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Search Results: 1 - 10 of 4414 matches for " Geraldo;Quintana "
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Fatores de risco para recidiva após tratamento de les?es provocadas pelo HPV no trato genital feminino
Marana, Heitor Ricardo Cosiski;Duarte, Geraldo;Quintana, Silvana Maria;
Revista Brasileira de Ginecologia e Obstetrícia , 1999, DOI: 10.1590/S0100-72031999000400004
Abstract: purpose: evaluation of the risk factors [lesion grade, seropositivity for type 1 acquired immunodeficiency virus (hiv-1) and association with pregnancy ] for relapse of human papillomavirus (hpv) induced lesions of the female genital tract. patients and methods: seventy patients with a clinical, colposcopic and cytologic diagnosis of hpv infection were studied. clinical follow-up lasted at least 6 months after the initial treatment, thus permitting the evaluation of the therapeutic results. twenty-seven of these patients were pregnant and 12 were seropositive for hiv-1. the remaining 44 patients were not in the pregnancy-puerperium cycle and 14 of them were hiv-1 positive. according to cytologic criteria, the cervical lesions were classified as changes associated with hpv or grade i cervical intraepithelial neoplasia (cin i) (low grade lesions) or cin ii/iii (high grade lesions). data were analyzed statistically by the exact fisher test, with the level of significance set at p<0.05. the therapeutic scheme for lesions limited to the uterine cervix was cryo- or electrocautery (ec), whereas topical 5-fluorouracil was used for the diffused lesions through the vaginal wall. for the lesions in the vulvoperineal region, 80% trichloroacetic acid was used, and when they were voluminous, ec was applied. among the pregnant women, a cryocautery was used for lesions limited to the cervix and ec for diffuse lesions. results: among the hiv-1-negative pregnant women there was an 87.5% rate of recurrence when the lesions were in the cervix-vagina, and no recurrence when the lesions were vulvoperineal. in contrast, seropositive pregnant women presented 100% recurrence regardless of the site of the lesion. among nonpregnant hiv negative women, 20 and 24% recurrence was observed in the cervix-vagina and in the vulvoperineal region, respectively, as opposed to 87.5 and 100% recurrence, respectively, for the same regions among hiv positive women. the lesions associated with cin showed a
Estratégias que reduzem a transmiss?o vertical do vírus da imunodeficiência humana tipo 1
Duarte, Geraldo;Quintana, Silvana Maria;El Beitune, Patricia;
Revista Brasileira de Ginecologia e Obstetrícia , 2005, DOI: 10.1590/S0100-72032005001200010
Abstract: knowledge about the factors or situations that influence the vertical transmission (vt) of human immunodeficiency type 1 (hiv-1) has led to the implementation of strategies which have promoted a rate decline along the years, from 40% to less than 3% nowadays. one of the major advances in the area has been the prophylactic administration of zidovudine (azt), in the prenatal phase (oral route), in the predelivery phase (intravenous route) and to the newborn (oral route). this intervention may reduce hiv-1 vt 68%, thus being the most effective isolated strategy used so far. in the chronological sequence of advances, it has been observed that a high viral load is the main risk indicator for this type of transmission. as azt does not reduce the viral load and does not control the residual rate observed in hiv-1 vt, the use of prophylactic schemes using three antiretroviral drugs has been encouraged. elective caesarean section completes the range of obstetric strategies with major impact on the reduction of hiv-1 vt. its effectiveness is linked to the observation of the criteria for its indication: viral load assessed after the 34th week of pregnancy with levels over 1000 copies/ml, gestation over 38 weeks confirmed by ultrasonography, intact chorioamniotic membranes, and performed before labor has started. in cases where normal delivery is indicated, it should be remembered that prolonged chorioamniorrhexis, invasive manipulation of the fetus, delivery with instruments and episiotomy are situations to be avoided. among the postnatal interventions considered important for the reduction of hiv-1 vt are: pediatric reception (this should be done by trained professionals, avoiding microtraumas in the mucosa during the sucking maneuvers, use of neonatal azt (for a period of six weeks) and bottle feeding. special attention should be given to the orientation for the mother, in order to prevent acute infection by hiv-1 in this period, what would markedly increase virus vt rate.
