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1.
Cell Mol Biol (Noisy-le-grand) ; 70(5): 275-283, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38814202

RESUMO

Sport is a multifactorial phenomenon that is influenced by many factors. Although many factors affect sports performance, genetic factors may be important issues that need to be examined. In addition, the relationship between sports performance and genes is still unclear. Due to the developments in omics technologies, approximately 185 genetic markers have been identified for the relationship between sports performance and genes. These genes are expressed differently in metabolism according to the characteristics of sports performance. The aim of this study was to investigate the relationship between sports and genetics. Pubmed, Pubmed Central and Google Scholar internet search engines were used in current study. Additionally, the PRISMA technique was used in the study design. For this purpose, COL1A1, COL5A1, ACTN3 and ELN genes may be important regulators on soft tissues. For endurance sports, genes like ACE, ACTN3, ADRB2, HFE, COL5A1, BDKRB2, NOS3, HIF, VEGF, AMPD and PPARGC1A significantly may influence performance limits. ACE and ACTN3 genes, on the other hand, may determine power/strength and speed skills in athletes. As a result, knowing the athlete's genetic predisposition to sports can be effective in achieving success.


Assuntos
Desempenho Atlético , Humanos , Desempenho Atlético/fisiologia , Actinina/genética , Actinina/metabolismo
2.
Am J Emerg Med ; 82: 117-124, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38901332

RESUMO

BACKGROUND: Imaging may inadvertently reveal pathologies unrelated to their performing purpose, known as incidental findings (IF). This study aimed to assess the prevalence, clinical significance, and documentation of IFs in chest and abdominopelvic computed tomography (CT) scans of trauma patients. METHODS: This observational study was conducted at two urban level-1 trauma centers from March 2019 through April 2022. Official radiology reports of trauma patients who underwent chest and/or abdominopelvic CT scans at the emergency department (ED) were explored, and IF were extracted. Predictive factors of the presence of IFs and their documenting were investigated. RESULTS: Out of 656 chest and 658 abdominopelvic CT scans, 167 (25.37%) and 212 (32.31%) scans harbored at least one IF, respectively. Patients with IFs tended to be of higher age and female in both chest (age: 48 [IQR: 35-62] vs. 34 [IQR: 25-42.5]; female: 31.14% vs 14.66%, p < 0.001 for both) and abdominopelvic CT scans (age: 41 [IQR: 30-57.5] vs 33 [IQR: 25-43], female: 26.42% vs. 13.96%, p < 0.001 for both). As for documentation of significant IFs, only 49 of 112 chest IFs (43.8%) and 55 of 176 abdominopelvic IFs (31.3%) were documented. Investigating factors associated with documentation of clinically significant IFs, shorter length of hospital stay (1.5 (IQR: 0-4) vs. 3 (IQR: 2-8), p = 0.003), and discharging by ED physicians (documentation rate: 13.2% vs 42.6%, p < 0.001) were associated with poorer documentation of IFs only in abdominopelvic scans. CONCLUSION: CT imaging in ED trauma patients often reveals incidental findings, especially in older patients. Over 50% of these findings are clinically significant, yet they are frequently ignored and not documented. Physicians need to be more vigilant in recognizing and documenting these incidental findings and informing patients of the need for further evaluation.


Assuntos
Achados Incidentais , Tomografia Computadorizada por Raios X , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Adulto , Prevalência , Serviço Hospitalar de Emergência/estatística & dados numéricos , Centros de Traumatologia/estatística & dados numéricos , Pelve/diagnóstico por imagem , Pelve/lesões , Radiografia Torácica/estatística & dados numéricos , Radiografia Abdominal/estatística & dados numéricos , Ferimentos e Lesões/diagnóstico por imagem , Ferimentos e Lesões/epidemiologia , Relevância Clínica
3.
Eur J Appl Physiol ; 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38951182

