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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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Small Cell Neuroendocrine Carcinoma of the Vulva: Case Report and Literature Review

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 295-300页

作者： Gabriela Françóes Rostirolla Alessandra Guerra Maria carolina Rey Alt Luiza Tesser Dalla Libera Maria Eduarda Appel Binda Márcia Appel Fernando De Marco dos Santos Department of Obstetrics and Gynecology Caxias do Sul University Caxias do Sul Brazil Department of Pathology UNIVATES Lajeado RS Medical Student Caxias do Sul University Caxias do Sul Brazil Department of Obstetric and Gynecology Federal University of Rio Grande do Sul Porto Alegre Brazil Department of Oncology Surgeon Caxias do Sul University Caxias do Sul Brazil

Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.

关键词： Vulvar Neoplasms Carcinoma Small Cell Carcinoma Neuroendocrine Genital Neoplasms Female Vulvar Diseases

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Feasibility of performing the 3-minute step test with remote supervision in children and adolescents with cystic fibrosis: A comparative study

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Pediatric Investigation 2024年第2期8卷 83-90页

作者： Fernanda Maria Vendrusculo Gisele Apolinario da Costa Maria Amelia Bagatini Brenda Maria Henrique Maia Lemes carolina Aguiar Faria Larissa Carvalhaes de Oliveira Evanirso da Silva Aquino Marcio Vinicius Fagundes Donadio Laboratory of Pediatric Physical Activity Infant CenterPontificia Universidade Catolica do Rio Grande do Sul(PUCRS)Porto AlegreBrazil Hospital Infantil Joao Paulo II-Fundacao Hospitalar do Estado de Minas Gerais(FHEMIG) Belo HorizonteBrazil Departament of Physiotherapy Pontificia Universidade Catolica de Minas Gerais(PUCMG)-Campus BetimBetimBrazil Department of Physiotherapy Faculty of Medicine and Health SciencesUniversitat Internacional de Catalunya(UIC)BarcelonaSpain

Importance:The 3-min step test is a simple option to monitor submaximal exercise capacity,although its use via remote video monitoring has not been investigated in children with cystic fibrosis(CF).Objective:This study aimed to assess the feasibility and reproducibility of performing the 3-min step test with remote ***:A cross-sectional study including CF patients(6-18 years)from two CF services were ***,anthropometric,clinical,and lung function data were collected and two 3-min step tests were performed:(i)in-person supervision,and(ii)remotely supervised by video *** and after the tests,heart rate(HR),oxygen saturation(SpO_(2)),and the Borg score for dyspnea and lower limb fatigue were ***:Twenty-three patients(10.7±3.7 years)with a mean FEV1 of 89.5%±23.2%were *** were no significant differences between tests,with mean differences(95%confidence intervals)in final HR of-3.3(-8.9,2.4),change in HR of-1.9(-6.1,2.1),final SpO_(2) of 0.3(-0.4,1.0),and final dyspnea of 0.1(-0.8,0.9).The intraclass correlation coefficient was 0.852(final HR),0.762(final SpO_(2)),and 0.775(final lower limb fatigue).Significant and moderate correlations were found between tests for final HR(r=0.75),change in HR(r=0.61),and final SpO_(2)(r=0.61).The Bland-Altman analysis showed a mean difference in final SpO_(2) between tests of 0.3%(limit of agreement-3.0%,3.5%).Interpretation:Physiological responses between tests were similar,indicating it was feasible to perform the 3-min step test with remote supervision in CF children.

关键词： Children Cystic fibrosis Exercise test Telehealth

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Overweight/Obesity in University Students from Mexico: Comparison Using Different Indices

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Journal of Biosciences and Medicines 2024年第7期12卷 151-159页

作者： Gabriel Medrano-Donlucas Claudia carolina Hernández-Peña Ricardo Juárez-Lozano Cecilia López-López Santiago C. Sigrist Flores Rafael Villalobos-Molina Itzell A. Gallardo-Ortíz Instituto de Ciencias Biomdicas Universidad Autnoma de Ciudad Jurez Ciudad Jurez Mxico Facultad de Estudios Superiores Iztacala Universidad Nacional Autnoma de Mxico Tlalnepantla de Baz Mxico

The goal was to compare body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), and relative fat mas (RFM), to identify the best predictor of overweight and obesity in university students from Mexico. This is a cross-sectional survey with 697 university students from northern and central Mexico (448 women, and 249 men aged 18 - 19 years). Data was collected during 2018. Overweight and obesity were calculated from those indices and for both, female and male students, the order of correlation between a pair of indices were WHtR vs. RFM > WHtR vs. WC > RFM vs. WC > WHtR vs. BMI > BMI vs. WC > RFM vs. BMI. It is concluded to use the WHtR and the RFM to better predict overweight and obesity in young Mexican university students.

