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1.
Radiol Clin North Am ; 58(2): 445-462, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32044017

RESUMO

Radiological guided intervention techniques are discussed in obstetric and gynecologic patients. Fallopian tube recanalization, postpartum hemorrhage control, techniques of treating uterine leiomyomas, pelvic congestion treatment, and the use of percutaneous and transvaginal ultrasonography-guided aspirations and biopsy are covered. These techniques use basic radiological interventional skills and show how they are adapted for use in the female pelvis.


Assuntos
Embolização Terapêutica/métodos , Doenças Urogenitais Femininas/diagnóstico por imagem , Doenças Urogenitais Femininas/terapia , Complicações na Gravidez/diagnóstico por imagem , Complicações na Gravidez/terapia , Ultrassonografia de Intervenção/métodos , Feminino , Doenças Urogenitais Femininas/patologia , Ginecologia , Humanos , Biópsia Guiada por Imagem/métodos , Obstetrícia , Gravidez , Complicações na Gravidez/patologia
2.
Pan Afr Med J ; 33: 300, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31693725

RESUMO

Anal fibroepithelial polyp is a benign tumor rarely reported during pregnancy. We here report a case of giant anal fibroepithelial polyp in a 31-year old multiparous woman. It developed progressively over the previous 3 years. Clinical examination showed firm sessile bud formation, at the anal margin. The patient had normal ongoing pregnancy (31 weeks of amenorrhea). Endoanal examination was normal. Surgical resection was preformed under spinal anesthesia. The specimen measured 21x12x7cm and was covered by the skin. Histological examination showed anal fibroepithelial polyp without signs of malignancy. The postoperative course was uneventful.


Assuntos
Doenças do Ânus/diagnóstico , Pólipos Intestinais/diagnóstico , Complicações na Gravidez/diagnóstico , Adulto , Canal Anal/patologia , Canal Anal/cirurgia , Doenças do Ânus/patologia , Doenças do Ânus/cirurgia , Feminino , Humanos , Pólipos Intestinais/patologia , Pólipos Intestinais/cirurgia , Gravidez , Complicações na Gravidez/patologia , Complicações na Gravidez/cirurgia
3.
Pan Afr Med J ; 34: 49, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762915

RESUMO

Massive and severe epistaxis is an uncommon event in pregnancy. It could be life threatening and could affect the normal pregnancy course. The best management is still on debate; it could be medical, conservative or surgical. Pregnancy termination often is problem solving. Hormonal changes during pregnancy affects nasal physiology. Vaginal delivery, labour induction or cesarean section are all suitable, after hemodynamic stabilization of pregnant woman. We report a case and review the available literature.


Assuntos
Epistaxe/complicações , Nariz/patologia , Complicações na Gravidez/patologia , Adulto , Epistaxe/terapia , Feminino , Humanos , Gravidez , Complicações na Gravidez/terapia , Recidiva , Índice de Gravidade de Doença
4.
An Bras Dermatol ; 94(5): 549-552, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31777355

RESUMO

BACKGROUND: Nipple eczema is a less common presentation of atopic dermatitis. No studies in the literature have correlated nipple eczema in pregnancy as a manifestation of atopic dermatitis. OBJECTIVE: To evaluate whether nipple eczema presenting in pregnancy is a manifestation of atopic dermatitis. METHODS: This was a prospective observational study including 100 women who presented with nipple eczema for the first time during pregnancy. The exclusion criteria were any patient with previous history of nipple eczema, those already on oral or topical treatment for atopic dermatitis or nipple eczema, and other disorders mimicking eczema. Patients were divided into two groups ‒ nipple eczema with atopic dermatitis and without atopic dermatitis. Demographic data, clinical features, total leukocyte count, differential leukocyte count, absolute eosinophil counts, and serum IgE levels were compared between the two groups to detect association between nipple eczema in pregnancy and atopic dermatitis. RESULTS: Out of 100 patients, 39 were diagnosed with atopic dermatitis, whereas 61 were ruled out to have any features suggestive of atopic dermatitis. There were no statistically significant differences in mean age, mean duration of symptoms, and serum IgE levels. In patients with atopic dermatitis, bilateral symptoms were noted more commonly than in patients without the disease, but this was statistically insignificant. STUDY LIMITATIONS: Lack of long term follow-up and no large studies in literature to compare results. CONCLUSION: Nipple eczema in pregnancy follows a similar pattern as in other age groups. The clinical profile of patients is similar in cases with and without atopic dermatitis.


