Edson Vieira da Cunha Filho

Prevalência de sintomas depressivos em uma amostra de prostitutas de Porto Alegre

INTRODUCCION: la prevalencia de trastornos depresivos en la poblacion femenina de Porto Alegre es estimada en 14,5 %. No existen relatos sobre la prevalencia de sintomas o trastornos depresivos entre las prostitutas, poblacion de riesgo para trastornos mentales. OBJETIVOS: cuantificar la prevalencia de sintomas depresivos en muestra de prostitutas de Porto Alegre y factores asociados. MATERIAL Y METODOS: fue estudiada una muestra consecutiva y no aleatoria de 97 mujeres entre 18 y 60 anos, cadastradas en la Organizacion No Governamental Nucleo de Estudios de la Prostitucion (NEP), de Porto Alegre. Despues de informado el consentimiento, las entrevistadas fueron investigadas a traves del Inventario para Depresion de Beck (BDI). El punto de corte igual o mayor que 13 fue utilizado para deteccion de sintomas depresivos. RESULTADOS: en la muestra estudiada la edad media fue de 29,6 anos (dp 8,5 anos), 67% presentaron sintomas depresivos (punto de corte3 13) con escore medio en el BDI de 19,1 (dp 10,9); 24,7 % de la muestra presentaba sintomas leves, 40,2 % sintomas moderados y 7,2 % sintomas graves. Hubo asociacion estatisticamente significativa entre la presencia de sintomas depresivos y el uso de alcohol, historico de enfermedades sexualmente transmisibles y la ausencia de practica religiosa, (p<0,05). CONCLUSION: ademas de la alta tasa de prevalencia de sintomas depresivos (67%) 47,4% de las mujeres evaluadas presentaron niveles moderado y grave de sintomatologia. El uso de alcohol, historico de enfermedades sexualmente transmisibles y la ausencia de practica religiosa surgieron como factores asociados a la presencia de sintomas depresivos en la muestra estudiada.

Flow-mediated dilatation in the differential diagnosis of preeclampsia syndrome

BACKGROUND The preeclampsia syndrome is associated with endothelial dysfunction and the differential diagnosis between pure preeclampsia (PE) and superimposed preeclampsia (SPE) can be only be attained 12 weeks after delivery. OBJECTIVE To compare the assessment of endothelial function through flow-mediated dilatation in pregnant women with pure preeclampsia and superimposed preeclampsia. METHODS The flow-mediated dilatation of the brachial artery was carried out according to the recommendations of the International Brachial Artery Reactivity Task Force in pregnant women with preeclampsia syndrome. PE (n=14) and SPE (n=13) were diagnosed in the postpartum period according to the definitions of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTS The median of the flow-mediated dilatation (FMD) in SPE (6.0%; 1.9-10.3) was decreased in comparison with the PE (13.6%;4.4-17.1), an apparently relevant difference , but not statistically significant (p = 0.08). The FMD < 10% was detected in 30.8% of the PE cases and in 69.2% of the SPE cases (p = 0.057). Significant differences could not be detected in the morphology of the uterine arteries between the PE and SPE cases through the Doppler spectrum. CONCLUSION The FMD of the brachial artery of patients with preeclampsia syndrome was not capable of differentiating between PE and SPE. However, the data suggest that SPE is associated with worse endothelial function I comparison to PE.FUNDAMENTO: El sindrome de preeclampsia se asocia con la disfuncion endotelial y el diagnostico diferencial entre preeclampsia pura (PE) y sobreagregada (PES) solo puede realizarse 12 semanas despues del parto. OBJETIVO: Comparar la evaluacion de la funcion endotelial a traves de dilatacion mediada por flujo en gestantes con preeclampsia pura y sobreagregada. METODOS: La dilatacion mediada por flujo de la arteria braquial se realizo utilizando las recomendaciones de la International Brachial Artery Reactivity Task Force en gestantes con Sindrome de Preeclampsia. La Preeclampsia (n = 14) y preeclampsia sobreagregada (n = 13) fueron diagnosticadas en el posparto segun las definiciones del National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTADOS: El promedio de la dilatacion mediada por flujo (DMF) en la PES (6,0%; 1,9-10,3) fue reducido en comparacion con la PE (13,6%; 4,4-17,1), una disparidad aparentemente relevante, pero sin diferencia estadisticamente significativa (p = 0,08). Una DMF inferior al 10% se detecto en el 30,8% de las PE y en el 69,2% de las PES (p = 0,057). No aparecieron diferencias significativas en la comparacion entre la morfologia de las arterias uterinas de PE y PES a traves del espectro del Doppler. CONCLUSION: La DMF de la arteria braquial de pacientes con Sindrome de Preeclampsia no demostro ser un metodo capaz de diferenciar PE de PES. No obstante, los datos sugieren que la PES se asocia a una peor funcion endotelial en comparacion con la PE.

