23 results on '"Martins-Costa SH"'
Search Results
2. Serum S100B in pregnancy complicated by preeclampsi: a case-control study.
- Author
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Vettorazzi, J, Torres, FV, de Ávila, TT, Martins-Costa, SH, Souza, DO, Portela, LV, and Ramos, JG
- Abstract
Background Serum S100B is a protein produced and released primarily by astrocytes of the Central Nervous System (CNS). Elevated levels of serum S100B are associated with several types of pathological conditions of the brain, including the eclampsia in pregnant women. The aim of this study was to compare serum S100B concentrations in pregnant women with severe and mild preeclampsia (PE) with S100B serum levels in normotensive pregnant women. Material and methods Serum S100B protein was measured in normotensive pregnant women (n=15) and in women with mild PE (n=12) or severe PE (n=34). The serum S100B level (?g/L) was determined by an luminometric assay. Results Sixty-one expectant mothers were studied, aged 26.6±8.7 (mean±SD) years and with a gestational age of 33.3±4.2 weeks. The severe PE group demonstrated higher S100B levels (0.20±0.19), as compared with mild PE (0.07±0.05) or normotensive groups (0.04±0.05). Conclusion Elevated serum S100B levels in pregnant women with severe PE suggest that some kind of neural damage and subsequent astrocytic release of S100B is not dependent on the progression from severe preeclampsia to eclampsia. [ABSTRACT FROM AUTHOR]
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- 2012
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3. The experience of pregnant women and their families who were infected with covid-19 before vaccination: A qualitative approach within a multicenter study in Brazil.
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Soeiro RE, Souza RT, Bento SF, Cecatti JG, Surita FG, Freitas-Jesus JV, Pacagnella RC, Ribeiro-Do-Valle CC, Luz AG, Lajos GJ, Nobrega GM, Griggio TB, Charles CM, Silveira C, Miele MJ, Tedesco RP, Fernandes KG, Martins-Costa SH, Peret FJ, Feitosa FE, Traina E, Cunha Filho EV, Vettorazzi J, Haddad SM, Andreucci CB, Guida JP, Correa Junior MD, Dias MA, Oliveira LG, Melo Junior EF, Luz MGD, and Costa ML
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- Humans, Female, Pregnancy, Brazil epidemiology, Adult, SARS-CoV-2, Family psychology, Pregnancy Complications, Infectious psychology, Pregnancy Complications, Infectious prevention & control, Vaccination psychology, Vaccination statistics & numerical data, COVID-19 prevention & control, COVID-19 psychology, COVID-19 epidemiology, Qualitative Research, Pregnant Women psychology
- Abstract
Background: Pregnant and postpartum women infected by COVID-19 are at increased risk of adverse outcomes, including negative effects on their mental health. Brazilian maternal mortality rate due to COVID-19 is 2.5 times higher than overall mortality rates. This study aimed to understand how pregnant/postpartum women experienced the COVID-19 suspicion/investigation or confirmed infection in different Brazilian cities, the pandemic's consequences to women and their families, and their needs to improve maternal health services during public health emergencies., Methods: We conducted a qualitative study with 27 women with COVID-19 and 6 of their family members, as part of a multicenter study among 15 maternity hospitals in Brazil. We applied in-depth interviews through telephone calls when women received the diagnostic or had a suspect infection and after 60 days. Another semi-structured interview was applied to their close family members. The interviews were considered through thematic analysis., Results: From the thematic content analysis three major themes emerged from the first and second interviews: (Cucinotta and Vanelli, 2020) assistance received by the woman and newborn in the medical services; (World Health Organization (WHO) 2021) stigma/fear of contamination from health workers and from family and friends reported by the women; (Allotey et al., 2020) the COVID-19 pandemic impact., Conclusion: Before the availability of the COVID-19 vaccine, pregnant women experienced fear of death, hospitalization, quarantine, loss of family members, and financial repercussions, resulting in physical, psychological, and socioeconomic impacts on these women's lives., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Biomed Research International and BMC Pregnancy and Childbirth] and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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4. The effect of body mass index on maternal and perinatal outcomes in COVID-19 infection during pregnancy and postpartum: Secondary analysis from the REBRACO cohort study.
