Search

To calculate the accuracy (A) and establish the best cutoff value for ophthalmic artery (OA) Doppler velocimetry indexes in patients diagnosed with preeclampsia (PE), compared with healthy pregnant women.This prospective experimental study enrolled 268 women: 133 with PE and 135 healthy pregnant women. All patients were evaluated by OA Doppler sonography, bilaterally, to assess their pulsatility index (PI), resistance index (RI), peak systolic velocity (PVS), second peak systolic velocity (P2), end-diastolic velocity (EDV), and peak ratio (PR). Means were compared using Student'sROC curve analysis showed that P2 and PR were superior to the other parameters for PE diagnosis. We tested two cutoff values: (1) using PR ≥0.70, obtained A: 88.72%, S: 81.95%, and Sp: 95.48% and (2) using PR ≥0.75, and A: 86.24%, S: 74.43%, and Sp: 99.24%. By adopting P2 ≥ 21.5 cm/s, we obtained A: 87.59%, S: 84.96%, and Sp: 90.22% and when the cutoff point was P2 ≥ 22 cm/s, there was a slight decrease in A to 86.46% and S to 81.20%, with Sp: 91.89.3%.Ophthalmic artery Doppler demonstrated to be an effective and high-performance imaging method for the diagnosis of PE and the indexes P2 and PR demonstrated superior accuracy to the other Doppler parameters assessed. Higher performance occurred when the cutoff values with greater specificity were adopted, PR ≥ 0.75 and P2 ≥ 22 cm/s, considering that the proposed OA Doppler is to be a complementary method for preeclampsia.

Vascular dysfunctions can progress and lead to stroke and cardiovascular disease, especially in smokers. The presence of particular vascular changes according to sex has been described and they can be identified by the Doppler method. This study evaluated Doppler velocimetry parameters of the Ophthalmic Artery (OA) and the Middle Cerebral Artery (MCA) according to sex in smokers regarding a non-smoker group. This cross-sectional observational study included 178 subjects: 93 women and 85 men. Doppler parameters were assessed in OA and MCA. Student’s t-test was used, with p

Objectives To evaluate ophthalmic Doppler velocimetry patterns in pregnant women with pregestational diabetes mellitus with and without retinopathy in comparison to pregnant women without gestational intercurrences. Methods This cross-sectional observational study analyzed Doppler indices of the ophthalmic arteries, including the resistive index (RI), pulsatility index, peak systolic velocity, second peak systolic velocity, peak ratio, and end-diastolic velocity (EDV), in 3 groups of pregnant women: diabetic with retinopathy (n = 12); diabetic without retinopathy (n = 85); and nondiabetic controls (n = 122). The Kruskal-Wallis test was used for the statistical analysis with a probability of 95%. Results The mean gestational ages ± SDs of pregnant women with and without retinopathy and nondiabetic controls were 29.1 ± 2.2, 29.7 ± 2.7, and 31 ± 1.0 weeks, respectively, with no significant differences between the groups (P > .099). The mean RI in the group with retinopathy was significantly higher (P = .030) than in the control group, but it did not significantly differ compared to the group without retinopathy (P = .204). The RI in the control group did not differ from that in the group without retinopathy (P = .079). The EDV was significantly lower in the group with retinopathy (P = .015) in relation to the control group, but there were no differences compared to the group without retinopathy (P = .217). Conclusions Pregnant women with pregestational diabetes mellitus and retinopathy had increased vascular impedance in the ophthalmic artery together with a reduction in the EDV, which was probably related to ischemia, thrombosis, and neovascularization of retinal vessels.

