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Amaral-Moreira CDFA, Redezuk G, Pereira BG, Borovac-Pinheiro A, Rehder PM. Iron Deficiency Anemia in Pregnancy after Bariatric Surgery: Etiology, Risk Factors, and How to Manage It. Rev Bras Ginecol Obstet 2023; 45:e562-e567. [PMID: 37944922 PMCID: PMC10635785 DOI: 10.1055/s-0043-1776026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 08/01/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Pregnancy after bariatric surgery is a reality of the 21st century and therefore is essential that all obstetricians know how to manage it. The most prevalent nutritional deficiency is iron deficiency and, consequently, anemia. Although bariatric surgery and pregnancy are already risk factors for anemia, we evaluated in our study if there were any other risk factors and actions to improve hemoglobin levels in this population. METHODS We performed a retrospective cohort study, and performed frequency measurements and analyzes of odds ratio, X2 and Fisher exact test to evaluate the risk factors. RESULTS We evaluated 44 pregnancies after bariatric surgery, with an incidence of anemia of 62%, and the only identifiable risk factor for anemia was being black. As for the treatment, the iron salt used for oral supplementation did not associate with anemia risk, and in 27% of the patients, the adjustment of the oral dosage was enough for improvement in hemoglobin levels, but in 36% supplementation with intravenous iron was necessary. CONCLUSION Being black is a risk factor for anemia. The type of iron salt does not correlate with the incidence of anemia, and for the treatment and improvement of iron dosages, it seems an effective increase in iron intake.
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Affiliation(s)
| | - Guilherme Redezuk
- Departamento de Tocoginecologia da Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Belmiro Gonçalves Pereira
- Departamento de Tocoginecologia da Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Anderson Borovac-Pinheiro
- Departamento de Tocoginecologia da Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Patricia Moretti Rehder
- Departamento de Tocoginecologia da Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Rehder PM, Borovac-Pinheiro A, de Araujo ROMB, Diniz JAPM, Ferreira NLC, Branco ACR, Dias ADF, Pereira BG. Gestational Diabetes Mellitus and Obesity are Related to Persistent Hyperglycemia in the Postpartum Period. Rev Bras Ginecol Obstet 2021; 43:107-112. [PMID: 33465794 PMCID: PMC10183874 DOI: 10.1055/s-0040-1721356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To evaluate the obstetric and sociodemographic characteristics of gestational diabetic women who maintained hyperglycemia in the postpartum period (6-12 weeks postpartum). METHODS This is a longitudinal cohort study with women who have had gestational diabetes and/or macrosomic children between March 1st, 2016 and March 1st, 2017. Between 6 and 12 weeks after birth, women who had gestational diabetes collected fasting glycemia, glucose tolerance test, and glycated hemoglobin results. The data were collected from medical records and during an interview in the first postpartum consultation. A statistical analysis was performed using frequency, percentage, Chi-Squared test, Fisher exact test, Mann-Whitney test, and multivariate Poisson regression. The significance level adopted for the statistical tests was 5%. RESULTS One hundred and twenty-two women were included. Most of the women were younger than 35 years old (70.5%), white, multiparous, and with no history of gestational diabetes. Thirteen percent of the participants developed persistent hyperglycemia. A univariate analysis showed that maternal age above 35 years, being overweight, having grade 1 obesity and weight gain under 5 kg was related to the persistence of hyperglycemia in the postpartum period. CONCLUSION Maternal age above 35 years, obesity and overweight, and the diagnosis of gestational diabetes in the first trimester of pregnancy are associated with hyperglycemia during the postpartum period.
