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1.
Medicine (Baltimore) ; 99(8): e19242, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080127

RESUMO

The gestational diabetes mellitus (GDM) diagnostic criteria recommended by the International Association of Diabetes and Pregnancy Study Group (IADPSG) were established based on the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study and have been the most commonly used criteria for determining GDM worldwide. Although individuals from mainland China were not included in the HAPO study, the IADPSG criteria have been used in China since 2011. However, the appropriateness of the criteria for evaluating maternal postpartum outcomes in mainland China are unknown. We conducted this study to determine whether the IADPSG criteria are appropriate for Chinese patients for evaluating long-term maternal postpartum outcomes.Eighty-four patients who were diagnosed with hyperglycemia during pregnancy and had delivery in Peking University First Hospital from February 2007 to December 2009 were enrolled in the study. For patients in Group A, GDM was diagnosed using both the National Diabetes Data Group (NDDG) and the IADPSG criteria, while patients in Group B, gestational impaired glucose tolerance (GIGT) was diagnosed using the NDDG criteria while GDM was diagnosed based on the IADPSG criteria. Anthropometric data, glucose metabolism, lipid profiles, ß cell function, and insulin resistance index were evaluated and compared to baseline after 5- to 6-year postpartum period.Patients in group A had significantly higher oral glucose tolerance test (OGTT) fasting, 2-hour and 3-hour plasma glucose levels compared to patients in group B at 24 to 28 weeks of gestation (P < .05). No significant differences were observed between the groups for anthropometric data, postpartum abnormal glucose metabolism (50.91% vs 44.83%, P = .596), type 2 diabetes mellitus (T2DM) (16.36% vs 3.45%, P = .167), lipid profiles, ß cell function (homeostasis model assessment ß-cell function index (HOMA-ß) 1.04 vs 0.99, P = .935) and insulin resistance (homeostasis model assessment insulin resistance index (HOMA-IR) 2.01 vs 1.69, P = .583).Patients diagnosed with GDM using either the NDDG or IADPSG criteria had abnormal glucose levels and lipid metabolism after delivery. Patients with mild hyperglycemia had similar postpartum ß-cell functional impairment and insulin resistance to those with moderate hyperglycemia during pregnancy. Hence, with respect to maternal long-term postpartum outcomes, the IADPSG diagnostic criteria for GDM could be appropriate for patients in mainland China.


Assuntos
Diabetes Gestacional/fisiopatologia , Período Pós-Parto/fisiologia , Adulto , Pesos e Medidas Corporais , China , Feminino , Glucose/metabolismo , Teste de Tolerância a Glucose , Humanos , Resistência à Insulina/fisiologia , Células Secretoras de Insulina/metabolismo , Lipídeos/sangue , Gravidez
2.
Medicine (Baltimore) ; 98(46): e17969, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725660

RESUMO

Alanine transaminase (ALT) abnormalities are common in chronic hepatitis B (CHB) carriers during postpartum period. Disturbances in cytokines are considered to be associated with hepatitis Flares. There are limited data on cytokines changes in HBeAg positive patients with ALT abnormalities.This is an observational study. Pregnant patients with hepatitis B e-antigen (HBeAg) positive were enrolled from January 2014 to September 2018. Patients were assigned into three groups based on ALT levels in postpartum 6 to 8 weeks: ALT in normal range, ALT in 1 to 2-fold upper limits of normal (ULN) and ALT >2-fold ULN. Serum cytokines, ratios of regulatory T cells, and the concentration of cortisol were collected and compared among the three groups.Of the 135 mothers enrolled, 80.7% (109/135) completed the postpartum 6-week study. 13.8% (15/109) patients had postpartum ALT higher than 2ULN, 27.5% (30/109) patients had ALT in 1 to 2ULN and 58.7% (64/109) patients had ALT in normal range. Compared to control group, patients with ALT >2ULN had a higher IL-10 level (P < .05). No differences of IL-10 levels were found in the comparison of other inter comparison among three groups. No differences were found in the levels of other collected serum cytokines, cortisol, and regulatory T cells among three groups. On multivariate analysis, abnormal IL-10 level was independent risk factor for postpartum ALT elevating >2ULN. At the same time, the incidence of postpartum ALT elevated >2ULN were higher in patients with abnormal elevation IL-10 level than in patients with normal IL-10 level (14/68 vs 1/41, P = .008).CHB patients with postpartum ALT abnormalities show higher IL-10 level and postpartum ALT abnormalities were mainly occurred in patients with abnormal IL-10 level. IL-10 may be an underlying predictor and treatment target of hepatitis B, and further studies are needed.


Assuntos
Alanina Transaminase/sangue , Antígenos E da Hepatite B/sangue , Hepatite B Crônica/sangue , Interleucina-10/sangue , Período Pós-Parto/fisiologia , Adulto , Antivirais/uso terapêutico , Citocinas/sangue , Feminino , Antígenos E da Hepatite B/imunologia , Hepatite B Crônica/tratamento farmacológico , Humanos , Hidrocortisona/sangue
3.
BMC Health Serv Res ; 19(1): 851, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31747914

RESUMO

BACKGROUND: Over time, the Brazilian health system, a growing country, has been developing to ensure good accessibility to health goods and services. This development is focusing on the principle of universality of access and completeness of health care. In this context, we aimed to evaluate the completeness of care and universality of access for women in their pregnancy and puerperal period in Ceará, Brazil. METHODS: A descriptive, cross-sectional study based on a quantitative approach, using information collected from the database of the regulation system of the state of Ceará and data from the Prenatal Monitoring System. The research population comprised of 1701 women who delivered a baby in an obstetric reference unit in the Health Macro-Region of Cariri, Ceará, Brazil from January to December 2015. RESULTS: There was a high rate of cesarean delivery (49.7%) and a high waiting time for access to high-risk delivery (32.6%) and neonatal intensive care unit (72.9%). There was also a low percentage (41.1%) of pregnant women undergoing an adequate number of prenatal consultations, dental care (20%), educational activities (15%), visits to the maternity ward (0.1%), laboratory tests of the third trimester (29.2%) and puerperal consultation (37.9%). CONCLUSIONS: It was concluded that the Maternal and Child Health Policy, especially the Rede Cegonha, which is still under development, does not ensure access and completeness of care for women during the prenatal, delivery, and puerperal periods, thus violating their reproductive rights. The results of this study allow a critical analysis by the academia and health managers in search of strategies to improve the services of Rede Cegonha in Brazil.


