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Risk Stratification in Obstetrics: An Integrated Approach to Maternal Health

Open Journal of Obstetrics and Gynecology 2024年第6期14卷 903-910页

作者： Taina Crespo Mendonca bianca beatriz soares dos reis Júlia Cruz Coelho Antônio de Oliveira Battistini Pestana Vitória Carolina Barreto Negri Alvaro Augusto Trigo Department of Medicine University of Franca Franca Brazil

Introduction: Prenatal care is crucial for maternal and fetal health, highlighting the importance of obstetric risk stratification. This enables personalized care, avoiding unnecessary interventions and reducing costs. Conditions such as first trimester bleeding, spontaneous abortion, gestational trophoblastic disease, and ectopic pregnancy require specific approaches. Early identification of these complications is vital, especially in urgent and emergency obstetric cases, which demand immediate hospital attention. Objective: Comprehensive review of first trimester pathologies and gestational hypertension, focusing on obstetric risks and personalized prenatal management. Methods: Literature review on bleeding and gestational hypertension. Results: The study provides a detailed analysis of pathologies associated with first trimester uterine bleeding and hypertensive disorders, focusing on obstetric risk stratification. The main causes of maternal and fetal mortality are hypertensive disorders, hemorrhages, infections, childbirth complications, and abortion. Spontaneous abortion is common, with different classifications, ranging from threatened to missed abortion. Infected abortion is a severe complication. Brazil has restrictive abortion laws, but many unsafe abortions occur, resulting in high public health costs. Pharmacological treatment with misoprostol is a safe option. Other pathologies include gestational trophoblastic disease, ectopic pregnancy, and placenta previa. Preeclampsia and eclampsia are severe conditions requiring immediate treatment to avoid complications. Conclusion: Early identification and management of obstetric risk factors, such as uterine bleeding, are essential for positive maternal and fetal outcomes. A multidisciplinary approach is fundamental.

关键词： Obstetrics Emergencies Hypertension Pregnancy-Induced Uterine Hemorrhage Pregnancy Trimester First

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Risk Stratification in Obstetrics: An Integrated Approach to Maternal Health

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第6期 903页

作者： Taina Crespo Mendonca bianca beatriz soares dos reis Júlia Cruz Coelho Antônio de Oliveira Battistini Pestana Vitória Carolina Barreto Negri Alvaro Augusto Trigo

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Laminated Solid Timber Slab with Transverse Prestressing Using the Strategy of Interleaved Vertical Displacement of Lamellae

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Journal of Civil Engineering and Architecture 2024年第4期18卷 186-198页

作者： bianca Bispo dos reis Jorge Daniel de Melo Moura Marcos Vinício de Camargo Everaldo Pletz Graduate Program in Architecture and Urbanism Londrina State UniversityJardim Portal de Versalhes 1Londrina 86057-970PRBrazil Department of Civil Engineering Federal Technological University of Paraná(UTFPR)Apucarana 86812-460PRBrazil Retired professor Department of Structural Engineering Londrina State UniversityLondrina 86057-970PRBrazil

This article presents a study on the structural behavior of transversely prestressed laminated timber slabs,focusing on an innovative approach:vertically misaligned *** misalignment,achieved by sliding vertically the wooden lamellae rather than aligning them,enhances the slab’s cross-section moment of inertia,thereby improving load-bearing capacity and *** involved two groups of structural size specimens:one with vertically aligned lamellae(control group)and the other with misaligned lamellae(study group).Results showed the study group exhibited 42%superior stiffness and 10%less load capacity compared to the *** typically occurred individually in the lamellae,particularly in those with defects or lower modulus of elasticity,concentrated in the middle third of the slabs’free span where tensile stresses *** a higher number of failed lamellae,the study group demonstrated promising *** of prestressing bar indicated no damage at all in the thread,suggesting potential for reducing bar *** findings offer crucial insights into applying these slabs in timber construction as well as to any kind of construction.

