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1.
Rev Sci Instrum ; 94(5)2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37129462

RESUMO

Accurate understanding of x-ray diagnostics is crucial for both interpreting high-energy-density experiments and testing simulations through quantitative comparisons. X-ray diagnostic models are complex. Past treatments of individual x-ray diagnostics on a case-by-case basis have hindered universal diagnostic understanding. Here, we derive a general formula for modeling the absolute response of non-focusing x-ray diagnostics, such as x-ray imagers, one-dimensional space-resolved spectrometers, and x-ray power diagnostics. The present model is useful for both data modeling and data processing. It naturally accounts for the x-ray crystal broadening. The new model verifies that standard approaches for a crystal response can be good approximations, but they can underestimate the total reflectivity and overestimate spectral resolving power by more than a factor of 2 in some cases near reflectivity edge features. We also find that a frequently used, simplified-crystal-response approximation for processing spectral data can introduce an absolute error of more than an order of magnitude and the relative spectral radiance error of a factor of 3. The present model is derived with straightforward geometric arguments. It is more general and is recommended for developing a unified picture and providing consistent treatment over multiple x-ray diagnostics. Such consistency is crucial for reliable multi-objective data analyses.

2.
Rev Sci Instrum ; 93(11): 113515, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36461442

RESUMO

The Opacity Platform on the National Ignition Facility (NIF) has been developed to measure opacities at varying densities and temperatures relevant to the solar interior and thermal cooling rates in white dwarf stars. The typical temperatures reached at NIF range between 150 and 210 eV, which allow these measurements to be performed experimentally. The captured opacities are crucial to validating radiation-hydrodynamic models that are used in astrophysics. The NIF opacity platform has a unique new capability that allows in situ measurement of the sample expansion. The sample expansion data are used to better understand the plasma conditions in our experiments by inferring the sample density throughout the duration of the laser drive. We present the details of the density measurement technique, data analysis, and recent results for Fe and MgO.

3.
Rev Sci Instrum ; 93(4): 043502, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35489931

RESUMO

Plasma density measurements are key to a wide variety of high-energy-density (HED) and laboratory astrophysics experiments. We present a creative application of photonic Doppler velocimetry (PDV) from which time- and spatially resolved electron density measurements can be made. PDV has been implemented for the first time in close proximity, ∼6 cm, to the high-intensity radiation flux produced by a z-pinch dynamic hohlraum on the Z-machine. Multiple PDV probes were incorporated into the photoionized gas cell platform. Two probes, spaced 4 mm apart, were used to assess plasma density and uniformity in the central region of the gas cell during the formation of the plasma. Electron density time histories with subnanosecond resolution were extracted from PDV measurements taken from the gas cells fielded with neon at 15 Torr. As well, a null shot with no gas fill in the cell was fielded. A major achievement was the low noise high-quality measurements made in the harsh environment produced by the mega-joules of x-ray energy emitted at the collapse of the z-pinch implosion. To evaluate time dependent radiation induced effects in the fiber optic system, two PDV noise probes were included on either side of the gas cell. The success of this alternative use of PDV demonstrates that it is a reliable, precise, and affordable new electron density diagnostic for radiation driven experiments and more generally HED experiments.

4.
Phys Rev E ; 104(3-2): 035202, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34654098

RESUMO

We report experimental and modeling results for the charge state distribution of laboratory photoionized neon plasmas in the first systematic study over nearly an order of magnitude range of ionization parameter ξ∝F/N_{e}. The range of ξ is achieved by flexibility in the experimental platform to adjust either the x-ray drive flux F at the sample or the electron number density N_{e} or both. Experimental measurements of photoionized plasma conditions over such a range of parameters enable a stringent test of atomic kinetics models used within codes that are applied to photoionized plasmas in the laboratory and astrophysics. From experimental transmission data, ion areal densities are extracted by spectroscopic analysis that is independent of atomic kinetics modeling. The measurements reveal the net result of the competition between photon-driven ionization and electron-driven recombination atomic processes as a function of ξ as it affects the charge state distribution. Results from radiation-hydrodynamics modeling calculations with detailed inline atomic kinetics modeling are compared with the experimental results. There is good agreement in the mean charge and overall qualitative similarities in the trends observed with ξ but significant quantitative differences in the fractional populations of individual ions.

