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1.
Clin Chem Lab Med ; 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31469650

RESUMO

Background Non-small cell lung cancer (NSCLC) patients benefit from targeted therapies both in first- and second-line treatment. Nevertheless, molecular profiling of lung cancer tumors after first disease progression is seldom performed. The analysis of circulating tumor DNA (ctDNA) enables not only non-invasive biomarker testing but also monitoring tumor response to treatment. Digital PCR (dPCR), although a robust approach, only enables the analysis of a limited number of mutations. Next-generation sequencing (NGS), on the other hand, enables the analysis of significantly greater numbers of mutations. Methods A total of 54 circulating free DNA (cfDNA) samples from 52 NSCLC patients and two healthy donors were analyzed by NGS using the Oncomine™ Lung cfDNA Assay kit and dPCR. Results Lin's concordance correlation coefficient and Pearson's correlation coefficient between mutant allele frequencies (MAFs) assessed by NGS and dPCR revealed a positive and linear relationship between the two data sets (ρc = 0.986; 95% confidence interval [CI] = 0.975-0.991; r = 0.987; p < 0.0001, respectively), indicating an excellent concordance between both measurements. Similarly, the agreement between NGS and dPCR for the detection of the resistance mutation p.T790M was almost perfect (K = 0.81; 95% CI = 0.62-0.99), with an excellent correlation in terms of MAFs (ρc = 0.991; 95% CI = 0.981-0.992 and Pearson's r = 0.998; p < 0.0001). Importantly, cfDNA sequencing was successful using as low as 10 ng cfDNA input. Conclusions MAFs assessed by NGS were highly correlated with MAFs assessed by dPCR, demonstrating that NGS is a robust technique for ctDNA quantification using clinical samples, thereby allowing for dynamic genomic surveillance in the era of precision medicine.

2.
Reumatol. clín. (Barc.) ; 15(2): 102-108, mar.-abr. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: ibc-ET1-3371

RESUMO

Objectives: To describe the prevalence of comorbidities in patients with RA in Spain and discuss their management and implications using data from the Spanish cohort of the multinational study on COMOrbidities in Rheumatoid Arthritis (COMORA). Methods: This is a national sub-analysis of the COMORA study. We studied the demographics and disease characteristics of 200 adults patients diagnosed with RA (1987 ACR), and routine practices for screening and preventing the following selected comorbidities: cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and depression. Results: Patients had a mean age of 58 years and a mean RA duration of 10 years. Mean DAS28 score was 3.3 and approximately 25% of patients were in remission (DAS28 <2.6). Forty-four (22%) patients had ≥1 comorbidity, the most frequent being depression (27%) and obesity (26%). A history of myocardial infarction or stroke was observed in 5% and 1% of patients, respectively, and any solid tumor in 6%. Having a Framingham Risk Score >20% (51%), hypercholesterolemia (46%) or hypertension (41%) and smoking (25%) were the most common CV risk factors. For prostate, colon and skin cancers, only 9%, 10% and 18% of patients, respectively, were optimally monitored. Infections were also inadequately managed, with 7% and 17% of patients vaccinated against influenza and pneumococcal, respectively, as was osteoporosis, with 47% of patients supplemented with vitamin D and 56% with a bone densitometry performed. Conclusions: In Spain, the prevalence of comorbidities and CV risk factors in RA patients with established and advanced disease is relatively high, and their management in clinical daily practice remains suboptimal


