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1.
Ultrasound Obstet Gynecol ; 63(5): 586-591, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38214544

RESUMO

OBJECTIVE: Docosahexaenoic acid (DHA) is recommended routinely in pregnancy to promote fetal development. DHA has anti-inflammatory activity, but its effects on the fetal heart and circulation are unknown. This study aimed to investigate whether maternal DHA supplementation in the third trimester affects maternal prostaglandin levels and fetal ductus arteriosus flow dynamics. METHODS: This was a double-blind randomized controlled trial with parallel groups conducted between 2018 and 2021. Pregnant women aged over 18 years with a normal fetus at 27-28 weeks' gestation showing no cardiac/extracardiac anomalies or ductal constriction were eligible for the trial. Women consuming substances with a known inhibitory effect on prostaglandin metabolism, such as non-steroidal anti-inflammatory drugs and polyphenol-rich foods, were excluded. The intervention group received oral supplementation of omega-3 with 450 mg/day of DHA for 8 weeks and the placebo group received capsules of soy lecithin for 8 weeks. Anthropometric measurements, assessment of polyphenol and omega-3 consumption, fetal morphological ultrasound examination, fetal Doppler echocardiographic examination and blood sample collection were performed at the start of the study and the latter two were repeated at follow-up. Prostaglandin E2 (PGE2) level and echocardiographic parameters were compared between the intervention and placebo groups and between baseline and follow-up. RESULTS: A total of 24 participants were included in each group. After 8 weeks, there were no significant differences between the intervention and placebo groups in maternal serum PGE2 level or Doppler echocardiographic parameters of ductal flow. No case of ductus arteriosus constriction was observed. The expected intragroup changes in cardiac morphology, as a result of advancing gestation, were present. CONCLUSIONS: Maternal DHA supplementation in the third trimester at a clinically recommended dose did not result in inhibition of PGE2 or constriction of the ductus arteriosus. These findings should be confirmed in postmarket surveillance studies with larger patient numbers in order to test the full safety profile of DHA and provide robust clinical reassurance. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Suplementos Nutricionais , Ácidos Docosa-Hexaenoicos , Canal Arterial , Terceiro Trimestre da Gravidez , Ultrassonografia Pré-Natal , Humanos , Feminino , Ácidos Docosa-Hexaenoicos/administração & dosagem , Gravidez , Método Duplo-Cego , Adulto , Canal Arterial/diagnóstico por imagem , Canal Arterial/efeitos dos fármacos , Canal Arterial/embriologia , Constrição Patológica
2.
Ultrasound Obstet Gynecol ; 58(3): 420-427, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33502049

