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Search Results: 1 - 10 of 143170 matches for " Henrique Vítor Leite "
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Correla??o entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentra??o de hemoglobina do cord?o em fetos de gestantes isoimunizadas
Taveira, Marcos Roberto;Cabral, Ant?nio Carlos Vieira;Leite, Henrique Vítor;
Revista Brasileira de Ginecologia e Obstetrícia , 2003, DOI: 10.1590/S0100-72032003000800006
Abstract: purpose: to determine the relationship between the doppler indices of inferior vena cava and ductus venosus and the fetal hemoglobin concentration. methods: a cross-sectional prospective study was performed at the "centro de medicina fetal hc ufmg" from january 1998 to july 2001. thirty-one pregnant women with isoimmunization, detected by an indirect coombs test >1:8, underwent a protocol for the identification of fetal hemolysis. when intrauterine transfusions were indicated, the umbilical cord hemoglobin concentration was measured at the begining of the procedure. in the other cases, it was measured at delivery. every single intrauterine transfusion preceded by doppler flow velocity waveforms from inferior vena cava and ductus venosus was defined as one case. hemocue? (b-hemoglobin photometer hemocue ab; angelholm, sweden) was used to measure the fetal hemoglobin concentration. in all cases, inferior vena cava and ductus venosus doppler examinations were performed before the collection of fetal blood samples. for the inferior vena cava doppler, the studied indices were pulsatility index for veins (pvi), peak velocity index for veins (pviv) and atrial/systole ratio (ca/sv ratio or preload index); for ductus venosus, pvi, pviv and systole/atrial ratio (sv/ca ratio). the relationship between inferior vena cava and ductus venosus doppler indices and cord blood hemoglobin concentration was obtained by simple linear regression analysis. moreover, an association between those indices and the finding of fetal hemoglobin <10 g/dl was shown by the c2 test, significant at p<0.05. results: seventy-four procedures were studied. in twenty-three cases fetal hemoglobin was below 7 g/dl. a significant negative correlation between all studied doppler indices and fetal concentration of hemoglobin was observed (p<0.05). the highest doppler index values were observed in severe anemic fetuses. fetuses with cord blood hemoglobin below 10 g/dl presented inferior vena cava and ductus veno
Avalia o da Velocidade Média na Aorta Torácica Descendente em Fetos com Anemia
Taveira Marcos Roberto,Cabral Ant?nio Carlos Vieira,Leite Henrique Vítor,Brum Ana Paula
Revista Brasileira de Ginecologia e Obstetrícia , 2001,
Abstract: Objetivo: verificar se existe correla o significativa entre a velocidade média na dopplerfluxometria da artéria aorta torácica descendente e o grau de anemia fetal. Métodos: estudo prospectivo, transversal, no qual foram analisados 66 fetos de gestantes isoimunizadas, em que se realizou a cordocentese para a realiza o de transfus es intra-uterinas pela via intravascular (66,7%). Nos fetos que foram submetidos à transfus o intra-uterina pela via intraperitoneal, ou naqueles casos em que n o houve necessidade de tratamento intra-uterino (33,3%), a determina o da concentra o de hemoglobina do cord o foi realizada pela pun o do cord o umbilical, no momento da interrup o da gesta o. Neste grupo de fetos estudados, foi realizado exame dopplerfluxométrico da artéria aorta torácica descendente, sendo calculada a velocidade média de fluxo. Foi realizado estudo de associa o entre as variáveis. Foram também calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. Resultados: observou-se correla o significativa e inversa entre a velocidade média na artéria aorta torácica descendente e o nível de hemoglobina fetal. A velocidade média na dopplerfluxometria da artéria aorta torácica descendente apresentou sensibilidade de 47,5% para anemia fetal moderada (Hg<10 g/dL), com o teste exato de Fisher apresentando valor de p<0,01, e de 54,5% para anemia fetal grave (Hg<7,0 g/dL), com um valor de p=0,01. Conclus es: houve associa o significativa entre a velocidade média na aorta torácica descendente e o grau de diagnóstico de anemia fetal.