5.
Phys Rev E ; 101(5-1): 051201, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32575250

RESUMO

We discuss the experimental and modeling results for the x-ray heating and temperature of laboratory photoionized plasmas. A method is used to extract the electron temperature based on the analysis of transmission spectroscopy data that is independent of atomic kinetics modeling. The results emphasized the critical role of x-ray heating and radiation cooling in determining the energy balance of the plasma. They also demonstrated the dramatic impact of photoexcitation on excited-state populations, line emissivity, and radiation cooling. Modeling calculations performed with astrophysical codes significantly overestimated the measured temperature.

6.
J Insect Sci ; 19(2)2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31222324

RESUMO

Developments in understanding bee responses to habitat loss indicate that body size is a trait with important consequences for conservation. Stingless bees (Hymenoptera, Apidae, Meliponini) are a diverse group of eusocial bees providing pollination services in tropical landscapes, exhibiting a large range in body size across species. We tested the effects of deforestation on the body sizes of stingless bee communities by using museum specimens and revisiting a previous effort that sampled stingless bee communities across varying levels of deforestation at 183 sites in Rondônia, Brazil, in 1996-1997. Body size measurements (intertegular distance) from 72 species collected were included as dependent variables in response to forest area, forest edge, and connectivity of forest patches at several spatial scales. We find that stingless bee body size is negatively related to forest cover: mean community body size was larger in areas with greater amounts of deforestation, and smaller in areas with less deforestation. Second, stingless bee species richness was positively associated with forest edge regardless of body size. Lastly, we find that as forest patch isolation increased, the stingless bee community body size also increased. These findings support hypotheses that small stingless bee species might be more negatively affected by deforestation, adding to the growing body of evidence that stingless bees require areas of intact forest in near proximity to other forest patches to conserve these diverse pollinator communities.


Assuntos
Abelhas , Tamanho Corporal , Conservação dos Recursos Naturais , Ecossistema , Animais , Brasil
7.
Rev Sci Instrum ; 86(11): 113505, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26628133

RESUMO

Temperature and density asymmetry diagnosis is critical to advance inertial confinement fusion (ICF) science. A multi-monochromatic x-ray imager (MMI) is an attractive diagnostic for this purpose. The MMI records the spectral signature from an ICF implosion core with time resolution, 2-D space resolution, and spectral resolution. While narrow-band images and 2-D space-resolved spectra from the MMI data constrain temperature and density spatial structure of the core, the accuracy of the images and spectra depends not only on the quality of the MMI data but also on the reliability of the post-processing tools. Here, we synthetically quantify the accuracy of images and spectra reconstructed from MMI data. Errors in the reconstructed images are less than a few percent when the space-resolution effect is applied to the modeled images. The errors in the reconstructed 2-D space-resolved spectra are also less than a few percent except those for the peripheral regions. Spectra reconstructed for the peripheral regions have slightly but systematically lower intensities by ∼6% due to the instrumental spatial-resolution effects. However, this does not alter the relative line ratios and widths and thus does not affect the temperature and density diagnostics. We also investigate the impact of the pinhole size variation on the extracted images and spectra. A 10% pinhole size variation could introduce spatial bias to the images and spectra of ∼10%. A correction algorithm is developed, and it successfully reduces the errors to a few percent. It is desirable to perform similar synthetic investigations to fully understand the reliability and limitations of each MMI application.

8.
Stud Health Technol Inform ; 143: 186-91, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19380934

RESUMO

The Intensive Care Unit (ICU) is a complex and dynamic tertiary care environment that requires health care providers to balance many competing tasks and responsibilities. Inefficient and interruption-driven workflow is believed to increase the likelihood of medical errors and, therefore, present a serious risk to patients in the ICU. The introduction of a Critical Care Information System (CCIS), is purported to result in fewer medical errors and better patient care by streamlining workflow. Little objective research, however, has investigated these assertions. This paper reports on the design of a research methodology to explore the impact of a CCIS on the workflow of Respiratory Therapists, Pediatric Intensivists, Nurses, and Unit Clerks in a Pediatric ICU (PICU) and a General Systems ICU (GSICU) in Northern Canada.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Unidades de Terapia Intensiva , Admissão e Escalonamento de Pessoal , Pesquisa , Humanos , Erros Médicos/prevenção & controle , Gestão da Segurança , Recursos Humanos , Carga de Trabalho
10.
J Agric Food Chem ; 49(9): 4161-7, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11559103

RESUMO

Salt and moisture content of cured salmon roe (ikura) was determined using short-wavelength-near-infrared (SW-NIR) reflectance spectroscopy (600-1100 nm). SW-NIR can be used to measure chloride species. Calibrations for salt in bulk samples of high-quality roe (R(2) = 0.904, SEP = 0.421%, RPD = 3.21) and average-quality roe (R(2) = 0.711, SEP = 1.13%, RPD = 1.81), crushed eggs (R(2) = 0.857, SEP = 0.509%, RPD = 2.62), and individual eggs (R(2) = 0.731, SEP = 0.698%, RPD = 1.98) were developed using partial least squares (PLS) regression models. The heterogeneous distribution of lipid and moisture in the individual eggs limit the sensitivity of this method; however, this method provides a rapid nondestructive method for high-value food products where destructive testing is expensive or impractical and for process control applications.