RESUMO

OBJECTIVES: To test the hypotheses that estimated mean pulmonary arterial pressure (MPAP) decreases and pulmonary vascular maturation, assessed by the ratio of pulmonary arterial flow acceleration time to ejection time (AT/ET ratio), increases after reversal of fetal ductus arteriosus constriction by reducing maternal intake of the causal agent (prostaglandin inhibitors, such as polyphenol-rich foods or non-steroidal anti-inflammatory drugs), and that these effects are independent of gestational age, which are inferences not yet demonstrated in the clinical setting. METHODS: This was a prospective cohort study comparing Doppler echocardiographic ductal flow dynamics, MPAP and pulmonary arterial flow AT/ET ratio in third-trimester fetuses (≥ 28 weeks' gestation) with ductus arteriosus constriction, at the time of diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors either by suspending the use of pharmacological agents with potential for prostaglandin inhibition or by restricting the consumption of polyphenol-rich foods. MPAP was estimated using the Dabestani equation (MPAP = 90 - (0.62 × AT)), and pulmonary vascular maturity was assessed using the AT/ET ratio, according to reported validation studies. Student's t-test was used for comparison of variables at diagnosis with those after reversal of ductal constriction. Change in MPAP and pulmonary AT/ET ratio between the two assessments was compared with the expected change in the same gestational period in normal fetuses based on reference curves of MPAP and pulmonary AT/ET ratio constructed in normal fetuses from healthy pregnant women at 19-37 weeks' gestation, encompassing the same gestational age range as the study group (28-37 weeks). RESULTS: Seventy pregnancies with fetal ductus arteriosus constriction were included in the study. After 2 weeks of reduced maternal intake of prostaglandin inhibitors, normalization of mean systolic (change from 1.86 ± 0.34 m/s at diagnosis to 1.38 ± 0.41 m/s; P < 0.001) and diastolic (change from 0.41 ± 0.11 m/s to 0.21 ± 0.065 m/s; P < 0.001) ductal velocities and of mean pulsatility index (change from 1.99 ± 0.20 to 2.55 ± 0.42; P < 0.001) was demonstrated. MPAP decreased between the assessments (change from 66.7 ± 6.90 mmHg at diagnosis to 54.5 ± 6.70 mmHg after 2 weeks; P < 0.001) and mean pulmonary AT/ET ratio increased (change from 0.20 ± 0.06 to 0.33 ± 0.07; P < 0.001). Change in MPAP between diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors was -12.2 ± 0.30 mmHg, which was 5.3-times higher than that in 305 normal fetuses over 2 weeks during the same gestational period (-2.3 ± 0.19 mmHg) (P < 0.001), and change in pulmonary AT/ET ratio between the two assessments was 0.13 ± 0.08, which was 8.7-times higher than that in normal fetuses in the same gestational period (0.015 ± 0.08) (P < 0.001). CONCLUSIONS: Resolution of fetal ductal constriction is followed by a fall in MPAP and by an increase in pulmonary vascular maturity, to a significantly greater degree than is observed in normal fetuses in the same gestational-age period. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Canal Arterial/patologia , Feto/irrigação sanguínea , Hipertensão Pulmonar/embriologia , Cuidado Pré-Natal/métodos , Adulto , Pressão Arterial , Velocidade do Fluxo Sanguíneo , Constrição Patológica/induzido quimicamente , Constrição Patológica/embriologia , Canal Arterial/efeitos dos fármacos , Canal Arterial/embriologia , Ecocardiografia Doppler , Feminino , Desenvolvimento Fetal/efeitos dos fármacos , Feto/embriologia , Idade Gestacional , Humanos , Hipertensão Pulmonar/etiologia , Polifenóis/efeitos adversos , Gravidez , Estudos Prospectivos , Antagonistas de Prostaglandina/efeitos adversos , Artéria Pulmonar/embriologia , Artéria Pulmonar/crescimento & desenvolvimento , Artéria Pulmonar/fisiopatologia , Fluxo Pulsátil , Volume Sistólico , Ultrassonografia Pré-Natal
3.
Ultrasound Obstet Gynecol ; 52(5): 617-622, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29205592

RESUMO

OBJECTIVE: Anti-inflammatory substances that inhibit the synthesis of prostaglandins, such as non-steroidal anti-inflammatory drugs (NSAIDs) and polyphenol-rich foods, can cause constriction of the fetal ductus arteriosus. This study aimed to test the hypothesis that reversal of fetal ductal constriction after maternal restriction of polyphenol-rich foods, in the third trimester of pregnancy, is accompanied by increased plasma levels of prostaglandin E2 (PGE2). METHODS: This was a controlled clinical trial of women with singleton pregnancy ≥ 28 weeks undergoing fetal echocardiography. The intervention group included pregnancies with diagnosis of fetal ductal constriction and not exposed to NSAIDs. The control group consisted of third-trimester normal pregnancies. Both groups answered a food frequency questionnaire to assess the amount of total polyphenols in their diet, underwent Doppler echocardiographic examination and had blood samples collected for analysis of plasma levels of PGE2. Intervention group participants received dietary guidance to restrict the intake of polyphenol-rich foods. The assessments were repeated after 2 weeks in both groups. RESULTS: Forty normal pregnancies were assessed in the control group and 35 with fetal ductal constriction in the intervention group. Mean maternal age (26.6 years) and mean body mass index (30.12 kg/m2 ) were similar between the two groups. Intragroup analysis showed that dietary guidance reduced the median consumption of polyphenols (from 1234.82 to 21.03 mg/day, P < 0.001), increasing significantly the plasma concentration of PGE2 (from 1091.80 to 1136.98 pg/mL, P < 0.05) in the intervention group after 2 weeks. In addition, Doppler echocardiography showed reversal of fetal ductal constriction in the intervention group. No significant changes were observed in the control group. CONCLUSIONS: Dietary intervention for maternal restriction of polyphenol-rich foods in the third trimester of pregnancy is accompanied by increase in plasma levels of PGE2 and reversal of fetal ductal constriction. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Dieta , Dinoprostona/sangue , Permeabilidade do Canal Arterial/diagnóstico por imagem , Polifenóis/administração & dosagem , Adulto , Velocidade do Fluxo Sanguíneo , Estudos de Casos e Controles , Permeabilidade do Canal Arterial/sangue , Permeabilidade do Canal Arterial/fisiopatologia , Feminino , Humanos , Gravidez , Terceiro Trimestre da Gravidez , Ultrassonografia Pré-Natal
4.
Artigo em Inglês | MEDLINE | ID: mdl-28408067