Assuntos
Acesso aos Serviços de Saúde/normas , Serviços de Saúde Materna/normas , Adulto , Brasil , Cesárea/estatística & dados numéricos , Criança , Estudos Transversais , Feminino , Política de Saúde , Humanos , Assistência Médica/normas , Cuidado Pós-Natal/normas , Período Pós-Parto/fisiologia , Gravidez , Complicações na Gravidez/terapia , Gestantes , Cuidado Pré-Natal/normas , Encaminhamento e Consulta , Direitos Sexuais e Reprodutivos/normas , Adulto Jovem
4.
Sleep Health ; 5(6): 598-605, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31521562

RESUMO

OBJECTIVE: To describe sleep quality and sleep duration in primiparous women 6 months postpartum and to determine whether sleep quality is associated with 24-hour physical activity assessed using triaxial wrist accelerometry and a novel analytic technique, functional data analysis (FDA). METHODS: Six months postpartum, participants wore a triaxial wrist accelerometer for 7 days and completed the Pittsburgh Sleep Quality Index (PSQI). We categorized sleep quality as good (score ≤5) or poor (>5). Data were summarized as vector magnitude of accelerations net of local gravity, or "Euclidean Norm Minus One" (ENMO, mg), in 5-second epochs. Using FDA, we modeled ENMO as a continuously changing, functional outcome predicted by sleep quality. We also compared mean total ENMO per 24-hour day, mean minutes of moderate to vigorous physical activity (MVPA) and of light activity/day, and mean minutes of MVPA in 10-minute bouts/day by sleep quality. RESULTS: Of 365 women that completed the PSQI, 215 (59%) reported poor sleep quality. Two hundred ninety-six women completed both the PSQI and valid accelerometry. With the exception of one brief period around noon, sleep quality was not significantly associated with 24-hour physical activity according to FDA. Women with poor sleep quality had slightly greater total mean activity, minutes of light activity, and minutes of MVPA per day, but no difference in minutes of MVPA in at least 10-minute bouts. CONCLUSION: Poor sleep quality is common 6 months postpartum. We identified no clinically significant differences in physical activity metrics between women with good and poor quality sleep.


Assuntos
Exercício/fisiologia , Período Pós-Parto/fisiologia , Sono/fisiologia , Acelerometria , Adulto , Estudos Transversais , Feminino , Humanos , Fatores de Tempo , Adulto Jovem
5.
J Ethnopharmacol ; 245: 112175, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31442621

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Marantodes pumilum (Blume) Kuntze has traditionally been used to firm the uterus after delivery, however scientific evidences behind this claim is still lacking. AIMS OF STUDY: To demonstrate Marantodes pumilum leaves aqueous extract (MPE) has an effect on uterine contraction after delivery and to elucidate the molecular mechanisms involved. METHODS: Day-1 post-delivery female rats were given MPE (100, 250 and 500 mg/kg/day) orally for seven consecutive days. A day after the last treatment (day-8), rats were sacrificed and uteri were harvested and subjected for ex-vivo contraction study using organ bath followed by protein expression and distribution study by Western blotting and immunohistochemistry techniques, respectively. The proteins of interest include calmodulin-CaM, myosin light chain kinase-MLCK, sarcoplasmic reticulum Ca2+-ATPase (SERCA), G-protein α and ß (Gα and Gß), inositol-triphosphate 3-kinase (IP3K), oxytocin receptor-OTR, prostaglandin (PGF)2α receptor-PGFR, muscarinic receptor-MAChR and estrogen receptor (ER) isoforms α and ß. Levels of estradiol and progesterone in serum were determined by enzyme-linked immunoassay (ELISA). RESULTS: Ex-vivo contraction study revealed the force of uterine contraction increased with increasing doses of MPE. In addition, expression of CaM, MLCK, SERCA, Gα, Gß, IP3K, OTR, PGF2α, MAChR, Erα and ERß in the uterus increased with increasing doses of MPE. Serum analysis indicate that estradiol levels decreased while progesterone levels remained low at day-8 post-partum in rats receiving 250 and 500 mg/kg/day MPE. CONCLUSIONS: These findings support the claims that MPE help to firm the uterus and pave the way for its use as a uterotonic agent after delivery.