Fatores que influenciam a transmiss?o vertical do vírus da imunodeficiência humana tipo 1
Duarte, Geraldo;Quintana, Silvana Maria;El Beitune, Patricia;
Revista Brasileira de Ginecologia e Obstetrícia , 2005, DOI: 10.1590/S0100-72032005001100011
Abstract: one of the most important advances in the control of the spread of infection with type 1 human immunodeficiency virus (hiv-1) occurred within the context of vertical transmission (vt), with a reduction from levels of more than 40% to levels of less than 3%. technological progress together with a better physiopathological understanding of this infection has permitted the determination of the situations and factors that increase the rates of perinatal transmission of the virus, indicating which interventions are most adequate for its control. the situations of higher risk for vt of hiv involve maternal, adnexal, obstetrical, fetal, viral, and postnatal factors. among maternal factors, particularly important is viral load, the major indicator of the risk of this form of transmission. however, despite its relevance, viral load is not the only variable in this equation, with the following factors also playing important roles: use of illicit drugs, multiple sex partners and unprotected sex, malnutrition, smoking habit, advanced maternal disease, and lack af access or compliance with antiretroviral drugs. among the adnexal factors are prolonged chorion-amniorrhexis, loss of placental integrity, and the expression of secondary receptors in placental tissue. among the obstetrical factors, it should be remembered that invasive interventions in the fetus or amniotic chamber, internal cardiotocography, type of delivery, and contact of the fetus/newborn infant with maternal blood are also important elements to be controlled. among the fetal factors are the expression of secondary hiv-1 receptors, genetic susceptibility, reduced cytotoxic t-lymphocyte function, and prematurity. among the viral factors, mutations and syncytium-inducing strains are believed to be risk factors for vt. finally, there are postnatal factors represented by an elevated viral load in maternal milk, a low antibody concentration in this fluid, clinical mastitis and nipple lesions, which can be grouped withi
Deficiência da vitamina a e associa??es clínicas: revis?o
El Beitune,Patrícia; Duarte,Geraldo; Nunes de Morais,Edson; Quintana,Silvana Maria; Vannucchi,Hélio;
Archivos Latinoamericanos de Nutrición , 2003,
Abstract: summary. vitamin a deficiency and clinical associations: a review. an important focus of attention in public health has been micronutrient deficiency in human being because of the enhanced vulnerability of individuals to the effects of micronutrient deficiency or imbalance. among all micronutrients deficiencies, vitamin a has been one of the most important public health problems, affecting a large percentage of people in developing countries. vitamin a is particularly important for its role in the process of organism defense against infections. this article reviews comprehensively vitamin a metabolism, it highlights hypovitaminosis a relationship with pregnancy and human imunodeficiency, showing its repercussions in several clinical conditions.
Effects of antiretroviral agents during pregnancy on liver enzymes and amylase in HIV-exposed, uninfected newborn infants
El Beitune, Patrícia;Duarte, Geraldo;Campbell, Oona;Quintana, Silvana Maria;Rodrigues, Laura C.;
Brazilian Journal of Infectious Diseases , 2007, DOI: 10.1590/S1413-86702007000300003
Abstract: this study assessed the effect of antiretroviral drugs administered to pregnant women on amylase and liver enzymes of the neonate. a prospective study was conducted on 52 neonates divided into three groups: infants born to hiv-infected mothers taking zidovudine (zdv group, n = 18), infants born to mothers taking zidovudine + lamivudine + nelfinavir (tt group, n = 22) and infants born to normal women (control group, n = 12). umbilical cord blood from the newborn infant was used to determine liver transaminases and amylase. data were analyzed statistically by nonparametric tests, with the level of significance set at p<0.05. the median levels for tt group newborns were 33.3 u/l for oxaloacetic transaminase, 21.5 u/l for pyruvic transaminase, 1.9 mg/dl for total bilirubin, 153 mg/dl for alkaline phosphatase, and 9.6 u/l for amylase. these results did not differ from those obtained for control newborns or newborns exposed to zdv alone. no association was observed between the use of antiretroviral drugs during pregnancy and adverse effects on neonatal amylase and hepatic parameters at birth.