RESUMO

Anti-inflammatory property of polyphenols and their effect on the metabolism of prostaglandins is not established in healthy humans. This study aimed to evaluate the effect of polyphenol supplementation in plasma levels of prostaglandin E2 and other markers of inflammation and oxidative stress in women using contraceptives. In this randomized double-blind clinical trial, women aged 25-35 years were selected. Participants received capsules containing polyphenols or placebo, to be consumed for fifteen days. From 40 women randomized, 28 completed the study. Control group showed a significant increase in the levels of PGE2 (p=0.01) while the polyphenols group showed no change in these levels (p=0.79). There was an increase in hs-CRP (p<0.01) and F2-isoprostane (p=0.04) in the control group. The GSSG to GSH ratio significantly reduced in the polyphenols group (p=0.02). Supplementation with polyphenol capsules inhibited the increase in markers of inflammation and oxidative stress in women of childbearing age using combined hormonal contraceptives.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Estresse Oxidativo/efeitos dos fármacos , Polifenóis/administração & dosagem , Prostaglandinas E/sangue , Adulto , Anti-Inflamatórios não Esteroides/farmacologia , Cápsulas , Anticoncepção , Suplementos Nutricionais , Método Duplo-Cego , F2-Isoprostanos/sangue , Feminino , Humanos , Polifenóis/farmacologia , Reprodução
5.
J Perinatol ; 32(8): 574-9, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22052330

RESUMO

OBJECTIVE: To test the hypothesis that maternal restriction of polyphenol-rich foods (PRF), which, like non-steroidal anti-inflammatory drugs (NSAID), inhibit prostaglandin synthesis in the third trimester, reverse fetal ductal constriction (DC). STUDY DESIGN: An open clinical trial of 51 third trimester fetuses with DC with no history of NSAID intake was designed. All mothers were submitted to a food frequency questionnaire and were oriented to withdrawl PRF, being reassessed after 3 weeks. Doppler parameters were assessed before and after discontinuation of these substances. A control group of 26 third trimester normal fetuses, with no ductus arteriosus (DA) constriction, in which no dietary intervention was offered, was reviewed after 3 weeks. Student's t-test and Wilcoxon's test were used. RESULT: Mean gestational age was 32±3 weeks (28 to 37 weeks). After discontinuation of PRF (≥3 weeks), 48/51 fetuses (96%) showed complete reversal of DC, with decrease in mean ductal systolic velocity (1.74±0.20 m s(-1) to 1.31±0.34 m s(-1), P<0.001), mean diastolic velocity (0.33±0.09 m s(-1) to 0.21±0.07 m s(-1), P<0.001) and mean right to left ventricular dimension ratio (1.37±0.26 to 1.12±0.17, P<0.001) and increase in mean ductal pulsatility index (PI) (1.98±0.36 to 2.46±0.23, P<0.001). Median daily maternal consumption of PRF was 286 mg per day and decreased after orientation to 0 mg per day, P<0.001. In the control group, with GA of 32±4 w (29-37 w), there was no significant differences in median daily maternal consumption of PRF, mean ductal systolic velocitiy, diastolic velocity, PI and right ventricular to left ventricular diameter ratio (RV/LV) ratio. CONCLUSION: Reduction of maternal PRF intake during pregnancy, especially in the third trimester, is followed by complete reversal of DC (wide open DA), which may influence maternal dietary habits in late pregnancy.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Canal Arterial/efeitos dos fármacos , Coração Fetal/efeitos dos fármacos , Polifenóis/farmacologia , Adolescente , Adulto , Velocidade do Fluxo Sanguíneo , Constrição Patológica , Canal Arterial/diagnóstico por imagem , Canal Arterial/patologia , Feminino , Coração Fetal/diagnóstico por imagem , Humanos , Gravidez , Complicações na Gravidez , Terceiro Trimestre da Gravidez , Inquéritos e Questionários , Ultrassonografia Pré-Natal , Adulto Jovem
6.
J Perinatol ; 30(1): 17-21, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19641513