Assuntos
Extratos Vegetais/farmacologia , Primulaceae , Contração Uterina/efeitos dos fármacos , Animais , Estradiol/sangue , Estrogênios/sangue , Feminino , Folhas de Planta , Período Pós-Parto/sangue , Período Pós-Parto/fisiologia , Progesterona/sangue , Ratos Sprague-Dawley , Receptores Estrogênicos/fisiologia , Útero/efeitos dos fármacos , Útero/fisiologia
6.
J Med Life ; 12(2): 178-183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31406521

RESUMO

Weight gain during pregnancy can be a real risk factor for long-term obesity which has implications in all areas of medicine. This study is designed to assess pregnancy-related weight gain and postpartum weight loss, to identify a possible correlation between weight gain during pregnancy and the risk of obesity in the late postpartum period. The batch comprised 306 women, hospitalized in the Obstetrics and Gynecology Section of the "Nicolae Malaxa" Clinical Hospital between June - November 2017. During this study, we assessed the weight status using the Weight, Body Mass Index, Height, and Abdominal Circumference. These parameters were clinically assessed in three periods pre-pregnancy, early postpartum period, late postpartum period. We also collected data on the evolution of the pregnancy using the anamnesis and the personal pregnancy monitoring sheet. Pregnancy and postpartum period represent a key moment in women's lives in which the risk of obesity is real. Understanding women experiences with weight changes during pregnancy and postpartum period can improve the management of losing weight following pregnancy, avoid long-term weight gain and so reduce the risk for obesity. Also, the correct management of obesity should include the assessment of somatic disorders that may cause major dysfunction, requiring complex rehabilitation programs.


Assuntos
Ganho de Peso na Gestação/fisiologia , Obesidade/complicações , Período Pós-Parto/fisiologia , Perda de Peso , Adolescente , Adulto , Índice de Massa Corporal , Parto Obstétrico , Feminino , Humanos , Gravidez , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
7.
Arq. bras. med. vet. zootec. (Online) ; 71(4): 1307-1315, jul.-ago. 2019. tab
Artigo em Português | LILACS, VETINDEX | ID: biblio-1038618

RESUMO

Nas ovelhas, a demanda de nutrientes aumenta durante a gestação, especialmente nas últimas seis semanas, quando ocorre maior desenvolvimento do feto. Os objetivos deste trabalho foram estudar o perfil bioquímico de ovelhas durante a gestação e no periparto imediato, comparando-se gestação única com gemelar. Foram utilizadas 60 ovelhas, Dorper, divididas em dois grupos experimentais com base no diagnóstico de gestação ultrassonográfico: grupo 1: 30 ovelhas com feto único; grupo 2: 30 ovelhas com gestação gemelar. Em nove momentos de coleta, foram mensurados no soro sanguíneo: ureia, creatinina, proteína total (PT), albumina, globulina, aspartato aminotransferase (AST), gamaglutamiltransferase, fosfatase alcalina, colesterol e triglicérides. O peso vivo das ovelhas do G2 foi maior que do G1 em todos os momentos, inclusive quando estavam vazias. Houve diferença entre as ovelhas do G1 e do G2 nos valores de PT, albumina, AST e triglicérides. A partir de 120 dias de gestação, o perfil proteico se modificou, com menores níveis de ureia, PT, albumina e globulina, mostrando que a demanda metabólica se intensificou no último mês da gestação. Os níveis de colesterol e triglicérides diminuíram de 140 dias de gestação para o parto. Este trabalho mostrou que a gestação proporcionou mudanças significativas no metabolismo da ovelha, principalmente no terço final da gestação, quando há maior necessidade de acompanhamento para evitar a incidência de doenças metabólicas.(AU)


In sheep, nutrient demand increases during gestation, particularly in the last six weeks, when the fetuses develop. The objectives of this study were to evaluate the biochemical profile of ewes during pregnancy and in the immediate peripartum comparing single with twin pregnancies. Sixty ewes of Dorper breed were divided into two groups by pregnancy ultrasonographic diagnosis: 1 - 30 ewes with single fetus gestation; 2 - 30 ewes with twin pregnancy. In nine collection moments the following parameters were measured: urea, creatinine, total protein (TP), albumin, globulin, aspartate aminotransferase, gamma glutamyltransferase, alkaline phosphatase, cholesterol and triglycerides. The weight of G2 sheep was higher than G1 since they were empty. There were differences in G1 and G2 sheep metabolism in TP, Albumin, AST and Triglycerides. From 120 days of pregnancy, the protein profile changed, with lower levels of urea, TP, albumin and globulin, showing that the metabolic demand intensified in the last month of pregnancy. The levels of cholesterol and triglycerides decreased from 140 days of pregnancy to lambing day. This study showed that gestation provided significant changes in the ewe's metabolism, especially in the final third of gestation, when there is a greater need to follow the animals to avoid the incidence of metabolic diseases.(AU)


Assuntos
Animais , Feminino , Gravidez , Pré-Eclâmpsia/veterinária , Ovinos/fisiologia , Ovinos/sangue , Período Pós-Parto/fisiologia , Período Periparto/fisiologia , Doenças Metabólicas/veterinária , Análise Química do Sangue/veterinária
8.
Nutr. hosp ; 36(4): 931-938, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184721

RESUMO

Introducción: el ejercicio físico es una buena forma de mantener un estilo de vida saludable y su práctica regular es recomendable durante el periodo gestacional, favoreciendo, entre otros, una adecuada ganancia ponderal durante la gestación y una mejor recuperación del peso pregestacional. Objetivo: analizar la evolución del peso, gestacional y posparto, en mujeres embarazadas que realizan un programa de ejercicio físico moderado en el medio acuático. Material y métodos: se realizó una intervención mediante un programa de ejercicio físico acuático diseñado específicamente para mujeres embarazadas. Los participantes fueron asignados al azar al grupo de ejercicios (GE; n = 65) o al grupo de control (GC; n = 64). Los participantes en el GE realizaron tres sesiones por semana de ejercicios físicos, que fueron dirigidos por el investigador principal. Las participantes del GC recibieron atención prenatal de rutina. El peso materno se midió durante la gestación en las semanas 20 y 35 y en el posparto en las semanas 16 y 28 del mismo. Resultados: la ganancia ponderal durante la gestación presenta diferencias significativas entre grupos (p < 0,001). Las retenciones de peso a los cuatro meses y a los siete meses fueron significativas entre GE y GC (p < 0,001). El peso del recién nacido se mantuvo en el rango de peso normal para recién nacidos a término en ambos grupos, aunque con diferencias significativas (p = 0,011). Conclusión: la metodología Study of Water Exercise Pregnancy (SWEP) durante el embarazo ayuda al control de la ganancia de peso gestacional y a la recuperación del peso pregestacional