关键词： Overweight and Obesity Anthropometry Anthropometry Indices

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Exercise training improves long-term memory in obese mice

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Life Metabolism 2024年第1期3卷 37-50页

作者： Oliver K.Fuller Casey L.Egan Tina L.Robinson Nimna Perera Heidy K.Latchman Lauren V.Terry Emma D.McLennan carolina Chavez Emma L.Burrows John W.Scott Robyn M.Murphy Henriette van Praag Martin Whitham Mark A.Febbraio Monash Institute of Pharmaceutical Sciences Monash UniversityMelbourneVictoria3052Australia La Trobe Institute for Molecular Science La Trobe UniversityMelbourneVictoria3086Australia Florey Institute of Neuroscience and Mental Health University of MelbourneMelbourneVictoria3052Australia Department of Biomedical Sciences Charles E.Schmidt College of Medicineand Stiles-Nicholson Brain InstituteFlorida Atlantic UniversityJupiterFL 33458United States College of Life and Environmental Sciences University of BirminghamEdgbastonBirmingham B152TTUnited Kingdom

Obesity has been linked to a range of pathologies,including *** contrast,regular physical activity is associated with the prevention or reduced progression of ***,physical activity can improve memory and spatial cognition,reduce age-related cognitive decline,and preserve brain volume,but the mechanisms are not fully ***,we investigated whether any detrimental effects of high-fat diet(HFD)-induced obesity on cognition,motor behavior,adult hippocampal neurogenesis,and brain-derived neurotrophic factor(BDNF)could be mitigated by voluntary exercise training in male C57Bl/6 ***-induced impairment of motor function was not reversed by ***,voluntary wheel running improved long-term memory and increased hippocampal neurogenesis,suggesting that regular physical activity may prevent cognitive decline in obesity.

关键词： obesity exercise cognition

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Radiomics in pancreatic cancer for oncologist:Present and future

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 356-361页

作者： carolina de la Pinta Radiation Oncology Department Ramón y Cajal University HospitalIRYCISAlcaláUniversity28034 MadridSpain

Radiomics is changing the world of medicine and more specifically the world of *** diagnosis and treatment improve the prognosis of patients with *** treatment,the evaluation of the response will determine future *** oncology,every change in treatment means a loss of therapeutic options and this is key in pancreatic *** has been developed in oncology in the early diagnosis and differential diagnosis of benign and malignant lesions,in the evaluation of response,in the prediction of possible side effects,marking the risk of recurrence,survival and prognosis of the *** studies have validated its use to differentiate normal tissues from tumor tissues with high sensitivity and specificity,and to differentiate cystic lesions and pancreatic neuroendocrine tumor grades with texture *** addition,these parameters have been related to survival in patients with pancreatic cancer and to response to radiotherapy and *** review aimed to establish the current status of the use of radiomics in pancreatic cancer and future perspectives.

关键词： Pancreatic cancer Radiomics Radiogenomics

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Selective catalytic reduction of nitrogen oxides over a modified silicoaluminophosphate commercial zeolite

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Journal of Environmental Sciences 2018年第3期30卷 246-252页

作者： carolina Petitto Gérard Delahay Institut Charles Gerhardt Montpellier UMR 5253 CNRS/UM/ENSCM Matériaux Avancés pour la Catalyse et la Santé 8 rue de l'Ecole Normale

Nitrogen oxides（NOx：NO,NO2）are a concern due to their adverse health *** engine transport sector is the major emitter of *** regulations have been strengthened and to comply with them,one of the two methods commonly used is the selective catalytic reduction of NOxby NH3（NH3-SCR）,NH3being supplied by the in-situ hydrolysis of *** and durability of the catalyst for this process are highly *** is evaluated by hydrothermal treatment of the catalysts at temperature above 800℃.In this study,very active catalysts for the NH3-SCR of NOxwere prepared by using a silicoaluminophosphate commercial zeolite as copper host *** by X-ray diffraction（XRD）,scanning electron microscopy（SEM）and temperature programmed desorption of ammonia（NH3-TPD）showed that this commercial zeolite was hydrothermally stable up to 850℃ and,was able to retain some structural properties up to950℃.After hydrothermal treatment at 850℃,the NOxreduction efficiency into NH3-SCR depends on the copper *** catalyst with a copper content of 1.25 wt.%was the most *** difference in activity was much more important when using NO than the fast NO/NO2reaction mixture.