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Sardinha TG, Lajos GJ, Souza RT, Cecatti JG, Luz AG, Oppermann MLR, Pacagnella RC, Ribeiro-Do-Valle CC, Nobrega GM, Griggio TB, Charles CM, Silveira C, Miele MJ, Tedesco RP, Fernandes KG, Martins-Costa SH, Peret FJ, Feitosa FE, Traina E, Cunha Filho EV, Vettorazzi J, Haddad SM, Candreucci CB, Guida JP, Correa Junior MD, Dias MA, Oliveira LG, Melo Junior EF, Da Luz MG, and Costa ML
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- Pregnancy, Female, Humans, Overweight complications, Overweight epidemiology, Cohort Studies, Pregnancy Outcome epidemiology, Body Mass Index, Prospective Studies, SARS-CoV-2, Obesity complications, Obesity epidemiology, Postpartum Period, Pregnancy Complications, COVID-19 epidemiology, COVID-19 complications
- Abstract
Objectives: To compare maternal and perinatal outcomes among women with obesity, overweight, and normal body mass index, associated with COVID-19 infection during pregnancy and postpartum., Method: Prospective Cohort Study, within the REBRACO (Brazilian Network of COVID-19 in Pregnancy) multicenter initiative. Confirmed positive cases of SARS-CoV-2 were included, and women categorized into three groups according to their pre-pregnancy BMI: obesity (BMI ≥ 30), overweight (BMI <30 but >25), and normal BMI. Sociodemographic, clinical, and obstetric characteristics and different maternal and perinatal outcomes were compared, and a multiple regression analysis was performed to investigate factors independently associated with adverse maternal and perinatal outcomes., Results: Two hundred eighty-nine women positive for SARS-CoV-2 infection were considered, and 202 had available data on maternal BMI for the current analysis. Overall, 72 (35.6%)obese, 68 (33.6%) overweight, and 60 (29.7%) normal BMI. Obesity was associated with increased adverse clinical outcomes including sepsis (P = 0.02), acute respiratory distress syndrome (P = 0.002), and the need for mechanical ventilation (P = 0.044). Considering perinatal outcomes, a multiple regression model confirmed obesity as an independent factor associated with adverse results (adjusted odds ratio 3.73, 95% CI 1.54-9.08)., Conclusion: Obesity and overweight were associated with worse clinical outcomes, severe/critical COVID-19, and adverse perinatal outcomes., (© 2023 International Federation of Gynecology and Obstetrics.)
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- 2024
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5. Eclampsia in Brazil in the 21st Century.
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Ramos JGL, Martins-Costa SH, and Sass N
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- Brazil epidemiology, Female, History, 20th Century, History, 21st Century, Humans, Pregnancy, Eclampsia diagnosis, Eclampsia epidemiology
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Competing Interests: None to declare.
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- 2022
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6. Peripartum Hysterectomies over a Fifteen-year Period.
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Dorigon A, Martins-Costa SH, and Ramos JGL
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- Adult, Brazil epidemiology, Cross-Sectional Studies, Electronic Health Records, Female, Hospitals, University, Humans, Incidence, Peripartum Period, Placenta Accreta surgery, Placenta Previa surgery, Pregnancy, Retrospective Studies, Risk Factors, Hysterectomy statistics & numerical data, Postpartum Hemorrhage surgery, Prenatal Care
- Abstract
Objective: To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure., Methods: A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019., Results: The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age., Conclusion: Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery., Competing Interests: The authors have no conflict of interests to declare., (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)
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- 2021
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7. Comparison of serum selenium levels among hypertensive and normotensive pregnant women.
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da Silva AC, Martins-Costa SH, Valério EG, and Lopes Ramos JG
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- Adult, Blood Pressure, Body Mass Index, Brazil, Case-Control Studies, Female, Humans, Maternal Age, Pregnancy, Young Adult, Hypertension blood, Hypertension, Pregnancy-Induced blood, Selenium blood
- Abstract
Objective: To correlate serum selenium levels with hypertensive disorders of pregnancy (HDP) in a selected population and evaluate this mineral as a possible protective factor., Methods: This case-control study included 32 normotensive, 20 hypertensive (chronic and gestational hypertension), and 38 preeclamptic pregnant women. All patients were recruited from antenatal or obstetric admissions of a tertiary hospital in Brazil. Serum selenium was measured at the time of inclusion. Patients were followed up until hospital discharge after delivery., Results: Groups did not differ with regard to maternal age, ethnicity, educational attainment, parity, or smoking prevalence. Normotensive patients had lower body mass index and were included in the study earlier. These patients also had a higher prevalence of comorbidities other than hypertension. Continuous use of medication and a history of HDP in previous pregnancies were more common in preeclamptic patients. Serum selenium levels were not significantly different between groups, with an average of 56.4 ± 15.3 μg/L in the control group, 53.2 ± 15.2 μg/L in the hypertension group, and 53.3 ± 16.8 μg/L in the preeclampsia group (p = 0.67). Among patients with preeclampsia, 52.6% had the severe form. Serum selenium levels in these patients also did not differ significantly from those of controls (p = 0.77). Preeclampsia was associated with earlier termination of pregnancy and lower birth weight (p < 0.05). There were no significant differences across groups in other outcomes of interest., Conclusion: Serum selenium levels did not differ significantly between groups. Thus, we could not establish whether selenium is a protective factor against these conditions.
