiety. The findings contribute to the literature supporting an association between pregnancy-specific anxiety and cognitive development and extend our knowledge about the persistence of this effect until middle childhood.


Assuntos
Ansiedade/complicações , Função Executiva , Mães , Complicações na Gravidez/psicologia , Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal/psicologia , Adulto , Transtornos de Ansiedade/etiologia , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , Caracteres Sexuais
5.
Stress ; 13(3): 214-20, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20392193

RESUMO

Psychological stress is known to activate the hypothalamic-pituitary-adrenal axis, resulting in the release of cortisol from the adrenal cortex into the bloodstream. Cortisol is the major human stress hormone and its health correlates continue to be investigated by laboratories around the world. One line of research suggests that specific situational variables play a role in the creation of a stressful situation. The current study examined the effects of systematically varying several situational characteristics on the cortisol stress response in 80 healthy young women exposed to a public speaking task. Three main factors and its interactions were investigated by locating the expert panel either inside or outside of the room, having the subjects speak either about themselves or somebody else, and by asking half of the subjects to perform a distractor task in addition to performing the public speaking. We interpreted these manipulations as variations of social evaluative threat, ego-involvement, and divided attention. We hypothesized that the variations and their interactions would cause differences in endocrine stress responses. The results showed that only the manipulation of social-evaluative threat had a significant main effect on the cortisol stress response in women. There was a further trend (p = 0.07) for a four-way interaction effect. No other main or interaction effects could be observed. We conclude that in women, social-evaluative threat affects the endocrine stress response. This is in contrast to a previous study showing no effects of this variation in men. Thus, future studies should more closely investigate sex or gender effects that might be interacting with the situational aspects of a stressful task.


Assuntos
Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisário/fisiologia , Comportamento Social , Fala/fisiologia , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Feminino , Humanos , Personalidade , Saliva/metabolismo , Estresse Psicológico/metabolismo , Inquéritos e Questionários , Adulto Jovem
6.
Neuroscience ; 342: 68-100, 2017 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-26434624

RESUMO

Thyroid hormones (THs) play an obligatory role in many fundamental processes underlying brain development and maturation. The developing embryo/fetus is dependent on maternal supply of TH. The fetal thyroid gland does not commence TH synthesis until mid gestation, and the adverse consequences of severe maternal TH deficiency on offspring neurodevelopment are well established. Recent evidence suggests that even more moderate forms of maternal thyroid dysfunction, particularly during early gestation, may have a long-lasting influence on child cognitive development and risk of neurodevelopmental disorders. Moreover, these observed alterations appear to be largely irreversible after birth. It is, therefore, important to gain a better understanding of the role of maternal thyroid dysfunction on offspring neurodevelopment in terms of the nature, magnitude, time-specificity, and context-specificity of its effects. With respect to the issue of context specificity, it is possible that maternal stress and stress-related biological processes during pregnancy may modulate maternal thyroid function. The possibility of an interaction between the thyroid and stress systems in the context of fetal brain development has, however, not been addressed to date. We begin this review with a brief overview of TH biology during pregnancy and a summary of the literature on its effect on the developing brain. Next, we consider and discuss whether and how processes related to maternal stress and stress biology may interact with and modify the effects of maternal thyroid function on offspring brain development. We synthesize several research areas and identify important knowledge gaps that may warrant further study. The scientific and public health relevance of this review relates to achieving a better understanding of the timing, mechanisms and contexts of thyroid programing of brain development, with implications for early identification of risk, primary prevention and intervention.


Assuntos
Encéfalo/embriologia , Encéfalo/metabolismo , Hormônios Tireóideos/metabolismo , Animais , Cognição/fisiologia , Feminino , Humanos , Gravidez , Complicações na Gravidez/metabolismo , Hormônios Tireóideos/deficiência
7.
Pediatr Obes ; 12 Suppl 1: 86-93, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27900852