RESUMO

This study examined the effect of acute acetaminophen (ACTP) ingestion on physical performance during the 5 m shuttle run test (5mSRT), attention, mood states, and the perception of perceived exertion (RPE), pain (PP), recovery (PRS), and delayed onset of muscle soreness (DOMS) in well-trained female athletes. In a randomized, placebo-controlled, double-blind, crossover trial, fifteen well-trained female athletes (age 21 ± 2 years, height 165 ± 6 cm, body mass 62 ± 5 kg) swallowed either 1.5 g of ACTP or 1.5 g of placebo. The profile of mood states (POMS) and digit cancellation (DCT) were assessed 45 min postingestion, and 5mSRT was performed 60 min postingestion. The RPE and PP were determined immediately after each 30-s repetition of the 5mSRT, and the PRS and DOMS were recorded at 5 min and 24 h post-5mSRT. For the 5mSRT, ACTP ingestion improved the greatest distance (+ 10.88%, p < 0.001), total distance (+ 11.33%, p = 0.0007) and fatigue index (+ 21.43%, p = 0.0003) compared to PLA. Likewise, the DCT score was better on the ACTP (p = 0.0007) than on the PLA. RPE, PP, PRS, and DOMS scores were improved after ACTP ingestion (p < 0.01 for all comparisons) compared to PLA. POMS scores were enhanced with ACTP ingestion compared to PLA (p < 0.01). In conclusion, this study indicates that acute acetaminophen ingestion can improve repeated high intensity short-term maximal performance, attention, mood states, and perceptions of exertion, pain, recovery, and muscle soreness in well-trained female athletes, suggesting potential benefits for their overall athletic performance and mood state.

4.
Prague Med Rep ; 125(1): 15-33, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38380451

RESUMO

Endovascular treatment is widely applied as the first-line treatment for intracranial aneurysms and includes simple coiling (SC), stent-assisted coiling (SAC), flow diversion stent, and flow disruption stent. The present study is a retrospective cohort study performed in Imam Khomeini Hospital, Department of Neurovascular Intervention, between March 2016 and March 2021. A total number of 229 patients with intracranial aneurysms who underwent therapeutic intravascular interventions were enrolled, of which 89 were treated with SC, 111 with SAC, 25 with flow diversion stent, and 4 with flow disruption stent. The mean age of the subjects was 51.8±12.6 years, and 51.1% were male. Modified Raymond-Roy classification (MRRC) was used to define the occlusion outcome. The success rate, considered as Class I and Class II of MRRC at treatment time was 89% (94.4% in SC, and 84.7% in SAC), which was increased to 90.9% (94% in SC, 93% in SAC, 69.6% in flow diversion stenting, 100% in flow disruption) at 6-month follow-up, and 84.6% (80.8% in SC, 87.8% in SAC, 78.3% in flow diversion stenting, and 100% in flow disruption) at 12-month follow-up. The mean modified Rankin Scale (mRS) before the procedure was 0.05±0.26 which was increased to 0.22±0.76 after the procedure, 0.22±0.76 at 6 months, and 0.30±0.95 at 12 months (P<0.001). Similar to previous studies, the present study demonstrates that neurovascular intervention can treat ruptured aneurysms as the first therapeutic modality with favourable outcomes. A double-blind, randomized clinical trial is needed to eliminate the confounding factors and better demonstrate the outcome.


Assuntos
Embolização Terapêutica , Procedimentos Endovasculares , Aneurisma Intracraniano , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Embolização Terapêutica/métodos , Procedimentos Endovasculares/métodos , Aneurisma Intracraniano/terapia , Estudos Retrospectivos , Stents , Resultado do Tratamento
5.
J Exerc Sci Fit ; 22(2): 140-144, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38404749

RESUMO

Purpose: The performance of sodium citrate has been investigated in high-intensity exercises, but fewer studies have addressed the role of citrate in weight-bearing exercises. Methods: Twenty fitness challenge athletes, aged 24-32 years, volunteered to participate in this crossover, placebo-controlled, double-blind study. Initially, ten athletes were given a placebo and asked to complete a fitness challenge (i.e., chin-ups, squat jumps, dips, walking lunges, sit-ups, and burpees-devil press). Another ten athletes were supplemented with sodium citrate 0.5 g/kg body mass supplements 3 h prior to performing the fitness challenges. The same procedures were completed two days later with the supplement and placebo dextrose groups switched in a cross-over design. Athletes and assessors were blinded for the experimental condition (placebo vs. verum). Lactate levels were measured 5 min after exercise. The athletes' performance on each item of the fitness challenge as well as their lactate levels, were compared. Differences between the means of the measured variables were contrasted using a dependent t-test. Results: Supplementing sodium citrate substantially improved athletes' performance in all six fitness challenge items (p < 0.05, 0.69

6.
Biol Sport ; 41(2): 221-241, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38524814

RESUMO

The rise of artificial intelligence (AI) applications in healthcare provides new possibilities for personalized health management. AI-based fitness applications are becoming more common, facilitating the opportunity for individualised exercise prescription. However, the use of AI carries the risk of inadequate expert supervision, and the efficacy and validity of such applications have not been thoroughly investigated, particularly in the context of diverse health conditions. The aim of the study was to critically assess the efficacy of exercise prescriptions generated by OpenAI's Generative Pre-Trained Transformer 4 (GPT-4) model for five example patient profiles with diverse health conditions and fitness goals. Our focus was to assess the model's ability to generate exercise prescriptions based on a singular, initial interaction, akin to a typical user experience. The evaluation was conducted by leading experts in the field of exercise prescription. Five distinct scenarios were formulated, each representing a hypothetical individual with a specific health condition and fitness objective. Upon receiving details of each individual, the GPT-4 model was tasked with generating a 30-day exercise program. These AI-derived exercise programs were subsequently subjected to a thorough evaluation by experts in exercise prescription. The evaluation encompassed adherence to established principles of frequency, intensity, time, and exercise type; integration of perceived exertion levels; consideration for medication intake and the respective medical condition; and the extent of program individualization tailored to each hypothetical profile. The AI model could create general safety-conscious exercise programs for various scenarios. However, the AI-generated exercise prescriptions lacked precision in addressing individual health conditions and goals, often prioritizing excessive safety over the effectiveness of training. The AI-based approach aimed to ensure patient improvement through gradual increases in training load and intensity, but the model's potential to fine-tune its recommendations through ongoing interaction was not fully satisfying. AI technologies, in their current state, can serve as supplemental tools in exercise prescription, particularly in enhancing accessibility for individuals unable to access, often costly, professional advice. However, AI technologies are not yet recommended as a substitute for personalized, progressive, and health condition-specific prescriptions provided by healthcare and fitness professionals. Further research is needed to explore more interactive use of AI models and integration of real-time physiological feedback.

7.
Spinal Cord Ser Cases ; 10(1): 55, 2024 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-39097598

RESUMO

INTRODUCTION: Spinal cord infarction (SCI) is a rare disease representing nearly 1% of all strokes with a wide variety of symptoms at presentation. SCI diagnosis is very challenging owing to its low incidence and the variety of symptoms, and could be misdiagnosed with neuromyelitis optica spectrum disorders (NMOSD). CASE PRESENTATION: We describe the case of an 18-year-old girl who presented to the emergency department with acute neck pain and flaccid paralysis of the left upper and lower extremities. Few hours later, she developed apnea and was endotracheally intubated. Brain MRI was normal but spinal cord MRI revealed non-enhancing longitudinal abnormal high T2 signal intensity extending from C1 to C5. The patient underwent steroid therapy with methylprednisolone (1 g daily for 7 consecutive days) combined with physiotherapy. She was extubated after 3 weeks and discharged after 30 days of hospitalization with a muscle force of 4/5 in her left extremities. DISCUSSION: Idiopathic SCI in adolescence is a rare but often devastating disorder with unknown pathophysiology, however, some specific conditions in adolescent such as mechanical stresses on the immature spine can be considered as risk factors for SCI development. Early diagnosis and treatment can improve outcomes in SCI.


Assuntos
Medula Cervical , Infarto , Cervicalgia , Humanos , Feminino , Adolescente , Infarto/diagnóstico , Infarto/complicações , Infarto/diagnóstico por imagem , Medula Cervical/diagnóstico por imagem , Cervicalgia/etiologia , Paralisia/etiologia , Paralisia/diagnóstico , Metilprednisolona/uso terapêutico
8.
Arch Acad Emerg Med ; 12(1): e23, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38572220

RESUMO

Aortitis is the inflammation of the aortic wall. It can be caused by both infectious and non-infectious etiologies. Mycotic aneurysm is a rare, serious medical condition and typically requires prompt treatment with antibiotics, surgical intervention, or endovascular procedures to prevent rupture and complications. Here we reported, a 66-year-old male patient with a medical history of diabetes and hypertension, who presented to the emergency department (ED) with left-sided hemiplegia. Brain magnetic resonance imaging (MRI) revealed infarction in the right parietooccipital and left occipital lobes, demonstrating an embolic pattern. laboratory analysis revealed elevated levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC). In order to investigate the possibility of sepsis, a non-contrast chest computed tomography (CT) scan was performed, which showed a soft tissue density surrounded by gas in the posterior mediastinum; for which the rupture of esophagus and infected aorta pseudoaneurysm were among differential diagnoses. To confirm the diagnosis, CT angiography was ordered. The infected ruptured pseudo-aneurysm(s) was confirmed and patient underwent thoracotomy surgery.

9.
Front Nutr ; 11: 1390751, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39171102

RESUMO

Objective: This study aims to evaluate and predict the long-term effectiveness of five lifestyle interventions for individuals with eating disorders using machine learning techniques. Methods: This study, conducted at Dr. Irandoust's Health Center at Qazvin from August 2021 to August 2023, aimed to evaluate the effects of five lifestyle interventions on individuals with eating disorders, initially diagnosed using The Eating Disorder Diagnostic Scale (EDDS). The interventions were: (1) Counseling, exercise, and dietary regime, (2) Aerobic exercises with dietary regime, (3) Walking and dietary regime, (4) Exercise with a flexible diet, and (5) Exercises through online programs and applications. Out of 955 enrolled participants, 706 completed the study, which measured Body Fat Percentage (BFP), Waist-Hip Ratio (WHR), Fasting Blood Sugar (FBS), Low-Density Lipoprotein (LDL) Cholesterol, Total Cholesterol (CHO), Weight, and Triglycerides (TG) at baseline, during, and at the end of the intervention. Random Forest and Gradient Boosting Regressors, following feature engineering, were used to analyze the data, focusing on the interventions' long-term effectiveness on health outcomes related to eating disorders. Results: Feature engineering with Random Forest and Gradient Boosting Regressors, respectively, reached an accuracy of 85 and 89%, then 89 and 90% after dataset balancing. The interventions were ranked based on predicted effectiveness: counseling with exercise and dietary regime, aerobic exercises with dietary regime, walking with dietary regime, exercise with a flexible diet, and exercises through online programs. Conclusion: The results show that Machine Learning (ML) models effectively predicted the long-term effectiveness of lifestyle interventions. The current study suggests a significant potential for tailored health strategies. This emphasizes the most effective interventions for individuals with eating disorders. According to the results, it can also be suggested to expand demographics and geographic locations of participants, longer study duration, exploring advanced machine learning techniques, and including psychological and social adherence factors. Ultimately, these results can guide healthcare providers and policymakers in creating targeted lifestyle intervention strategies, emphasizing personalized health plans, and leveraging machine learning for predictive healthcare solutions.

10.
Sports Med Health Sci ; 6(2): 167-172, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38708329

RESUMO

Self-modeling (SM) and self-control (SC) feedback can be presented as two solutions for learning improvement. Therefore, the aim of the present study was to investigate the effects of SM and SC feedback on 100-m freestyle performance of professional swimmers and waterpolo players. 25 elite male swimmers and waterpolo players, were randomly assigned to four groups: swimmer group with SM, swimmer group with SM and SC feedback, waterpolo players group with SM, and waterpolo players group with SM and SC feedback. 100-m freestyle times and performance were recorded. SM and SC feedback for the participants were utilized at the acquisition stage. The device used included a Lenovo B570 laptop and an Exilim ZR200 canon camcorder. SM and SC feedback presented to the swimmers and waterpolo players led to improved speed and results, and the effect of presenting SM with SC feedback to swimmers had better results. In conclusion, the present study indicates that SC modeling of watching video is a suitable method for professional swimmers. Water polo trainers can also use SM and SC feedback to enhance their players' swimming technique.

11.
medRxiv ; 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38645255

RESUMO

This study challenges the conventional psycholinguistic view that the distinction between nouns and verbs is pivotal in understanding language impairments in neurological disorders. Traditional views link frontal brain region damage with verb processing deficits and posterior temporoparietal damage with noun difficulties. However, this perspective is contested by findings from patients with Alzheimer's disease (pwAD), who show impairments in both word classes despite their typical temporoparietal atrophy. Notably, pwAD tend to use semantically lighter verbs in their speech than healthy individuals. By examining English-speaking pwAD and comparing them with Persian-speaking pwAD, this research aims to demonstrate that language impairments in Alzheimer's disease (AD) stem from the distributional properties of words within a language rather than distinct neural processing networks for nouns and verbs. We propose that the primary deficit in AD language production is an overreliance on high-frequency words. English has a set of particularly high-frequency verbs that surpass most nouns in usage frequency. Since pwAD tend to use high-frequency words, the byproduct of this word distribution in the English language would be an over-usage of high-frequency verbs. In contrast, Persian features complex verbs with an overall distribution lacking extremely high-frequency verbs like those found in English. As a result, we hypothesize that Persian-speaking pwAD would not have a bias toward the overuse of high-frequency verbs. We analyzed language samples from 95 English-speaking pwAD and 91 healthy controls, along with 27 Persian-speaking pwAD and 27 healthy controls. Employing uniform automated natural language processing methods, we measured the usage rates of nouns, verbs, and word frequencies across both cohorts. Our findings showed that English-speaking pwAD use higher-frequency verbs than healthy individuals, a pattern not mirrored by Persian-speaking pwAD. Crucially, we found a significant interaction between the frequencies of verbs used by English and Persian speakers with and without AD. Moreover, regression models that treated noun and verb frequencies as separate predictors did not outperform models that considered overall word frequency alone in classifying AD. In conclusion, this study suggests that language abnormalities among English-speaking pwAD reflect the unique distributional properties of words in English rather than a universal noun-verb class distinction. Beyond offering a new understanding of language abnormalities in AD, the study highlights the critical need for further investigation across diverse languages to deepen our insight into the mechanisms of language impairments in neurological disorders.

12.
medRxiv ; 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38562858

RESUMO

INTRODUCTION: This research investigates the psycholinguistic origins of language impairments in Alzheimer's Disease (AD), questioning if these impairments result from language-specific structural disruptions or from a universal deficit in generating meaningful content. METHODS: Cross-linguistic analysis was conducted on language samples from 184 English and 52 Persian speakers, comprising both AD patients and healthy controls, to extract various language features. Furthermore, we introduced a machine learning-based metric, Language Informativeness Index (LII), to quantify informativeness. RESULTS: Indicators of AD in English were found to be highly predictive of AD in Persian, with a 92.3% classification accuracy. Additionally, we found robust correlations between the typical linguistic abnormalities of AD and language emptiness (low LII) across both languages. DISCUSSION: Findings suggest AD linguistics impairments are attributed to a core universal difficulty in generating informative messages. Our approach underscores the importance of incorporating biocultural diversity into research, fostering the development of inclusive diagnostic tools.

13.
Rev. bras. ciênc. mov ; 27(3): 139-149, jul.-set. 2019. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1016130

RESUMO

Resistance training (RT) with blood flow restriction (BFR) has been used to increase muscle strength and hypertrophy, however, the best strategy to perform BFR (continuous or intermittent) has not yet been established. The aim of this study was to analyze the chronic effect of RT with continuous or intermittent blood flow restriction (CBFR or IBFR) on muscle activation. A total of 24 men with RT experience were randomly divided into three experimental groups: low-load exercises at 20% of one repetition maximum (1RM) combined with CBFR (LL + CBFR), low-load exercises at 20% of 1RM combined with IBFR (LL + IBFR), or low-load exercises at 20% of 1RM without BFR (LL). Twelve RT sessions were performed for 6 weeks, twice a week. A comparative analysis of the activation of the biceps and triceps brachial muscles after the bench press, triceps pulley, and biceps pulley exercises did not reveal group × evaluations × sets, group × evaluations, group × sets, or evaluations × sets interactions with regard to group, evaluation, or sets (p > 0.05). However, the evaluations showed a significant increase in the LI+IBFR group after the 1st, 2nd, and 4th sets (p < 0.05) only with regard to biceps muscle activation. It was concluded that the muscle activations of the biceps and triceps are similar with regard to the bench press, triceps pulley, and biceps pulley exercises when CBFR is compared with IBFR; however, IBFR improved the muscle activation of the biceps brachial only with regard to the front pull down exercise.se....(AU)