Assuntos
Doenças Mamárias/patologia , Dermatite Atópica/patologia , Eczema/patologia , Mamilos/patologia , Complicações na Gravidez/patologia , Adulto , Doenças Mamárias/sangue , Doenças Mamárias/diagnóstico , Dermatite Atópica/sangue , Dermatite Atópica/diagnóstico , Eczema/sangue , Eczema/diagnóstico , Feminino , Humanos , Imunoglobulina E/sangue , Índia , Contagem de Leucócitos , Neutrófilos , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/diagnóstico , Trimestres da Gravidez , Estudos Prospectivos
6.
Urology ; 133: e5-e6, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31404582

RESUMO

Fetal rhabdomyomatous nephroblastoma (FRN) is a rare variant of Wilms tumor with distinct morphologic features and biologic behavior compared to conventional nephroblastoma. It mainly occurs in patients under 4 years. In adults, extremely rare cases of nephroblastoma were reported. Among these cases, none has been interested a FRN. We report an exceptional case of a 31-year-old woman diagnosed with FRN discovered incidentally, to illustrate clinical and histopathological characteristics of this entity.


Assuntos
Doenças Fetais/patologia , Neoplasias Renais/patologia , Complicações na Gravidez/patologia , Tumor de Wilms/patologia , Adulto , Feminino , Humanos , Gravidez , Rabdomioma/patologia
7.
Arch Immunol Ther Exp (Warsz) ; 67(5): 295-309, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286151

RESUMO

Macrophages (MФs) are the leukocytes produced from differentiation of monocytes and are located in almost all tissues of human body. They are involved in various processes, such as phagocytosis, innate and adaptive immunity, proinflammatory (M1) and anti-inflammatory (M2) activity, depending on the tissue microenvironment. They play a crucial role in pregnancy, and their dysfunction or alteration of polarity is involved in pregnancy disorders, like preeclampsia, recurrent spontaneous abortion, infertility, intrauterine growth restriction, and preterm labor. About 50-60% of decidual leukocytes are natural killer (NK) cells followed by MФs (the second largest population). MФs are actively involved in trophoblast invasion, tissue and vascular remodeling during early pregnancy, besides their role as major antigen-presenting cells in the decidua. These cells have different phenotypes and polarities in different stages of pregnancy. They have also been observed to enhance tumor growth by their anti-inflammatory activity (M2 type) and prevent immunogenic rejection. Targeted alteration of polarity (M1-M2 or vice versa) could be a major focus in the future treatment of pregnancy complications. This review is focused on the role of MФs in pregnancy, their involvement in pregnancy disorders, and decidual MФs as possible therapeutic targets for the treatment of pregnancy complications.


Assuntos
Decídua/imunologia , Macrófagos/fisiologia , Complicações na Gravidez/imunologia , Gravidez/imunologia , Animais , Implantação do Embrião/imunologia , Feminino , Humanos , Tolerância Imunológica , Macrófagos/imunologia , Macrófagos/patologia , Complicações na Gravidez/patologia , Fatores de Crescimento do Endotélio Vascular/metabolismo
8.
Low Urin Tract Symptoms ; 11(4): 217-223, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31318179