Objetivos: Describir la prevalencia de comorbilidades en pacientes con AR en España y discutir sobre su manejo en la clínica diaria utilizando los datos de la cohorte española del estudio internacional COMORA. Métodos: Subanálisis nacional del estudio COMORA en el que se analizaron las características demográficas y clínicas de 200 pacientes con AR (1987 ACR) y las prácticas rutinarias para el cribado y la prevención de eventos cardiovasculares (CV), gastrointestinales y pulmonares, infecciones, cáncer, osteoporosis y depresión. Resultados: Los pacientes tenían una edad media de 58 años, una duración media de la enfermedad de 10 años, un DAS28 de 3,3 y el 25% estaba en remisión (DAS28 <2,6). El 22% de los pacientes presentaba al menos una comorbilidad, principalmente depresión (27%) y obesidad (26%). El 5% tenía historia de infarto de miocardio, el 1% de ictus y el 6% de tumor sólido. Una puntuación de Framingham >20% (51%), tener hipercolesterolemia (46%), hipertensión (41%) y fumar (25%) fueron los factores de riesgo CV más comunes. En relación con el cáncer de próstata, colon y piel, solo el 9, 10 y el 18% de los pacientes, respectivamente, estaban óptimamente controlados. Las infecciones tampoco se manejaban de forma óptima, con solo el 7 y el 17% de los pacientes vacunados contra la influenza y neumococo, respectivamente, al igual que la osteoporosis, con el 47% suplementados con la vitamina D y el 56% con una densitometría realizada. Conclusiones: En España, la prevalencia de comorbilidades y factores de riesgo CV en pacientes con AR establecida y avanzada es relativamente alta, y su manejo en la clínica diaria continúa siendo subóptimo

3.
Free Radic Biol Med ; 135: 167-181, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30880247

RESUMO

BACKGROUND: Platinum-based chemotherapy remains the standard of care for most lung cancer cases. However chemoresistance is often developed during the treatment, limiting clinical utility of this drug. Recently, the ability of tumor cells to adapt their metabolism has been associated to resistance to therapies. In this study, we first described the metabolic reprogramming of Non-Small Cell Lung Cancer (NSCLC) in response to cisplatin treatment. METHODS: Cisplatin-resistant versions of the A549, H1299, and H460 cell lines were generated by continuous drug exposure. The long-term metabolic changes, as well as, the early response to cisplatin treatment were analyzed in both, parental and cisplatin-resistant cell lines. In addition, four Patient-derived xenograft models treated with cisplatin along with paired pre- and post-treatment biopsies from patients were studied. Furthermore, metabolic targeting of these changes in cell lines was performed downregulating PGC-1α expression through siRNA or using OXPHOS inhibitors (metformin and rotenone). RESULTS: Two out of three cisplatin-resistant cell lines showed a stable increase in mitochondrial function, PGC1-α and mitochondrial mass with reduced glycolisis, that did not affect the cell cycle. This phenomenon was confirmed in vivo. Post-treatment NSCLC tumors showed an increase in mitochondrial mass, PGC-1α, and a decrease in the GAPDH/MT-CO1 ratio. In addition, we demonstrated how a ROS-mediated metabolism reprogramming, involving PGC-1α and increased mitochondrial mass, is induced during short-time cisplatin exposure. Moreover, we tested how cells with increased PGC-1a induced by ZLN005 treatment, showed reduced cisplatin-driven apoptosis. Remarkably, the long-term metabolic changes, as well as the metabolic reprogramming during short-time cisplatin exposure can be exploited as an Achilles' heel of NSCLC cells, as demonstrated by the increased sensitivity to PGC-1α interference or OXPHOS inhibition using metformin or rotenone. CONCLUSION: These results describe a new cisplatin resistance mechanism in NSCLC based on a metabolic reprogramming that is therapeutically exploitable through PGC-1α downregulation or OXPHOS inhibitors.

4.
Free Radic Biol Med ; 130: 163-173, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30391585

RESUMO

Lung cancer is a major public health problem due to its high incidence and mortality rate. The altered metabolism in lung cancer is key for the diagnosis and has implications on both, the prognosis and the response to treatments. Although Cancer-associated fibroblasts (CAFs) are one of the major components of the tumor microenvironment, little is known about their role in lung cancer metabolism. We studied tumor biopsies from a cohort of 12 stage IIIA lung adenocarcinoma patients and saw a positive correlation between the grade of fibrosis and the glycolysis phenotype (Low PGC-1α and High GAPDH/MT-CO1 ratio mRNA levels). These results were confirmed and extended to other metabolism-related genes through the in silico data analysis from 73 stage IIIA lung adenocarcinoma patients available in TCGA. Interestingly, these relationships are not observed with the CAFs marker α-SMA in both cohorts. To characterize the mechanism, in vitro co-culture studies were carried out using two NSCLC cell lines (A549 and H1299 cells) and two different fibroblast cell lines. Our results confirm that a metabolic reprogramming involving ROS and TGF-ß signaling occurs in lung cancer cells and fibroblasts independently of α-SMA induction. Under co-culture conditions, Cancer-Associated fibroblasts increase their glycolytic ability. On the other hand, tumor cells increase their mitochondrial function. Moreover, the differential capability among tumor cells to induce this metabolic shift and also the role of the basal fibroblasts Oxphos Phosphorylation (OXPHOS) function modifying this phenomenon could have implications on both, the diagnosis and prognosis of patients. Further knowledge in the mechanism involved may allow the development of new therapies.