Introduction: physical exercise is a good way to maintain a healthy lifestyle and its regular practice is recommended during the gestational period, favoring, among others, an adequate weight gain during pregnancy and a better recovery of pre-pregnancy weight. Objective: to analyze the evolution of weight, gestational and postpartum, in pregnant women who perform a program of moderate physical exercise in the aquatic environment. Material and methods: an intervention was carried out through a program of aquatic physical exercise designed specifically for pregnant women. The participants were randomly assigned to the exercise group (EG; n = 65) or to the control group (CG; n = 64). Participants in the EG performed three sessions per week of physical exercises, which were led by the principal investigator. CG participants received routine prenatal care. Maternal weight was measured during pregnancy at weeks 20 and 35, and postpartum at weeks 16 and 28 of the same. Results: weight gain during pregnancy shows significant differences between groups (p < 0.001). Weight retention at four months and at seven months were significant between EG and GC (p < 0.001). The weight of the newborn remained in the range of normal weight for term newborns in both groups, although with significant differences (p = 0.011). Conclusion: the Study of Water Exercise Pregnancy (SWEP) methodology during pregnancy helps control the gain of gestational weight and the recovery of pre-pregnancy weight


Assuntos
Humanos , Feminino , Gravidez , Adulto , Peso Corporal/fisiologia , Ganho de Peso na Gestação/fisiologia , Exercício , Esportes Aquáticos/fisiologia , Período Pós-Parto/fisiologia , Inquéritos e Questionários , Frequência Cardíaca
9.
Pol J Vet Sci ; 22(2): 363-368, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31269342

RESUMO

The objectives of this study were to examine the option of being able to use rumination time (RT) as a form of stress indicator in the first thirty days after calving, and to determine the relationship between rumination time, blood cortisol levels, and lactate concentration levels in dairy cows during the first thirty days after calving. Ninety cows which produced milk (DIM) within 1-30 days were selected and categorised into the following groups: the first group (1) fell within 1-7 days after parturition (dpp) (n=30); the second group (2) fell within 8-14dpp (n=30); and the third group (3) fell within 15-30dpp (n=30) after calving. The cows were milked using Lely Astronaut® A3 milking robots with free traffic. The blood samples were tested using the fluorescence enzyme immunoassay method for cortisol analysis. Lactate concentrations were tested with a Lactate Pro2 ®. The RT increased during all of the exploratory periods (with readings between 1.12-4.90%). A decrease was also observed in the lactate levels (by 1.10 times) and cortisol levels (by 1.98 times, p⟨0.05) of cows which fell within the 8-14dpp group, when compared to an average of 1-7dpp in the previous study period (15-30dpp). However, lactate concentrations increased (by 1.84 times, p⟨0.05) as well as cortisol levels (by 2.09 times, p ⟨0.01) when compared with a figure between 8-14 dpp on the average. The results obtained indicate that, RT increased during all exploratory periods, while a decrease by 1.10 times and 1.98 times was observed in lactate levels and cortisol levels, respectively. During the entire period of the study RT was positively correlated with the lactate concentration levels, and negatively correlated with cortisol levels. Within a period of 1-14 days, a negative correlation was determined with lactate levels along with a 15-30dpp-positive correlation coefficient. In conclusion, RT can be used as a kind of stress indicator for cows in the first thirty days after calving; however, further research is required to ascertain this conclusion.


Assuntos
Bovinos/fisiologia , Comportamento Alimentar/fisiologia , Período Pós-Parto/fisiologia , Estresse Fisiológico , Animais , Bovinos/sangue , Feminino , Hidrocortisona/sangue , Ácido Láctico/sangue
10.
J Dairy Sci ; 102(8): 7398-7407, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31229279

RESUMO

The present study investigated the effect of straw yard housing during the dry period and 2 d of additional maternity pen housing postcalving on lying and feeding behavior and calving difficulty in Holstein dairy cows. In this study, 122 multiparous cows were moved to either a straw yard or into freestall housing 4 wk before their expected calving date. Cows that had been housed in straw yards stayed in the maternity pen for an additional 2 d after their calving day, but cows that had been housed in freestalls were moved to the general lactation group the morning after calving. Lying time, lying bouts, feeding time, number of feeder visits, feed intake, feeding rate, and assisted calvings were recorded. Observations were divided into 2 periods: precalving (the 4-wk dry period before calving) and postcalving (the day of calving and the 2 d after). During the precalving period, cows housed in straw yards showed a higher number of lying bouts but no difference in lying time compared with cows housed in freestalls. Cows that were housed longer in the straw-bedded maternity pen postcalving spent more time lying during the 2 d postcalving and had a higher number of lying bouts on the day of calving than cows moved to the freestall area on the day postcalving. Additionally, cows that were housed longer in the maternity pen had a slower feeding rate and longer total feeding time during the 2 d after calving than cows with a shorter stay in the maternity pen. We found no difference in the number of assisted calvings. This study suggests that straw yard housing during the dry period may facilitate the transition between standing and lying. Furthermore, the extended stay in the maternity pen postcalving increased lying time, the number of lying bouts, and feeding time, but decreased feeding rate compared with cows that were moved to the general lactation group on the day postcalving. These results suggest potential recovery benefits with an extended stay in a maternity pen postcalving. However, further studies are needed to separate the effects of housing in the dry period and the effects of an extended housing in individual maternity pens.