The vascular endothelium has specific estrogen receptors and the impact of hormone therapy (HT) on circulation is associated with cardiovascular protection in perimenopause and postmenopause. Blood vessels can be assessed by ultrasound Doppler velocimetry, and more specifically the study of the ophthalmic artery (OA) can be used for brain vessel assessment; more recently, it is a possible method for cardiovascular risk assessment.A cross-sectional study involved perimenopausal and postmenopausal women divided into three groups: 60 non-HT users (control group), 23 users of estrogen therapy (ET group), and 23 users of estrogen-progesterone therapy (EPT group). Doppler velocimetry of the OA was performed with analysis of the resistance index (RI), pulsatility index (PI), systolic peak velocity (P1), second systolic peak velocity (P2), peak velocity ratio (PVR), final diastolic velocity (FDV), and ratio between means of systolic and diastolic velocity (SDR).There was no significant difference between the groups in Doppler velocimetry indices of the OA: RI (There is a positive correlation between the SDR and age in the control group. Therefore, this new index is a promising instrument in the non-invasive assessment of cardiovascular risk.

Pre-eclampsia (PE) is a severe disorder that affects up to 8% of all pregnancies and represents an important cause of maternal and perinatal morbidity and mortality. The screening of the disease is a subject of studies, but the complexity and uncertainties regarding its etiology make this objective a difficult task. In addition, the costs related to screening protocols, the heterogeneity of the most affected populations and the lack of highly effective prevention methods reduce the potential of current available algorithms for screening. Thus, the National Specialized Commission of Hypertension in Pregnancy of the Brazilian Association of Gynecology and Obstetrics Federation (Febrasgo, in the Portuguese acronym) (NSC Hypertension in Pregnancy of the Febrasgo) considers that there are no screening algorithms to be implemented in the country to date and advocates that Aspirin and calcium should be widely used.

Vascular dysfunctions can progress and lead to stroke and cardiovascular disease, especially in smokers. The presence of particular vascular changes according to sex has been described and they can be identified by the Doppler method. This study evaluated Doppler velocimetry parameters of the ophthalmic artery (OA) and the middle cerebral artery (MCA) according to sex in smokers regarding a non-smoker group. This cross-sectional observational study included 178 subjects: 93 women and 85 men. Doppler parameters were assessed in OA and MCA. Student’s t-test was used, with p < 0.05. There were no significant differences in OA and MCA Doppler velocimetry data between male non-smokers and smokers. However, female smokers presented several differences compared with non-smokers: lower pulsatility index (PI) and higher peak ratio and second peak of systolic velocity in OA, and higher PI and resistance index and lower end diastolic velocity in MCA. There were different brain vascular waveforms in the group of female smokers compared with non-smokers. Cigarette smoking also led to opposite arterial patterns in OA and MCA in the female group, with signs of falling impedance in OA and increased impedance in MCA. An individualised approach regarding arterial changes according to sex is desirable.

Made available in DSpace on 2021-06-25T12:40:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01. Added 1 bitstream(s) on 2021-07-15T14:36:35Z : No. of bitstreams: 1 S0100-72032021000100061.pdf: 351132 bytes, checksum: ec2e22a997ed83c899edfdc67368253f (MD5) Brazilian Federation of Gynecology and Obstetrics (FEBRASGO) Pre-eclampsia (PE) is a severe disorder that affects up to 8% of all pregnancies and represents an important cause of maternal and perinatal morbidity and mortality. The screening of the disease is a subject of studies, but the complexity and uncertainties regarding its etiology make this objective a difficult task. In addition, the costs related to screening protocols, the heterogeneity of the most affected populations and the lack of highly effective prevention methods reduce the potential of current available algorithms for screening. Thus, the National Specialized Commission of Hypertension in Pregnancy of the Brazilian Association of Gynecology and Obstetrics Federation (Febrasgo, in the Portuguese acronym) (NSC Hypertension in Pregnancy of the Febrasgo) considers that there are no screening algorithms to be implemented in the country to date and advocates that Aspirin and calcium should be widely used. Univ Estadual Paulista, Botucatu Med Sch, Dept Gynecol & Obstet, Botucatu, SP, Brazil Univ Fed Uberlandia, Fac Med, Dept Obstet & Gynecol, Uberlandia, MG, Brazil Univ Sao Paulo, Fac Med, Dept Gynecol & Obstet, Ribeirao Preto, SP, Brazil Pontificia Univ Catolica Rio Grande do Sul, Gynecol & Obstet Training Ctr, Sch Med, Porto Alegre, RS, Brazil Ctr Univ Lusiada, Dept Tocoginecol, Santos, SP, Brazil Pontificia Univ Catolica Sao Paulo, Fac Med, Dept Obstet & Gynecol, Sorocaba, SP, Brazil Univ Fed Rio Grande do Sul, Fac Med, Dept Gynecol & Obstet, Porto Alegre, RS, Brazil Univ Estadual Campinas, Fac Med Sci, Dept Gynecol & Obstet, Campinas, SP, Brazil Univ Fed Minas Gerais, Fac Med, Dept Gynecol & Obstet, Belo Horizonte, MG, Brazil Univ Fed Sao Paulo, Escola Paulista Med, Sao Paulo, SP, Brazil Univ Estadual Paulista, Botucatu Med Sch, Dept Gynecol & Obstet, Botucatu, SP, Brazil