Assuntos
Ovos/análise , Salmão/metabolismo , Cloreto de Sódio/análise , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Animais , Calibragem , Contaminação de Alimentos/análise , Manipulação de Alimentos , Sensibilidade e Especificidade
11.
J Am Dent Assoc ; 132(1): 20, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11194391
12.
J Reprod Med ; 45(9): 727-32, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11027081

RESUMO

OBJECTIVE: To study the relationship between maternal smoking and preeclampsia and whether this association differs between primiparous and multiparous women. STUDY DESIGN: We conducted a population-based, retrospective, cohort study of 58,216 singleton pregnancies from northern and central Alberta, Canada, between 1995 and 1997. Multivariate logistic regression was used to control for maternal alcohol consumption, drug dependence, maternal age, maternal weight, prior intrauterine growth restriction and other confounders. RESULTS: Maternal smoking was associated with a significantly reduced overall risk of preeclampsia (adjusted odds ratio [aOR]: .61; 95% confidence interval [CI]: .50-.75; P < .01). Stratified analyses showed that in primiparous pregnancies, maternal smoking was associated with a significantly decreased risk (aOR: .63; 95% CI: .50-.80; P < .01); in multiparous women, maternal smoking was not associated with a statistically significant decreased risk of preeclampsia (aOR: 0.72; 95% CI: .51-1.02; P > .05). CONCLUSION: Maternal smoking is protective against preeclampsia. Understanding the underlying biologic mechanisms of this protective effect may advance our knowledge of the pathogenesis of preeclampsia.


Assuntos
Pré-Eclâmpsia/etiologia , Fumar , Adolescente , Adulto , Alberta/epidemiologia , Estudos de Coortes , Feminino , Humanos , Paridade , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/prevenção & controle , Gravidez , Estudos Retrospectivos , Fatores de Risco
13.
Am J Gastroenterol ; 95(4): 1021-6, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10763954

RESUMO

OBJECTIVE: Although there is general agreement that conception should be avoided when Crohn's disease is active, many questions remain unanswered for the woman with Crohn's disease in remission who becomes pregnant. METHODS: Sixty-five charts of women with Crohn's disease quiescent at the start of pregnancy were identified between January 1993 and December 1997. Each pregnancy was matched to a healthy control pregnancy by date, age, parity, smoking status, and gestational age +/- 1 wk, and comparisons were carried out using matched analyses. RESULTS: The two groups were similar in terms of maternal height, weight, and body mass index (BMI), in addition to the matched variables. The incidence of pregnancy complications was similar for most of the complications examined, whereas the incidence of poor maternal weight gain differed significantly between the groups (17/65 vs 2/65, p < 0.001). Flare-up of the Crohn's disease was seen in 13/65 (20%) of pregnancies. The greatest differences in neonatal outcomes were in terms of birth weight (3150+/-80 g vs 3500+/-60 g) and birth weight percentile (36.7%+/-.6% vs 57.5%+/-3.4%). Overall, there were 16 (24.6%) small for gestational age (SGA) births in the Crohn's group, compared with only one (1.5%) in the control group (p = 0.0007). Multivariate analysis was performed to identify factors predictive of SGA births in the Crohn's group. Ileal Crohn's disease was a statistically significant predictor (p = 0.035), whereas previous bowel resection trended toward statistical significance (p = 0.065). CONCLUSIONS: In view of the risk of low birth weight, all women with Crohn's disease who become pregnant should be followed carefully during the pregnancy, particularly those who have ileal disease or who have previously undergone bowel resection. Furthermore, smoking cessation needs to be aggressively pursued in these patients.