5.
Sci Rep ; 7(1): 16661, 2017 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-29192176

RESUMO

Lung cancer remains the leading cause of cancer-related death worldwide, with one-third diagnosed with locally advanced (stage III) disease. Preoperative induction chemo-radiotherapy is key for the treatment of these patients, however conventional cisplatin based approaches has apparently reached a plateau of effectiveness. In the search for new therapies, the targeting of tumor metabolism is revealed as an interesting option to improve the patient's responses. Here we describe the importance of PGC-1alpha and GAPDH/MT-CO1 ratio levels as surrogates of the Warburg effect from a series of 28 stage III NSCLC patients, on PFS, OS and PET uptake. Moreover, our results show a great variability between tumors of different individuals, ranging from very glycolytic to more OXPHOS-dependent tumors, which compromises the success of therapies directed to metabolism. In this sense, using 3 different cell lines, we describe the relevance of Warburg effect on the response to metabolism-targeted therapies. Specifically, we show that the inhibitory effect of metformin on cell viability depends on cell's dependence on the OXPHOS system. The results on cell lines, together with the results of PGC-1alpha and GAPDH/MT-CO1 as biomarkers on patient's biopsies, would point out what type of patients would benefit more from the use of these drugs.

6.
Oncotarget ; 8(35): 59408-59416, 2017 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-28938646

RESUMO

BACKGROUND: The identification of anaplastic lymphoma kinase (ALK) rearrangements is found in approximately 5% of non-small-cell lung cancers (NSCLCs). However, the development of liquid biopsies as a diagnostic tool is less developed in these cases. This study investigates the use of CTCs during treatment, together with an extended follow-up to correlate with clinical evolution. PATIENTS AND METHODS: A total of 13 patients out of a cohort of 212 patients with lung adenocarcinoma, presented ALK rearrangements (6%) confirmed by tumor biopsy. A total of 60 serial blood samples were collected from these patients who were prospectively enrolled in the study. RESULTS: All patients had a positive CTC count at baseline (mean = 3). The median follow-up was 9 months (range 1-17 months). Three patients underwent surgery and their CTC counts decreased after the procedure but still remained detectable. After radiotherapy, 3 cases showed an average decrease of 5 CTCs. A total of 6 patients were treated with ALK inhibitors and a partial response was observed in 3 of them, who also presented decreased CTC counts. The other 3 patients presented primary resistance, and their CTC counts were higher than those obtained prior to progression. CONCLUSION: We believe that the use of CTCs for dynamic monitoring of NSCLC with ALK rearrangement and to detect disease persistence or recurrence may be a reliable technique. CTC counts may also have potential use to monitor the efficacy of ALK inhibitors, facilitating detection of resistance to treatment.

7.
Oncotarget ; 8(36): 60291-60298, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28947971

RESUMO

BACKGROUND: Liquid biopsy has evolved from being a promising line to becoming a validated approach for biomarker testing. However, its utility for individualization of therapy has been scarcely reported. In this study, we show how monitoring levels of EGFR mutation in plasma can be useful for the individualization of treatment. RESULTS: Longitudinal EGFR mutation levels in plasma always correlated with tumor response ascertained by RECIST criteria. Moreover, decreasing EGFR mutation levels were detected in all patients benefiting from locoregional radiotherapy, whereas the opposite occurred when a patient progressed soon after radiotherapy treatment. Similarly, increasing EGFR mutation levels anticipated disease progression after TKI dose reduction, discontinuation of treatment, or reduced bioavailability due to drug interactions. In addition, EGFR mutation levels were useful to monitor treatment outcome of new therapies and constituted a decisive factor when the clinical situation of the patient did not correlate with responses ascertained by radiologist. Finally, our results indicate that cancer associated body fluids (pleural, pericardial or cerebrospinal fluid) are certainly a suitable source for biomarker testing that can extend EGFR mutation detection to biofluids other than blood. MATERIALS AND METHODS: A total of 180 serial plasma samples from 18 non-small-cell lung cancer patients who carried an activating EGFR mutation were investigated by digital PCR. CONCLUSIONS: Monitoring levels of EGFR mutation in plasma allows resolving doubts that frequently arise in daily clinical practice and constitutes a major step towards achieving personalized medicine.