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Campos MST, Fialho SL, Pereira BG, Yoshida MI, Mussel WN, Junior ASC, Oliveira MA. Development and chemical characterization of biodegradable polymeric implants containing sirolimus for the treatment of malignant solid tumors. Pharmazie 2019; 74:221-226. [PMID: 30940305 DOI: 10.1691/ph.2019.8201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The use of sirolimus and its analogs has been evaluated in studies aimed at combating several types of cancer; however, because of the limited bioavailability of the drug, the search for new forms of administration is required. Biodegradable polymeric implants containing sirolimus were developed and assessed as an alternative method of drug administration. Implants containing 25 % (w/w) sirolimus were prepared employing the polymer matrices chitosan, polycaprolactone and poly(lactic-co-glycolic acid) (PLGA) in two proportions: PLGA 50:50 and PLGA 75:25. Thermal analysis techniques such as thermogravimetry and differential scanning calorimetry, combined with x-ray diffraction were used to characterize and evaluate the compatibility of the constituents of the formulation. No incompatibilities were found between the components, but drug amorphization was observed in all samples. Implants made from the polymers chitosan and PCL may accelerate the degradation of SRL when these polymers are dissolved in methanol at 50 °C. HPLC analysis showed that the implant prepared with PLGA 75:25 did not present degradation products and maintained its appropriate drug content, even when dissolved in methanol and heated to 50 °C. Therefore, it represents the most suitable biodegradable polymer for use in implants developed for the treatment of malignant solid tumors. However, it is still necessary to further study the drug effects after amorphization of the crystal and also to perform stability and solubility analysis.
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Trigo LAMC, Surita FG, Parpinelli MA, Pereira BG, Fertrin KY, Costa ML. [Beta thalassemia major and pregnancy during adolescence: report of two cases]. ACTA ACUST UNITED AC 2015. [PMID: 26200828 DOI: 10.1590/so100-720320150005169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Beta thalassemia major is a rare hereditary blood disease in which impaired synthesis of beta globin chains causes severe anemia. Medical treatment consists of chronic blood transfusions and iron chelation. We describe two cases of adolescents with beta thalassemia major with unplanned pregnancies and late onset of prenatal care. One had worsening of anemia with increased transfusional requirement, fetal growth restriction, and placental senescence. The other was also diagnosed with hypothyroidism and low maternal weight, and was admitted twice during pregnancy due to dengue shock syndrome and influenza H1N1-associated respiratory infection. She also developed fetal growth restriction and underwent vaginal delivery at term complicated by uterine hypotonia. Both patients required blood transfusions after birth and chose medroxyprogesterone as a contraceptive method afterwards. This report highlights the importance of medical advice on contraceptive methods for these women and the role of a specialized prenatal follow-up in association with a hematologist.
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Affiliation(s)
| | - Fernanda Garanhani Surita
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Mary Angela Parpinelli
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Belmiro Gonçalves Pereira
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Kleber Yotsumoto Fertrin
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Maria Laura Costa
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Pereira BG. Diabetes gestacional: seguimento após o parto. Rev Bras Ginecol Obstet 2014; 36:481-483. [DOI: 10.1590/s0100-720320140005157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 09/23/2014] [Indexed: 11/22/2022] Open
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Magdaleno R, Pereira BG, Chaim EA, Turato ER. Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges. Arch Gynecol Obstet 2011; 285:559-66. [PMID: 22205187 DOI: 10.1007/s00404-011-2187-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 12/14/2011] [Indexed: 01/25/2023]
Abstract
UNLABELLED With the increase in the number of bariatric surgeries being performed in women of childbearing age, physicians must have concerns regarding the safety of pregnancy after bariatric surgery. The aim of this review is to summarize the literature reporting on maternal, obstetrical and perinatal implications of pregnancy following BS. METHODS English, Spanish and Portuguese-language articles were identified in a PUBMED search from 2005 to February 2011 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding. RESULTS The studies show improved fertility and a reduced risk of gestational diabetes, pregnancy-induced hypertension and pre-eclampsia, macrosomia in pregnant women after bariatric surgery. The incidence of intrauterine growth restriction and small for gestational age are increased. No conclusions can be drawn concerning the risk for cesarean delivery and the best surgery-to-conception interval. Deficiencies in iron, vitamin A, vitamin B12, vitamin K, folate and calcium can result in maternal and fetal complications. CONCLUSIONS Pregnancy outcome of women who delivered after BS, as compared to obese populations, is better and safer and comparable to the general population. Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient's individual requirements can prevent nutrition-related complications and improve maternal and fetal health.
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Affiliation(s)
- Ronis Magdaleno
- Department of Medical Psychology and Psychiatry, State University of Campinas, Rua Padre Almeida 515, sala 14, Campinas, SP CEP: 13025-251, Brazil.
