Diabetes e Gestação: Perfil Clínico e Laboratorial em Pré-Natal de Alto Risco

Introdução: O diabetes é complicação clínica frequente na gestação e sua prevalência vem aumentando nos últimos anos.Objetivo: Analisar a frequência dos tipos de diabetes na gestação, as características clínicas das gestantes e alguns desfechos materno-fetais, em pré-natal de alto risco.Método: Estudo retrospectivo de revisão dos prontuários eletrônicos de mulheres com diabetes e gestação atendidas no período de janeiro 2009 a junho 2010 no Hospital de Clínicas de Porto Alegre (HCPA).Resultados: Nesse período, 173 gestantes foram atendidas no ambulatório de gestação e diabetes, no total de 1459 consultas. O diabetes gestacional ocorreu em 84% das gestantes, 8% apresentaram diabetes tipo 2, 6%, diabetes tipo 1 e 2%, outros tipos. As mulheres com diabetes gestacional apresentaram HbA1c inferior às demais. A maioria das pacientes iniciou o pré-natal após o primeiro trimestre. A taxa geral de cesariana foi de 56%, tendo sido mais frequente no diabetes tipo 1. O recém-nascido foi considerado pequeno para a idade gestacional em 9% dos casos, e grande em 13%, sem diferença entre os tipos de diabetes. Nas mulheres com diabetes gestacional, o peso do recém-nascido correlacionou-se positivamente com o índice de massa corporal, glicemia de jejum ao diagnóstico e HbA1c da mãe.Conclusão: O diabetes associado à gestação é motivo frequente de atendimento no pré-natal especializado do HCPA, sendo a maioria diabetes gestacional. Nesses casos, obesidade e pior controle glicêmico associaram-se com o peso fetal aumentado. As gestantes chegam tardiamente ao centro de tratamento, com controle metabólico aquém do recomendado

Tuberculosis in childhood: retrospective study

Introdução: a tuberculose (TB) infantil permanece como uma das doenças mais prevalentes e preocupantes no mundo, sobretudo em nações em desenvolvimento, onde as taxas são ainda mais elevadas e os casos descritos subestimados pela dificuldade em se estabelecer um diagnóstico definitivo. Objetivo: descrever o perfil clínico e epidemiológico dos pacientes com TB infantil pulmonar e ex trapulmonar. Métodos: foram avaliados retrospectivamente, através de questionário, pacientes com idade de até 15 anos, internados no Serviço de Pediatria do Hospital de Clínicas de Porto Alegre (HCPA), no período de janeiro de 2002 a setembro de 2007. Resultados: dos 52 pacientes incluídos, 63% apresentavam TB pulmonar. Das formas extrapulmonares, a meningoencefalite foi a mais prevalente (22%). Comorbidades foram detectadas em 31 (60%) pacientes, dos quais 15 (29%) apresentavam desnutrição grave, 9 (18%) HIV positivo e 7 (13%) pneumopatia crônica. Das manifestações clínicas, febre e tosse estavam presentes na maioria dos pacientes. O padrão radiológico predominante foi o de consolidação pulmonar (51%). A maioria dos pacientes referia história de contato com paciente bacilífero (64%). Conclusão: a TB pulmonar representa a principal forma de apresentação clínica da TB, sendo o diagnóstico feito de forma presuntiva na maioria dos casos. Os resultados do nosso estudo reforçam a importância da anamnese (história epidemiológica e vacinal) e achados clínicos e radiológicos para o diagnóstico de TB infantil. Tendo em vista que a TB em crianças é considerada um “evento sentinela”, indicando recente transmissão a partir de um adulto infectado, além da maior gravidade da doença nesta população, torna-se imperativo uma maior ênfase na prevenção e diagnóstico precoces.Background: tuberculosis (TB) in childhood remains one of the most prevalent and disturbing diseases worldwide. This is especially true in developing countries, where TB rates are even higher and the number of cases is underestimated because of the difficulty to establish definitive diagnosis. Aim: the present study was to describe the clinical and epidemiological profile of children with pulmonary and extrapulmonary TB. Methods: we used a questionnaire to retrospectively evaluate patients aged up to 15 years admitted to the Pediatric Unit of HCPA from January 2002 to September 2007. Results: of the 52 patients included in the study, 63% had pulmonary TB. Among the extrapulmonary forms, meningoencephalitis was the most prevalent (22%). Comorbidities were detected in 31 (60%) patients, and 15 (29%) of them had severe malnutrition, 9 (18%) were positive for HIV, and 7 (13%) had chronic lung disease. Among the clinical manifestations, fever and cough were present in most patients. The predominant radiological pattern was pulmonar y consolidation (51%). Most patients repor ted a history of contact with contagious TB patients (64%). Conclusion: pulmonary TB is the main clinical presentation of TB, and most patients receive a presumptive diagnosis. Our results reinforce the impor tance of anamnesis (epidemiological and vaccination history) and clinical and radiological findings to establish the diagnosis of TB in childhood. Considering that TB in children is a “sentinel event”, indicating recent transmission from an infected adult, and because of the greater severity of the disease in this population, it is crucial to emphasize prevention and early diagnosis

Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic

Introduction: atrial fibrillation (AF) is one of the main risk factors for stroke. Vitamin K antagonists (VKA) reduce this risk, and the effectiveness of this treatment is directly related to time in therapeutic range (TTR). This study aimed to report the TTR in patients with non-valvular AF at an anticoagulation outpatient clinic; and to describe the profile of this population of patients in terms of risk of stroke, as well as the occurrence of adverse events during the follow-up. Methods: Retrospective cohort study involving patients of the anticoagulation outpatient clinic of the Department of Internal Medicine at Hospital de Clínicas de Porto Alegre. We evaluated outpatient visits, hospital admissions, and emergency visits from January to December 2011. TTR was calculated using the Rosendaal method. Results: Sixty-three patients were investigated. Their mean age was 74.3±10.9 years. The CHADS2 score was ≥ 4 in 44.5% of the patients; 63.5% of them had a CHA2DS2-VASc score ≥ 5. The TTR was 64.8%. During follow-up, the incidence of overall bleeding was 31.7%, with major and minor bleeding rates of 4.8% and 34.9%, respectively. There were no other complications related to AF or anticoagulation. Conclusion: The patients achieved a TTR of 64.8% during follow-up, which is deemed appropriate and in agreement with the literature. Patients had high risk for stroke, and the incidence of minor bleeding was higher than the rate found in the literature, whereas the incidence of major bleeding was similar to the one found in previous studies

The impact of plant diseases throughout history.

reservedI rapporti ostili tra funghi e piante, probabilmente risalgono alla fase di passaggio dalla vita acquatica a quella terrestre. Nei vari processi di adattamento alla nuova forma di vita, alcuni funghi si sono specializzati verso forme di vita parassitaria, cercando di trarre il loro nutrimento dalle piante. In alcuni casi senza danneggiare eccessivamente l’ospite (endofiti commensali) o addirittura con mutuo vantaggio (funghi micorrizici), in altri causando la morte di cellule, tessuti, organi e/o dell’intera pianta (patogeni). Il passaggio dalla vita saprofitaria a quella parassitaria è un processo ancora in evoluzione. Tra piante e funghi vi è una costante "corsa agli armamenti", per cui alle mutazioni che portano ad un aumento della virulenza in un agente patogeno si contrappongono specifiche risposte in termini di resistenza da parte delle piante ospiti. Questo equilibrio dinamico tra funghi e piante nel corso della storia è stato significativamente alterato dall’uomo con la coltivazione e la selezione delle piante che meglio potevano fornirgli cibo e beni. L’agricoltura ha profondamente modificato i principali fattori che regolano il rapporto parassitario tra funghi e piante e che contribuiscono alla dinamica delle associazioni vegetali naturali. Nel corso dei secoli, l’uomo ha progressivamente sostituito le popolazioni eterogenee della vegetazione naturale con popolamenti di piante addomesticate, ingentilite e selezionate per specifici caratteri produttivi. Ciò ha determinato una progressiva riduzione delle specie utilizzate in agricoltura; oggi, poche decine di specie vegetali assicurano la base alimentare alla maggior parte della popolazione mondiale. L’impiego di poche specie vegetali spesso uniformi dal punto di vista genetico ha favorito l’azione parassitaria dei funghi e lo sviluppo di gravi epidemie che hanno condizionato la vita dell’uomo fin dall’antichità. In questa tesi sono trattate alcune delle principali malattie che dagli albori della storia fino ai giorni nostri hanno colpito piante di interesse forestale ed agrario portando carestie e fame.The antagonistic relationships between fungi and plants probably date back to the transition phase from aquatic to terrestrial life. In the various processes of adaptation to the new form of life, some fungi have specialized towards parasitic life forms, trying to obtain their sustenance from plants. In some cases without excessively damaging the host (commensal endophytes) or even with mutual advantage (mycorrhizal fungi), in others causing the death of cells, tissues, organs and/or the entire plant (pathogens). The transition from saprophytic to parasitic life is an evolving process. There is a constant "arms race" between plants and fungi, whereby mutations that lead to an increase in virulence in a pathogen are opposed by specific responses in terms of resistance on the part of the host plants. This dynamic equilibrium between fungi and plants throughout history has been significantly altered by the human being with the cultivation and selection of the best plants from a productive point of view. Agriculture has profoundly modified the main factors which regulate the parasitic relationship between fungi and plants and which contribute to the dynamics of natural plant associations. Over the centuries, the human being has progressively replaced the heterogeneous populations of natural vegetation with populations of domesticated plants selected for specific productive characteristics. This has resulted in a progressive reduction of the species used in agriculture; today, a few dozen plant species provide the food base for the majority of the world's population. The use of a few plant species, often uniform from a genetic point of view, has favoured the parasitic action of fungi and the development of serious epidemics that have affected human life since ancient times. This thesis deals with some of the main diseases that from the dawn of history to the present day have affected plants of forestry and agricultural interest, leading to famine and hunger