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- 2017
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8. Natriuria and calciuria levels in preeclampsia: a cross-sectional study.
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Gasnier R, Valério EG, Vettorazzi J, Martins-Costa SH, Barros EG, and Ramos JG
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- Adult, Biomarkers urine, Diagnosis, Differential, Epidemiologic Methods, Female, Humans, Pregnancy, Calcium urine, Pre-Eclampsia urine, Sodium urine
- Abstract
Context and Objective: Sodium excretion abnormalities in preeclampsia have been studied in relation to several factors. The objective of this study was to compare natriuria (mEq/24 h) and calciuria levels (mg/24 h) in preeclamptic patients., Design and Setting: An analytical cross-sectional study with a control group was conducted in the obstetric center and the high-risk pregnancy outpatient clinic at a university hospital in southern Brazil, and in a primary healthcare unit in the same city, including pregnant women with mild preeclampsia, severe preeclampsia or chronic hypertension, and women with normal pregnancies (14 patients in each group)., Method: Natriuria was measured using an ion-selective electrode in an automated clinical chemistry analyzer (Hitache 917, Roche). All the patients collected 24-hour urine, at home or at the hospital, for analysis of proteins, creatinine, calcium, sodium and uric acid. Quantitative variables with asymmetrical distribution were described using the median, minimum and maximum, and were compared using the Kruskal-Wallis test. The results were logarithmically transformed, with one-way analysis of variance (ANOVA) by ranks and then the post-hoc Tukey test, and were analyzed by means of the Spearman correlation and receiver operating characteristic (ROC) curve. The significance level used was 0.05., Results: There were significant differences between the groups in comparing severe preeclampsia with chronic hypertension and severe preeclampsia with controls (P < 0.0001 for both measurements)., Conclusion: Natriuria levels may be lower in preeclampsia when associated with calciuria. Natriuria assessment is an additional test for differential diagnosis of hypertensive diseases in pregnancy, but is a poor predictor when used alone.
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- 2013
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9. Calciuria and preeclampsia: a case-control study.
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Gasnier R, Valério EG, Vettorazzi J, Barros EG, Martins-Costa SH, and Ramos JG
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- Adult, Case-Control Studies, Female, Humans, Hypertension urine, Pregnancy, ROC Curve, Severity of Illness Index, Uric Acid blood, Calcium urine, Pre-Eclampsia urine
- Abstract
Aim: Calciuria has been reported to decrease in preeclampsia. We compared calciuria among groups of normal, hypertensive and preeclamptic pregnant women, and assessed its correlation with the severity of the disease., Material and Methods: We conducted a case-control study of mild and severe preeclampsia, chronic hypertension, and normal pregnancy, with 14 patients in each group. The groups were analyzed by one-way anova (variance analysis) for symmetrical distribution and Kruskal-Wallis test for asymmetrical distribution when comparing quantitative variables, and by crossed tables when comparing qualitative variables., Results: There were statistically significant differences between the groups when comparing severe preeclampsia with chronic hypertension, and severe preeclampsia with the control group (P < 0.0001). The calciuria medians were 81.5 mg/24 h for severe preeclampsia, 118 mg/24 h for mild preeclampsia, 226 mg/24 h for chronic hypertension, and 272 mg/24 h for the control group. In a ROC (receiver operating characteristic) curve analysis, the best cutoff point for preeclampsia diagnosis was 167 mg/24 h, with a sensitivity of 75% and a specificity of 85%. The outcomes were more severe as the level of calciuria dropped., Conclusion: Measurement of calciuria can differentiate between severe preeclampsia and chronic hypertension, and hypocalciuria is also a marker for disease severity., (© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.)
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- 2012
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10. Calcium-to-creatinine ratio in pregnancy-induced hypertension.