Cardiovascular and endothelial dysfunction is recognized nowadays as an important etiological factor contributing to the development of hypertensive disorders of pregnancy. Preeclampsia is considered a specific disease of pregnancy, but recent theories suggest that women suffering from the condition have greater propensity to develop atherosclerosis, heart disease, and stroke over the years. It is possible that transient but severe endothelial dysfunction observed in preeclampsia potentiates a cascade of events that progresses to atherosclerosis. Preeclampsia offers a unique window of opportunity to identify maternal endothelial dysfunction and pre-existing cardiovascular disease. The placenta is closely involved in the onset of preeclampsia, but endothelial and cardiac vascular factors also play important causal roles in the development of hypertension during pregnancy. According to the data presented, it is clear that preeclampsia selects a group at high risk of development of atherosclerosis and at increased cardiovascular risk, as well as of stroke, in the decades following childbirth.

The aim of this study was to evaluate the hemodynamic behavior of the ophthalmic artery by means of the Doppler ultrasound, in postpartum preeclamptic women. It was an observational prospective study with 44 postpartum preeclamptic women (group 1) and 49 postpartum normal women with normal blood pressure and with no previous illnesses known (group 2). All the pregnant women had a Doppler ultrasound exam of the ophthalmic artery in the immediate puerperium, that is, 10 days for the delivery (time 1). Group 1 was then followed prospectively, 26 patients of which returned to the last test in the remote puerperium in 45 days (time 2) and 29 patients returned to the last test in the remote puerperium in 90 days (time 3). All these women had preeclampsia before the delivery. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), end diastolic flow velocity (EDV), second peak of systolic velocity (P2), and the peak ratio (PR) were calculated. The data obtained are expressed in average and standard deviation, by using the Lilliefors test for normality. The average of the Doppler indexes in groups 1 and 2 was compared by means of test t of the student. Group 1 was analyzed separately, comparing the three times, using the test of ANOVA for repetitive measures and Tukey post-hoc range test. In the "Results" section, the statically meaningful differences in RI, PI, P2, RPV, and EDV (p < 0.0001, p < 0.0001, p < 0.0009, p < 0.0001, p < 0.0028) were found in the immediate puerperium of group 1 in relation to group 2, indicating the persistence of hyperperfusion and orbital vasodilatation in the immediate postpartum period in patients who had complicated pregnancies previously due to preeclampsia. In the evolutionary analysis of group 1, comparing the Doppler indexes between the immediate and late puerperium, statistically relevant differences between the rates of RI, P2, and PR (p < 0,01) were observed, showing a raise of RI and reduction of P2 and PR, and also a tendency of normalization of these rates in the late puerperium. When the same indexes were compared (PI, P2, and PR) now in times 2 and 3, the remote, and late puerperium, respectively, there were no significant differences, indicating the stabilization of these indexes since the 45th day of the puerperium. Within 90 days, RI, PI, and PR are not stabilized yet in relation to the control, even though there is a tendency of these indexes to reach the control. In conclusion, there was persistence of signs of vasodilatation and hyperperfusion of the orbital territory, represented by Doppler of the ophthalmic artery in the immediate puerperium of preeclamptic women. A tendency of normalization of the orbital hemodynamic standard in the pregnant women from the period of the late puerperium was observed, but there was no complete normalization of the vascular pattern on the remote postpartum.