RESUMO

OBJECTIVE: To test the hypothesis that maternal consumption of polyphenol-rich foods during third trimester interferes with fetal ductal dynamics by inhibition of prostaglandin synthesis. STUDY DESIGN: In a prospective analysis, Doppler ductal velocities and right-to-left ventricular dimensions ratio of 102 fetuses exposed to polyphenol-rich foods (daily estimated maternal consumption >75th percentile, or 1089 mg) were compared with 41 unexposed fetuses (flavonoid ingestion <25th percentile, or 127 mg). RESULT: In the exposed fetuses, ductal velocities were higher (systolic: 0.96+/-0.23 m/s; diastolic: 0.17+/-0.05 m/s) and right-to-left ventricular ratio was higher (1.23+/-0.23) than in unexposed fetuses (systolic: 0.61+/-0.18 m/s, P<0.001; diastolic: 0.11+/-0.04 m/s, P=0.011; right-to-left ventricular ratio: 0.94+/-0.14, P<0.001). CONCLUSION: As maternal polyphenol-rich foods intake in late gestation may trigger alterations in fetal ductal dynamics, changes in perinatal dietary orientation are warranted.


Assuntos
Velocidade do Fluxo Sanguíneo , Canal Arterial/diagnóstico por imagem , Comportamento Alimentar , Flavonoides/metabolismo , Fenóis/metabolismo , Terceiro Trimestre da Gravidez , Ultrassonografia Pré-Natal , Adolescente , Adulto , Registros de Dieta , Canal Arterial/fisiologia , Ecocardiografia Doppler , Feminino , Humanos , Polifenóis , Gravidez , Estudos Prospectivos , Adulto Jovem
7.
Braz. j. med. biol. res ; 37(1): 31-36, Jan. 2004. ilus
Artigo em Inglês | LILACS | ID: lil-352098

RESUMO

Alternative methods to assess ventricular diastolic function in the fetus are proposed. Fetal myocardial hypertrophy in maternal diabetes was used as a model of decreased left ventricular compliance (LVC), and fetal respiratory movements as a model of increased LVC. Comparison of three groups of fetuses showed that, in 10 fetuses of diabetic mothers (FDM) with septal hypertrophy (SH), the mean excursion index of the septum primum (EISP) (ratio between the linear excursion of the flap valve and the left atrial diameter) was 0.36 ± 0.09, in 8 FDM without SH it was 0.51 ± 0.09 (P = 0.001), and in the 8 normal control fetuses (NCF) it was 0.49 ± 0.12 (P = 0.003). In another study, 28 fetuses in apnea had a mean EISP of 0.39 ± 0.05 which increased to 0.57 ± 0.07 during respiration (P < 0.001). These two studies showed that the mobility of the septum primum was reduced when LVC was decreased and was increased when LVC was enhanced. Mean pulmonary vein pulsatility was higher in 14 FDM (1.83 ± 1.21) than in 26 NCF (1.02 ± 0.31; P = 0.02). In the same fetuses, mean left atrial shortening was decreased (0.40 ± 0.11) in relation to NCF (0.51 ± 0.09; P = 0.011). These results suggest that FDM may have a higher preload than normal controls, probably as a result of increased myocardial mass and LV hypertrophy. Prenatal assessment of LV diastolic function by fetal echocardiography should include analysis of septum primum mobility, pulmonary vein pulsatility, and left atrial shortening.