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Pereira BG, Pinheiro RP, Chain EA, Pinto e Silva JLC. [Acute abdomen in pregnant woman treated for bariatric surgery for obesity: case report]. Rev Bras Ginecol Obstet 2011; 32:516-9. [PMID: 21271160 DOI: 10.1590/s0100-72032010001000008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Accepted: 10/29/2010] [Indexed: 11/22/2022] Open
Abstract
Bariatric surgery is currently considered as an alternative for the treatment of morbid obesity refractory to conventional clinical treatments. The surgeries more frequently used, which are radical and invasive, yield better and faster results, but are subject to clinical and surgical complications such as intestinal obstructions and subocclusions. Pregnancies in women submitted to this type of surgery are increasingly frequent, and the related complications have been increasingly reported. We present the case of a pregnant woman previously submitted to bariatric surgery who developed subocclusion with intestinal intussusception. This extremely serious complication requires attention for its diagnosis, i.e. , imaging and laboratory exams that are not usually employed during pregnancy. Gestation confuses and impairs their interpretation. In addition to the fact that the only treatment that reaches a good result is invasive, exploratory laparotomy is undesirable during this period. Maternal, fetal and perinatal mortality is usually high. In the present case, delivery occurred spontaneously during the first hours of hospitalization before the surgical procedure. Evolution was good and both mother and newborn, although premature, had good course and were discharged in good conditions.
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Affiliation(s)
- Belmiro Gonçalves Pereira
- Departamento de Ginecologia e Obstetrícia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas – UNICAMP – Campinas (SP), Brasil.
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Rehder PM, Pereira BG, Silva JLPE. [Gestational and neonatal outcomes in women with positive screening for diabetes mellitus and 100g oral glucose challenge test normal]. Rev Bras Ginecol Obstet 2011; 33:81-86. [PMID: 21779650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 03/18/2011] [Indexed: 05/31/2023] Open
Abstract
PURPOSE to determine the prevalence of adverse gestational and neonatal outcomes in women with a positive screening and negative diagnosis for gestational diabetes mellitus (GDM). METHODS a retrospective descriptive cross-sectional study was conducted from 2000 to 2009 on 409 women with positive screening for GDM. The maternal variables studied were: age, body mass index, history of cesarean section, macrosomia or diabetes mellitus in a previous pregnancy and a personal or family history of diabetes mellitus and chronic arterial hypertension. The neonatal variables studied were: polyhydramnios, gestational age at birth, prematurity, cesarean delivery, large for gestational age (LGA) newborn, macrosomia, Apgar score, neonatal respiratory distress syndrome, hypoglycemia and hyperbilirubinemia. Uni- and multivariate descriptive analyses were first performed regarding risk factors and neonatal outcome and the prevalences and respective 95% confidence intervals were determined. RESULTS the route of delivery was cesarian section in 255 cases (62.3%), preterm birth occurred in 14.2% of cases and 19.3% of the newborns were LGA. The risk factors correlated with LGA newborns were overweight or obesity, maternal age and a history of macrosomia in a previous pregnancy. CONCLUSIONS a high rate of LGA newborns was observed in the population with positive risk factors or altered fasting glycemia on the occasion of the first prenatal visit, even when the glycemia curve was normal, with cesarean rates above those habitually observed in populations considered to be of low risk. Pregnant women with these characteristics represent a differential group.
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Negrato CA, Montenegro RM, Mattar R, Zajdenverg L, Francisco RPV, Pereira BG, Sancovski M, Torloni MR, Dib SA, Viggiano CE, Golbert A, Moisés ECD, Favaro MI, Calderon IMP, Fusaro S, Piliakas VDD, Dias JPL, Gomes MB, Jovanovic L. Dysglycemias in pregnancy: from diagnosis to treatment. Brazilian consensus statement. Diabetol Metab Syndr 2010; 2:27. [PMID: 20416099 PMCID: PMC2867808 DOI: 10.1186/1758-5996-2-27] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Accepted: 04/24/2010] [Indexed: 12/16/2022] Open
Abstract
There is an urgent need to find consensus on screening, diagnosing and treating all degrees of dysglycemia that may occur during pregnancies in Brazil, considering that many cases of dysglycemia in pregnant women are currently not diagnosed, leading to maternal and fetal complications. For this reason the Brazilian Diabetes Society (SBD) and the Brazilian Federation of Gynecology and Obstetrics Societies (FEBRASGO), got together to introduce this proposal. We present here a joint consensus regarding the standardization of clinical management for pregnant women with any degree of dysglycemia, on the basis of current information, to improve medical assistance and to avoid related complications of dysglycemia in pregnancy to the mother and the fetus. This consensus aims to standardize the diagnosis among general practitioners, endocrinologists and obstetricians allowing the dissemination of information in basic health units, public and private services, that are responsible for screening, diagnosing and treating disglycemic pregnant patients.