8.
Reumatol Clin ; 2017 Jul 12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28711461

RESUMO

OBJECTIVES: To describe the prevalence of comorbidities in patients with RA in Spain and discuss their management and implications using data from the Spanish cohort of the multinational study on COMOrbidities in Rheumatoid Arthritis (COMORA). METHODS: This is a national sub-analysis of the COMORA study. We studied the demographics and disease characteristics of 200 adults patients diagnosed with RA (1987 ACR), and routine practices for screening and preventing the following selected comorbidities: cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and depression. RESULTS: Patients had a mean age of 58 years and a mean RA duration of 10 years. Mean DAS28 score was 3.3 and approximately 25% of patients were in remission (DAS28 <2.6). Forty-four (22%) patients had ≥1 comorbidity, the most frequent being depression (27%) and obesity (26%). A history of myocardial infarction or stroke was observed in 5% and 1% of patients, respectively, and any solid tumor in 6%. Having a Framingham Risk Score >20% (51%), hypercholesterolemia (46%) or hypertension (41%) and smoking (25%) were the most common CV risk factors. For prostate, colon and skin cancers, only 9%, 10% and 18% of patients, respectively, were optimally monitored. Infections were also inadequately managed, with 7% and 17% of patients vaccinated against influenza and pneumococcal, respectively, as was osteoporosis, with 47% of patients supplemented with vitamin D and 56% with a bone densitometry performed. CONCLUSIONS: In Spain, the prevalence of comorbidities and CV risk factors in RA patients with established and advanced disease is relatively high, and their management in clinical daily practice remains suboptimal.

9.
PLoS One ; 11(1): e0146816, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26784702

RESUMO

The presence of more than one non-severe pathogenic mutation in the same mitochondrial DNA (mtDNA) molecule is very rare. Moreover, it is unclear whether their co-occurrence results in an additive impact on mitochondrial function relative to single mutation effects. Here we describe the first example of a mtDNA molecule harboring three Leber's hereditary optic neuropathy (LHON)-associated mutations (m.11778G>A, m.14484T>C, m.11253T>C) and the analysis of its genetic, biochemical and molecular characterization in transmitochondrial cells (cybrids). Extensive characterization of cybrid cell lines harboring either the 3 mutations or the single classic m.11778G>A and m.14484T>C mutations revealed no differences in mitochondrial function, demonstrating the absence of a synergistic effect in this model system. These molecular results are in agreement with the ophthalmological characteristics found in the triple mutant patient, which were similar to those carrying single mtDNA LHON mutations.


Assuntos
DNA Mitocondrial/genética , Mutação , Atrofia Óptica Hereditária de Leber/genética , Adulto , Linhagem Celular , Respiração Celular , Feminino , Humanos , Mitocôndrias/genética , Mitocôndrias/metabolismo , Atrofia Óptica Hereditária de Leber/metabolismo
10.
Oncotarget ; 6(15): 13628-43, 2015 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-25909222

RESUMO

To understand how mitochondria are involved in malignant transformation we have generated a collection of transmitochondrial cybrid cell lines on the same nuclear background (143B) but with mutant mitochondrial DNA (mtDNA) variants with different degrees of pathogenicity. These include the severe mutation in the tRNALys gene, m.8363G>A, and the three milder yet prevalent Leber's hereditary optic neuropathy (LHON) mutations in the MT-ND1 (m.3460G>A), MT-ND4 (m.11778G>A) and MT-ND6 (m.14484T>C) mitochondrial genes. We found that 143B ρ0 cells devoid of mtDNA and cybrids harboring wild type mtDNA or that causing severe mitochondrial dysfunction do not produce tumors when injected in nude mice. By contrast cybrids containing mild mutant mtDNAs exhibit different tumorigenic capacities, depending on OXPHOS dysfunction.The differences in tumorigenicity correlate with an enhanced resistance to apoptosis and high levels of NOX expression. However, the final capacity of the different cybrid cell lines to generate tumors is most likely a consequence of a complex array of pro-oncogenic and anti-oncogenic factors associated with mitochondrial dysfunction.Our results demonstrate the essential role of mtDNA in tumorigenesis and explain the numerous and varied mtDNA mutations found in human tumors, most of which give rise to mild mitochondrial dysfunction.


Assuntos
Carcinogênese/genética , DNA Mitocondrial/genética , Mutação , Animais , Linhagem Celular Tumoral , DNA Mitocondrial/metabolismo , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Mitocôndrias/genética , Mitocôndrias/metabolismo , Consumo de Oxigênio , Espécies Reativas de Oxigênio/metabolismo
11.
J Biol Chem ; 288(12): 8321-31, 2013 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-23362268

RESUMO

Cytochrome c oxidase (COX) or complex IV of the mitochondrial respiratory chain plays a fundamental role in energy production of aerobic cells. In humans, COX deficiency is the most frequent cause of mitochondrial encephalomyopathies. Human COX is composed of 13 subunits of dual genetic origin, whose assembly requires an increasing number of nuclear-encoded accessory proteins known as assembly factors. Here, we have identified and characterized human CCDC56, an 11.7-kDa mitochondrial transmembrane protein, as a new factor essential for COX biogenesis. CCDC56 shares sequence similarity with the yeast COX assembly factor Coa3 and was termed hCOA3. hCOA3-silenced cells display a severe COX functional alteration owing to a decreased stability of newly synthesized COX1 and an impairment in the holoenzyme assembly process. We show that hCOA3 physically interacts with both the mitochondrial translation machinery and COX structural subunits. We conclude that hCOA3 stabilizes COX1 co-translationally and promotes its assembly with COX partner subunits. Finally, our results identify hCOA3 as a new candidate when screening for genes responsible for mitochondrial diseases associated with COX deficiency.


Assuntos
Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Proteínas de Membrana/metabolismo , Mitocôndrias/enzimologia , Proteínas Mitocondriais/metabolismo , Multimerização Proteica , Complexo IV da Cadeia de Transporte de Elétrons/fisiologia , Estabilidade Enzimática , Técnicas de Silenciamento de Genes , Células HeLa , Humanos , Proteínas de Membrana/genética , Membranas Mitocondriais/metabolismo , Proteínas Mitocondriais/genética , Ligação Proteica , Subunidades Proteicas/metabolismo , Subunidades Proteicas/fisiologia , Proteólise , RNA Interferente Pequeno/genética
12.
Biochimie ; 95(6): 1171-6, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23353111

RESUMO

Metabolic reprogramming from mitochondrial aerobic respiration to aerobic glycolysis is a hallmark of cancer. However, whether it is caused by a dysfunction in the oxidative phosphorylation pathway is still under debate. In this work, we have analyzed the bioenergetic cellular (BEC) index and the relative cell ability to grow in the presence of either galactose or glucose as sources of sugar (Gal/Glu index) of a system formed by four epidermal cell lines with increasing tumorigenic potentials, ranging from nontumorigenic to highly malignant. We find that the BEC index gradually decreases whereas the Gal/Glu index increases with tumorigenicity, indicating that a progressive metabolic adaptation to aerobic glycolysis occurs in tumor cells associated with malignancy. Interestingly, this metabolic adaptation does not appear to be caused by damaged respiration, since the expression and activity of components of the respiratory chain complexes were unchanged in the cell lines. Moreover, the corresponding mitochondrial ATP synthetic abilities of the cell lines were found similar. The production of reactive oxygen species was also measured. A shift in ROS generation was found when compared nontumorigenic with tumorigenic cell lines, the latter exhibiting about threefold higher ROS levels than nontumorigenic cells. This result indicates that oxidative stress is an early event during tumor progression.