RESUMO

BACKGROUND: Newborns exhibit substantial variation in gestational age-adjusted and sex-adjusted fat mass proportion. The antecedent characteristics of fetal body composition that are associated with newborn fat mass proportion are poorly understood. OBJECTIVE: The aim of this study was to determine whether a composite measure of fetal fat mass is prospectively associated with newborn adiposity. METHODS: In a longitudinal study of 109 low-risk pregnancies, fetal ultrasonography was performed at approximately 12, 20 and 30 weeks gestation. Estimated fetal adiposity (EFA) was derived by integrating cross-sectional arm and thigh per cent fat area and anterior abdominal wall thickness. Newborn per cent body fat was quantified by Dual Energy X-Ray Absorptiometry. The association between EFA and newborn per cent body fat was determined by multiple linear regression. RESULTS: After controlling for confounding factors, EFA at 30 weeks was significantly associated with newborn per cent body fat (standardized ß = 0.41, p < 0.001) and explained 24.0% of its variance, which was substantially higher than that explained by estimated fetal weight (8.1%). The observed effect was driven primarily by arm per cent fat area. CONCLUSIONS: A composite measure of fetal adiposity at 30 weeks gestation may constitute a better predictor of newborn per cent body fat than estimated fetal weight by conventional fetal biometry. Fetal arm fat deposition may represent an early indicator of newborn adiposity. After replication, these findings may provide a basis for an improved understanding of the ontogeny of fetal fat deposition, thereby contributing to a better understanding of its intrauterine determinants and the development of potential interventions.


Assuntos
Adiposidade/fisiologia , Composição Corporal/fisiologia , Ultrassonografia Pré-Natal/métodos , Absorciometria de Fóton , Adulto , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Gravidez , Estudos Prospectivos
8.
Ann N Y Acad Sci ; 1032: 195-7, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15677409

RESUMO

Glucocorticoids secreted in response to stress modulate memory in animals and humans. Studies in rodents suggest that glucocorticoids enhance memory consolidation but impair delayed retrieval. Similar negative effects on memory retrieval have been reported in humans. The human studies so far have not addressed the issue of emotional valence, which conceivably could modulate the effects of cortisol on retrieval. The present mini-review discusses two recent studies from our laboratories that investigate the influence of emotional valence on the retrieval-impairing effects of cortisol. Both studies observed that cortisol impaired retrieval and that emotional valence influenced these effects. For autobiographical memory the impairing effects were stronger for neutral than for emotional items, whereas for word retrieval the opposite pattern was observed (stronger effects on emotional words). Possible reasons for these results are the different memory domains tested as well as the different sex of the subjects. Future studies will address these issues, which are of relevance for psychiatric disorders such as posttraumatic stress disorder or major depression.


Assuntos
Emoções/fisiologia , Hidrocortisona/fisiologia , Memória/fisiologia , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Caracteres Sexuais , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia
9.
Vision Res ; 22(6): 693-709, 1982.
Artigo em Inglês | MEDLINE | ID: mdl-7112963

RESUMO

Threshold vs intensity curves for cone vision, measured in the parafoveal retina, quickly saturate if the adapting background is made small (e.g. 19' at 5 degrees eccentricity). Log increment threshold increases at a rate of about 3:1 with log background illuminance at levels as low as 10 td. This shows that lateral interactions are an important process in preserving differential sensitivity in cone vision across the wide range of illuminances over which it normally operates. Parallels between light and dark adaptation in the effect of field size were explored, since effects of comparable magnitude are observed in both. Backgrounds and bleaches equated for their effects at one field size do not have equal effects on threshold at other field sizes, however, with small-area bleaches raising threshold more than predicted. This failure of equivalence was also revealed in a second experiment, in which recovery of sensitivity following small area bleaches was measured in the presence of large steady background fields, which have the effect of lowering threshold. Thresholds following the small bleach were lowered less than expected on the basis of the "equivalent background" hypothesis, a result which we take to mean that signals from bleached cones exceed those produced by a background which has an equivalent effect on threshold (the "equivalent background"). Control experiments examined whether rods contribute to the overloading of cone response by small fields and the possible contribution of such central adaptation processes as spatial frequency adaptation.