Correla o entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentra o de hemoglobina do cord o em fetos de gestantes isoimunizadas
Taveira Marcos Roberto,Cabral Ant?nio Carlos Vieira,Leite Henrique Vítor
Revista Brasileira de Ginecologia e Obstetrícia , 2003,
Abstract: OBJETIVO: o objetivo principal desse estudo foi verificar se existe correla o entre os índices dopplervelocimétricos da veia cava inferior e do ducto venoso e a concentra o sérica da hemoglobina fetal. MéTODOS: estudo transversal e prospectivo, realizado entre janeiro de 1998 e junho de 2001. Foram acompanhadas 31 gestantes isoimunizadas com resultado do teste de Coombs indireto maior que 1:8, que foram submetidas à pesquisa de hemólise fetal. Quando foram indicadas as transfus es intra-uterinas intravasculares, a hemoglobina do cord o foi dosada no início do procedimento. Nos demais casos, a hemoglobina do cord o foi mensurada no momento do parto, sempre por cesariana eletiva. Obteve-se um total de 74 procedimentos estudados, definidos como sendo cada transfus o intra-uterina precedida pela dopplervelocimetria venosa. A mensura o da concentra o da hemoglobina fetal foi realizada no Hemocue (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden), dispositivo usado para a determina o quantitativa de hemoglobina no sangue. A dopplervelocimetria da cava inferior e do ducto venoso foi realizada antecedendo a coleta do sangue fetal, sempre em intervalo de tempo inferior a 24 horas. Os índices dopplervelocimétricos estudados foram o índice de pulsatilidade para veias (IPV), o índice do pico de velocidade para veias (IPVV) e a rela o entre o pico de velocidade durante a fase de contra o atrial e o pico de velocidade na sístole ventricular (rela o CA/SV ou índice de pré-carga), na veia cava inferior, e o IPV, IPVV e a rela o entre os picos de velocidade da sístole ventricular e da contra o atrial (rela o SV/CA), no ducto venoso. Foi realizado estudo de correla o entre a dopplervelocimetria da veia cava inferior e do ducto venoso e a hemoglobina do cord o, pela técnica de regress o linear simples. Realizou-se também estudo de associa o entre os índices dopplervelocimétricos do compartimento venoso e a hemoglobina fetal inferior a 10 g/dL, por meio do teste do c2. RESULTADOS: foi efetuado um total de 74 procedimentos. Em 23 desses a hemoglobina fetal era inferior a 7,0 g/dL. Houve correla o negativa significativa entre todos os índices dopplerfluxométricos estudados e a concentra o de hemoglobina fetal (p<0,05), ou seja, os valores mais elevados dos índices dopplervelocimétricos foram observados nos fetos com anemia mais acentuada. Os fetos com nível de hemoglobina inferior ou igual a 10,0 g/dL apresentaram valores dos índices dopplervelocimétricos da cava e do ducto venoso acima do percentil 95 para a idade gestacional. CONCLUS ES: a dopplerveloc
Correla??o entre o Diagnóstico Morfológico Pré e Pós-Natal das Nefrouropatias Fetais
Pereira, Alamanda Kfoury;Oliveira, Eduardo Araújo de;Leite, Henrique Vítor;Cabral, Ant?nio Carlos Vieira;
Revista Brasileira de Ginecologia e Obstetrícia , 2000, DOI: 10.1590/S0100-72032000000600007
Abstract: purpose: to evaluate the accuracy of prenatal ultrasound in the diagnosis of nephrouropathies. methods: the authors followed-up 127 pregnancies referred to the fetal medicine center of ufmg with suspicion of these anomalies. fetal biometry, growth, vitality, and associated malformations were evaluated. finally, a detailed description of the renal system was made to define the prenatal morphologic diagnosis of the malformations to be compared with the postnatal diagnosis. results: based on the kappa index (statistical method that measures the concordance between different measurements, methods or measurement instruments: below 0.40, poor agreement; between 0.40 and 0.75, good agreement; above 0.75, excellent ageement), the authors found an excellent concordance (kappa index 0.95). among the 127 cases, there were only 9 misdiagnoses, all of them of obstructive uropathies: 6 cases showed different obstruction levels after delivery and in three cases there were confounding diagnosis with multicystic kidney. conclusions: the detailed ultrasonographic description of the renal system is a good method for prenatal diagnosis of the fetal nephropathies, allowing some options to modify the outcome of these fetuses, like to send them to specialized centers, to anticipate delivery and even to apply intrauterine therapy, in order to preserve the renal function. serial echography and amnioinfusion can be used to improve the precision of prenatal diagnosis.