Assuntos
Transformação Celular Neoplásica/metabolismo , Metabolismo Energético/fisiologia , Mitocôndrias/metabolismo , Estresse Oxidativo/fisiologia , Neoplasias Cutâneas/metabolismo , Animais , Western Blotting , Linhagem Celular Tumoral , Modelos Animais de Doenças , Progressão da Doença , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Espécies Reativas de Oxigênio/metabolismo , Neoplasias Cutâneas/patologia
13.
Rev. obstet. ginecol. Venezuela ; 55(3): 137-141, 1995. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: lil-320916

RESUMO

El propósito del siguiente trabajo fue establecer los valores de referencia de la medida de los diámetros interorbitarios extreno e interno para cada edad gestacional, la magnitud de dicha correlación y su capacidad diagnóstica en gestaciones menores y mayores de 37 semanas. Se realizó un estudio mixto de tipo prospectivo y corte transversal, en una población de 1354 fetos con crecimiento normal entre las 15 y 41 semanas de gestación; fueron seleccionándose 689 casos para la medida del diámetro interorbitario interno (DIOI) y 704 casos para la medida del diámetro interorbitario externo (DIOE). Se demostró una correlación lineal entre la edad gestacional y el DIOE y DIOI de 0,89 y 0,68 respectivamente. Se evaluó la capacidad diagnóstica de ambos parámetros una vez dividida la muestra a las 37 semanas obteniéndose para el DIOE una sensibilidad de 91 por ciento, especificidad de 72 por ciento, valor predictivo positivo de 94 por ciento, valor predictivo negativo de 65 por ciento, falsos positivos de 9 por ciento y falsos negativos de 28 por ciento. Para el DIOI la sensibilidad fue de 85 por ciento, especificidad de 64 por ciento, valor predictivo positivo 90 por ciento, valor predictivo negativo 52 por ciento, falsos positivos 9 por ciento y falsos negativos 47 por ciento. El estudio demuestra que el DIOE presenta una correlación lineal mayor que el DIOI, así como también una capacidad diagnóstica más elevada para predecir la edad gestacional


Assuntos
Humanos , Feminino , Gravidez , Desenvolvimento Fetal , Idade Gestacional , Crescimento , Substâncias de Crescimento , Gravidez , Ultrassom , Ginecologia , Obstetrícia , Venezuela
14.
Rev. obstet. ginecol. Venezuela ; 55(3): 161-165, 1995. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-320919

RESUMO

La iniencefalia es una rara, compleja y hasta ahora, salvo algunas excepciones, letal malformación del tubo neural donde el cerebro, cuello y estructuras subyacentes muestran las principales alteraciones anatómicas. El presente estudio muestra una serie de 6 casos diagnosticados antenatalmente en la Unidad de Perinatología de la Universidad de Carabobo mediante ultrasonografía y a los cuales se les practicó estudios radiológicos y anatomopatológico correspondientes. Una hipótesis propuesta por Stevenson y col. invoca una aberración o demora en el establecimiento del flujo sanguíneo que limita el aporte de nutrientes al tejido neural en desarrollo y sus estructuras de sostén, evitando un adecuado crecimiento y cierre del mismo. Los casos reportados en nuestra investigación muestran hallazgos que sustentan la teoría de Stevenson, siendo evidente la ausencia de arterias inercostales en los segmentos involucrados y la existencia de un tronco carotídeo común, el cual que si bien ha sido asociado a otras patologías como anencefalia, encefalocele, raquisquisis, etc. y se ha visto en pacientes por lo demás normales, que tienen en común malformaciones tipificables dentro de las disrupciones


Assuntos
Humanos , Feminino , Gravidez , Anormalidades Congênitas , Malformações do Sistema Nervoso , Perinatologia , Gravidez , Ginecologia , Obstetrícia , Venezuela
15.
Ultrason. med ; 11: 11-4, 1995. ilus
Artigo em Espanhol | LILACS | ID: lil-180744