Introduction: The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia and an increased risk of cardiovascular events. One function of high-density lipoprotein (HDL) cholesterol (HDL-C) is the cholesterol-efflux pathway, which is the pathway where cholesterol is removed from macrophages within the arterial walls back into the bloodstream and out to the liver. As one of the key functions of HDL, their hypothesis was that if they could measure HDL-C-efflux capacity, they would have a better handle on the role of HDL in atherosclerosis. However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between HDL-C functionality and MetS. The aim of this study is to examine this association of HDL-C functionality with MetS in different ages and sex. Methods and analysis: The update systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (i.e., PubMed, EMBASE, Web of Science, and Google Scholar). Studies that examined the association between HDL-C functionality and MetS; focused on cohort, case-control, and cross-sectional studies; were conducted among in adults aged 40 to 70 years; provided sufficient data for calculating odds ratio or relative risk with a 95% confidence interval; were published as original articles written in English or other languages; and have been published until January 2018 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. Ethics and dissemination: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. Trial registration number: PROSPERO (CRD42018083465).

The objective of this study was to analyze the relationships of osmotic and mechanical stability of erythrocytes with anthropometric, biochemical, hematologic and hemodynamic variables in pregnant women with preeclampsia (PE). The studied population consisted of 20 normotensive patients and 16 patients with PE. Patients with PE presented worse gestational outcome, greater hematologic impairment, erythrocytes osmotically more stable in vitro, but in conditions of isotonicity with the in vivo medium, in addition to hyperflow in orbital territory, when compared to normotensive patients. The correlation analysis between anthropometric, hematologic and hemodynamic variables in patients with PE indicated that erythrocytes with lower volumes and lower levels of hemoglobin favor the occurrence of a better gestational outcome, because they are more stable and because they are associated with a decrease in the hemodynamic changes present in the disease. This should mean that the tendency to microcytosis, probably due to a mechanism of compensatory mechanical selection, is a desirable characteristic in the disease.

Aim The aim of this study was to assess the Doppler parameters of the ophthalmic artery of pregnant women carrying fetuses with growth restriction (FGR) compared with normal fetuses. Material and Methods A prospective cross-sectional study was conducted with 120 pregnant women (60 FGR and 60 normal fetuses) between 32 and 40 weeks of gestation. FGR diagnosis was based on an estimated fetal weight below the 10th percentile of the Hadlock curve. Ophthalmic artery Doppler images were obtained with a linear transducer, with color Doppler examination of the region medial to the optic nerve. The following indices were obtained: pulsatility index, resistance index, peak systolic velocity, second peak velocity (P2), end diastolic velocity, and P2 / peak systolic velocity ratio. The Mann–Whitney U-test and Student's t-test were used to compare the groups with regard to quantitative variables, and the χ2-test was used for categorical variables. Results Pulsatility index and resistance index were significantly lower in pregnant women with FGR than in those with normal fetuses, with P

OBJETIVO:Verificar se a contagem de foliculos antrais pode predizer o numero de oocitos captados em pacientes submetidas a fertilizacao in vitro (FIV), bem como correlaciona-la com a idade materna e a taxa de gestacao.METODOS:Estudo observacional retrospectivo que incluiu 193 pacientes submetidas a tecnicas de reproducao assistida, entre setembro de 2010 e setembro de 2012, em uma Clinica de Reproducao Humana do Sudeste do Brasil. O estudo incluiu mulheres com indicacao de FIV e com dosagem de hormonio foliculo-estimulante inferior a 10 mUI/mL no terceiro dia do ciclo, sendo excluidas as receptoras de oocitos. As pacientes foram divididas em tres grupos de acordo com o numero de foliculos antrais (ate 10, de 11 a 22, maior ou igual a 23 foliculos). Para a comparacao entre esses tres grupos e o grupo das pacientes que engravidaram, foram excluidas as pacientes que nao desenvolveram oocitos e as que nao tiveram embrioes transferidos. Utilizou-se o coeficiente de correlacao de Spearman para medir o grau de associacao entre as variaveis numericas e o teste do χ2 para comparar taxa de gravidez e contagem de foliculos antrais. Para avaliar a probabilidade de gravidez, utilizou-se a regressao logistica multivariada, com nivel de significância de 5%.RESULTADOS:A taxa de gestacao da amostra foi 35,6%. Observou-se correlacao significativa (cs) positiva entre contagem de foliculos antrais e numero de oocitos aspirados (cs=0,5; p