关键词： Transversal prestressed slabs wooden construction plantation wood flexural testing design methodology

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Plant growth and metabolism of exotic and native Crotalaria species for mine land rehabilitation in the Amazon

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Journal of Forestry Research 2024年第1期35卷 143-154页

作者： Hemelyn soares das Chagas Rafael Silva Guedes Markus Gastauer Paula Godinho Ribeiro Allan Klynger da Silva Lobato Cecílio Frois Caldeira Fabrício William deÁvila AndréRodrigues dos reis Silvio Junio Ramos Instituto Tecnológico Vale Rua Boaventura da Silva955BelémPA 66055-090Brazil Universidade Federal do Sul e Sudeste do Pará XinguaraPABrazil Núcleo de Pesquisa Vegetal Básica e Aplicada Universidade Federal Rural da AmazôniaParagominasPABrazil Departamento de Engenharia Florestal Universidade Estadual do Centro-Oeste/UNICENTROIratiPRBrazil School of Sciences and Engineering São Paulo State University(UNESP)TupãSP.CEP 17602-496Brazil

Despite its enormous benefits,mining is respon-sible for intense changes to vegetation and soil ***,after extraction,it is necessary to rehabilitate the mined areas,creating better conditions for the establishment of plant species which is *** study evaluated mineral and organic fertilization on the growth,and carbon and nitrogen(N)metabolism of two Crotalaria species[Cro-talaria spectabilis(exotic species)and Crotalaria maypu-rensis(native species from Carajás Mineral Province(CMP)]established on a waste pile from an iron mine in CMP.A control(without fertilizer application)and six fertilization mixtures were tested(i=NPK;ii=NPK+micronutrients;iii=NPK+micronutrients+organic compost;iv=PK;v=PK+micronutrients;vi=PK+micronutrients+organic compost).Fertilization contributed to increased growth of both species,and treatments with NPK and micronutrients had the best results(up to 257%***),while organic fertilization did not show *** Crotalaria had a greater number of nodules,higher nodule dry mass,chlorophyll a and b contents and showed free ammonium as the predominant N form,reflecting greater increments in biomass compared to native *** having lower growth,the use of this native species in the rehabilitation of mining areas should be considered,mainly because it has good development and meets current government legislation as an opportunity to restore local biodiversity.

关键词： Biological nitrogen fixation Mining Nitrogen metabolism Plant nutrition

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Plant growth and metabolism of exotic and native Crotalaria species for mine land rehabilitation in the Amazon

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林业研究（英文版） 2024年第1期 147页

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Water availability drives gradients of tree diversity,structure and functional traits in the Atlantic-Cerrado-Caatinga transition,Brazil

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Journal of Plant Ecology 2018年第6期11卷 803-814页

作者： Marcela de Castro Nunes Santos Terra Rubens Manoel dos Santos Jamir Afonso do Prado Júnior José Marcio de Mello José Roberto soares Scolforo Marco Aurélio Leite Fontes Ivan Schiavini Aliny Aparecida dos reis Inacio Thomaz Bueno Luiz Fernando Silva Magnago Hans ter Steege Departamento de Ciências Florestais Universidade Federal de LavrasCampus UniversitárioPO Box 3037LavrasMinas Gerais 37200-000Brazil Instituto de Biologia Universidade Federal de UberlândiaCampus Umuarama-Bloco 2DPO Box 593UberlândiaMinas Gerais 38400-902Brazil Applied Ecology and Conservation Lab Programa de Pós‐graduação Ecologia e Conservação da BiodiversidadeUniversidade Estadual de Santa CruzIlhéusBahia 45662-900Brazil Naturalis Biodiversity Center Vondellaan 55Postbus 95172300 RA LeidenThe Netherlands Coordenação de Botânica Museu Paraense Emílio GoeldiAv.Magalhães Barata 376PO Box 399BelémPara´66040-170Brazil

Aims Climate and soil are among the most important factors determin-ing variation in tree communities,but their effects have not been thoroughly elucidated to date for many vegetation *** this study,we evaluate how climate and soil gradients affect gradients of vegetation composition,species diversity and dominance,structure and functional traits(seed mass and wood density)using over 327000 trees in 158 sites distributed along environmental gradients in the transitions among the Atlantic forest,Cerrado and Caatinga in Minas Gerais State(MG),Brazil(nearly 600000 km2).Methods Gradients in species,genus and family abundance in addition to basal area,stem density,species diversity(Fisher’s alpha),domin-ance percentage,seed mass and wood density were correlated using multiple regressions with environmental variables,as summarized in four principal component analysis axes(two climatic-precipi-tation seasonality and temperature range-and two edaphic-soil fertility and soil moisture).Additionally,ordinary kriging maps were used to better illustrate the *** Findings Multiple regression models indicate that all variables but domin-ance percentage were affected by one or more of the environmental gradients,but the average R2 was low(26.25%).Kriging maps rein-forced the patterns observed in the regression *** seasonality and soil moisture gradients were the most important gra-dients affecting vegetation *** finding suggests that water availability is an important determinant of vegetation features in these vegetation transitions.