关键词： Diesel Nitrogen oxides SCR process Copper Zeolite Silicoaluminophosphate

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The future of underground spatial planning and the resulting potential risks from the point of view of mining subsidence engineering

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International Journal of Mining Science and Technology 2020年第1期30卷 93-98页

作者： carolina Brücker Axel Preuβe Institute for Mine Surveying Mining Subsidence Engineering and Geophysics in MiningRWTH Aachen UniversityWüllnerstr.2Aachen 52062Germany

The topic of ground movements in Germany has been studied extensively in the past,especially in the field of active *** active hard coal mines in Germany were finally shut down in 2018 and lignite mining is expected to take place only until *** so-called long-term liabilities of the mine operators in Germany include,among other things,the long-term guarantee of stability and thus the monitoring of ground *** far,the economic use of underground mining in Germany was mainly the supply of raw *** the future,the underground storage of compressed air,methane or hydrogen will play an important role in renewable energy supply and climate ***,the underground storage space will become more important and the spatial planning is essential to ensure availability of safe underground openings for the various options of environmentally friendly energy ***,this renewed usage of underground openings may also bring new and sometimes unknown challenges of geomechanical *** aftermath of hard coal and lignite mining will be an increasing challenge in mining subsidence *** the other hand,new possibilities due to underground spatial planning may lead to subsidence and/or heaving of the upper surface.

关键词： Mining Surveying Underground spatial planning Mining engineering Renewable energies

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围术期神经肌肉阻滞的管理:欧洲麻醉和重症监护学会临床指南

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中华麻醉学杂志 2024年第6期44卷 641-656页

作者： Thomas Fuchs-Buder carolina S.Romero Heidrun Lewald Massimo Lamperti Arash Afshari Ana-Marjia Hristovska Denis Schmartz Jochen Hinkelbein Dan Longrois Maria Popp Hans Dde Boer Massimiliano Sorbello Radmilo Jankovic Peter Kranke 法国南锡大学医学院附属医院麻醉学、重症监护与围术期医学科法国南锡54000 巴伦西亚大学综合医院麻醉与重症监护科西班牙巴伦西亚46014 慕尼黑工业大学麻醉学与重症监护科德国慕尼黑80333 克利夫兰阿布扎比诊所麻醉学研究所阿联酋阿布扎比31250 哥本哈根大学医院小儿和产科麻醉科丹麦哥本哈根2100 哥本哈根大学医院麻醉学与重症监护科丹麦赫维德2650 布鲁塞尔自由大学Erasme医院麻醉科比利时布鲁塞尔1070 科隆大学医院麻醉学与重症监护科德国科隆50937 巴黎大学附属比查特克劳德伯纳德医院麻醉学与重症监护医学科法国巴黎75018 维尔茨堡大学医院麻醉学、危重病医学、急诊医学和疼痛医学科德国维尔茨堡97080 格罗宁根大学医院麻醉学、疼痛医学与程序性镇静与镇痛科荷兰格罗宁根9713 GZ 卡坦尼亚大学医院麻醉与重症监护科意大利卡坦尼亚95123 尼什大学医学院尼什临床中心麻醉学与重症治疗科塞尔维亚尼什18000

近来的研究表明,由于围术期神经肌肉阻滞管理不当,肌肉松弛药(肌松药)残留阻滞及其术后并发症的发生率居高不下。需要重视神经肌肉功能监测仪、肌松药及其拮抗剂的合理应用,以利于改善神经肌肉阻滞管理。欧洲麻醉和重症监护学会(Europea... 详细信息