To compare the ophthalmic artery (OA) perfusion of pregnant smokers and nonsmokers by Doppler indexes. Correlate these with the interval of last cigarette, cigarettes per day, years smoking and carbon monoxide expired (COex).Transversal study involving 70 pregnant smokers divided into 33 pregnant who smoked until 2 h: A group (AG) and B group (BG): 37, who smoked between 2 and 24 h before test. Control group (CG) was composed of 51 pregnant nonsmokers. Doppler indexes were assessed: PSV (Peak Systolic Velocity), EDV (End Diastolic Velocity), PI (Pulsatility Index), RI (Resistance Index) and PR (Peak Ratio). Groups were compared using ANOVA, Kruskal-Wallis test, Student's t test, Mann-Whitney and Pearson's correlation coefficient, whereas p 0.05.RI and PI were higher (p 0.01) and PSV and EDV were lower (p 0.05) in B group compared to other groups. A group presented higher PR (p 0.01) compared to control. AG presented years of smoking, cigarettes per day, COex greater than BG and lower interval of last cigarette than BG.The OA in pregnant smokers shows a biphasic pattern of perfusion correlated with the time of consumption of the last cigarette. There are signs of vasoconstriction and hypoperfusion to tobacco exposure between 2 and 24 and hyperperfusion in A Group compared to B Group.

The aim of this study was to evaluate hepatic Doppler ultrasound (US) indices for steatosis diagnosis and grading, having biopsy as reference.Doppler and conventional US were performed in 49 healthy volunteers, without risk factors for nonalcoholic fatty liver disease (NAFLD), and in 49 patients with NAFLD and at least one risk factor: obesity, dyslipidemia and/or diabetes mellitus. Significant alcohol intake and hepatitis B or C were exclusion criteria. NAFLD patients were biopsied, and steatosis severity graded histologically. Portal Venous Pulsatility Index (PVI), Hepatic Artery Resistance Index (HARI) and Pulsatility Index (HAPI) were analyzed in hilum. Hepatic vein waveform pattern (HVWP) was classified as triphasic, biphasic or monophasic. Two pathologists analyzed histological samples. ROC curve defined sensitivity and specificity and multivariate analysis defined an equation for classifying patients.In NAFLD group, 89.79% had histologic criteria for non-alcoholic steatohepatitis (NASH). Mild steatosis was present in 44.89%, moderate steatosis in 38.77% and severe steatosis in 16.32%. In NAFLD group, 65.29% were obese and body mass index (BMI) had significant correlation with steatosis grading (r=0.77; P0.0001). PVI correlated with presence of steatosis (r=-0.69, P0.0001) as HVWP (r=-0.61, P0.0001). PVI ideal cutoff for predicting steatosis was 0.26 (sensitivity, 91%; specificity, 79.6%). The equation 16.15PVI+1.96HVWP enables to differentiate the healthy and the steatosis patients. HARI and HAPI could not differentiate the healthy from the steatosis group. None of the indices correlated with steatosis grading.Portal and hepatic vein indices allow non-invasive steatosis diagnosis but are limited to quantify it. Histology remains important for steatohepatitis diagnosis and for steatosis grading.

Critical evaluation is used to identify the strengths and weaknesses of an article, in order to evaluate the usefulness and validity of research results. The components of the critical appraisal are the appropriateness of the study design for the research question and a thorough evaluation of important methodological characteristics of this study, the adequacy of the used statistical methods and their subsequent interpretation, potential conflicts of interest and the relevance of research for clinical practice. This review steps for review and also helps in identifying highquality studies that can guide clinical practice safely and evidence-based.