Correla o entre o Diagnóstico Morfológico Pré e Pós-Natal das Nefrouropatias Fetais
Pereira Alamanda Kfoury,Oliveira Eduardo Araújo de,Leite Henrique Vítor,Cabral Ant?nio Carlos Vieira
Revista Brasileira de Ginecologia e Obstetrícia , 2000,
Abstract: Objetivo: avaliar a acuidade da ecografia antenatal no diagnóstico das nefrouropatias fetais. Pacientes e Métodos: os autores acompanharam prospectivamente 127 gesta es, referidas ao Centro de Medicina Fetal da UFMG devido à suspeita de anomalia do trato urinário fetal. Procedeu-se ent o ao ultra-som morfológico, no qual procurou-se verificar a biometria, padr o de crescimento fetal, vitalidade, malforma es associadas e, finalmente, uma descri o sistematizada do sistema renal fetal, visando-se estabelecer o diagnóstico pré-natal. Este foi posteriormente correlacionado com o diagnóstico obtido após o nascimento. Resultados: utilizando-se o índice kappa (que mede a concordancia entre diferentes medidas, métodos ou instrumentos de medi o com os seguintes critérios: abaixo de 0,40, baixa concordancia; entre 0,40 e 0,75, concordancia razoável e acima de 0,75, excelente concordancia), os autores encontraram excelente índice de concordancia global entre o diagnóstico pré e pós-natal (índice kappa 95%). Dos 127 casos, houve apenas 9 casos discordantes, todos referentes às uropatias obstrutivas, nos quais o diagnóstico pós-natal mostrou diferente nível de obstru o (6 casos) ou confus o com rim multicístico (3 casos). Conclus o: o estudo ecográfico sistematizado do sistema renal é um método eficaz de diagnóstico pré-natal das nefrouropatias, permitindo ado o de medidas que visem melhorar a evolu o destes neonatos, desde o encaminhamento para centros especializados, antecipa o do parto (nos casos em agravamento) até a terapia intra-útero (para preservar a fun o renal até que seja possível o nascimento). O estudo ecográfico seriado e a amnioinfus o podem ser úteis para melhorar a precis o do diagnóstico pré-natal.
Diagnóstico n?o invasivo da anemia fetal pela medida do pico de velocidade sistólica na dopplervelocimetria da artéria cerebral média
Taveira, Marcos Roberto;Cabral, Ant?nio Carlos Vieira;Leite, Henrique Vítor;Melo, Isabela Gomes de;Lopes, Ana Paula Brum de Miranda;
Revista Brasileira de Ginecologia e Obstetrícia , 2004, DOI: 10.1590/S0100-72032004000800009
Abstract: purpose: to assess the correlation between middle cerebral artery peak systolic velocity and umbilical cord blood hemoglobin concentration and to determine its diagnostic value. patients and methods: a cross-sectional prospective study was performed from january 2000 to may 2003. forty-four isoimmunized pregnant women underwent a protocol for the identification of fetal hemolysis. when intrauterine transfusions were indicated, the umbilical cord blood hemoglobin concentration was measured at the beginning of the procedure. each intrauterine transfusion preceded by doppler velocimetry of the middle cerebral artery was regarded as one case, summing up eighty-three procedures. in all cases, the middle cerebral artery doppler examinations were performed within the three hours preceding fetal blood sample collection. the systolic velocity peak was recorded and considered abnormal when its value was above 1.5 times the median for the corresponding gestational age. hemocue? (b-hemoglobin photometer hemocue ab; angelholm, sweden) was the device used to measure fetal hemoglobin concentration. the relationship between middle cerebral artery peak systolic velocity and cord blood hemoglobin was obtained by the c2 test, considered significant at p<0.05. results: in thirty-three cases the cord blood hemoglobin concentration was below 10.0 g/dl. there was a strong correlation between the two measured variables (p<0.001). the middle cerebral artery peak systolic velocity with values above 1.5 times the median was associated with cord blood hemoglobin concentration below 10 g/ml (p<0,001). the sensitivity of an increased middle cerebral artery peak systolic velocity was 75.8% for the detection of a cord blood hemoglobin level of 10 g/dl or lower. conclusion: the middle cerebral artery peak systolic velocity can be used as a noninvasive method for the diagnosis of fetal anemia.
Avalia??o da Velocidade Média na Aorta Torácica Descendente em Fetos com Anemia
Taveira, Marcos Roberto;Cabral, Ant?nio Carlos Vieira;Leite, Henrique Vítor;Brum, Ana Paula;Demian, Alim Alves;Melo, Isabela Gomes de;
Revista Brasileira de Ginecologia e Obstetrícia , 2001, DOI: 10.1590/S0100-72032001001000007
Abstract: purpose: to verify if there is an association between the mean blood velocity in the descending thoracic aorta and fetal anemia diagnosis. methods: this is a prospective, cross-sectional study in which the mean blood velocities in the fetal aorta, in 66 fetuses at risk for severe anemia due to severe rh immunization, and cord blood hemoglobin levels were analyzed comparatively. the hemoglobin level was obtained by cordocentesis if an intravascular transfusion was performed for severe anemia, however, if the fetus received an intrauterine transfusion by the intraperitoneal route or if the fetus did not receive a transfusion at all, hemoglobin level was measured at the time of pregnancy termination by umbilical cord puncture. the authors made a statistical association between the mean blood velocity in fetal descending thoracic aorta and the diagnosis of fetal anemia. the c2 test was used for statistical analysis and a p value <0,05 was used to indicate significance. results: there was a significant and indirect association between the mean blood velocity in the descending thoracic aorta and the detection of fetal anemia. the mean blood velocity in fetal thoracic aorta had a sensitivity of 47.4% for the diagnosis of moderate fetal anemia (hg<10.0 g/dl), with a p value <0.01 by the fisher exact test, and a sensitivity of 54.5% for severe rh isoimmunization (hg<7.0 g/dl), with a p value =0.01. conclusion: this study revealed a significant indirect correlation between mean blood velocity in the descending thoracic aorta and the detection of fetal anemia due to rh isoimmunization.