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Affiliation(s)
| | - Renan M Montenegro
- School of Medicine of the Federal University of Ceará, Fortaleza-Ce, Brazil
| | - Rosiane Mattar
- Federal School of Medicine of São Paulo State (UNIFESP), São Paulo-SP, Brazil
| | | | | | | | | | | | - Sergio A Dib
- Federal School of Medicine of São Paulo State (UNIFESP), São Paulo-SP, Brazil
| | - Celeste E Viggiano
- Nutrition Department of the Brazilian Diabetes Society, São Paulo-SP, Brazil
| | - Airton Golbert
- Federal University of Health Sciences of Porto Alegre (UFRGS), Porto Alegre-RS, Brazil
| | - Elaine CD Moisés
- School of Medicine of Ribeirão Preto (USP), Ribeirão Preto-SP, Brazil
| | | | - Iracema MP Calderon
- Botucatu Medical School, São Paulo State University (UNESP), Botucatu-SP, Brazil
| | - Sonia Fusaro
- Federal School of Medicine of São Paulo State (UNIFESP), São Paulo-SP, Brazil
| | - Valeria DD Piliakas
- Hospital and Maternity Leonor Mendes de Barros, and UNICASTELO, São Paulo-SP, Brazil
| | | | - Marilia B Gomes
- Endocrine and Diabetes Unit, State University of Rio de Janeiro, Rio de Janeiro-RJ, Brazil
| | - Lois Jovanovic
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
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Franzin CMMDO, e Silva JLP, Pereira BG, Marba STM, Morais SS, Amaral T, Reszka EB. [Brain-sparing effect: comparison of diagnostic indices]. Rev Bras Ginecol Obstet 2010; 32:11-8. [PMID: 20209257 DOI: 10.1590/s0100-72032010000100003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 11/24/2009] [Indexed: 11/22/2022] Open
Abstract
PURPOSE to describe adverse perinatal outcomes in patients with fetal blood flow centralization, using the relationship between the pulsatility indexes of the middle cerebral and umbilical arteries (MCAPI/UAPI), and between the resistance indexes of the middle cerebral and umbilical arteries (MCARI/UARI), as well as to compare both diagnostic indexes. METHODS 151 pregnant women with diagnosis of blood flow centralization, attended to at the maternity hospital of Universidade Estadual de Campinas, whose delivery occurred up to 15 days after the ultrasonographic diagnosis, were included. It was considered as adverse perinatal outcomes: Apgar index lower than 7 at the fifth minute, permanence in neonatal ICU, small fetus for the gestational age, severe fetal suffering, perinatal death, hypoglycemia, polycythemia, necrotizing enterocolitis, brain hemorrhage, lung hemorrhage, anemia, septicemia, hyaline membrane disease, convulsive syndromes, hyperreflexia syndrome and kidney insufficiency. Rates of the perinatal adverse outcomes (PAO) for the brain-placentary ratios have been compared, using Fisher's exact or Pearson's chi2 tests, at 5% significance level. Adverse perinatal outcomes according to the gestational age have been evaluated using the Cochrane-Armitage test for trend. RESULTS the adverse perinatal outcomes for the group with the two indexes altered were: 62.5% of the newborns needed to be placed in an ICU, 75.2% were small for the gestational age (SGA), 35.3% were under severe fetal suffering, 84.4% had hypoglycemia, 8.3% polycythemia, 4.2% necrotizing enterocolitis, and 2.1% brain hemorrhage. There has been significant association between the MCAPI/UAPI and MCARI/UARI ratios along the gestational age, and the need for neonatal intensive care, small fetuses for the gestational age, septicemia, necrotizing enterocolitis, kidney insufficiency, hyaline membrane disease, and anemia. There has been no significant difference between the two indexes of adverse perinatal outcome.