Assuntos
Células Fotorreceptoras/fisiologia , Percepção Visual/fisiologia , Adaptação à Escuridão , Humanos , Limiar Sensorial , Percepção Espacial/fisiologia
10.
Int Angiol ; 19(3): 206-11, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11201587

RESUMO

BACKGROUND: Risk factors and especially the combination of multiple risk factors are associated with the development of atherosclerosis. Therefore, patients with an early manifestation of atherosclerotic disease are likely to show an extraordinary risk profile. We analysed the frequencies and severity of risk factors in young patients with manifest peripheral arterial occlusive disease as compared to old patients. METHODS: We analysed the risk profiles in 303 patients who were sent for interventional treatment of a symptomatic peripheral arterial occlusive disease. The risk profiles were described for different age groups (54 patients under 50 years of age, 194 patients from 51 to 74 years, 55 patients over 75 years). Multiple linear regression analysis and analysis of variance were performed to look for age-dependent effects. RESULTS: Elevated total cholesterol, and triglyceride levels and nicotine abuse were more frequent in patients younger than 50 years. Diabetes mellitus and hypertension were more frequent in patients older than 75 years. The different frequencies for smoking, diabetes mellitus and hypertension were age-related (p<0.05). Concerning laboratory parameters such as HDL- and LDL-cholesterol, fibrinogen, lipoprotein(a) and homocysteine there were no relevant age-related differences in frequency nor in absolute values with the exception of the hematocrit and uric acid. The coincidence with clinically manifest myocardial infarction was 11.15% in the patients under 50 years compared to 20.6% in those aged 51-74 years and 16.4% in those over 75 years, for cerebral stroke it was 5.6%, 17.5% and 14.5%, respectively. Patients under 50 years with peripheral arterial occlusive disease and a history of myocardial infarction were characterised by high levels of total cholesterol, triglyceride and lipoprotein(a). Excluding patients with prior myocardial infarction patients did not show any difference in risk profile between the three age groups. CONCLUSIONS: In a population suffering from manifest peripheral arterial occlusive disease the risk profile in patients under 50 years is not different from that in older patients. In contrast an additional myocardial infarction in such a population is associated with pathological lipid profiles.


Assuntos
Arteriosclerose/etiologia , Adulto , Fatores Etários , Idoso , Arteriosclerose/diagnóstico , Arteriosclerose/epidemiologia , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco
11.
Angiology ; 51(5): 377-84, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10826854

RESUMO

Although thrombolysis has been established for recanalization of acute and in part chronic peripheral artery occlusions, only smaller studies exist regarding the use of long-term rt-pa infiltration-thrombolysis. The objective of this study was to evaluate the benefit of additional long-term thrombolysis in patients with peripheral arterial occlusions for whom acute thrombolysis failed. From 1992 to 1997, 323 patients with peripheral arterial occlusions were treated with rt-pa (recombinant tissue-type plasminogen activator). When the thrombolysis failed during the first 3 hours, the thrombolytic therapy was continued as a long-term treatment with 3 mg rt-pa alternated by PGE1 (2.1 mL/hr for 3 hours, concentration: 20 microg/50 mL NaCl) every 3 hours. Additional heparin was applied in doses of 15,000 IE/24 hr or more to slightly increase the partial thromboplastin time. Angiographic controls were performed every 24 hours. If necessary, a final angioplasty was performed. In 142 of the 323 patients the occlusions were recanalized during the first 3 hours; 119 patients were treated with a long-term thrombolysis and in 72 (61%) a recanalization was ultimately achieved. Thus, the recanalization rate increased to 214 of 323 patients (p < 0.02). Mean treatment time was 2.8 +/- 2.2 days, range: 1 to 13 days. The rates of recanalization were not different in iliac, femoral, or crural arteries. Fibrinogen levels did not decrease during thrombolysis. Severe bleeding (with a decrease of more than 3 g/dL hemoglobin requiring transfusion) occurred in four patients after finishing the thrombolysis with short-term and in six with long-term therapy; two required surgical treatment. The 1-, 2-, and 3-year cumulative patency rates were respectively 90.1%, 74.2% and 64.9%. Patency rates in patients with acute or long-term thrombolysis were not different. A composite thrombolytic treatment using low-dose rt-pa in combination with PGE1 offers significantly better results than an acute thrombolytic treatment alone. It can be an effective and practicable regimen in about 60% of patients in whom acute thrombolysis fails.