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Gasnier R, Valério EG, Vettorazzi J, Martins-Costa SH, Barros EG, and Ramos JG
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Objectives: Hypocalciuria has been correlated with preeclampsia. This study compared the calcium-to-creatinine ratio among the groups, and the correlation with the 24-h measurement of this ratio and a diagnosis of preeclampsia., Study Design: Case-control study including mild and severe preeclampsia, chronic hypertension and normal pregnancy., Main Outcome Measurements: The calcium-to-creatinine ratio differentiates severe preeclampsia from mild preeclampsia, chronic hypertension and normal pregnancy., Results: There were statistically significant differences between the groups when comparing severe preeclampsia and chronic hypertension, severe preeclampsia and normal pregnancy, and mild and severe preeclampsia (p<0.0001). The Spearman index between the calcium-to-creatinine ratio and 24-h calciuria was 0.65 (high correlation)., Conclusions: The calcium-to-creatinine ratio can reliably estimate 24-h calciuria, differentiating severe preeclampsia from mild preeclampsia, chronic hypertension and normal pregnancy., (Copyright © 2011 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)
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- 2012
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11. Insulin stimulation of Akt/PKB phosphorylation in the placenta of preeclampsia patients.
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Ferreira GD, Orcy RB, Martins-Costa SH, Ramos JG, Brum IS, Corleta Hv, and Capp E
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- Adult, Blotting, Western, Case-Control Studies, Cross-Sectional Studies, Enzyme Activation, Female, Humans, Insulin Resistance physiology, Phosphorylation, Placenta enzymology, Pregnancy, Signal Transduction, Insulin pharmacology, Placenta drug effects, Pre-Eclampsia enzymology, Proto-Oncogene Proteins c-akt metabolism
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Context and Objective: Preeclampsia is a multi-systemic disease and one of the most frequent severe health problems during pregnancy. Binding of insulin triggers phosphorylation and activates cytoplasmic substrates such as phosphatidylinositol 3 kinase (PI3K). Phosphorylation of membrane phosphoinositide 2 (PIP2) to phosphoinositide 3 (PIP3) by PI3K starts Akt/PKB activation. Defects in phosphorylation of the insulin receptor and its substrates have an important role in insulin resistance. Studies have shown that insulin resistance is associated with preeclampsia and its pathophysiology. The aim here was to investigate insulin stimulation of the Akt/PKB pathway in the placenta, in normal and preeclampsia parturients., Design and Setting: Cross-sectional study in a tertiary public university hospital., Methods: Placentas were collected from 12 normal and 12 preeclampsia patients. These were stimulated and analyzed using Western blot to quantify the Akt/PKB phosphorylation., Results: The insulin stimulation was confirmed through comparing the stimulated group (1.14 ± 0.10) with the non-stimulated group (0.91 ± 0.08; P < 0.001). The phosphorylation of Akt/PKB did not differ between the placenta of the normal patients (1.26 ± 0.16) and those of the preeclampsia patients (1.01 ± 0.11; P = 0.237)., Conclusions: In vitro insulin stimulation of the human placenta has been well established. There was no difference in Akt/PKB phosphorylation, after stimulation with insulin, between placentas of normal and preeclampsia patients. Nevertheless, it cannot be ruled out that the Akt/PKB signaling pathway may have a role in the pathophysiology of preeclampsia, since the substrates of Akt/PKB still need to be investigated.
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- 2011
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12. Are insulin resistance index, IGF-1 and metabolic syndrome components correlates with severe preeclampsia?
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Valério EG, Müller AL, Martins-Costa SH, Lopes Ramos JG, and Rodini G
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- Blood Glucose metabolism, Body Mass Index, Case-Control Studies, Female, Humans, Metabolic Syndrome physiopathology, Pre-Eclampsia physiopathology, Pregnancy, Severity of Illness Index, Insulin Resistance physiology, Insulin-Like Growth Factor I metabolism, Metabolic Syndrome metabolism, Pre-Eclampsia metabolism
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Objective: Analyse the relation between insulin resistance and severe preeclampsia (SPE)., Methods: Case control study paired by body mass index and gestational age; including 16 patients with severe SPE and 16 normotensive controls. Insulin resistance was assessed through the HOMA-IR and QUICKI-IS indexes., Results: There was no significant difference between the groups regarding the HOMA-IR and QUICKI-IS indexes and HDL cholesterol. Triglyceride levels were higher and the IGF-1 was lower in the SPE group than in the control group., Conclusions: There were no differences in the insulin resitance indexes between the group with SPE and normal controls.
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- 2011
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13. Protein creatinine ratio in random urine sample of hypertensive pregnant women: maternal and perinatal outcomes.