Efeito diabetogênico das drogas anti-retrovirais em ratas Wistar prenhes
Figueiró-Filho, Ernesto Antonio;Duarte, Geraldo;El Beitune, Patrícia;Quintana, Silvana Maria;Marcolin, Alessandra Cristina;
Revista Brasileira de Ginecologia e Obstetrícia , 2004, DOI: 10.1590/S0100-72032004000100005
Abstract: purpose: to experimentally evaluate the diabetogenic effects of antiretroviral drugs on pregnant wistar rats and the perinatal effects on the offspring. methods: adult female pregnant wistar rats weighing 200-230 g were used. the antiretroviral drugs zidovudine (zdv), lamivudine (3tc) and nelfinavir (nfv) were used alone and in association at daily doses of ten times the dose normally used in pregnant women, proportionally to the animal's body weight. seven groups were studied, including the control. the experiment started on day 0 of pregnancy and the pregnant animals were sacrificed on day 21. the fetuses were counted and weighed. blood determinations of glucose, insulin, glucagon and lactate were performed on day 21. the retroperitoneal adipose tissue was weighed. data were analyzed statistically by student's t-test. results: the groups treated with 3tc, zdv + 3tc and zdv + 3tc + nfv showed decreasing values of maternal daily body weight gain, retroperitoneal adipose tissue weight and weight of fetuses (control group: 6.2 g; 3tc group variation: 4.1-5.6 g). the serum lactate levels were also decreased when compared to the control in these groups (control group: 5.8 mmol/ml; 3tc group variations: 3.2-3.7 mmol/ml). all antiretroviral-treated groups showed a decreasing number of fetuses when compared to the control (control group: 14.7; drug group variation: 11.1-12.7). all treated groups also showed decreasing serum values of insulin (control group: 6.2 μiu/ml; drug group variation: 2.1 to 2.7 μiu/ml) and increasing serum levels of glucagon when compared to the control (control group: 88.2 pg/ml; drug group variation: 99.7 to 120.7 pg/ml). there was no statistical significance of glucose levels when comparing treated groups to the control. conclusions: the antiretroviral drugs interfered in carbohydrate metabolism of pregnant rats and reduced the number of fetuses. 3tc caused less maternal body weight gain, decreased fetus weight and lactate and insulin levels and
Infec??o urinária na gravidez
Duarte, Geraldo;Marcolin, Alessandra Cristina;Quintana, Silvana Maria;Cavalli, Ricardo Carvalho;
Revista Brasileira de Ginecologia e Obstetrícia , 2008, DOI: 10.1590/S0100-72032008000200008
Abstract: several factors cause urinary tract infection (uti) to be a relevant complication of the gestational period, aggravating both the maternal and perinatal prognosis. for many years, pregnancy has been considered to be a factor predisposing to all forms of uti. today, it is known that pregnancy, as an isolated event, is not responsible for a higher incidence of uti, but that the anatomical and physiological changes imposed on the urinary tract by pregnancy predispose women with asymptomatic bacteriuria (ab) to become pregnant women with symptomatic uti. ab affects 2 to 10% of all pregnant women and approximately 30% of these will develop pyelonephritis if not properly treated. however, a difficult to understand resistance against the identification of ab during this period is observed among prenatalists. the diagnosis of uti is microbiological and it is based on two urine cultures presenting more than 105 colonies/ml urine of the same germ. treatment is facilitated by the fact that it is based on an antibiogram, with no scientific foundation for the notion that a pre-established therapeutic scheme is an adequate measure. for the treatment of pyelonephritis, it is not possible to wait for the result of culture and previous knowledge of the resistance profile of the antibacterial agents available for the treatment of pregnant women would be the best measure. another important variable is the use of an intravenous bactericidal antibiotic during the acute phase, with the possibility of oral administration at home after clinical improvement of the patient. at our hospital, the drug that best satisfies all of these requirements is cefuroxime, administered for 10-14 days. third-generation cephalosporins do not exist in the oral form, all of them involving the inconvenience of parenteral administration. in view of their side effects, aminoglycosides are considered to be inadequate for administration to pregnant women. the inconsistent insinuation of contraindication of monoflu
HIV-1: maternal prognosis
El Beitune, Patrícia;Duarte, Geraldo;Quintana, Silvana Maria;Figueiró-Filho, Ernesto Ant?nio;
Revista do Hospital das Clínicas , 2004, DOI: 10.1590/S0041-87812004000100005
Abstract: profound modifications in the profile of patients are currently being observed within the epidemic context of aids, especially with respect to pauperization and feminization of the disease. the population most frequently affected is in the reproductive age, and among adults aged 18 to 24 years, the ratio is 1 man to 1 woman, a phenomenon occurring uniformly all over the world. one of the main challenges for hiv-1-infected pregnant women and their doctors is the effect of the interaction between hiv infection and pregnancy. the present article is a review of the literature; and its objective is to assess the influence of hiv-1 infection seen from the maternal perspective, with a discussion of immunologic function, maternal prognosis, and the hiv-abortion interface. at present, we cannot conclude that pregnancy has a short-term effect on the evolution of hiv infection, but the concomitance of hiv and pregnancy may adversely affect the prognosis of gestation, especially in view of its frequent association with increased abortion and puerperal morbidity rates.