Assuntos
Peso ao Nascer , Doença de Crohn/diagnóstico , Complicações na Gravidez/diagnóstico , Adulto , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Fatores de Risco
14.
J Pediatr Endocrinol Metab ; 13(2): 141-8, 2000 02.
Artigo em Inglês | MEDLINE | ID: mdl-10711658

RESUMO

Leptin circulates in serum bound to high molecular weight proteins. Hypothesizing that leptin binding proteins may regulate the functional efficiency of leptin, we characterized auxologic and hormonal factors that influence leptin binding in three disparate groups: normal adolescents, obese children, and teenagers with type I diabetes mellitus (IDDM). Specific leptin binding activity (sLBA) was assessed by column chromatography after incubation of serum with 125I-leptin in the presence and absence of excess unlabeled leptin. Mean sLBA was 17.0 +/- 7% (SD) in the healthy adolescents (n=41), 6.6 +/-4.3% in the obese children (n=26), and 14.9 +/-7.3% in the diabetic teenagers (n=17). At any value of sLBA, obese children had higher serum leptin levels than non-obese adolescents or diabetic teenagers, consistent with "leptin resistance" in the obese group. sLBA was higher in males than in females only in those with diabetes (18.6 +/- 7.3 vs 10.9 +/- 5.1%, p<0.05). sLBA correlated inversely with serum insulin-like growth factor-I values in the normal group (r= -0.45, p<0.01) and with insulin in the obese children (r= -0.53, p<0.01). There was no correlation between sLBA or serum leptin values and HbA1c, in the diabetic group. The serum leptin concentration was the principal determinant explaining the total variability of sLBA in all three cohorts. However, body mass index (BMI = weight/ height2) accounted for more of the total variability of percent specific binding in the healthy adolescents than in the other groups. We conclude that sLBA reflects circulating leptin levels, body composition, and hormonal milieu. Thus, in addition to leptin, qualitative and quantitative characteristics of leptin binding may play a physiological role in the regulation of appetite and in the "leptin resistance" of obesity.


Assuntos
Diabetes Mellitus Tipo 1/sangue , Leptina/sangue , Obesidade/sangue , Adolescente , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Diabetes Mellitus Tipo 1/fisiopatologia , Feminino , Humanos , Masculino , Ligação Proteica
15.
Bone ; 26(1): 79-85, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10617160

RESUMO

Rodent models suggest that estradiol deficiency promotes bone loss through increasing interleukin-6 (IL-6) activity. However, it is controversial as to whether these findings are applicable to humans. To evaluate estradiol-mediated modulation of IL-6 activity in relation to bone metabolism in humans, we measured serum IL-6, soluble interleukin-6 receptor (sIL-6R), estradiol (E2), progesterone, luteinizing hormone, follicle-stimulating hormone, intact parathyroid hormone (PTH), serum and urine Ca, and bone biochemical markers (serum bone-specific alkaline phosphatase, osteocalcin, and serum and urine deoxypyridinoline [Dpd]) across one menstrual cycle for 211 women. Neither IL-6 nor sIL-6R levels differed between the follicular phase (FP) and the luteal phases (LP). However, IL-6 was negatively correlated with E2 during the FP (p =0.003). Furthermore, IL-6 correlated positively with serum Ca over the entire cycle (p = 0.0091. Serum Ca correlated positively with serum (p = 0.040) and urine (p = 0.006) Dpd. PTH was significantly higher during the FP than in the LP (p = 0.004). PTH was negatively related to E2 (p = 0.002), serum Ca (p < 0.001), and urine Ca (p = 0.036), whereas it was positively correlated with IL-6 (p = 0.027). These data demonstrate that IL-6 and PTH fluctuate with E2, and serum II-6 is associated with PTH levels during the menstrual cycle. However, the role of 11-6 in bone remodeling during the normal menstrual cycle remains to be determined.


Assuntos
Estradiol/sangue , Interleucina-6/sangue , Ciclo Menstrual , Hormônio Paratireóideo/sangue , Receptores de Interleucina-6/sangue , Adulto , Biomarcadores , Remodelação Óssea , Cálcio/metabolismo , Feminino , Humanos , Masculino , Solubilidade
16.
Arch Dis Child Fetal Neonatal Ed ; 81(2): F105-9, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10448177

RESUMO

AIM: To determine the correlation between gastric intramucosal pH and superior mesenteric artery (SMA) flow in newborn piglets. METHODS: Fourteen newborn piglets were randomly assigned to either a control or to an epinephrine group which received 0,1,2,4,0 microg/kg/min of epinephrine for 60 minutes, each dose. Gastric tonometry was performed, SMA flow was measured, and intramucosal pH and the ratio of tonometer pCO(2) over arterial pCO(2) (rCO(2)) were calculated. RESULTS: Intramucosal pH decreased over time in both groups, but tended to be lower in the epinephrine group. With increasing dose of epinephrine, SMA flow decreased; this in turn increased rCO(2) (p = 0.04) with a tendency to decrease intramucosal pH (p = 0.06). CONCLUSIONS: Gastric tonometry may be useful in human neonates to evaluate gut ischaemia.