Assuntos
Alprostadil/administração & dosagem , Arteriopatias Oclusivas/tratamento farmacológico , Fibrinolíticos/administração & dosagem , Terapia Trombolítica , Ativador de Plasminogênio Tecidual/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Alprostadil/efeitos adversos , Angiografia , Arteriopatias Oclusivas/sangue , Arteriopatias Oclusivas/diagnóstico por imagem , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Feminino , Fibrinolíticos/efeitos adversos , Humanos , Isquemia/diagnóstico por imagem , Isquemia/terapia , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Retratamento , Estudos Retrospectivos , Ativador de Plasminogênio Tecidual/efeitos adversos , Falha de Tratamento
12.
Clin Hemorheol Microcirc ; 24(3): 167-74, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11455056

RESUMO

INTRODUCTION: A Raynaud phenomenon can be associated with cold agglutinins or cryoglobulins. Although cold agglutinins or cryoglobulins may lead to severe acral gangrene the finding of relevant titers is rare. Low titers of cold agglutinins or cryoglobulins are detected more frequently but are assumed to be without any importance. OBJECTIVES: To prove a possible diagnostic or prognostic role of low titers of cold agglutinins or cryoglobulins in patients presenting an isolated Raynaud phenomenon we did a retrospective analysis. SETTINGS AND SUBJECTS: In 306 patients (40+/-16 years, range: 15-83 years) with a mean duration of the history of an isolated Raynaud phenomenon of 48+/-73 months we did a clinical examination, an analysis of antinuclear antibodies, extractable antibodies, cold agglutinins, cryoglobulins, plasma and blood viscosity, erythrocyte aggregation and a nail fold capillaroscopy. RESULTS: Low titers of cold agglutinins were found in 49 patients and of cryoglobulins in 7 patients. The finding of such low titers was not associated with extensive clinical symptoms, duration of clinical symptoms, megacapillaries or haemorrhagies in capillaroscopy, pathologic plasma and blood viscosity and erythrocyte aggregation. The follow-up investigations (mean: 3.1+/-1.2 years, range: 3-7 years) revealed no development of a haematological, vasculitic or connective tissue disease in the subgroup of patients who only had low titers of cold agglutinins. CONCLUSION: The detection of low titers of cold agglutinins in patients with isolated Raynaud phenomenon is of no diagnostic or prognostic relevance.


Assuntos
Aglutininas/sangue , Crioglobulinas/análise , Doença de Raynaud/sangue , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antinucleares/sangue , Autoanticorpos/sangue , Viscosidade Sanguínea , Capilares/patologia , Capilares/fisiopatologia , Agregação Eritrocítica , Feminino , Humanos , Fluxometria por Laser-Doppler , Masculino , Pessoa de Meia-Idade , Unhas/irrigação sanguínea , Artéria Radial/fisiopatologia , Doença de Raynaud/imunologia , Doença de Raynaud/fisiopatologia , Valores de Referência , Artéria Ulnar/fisiopatologia
13.
Prim Care ; 14(2): 317-35, 1987 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-3110812

RESUMO

The maintenance of nutritional status in cancer patients is a critical part of the overall care. The cachetic, malnourished patient represents a compromised host that may be less responsive to aggressive antitumor therapy. Assessment and monitoring of nutritional status should begin as soon as the diagnosis is made, as maintenance of good nutritional standing is far easier and less expensive than rehabilitating a depleted patient.


Assuntos
Neoplasias/dietoterapia , Fenômenos Fisiológicos da Nutrição , Caquexia/diagnóstico , Caquexia/etiologia , Dieta , Nutrição Enteral , Feminino , Humanos , Masculino , Anamnese , Neoplasias/complicações , Neoplasias/terapia , Estado Nutricional , Nutrição Parenteral Total , Exame Físico
14.
Vasa ; 29(3): 199-203, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11037718

RESUMO

BACKGROUND: To prove whether the aortoiliac, femoropopliteal or crural segments of the peripheral arteries might have a different sensitivity to a risk profile we did a statistical analysis of segmental peripheral atherosclerosis and risk factors. PATIENTS AND METHODS: In 132 patients (mean age 61 +/- 13 years) with peripheral arterial occlusions the arterial segments with occlusion or stenosis were angiographically documented: 17 had occluded or stenosed aortoiliac, 45 femoropopliteal and 25 crural arteries and 45 patients had multiple manifestations. Analysis of total cholesterol, HDL- and LDL-cholesterol, triglyceride, lipoprotein a, fibrinogen, uric acid, homocysteine, hematocrit, erythrocyte sedimentation rate, HBA1, IgG- and IgM-antibodies versus Cytomegalovirus, Herpes simplex-virus, Chlamydia pneumoniae and Helicobacter pylori were done and nicotine abuse, arterial hypertension and obesity were evaluated. RESULTS: Age of the patients had the strongest correlation with isolated segmental manifestation (p < 0.0001). Patients with isolated aortoiliac manifestation were younger than patients without this manifestation (54 +/- 9 years versus 62 +/- 13 years). Patients with isolated femoropopliteal manifestation were older than patients without this manifestation (66 +/- 11 years versus 58 +/- 13 years). None of the investigated risk factors showed a correlation with these age related differences. Independent from the age related differences for the nicotine abuse a p-value of 0.08 was estimated, but in smokers a diffuse manifestation was most frequent. CONCLUSION: There are age dependent differences of the prevalence of isolated aortoiliac or femoropopliteal atherosclerotic occlusions or stenosis. An association of these differences to a specific risk profile was not found.