关键词： climate environmental gradient soil southeastern Brazil vegetation

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Crohn's disease in one mixed-race population in Brazil

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World Journal of Gastroenterology 2007年第33期13卷 4489-4492页

作者： Genoile Oliveira Santana Luiz Guilherme Costa Lyra Tamara Celi Almeida Santana Lidiane bianca dos reis Jorge Carvalho Guedes Maria Betania Toralles André Castro Lyra Gastrohepatology Unit Federal University of Bahia Brazil Gastrohepatology Unit Hospital San Rafael BahiaBrazil Gastrohepatology Unit Federal University of Bahia Brazil Department of Medicine Federal University of Bahia Brazil Gastrohepatology Unit Hospital San Rafael BahiaBrazil Department of Medicine Federal University of Bahia Brazil Gastrohepatology Unit Federal University of Bahia Brazil Department of Medicine Federal University of Bahia Brazil Genetic Unit Federal University of Bahia Brazil

AIM： To evaluate the classification and severity of Crohn＇s disease in different racial groups. METHODS： Patients with Crohn＇s disease from the outpatient clinic of the University Hospital Prof. Edgard Santos were enrolled in the study. This hospital is a reference centre for inflammatory bowel disease. Race was determined using self-identification. The Vienna＇s classification was applied for all subjects. The severity of Crohn＇s disease was determined according to the number of surgical procedures, hospital admissions in the last year and treatment with steroids and immunosuppressors. Statistical analysis was calculated using t test for means,χ^2 or F for proportions. A P value 〈 0.05 was considered to be significant. RESULTS： Sixty-five patients were enrolled. Non-white patients were more frequently diagnosed with Crohn＇s disease in the age less than 40 years than white patients. The behaviour of disease was similar in both groups with a high frequency of the penetrating form. There was a tendency for non-white patients to have a greater frequency of hospital admissions in the last year compared to white subjects. Non-whites also had a higher rate of colonic and upper gastrointestinal involvement, and were also more frequently on treatment with immunossupressors than white patients although this difference was not statistically significant. CONCLUSION： Non-white patients with Crohn＇s disease had an earlier diagnosis and appeared to have had a more severe disease Dresentation than white patients.

关键词： Racial group Brazil Race Inflammatory bowel disease Crohn's disease

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Hemodynamic Fetal Response to Maternal Isometric Exercise in Pregnant Patients with Hypertension

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1399-1416页

作者： Tatiana Frehner Kavalco José Antônio reis Ferreira de Lima Monique soares Paz Wendel Mombaque dos Santos Francisco Maximiliano Pancich Gallarreta Department of Gynecology and Obstetrics Federal University of Santa Maria Santa Maria Brazil The Brazilian Centre for Evidence-Based Health Care: A JBI Centre of Excellence (JBI Brazil) S&#227o Paulo Brazil

Objective: to evaluate the maternal-fetal hemodynamic response with Doppler in pregnant women with chronic arterial hypertension and preeclampsia submitted to controlled isometric activity. Methods: experimental study comparing 50 healthy and 26 hypertensive and 24 preeclamptic pregnant women, from 26 to 36 weeks of gestational age, submitted to isometric contraction with handgrip dynamometer. Maternal hemodynamic parameters (systolic and diastolic blood pressure;heart rate;uterine arteries Doppler) and fetal (heart rate;umbilical artery, middle cerebral and venous duct Doppler) were evaluated before, during and post-isometry. Results: in preeclampsia were observed higher values of blood pressure and uterine artery indexes in all times;middle cerebral artery indexes in the pre and post-isometry;and of maternal heart rate post-isometry. In hypertensive women, systolic blood pressure is increased all the times, with indexes of the right uterine and middle cerebral arteries higher in pre-isometry;middle cerebral and umbilical arteries greater during isometry;and maternal heart rate and umbilical artery indexes bigger after isometry. Conclusion: blood pressure is higher in preeclamptic and hypertension women. The right uterine artery has more resistance in preeclampsia, with a significant decrease in pre to isometry in hypertensive and preeclamptic women;and increased in contraction to post-isometry in healthy and hypertensive women. The left uterine artery increases resistance post-isometry in all groups. The fetal hemodynamic parameters did not show significant differences when comparing the before, during and post-isometry.