近来的研究表明,由于围术期神经肌肉阻滞管理不当,肌肉松弛药(肌松药)残留阻滞及其术后并发症的发生率居高不下。需要重视神经肌肉功能监测仪、肌松药及其拮抗剂的合理应用,以利于改善神经肌肉阻滞管理。欧洲麻醉和重症监护学会(European Society of Anaesthesiology and Intensive Care,ESAIC)首次发布围术期神经肌肉阻滞管理临床指南,旨在为临床医生提供最佳医疗管理的循证建议,以提高围术期患者安全。本指南主要聚焦在3个临床问题:肌松药是否有助于成人气管插管?神经肌肉阻滞深度是否影响腹部手术患者的预后?肌松药残留阻滞的诊断和治疗策略有哪些?根据PICO原则(患者、干预、对照、结局;patient,intervention,comparator,outcome;PICO)构建临床问题并进行文献检索。初始纳入的临床研究为24 000篇,采用逐步筛选策略,最终临床研究88篇纳入指南分析。应用GRADE方法学(Grading of Recommendations,Assessment,Development and Evaluation,GRADE)对结局指标证据、质量等级进行评价。运用两轮德尔菲法收集专家组建议并形成统一推荐:R1推荐应用肌松药辅助气管插管(1A)。R2推荐应用肌松药以减少气管插管导致的咽部和(或)喉部损伤(1C)。R3推荐在快速顺序诱导插管(rapid sequence induction intubation,RSII)时使用短效肌松药,例如琥珀胆碱1 mg/kg或罗库溴铵0.9~1.2 mg/kg(1B)。R4推荐在需要改善外科手术条件时,加深神经肌肉阻滞深度(1B)。R5尚无足够的证据推荐深度神经肌肉阻滞可减轻术后疼痛或降低围术期并发症的发生率(2C)。R6推荐在拇内收肌处刺激尺神经,定量监测神经肌肉阻滞深度以排除肌松药残留阻滞(1B)。R7推荐应用舒更葡糖钠逆转甾体类肌松药(罗库溴铵、维库溴铵)诱导的深、中及浅度神经肌肉阻滞(1A)。R8推荐在使用新斯的明前,TOFr自行恢复至>0.2,并继续定量监测神经肌肉功能,直至TOFr超过0.9(1C)。

关键词：神经肌肉阻滞神经肌肉功能肌松药临床指南罗库溴铵琥珀胆碱外科手术定量监测

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Evidence-Based Complementary and Alternative Medicine Effects of Capybara Oil on Cardiac Remodeling of C57bl/6 Mice

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Journal of Biosciences and Medicines 2024年第5期12卷 213-232页

作者： Rafael M. Almeida Wagner D. Giannetti Guilherme R. Silveira carolina R. Castilho Renata V. Lisboa Bianca T. Ciambarella Rodrigo N. Ferreira Jorge José de Carvalho Laboratory of Ultrastructure and Tissue Biology Institute of Biology State University of Rio de Janeiro Rio de Janeiro Brazil Higher Education Center of Valenç a Dom Andr&#233 Arcoverde Educational Foundation Valen&#231a Brazil

Cardiovascular diseases are the main cause of morbidity and mortality in the world, and obesity and the metabolic syndrome are risk factors for its development. One of the therapies to reduce cardiovascular risk is the use of polyunsaturated fatty acids. In Brazil, a source of such acid is the oil extracted from the fat of the capybara. The objective of this work is to study the effects of the capybara oil on lipid and glucose metabolism, as well as its effects on the adipose tissue and cardiac remodeling. We assessed the effects of capybara oil treatment on body mass, lipid and carbohydrate metabolism, systolic blood pressure, adipose tissue and cardiac remodeling, and performed an ultrastructural evaluation of the myocardium in C57Bl/6 mice treated with high-fat diet. Treatment with capybara oil reduced total cholesterol and triglyceride levels, systolic blood pressure, visceral and subcutaneous adipose tissue, and adipocyte diameter. In addition, cardiac remodeling was attenuated, preserving cardiomyocytes, increasing vascularization, reducing cardiomyocyte hypertrophy and the extracellular matrix, and preserving the morphological integrity of mitochondria. Capybara oil has several beneficial effects on the cardiovascular and metabolic system, and further studies are needed to better understand its role in the prevention or treatment of cardiovascular diseases.

关键词： Capybara Oil Cardiac Remodeling Polyunsaturated Fatty Acids Obesity Metabolic Syndrome

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