Efeito diabetogênico das drogas anti-retrovirais em ratas Wistar prenhes
Figueiró-Filho Ernesto Antonio,Duarte Geraldo,El Beitune Patrícia,Quintana Silvana Maria
Revista Brasileira de Ginecologia e Obstetrícia , 2004,
Abstract: OBJETIVO: estudar a a o diabetogênica de drogas anti-retrovirais em ratas prenhes e o prognóstico perinatal das crias. MéTODOS: estudo com ratas fêmeas prenhes adultas da ra a Wistar, pesando entre 200-230 g. Foram testadas a azidotimidina (AZT), lamivudina (3TC) e nelfinavir (NFV), cujas dosagens foram padronizadas em 10 vezes a dose utilizada em gestantes, proporcionalmente ao peso dos animais. Foram avaliados sete grupos, incluindo o controle, contendo 10 ratas por grupo. O início do experimento foi o dia zero da prenhez e as cesarianas realizadas no 21o dia, após decapita o, sendo os fetos contados e pesados. Procedeu-se a dosagens de glicemia, insulina, glucagon e lactato no 21o dia. Avaliou-se também o peso do tecido adiposo retroperitoneal. Os dados foram analisados utilizando-se o teste t de Student para a análise estatística. RESULTADOS: os grupos tratados com 3TC, AZT + 3TC e AZT + 3TC + NFV demonstraram altera es com a redu o das médias de ganho de peso materno diário, do peso da gordura retroperitoneal e peso das crias (grupo controle: 6,2 g; grupos contendo 3TC: 4,1 a 5,6 g), bem como dos valores de lactato (grupo controle: 5,8 mmol/mL; grupos contendo 3TC: 3,2 a 3,7 mmol/mL), quando comparados ao controle. Todos os grupos tratados com drogas anti-retrovirais apresentaram redu o significativa do número de fetos por ninhada (grupo controle: 14,7; grupos medicamentos: 11,1 a 12,7) e dos valores séricos de insulinemia (grupo controle: 6,2 μUI/mL; grupos medicamentos: 2,1 a 2,7 μUI/mL) e eleva o da glucagonemia (grupo controle: 88,2 pg/mL; grupos medicamentos: 99,7 a 120,7 pg/mL). N o houve diferen as estatisticamente significantes entre o grupo controle e tratados nos valores de glicemia. CONCLUS ES: o uso de anti-retrovirais em ratas prenhes causa interferência no metabolismo glicídico dos animais durante o período de prenhez, provocando significativa redu o do número das crias. Observou-se que o uso do 3TC resultou em menor ganho de peso materno e das crias, redu o de insulina e lactato e eleva o do glucagon.
Intolerancia glicêmica e o prognóstico perinatal em gestantes utilizando anti-retrovirais
Duarte Geraldo,El Beitune Patrícia,Figueiró-Filho Ernesto Antonio,Quintana Silvana Maria
Revista Brasileira de Ginecologia e Obstetrícia , 2004,
Abstract:
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