Assuntos
Humanos , Feminino , Gravidez , Cardiomiopatia Hipertrófica , Coração Fetal , Complicações Cardiovasculares na Gravidez , Gravidez em Diabéticas , Disfunção Ventricular Esquerda , Cardiomiopatia Hipertrófica , Estudos de Casos e Controles , Estudos Transversais , Ecocardiografia Doppler , Complicações Cardiovasculares na Gravidez , Gravidez em Diabéticas , Veias Pulmonares , Reprodutibilidade dos Testes , Ultrassonografia Pré-Natal , Disfunção Ventricular Esquerda
8.
Arq Bras Cardiol ; 75(1): 65-8, 2000 Jul.
Artigo em Inglês, Português | MEDLINE | ID: mdl-10983021

RESUMO

This is the report of a case of fetal tachyarrhythmia with 1:1 atrioventricular conduction detected by pre-natal echocardiography in a fetus at 25-weeks gestation. Adenosine infusion via cordocentesis was performed as a diagnostic test to differentiate between atrioventricular nodal reentrant supraventricular tachyarrhythmia and atrial flutter. After infusion, transient 2:1 atrioventricular dissociation was obtained and the diagnosis of atrial flutter was made. Transplacental therapy with digoxin and amiodarone was then successfully used.


Assuntos
Adenosina , Antiarrítmicos , Doenças Fetais/diagnóstico por imagem , Taquicardia Supraventricular/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Adenosina/administração & dosagem , Adulto , Antiarrítmicos/administração & dosagem , Digoxina/administração & dosagem , Feminino , Doenças Fetais/tratamento farmacológico , Humanos , Injeções Intravenosas , Gravidez , Taquicardia Supraventricular/tratamento farmacológico , Veias Umbilicais
9.
Am J Cardiol ; 85(10): 1230-3, 2000 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-10802006

RESUMO

Prenatal alleviation of severe fetal aortic valve obstructions by percutaneous ultrasound-guided balloon valvuloplasty has been performed to improve the fate of affected fetuses. The purpose of this study was to analyze the current world experience of these procedures in human fetuses. Data from 12 human fetuses were available for analysis. The mean gestational age at intervention was 29.2 weeks (range 27 to 33). The mean time period between initial presentation and intervention was 3.3 weeks (range 3 days to 9 weeks). Technically successful balloon valvuloplasties were achieved in 7 fetuses, none of whom had an atretic valve. Only 1 of these fetuses remains alive today. Of the 5 remaining technical failures, 1 patient with severe aortic stenosis underwent successful postnatal intervention and remains alive. Six patients who survived prenatal intervention died from cardiac dysfunction or at surgery in the first days or weeks after delivery. Four fetuses died early within 24 hours after the procedure, 1 from a bleeding complication, 2 from persistent bradycardias, and 1 at valvotomy after emergency delivery. Thus, the early clinical experience of percutaneous ultrasound-guided fetal balloon valvuloplasty in human fetuses with severe aortic valve obstruction has been poor due to selection of severe cases, technical problems during the procedure, and high postnatal operative mortality in fetuses who survived gestation. Improved patient selection and technical modifications in interventional methods may hold promise to improve outcome in future cases.


Assuntos
Estenose da Valva Aórtica/terapia , Valva Aórtica/anormalidades , Cateterismo/métodos , Feto/cirurgia , Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/diagnóstico por imagem , Morte Fetal , Idade Gestacional , Humanos , Mortalidade Infantil , Recém-Nascido , Estudos Retrospectivos , Falha de Tratamento , Ultrassonografia Pré-Natal
10.
Arq Bras Cardiol ; 71(1): 65-7, 1998 Jul.
Artigo em Português | MEDLINE | ID: mdl-9755537

RESUMO

Aneurysm of the arterial duct is an infrequent finding, which is very rarely detected prenatally. A case of antenatal diagnosis in a pregnant patient (33 weeks) is reported. The fetus presented an aneurysmatic dilation of the arterial duct with uniformly enlarged diameter, inserting into the descending aorta, which was interrupted. The neonate was born by cesarean section and was kept on postaglandins till the 9th day of life, when he was sent to surgery. During the surgical procedure, the baby died as a result of biventricular failure. This is the first report of prenatal association of aneurysm of the ducts anteriosus with other cardiovascular malformations and emphasizes that this finding does not always have a benign course.


