RESUMO
INTRODUCTION: Forty percent of Down syndrome (DS) fetuses have congenital heart defects (CHD). An abnormal angiogenic environment has been described in euploid fetuses with CHD. However, the underlying pathophysiologic pathway that contributes to CHD in DS remains unknown. The objective was to compare the expression of angiogenic factors and chronic hypoxia genes in heart tissue from DS and euploid fetuses with and without CHD. METHODS: The gene expression profile was determined by real-time PCR quantification in heart tissue from 33 fetuses with DS, 23 euploid fetuses with CHD and 23 control fetuses. RESULTS: Angiogenic factors mRNA expression was significantly increased in the DS group compared to the controls (soluble fms-like tyrosine kinase-1, 81%, p = 0.007; vascular endothelial growth factor A, 57%, p = 0.006, and placental growth factor, 32%, p = 0.0227). Significant increases in the transcript level of hypoxia-inducible factor-2α and heme oxygenase 1 were also observed in the DS group compared to the controls. The expression of angiogenic factors was similar in DS fetuses and CHD euploid fetuses with CHD. CONCLUSION: Abnormal angiogenesis was detected in the hearts of DS fetuses with and without CHD. Our results suggest that DS determines an intrinsically angiogenic impairment that may be present in the fetal heart.
Assuntos
Proteínas Angiogênicas/metabolismo , Síndrome de Down/metabolismo , Cardiopatias Congênitas/metabolismo , Miocárdio/metabolismo , Neovascularização Patológica/economia , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Síndrome de Down/complicações , Síndrome de Down/patologia , Feminino , Perfilação da Expressão Gênica , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/patologia , Heme Oxigenase-1/genética , Heme Oxigenase-1/metabolismo , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Masculino , Fator de Crescimento Placentário/genética , Fator de Crescimento Placentário/metabolismo , RNA Mensageiro/metabolismo , Superóxido Dismutase-1/genética , Superóxido Dismutase-1/metabolismo , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/genética , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/metabolismoRESUMO
Maternal group B streptococcal infection is an uncommon entity. Herein we describe a case of a 27-year-old-woman who presented life-threateniing group B streptococcus meningitis with an ectopic cervical pregnancy. No other infectious focus have been found. To our knowledge this is the first time that this association has been reported.
Assuntos
Colo do Útero , Meningites Bacterianas/diagnóstico , Gravidez Ectópica/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae , Adulto , Colo do Útero/diagnóstico por imagem , Embolização Terapêutica , Feminino , Humanos , Meningites Bacterianas/complicações , Meningites Bacterianas/microbiologia , Metotrexato/administração & dosagem , Gravidez , Gravidez Ectópica/microbiologia , Gravidez Ectópica/terapia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/tratamento farmacológico , Ultrassonografia , Hemorragia Uterina/terapiaRESUMO
PROBLEM: To examine the associative relationship among autoantibodies, C4 levels and intrauterine hematomas (IUH) in more detail than in the studies published earlier. METHOD OF STUDY: We performed a retrospective study of 54 women with poor obstetric outcomes. Sera were screened for antinuclear antibodies (ANA), anti-DNA antibodies, antiphospholipid antibodies (aPL), and antithyroid antibodies. C4-complement and gammaglobulin levels were also monitored. We compared the main variables in IUH complicated pregnancy group with the risk pregnancy group without IUH. We also compared these variables in the IUH cases before and during IUH. RESULTS: Eight IUH were detected. The average number of spontaneous losses for these eight women was 3.3 +/- 2.1 (range: 1-8). aPL was present in 100% of cases. ANAs and hypergammaglobulinemia were present in 50% of cases and low C4 in 87.5% of cases. After comparing these variables apart from C4 before and during IUH, we found no statistical differences. However, C4 was low in four patients before IUH and in seven patients during IUH (OR: 7.0; 95% CI: 0.57-86.33). When we compared autoantibodies apart from lupus anticoagulant (LAC) between the two groups, no differences were observed. However, seven of the eight (87.5%) patients with IUH were LAC positive whereas only 24 of the 46 patients (52.1%) were positive in the non-IUH group (OR: 6.42; 95% CI: 0.73-56.41). Rapid plasma reagin was present in 8/46 in the non-IUH group (16.7%) and 5/8 in the IUH group (62.5%) P < 0.015). CONCLUSIONS: In women with poor obstetric histories, autoantibodies, especially antiphospholid antibodies, may play a role in the IUH development especially if low C4 and/or hypergammaglobulinemia are present.
Assuntos
Autoanticorpos/sangue , Complemento C4/análise , Hematoma/sangue , Hipergamaglobulinemia/sangue , Hemorragia Uterina/sangue , Adulto , Anticorpos Antinucleares/sangue , Anticorpos Antifosfolipídeos/sangue , Feminino , Humanos , Inibidor de Coagulação do Lúpus/sangue , Gravidez , Complicações na Gravidez , Estudos Retrospectivos , Estatística como AssuntoAssuntos
Fibromialgia/diagnóstico , Fibromialgia/terapia , Fibromialgia/classificação , Humanos , EspanhaRESUMO
Este documento de consenso ha sido realizado por el grupo de trabajo del Síndrome de Fatiga Crónica en Catalunya, constituido a iniciativa del Àrea Sanitària del Servei Català de Salut (Conselleria de Sanitat i Seguretat Social, Generalitat de Catalunya). Cuenta con el aval y el consenso de la Societat Catalana de Medicina Interna y de la Societat Catalana de Medicina Familiar i Comunitària. Financiado parcialmente con la ayuda CUIR-1999/SRG-279.Generalitat de Catalunya (AU)