RESUMO

OBJECTIVES: Nationwide prospective studies of lower urinary tract symptoms (LUTS) during and after pregnancy have never been conducted in mainland China. A prospective longitudinal study was performed to evaluate the association of pregnancy and delivery on LUTS in a representative sample of primiparous Chinese women. METHODS: A national survey on urinary incontinence (UI) was conducted in 10,098 pregnant females during late pregnancy (37 to 42 weeks of gestation) and at 6 weeks postpartum.in seven administrative regions of China from September 2007 to May 2009. No intervention was implemented. International Consultation on Incontinence Questionnaire Female Lower Urinary tract Symptoms Module (ICIQ-FLUTS) was administered. The participants were asked about the presence of individual LUTS and rated their symptom bother. Data were analyzed by descriptive statistics, Chi-square tests, and multivariate logistic regression. RESULTS: Among all participants (mean ± SD maternal age 26.44 ± 3.97 years), the most commonly reported storage LUTS during pregnancy were nocturia (72.3%) and frequency (43.9%). LUTS were much less prevalent after childbirth than during pregnancy. Moderate to severe bother was more common during than after pregnancy. Compared with vaginal delivery (VD), cesarean section (CS) was a protective factor against voiding LUTS (AOR (adjusted odd ration), 0.66; 95% CI, 0.52-0.82) and storage LUTS (AOR, 0.74; 95% CI, 0.66-0.83). CONCLUSIONS: LUTS were much more prevalent during than after pregnancy, with nocturia and frequency being the most prevalent. Moderate or severe bother was more common during pregnancy than after pregnancy. CS was associated with a decreased prevalence both of storage and voiding LUTS after delivery.


Assuntos
Sintomas do Trato Urinário Inferior/etiologia , Complicações na Gravidez/etiologia , Adulto , China/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/patologia , Período Pós-Parto , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/patologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
9.
PLoS One ; 14(7): e0218799, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31318865

RESUMO

Ambient air pollution is considered a major environmental health threat to pregnant women. Our previous work has shown an association between exposure to airborne particulate matter (PM) and an increased risk of developing pre-eclamspia. It is now recognized that many pregnancy complications are due to underlying placental dysfunction, and this tissue plays a pivotal role in pre-eclamspia. Recent studies have shown that PM can enter the circulation and reach the human placenta but the effects of PM on human placental function are still largely unknown. In this work we investigated the effects of airborne PM on trophoblast cells. Human, first trimester trophoblast cells (HTR-8/SV) were exposed to urban pollution particles (Malmö PM2.5; Prague PM10) for up to seven days in vitro and were analysed for uptake, levels of hCGß and IL-6 secretion and proteomic analysis. HTR-8/SVneo cells rapidly endocytose PM within 30 min of exposure and particles accumulate in the cell in perinuclear vesicles. High doses of Prague and Malmö PM (500-5000 ng/ml) significantly decreased hCGß secretion and increased IL-6 secretion after 48 h exposure. Exposure to PM (50 ng/ml) for 48h or seven days led to reduced cellular growth and altered protein expression. The differentially expressed proteins are involved in networks that regulate cellular processes such as inflammation, endoplasmic reticulum stress, cellular survival and molecular transport pathways. Our studies suggest that trophoblast cells exposed to low levels of urban PM respond with reduced growth, oxidative stress, inflammation and endoplasmic reticulum stress after taking up the particles by endocytosis. Many of the dysfunctional cellular processes ascribed to the differentially expressed proteins in this study, are similar to those described in PE, suggesting that low levels of urban PM may disrupt cellular processes in trophoblast cells. Many of the differentially expressed proteins identified in this study are involved in inflammation and may be potential biomarkers for PE.


Assuntos
Poluição do Ar/efeitos adversos , Inflamação/genética , Pré-Eclâmpsia/genética , Trofoblastos/efeitos dos fármacos , Poluentes Atmosféricos/efeitos adversos , Sobrevivência Celular/efeitos dos fármacos , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Inflamação/induzido quimicamente , Inflamação/patologia , Interleucina-6/genética , Estresse Oxidativo/efeitos dos fármacos , Material Particulado/efeitos adversos , Placenta/efeitos dos fármacos , Placenta/patologia , Pré-Eclâmpsia/induzido quimicamente , Pré-Eclâmpsia/patologia , Gravidez , Complicações na Gravidez/induzido quimicamente , Complicações na Gravidez/genética , Complicações na Gravidez/patologia , Proteômica/métodos , Trofoblastos/metabolismo , Trofoblastos/patologia
10.
Biomed Res Int ; 2019: 3768601, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31355258