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Lajos GJ, Passini Junior R, Nomura ML, Amaral E, Pereira BG, Milanez H, Parpinelli MA. [Cervical bacterial colonization in women with preterm labor or premature rupture of membranes]. Rev Bras Ginecol Obstet 2009; 30:393-9. [PMID: 19142522 DOI: 10.1590/s0100-72032008000800004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 08/19/2008] [Indexed: 11/21/2022] Open
Abstract
PURPOSE to study cervical colonization in women with preterm labor or premature rupture of membranes. METHODS two hundred and twelve pregnant women with preterm labor or premature rupture of membranes were studied. Two cervical samples from each woman were collected and bacterioscopy and culture were performed. Association of cervical microorganisms and urinary tract infection, chorioamnionitis, fetal stress, antibiotic use, prematurity, neonatal infection, and neonatal death were evaluated. RESULTS the prevalence of endocervical colonization was 14.2% (CI95%=9.5-18.9%), with similar results in preterm labor or premature rupture of membranes. Group B streptococcus was the most prevalent organism (9.4%). Other organisms isolated were Candida sp, Streptococcus sp, Streptococcus pneumoniae, Escherichia coli and Enterococcus sp. The most common findings of bacterioscopy were a reduced number of lactobacilli and a great number of leukocytes. Endocervical colonization was associated with a higher occurrence of urinary tract infection (23.8 versus 5.4%; p<0.01), early-onset neonatal infection (25.0 versus 7.3%; p<0.01) and neonatal mortality (two cases in colonized women; p<0.02) when compared with a negative culture of endocervical mucus. CONCLUSIONS this study showed high prevalence of endocervical colonization despite the use of a nonselective culture media. The main microorganism isolated was group B streptococcus, but other organisms were present in one third of the studied population. More studies are needed to evaluate the influence of endocervical colonization on obstetrical outcome and on neonatal infection and mortality.
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Affiliation(s)
- Giuliane Jesus Lajos
- Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Pereira BG, Vianna-Soares CD, Righi A, Pinheiro MVB, Flores MZS, Bezerra EM, Freire VN, Lemos V, Caetano EWS, Cavada BS. Identification of lamivudine conformers by Raman scattering measurements and quantum chemical calculations. J Pharm Biomed Anal 2007; 43:1885-9. [PMID: 17303364 DOI: 10.1016/j.jpba.2007.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Revised: 01/06/2007] [Accepted: 01/08/2007] [Indexed: 10/23/2022]
Abstract
Characterization of nucleoside and non-nucleoside human immunodeficiency virus (HIV) reverse transcriptase inhibitors conformers, NRTIs and NNRTIs, respectively, is fundamental for an improved treatment of infected individuals. Three conformers in lamivudine I powder are quickly identified in this work by assignment of some Raman peaks to their vibrational frequencies, as obtained by first principles quantum chemical calculations. The method is proposed as a practical procedure for non-destructive identification, analysis, and process monitoring of NRTIs and NNRTIs conformers.
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Affiliation(s)
- B G Pereira
- Escola de Farmácia, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, 30123-970 Belo Horizonte, Minas Gerais, Brazil
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Rehder PM, Pereira BG, Couto EC, Amaral E, Parpinelli MÂ. Prevalência de anticorpos antifosfolípides em diabéticas gestacionais e pré-gestacionais. Rev Bras Ginecol Obstet 2006. [DOI: 10.1590/s0100-72032006000300007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Couto E, Barini R, Zaccaria R, Annicchino-Bizzacchi JM, Passini Junior R, Pereira BG, Silva JCGD, Pinto e Silva JL. Association of anticardiolipin antibody and C677T in methylenetetrahydrofolate reductase mutation in women with recurrent spontaneous abortions: a new path to thrombophilia? SAO PAULO MED J 2005; 123:15-20. [PMID: 15821810 DOI: 10.1590/s1516-31802005000100004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Recurrent spontaneous abortion (RSA) has been associated with venous thrombosis in the mother. Acquired and inherited thrombophilia factors are possible causes. OBJECTIVE To evaluate the association between thrombogenic factors and recurrent spontaneous abortion. TYPE OF STUDY Case-control study. SETTING Centro de Atenção Integral à Saúde da Mulher, Universidade Estadual de Campinas. METHODS 40 ml of blood was collected from 88 women attending an RSA clinic and 88 fertile women attending a family planning clinic, to evaluate the presence of acquired and inherited thrombophilia factors. Anticardiolipin antibodies (ACA), lupus anticoagulant and deficiencies of proteins C and S and antithrombin III were evaluated by enzyme-linked immunosorbent assay (ELISA), dilute Russell Viper Venom time (dRVVT), coagulometric and chromogenic methods. DNA was amplified by the polymerase chain reaction (PCR) to study factor V Leiden and G20210A mutations in the prothrombin gene and C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene. Data were analyzed using odds ratios and a regression model for age adjustment. Fishers exact test was used to evaluate statistical relationships between associated factors and RSA. RESULTS ACA was detected in 11 women with RSA and one fertile woman. Heterozygous C677T was detected in 59 women with RSA and 35 fertile women. Concomitant presence of ACA and C677T was found in eight women with RSA and no fertile women (p < 0.01). DISCUSSION The meaning of the association between C677T mutation in the MTHFR gene and ACA is still not clear. It is possible that an inherited factor that alone would not strongly predispose a woman to thrombosis could, when associated with an acquired factor, start the process and increase the likelihood of thrombosis expression. CONCLUSIONS ACA and C677T in the MTHFR gene are statistically associated with RSA. The association of these two conditions is a new finding in thrombogenic factors and RSA.