Assuntos
Comportamento Animal/fisiologia , Bovinos/fisiologia , Comportamento Alimentar/fisiologia , Abrigo para Animais , Lactação/fisiologia , Animais , Feminino , Paridade , Parto/fisiologia , Período Pós-Parto/fisiologia , Postura/fisiologia , Gravidez
11.
Acta Vet Hung ; 67(2): 241-245, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31238723

RESUMO

Activities of alkaline phosphatase, aspartate aminotransferase and alanine aminotransferase, and concentrations of serum metabolites [beta-hydroxybutyrate (BHB) and non-esterified fatty acids (NEFA)] of primiparous (n = 83) and multiparous (n = 213) Holstein cows were studied as possible predictors of retained fetal membranes (RFM), grade 2 clinical metritis (CM) and clinical endometritis (CEM). A logistic regression model was used to calculate odds ratios (OR) for the prevalence of CM diagnosed between 0-5, 6-10 and 11-20 days in milk (DIM) and for the prevalence of CEM diagnosed between 22-28 and 42-49 DIM. The activities of the examined serum enzymes did not show significant associations either with CM or with CEM. For NEFA sampled on days 0 and 5, an OR of 2.38 for CM 0-20 DIM and an OR of 2.58 for CM 11-20 DIM was found. For BHB sampled on days 0 and 5, an OR of 8.20 for CEM 22-28 and 42-49 DIM and an OR of 1.98 for CM 6-10 DIM were found. The prevalence of RFM was higher in ≥ 4 parity cows compared to primiparous cows (46.3% vs. 26.5%). BHB and NEFA levels measured between 0 and 5 DIM could have a predictive ability for postpartum uterine disorders such as RFM, CM and CEM.


Assuntos
Doenças dos Bovinos/metabolismo , Endometrite/veterinária , Metabolismo Energético , Enzimas/sangue , Paridade/fisiologia , Animais , Bovinos , Doenças dos Bovinos/diagnóstico , Endometrite/diagnóstico , Endometrite/metabolismo , Feminino , Hungria , Período Pós-Parto/fisiologia
12.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(2): 69-76, abr.-jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183391

RESUMO

Introducción: La prevalencia de la diferencia de la presión arterial (PA) entre brazos mayor a 10mmHg es baja, en la población es del 4,2%, en la embarazada es del 3,2%, y es mayor en la que presenta hipertensión. Ningún artículo asocia si la diferencia en la PA cuando es mayor a 10mmHg afecta al recién nacido. Objetivo: Determinar la prevalencia de la diferencia de PA en embarazadas y puérperas con hipertensión arterial y obesidad, y su impacto sobre el recién nacido. Material y métodos: Se determinaron las diferencias de la PA en 493 pacientes, 223 embarazadas y 270 puérperas, se dividieron en grupos embarazo normal 222 (45%), hipertensas gestacionales 39 (7,9%), preeclampsia 156 (31,6%), hipertensas crónicas 55 (11,2%), hipertensas crónicas más preeclampsia 12 (2,4%) y síndrome de HELLP 9 (1,8%), de acuerdo con el índice de masa corporal de la OMS, 78 (22,5%) pacientes presentaron peso normal, el resto presentó sobrepeso y obesidad de los 3 tipos. La diferencia de ≤ 10mmHg entre brazos se encontró en el 76,91% (379 pacientes), entre 11mmHg y 20mmHg, 102 pacientes (20,7%) y más de 20mmHg 12 pacientes (2,4%), en este grupo se encontraron diferencias estadísticamente significativas en peso y talla del recién nacido y 2muertes fetales. Conclusión: La prevalencia de más de 20mmHg fue del 2,4%, con mayor repercusión sobre el recién nacido. Debe medirse la PA en ambos brazos durante el control prenatal, para diagnosticar hipertensión arterial asociada al embarazo y posible daño vascular periférico


Introduction: The prevalence of the difference in blood pressure between arms greater than 10mmHg is low, in the population it is 4.2%, in the pregnant woman it is 3.2%, and it is higher in those with hypertension. No article associates if the difference in BP when it is greater than 10mmHg would affect the newborn. Objective: To determine the prevalence of BP difference in pregnant women with hypertension and obesity and its impact on the newborn. Material and methods: Blood pressure differences were determined in 493 patients, 223 pregnant women and 270 puerperal women, were divided into 222 normal pregnancy (45%), 39 gestational hypertensives (7.9%), 156 preeclampsia (31.6%), chronic hypertensive patients 55 (11.2%), chronic hypertensive patients plus preeclampsia 12 (2.4%), and hellp syndrome 9 (1.8%), according to the WHO Body Mass Index, 78 (22.5%) patients presented normal weight, the rest They presented overweight and obesity of the 3 types. The difference of 10mmHg between arms was found in 76.91% (379 patients), between 11mmHg and 20mmHg, 102 patients (20.7%) and more than 20mmHg 12 patients (2.4%), in this group statistically differences were found significant in terms of weight and height of the newborn and 2fetal deaths. Conclusion: The prevalence of more than 20mmHg was 2.4% and we determined a greater impact on the newborn. Blood pressure should be measured in both arms during prenatal control, to diagnose arterial hypertension associated with pregnancy and possible peripheral vascular damage


Assuntos
Humanos , Feminino , Recém-Nascido , Adulto Jovem , Adulto , Hipertensão/fisiopatologia , Determinação da Pressão Arterial/métodos , Período Pós-Parto/fisiologia , Obesidade/fisiopatologia , Resultado da Gravidez , Índice de Massa Corporal , Hipertensão/epidemiologia , México/epidemiologia , Prevalência
13.
Med Sci Sports Exerc ; 51(6): 1292-1302, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31095086