RESUMO

Objective: This study aimed to clarify the effect of gestational weight gain (GWG) on perinatal outcomes in low risk pregnancies with normal prepregnancy body mass index (BMI). Study Design: A total of 572 low-risk pregnant women with a normal prepregnancy BMI were included. GWG and inadequate or excessive weight gain were defined according to the United States Institute of Medicine updated guidelines. Adverse perinatal outcomes were compared among inadequate, normal, and excessive weight gain groups. Results: Of the 572 pregnant women enrolled, 62 belonged to inadequate GWG group, 80 to excessive GWG group, and 430 to normal GWG group. Maternal age, prepregnancy BMI, gravity, parity, and previous cesarean delivery rates were similar among groups. Adverse perinatal outcomes were not statistically significant among groups. Fetal weight was significantly lower in inadequate weight gain group compared to normal weight gain group (p<0.001) and fetal weight was significantly lower in normal weight gain group compared to excessive weight gain group (p<0.001). Additionally, low birth weight <2.5kgs, birth weight > 4.0kgs, and SGA and LGA rates were similar among groups (P = 0.765, P = 0. 711, P = 0. 702, and P = 0.414, respectively). Although gestational age at delivery was term in normal percentile it was significantly lower in the inadequate weight gain group compared to others (P=0.010). Conclusions: This study showed that an inadequate or excessive weight gain in low-risk pregnancies with a normal prepregnancy BMI did not increase the risk of adverse perinatal outcomes.


Assuntos
Peso ao Nascer , Índice de Massa Corporal , Ganho de Peso na Gestação , Sobrepeso , Complicações na Gravidez , Resultado da Gravidez , Adolescente , Adulto , Feminino , Humanos , Sobrepeso/epidemiologia , Sobrepeso/patologia , Sobrepeso/fisiopatologia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/patologia , Complicações na Gravidez/fisiopatologia , Estudos Retrospectivos
11.
Int J Mol Sci ; 20(15)2019 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-31357698

RESUMO

The proper functioning of the monocyte-macrophage system, an important unit of innate immunity, ensures the normal course of pregnancy. In this review, we present the current data on the origin of the monocyte-macrophage system and its functioning in the female reproductive system during the ovarian cycle, and over the course of both normal and complicated pregnancy. Preeclampsia is a crucial gestation disorder characterized by pronounced inflammation in the maternal body that affects the work of the monocyte-macrophage system. The effects of inflammation at preeclampsia manifest in changes in monocyte counts and their subset composition, and changes in placental macrophage counts and their polarization. Here we summarize the recent data on this issue for both the maternal organism and the fetus. The influence of estrogen on macrophages and their altered levels in preeclampsia are also discussed.


Assuntos
Imunidade Inata/genética , Inflamação/genética , Sistema Fagocitário Mononuclear/imunologia , Pré-Eclâmpsia/genética , Feminino , Humanos , Inflamação/imunologia , Inflamação/patologia , Macrófagos/imunologia , Ciclo Menstrual/genética , Ciclo Menstrual/imunologia , Monócitos/imunologia , Placenta/imunologia , Pré-Eclâmpsia/imunologia , Pré-Eclâmpsia/patologia , Gravidez , Complicações na Gravidez/genética , Complicações na Gravidez/imunologia , Complicações na Gravidez/patologia
12.
J Obstet Gynaecol Res ; 45(9): 1899-1905, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31293029

RESUMO

AIM: We evaluated and compared the clinical and pathological differences between pregnant and non-pregnant women with adnexal torsion. METHODS: We retrospectively reviewed 239 women with adnexal torsion from January 2006 to December 2015 in a tertiary hospital. The clinical and pathological differences between pregnant and non-pregnant women who underwent surgery for adnexal torsion were analyzed. RESULTS: The most common pathologies were corpus luteum cysts in pregnant women and dermoid cysts in non-pregnant women. Eight of the pregnant women (24.2%) had a history of exogenous ovarian stimulation, and their episodes were only caused by corpus luteum or a stimulated ovary. In pregnant women, 72.7% of the torsion occurred before the 14th week of gestation. CONCLUSION: The common pathology causing adnexal torsion was different, depending on the pregnancy status. Exogenous ovarian stimulation increases the risk of adnexal torsion, and the majority of episodes occurred in the first trimester in pregnant women.