Comparative Study of Endothelial Function and Uterine Artery Doppler Velocimetry between Pregnant Women with or without Preeclampsia Development
Augusto Henriques Fulgêncio Brand?o,Ludmila Maria Guimar?es Pereira,Alessandra Cristina de Oliveira Gon?alves,Zilma Silveira Nogueira Reis,Henrique Vítor Leite,Ant?nio Carlos Vieira Cabral
Journal of Pregnancy , 2012, DOI: 10.1155/2012/909315
Abstract: Background. Poor placentation and systemic endothelial dysfunction have been identified as main events in Preeclampsia (PE). The relationship and chronology of these phenomena are important if we are to understand the pathophysiological mechanisms underlying this major clinical problem. Objectives. To compare the evolution of placentation and endothelial function in normotensive and preeclamptic pregnancies. Patients and methods. In a prospective cohort study, 59 pregnant women with a high risk of developing PE were subjected to flow-mediated dilation (FMD) and to Doppler velocimetry of uterine arteries in order to obtain their Pulsatility Index (UtA-PI). The variations in the FMD and UtA-PI values, between 16+0 and 19+6 and 24+0 and 27+6 weeks of gestation, were compared, taking PE development into consideration. Results. Nine patients developed PE and the other 50 women remained normotensive. At 16+0 to 19+6 weeks of pregnancy, patients that developed PE presented higher values of UtA-PI than the normotensive group, but there was no difference in FMD results between them. At 24+0 to 27+6 weeks, the patients that developed PE presented higher values of UtA-PI and lower values of FMD than the women that remained normotensive. Conclusions. These results corroborate the evidence that endothelial injury is secondary to poor placentation. 1. Introduction Preeclampsia (PE) is a multisystemic disorder that accounts for a large number of maternal deaths in developed and developing countries worldwide [1–3]. Although its etiology remains unclear, several events in PE physiopathology are well studied and can be evaluated using biochemical or biophysical methods. In order to prevent PE complications, there are many early detection markers, which include maternal demographics, past medical, obstetric, family history, and some current pregnancy characteristics [4–6]. Maternal factors and history alone can be used as a PE risk stratification method. Elevated body mass index, maternal age extremes and Afro-American ethnicity are associated with a higher risk of PE [7]. Some diseases such as diabetes and chronic hypertension also significantly increase the risk [8]. The patients that present these conditions are the ones who will most benefit from a satisfactory and specific level of care, once the risk of developing PE in this groups rises threefold, reaching a PE prevalence of 45% [3]. Preeclampsia is essentially an endothelial disease [9, 10]. Progressive endothelial dysfunction leads to arterial hypertension, glomerular lesion, hepatic failure, and cerebral edema
A crise financeira e económica internacional
Vítor Bento,José Ferreira Machado,António Nogueira Leite
Rela??es Internacionais (R:I) , 2009,
Abstract:
Medical record review to recover missing data in a Portuguese birth cohort: agreement with self-reported data collected by questionnaire and inter-rater variability
Alves,Elisabete; Lunet,Nuno; Correia,Sofia; Morais,Vítor; Azevedo,Ana; Barros,Henrique;
Gaceta Sanitaria , 2011, DOI: 10.1590/S0213-91112011000300007
Abstract: objectives: to assess the yield of medical record review to recover missing data originally collected by questionnaire, to analyze the agreement between these two data sources and to determine interobserver variability in clinical record review. methods: we analyzed data from a birth cohort of 8,127 women who were consecutively recruited after giving birth from 2005-2006. recruitment was conducted at all public maternity units of porto, portugal. we reviewed the medical records of 3,657 women with missing data in the baseline questionnaire and assessed agreement between these two sources by using information from participants with data from both sources. interobserver variability was assessed by using 400 randomly selected clinical records. results: data on pregnancy complications and maternal anthropometric parameters were successfully recovered. agreement between the questionnaire and records in family history data was fair, particularly for cardiovascular disease [k=0.27; 95% confidence interval (95%ci): 0.23-0.32]. the highest agreement was observed for personal history of diabetes (k=0.82; 95%ci 0.70-0.93), while agreement for hypertension was moderate (k=0.60; 95%ci 0.50-0.69). discrepancies in prepregnancy body mass index classes were observed in 10.3% women. data were highly consistent between the two reviewers, with the highest agreement found for gestational diabetes (k=1.00) and birth weight (99.5% concordance). conclusion: data from the medical records and questionnaire were concordant with regard to pregnancy and well-known risk factors. the low interobserver variability did not threaten the precision of our data.
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