Assuntos
Determinação da Acidez Gástrica , Artéria Mesentérica Superior/fisiologia , Animais , Animais Recém-Nascidos , Dióxido de Carbono/sangue , Relação Dose-Resposta a Droga , Epinefrina/farmacologia , Mucosa Gástrica/metabolismo , Concentração de Íons de Hidrogênio/efeitos dos fármacos , Artéria Mesentérica Superior/efeitos dos fármacos , Pressão Parcial , Projetos Piloto , Fluxo Sanguíneo Regional/efeitos dos fármacos , Suínos , Vasoconstritores/farmacologia
17.
Hypertension ; 34(2): 315-9, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10454460

RESUMO

Blacks appear, on average, to retain more Na than whites. A higher production rate of mineralocorticoids could explain the greater Na retention in blacks. Although production of aldosterone has been shown to be lower in blacks, the level of another mineralocorticoid may be increased. Plasma levels of deoxycorticosterone and cortisol were measured in young whites (n=23; age=16.4+/-3.1[SD] years) and young blacks (n=25; age=13.8+/-1.3 years). Blacks had lower plasma levels of renin activity and aldosterone and lower urinary aldosterone excretion rates; thus, they appeared to be representative of blacks that retain additional Na. Plasma deoxycorticosterone levels were lower in blacks than in whites both at baseline (247+/-161 versus 381+/-270 pmol/L, P=0.048) and after stimulation with adrenocorticotropic hormone (822+/-294 versus 1127+/-628 pmol/L at 30 minutes, P=0.047; 925+/-366 versus 1440+/-834 pmol/L at 60 minutes, P=0.013). Cortisol levels were also lower in blacks at baseline (P=0.014) but were not significantly different from levels in whites after stimulation with adrenocorticotropic hormone. In a larger cohort of 407 whites (age=12.0+/-2.9 years) and 247 blacks (age=12.9+/-3.1 years), 18-hydroxycortisol excretion rates were also lower in blacks (P=0. 021). In conclusion, increased Na retention in blacks does not appear to be secondary to increased production of either aldosterone, deoxycorticosterone, cortisol, or 18-hydroxycortisol. A primary renal mechanism may mediate the increase in Na reabsorption in blacks.


Assuntos
População Negra , Mineralocorticoides/sangue , População Branca , Adolescente , Adulto , Fatores Etários , Aldosterona/sangue , Aldosterona/urina , Estudos de Coortes , Interpretação Estatística de Dados , Desoxicorticosterona/sangue , Feminino , Humanos , Hidrocortisona/análogos & derivados , Hidrocortisona/sangue , Hidrocortisona/urina , Masculino , Radioimunoensaio , Renina/sangue , Sódio/metabolismo
18.
J Bone Miner Res ; 14(4): 609-15, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10234583

RESUMO

To determine if the cyclic changes of female sex hormones during the menstrual cycle are related to changes in bone formation and resorption, we measured serum bone-specific alkaline phosphatase (BAP) and osteocalcin (OC) and bone resorption markers, serum and urine deoxypyridinoline (Dpyr), three times per week during one menstrual cycle in 20 healthy premenopausal women. Serum estradiol (E2) and progesterone (P) showed characteristic cyclic fluctuations. Serum Dpyr was higher during the follicular phase (FP) than in the luteal phase (p = 0.027). Serum BAP, OC, and urine Dpyr levels did not change substantially across the cycle. Serum Dpyr correlated negatively with serum E2 values measured 6 (p = 0.011) and 8 (p = 0.001) days earlier and with P measured concurrently (p = 0.033) 2 (p = 0.002), 4 (p = 0.003), and 6 (p = 0.014) days earlier. BAP correlated negatively with E2 measured 6 days earlier (p = 0.006). We found no statistically significant correlations of E2 or P with OC or urine Dpyr within women over their cycles. BAP was positively correlated with concurrent serum Dpyr (p = 0.015) during the menstrual cycle. Serum OC levels correlated inversely with age (rs = -0.48, p = 0.036). Women with higher mean urine Dpyr levels had higher mean serum OC levels (rs = 0.49, p = 0.033) and showed a trend toward lower hip bone mineral density (rs = -0.40, p = 0.078). We conclude that the low level of E2 and/or P observed during the FP of the normal menstrual cycle is associated with increased bone resorption. These relationships suggest that normal women experience monthly episodes of increased bone resorption from menarche to menopause.