Characterization of protein hydrolysates of cosmetic use by CE-MS

Protein hydrolysates have been used as active principles in cosmetic products conferring different properties to the final formulations, which are mostly controlled by the peptide size and its amino acid sequence. In this work, capillary electrophoresis coupled to mass spectrometry analyses were carried out in order to investigate such characteristics of protein hydrolysates. Samples of different origins (milk, soy and rice) were obtained from a local company, and were analyzed without a previous preparation step. The background electrolyte (BGE) and sheath liquid compositions were optimized for each sample. The best BGE composition (860 mmol/L formic acid - pH 1.8 - in 70: 30 v/v water/methanol hydro-organic solvent) was chosen based on the overall peak resolution whereas the best sheath liquid was selected based on increased sensitivity and presented different compositions to each sample (10.9-217 mmol/L formic acid in 75: 25-25: 75 v/v water/methanol hydro-organic solvent). Most of the putative peptides in the hydrolysate samples under investigation presented molecular masses of 1000 Da or less. De novo sequencing was carried out for some of the analytes, revealing the hydrophobicity/polarity of the peptides. Hence, the technique has proved to be an advantageous tool for the quality control of industrial protein hydrolysates.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)[Fapesp 04/08931-4]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) of Brazil[CNPq 151562/2005-9]Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) of Brazil[300595/2007-7

Characterization Of Protein Hydrolysates Of Cosmetic Use By Ce-ms.

Protein hydrolysates have been used as active principles in cosmetic products conferring different properties to the final formulations, which are mostly controlled by the peptide size and its amino acid sequence. In this work, capillary electrophoresis coupled to mass spectrometry analyses were carried out in order to investigate such characteristics of protein hydrolysates. Samples of different origins (milk, soy and rice) were obtained from a local company, and were analyzed without a previous preparation step. The background electrolyte (BGE) and sheath liquid compositions were optimized for each sample. The best BGE composition (860 mmol/L formic acid--pH 1.8--in 70:30 v/v water/methanol hydro-organic solvent) was chosen based on the overall peak resolution whereas the best sheath liquid was selected based on increased sensitivity and presented different compositions to each sample (10.9-217 mmol/L formic acid in 75:25-25:75 v/v water/methanol hydro-organic solvent). Most of the putative peptides in the hydrolysate samples under investigation presented molecular masses of 1000 Da or less. De novo sequencing was carried out for some of the analytes, revealing the hydrophobicity/polarity of the peptides. Hence, the technique has proved to be an advantageous tool for the quality control of industrial protein hydrolysates.34947-5

Characterization of protein hydrolysates of cosmetic use by CE‐MS

Protein hydrolysates have been used as active principles in cosmetic products conferring different properties to the final formulations, which are mostly controlled by the peptide size and its amino acid sequence. In this work, capillary electrophoresis coupled to mass spectrometry analyses were carried out in order to investigate such characteristics of protein hydrolysates. Samples of different origins (milk, soy and rice) were obtained from a local company, and were analyzed without a previous preparation step. The background electrolyte (BGE) and sheath liquid compositions were optimized for each sample. The best BGE composition (860 mmol/L formic acid – pH 1.8 – in 70:30 v/v water/methanol hydro‐organic solvent) was chosen based on the overall peak resolution whereas the best sheath liquid was selected based on increased sensitivity and presented different compositions to each sample (10.9–217 mmol/L formic acid in 75:25–25:75 v/v water/methanol hydro‐organic solvent). Most of the putative peptides in the hydrolysate samples under investigation presented molecular masses of 1000 Da or less. De novo sequencing was carried out for some of the analytes, revealing the hydrophobicity/polarity of the peptides. Hence, the technique has proved to be an advantageous tool for the quality control of industrial protein hydrolysates348947956CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP151562/2005-9; 300595/2007-704/08931-

Characterization of protein hydrolysates of cosmetic use by CE-MS

Protein hydrolysates have been used as active principles in cosmetic products conferring different properties to the final formulations, which are mostly controlled by the peptide size and its amino acid sequence. In this work, capillary electrophoresis coupled to mass spectrometry analyses were carried out in order to investigate such characteristics of protein hydrolysates. Samples of different origins (milk, soy and rice) were obtained from a local company, and were analyzed without a previous preparation step. The background electrolyte (BGE) and sheath liquid compositions were optimized for each sample. The best BGE composition (860 mmol/L formic acid - pH 1.8 - in 70: 30 v/v water/methanol hydro-organic solvent) was chosen based on the overall peak resolution whereas the best sheath liquid was selected based on increased sensitivity and presented different compositions to each sample (10.9-217 mmol/L formic acid in 75: 25-25: 75 v/v water/methanol hydro-organic solvent). Most of the putative peptides in the hydrolysate samples under investigation presented molecular masses of 1000 Da or less. De novo sequencing was carried out for some of the analytes, revealing the hydrophobicity/polarity of the peptides. Hence, the technique has proved to be an advantageous tool for the quality control of industrial protein hydrolysates.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)[Fapesp 04/08931-4]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) of Brazil[CNPq 151562/2005-9]Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) of Brazil[300595/2007-7