Assuntos
Arteriopatias Oclusivas/diagnóstico , Arteriosclerose/diagnóstico , Isquemia/diagnóstico , Perna (Membro)/irrigação sanguínea , Adulto , Fatores Etários , Idoso , Arteriopatias Oclusivas/sangue , Arteriosclerose/sangue , Feminino , Humanos , Isquemia/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fumar/efeitos adversos
15.
Vasa ; 30(3): 189-94, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11582949

RESUMO

BACKGROUND: The etiology of thrombangitis obliterans is still unclear. Although cellular infiltration of the vessel wall is known, no studies on peripheral blood mononuclear cells are reported. Therefore, we assessed leucocyte subpopulations and circulating immune complexes in patients with thrombangitis obliterans and a control group of normal people. PATIENTS AND METHODS: 31 patients (40 +/- 2 years, 24 male, 7 female) with thrombangitis obliterans were included, based on the following criteria: age of manifestation, acral ischemia in legs and arms, previous thrombophlebitis or phlebitis saltans. Manifestation of atherosclerosis or other vasculitic manifestations were excluded. Leucocyte subpopulations, levels of C-reactive protein (CRP) and circulating immune complexes (CIC) were investigated. An age-matched control group (n = 25) was recruited from voluntary blood donors. RESULTS: Leucocyte counts in the thrombagitis group (mean +/- SD: 10,839 +/- 782/nl) were significantly different from the control group (6205 +/- 414/nl, p < 0.0001). The same was true for absolute counts of granulocytes, monocytes and lymphocytes. The results were independent from CRP, which was elevated only in 6 patients. Relative counts of naive helper T-cells were significantly lower in the patient group. HLA-DR expression on B-cells was lower on the patients' lymphocytes. The concentrations of IgA, IgG and IgM in CIC were higher in the thrombangitis patients compared to the control group. C1q-binding capacity and phosphatidylserine antibodies showed no differences. CONCLUSIONS: Patients suffering from thrombangitis obliterans show alterations of leucocyte counts and their subpopulations as well as alterations of the humoral (IgCIC) immune system.


Assuntos
Complexo Antígeno-Anticorpo/sangue , Subpopulações de Linfócitos T/imunologia , Tromboangiite Obliterante/imunologia , Adulto , Autoanticorpos/sangue , Complemento C1q/metabolismo , Feminino , Humanos , Doenças do Complexo Imune/imunologia , Contagem de Linfócitos , Masculino , Fosfatidilserinas/imunologia
16.
S Afr J Surg ; 28(4): 141-4, 1990 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2287974

RESUMO

The clinical notes of 148 patients who were admitted with head injuries and died were studied retrospectively and compared with the results of a postmortem examination. Risk factors predicting the presence of extracranial injuries were sought. Fourteen per cent of patients admitted with head injuries died. Two risk factors predicted the presence of extracranial injuries: 67% of the patients with an associated injury had been involved in a motor vehicle accident (MVA), compared with 32% of those with a head injury only. Shock was five times as common in the group with associated injuries than in those without. Associated injuries were present in 45% of patients, and 37% of these injuries were not diagnosed on admission. In 7% these injuries were the final cause of death. This study re-emphasises the fact that multi-organ trauma is common after MVA, and shock due to hypovolaemia is an unusual complication of head injury. Searching for associated injuries is mandatory in the head-injured patient. Since clinical examination is inaccurate, special investigations, such as peritoneal lavage or computed tomography, should be utilised for this purpose.