Assuntos
Doenças dos Anexos/patologia , Complicações na Gravidez/patologia , Anormalidade Torcional/patologia , Anormalidades Urogenitais/patologia , Doenças dos Anexos/congênito , Adulto , Feminino , Humanos , Cistos Ovarianos/etiologia , Cistos Ovarianos/patologia , Ovário/patologia , Gravidez , Complicações na Gravidez/etiologia , Estudos Retrospectivos , Anormalidade Torcional/congênito
13.
Life Sci ; 232: 116601, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31252000

RESUMO

AIMS: Tet1, Tet2, and interleukin-6 (IL-6) have been linked to atherosclerosis. Whether Tet3 has a relationship with atherosclerosis and IL-6 was unknown. This study aims to determine the link between Tet3 and IL-6, and the role of Tet3 in prenatal hypoxia-induced atherosclerosis in offspring rats. MAIN METHODS: Pregnant rats were divided into hypoxia and control group. Their male offspring were tested at 20 months old. Hematoxylin-eosin staining and transmission electron microscopic staining were used. Gene mRNA and protein levels were measured with q-PCR or Western blotting. Cell viability and migration was tested with MTT or cell scratch assay. 5-hmC and 5-mC expression were obtained by qGlucMS-PCR; 5-hmC and 5-mC activity were obtained by dot blotting. KEY FINDINGS: Chronic prenatal hypoxia increased Tet3 and IL-6 expression, and decreased Tet3 activity in offspring rats. GlucMS-qPCR showed the percentage of 5-hmC was significantly up-regulated in the promoter of IL-6 in both the rats and cells. Moreover, 5-hmC percentage also was increased in the A7r5 cells transfected with Tet3. Furthermore, Tet3 promoted proliferation and migration of A7r5 cells. However, Tet3 was not sensitive to acute hypoxia, while influenced by HIF-1α DNA element. SIGNIFICANCE: Tet3 enhanced IL-6 expression though up-regulating 5-hmC percentage in the IL-6 promoter.


Assuntos
Aterosclerose/metabolismo , Desoxicitidina/análogos & derivados , Dioxigenases/metabolismo , Hipóxia/metabolismo , Interleucina-6/biossíntese , Animais , Aterosclerose/genética , Aterosclerose/patologia , Movimento Celular/fisiologia , Sobrevivência Celular/fisiologia , Desoxicitidina/metabolismo , Epigênese Genética , Feminino , Hipóxia/genética , Hipóxia/patologia , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Interleucina-6/genética , Interleucina-6/metabolismo , Masculino , Oxigenases de Função Mista/metabolismo , Gravidez , Complicações na Gravidez/metabolismo , Complicações na Gravidez/patologia , Regiões Promotoras Genéticas , Proteínas Proto-Oncogênicas/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos , Ativação Transcricional , Regulação para Cima
14.
J Biol Regul Homeost Agents ; 33(3): 963-966, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31198012

RESUMO

The protective effect of pregnancy on endometriosis is well known, but complications related to the pregnant state, such as hemoperitoneum, uroperitoneum and bowel perforation may occur.


Assuntos
Endometriose/patologia , Hemoperitônio/patologia , Complicações na Gravidez/patologia , Feminino , Humanos , Gravidez
15.
Twin Res Hum Genet ; 22(2): 95-98, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31124778

RESUMO

Approximately 12% of U.S. adults have type 2 diabetes (T2D). Diagnosed T2D is caused by a combination of genetic and environmental factors including age and lifestyle. In adults 45 years and older, the Discordant Twin (DISCOTWIN) consortium of twin registries from Europe and Australia showed a moderate-to-high contribution of genetic factors of T2D with a pooled heritability of 72%. The purpose of this study was to investigate the contributions of genetic and environmental factors of T2D in twins 45 years and older in a U.S. twin cohort (Washington State Twin Registry, WSTR) and compare the estimates to the DISCOTWIN consortium. We also compared these estimates with twins under the age of 45. Data were obtained from 2692 monozygotic (MZ) and same-sex dizygotic (DZ) twin pairs over 45 and 4217 twin pairs under 45 who responded to the question 'Has a doctor ever diagnosed you with (type 2) diabetes?' Twin similarity was analyzed using both tetrachoric correlations and structural equation modeling. Overall, 9.4% of MZ and 14.7% of DZ twins over the age of 45 were discordant for T2D in the WSTR, compared to 5.1% of MZ and 8% of DZ twins in the DISCOTWIN consortium. Unlike the DISCOTWIN consortium in which heritability was 72%, heritability was only 52% in the WSTR. In twins under the age of 45, heritability did not contribute to the variance in T2D. In a U.S. sample of adult twins, environmental factors appear to be increasingly important in the development of T2D.