RESUMO

Se realizó un estudio prospectivo y de corte transversal, en una muestra de 788 casos sobre una población de 1.456 fetos con crecimiento normal, comprendidos entre las 15 y 41 semanas de gestación, con el propósito de establecer los valores de referencia de la circunferencia abdominal fetal para cada edad gestacional y evaluar la capacidad diagnóstica del parámetro en gestaciones mayores de 37 semanas. Se demostró una correlación (r al cuadrado=0,91) entre la edad gestional y la circunferencia abdominal; así mismo, al dicotomizar la muestra a las 37 semanas para evaluar la capacidad diagnóndtica del parámetro, obtuvimos una sensibilidad del 95 por ciento, especifícidad del 69 por ciento, falsos positivos 5 por ciento, falsos negativos 31 por ciento, valor predictivo positivo 92 por ciento, valor predictivo negativo 78 por ciento, eficacia 0,63, con un índice de Kappa en 0,67. Concluimos señalando que la obtención de la circunferrencia abdominal constituye una herramienta más a considerar en la evaluación de la edad gestacional, no olvidando sin embarazo que es menos específica que otros parámetros


Assuntos
Humanos , Feminino , Abdome , Biometria/métodos , Crescimento , Fatores de Risco , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Pré-Natal , Antropometria/métodos , Feto , Gravidez/fisiologia
16.
Ultrason. med ; 11: 15-9, 1995. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-180745

RESUMO

Un estudio mixto de tipo prospectivo y corte transversal se realizó sobre una población de 1.230 casos seleccionándose 616 casos de embarazos de alto riesgo por antecedentes atendidas en la Unidad de Perinatología de la Universidad de Carabobo entre el 15 de Noviembre de 1993 al 15 de Noviembre de 1994. El crecimiento del DOF y la CC mostró una tendencia ascendente y casi lineal entre las 16 semanas y las 31-32 semanas respectivamente, para luego presentar un aplanamiento hasta la semana 41. La capacidad del DOF menor de 10,91 para el diagnóstico de embarazo menor de 37 semanas (sensibilidad) fue del 93 por ciento, con falsos positivos del 7 por ciento y valor predictivo positivo del 89 por ciento. La capacidad de la CC menor de 31,02 cm para el diagnóstico de embarazo menor de 37 semanas (sensibilidad) fue del 98 por ciento, con falsos negativos del 2 por ciento y valor predictivo negativo del 90 por ciento. Estas cifras nos demuestran que el DOF y la CC son mejores predictores de edad gestacional cuando ésta es menor de 37 semanas. Se concluye señalando que la obtención del DOF y la CC constituyen una buena herramienta en la evaluación de la edad gestacional y en el diagnóstico de dolicocefalia y braquicefalia


Assuntos
Gravidez , Adolescente , Adulto , Humanos , Feminino , Antropometria/métodos , Cefalometria/métodos , Feto , Idade Gestacional , Crescimento , Cabeça
17.
Ultrason. med ; 10: 15-9, 1994. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-193676

RESUMO

El propósito del presente trabajo fue establecer los valores de referencia de la longitud del sacro para cada edad gestacional, la magnitud de dicha correlación y su capacidad diagnóstica en gestaciones menores y mayores de 37 semanas. Se realizó un estudio mixto de tipo prospectivo y transversal, en una población de 1.212 fetos con crecimiento normal comprendido entre las 19 y 40 semanas de gestación; seleccionándose 646 casos para obtener los valores promedio y dos desviaciones estándar para cada edad gestacional. La longitud del sacro de 7 fetos con crecimiento anormal (3 fetos P90 para la edad gestacional) fue relacionado con el normograma. Se demostró una correlación lineal (r2=0,96) entre la edad gestacional y la longitud del sacro. Se evaluó la capacidad diagnóstica de éste una vez dicotomizada la muestra a las 37 semanas, obteniéndose una sensibilidad de 98,89 por ciento, especificidad de 83,49 por ciento, valor predictivo positivo de 96,93 por ciento, valor predictivo negativo de 93,47 por ciento, falsos positivos de 16,5 por ciento y falsos negativos de 1,1 por ciento. La longitud del sacro de los 7 fetos con crecimiento fetal anormal mostró igual relación con aquellos de crecimiento normal. El índice de Kappa fue de 0,86. El estudio demuestra una correlación estadística significativa (p<0,0001) entre la longitud del sacro y la edad gestacional, así como también una elevada capacidad diágnostica de este dato biométrico para predecir si la edad gestacional se ubica en, por encima o por debajo de las 37 semanas.


Assuntos
Humanos , Biometria/métodos , Desenvolvimento Fetal/fisiologia , Feto , Idade Gestacional , Sacro
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