Assuntos
Traumatismos Craniocerebrais/complicações , Traumatismo Múltiplo , Adolescente , Adulto , Idoso , Causas de Morte , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
17.
S Afr J Surg ; 28(4): 137-40, 1990 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2287973

RESUMO

The clinical course of 95 comatose trauma patients was prospectively evaluated. The role of clinical findings and diagnostic peritoneal lavage (DPL) combined with computed tomography (CT) were assessed in the diagnosis of abdominal injuries. Seven per cent of the patients were comatose due to hypoperfusion, and did not have a primary brain injury. Of the remaining 88 patients, 28% had an associated abdominal injury. Hypotension predicted an associated abdominal injury with an accuracy of 72%, and a haematocrit less than 30% had an accuracy of 82%. Clinical examination was 50% accurate. DPL was 93% accurate, with a false-positive rate of 10%. No abdominal injuries were present in the group in whom the lavage results were negative, while no unnecessary laparotomies were performed in the group with a 4+ or 5+ positive DPL (calorimetric method). In the group with 1+, 2+ and 3+ positive DPL, 3/15 laparotomies (12%) were done for minor abdominal injuries. Minimising unnecessary laparotomies was achieved by utilising CT to determine the nature and extent of the injury. By using DPL as a screening test, and CT to quantify the injury, unnecessary operations can be avoided, and all injuries can still be diagnosed.


Assuntos
Traumatismos Abdominais/diagnóstico , Coma/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Traumatismos Craniocerebrais/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez
18.
Braz J Biol ; 74(2): 493-500, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-25166337

RESUMO

Podium angustifrons Kohl 1902 is a species of solitary wasp which nests in pre-existing cavities, with neotropical distribution in Argentina, Bolivia, Brazil, Colombia, Guyana and French Guyana. The aim of this study was to investigate the nesting biology of P. angustifrons, discussing aspects of their life history. To capture its nests, wooden trap-nests were installed in the Parque Municipal das Araucárias, Guarapuava (PR), Brazil, from January 2003 to April 2009. A total of 29 nests were collected, all during the warmer months. These showed no vestibular and intercalary cells, and their closures were made up of chewed plants and mud mixed with organic materials and resin-coated surfaces, sometimes showing a layer of lichens. The cells were provisioned with various wild species of cockroaches (Chorisoneura sp, Riata sp and Helgaia sp) in the nymph stage and/or adults. The sex ratio was 4.6 females per male, significantly higher that the expected 1:1. Most pre-pupae entered diapause in winter with development time ranging from 187 to 283 days for females and 180 to 283 days for males. Deaths occurred in 41.66% of cells provisioned, 33.33% were attributed to faulty development and 8.33% to Chrysididae.


Assuntos
Comportamento de Nidação/fisiologia , Vespas/fisiologia , Animais , Brasil , Feminino , Estágios do Ciclo de Vida , Masculino , Estações do Ano , Árvores , Vespas/crescimento & desenvolvimento
20.
J Dev Orig Health Dis ; 2(4): 212-7, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25141165

RESUMO

There is evidence that fetal exposure to maternal stress is associated with adverse birth outcomes. Less is known about the association between fetal responses to a stressor and indicators of fetal maturity and developmental outcomes. The purpose of the present study was to determine whether fetal heart rate (FHR) patterns in response to a startling stimulus at ∼30 weeks of gestation were associated with gestational age at birth and birth weight. FHR was measured in 156 maternal-fetal dyads following a vibroacoustic stimulus. All pregnancies were singleton intrauterine pregnancies in English-speaking women who were primarily married, middle class, White and at least 18 years of age. Group-based trajectory modeling identified five groups of fetuses displaying distinctive longitudinal trajectories of FHR response to the startling stimulus. The FHR group trajectories were significantly associated with birth weight percentile (P < 0.01) even after controlling for estimated fetal weight at the time of assessment and parity, which are the known factors influencing birth weight (P < 0.01). Post hoc analyses indicated that two groups accounted for the association between FHR patterns and birth weight. The group (n = 23) with the lowest birth weight exhibited an immediate FHR deceleration followed by an immediate acceleration that does not recover. An FHR pattern characterized by immediate and fast acceleration to the peak and a slow discovery to baseline was associated with the highest birth weight. This is the first direct evidence showing that low birth weight and the resulting neurological consequences may have their origins in early fetal development.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA