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Medicine (Baltimore) ; 99(11): e19349, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176056


The visual system was reported to be affected in over half of patients with preeclampsia (PE), though fundus examination was performed only among patients complaining of visual symptoms. Delayed diagnosis and treatment of PE-related retinopathy may lead to permanent visual impairment. Therefore, we hypothesize that some clinical or laboratory parameters could predict severity of retinal damage.The aim of the study was to explore the risk factors for retinopathy in severe preeclampsia (sPE) and investigate pregnancy outcomes with different degrees of retinopathy.This retrospective cohort study included women with sPE who underwent ophthalmoscopy and delivered after admission to West China Second University Hospital, between June 2013 and December 2016. Clinical and laboratory characteristics were retrieved from medical records. Patients confirmed with retinopathy were followed up with telephones. Multiple logistic regression analysis was performed to identify risk factors of PE-related retinopathy.Five hundred thirty-four patients were included, of which 17.6% having stage-1/2 retinopathy, 14.6% having stage-3/4 retinopathy, and 67.8% having normal retina. Compared with patients without retinopathy, patients with stage 3/4 retinopathy were more likely to have preterm-birth and low-birth-weight babies. Significant risk factors for stage 3/4 retinopathy in sPE included severe hypertension (odds ratio [OR] 2.24, 95% confidence interval [CI]: 1.10-4.56), elevated white blood cell (WBC) counts (OR 1.88, 95% CI: 1.05-3.35), decreased platelet counts (OR 2.12, 95% CI: 1.07-4.48), lactate dehydrogenase (LDH) concentration of >800 IU/L (OR 2.31, 95% CI: 1.05-5.06), low hemoglobin (HGB) concentrations of <110 g/L (OR 3.73, 95% CI: 1.21-11.47), 24-hour proteinuria of 2 to 5 g (OR 6.39, 95% CI: 2.84-14.39), and >5 g (OR 8.66, 95% CI: 3.67-20.44).This study confirms the association between retinopathy and preterm-birth and low-birth weight in sPE. The risk factors for severe PE-related retinopathy, including severe hypertension, platelet and WBC count, HGB and LDH concentration, and proteinuria, are associated with the development of retinopathy. Routine and repeated fundus examination is recommended for maternal monitoring in sPE.

Pré-Eclâmpsia/epidemiologia , Resultado da Gravidez , Gravidez de Alto Risco , Doenças Retinianas/epidemiologia , Retinoscopia/métodos , China , Estudos de Coortes , Feminino , Idade Gestacional , Hospitais Universitários , Humanos , Recém-Nascido , Modelos Logísticos , Análise Multivariada , Pré-Eclâmpsia/diagnóstico , Gravidez , Nascimento Prematuro , Doenças Retinianas/diagnóstico , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença
Ecotoxicol Environ Saf ; 187: 109820, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31670242


Huge amounts of fly ash (FA) can be annually produced in power plants. Fly ash always contains high levels of arsenic (As) and selenium (Se) due to the preconcentration of these two elements during coal combustion process. It would be much concerned to screen their fractions and potential environmental behaviors in fly ash for beneficial use and treatment. Fast and practical methods for this purpose are urgently needed. Two fast and effective microwave-assisted sequential extraction schemes (MASE) were developed for fast screening As and Se fractions in fly ash for the first time. The extraction parameters including microwave irradiation time, temperature and power energy were optimized by comparing the results from MASE and the conventional scheme (Wenzel method). The results indicate that the extraction efficiency of As and Se in various fractions can be significantly accelerated by microwave irradiation. The whole procedure operation time can be significantly reduced from 24.5 h to 44 min by microwave assistance compared with the conventional shaking schemes. The recoveries of As and Se in the various extracted fractions were all above 80% with relative standard deviations (RSDs) below 8%. The developed methods were further confirmed by the validation of the certified reference material GBW08401 and fly ash samples from six power plants. The developed MASE methods are practical and effective for fast screening arsenic and selenium fractions in fly ash samples.

Arsênico/análise , Cinza de Carvão/análise , Monitoramento Ambiental/métodos , Poluentes Ambientais/análise , Micro-Ondas , Selênio/análise , Disponibilidade Biológica , Centrais Elétricas