O treinamento de força (TF) com restrição de fluxo sanguíneo (RFS) tem sido utilizado para o aumento da força e hipertrofia muscular, entretanto, ainda não foi estabelecido a melhor estratégia para realizar a RFS (contínua ou intermitente). O objetivo do estudo foi analisar o efeito crônico do TF com a RFS, contínua ou intermitente, sobre ativação muscular. Participaram do estudo 24 homens com experiência em TF que foram divididos aleatoriamente em três grupos experimentais: a) exercícios de baixa carga a 20% de 1RM combinado com a RFS contínua (BC + RFSC), b) exercícios de baixa carga a 20% de 1RM combinado com a RFS intermitente (BC + RFSI), c) exercícios de baixa carga a 20% de 1RM sem a RFS (BC). Foram realizadas 12 sessões de TF (duração de seis semanas, sendo duas vezes por semana). Na primeira e na última sessão foi avaliada a ativação muscular do bíceps e tríceps nos quatro exercícios (supino reto, puxada frontal, rosca tríceps e rosca bíceps, respectivamente). Na análise comparativa da ativação muscular do bíceps e do tríceps braquial nos exercícios: supino reto, rosca tríceps e rosca bíceps, observou-se que não existiram interações entre grupo × avaliações × séries, grupo × avaliações, grupo × séries, avaliações × séries, no grupo, nas avaliações e nas séries (p > 0,05); entretanto, nas avaliações houve aumento significativo no grupo BC+RFSI, na 1ª, 2ª e 4ª séries (p < 0,05) apenas na ativação muscular do bíceps. Conclui-se que a ativação muscular do bíceps e tríceps parecem ser semelhantes nos exercícios supino reto, rosca tríceps e rosca bíceps quando comparada a RFS contínua vs. intermitente, porém, a RFS intermitente parece melhorar a ativação muscular do bíceps braquial apenas no exercício puxada frontal....(AU)


Assuntos
Humanos , Masculino , Adolescente , Adulto , Educação Física e Treinamento , Exercício Físico , Eletromiografia , Treinamento Resistido , Oclusão Terapêutica
14.
Rev. bras. ginecol. obstet ; 36(1): 35-39, 01/2014. tab
Artigo em Inglês | LILACS | ID: lil-702023

RESUMO

OBJETIVO: O objetivo do presente estudo longitudinal foi avaliar o valor da ultrassonografia Doppler das artérias uterinas no segundo e terceiro trimestres de gestação para a predição de desfecho adverso da gravidez em mulheres de baixo risco. MÉTODOS: De julho de 2011 até agosto de 2012, 205 gestantes de feto único atendidas em nossa clínica de pré-natal foram incluídas no presente estudo prospectivo e avaliadas em termos de dados demográficos e obstétricos. As pacientes foram submetidas à avaliação de ultrassom durante o segundo e terceiro trimestres, incluindo avaliação Doppler das artérias uterinas bilaterais, visando determinar os valores do índice de pulsatilidade (IP) e do índice de resistência (IR), bem como a presença de incisura diastólica precoce. O desfecho do presente estudo foi a avaliação da sensibilidade, especificidade, valor preditivo positivo (VPP) e valor negativo preditivo (VNP) da ultrassonografia Doppler das artérias uterinas para a predição de desfechos adversos da gravidez, incluindo pré-eclâmpsia, natimortalidade, descolamento prematuro da placenta e trabalho de parto prematuro. RESULTADOS: A média de idade das gestantes foi de 26,4±5,11 anos. Os valores de IP e IR das artérias uterinas para o primeiro (IP: 1,1±0,42 versus 1,53±0,59, p=0,002; IR: 0,55±0,09 versus 0.72±0.13, p=0,000, respectivamente) e para o terceiro trimestre (IP: 0,77±0,31 versus 1,09±0,46, p=0,000; IR: 0,46±0,10 versus 0,60±0,14, p=0,010, respectivamente) foram significativamente maiores em pacientes com desfecho adverso da gravidez em relação às mulheres com desfecho normal. A combinação de IP e IR > percentil 95 e a presença de incisura bilateral apresentou sensibilidade e especificidade de ...


PURPOSE: The aim of this longitudinal study was to investigate the value of uterine artery Doppler sonography during the second and third trimesters in the prediction of adverse pregnancy outcome in low-risk women. METHODS: From July 2011 to August 2012, a total of 205 singleton pregnant women presenting at our antenatal clinic were enrolled in this prospective study and were assessed for baseline demographic and obstetric data. They underwent ultrasound evaluation at the time of second and third trimesters, both included Doppler assessment of bilateral uterine arteries to determine the values of the pulsatility index (PI) and resistance index (RI) and presence of early diastolic notch. The endpoint of this study was assessing the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasonography of the uterine artery, for the prediction of adverse pregnancy outcomes including preeclampsia, stillbirth, placental abruption and preterm labor. RESULTS: The mean age of cases was 26.4±5.11. The uterine artery PI and RI values for both second (PI: 1.1±0.42 versus 1.53±0.59, p=0.002; RI: 0.55±0.09 versus 0.72±0.13, p=0.000 respectively) and third-trimester (PI: 0.77±0.31 versus 1.09±0.46, p=0.000; RI: 0.46±0.10 versus 0.60±0.14, p=0.010 respectively) evaluations were significantly higher in patients with adverse pregnancy outcome than in normal women. Combination of PI and RI >95th percentile and presence of bilateral notch in second trimester get sensitivity and specificity of 36.1 and 97% respectively, while these measures were 57.5 and 98.2% in third trimester. CONCLUSIONS: According to our study, it seems that uterine artery Doppler may be a valuable tool for the prediction of a variety of adverse outcomes in second and third trimesters. .