The purpose of this study was to compare the effects of 3 different modalities of exercise on metabolic control, insulin resistance, inflammatory markers, adipocytokines, and tissue expression of insulin receptor substrate (IRS)-1 after 12 weeks of training among patients with type 2 diabetes mellitus. Forty-eight patients with type 2 diabetes mellitus were randomly assigned to 4 groups of training (3 times a week, 60 minutes per session): aerobic group (n = 12), resistance group (n = 12), combined (aerobic and resistance) group (n = 12), and control group (n = 12). Fasting and postprandial blood glucose, glycated hemoglobin, lipid profile, insulin resistance index (homeostasis model assessment of insulin resistance), adipocytokines (adiponectin, visfatin, and resistin), tumor necrosis factor, interleukin, and high-sensitivity C-reactive protein (hs-CRP) were measured at baseline and at the end of the study. Patients also underwent a muscle microbiopsy before and after training to quantify IRS-1 expression. All 4 groups displayed decreases in blood pressure, fasting plasma glucose, postprandial plasma glucose, lipid profile, and hs-CRP (P < .05); and there was no difference across the groups. After training, the IRS-1 expression increased by 65% in the resistance group (P < .05) and by 90% in the combined group (P < .01). Exercise training favorably affects glycemic parameters, lipid profile, blood pressure, and hs-CRP. In addition, resistance and combined training can increase IRS-1 expression.

Supplemental Digital Content is available in the text, Background: Atherosclerosis is now widely recognized as a multifactorial disease with outcomes that arise from complex factors such as plaque components, blood flow, and inflammation. Epicardial adipose tissue (EAT) is a metabolically active fat depot, abundant in proinflammatory cytokines, and has been correlated with the extent and severity of carotid artery disease (CD). The locations most frequently affected by carotid atherosclerosis are the proximal internal carotid artery (ie, the origin) and the common carotid artery bifurcation. Progression of atheromatous plaque at the carotid bifurcation results in luminal narrowing, often accompanied by ulceration. However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between EAT and CD. The aim of this study is to examine this association of EAT with CD in different ages and sex. Methods: This systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, Web of Science, and Google Scholar. Studies that (1) examined the association between EAT and CD, (2) focus on cohort, case-control and cross-sectional studies, (3) will conducted among in adults aged 40 to 70 years, (4) provided sufficient data for calculating ORs or relative risk with a 95% CI, (5) will published as original articles written in English or other languages, and (6) have been published until January 2018 will be included. Study selection, data collection, quality assessment and statistical syntheses will be conducted based on discussions among investigators. Results: We propose the current protocol to evaluate the evaluation of EAT with ED. Conclusion: This systematic review will not need ethical approval, because it does not involve human beings. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. Ethics and dissemination: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. Trial registration number: PROSPERO (CRD42018083458).

Supplemental Digital Content is available in the text, Introduction: The metabolic syndrome is composed of several cardiovascular risk factors and has a high prevalence throughout the world. However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between metabolic syndrome and stroke. The aim of this study is to examine this association of metabolic syndrome with stroke in different ages and sex. Methods and analysis: The update systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (i.e., PubMed, EMBASE, Web of Science, and Google Scholar. Studies that examined the association between metabolic syndrome and stroke, had a longitudinal or prospective cohort design, were conducted among in adults aged 40 to 70 years, provided sufficient data for calculating ORs or relative risk with a 95% CI, were published as original articles written in English or other languages, and have been published until December 2017 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. Ethics and dissemination: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The findings from this study could be useful for assessing metabolic syndrome risk factors in stroke, and determining approaches for prevention of stroke in the future.