RESUMO

PURPOSE: This study aimed to summarize the evidence from the 2018 Physical Activity Guidelines Advisory Committee Scientific Report, including new evidence from an updated search of the effects of physical activity on maternal health during pregnancy and postpartum. METHODS: An initial search was undertaken to identify systematic reviews and meta-analyses published between 2006 and 2016. An updated search then identified additional systematic reviews and meta-analyses published between January 2017 and February 2018. The searches were conducted in PubMed®, CINAHL, and Cochrane Library and supplemented through hand searches of reference lists of included articles and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: The original and updated searches yielded a total of 76 systematic reviews and meta-analyses. Strong evidence demonstrated that moderate-intensity physical activity reduced the risk of excessive gestational weight gain, gestational diabetes, and symptoms of postpartum depression. Limited evidence suggested an inverse relationship between physical activity and risk of preeclampsia, gestational hypertension, and antenatal anxiety and depressive symptomology. Insufficient evidence was available to determine the effect of physical activity on postpartum weight loss, postpartum anxiety, and affect during both pregnancy and postpartum. For all health outcomes, there was insufficient evidence to determine whether the relationships varied by age, race/ethnicity, socioeconomic status, or prepregnancy weight status. CONCLUSIONS: The gestational period is an opportunity to promote positive health behaviors that can have both short- and long-term benefits for the mother. Given the low prevalence of physical activity in young women in general, and the high prevalence of obesity and cardiometabolic diseases among the U.S. population, the public health importance of increasing physical activity in women of childbearing age before, during, and after pregnancy is substantial.


Assuntos
Exercício , Período Pós-Parto/fisiologia , Gravidez/fisiologia , Pesquisa Biomédica , Depressão Pós-Parto/prevenção & controle , Feminino , Ganho de Peso na Gestação/fisiologia , Humanos , Saúde Materna , Guias de Prática Clínica como Assunto , Complicações na Gravidez/prevenção & controle , Fatores Socioeconômicos , Perda de Peso/fisiologia
14.
Reprod Domest Anim ; 54(7): 1010-1017, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31066470

RESUMO

The objectives of this study were to determine the effects of acupuncture in dairy cows (Bos taurus) on caruncular matrix metalloproteinase type-2 (MMP2) at 0, 2 and 4 hr after calving. Acupuncture (n = 6) was applied at 0 and 2 hr after calving to 6 points that relax the cervix and stimulate uterine contractions. Controls (n = 9) were kept in a stanchion for 15 min without acupuncture. All of the cows in the study delivered their placenta in <4 hr. Formalin-fixed caruncles were paraffin-embedded and subjected to routine immunohistochemistry to determine MMP2 expression, which was scored by a single observer. Flash frozen caruncles were homogenized, and protein concentration was determined. MMP2 concentrations were calculated using commercial bovine ELISAs. MMP2 enzyme activity was determined using zymography. The mean value for each time point for each cow was used to calculate the mean ± SEM for each treatment group. MMP2 was predominantly localized to the epithelial and subepithelial stromal cells of the caruncles in both treatment groups. MMP2 immunoexpression was lower 4 hr after calving in the control cows (p = 0.012) but not in the acupuncture treated cows indicating that acupuncture treatment maintained MMP expression. MMP2 tissue concentration was lower 2 hr after calving in the control cows (p = 0.048) but not in the acupuncture treated cows. MMP2 enzyme activity decreased from 0 to 2 hr after calving in control cows (p = 0.046) but not in acupuncture treated cows. This study provides physiologic evidence for the effects of acupuncture on the bovine reproductive tract and substantiates the use of this treatment in cases of placental retention.


Assuntos
Terapia por Acupuntura/veterinária , Metaloproteinase 2 da Matriz/metabolismo , Período Pós-Parto/fisiologia , Animais , Bovinos , Feminino , Metaloproteinase 2 da Matriz/genética , Placenta/enzimologia , Gravidez , Distribuição Tecidual
15.
J Dairy Sci ; 102(6): 5550-5565, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30954258

RESUMO

High-producing dairy cows experience a state of negative energy balance in the periparturient period that is partially addressed by increasing the rate of fat and protein mobilization. Previous studies have focused on the rate of fat mobilization, and consequently the rate of protein mobilization has not been well characterized. The objective of this study was therefore to determine the change in indicators of muscle mass during early lactation using ultrasonographic measurement of muscle thickness and changes in plasma creatinine concentration. The maximum thickness of the gluteus medius and longissimus dorsi muscles of 106 Holstein cows (34 primiparous, 72 multiparous) was determined ultrasonographically on d -3, 0, 3, 7, 14, 21, and 28 relative to the day of parturition. Plasma creatinine concentration was measured periodically during the same period. Mixed models analysis and Passing-Bablok regression were used to analyze the data. Gluteus medius thickness, longissimus dorsi loin thickness (LDLT), and longissimus dorsi thoracic thickness (LDTT) were decreased at 28 d postpartum compared with d 3 antepartum. Plasma creatinine concentration was weakly associated with gluteus medius thickness, LDLT, and LDTT (Spearman's rho = 0.31, 0.39, and 0.32, respectively). Plasma creatinine concentration in primiparous and multiparous cows at 28 d postpartum decreased by 0.24 and 0.30 mg/dL, respectively, compared with values 3 d antepartum. We concluded that ultrasonographic measurement of LDLT and LDTT and change in plasma creatinine concentration may provide practical methods for monitoring the rate of protein mobilization in periparturient dairy cows. Ultrasonographic examination of LDLT and LDTT therefore complements ultrasonographic measurement of backfat thickness and may be useful in the evaluation of energy reserve mobilization in periparturient dairy cows.