Assuntos
Diabetes Mellitus Tipo 2/genética , Doenças em Gêmeos/genética , Complicações na Gravidez/genética , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/patologia , Doenças em Gêmeos/epidemiologia , Doenças em Gêmeos/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/patologia , Sistema de Registros , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/genética , Washington/epidemiologia
16.
Int J Mol Sci ; 20(9)2019 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-31083536

RESUMO

Autophagy is an evolutionarily conserved process in eukaryotes to maintain cellular homeostasis under environmental stress. Intracellular control is exerted to produce energy or maintain intracellular protein quality controls. Autophagy plays an important role in embryogenesis, implantation, and maintenance of pregnancy. This role includes supporting extravillous trophoblasts (EVTs) that invade the decidua (endometrium) until the first third of uterine myometrium and migrate along the lumina of spiral arterioles under hypoxic and low-nutrient conditions in early pregnancy. In addition, autophagy inhibition has been linked to poor placentation-a feature of preeclamptic placentas-in a placenta-specific autophagy knockout mouse model. Studies of autophagy in human placentas have revealed controversial results, especially with regard to preeclampsia and gestational diabetes mellitus (GDM). Without precise estimation of autophagy flux, wrong interpretation would lead to fixed tissues. This paper presents a review of the role of autophagy in pregnancy and elaborates on the interpretation of autophagy in human placental tissues.


Assuntos
Autofagia , Animais , Autofagia/genética , Feminino , Humanos , Modelos Biológicos , Placentação , Gravidez , Complicações na Gravidez/patologia , Reprodução
17.
Tohoku J Exp Med ; 248(1): 57-61, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31142693

RESUMO

Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Although the etiology of ICP is not fully understood thus far, some genetic factors might contribute to the development of this condition. Sodium-taurocholate cotransporting polypeptide (NTCP), the protein encoded by the gene Solute Carrier Family 10, Member 1 (SLC10A1), is the primary transporter expressed in the basolateral membrane of the hepatocyte to uptake conjugated bile salts from the plasma. NTCP deficiency arises from biallelic SLC10A1 mutations which impair the NTCP function and cause intractably elevated levels of total bile acids (TBA) in the plasma (hypercholanemia). In this study, all the SLC10A1 exons and their flanking sequences were analyzed by Sanger sequencing to investigate the etiology for hypercholanemia in two male infants aged 2 and 20 months, respectively, from two unrelated families. As a result, both patients are homozygous for the reported pathogenic variant c.800C>T (p.Ser267Phe) that could impair the NTCP function to uptake bile acids, and the diagnosis of NTCP deficiency was thus made. Their mothers are also homozygotes of the same variant and both had been diagnosed to have ICP in the third trimester, with one of them undergoing cesarean section. The father of the first patient in this paper has the same SLC10A1 genotype c.800C>T/c.800C>T, also exhibiting slight hypercholanemia with a plasma TBA level of 21.5 µmol/L. In conclusion, we suggest that with hypercholanemia being a common laboratory change, NTCP deficiency may be a genetic factor leading to ICP and even cesarean section in clinical practice.