Background:Patients with HIV have been found to suffer from lipid abnormalities, including elevated levels of total and LDL-cholesterol as well as triglyceride levels. Abnormal lipid levels are associated with an increased risk of developing cardiovascular diseases, which are significant cau

Background The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia, and an increased risk of cardiovascular events. However, there are no systematic analyses, or well-conducted meta-analyses to evaluate the relationship between epicardial adipose tissue (EAT) and (MetS). The aim of this study is to examine this association of EAT with MetS in different ages and sex. Methods The update systematic review, and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, Web of Science, and Google Scholar. Studies that firstly, examined the association between EAT and MetS, secondly, focus on cohort, case-control, and cross-sectional studies, thirdly, were conducted among in adults aged between 40 and 70 years, fourth, provided sufficient data for calculating ORs or relative risk with a 95% CI, fifth, were published as original articles written in English or other languages, and sixth, have been published until January year 2018 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. Results Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. This study will provide a high quality synthesis on the association of EAT and MetS. Conclusion This systematic review will provide evidence to assess whether there is a strong association of EAT and MetS, and its components.

We sought to establish normative data for fetal liver volume (FLV) between 27 and 38 weeks' gestation using three-dimensional ultrasonography. The study design was a longitudinal prospective study involving 53 participants. A total of 250 FLV measurements were obtained, using the multiplanar method with 3.0-mm intervals. Polynomial regressions with adjustments using the determination coefficient ( R 2 ) were used to assess the correlation between FLV and gestational age (GA) and fetal parameters (biparietal diameter, head circumference, abdominal circumference, and estimated fetal weight). The mean, standard deviation, and median, minimum, and maximum values were calculated for each gestational age. The intraclass correlation coefficient (ICC) was used to determine inter- and intraobserver reliability. There was a high correlation between FLV and GA. The mean FLV went from 43.5 ± 7.6 cm 3 (29.1 to 62.2 cm 3 ) to 130.5 ± 20.1 cm 3 (87.5 to 191.1 cm 3 ). There was a high correlation between FLV and all fetal biometric parameters (all P < 0.0001). Intraobserver and interobserver correlations were excellent with an ICC = 0.993 and 0.984, respectively. There was a high correlation between GA and biometric parameters. Reference limits were generated for FLV between 27 and 38 weeks. FLV is highly reproducible.

OBJETIVO: O objetivo deste estudo é avaliar a variabilidade interobservador do método ultrassonográfico para medida da gordura subcutânea, visceral e perirrenal por meio de técnica padronizada. MATERIAIS E MÉTODOS: Foram avaliados 50 pacientes entre novembro de 2006 e janeiro de 2007. A medida da espessura subcutânea foi realizada com transdutor linear de 7,5 MHz posicionado transversalmente a 1 cm acima da cicatriz umbilical. Para a gordura visceral foi utilizado transdutor de 3,5 MHz posicionado 1 cm acima da cicatriz umbilical, considerando-se a medida entre a face interna do músculo reto abdominal e a parede posterior da aorta na linha média do abdome. A gordura perirrenal foi medida no terço médio do rim direito, com transdutor posicionado na linha axilar média. RESULTADOS: A reprodutibilidade interobservador foi analisada por meio do teste t de Student, com significância de 95%. Não houve diferença significativa entre as médias das medidas das gorduras subcutânea, visceral e perirrenal, com p = 0,7141, 0,7286 e 0,6368, respectivamente. As médias encontradas, com seus respectivos desvios-padrão, foram: 2,64 ± 1,37 para a espessura subcutânea, 6,84 ± 2,38 para a espessura visceral e 4,89 ± 2,6 para a espessura perirrenal. CONCLUSÃO: A ultrassonografia apresentou boa reprodutibilidade interobservador para avaliação da gordura abdominal por meio das medidas das espessuras subcutânea, visceral e perirrenal.OBJECTIVE: The purpose of this study was to evaluate the interobserver variability of ultrasound in the measurement of subcutaneous, visceral and perirenal fat through standard technique. MATERIALS AND METHODS: From November 2006 to January 2007, 50 patients were evaluated. The subcutaneous fat thickness was measured with a 7.5 MHz linear transducer transversely positioned 1 cm above the umbilical scar. For the visceral fat, a 3.5 MHz transducer was also positioned 1 cm above the umbilical scar, considering the distance between the internal surface of the abdominal rectus muscle and the posterior aortic wall in the abdominal midline. The perirenal fat was measured in the middle third of the right kidney, with the transducer positioned at the axillary midline. RESULTS: The t-Student test was utilized to analyze the interobserver reproducibility with significance level of 95%. No statistically significant difference was observed among mean values for subcutaneous, visceral and perirenal fat (p = 0.7141, 0.7286 and 0.6368, respectively). Mean and standard deviation corresponded to 2.64 ± 1.37 for subcutaneous thickness, 6.84 ± 2.38 for visceral fat, and 4.89 ± 2.6 for perirenal fat. CONCLUSION: Ultrasound presented a good interobserver reproducibility in the evaluation of abdominal fat based on measurement of subcutaneous, visceral and perirenal fat as parameters.