Assuntos
Bovinos/sangue , Creatinina/sangue , Gorduras/metabolismo , Músculo Esquelético/metabolismo , Proteínas/metabolismo , Animais , Bovinos/crescimento & desenvolvimento , Bovinos/fisiologia , Metabolismo Energético , Feminino , Lactação , Leite/metabolismo , Músculo Esquelético/crescimento & desenvolvimento , Parto , Período Pós-Parto/sangue , Período Pós-Parto/fisiologia , Gravidez
16.
PLoS One ; 14(4): e0215947, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31013338

RESUMO

BACKGROUND: Avoiding unintended pregnancies through family planning is a WHO strategy for preventing mother to child transmission of HIV (PMTCT) and maternal morbidity/mortality. We investigated factors associated with unintended index pregnancy, unmet contraceptive need, future pregnancy intention and current contraceptive use among Malawian women living with HIV in the Option B+ era. METHODS: Women who tested HIV positive at 4-26 weeks postpartum were enrolled into a cross-sectional study at high-volume Under-5 clinics. Structured baseline interviews included questions on socio-demographics, HIV knowledge, partner's HIV status/disclosure, ART use, pregnancy intention and contraceptive use. Logistic regression was used to determine factors associated with outcomes. RESULTS: We enrolled 578 HIV-positive women between May 2015-May 2016; median maternal age was 28 years (y) (interquartile-range [IQR]: 23-32), median parity was 3 deliveries (IQR: 2-4) and median infant age was 7 weeks (IQR: 6-12). Overall, 41.8% women reported unintended index pregnancy, of whom 35.0% reported unmet contraceptive need and 65.0% contraceptive failure. In multivariable analysis, unintended index pregnancy was higher in ≥35y vs. 14-24y (adjusted Odds Ratio [aOR]: 2.1, 95% Confidence Interval [95%CI]: 1.0-4.2) and in women with parity ≥3 vs. primiparous (aOR: 2.9, 95%CI: 1.5-5.6). Unmet contraceptive need at conception was higher in 14-24y vs. ≥35y (aOR: 4.2, 95%CI: 1.8-9.9), primiparous vs. ≥3 (aOR: 8.3, 95%CI: 1.8-39.5), and women with a partner of unknown HIV-status (aOR: 2.2, 95%CI: 1.2-4.0). Current contraceptive use was associated with being on ART in previous pregnancy (aOR: 2.5, 95%CI: 1.5-3.9). CONCLUSIONS: High prevalence of unintended index pregnancy and unmet contraceptive need among HIV-positive women highlight the need for improved access to contraceptives. To help achieve reproductive goals and elimination of MTCT of HIV, integration of family planning into HIV care should be strengthened to ensure women have timely access to a wide range of family planning methods with low failure risk.


Assuntos
Anticoncepção , Serviços de Planejamento Familiar , Infecções por HIV/epidemiologia , Técnicas de Reprodução Assistida , Adulto , Feminino , HIV , Infecções por HIV/fisiopatologia , Infecções por HIV/transmissão , Infecções por HIV/virologia , Humanos , Transmissão Vertical de Doença Infecciosa , Modelos Logísticos , Malaui/epidemiologia , Masculino , Período Pós-Parto/fisiologia , Gravidez , Religião , Adulto Jovem
17.
Biomed Res Int ; 2019: 6597503, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31016194

RESUMO

Background: Previous studies have demonstrated that acupuncture was an effective alternative for treating major depressive disorders. However, the use of acupuncture for the treatment of postpartum depression remains controversial. This review summarizes the most significant studies in the area of acupuncture treatment for postpartum depression and provides a detailed overview of the efficacy of acupuncture for the treatment of postpartum depression. Methods: We undertook a systematic review of publicly available electronic databases to identify studies that evaluated acupuncture for the treatment of postpartum depression. Our meta-analysis selected randomized controlled trials (RCTs) and quasi-RCTs that reported on the treatment effect of acupuncture on postpartum depression. Results: Eight prospective trials reporting data on postpartum depression were included in our meta-analysis. The results demonstrated that acupuncture treatment could significantly reduce HAMD scores (SMD: -1.08; 95%CI: -2.11 to -0.05; P=0.040). However, with regard to EPDS, clinical response, and serum estradiol levels, pooled analysis suggested no beneficial effects of acupuncture for postpartum women in EPDS (RR: 1.23; 95%CI: 0.90 to 1.67; P=0.195); clinical response (RR: 1.00; 95%CI: 0.89 to 1.12; P=0.969); and the levels of serum estradiol (SMD: 1.96; 95%CI: -0.01 to 3.93; P=0.051). Limitations: First, there was relatively high heterogeneity among the studies, except for clinical response. In order to identify the sources of heterogeneity, we divided the studies into subgroups by way of controls. However, heterogeneity still existed, which suggested that it arose from participants rather than controls. Second, the sample size of the studies was small, causing the power of summary results to be low. This may result in over- or underestimating the interpretation of the results. Third, our analysis used pooled data, which restricted us from performing a more detailed analysis. Conclusions: Our meta-analysis suggested that acupuncture treatment may reduce HAMD scores, while no significant effects on EPDS, clinical response, and serum estradiol levels were observed.