关键词： Exercise Isometric Pregnancy High-Risk Hemodynamics Ultrasonography Doppler Fetal-Placental Circulation

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Hemodynamic Fetal Response to Maternal Isometric Exercise in Pregnant Patients with Diabetes

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1324-1338页

作者： Monique soares Paz José Antônio reis Ferreira de Lima Tatiana Frehner Kavalco Wendel Mombaque dos Santos Francisco Maximiliano Pancich Gallarreta Department of Gynecology and Obstetrics Federal University of Santa Maria Santa Maria Brazil The Brazilian Centre for Evidence-Based Health Care: A JBI Centre of Excellence S&#227o Paulo Brazil

Background: Studies on physical activity during pregnancy and its impact on mother and fetus are still limited. International protocols consider only aerobic exercise and fail to provide information about other modalities such as isometric exercise. Isometric exercise promotes cardiorespiratory resistance and muscle strengthening, but it is rarely tested on pregnant women because it increases maternal blood pressure and can subsequently affect placental circulation. Objectives: To assess the fetal response by use of Doppler study in diabetes pregnant women submitted to isometric exercise. Methods: A cross-sectional experimental study was conducted on 25 diabetes pregnant women with gestational age between 26 and 36 weeks. The patients were submitted to isometric handgrip, and data were collected from the mother (blood pressure, heart rate and Doppler velocimetry for the uterine arteries) and from the fetus (heart rate, Doppler velocimetry for the umbilical artery, middle cerebral artery and ductus venosus). All variables were collected before, during and after the isometric handgrip. Results: There was a significant reduction in the pulsatilityindex (average values pre 0.77 ± 0.30, trans 0.65 ± 0.22, and post 0.75 ± 0.22, with p = 0.001), resistance index (average values pre 0.49 ± 0.12, trans 0.44 ± 0.10, and post 0.48 ± 0.90, with p =

关键词： Isometric Handgrip Pregnancy Fetal Hemodynamics Doppler Velocimetry

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Isolation of Filamentous Fungi from the Caatinga Region and Production of Amylolytic Enzymes of Great Industrial Interest

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Journal of Biosciences and Medicines 2020年第11期8卷 152-164页

作者： Ingrid Cristina soares Amorim Gessica Oliveira Marinho Tarcisio Michael Ferreira soares de Oliveira Juan Pedro Bretas Roa Arlete Barbosa dos reis David Lee Nelson Thiago Machado Pasin Vivian Machado Benassi Instituto de Ciência e Tecnologia Universidade Federal dos Vales dos Jequitinhonha e Mucuri Campus JK Diamantina Brasil Programa de Pós-Graduaç ã o em Biocombustíveis Universidade Federal dos Vales dos Jequitinhonha e Mucuri Campus JK Diamantina Brasil Departamento de Bioquímica e Imunologia Faculdade de Medicina de Ribeir&atilde o Preto Universidade de S&atilde o Paulo Ribeir&atilde o Preto Brasil

The industrial importance and the high cost of the commercial amylase require the study of microorganisms that produce these enzymes. For this reason, the objective of this work was to isolate filamentous fungi from a region of the caatinga and evaluate their potential for the production of amylase. Four soil samples were collected from a deactivated dump located in the city of Diamantina, MG, in a region of the caatinga. The analysis of amylolytic production in a submerged medium at the ideal temperature of each microorganism was performed using the saccharification method, and the reducing sugars formed were quantified by DNS. Fourteen filamentous fungi were isolated, which had different morphological aspects. Regarding amylase production, a mean activity of 0.477 U·mL-1 was obtained with the isolates I 1.2.1 and I 4.4.1. These results bring important information regarding the biodiversity of the caatinga, in addition to the isolation of microorganisms that can be used as biological machinery to obtain metabolites with high biotechnological and industrial potential.

关键词： Amylolytic Enzyme Bioprospecting Filamentous Fungi Industrial Interest

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