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Martins-Costa SH, Vettorazzi J, Valério E, Maurmman C, Benevides G, Hemessath M, Barros EG, and Ramos JG
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- Adult, Female, Humans, Pregnancy, Pregnancy Outcome, Retrospective Studies, Creatinine urine, Hypertension, Pregnancy-Induced urine, Proteinuria urine
- Abstract
Objective. To compare protein/creatinine ratio (PCR) in random urine sample levels and adverse outcomes in hypertensive pregnant women. Methods. A total of 370 medical charts from hypertensive pregnant women were reviewed and stratified into three groups according to different PCR in random urine sample levels (group 1: PCR < 0.3 mg/mg; group 2: PCR 0.3-1.99 mg/mg; group 3: PCR ≥ 2.0 mg/mg) and compared with composite maternal and perinatal outcomes. Those outcomes were severe hypertension, thrombocytopenia, high lactate dehydrogenase count, disseminated intravascular coagulation, abruptio placentae, HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, eclampsia, perinatal death, newborn cerebral hemorrhage, respiratory distress syndrome of newborn, neonatal sepsis, and newborn small for gestational age. Results. To obtain a composite maternal adverse outcome the odds ratio [ORs] between PCR groups were 1.8 (95% confidence interval [CI]: 1.1-3.2) between groups 1 and 2, and 3.1 (95% CI: 1.5-6.3) between groups 1 and 3; for composite perinatal adverse outcomes, the ORs were 3.0 (95% CI: 1.5-5.9) between groups 1 and 2, and 3.4 (95% CI: 1.6-7.5) between groups 1 and 3. Conclusions. Hypertensive pregnant women with a PCR ≥ 0.3 mg/mg, had worse maternal and perinatal outcomes than those with PCR < 0.3 mg/mg. Above the cut-off of 0.3 mg/mg, higher PCRs are not associated with a significant increase in maternal and perinatal morbidity.
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- 2011
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14. Risk factors for cardiovascular disease ten years after preeclampsia.
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Canti IC, Komlós M, Martins-Costa SH, Ramos JG, Capp E, and Corleta Hv
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- Adult, Body Mass Index, Brazil, Chi-Square Distribution, Cross-Sectional Studies, Female, Humans, Hypertension etiology, Male, Middle Aged, Pregnancy, Risk Factors, Cardiovascular Diseases etiology, Pre-Eclampsia
- Abstract
Context and Objective: Preeclampsia is a gestational disease that occurs mainly among nulliparous women after the 20th week of gestation, and frequently close to delivery. The effects of preeclampsia on women's blood pressure over the long term are still controversial. Patients with recurrent preeclampsia or preeclampsia in the early stages of pregnancy appear to present higher risk of hypertension. The aim of this study was to determine the risk factors for cardiovascular disease among women with preeclampsia 10 years earlier., Design and Setting: Cross-sectional study at Hospital de Clínicas de Porto Alegre (HCPA)., Methods: Forty women with preeclampsia and 14 normotensive pregnant women followed up 10 or more years earlier at HCPA underwent clinical and laboratory examinations. Spearman's correlation coefficient was used to correlate body mass index (BMI) and systolic and diastolic pressures. The risk of developing hypertension was measured using the chi-square test. P < 0.05 was considered significant., Results: The patients with preeclampsia 10 or more years earlier had significantly higher diastolic blood pressure (P = 0.047), BMI (P = 0.019) and abdominal circumference (P = 0.026). They presented positive correlations between BMI and diastolic blood pressure (0.341; P = 0.031) and between BMI and systolic blood pressure (0.407; P = 0.009)., Conclusion: The patients with preeclampsia 10 or more years earlier had significantly higher diastolic blood pressure, BMI and abdominal circumference than did the control group. This emphasizes the importance of long-term follow-up assessment for cardiovascular risk factors among patients with preeclampsia.
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- 2010
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15. [Obesity as a risk factor to Burch surgery failure].