Assuntos
Depressão Pós-Parto/terapia , Acupuntura/métodos , Terapia por Acupuntura/métodos , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Período Pós-Parto/fisiologia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Womens Health (Lond) ; 15: 1745506519842757, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30991911

RESUMO

OBJECTIVE: Most studies about truncal pain during and after pregnancy focus on low back pain, few prospectively define change in pain, and even fewer evaluate pain in all three major truncal areas: upper back, lower back, and pelvic girdle. Thus, the objective of this prospective cohort study was to describe, in primiparous women delivered vaginally, prevalence rates and severities of upper back, lower back, and pelvic girdle pain during pregnancy and 6-10 weeks postpartum and to describe the trajectory of pain constellations between time points. STUDY DESIGN: Participants completed questionnaires at each time point. Pain intensity was rated on a visual analogue scale ranging from 0 to 100. RESULTS: Of the 288 participants, 94% reported truncal pain during pregnancy, while 75% did so postpartum. Prevalence rates of upper back, lower back, and pelvic girdle pain with or without other types of pain during pregnancy were 42%, 77%, and 74% and postpartum were 43%, 52%, and 41%, respectively. Pain severity was highest for women endorsing pain in three locations (median 55-60). Of women with the most common pain constellation during pregnancy, lower back and pelvic girdle (32%), 18% had persistent low back and pelvic girdle pain postpartum, 20% had no pain, and the remainder had pain in a different location. Of women with pain in all three locations during pregnancy (27%), 34% had persistent pain in three locations postpartum, 13% had no pain, and the remainder had pain in at least one location. CONCLUSION: More women experience pain in a constellation of locations than in a single location. Severity increases as number of pain sites increase. Women with pain in three sites during pregnancy are least likely to have pain resolve. Interventions should focus on the entire trunk and not simply one site of pain.


Assuntos
Dor nas Costas/fisiopatologia , Dor da Cintura Pélvica/fisiopatologia , Período Pós-Parto/fisiologia , Complicações na Gravidez/fisiopatologia , Adulto , Dor nas Costas/epidemiologia , Comorbidade , Feminino , Humanos , Dor Lombar/epidemiologia , Dor Lombar/fisiopatologia , Paridade , Dor da Cintura Pélvica/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Prospectivos , Fatores Socioeconômicos , Saúde da Mulher
19.
Reprod Domest Anim ; 54(6): 924-927, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31004539

RESUMO

Cows experiencing high levels of inflammation and specific metabolic conditions tend to have slower follicular growth and lower serum and follicular concentrations of oestradiol (E2). Paraoxonase1 (PON1) activity decreases during inflammatory processes. Therefore, the aim of this study was to evaluate the association between serum and intrafollicular (FF) PON1 activity and the serum and intrafollicular levels of E2 and progesterone (P4), as well as the mRNA expression of genes related to steroidogenesis, metabolism and inflammation in the first post-partum dominant follicle of Holstein cows. No correlation was found between PON1 activity, the expression of the analysed genes and levels of follicular E2 and P4, except for a negative correlation between serum E2 and follicular PO1 activity. Also, no correlation was found between serum and follicular PON1 during the first post-partum follicular wave.


Assuntos
Arildialquilfosfatase/metabolismo , Bovinos/fisiologia , Líquido Folicular/enzimologia , Folículo Ovariano/metabolismo , Animais , Bovinos/genética , Indústria de Laticínios , Estradiol/metabolismo , Feminino , Regulação da Expressão Gênica , Período Pós-Parto/fisiologia , Progesterona/metabolismo , RNA Mensageiro , Esteroides/metabolismo
20.
PLoS One ; 14(4): e0214334, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30946759

RESUMO

INTRODUCTION: Postpartum intrauterine contraceptive devices (PP-IUCD) are one type of post-partum family planning method, which can be provided to a post-partum woman starting from the placental delivery time (within 10 minutes), or within the first 48 hours of postpartum period. In most developing countries, delivery time is the primary opportunity for women to access post-partum family planning methods, especially for those living in remote areas. Hence, this study assesses providers' knowledge on postpartum intrauterine contraceptive device service provision. METHODS: A facility-based cross-sectional study was conducted in Amhara region health center and hospitals. Health providers surveyed included obstetricians, gynecologists, general practitioners, emergency surgical officers, health officers, midwives and nurses from September 18, 2015 to December18, 2016. Simple random sampling was used to select 864 subjects. Data were collected by using a structured self-administered questionnaire and observing the facility. Multilevel analysis was done to see factors associated with outcome. RESULTS: A total of 197 health facilities and 864 providers are included in the final analysis. Of the total providers 524 (60.6%) were from a health center. The mean age (±SD) of participants was 27.8 years (±5.4). The number of providers with good knowledge accounted for 253 of those surveyed (29.3%). The proportion of good knowledge among trained PP-IUCD providers was 35.7% (those who scored above average), and 27.9% was untrained about PP-IUCD. A considerable heterogeneity was observed between health facilities for each indicator of provider's knowledge. Gender differences were observed as the mean knowledge score deference on PP-IUCD by 0.4 points (ß = -0.41; -0.72, -0.10) when the participant was female. Having experience of regular counseling of pregnant women increases PP-IUCD knowledge score by 0.97. (ß = 0.97; 95% CI: 0.48, 1.47). Where the health facility requested clients to purchase the IUCD themselves, the mean knowledge score decreased by 0.47 points compared with free of charge at the facility level (ß = -0.47; 95%CI: -0.87, -0.07). CONCLUSION: Our findings showed that providers' knowledge about postpartum IUCD was low in the Amhara region public health facility. The lowest knowledge score was noted among nurses, health Officers, midwives, and general practice professionals. Factors associated with providers' knowledge on PP-IUCD are the status of health facility, female sex, training on PP-IUCD, regular counseling of pregnant women, and unavailability of IUCD service.


Assuntos
Instalações de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Dispositivos Intrauterinos , Período Pós-Parto/fisiologia , Saúde Pública , Adulto , Etiópia , Feminino , Humanos , Modelos Teóricos , Análise Multinível , Análise Multivariada
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