Assuntos
Aorta Torácica/anormalidades , Aneurisma da Aorta Torácica/complicações , Permeabilidade do Canal Arterial/complicações , Adulto , Aneurisma da Aorta Torácica/diagnóstico por imagem , Canal Arterial/diagnóstico por imagem , Feminino , Humanos , Gravidez , Diagnóstico Pré-Natal , Ultrassonografia
11.
Arq. bras. cardiol ; 71(1): 65-7, jul. 1998. ilus
Artigo em Português | LILACS | ID: lil-234391

RESUMO

É relatado um caso de aneurisma de ducto arterioso, com diagnóstico pré-natal, o que é muito raro, numa gestante com 33 semanas, onde o feto apresentou um adilatação aneursimática do canal arterial, com calibre uniformemente aumentado, inserindo-se na aorta descendente, associado à interrupção do arco aórtico. A criança nasceu de parto cesáreo e manteve-se estável com o uso de prostaglandina até o 9§ dia de vida, quando foi levada à cirurgia, tendo falecido durante o procedimento por falência biventricular. Este é o primeiro relato da associação desta anomalia com outra malformação cardiovascular intra-uterina, mostrando que este achado nem sempre é associado a uma evolução benigna.


Assuntos
Humanos , Feminino , Adulto , Recém-Nascido , Gravidez , Aneurisma Aórtico/cirurgia , Aneurisma Aórtico/complicações , Ecocardiografia , Evolução Fatal , Fatores de Tempo
12.
Arq. bras. cardiol ; 69(6): 389-94, dez. 1997. ilus, tab
Artigo em Português | LILACS | ID: lil-234371

RESUMO

OBJETIVO - Testar a hipótese de associação entre hipertrofia miocárdica e níveis aumentados de insulina no soro de filhos de mães diabéticas, além de determinar a freqüência de regressão espontânea e o momento de sua ocorrência. MÉTODOS - Foram estudados 72 pacientes (54 filhos de mães diabéticas e 18 controles). O diagnóstico de hipertrofia miocárdica foi realizado por ecocardigrafia pré-natal, uni e bidimensional. Os registros da insulina amniótica foram obtidos de um estudo pré-natal prévio sobre hipertrofia miocárdica, pois a participação das gestantes era comum aos dois projetos. RESULTADOS - Houve 10 (18,52 'por cento') casos de hipertrofia miocárdica entre os filhos de mães diabéticas. As medidas do septo foram significamente diferentes entre os grupos (filhos de mães diabéticas e controles) na avaliação com 1 mês (p=0,04). A insulina manteve-se elevada nos filhos de diabéticas até 3 meses de idade, período em que era significantemente diferente em relação aos controles (p=0,003 e p =0,001, com 1 mês e 3 meses, respectivamente). A associação entre a regressão do septo interventricular e a regressão dos níveis de insulina ocorreu até 1 mês de idade. CONCLUSÄO - Houve regressão espontânea das medidas do septo interventricular até 6 meses de idade e a associação entre hiperinsulinismo e hipertrofia miocárdica esteve presente até 1 mês de idade.


Assuntos
Humanos , Masculino , Recém-Nascido , Diabetes Mellitus , Cardiomegalia/fisiopatologia , Hiperinsulinismo , Feto , Hiperplasia , Mães , Prevalência
13.
Arq. bras. cardiol ; 69(4): 231-6, out. 1997. tab, graf
Artigo em Português | LILACS | ID: lil-234348

RESUMO

OBJETIVO - Obter um perfil dos fatores de risco coronário em uma amostra populacional pediátrica da cidade de Bento Gonçalves, RS, no período de maio/90 a junho/91. MÉTODOS - Foram estudados 1501 escolares de 6 a 16 anos incompletos, visando a detecção dos níveis séricos de colesterol total, lipoproteínas, triglicérides, bem como a avaliação da pressão arterial e da história familiar de doença cardiovascular isquêmica e obesidade. RESULTADOS - Foram detectadas 420 (27,98 'por cento') crianças com hipercolesterolemia, sendo que 75 (5 'por cento') apresentavam hipetensão arterial sistólica e 48 (3,20 'por cento') hipertensão arterial diastólica. A história familiar foi importante quando positiva, porém, sua ausência não excluia a presença de fatores de risco para a aterosclerose. A hipertrigliceridemia foi encontrada em 136 (9,06 'por cento') escolares e a LDL-colesterol elevada em 155 (10,33 'por cento'), mostrando forte associação com hipercolesterolemia. Apresentaram índice de massa corporal acima de percentil 95, não mostrando uma maior prevalência de hipercolesterolemia, 111 crianças. CONCLUSÄO - Os fatores de risco para a aterosclerose estão presentes na infância e deveriam ser pesquisados independentemente do nível socioeconômico, da história familiar, da idade e do sexo, devendo o pediatra ser um dos responsáveis por esta investigação.