Assuntos
Reabsorção Óssea/fisiopatologia , Ciclo Menstrual/fisiologia , Adulto , Fosfatase Alcalina/sangue , Aminoácidos/sangue , Aminoácidos/urina , Biomarcadores , Densidade Óssea , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Osteocalcina/sangue , Progesterona/sangue
19.
Am J Obstet Gynecol ; 180(1 Pt 1): 207-13, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9914605

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the effect of different types of pregnancy-induced hypertension on fetal growth. STUDY DESIGN: A retrospective cohort study was conducted on the basis of 16,936 births from January 1, 1989, through December 31, 1990, by means of data from a population-based perinatal database in Suzhou, China. Pregnancy-induced hypertension was classified as gestational hypertension, preeclampsia, or severe preeclampsia-eclampsia. Univariate and multivariate regression analyses were performed to examine the effect of the various types of pregnancy-induced hypertension on gestational age, preterm birth, birth weight, low birth weight, and intrauterine growth restriction. RESULTS: Gestation was 0.6 week shorter in women with severe preeclampsia than in normotensive women (P <.01). However, the risk of preterm birth was not increased with any classification of pregnancy-induced hypertension (for severe preeclampsia: adjusted odds ratio 1.75; 95% confidence interval, 0.88-3.47). After adjustment for duration of gestation and other confounders, preeclampsia and severe preeclampsia increased the risk of intrauterine growth restriction and low birth weight. The adjusted odds ratios of low birth weight were 2.65 (1.73-4.39) for preeclampsia and 2.53 (1.19-4.93) for severe preeclampsia. However, the risk of low birth weight was not increased significantly for gestational hypertension (adjusted odds ratio 1.56 [1.00-2.41]). CONCLUSION: Preeclampsia increases the risk of intrauterine growth restriction and low birth weight.


Assuntos
Feto/fisiologia , Hipertensão/fisiopatologia , Complicações Cardiovasculares na Gravidez/fisiopatologia , Adulto , Peso ao Nascer/fisiologia , Estudos de Coortes , Eclampsia/fisiopatologia , Desenvolvimento Embrionário e Fetal/fisiologia , Feminino , Retardo do Crescimento Fetal/etiologia , Feto/anatomia & histologia , Humanos , Hipertensão/complicações , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Razão de Chances , Pré-Eclâmpsia/fisiopatologia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos
20.
Nephron ; 80(1): 79-84, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9730710

RESUMO

The assessment of the hypothalamic-pituitary-adrenal axis in patients with chronic renal failure (CRF) on hemodialysis is often hampered by abnormal responses to the standard 1-mg dexamethasone suppression test. Various mechanisms have been proposed to explain this lack of suppressibility. The present study was designed to look into the mechanisms possible for these findings in patients with CRF. We studied 6 patients with CRF on hemodialysis and 5 healthy subjects utilizing the 1-mg dexamethasone suppression test as well as the 50-mg hydrocortisone suppression test. Samples were assayed for dexamethasone, adrenocorticotropic hormone, corticosterone, and cortisol by both direct radioimmunoassay (RIA) and RIA after paper chromatography. Utilizing the direct cortisol RIA, 4 of 6 patients with CRF exhibited blunted dexamethasone suppression, while all 6 patients showed normal suppressibility after dexamethasone when cortisol was measured after paper chromatography. In contrast, all controls showed normal suppressibility regardless of the cortisol assay procedure used. The hydrocortisone suppression test was unreliable in the setting of CRF. Mean dexamethasone levels were similar in both groups. Plasma adrenocorticotropic hormone levels were significantly higher in the CRF patients, possibly indicative of an underlying hypothalamic-pituitary-adrenal axis abnormality. Abnormalities in dexamethasone suppression testing in patients with CRF may be explained by the overestimation of cortisol levels by direct RIA rather than by alteration of dexamethasone absorption or metabolism. Measurement of cortisol after paper chromatography is superior to direct RIA of cortisol in patients with CRF.


Assuntos
Hormônio Adrenocorticotrópico/sangue , Corticosterona/sangue , Dexametasona , Hidrocortisona/sangue , Falência Renal Crônica/sangue , Adulto , Cromatografia em Papel/métodos , Feminino , Glucocorticoides , Humanos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Radioimunoensaio/métodos , Diálise Renal , Reprodutibilidade dos Testes
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