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Viecelli CF, dos Santos DC, Aguiar WW, Martins-Costa SH, Corleta Hv, and Ramos JG
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- Female, Humans, Middle Aged, Retrospective Studies, Risk Factors, Treatment Failure, Urologic Surgical Procedures methods, Obesity complications, Urinary Incontinence, Stress complications, Urinary Incontinence, Stress surgery
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Purpose: to observe the impact of obesity and other risk factors on the rate of failure in patients submitted to Burch's surgery for the treatment of urinary incontinence., Methods: cases study of patients submitted to Burch's surgery, from 1992 to 2003. Patients were evaluated at the second post-surgery appointment (average 66 days) and after one-year follow-up, and classified in two groups: Continent and Non-continent. Variables analyzed were: age, parity, body mass index (BMI), menopause duration, duration of hormonal therapy, urodynamic evaluation, history of urinary tract infection, previous urinary incontinence surgery, diabetes, cystocele and uterine prolapse, time spent in hospital, necessity of self-probing, post-surgical spontaneous micturition, and surgical wound. Data were analyzed with the Statistical Package for Social Sciences 14.0 statistical package. For the comparison of continuous variables, Student's t-test or Mann-Whitney test were used, and Fisher exact and chi2 tests, for the categorical variables (p<0.05)., Results: at the second post-surgical evaluation, there was no significant difference between the two groups, concerning the variables analyzed. After one-year follow-up, from a total of 97 patients, 81 were continent and 16, non-continent, BMI and height being different between the groups. In the continent group, average BMI was 27.1 and height, 1.57 m, and, among the non-continent, 30.8 (p=0.02) and 1.52 m (p=0.01). The BMI>30 Odds Ratio was 3.7 (CI95%=1.2-11.5)., Conclusions: obesity has shown to be an important risk factor for the surgery failure in the first follow-up year. Results show that patients with BMI>30 have 3.7 times more chance of being non-continent one-year after Burch's surgery than non-obese patients.
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- 2009
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16. Signalization of Akt/PKB in the placenta, skeletal muscle and adipose tissue of preeclampsia patients.
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Orcy RB, Schroeder S, Martins-Costa SH, Ramos JG, Schechinger W, Klein H, Brum IS, von Eye Corleta H, and Capp E
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- Adult, Blotting, Western, Female, Humans, Pregnancy, Signal Transduction, Statistics, Nonparametric, Adipose Tissue enzymology, Muscle, Skeletal enzymology, Placenta enzymology, Pre-Eclampsia enzymology, Proto-Oncogene Proteins c-akt metabolism
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Unlabelled: Preeclampsia (PE) is a significant cause of fetal and maternal mortality around the world and there is evidence that insulin resistance has been implicated in the pathophysiology of PE. The Akt/PKB pathway is stimulated by insulin and performs several vital functions relative to growth, survival and cellular metabolism., Objective: To investigate the basal expression of Akt/PKB, HSP90 expression, proteins that regulate Akt/PKB activity and substrate in the placenta, skeletal muscle and adipocytes of normal and PE parturient., Method: Samples were collected from 17 normal patients and 17 PE patients, and analyzed by Western blot to quantify the protein expression involved in signaling cascade of Akt/PKB., Results: Total Akt/PKB expression for normal placentas was 1.85 (1.07-3.12) and 1.53 (1.27-3.08) in PE (p = 1.00); in the adipose tissue of normal placentas it was 1.10 (0.53-1.73) and 1.66 (0.83-2.00) in PE (p = 0.37)., Conclusions: There was no difference in the Akt/PKB pathway, in basal state, in placentas and skeletal muscle of normal and PE patients. However, defects in this signaling pathway as pathophysiology of PE cannot be excluded because it is necessary to analyze this pathway during stimulation., ((c) 2008 S. Karger AG, Basel.)
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- 2008
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17. Random albumin/creatinine ratio for quantification of proteinuria in manifest pre-eclampsia.
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Valerio EG, Ramos JG, Muller AL, and Martins-Costa SH
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- Female, Humans, Pregnancy, Albuminuria etiology, Hypertension, Pregnancy-Induced urine, Pre-Eclampsia diagnosis, Proteinuria etiology
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- 2007
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18. Reported calcium intake is reduced in women with preeclampsia.
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Ramos JG, Brietzke E, Martins-Costa SH, Vettorazzi-Stuczynski J, Barros E, and Carvalho C
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- Calcium deficiency, Cross-Sectional Studies, Diet, Female, Humans, Hypertension, Pregnancy-Induced metabolism, Pregnancy, Prospective Studies, Calcium, Dietary, Pre-Eclampsia metabolism
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Objective: The purpose of this trial is to investigate the relationship between dietary calcium content and incidence of preeclampsia, comparing diet calcium content in normotensive and preeclampsia patients. Dietary calcium was measured by a dietary interview conducted at the day after delivery., Methods: This is a prospective cross-sectional study involving 1092 patients who delivered at Hospital de Clínicas de Porto Alegre - Brazil., Results: The average diet calcium content in the studied population was 1038 mg. The average calcium intake in the normotensive group was 1057 mg, in chronic hypertension group was 962 mg, in transient hypertension group was 963 mg, in mild preeclampsia was 902 mg and in severe preeclampsia group was 755 mg. The results of this study show that pregnant women who develop severe preeclampsia have a significant lower diet calcium intake when compared to normotensive women (P = 0.018)., Conclusion: The results of the present study can provide the foundations for prospective trials, including randomised clinical trials involving only patients with a low content of calcium in their diet.