To establish normative data for ophthalmic artery Doppler parameters throughout a healthy pregnancy, to investigate the possible correlation between these Doppler measurements and gestational age, and to test intraobserver variability.A prospective cross-sectional study was performed to assess various Doppler parameters in 276 healthy women between 20 and 39 weeks of gestation. The following measurements were obtained: pulsatility and resistance indices (PI, RI), peak systolic velocity (PSV), peak diastolic velocity (PDV), end diastolic flow velocity (EDFV), and peak ratio (PR). Quantile regression was used to estimate reference values throughout pregnancy and P0.05 was considered significant. The intraclass correlation coefficient (Intra-CC) was used to calculate intraobserver variability.The 5th and 95th prediction intervals for each gestational age are presented. No significant correlation was detected between Doppler indices and gestational age. Intra-CC was excellent (0.996).Reference values were generated for ophthalmic artery Doppler measurements, and they did not vary significantly during healthy pregnancy.

The aim of this study was to assess the Doppler parameters of the ophthalmic artery of pregnant women carrying fetuses with growth restriction (FGR) compared with normal fetuses.A prospective cross-sectional study was conducted with 120 pregnant women (60 FGR and 60 normal fetuses) between 32 and 40 weeks of gestation. FGR diagnosis was based on an estimated fetal weight below the 10th percentile of the Hadlock curve. Ophthalmic artery Doppler images were obtained with a linear transducer, with color Doppler examination of the region medial to the optic nerve. The following indices were obtained: pulsatility index, resistance index, peak systolic velocity, second peak velocity (P2), end diastolic velocity, and P2 / peak systolic velocity ratio. The Mann-Whitney U-test and Student's t-test were used to compare the groups with regard to quantitative variables, and the χ(2) -test was used for categorical variables.Pulsatility index and resistance index were significantly lower in pregnant women with FGR than in those with normal fetuses, with P0.001 in both indices. P2 and end diastolic velocity were significantly higher in pregnant women with FGR than in those with normal fetuses (P = 0.002 and P = 0.004, respectively). The P2 / peak systolic velocity ratio was significantly higher in the FGR group than in the control group (P0.001). In FGR subgroups, with (17 fetuses) and without (43 fetuses) uterine artery Doppler abnormalities, no significant changes were observed between the groups.In the third trimester of pregnancy, we observed significant differences in the ophthalmic artery Doppler parameters of pregnant women with FGR compared with those with normal fetuses.

A dopplervelocimetria colorida é uma modalidade do exame ultra-sonográfico que se expandiu rapidamente em todas as áreas da medicina, em virtude da sua riqueza de informações. A dopplervelocimetria colorida das artérias orbitais tem sido empregada no auxílio diagnóstico de doenças oftalmológicas, bem como para o estudo de doenças específicas como a pré-eclâmpsia. O objetivo deste estudo é descrever a anatomia normal da região orbital e detalhar a técnica de exame dopplervelocimétrico colorido, tendo em vista ser este um exame acessível e reprodutível. Acreditamos que surgirão novas aplicações deste método, que deverá ser inserido na prática diária do radiologista, visando à melhoria da qualidade do diagnóstico e seguimento das doenças oculares e sistêmicas.