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Affiliation(s)
- Egle Couto
- Universidade Estadual de Campinas, São Paulo, Brazil.
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Pereira BG, Camargo MG, Couto EC, Amaral E, Passini Jr R, Parpinelli MA. Resultados neonatais no parto vaginal espontâneo comparados aos dos partos com fórcipe de Simpson-Braun em primíparas. Rev Bras Ginecol Obstet 2004. [DOI: 10.1590/s0100-72032004000100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Nomura ML, Passini Júnior R, Silva JCGD, Vaz MS, Amaral E, Pereira BG. Resultados gestacionais e perinatais de gestações com insuficiência cervical submetidas a circlagem eletiva. Rev Bras Ginecol Obstet 2003. [DOI: 10.1590/s0100-72032003000700004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Passini R, Knobel R, Parpinelli MA, Pereira BG, Amaral E, de Castro Surita FG, de Araújo Lett CR. Calcified abdominal pregnancy with eighteen years of evolution: case report. SAO PAULO MED J 2000; 118:192-4. [PMID: 11120551 DOI: 10.1590/s1516-31802000000600008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
CONTEXT The lithopedion (calcified abdominal pregnancy) is a rare phenomenon and there are less than 300 cases reported in the medical literature. CASE REPORT In this case, a 40 year-old patient had had her only pregnancy 18 years earlier, without medical assistance since then. She came to our hospital with pain and tumoral mass of approximately 20 centimeters in diameter. Complementary examinations (abdominal X-ray, ultrasonography and computerized tomography) demonstrated an extra-uterine abdominal 31-week pregnancy with calcification areas. Exploratory laparotomy was performed, with extirpation of a well-conserved fetus with partially calcified ovular membranes.
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Affiliation(s)
- R Passini
- Department of Obstetrics & Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
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Parpinelli MA, Faúndes A, Cecatti JG, Pereira BG, Passini Júnior R, Amaral E. Análise da Mortalidade Evitável de Mulheres em Idade Reprodutiva. Rev Bras Ginecol Obstet 2000. [DOI: 10.1590/s0100-72032000000900007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Parpinelli MA, Faúndes A, Cecatti JG, Surita FGDC, Pereira BG, Passini Júnior R, Amaral E. Subnotificação da mortalidade materna em Campinas: 1992 a 1994. Rev Bras Ginecol Obstet 2000. [DOI: 10.1590/s0100-72032000000100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pereira BG, Faúndes A, Parpinelli MA, Silva JCGD. Percepção materna de movimentos fetais como método de avaliação da vitalidade fetal em gestantes diabéticas. Rev Bras Ginecol Obstet 1999. [DOI: 10.1590/s0100-72031999001000003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Pereira BG, Faúndes A, Parpinelli MA, Passini Jr. R, Amaral E, Pires HB, Cecatti JG. Via de Parto e Resultados Perinatais em Gestantes Diabéticas. Rev Bras Ginecol Obstet 1999. [DOI: 10.1590/s0100-72031999000900004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Parpinelli MA, Faúndes A, Surita FGDC, Pereira BG, Cecatti JG. Mortalidade materna na cidade de Campinas, no período de 1992 a 1994. Rev Bras Ginecol Obstet 1999. [DOI: 10.1590/s0100-72031999000400008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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