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- 2006
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19. Transvaginal ultrasonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study.
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Letti Müller AL, Lopes Ramos JG, Martins-Costa SH, Palma Dias RS, Valério EG, Hammes LS, Glitz CL, Zucatto AE, Vettori DV, and Magalhães JA
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- Adult, Cesarean Section, Female, Humans, Natural Childbirth, Pilot Projects, Pregnancy, Intrauterine Device Expulsion, Postpartum Period, Ultrasonography methods
- Abstract
Objective: To compare the expulsion rates of intrauterine devices (IUDs) inserted in the immediate postpartum after vaginal birth and cesarean section., Methods: Nineteen patients who had a vaginal birth and 19 patients who had a cesarean section at Hospital de Clínicas de Porto Alegre, Brazil, were selected for copper T 380A IUD insertion. With the aim of detecting clinically unnoticed dislodged devices, ultrasound examinations were performed at 1 month and between 3 and 12 months after delivery. The IUDs were considered completely expelled when found outside the endometrial cavity (e.g., in the cervical canal) or outside the uterus (in the vagina)., Results: Expulsion rates were statistically different between the two groups: after a vaginal birth, 50% (ultrasound only) + 27.8% (clinical examination); and post-cesarean section, 0% (p < .001; OR 5.75, 95% CI 2.36-14.01)., Conclusion: Considering that the contraceptive efficacy of IUDs is associated with their intrauterine location, the high expulsion rates seen when they are inserted immediately after vaginal delivery contraindicate their use in this setting. The use of IUDs immediately after a cesarean section is still a reasonable alternative because its expulsion rate was zero. Ultrasound assessment of IUD positioning performed better than clinical examination, which failed to detect expulsion after postpartum insertion in 75% of the cases (9 from 12 cases).
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- 2005
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20. Variation in the urinary protein/creatinine ratio at four different periods of the day in hypertensive pregnant women.
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Gonsales Valério E, Lopes Ramos JG, Martins-Costa SH, and Müller AL
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- Adolescent, Adult, Circadian Rhythm, Cross-Sectional Studies, Female, Humans, Middle Aged, Polymerase Chain Reaction, Pregnancy, ROC Curve, Urinalysis, Creatinine urine, Hypertension, Pregnancy-Induced urine, Proteinuria urine
- Abstract
Objective: To assess the urine protein/creatinine ratio in urine samples of pregnant women with hypertension in regard to: 1) the presence of significant variation at different periods of the day; 2) the differences if they exist, to identify the most reliable period of the day for sampling; and 3) whether the first sample, obtained when the patient arrives at the clinic, correlates with the same accuracy, with the 24-hour proteinuria., Design: Cross-sectional study., Place: Obstetrics Emergency Department, Hospital de Clínicas de Porto Alegre, a teaching hospital in Porto Alegre, Brazil., Population: Seventy-five women with hypertension with 20-week gestation or over., Methods: Urine samples for determination of the protein/creatinine ratio were obtained on arrival (first specimen) and every 6 hours thereafter, totaling four samples in 24 hours. Four sampling periods were established: 1) from 8 am to 2 pm, 2) from 2 pm to 8 pm, 3) from 8 pm to 2 am, and 4) from 2 am to 8 am. The protein/creatinine ratio in the four different day periods were compared with the 24-hour proteinuria obtained simultaneously. The results were analyzed by the Spearman correlation and the receiver-operator characteristic (ROC) curve., Results: The urine protein/creatinine ratio is strongly correlated (Spearman correlation equal to 0.8 or greater) with the 24-hour proteinuria at all four periods of the day (p<0.001), as well as the first sample obtained on arrival (p=0.003). These findings were corroborated by the ROC curve in which the values of four day periods and that of the first sample were equal to or greater than 0.930., Conclusion: In hypertensive pregnant women, the single voided urine sample protein/creatinine ratio, irrespective of sampling time, is strongly correlated with the 24-hour proteinuria, as is the sample obtained on arrival.