Assuntos
Humanos , Criança , Adulto , Adolescente , Doença da Artéria Coronariana , Hipercolesterolemia , Aumento de Peso , Índice de Massa Corporal , Prevalência , Fatores de Risco , Fumar
14.
Arq. bras. cardiol ; 66(2): 83-86, fev. 1996.
Artigo em Português | LILACS | ID: lil-165721

RESUMO

A possibilidade de detectar e tratar alteraçöes do ritmo cardíaco durante a vida intra-uterina constituiu-se num dos grandes avanços da cardiologia fetal. Embora a situaçäo clínica mais frequente seja a observaçäo de arritmias benignas, como as extra-sístoles supraventriculares e mesmo ventriculares, que näo exigem tratamento específico além da silmples monitorizaçäo ecocardiográfica periódicas, os distúrbios graves do ritmo cardíaco fetal, como a taquicardia atrial paroxística, o flutter atrial, aaquicardia ventricular e bloqueio atrioventricular total (BAVT) säo facilmente diagnosticados. Nestes casos, a frequente presença de hidropisia näo imune, como manifestaçäo de insuficiência cardíaca fetal, indica a necessidade de terapêutica urgente, devido à alta mortalidade que os caracteriza quando näo tratados. O manejo dos distúrbios do ritmo fetal exige adequado ambiente hospitalar, que possibilite monitorizar a mäe e o feto simultaneamente, e que tenha condiçöes de permitir a realizaçäo de procedmntos fetais invasivos sob visäo ecocardiográfica e de parto vaginal ou operatório, além de dispor de unidade de terapia intensiva neonatal para os casos mais graves.


Assuntos
Feto , Frequência Cardíaca
15.
Arq Bras Cardiol ; 58(5): 383-5, 1992 May.
Artigo em Português | MEDLINE | ID: mdl-1340713

RESUMO

A 16 month-old baby submitted to systemic-pulmonary shunt with a polytetrafluorethylene prosthesis, who presented hyperthermia, radiologic signs of pulmonary opacifications and positive culture for staphylococcus aureus. Reoperation disclosed a prosthesis pseudoaneurysm, with disconnection of the anastomosis and evidences of infection. This complication has a low diagnostic rate and a high mortality and should always be suspected when signs of systemic infection become apparent in the postoperative period of polytetrafluorethylene systemic-pulmonary shunt.


Assuntos
Infecções Relacionadas à Prótese/etiologia , Infecções Estafilocócicas/complicações , Feminino , Humanos , Lactente , Politetrafluoretileno , Reoperação
16.
J. pediatr. (Rio J.) ; 57(4): 361-4, 1984.
Artigo em Português | LILACS | ID: lil-23517

RESUMO

Os autores revisam os aspectos etiopatogenicos, clinicos, de investigacao e de terapeutica da doenca de Kawasaki, com enfase especial no envolvimento cardiovascular e na sua abordagem cardiologica


Assuntos
Humanos , Cardiopatias , Síndrome de Linfonodos Mucocutâneos
17.
Rev. imagem ; 6(4): 167-72, 1984.
Artigo em Português | LILACS | ID: lil-26013

RESUMO

Os autores apresentam revisao dos sinais radiologicos convencionais mais frequentes na dupla via de saida do ventriculo direito, na conexao atrio-ventricular e na drenagem venosa pulmonar anomala total, enfatizando as diferencas observadas nos diversos subgrupos morfo-funcionais de cada uma dessas cardiopatias


Assuntos
Estenose da Valva Pulmonar , Radiografia , Tetralogia de Fallot , Transposição dos Grandes Vasos
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