Assuntos
Colestase Intra-Hepática/patologia , Transportadores de Ânions Orgânicos Dependentes de Sódio/deficiência , Complicações na Gravidez/patologia , Simportadores/deficiência , Sequência de Bases , Feminino , Humanos , Lactente , Masculino , Transportadores de Ânions Orgânicos Dependentes de Sódio/genética , Transportadores de Ânions Orgânicos Dependentes de Sódio/metabolismo , Gravidez , Simportadores/genética , Simportadores/metabolismo
18.
Pan Afr Med J ; 32: 50, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31143355

RESUMO

We here report the case of a 29-year old gravida 2, para 2 patient with no particular past medical history. Symptoms evolved over 2 months and were marked by bilateral breast growth impairing her daily activities. Clinical examination showed hypertrophied breasts and bilateral breast ulcers. She had a history of 28-weeks amenorrhea. Anatomopathological examination of ulcers showed fleshy bud-like tissue. The patient had high levels of prolactin (1345 µUI/ml). The levels of FSH and LH were normal. The patient underwent bromocriptine therapy without success. Patient's evolution was marked by decrease in size and regression in skin ulcers six months after vaginal birth. Gestational gigantomastia is a breast hypertrophy characterized by a breast volume exceeding 1500 cm3 . Its cause is unknown. Radical treatment is based on bilateral mastectomy.


Assuntos
Mama/anormalidades , Hipertrofia/patologia , Complicações na Gravidez/patologia , Prolactina/sangue , Adulto , Mama/patologia , Bromocriptina/administração & dosagem , Feminino , Humanos , Gravidez
19.
Acta Cir Bras ; 34(4): e201900401, 2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31066785

RESUMO

PURPOSE: To investigate the relations of neuropeptide Y (NPY) and heme oxygenase-1 (HO-1) expressions with fetal brain injury in rats with intrahepatic cholestasis of pregnancy (ICP). METHODS: Sixty rats pregnant for 15 days were randomly divided into experimental and control groups. The ICP model was established in experimental group. On the 21st day, the blood biochemical test, histopathological examination of pregnant rat liver and fetal brain tissues and immunohistochemical analysis of fetal rat brain tissues were performed. RESULTS: On the 21st day, the alanineaminotransferase, aspartate aminotransferase and total bile acid levels in experimental group were significantly higher than control group (P<0.01). Compared with control group, there was obvious vacuolar degeneration in pregnant rat liver tissue and fetal brain tissue in experimental group. NPY expression in fetal brain tissue was negative in control group and positive in experimental group. HO-1 expression in fetal brain tissue was strongly positive in control group and positive in experimental group. There was significant difference of immunohistochemical staining optical density between two groups (P<0.01). CONCLUSION: In fetal brain of ICP rats, the NPY expression is increased, and the HO-1 expression is decreased, which may be related to the fetal brain injury.


Assuntos
Lesões Encefálicas/metabolismo , Colestase Intra-Hepática/metabolismo , Heme Oxigenase-1/metabolismo , Neuropeptídeo Y/metabolismo , Complicações na Gravidez/metabolismo , Animais , Lesões Encefálicas/etiologia , Lesões Encefálicas/patologia , Colestase Intra-Hepática/complicações , Colestase Intra-Hepática/patologia , Modelos Animais de Doenças , Feminino , Imuno-Histoquímica , Gravidez , Complicações na Gravidez/patologia , Ratos , Ratos Sprague-Dawley
20.
Adv Exp Med Biol ; 1122: 211-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30937871

RESUMO

The structural components of the umbilical cord, including two arteries and one vein, the stromal region/Wharton's jelly, and amniotic epithelial membrane, are well described at various time points of gestation. Over the last two decades, evidence has emerged that multipotent cells sharing properties of mesenchymal stromal cell and pericytes/mural cells can be isolated from multiple regions of the umbilical cord, including the perivascular region of the umbilical cord arteries and vein, Wharton's jelly, and subamnion. These cells have increasingly gained interest for their potential use in regenerative and immunomodulatory medicine. Recent studies suggest that obstetrical complications including gestational diabetes mellitus and preeclampsia may alter the yield, properties, and potency of mesenchymal stromal cells isolated from the umbilical cord. The role that pericytes or pericyte-like cells play in the development of the human umbilical cord and associated pathologies, however, remains to be investigated.


Assuntos
Células-Tronco Mesenquimais/citologia , Pericitos/citologia , Cordão Umbilical/citologia , Âmnio/citologia , Diferenciação Celular , Feminino , Humanos , Gravidez , Complicações na Gravidez/patologia , Geleia de Wharton/citologia
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