- Published
- 2005
- Full Text
- View/download PDF
21. Serum S100B in pregnancy-related hypertensive disorders: a case-control study.
- Author
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Schmidt AP, Tort AB, Amaral OB, Schmidt AP, Walz R, Vettorazzi-Stuckzynski J, Martins-Costa SH, Ramos JG, Souza DO, and Portela LV
- Subjects
- Adult, Biomarkers blood, Case-Control Studies, Eclampsia blood, Female, Humans, Pregnancy, S100 Calcium Binding Protein beta Subunit, Serum, Hypertension blood, Nerve Growth Factors blood, Pregnancy Complications blood, S100 Proteins blood
- Published
- 2004
- Full Text
- View/download PDF
22. Urinary protein/creatinine ratio in hypertensive pregnant women.
- Author
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Ramos JG, Martins-Costa SH, Mathias MM, Guerin YL, and Barros EG
- Subjects
- Adolescent, Adult, Cross-Sectional Studies, Female, Humans, Pregnancy, ROC Curve, Sensitivity and Specificity, Creatinine urine, Hypertension urine, Pregnancy Complications, Cardiovascular urine, Proteinuria urine
- Abstract
Objectives: To determine the correlation between the protein/creatinine ratio and 24-h proteinuria; to estimate the sensitivity and specificity of this ratio for the diagnosis of significant proteinuria; to establish its cutoff point with the best predictive value for the diagnosis of significant proteinuria in patients with systemic arterial hypertension., Study Design: A cross-sectional study of 47 hypertensive patients who had been pregnant for 20 weeks or more seen at the Maternity of the University Hospital of Porto Alegre. The studied factor was the protein/creatinine ratio measured in a single random urine sample and the outcome was protein determination in 24-h urine. The level of significance was set at 0.05., Results: The correlation coefficient between the protein/creatinine ratio and 24-h proteinuria was 0.94 when urine was properly collected. A receiver-operator characteristic curve was constructed to determine the sensitivity and specificity of the ratio for the diagnosis of significant proteinuria (> or = 300 mg in 24 h). Specificity and predictive positive value were 100% for a ratio > or = 0.8. The best values for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of proteinuria > or = 300 mg in 24 h were obtained when the protein/creatinine ratio was 0.5 (0.96, 0.96, 0.96, and 0.96, respectively)., Conclusion: The protein/creatinine ratio measured in a single urine sample taken at random from hypertensive pregnant women showed good sensitivity and specificity for the diagnosis of 24-h proteinuria > or = 300 mg and was strongly correlated with 24-h proteinuria. A ratio of 0.5 mg/mg is predictive of significant proteinuria and can be used for the diagnosis and follow-up of hypertensive pregnant women.
- Published
- 1999
- Full Text
- View/download PDF
23. Calciuria and preeclampsia.
- Author
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Ramos JG, Martins-Costa SH, Kessler JB, Costa CA, and Barros E
- Subjects
- Chronic Disease, Cross-Sectional Studies, Female, Humans, Pre-Eclampsia complications, Pre-Eclampsia diagnosis, Pregnancy, Pregnancy Trimester, Second urine, Pregnancy Trimester, Third urine, Prospective Studies, Uric Acid blood, Calcium urine, Hypertension urine, Pre-Eclampsia urine, Pregnancy Complications, Cardiovascular
- Abstract
Urinary calcium excretion has been reported to be diminished in preeclampsia. The objective of the present study was to determine urinary calcium excretion in pregnant patients with chronic arterial hypertension (CAH) and preeclampsia (PE), and in normotensive patients (N). Forty-four pregnant patients (gestational age, 20-42 weeks; 18 CAH, 17 PE, 9 N) were evaluated for calciuria, proteinuria, plasma uric acid and blood pressure. Patients with PE (82 +/- 15.1 mg/24 h) showed significantly lower calciuria (P < 0.05) than the group with CAH (147 +/- 24.9 mg/24 h) and the N group (317 +/- 86.0 mg/24 h) (P < 0.05, Student t-test). Plasma uric acid was significantly higher in the PE group (6.1 +/- 0.38 mg/dl) than the CAH group (5.0 +/- 0.33 mg/dl; P < 0.05), which also presented higher proteinuria levels, although the difference was not statistically significant. Diastolic and systolic blood pressure did not differ between the PE (164 +/- 105 mmHg) and CAH (164 +/- 107 mmHg) groups. Calciuria was significantly lower in the group with preeclampsia than in the group with chronic arterial hypertension. We conclude that calciuria can be a further factor for identifying preeclampsia.
- Published
- 1998
- Full Text
- View/download PDF
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