Assuntos
Adulto , Feminino , Humanos , Gravidez , Fluxometria por Laser-Doppler , Resultado da Gravidez , Complicações na Gravidez , Ultrassonografia Doppler , Ultrassonografia Pré-Natal , Artéria Uterina , Estudos Longitudinais , Valor Preditivo dos Testes , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos
15.
Rev. bras. ginecol. obstet ; 35(7): 317-322, July 2013. graf, tab
Artigo em Inglês | LILACS | ID: lil-687374

RESUMO

PURPOSE: To investigate relationship between placental thickness during the second and third trimesters and placental and birth weights. METHODS: From January 2011 to June 2012, a total of 250 singleton pregnant women presented at our antenatal clinic were enrolled in this prospective study. All recruited women were assessed at the 1st trimester screening for baseline demographic and obstetric data. The placental thickness was measured trans-abdominally by placing the ultrasound transducer perpendicularly to the plane of the placenta, in the area of the cord insertion at second and third trimester. Pearson's correlation analysis was used to establish the degree of relationship between placental thickness and birth and placental weights. RESULTS: Of 250 recruited participants, 205 women were able to complete the study. The mean age of cases was 26.4±5.1. Values of mean birth and placental weights were 305.56±657.0 and 551.7±104.8 grams respectively. Ultrasonographic measures of placental thickness in second and third trimester and changes between them were 21.68±4.52, 36.26±6.46 and 14.67±5.67 mm respectively. There was a significant positive correlation between placental thickness and birth weight in the second and third trimesters (r=0.15, p=0.03; r=0.14, p=0.04 correspondingly). CONCLUSION: According to our study, birth weight has a positive relation with both second and third trimester placental thickness; however, placental thickness change could not predict low birth weight.


OBJETIVO: Investigar a relação entre espessura da placenta no segundo e terceiro trimestre e peso ao nascer e da placenta. MÉTODOS: Um total de 250 gestantes portadoras de um feto único que atenderam nossa clínica pré-natal de janeiro a junho de 2012 foram incluídas no estudo. Todas as mulheres recrutadas foram avaliadas na triagem do 1º trimestre a respeito dos dados demográficos e obstétricos basais. A espessura da placenta foi medida trans-abdominalmente colocando-se o transdutor do ultrassom perpendicular ao plano da placenta, na área de inserção do cordão, no segundo e terceiro trimestre. A análise de correlação de Pearson foi utilizada para estabelecer o grau de relação entre a espessura da placenta e o peso ao nascer e da placenta. RESULTADOS: Entre as 250 participantes recrutadas, 205 conseguiram completar o estudo. A média de idade das mulheres foi de 26,4±5,1 anos. O peso médio ao nascer e da placenta foram, respectivamente, de 305,56±657,0 e 551,7±104,8 gramas. As medidas ultrassonográficas da espessura da placenta no segundo e terceiro trimestre e as mudanças entre eles foram, respectivamente, de 21,68±4,52, 36,26±6,46 e 14,67±5,67 mm. Houve uma correlação positiva significativa entre a espessura da placenta no segundo e terceiro trimestre e o peso ao nascer (r=0.15, p=0.03; r=0.14, p=0.04). CONCLUSÃO: Com base em nosso estudo, o peso ao nascer tem correlação positiva com a espessura da placenta tanto no segundo como no terceiro semestre; entretanto, a espessura da placenta não pode predizer baixo peso ao nascer.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Adulto Jovem , Peso Fetal , Placenta/anatomia & histologia , Peso ao Nascer , Idade Gestacional , Tamanho do Órgão , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos
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