Amyotrophic lateral sclerosis and riluzole use during pregnancy: a case report.

arteri osus without clinical symptoms or haemody-namic repercussion. Association between ALS and pregnancy has rarely been described. Since 1977, 19 pregnancies in 16 women have been reported, including the present case (2 6). As foetal growth can be affected by mul-tiple factors, it is diffi cult to attribute this fi nding to the drug use. This is the fi rst report of association between riluzole use and cardiac malformation, although prevalence of cardiac malformations in the general population is considerable. Riluzole use during pregnancy is thought to be harmless, but foetal effects are unknown. It is catego-rized as a Class C drug by the Food and Drug Administration (FDA) (7). The only case of riluzole use throughout pregnancy reported a low birth weight of the newborn, but IURG was not consid-ered because of an uncertain gestational age (2). There has been another case in which riluzole was used until pregnancy diagnosis, at nine weeks GA, when the drug was discontinued (3). ALS seems not to cause obstetric complications. In advanced cases, respiratory complications have been described (4). This was not seen in our patient, whose neurological evaluation deteriorated as a normal progression. Also, uterine contractions seem not to be adversely affected by ALS (5). No clear evidence exists as to the better method of delivery. Besides incipient respiratory failure, caesarean delivery indication should follow obstetrics routine (6).

Dilatação mediada por fluxo no diagnóstico diferencial da síndrome de pré-eclâmpsia

BACKGROUND The preeclampsia syndrome is associated with endothelial dysfunction and the differential diagnosis between pure preeclampsia (PE) and superimposed preeclampsia (SPE) can be only be attained 12 weeks after delivery. OBJECTIVE To compare the assessment of endothelial function through flow-mediated dilatation in pregnant women with pure preeclampsia and superimposed preeclampsia. METHODS The flow-mediated dilatation of the brachial artery was carried out according to the recommendations of the International Brachial Artery Reactivity Task Force in pregnant women with preeclampsia syndrome. PE (n=14) and SPE (n=13) were diagnosed in the postpartum period according to the definitions of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTS The median of the flow-mediated dilatation (FMD) in SPE (6.0%; 1.9-10.3) was decreased in comparison with the PE (13.6%;4.4-17.1), an apparently relevant difference , but not statistically significant (p = 0.08). The FMD < 10% was detected in 30.8% of the PE cases and in 69.2% of the SPE cases (p = 0.057). Significant differences could not be detected in the morphology of the uterine arteries between the PE and SPE cases through the Doppler spectrum. CONCLUSION The FMD of the brachial artery of patients with preeclampsia syndrome was not capable of differentiating between PE and SPE. However, the data suggest that SPE is associated with worse endothelial function I comparison to PE.FUNDAMENTO: El sindrome de preeclampsia se asocia con la disfuncion endotelial y el diagnostico diferencial entre preeclampsia pura (PE) y sobreagregada (PES) solo puede realizarse 12 semanas despues del parto. OBJETIVO: Comparar la evaluacion de la funcion endotelial a traves de dilatacion mediada por flujo en gestantes con preeclampsia pura y sobreagregada. METODOS: La dilatacion mediada por flujo de la arteria braquial se realizo utilizando las recomendaciones de la International Brachial Artery Reactivity Task Force en gestantes con Sindrome de Preeclampsia. La Preeclampsia (n = 14) y preeclampsia sobreagregada (n = 13) fueron diagnosticadas en el posparto segun las definiciones del National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTADOS: El promedio de la dilatacion mediada por flujo (DMF) en la PES (6,0%; 1,9-10,3) fue reducido en comparacion con la PE (13,6%; 4,4-17,1), una disparidad aparentemente relevante, pero sin diferencia estadisticamente significativa (p = 0,08). Una DMF inferior al 10% se detecto en el 30,8% de las PE y en el 69,2% de las PES (p = 0,057). No aparecieron diferencias significativas en la comparacion entre la morfologia de las arterias uterinas de PE y PES a traves del espectro del Doppler. CONCLUSION: La DMF de la arteria braquial de pacientes con Sindrome de Preeclampsia no demostro ser un metodo capaz de diferenciar PE de PES. No obstante, los datos sugieren que la PES se asocia a una peor funcion endotelial en comparacion con la PE.

Dilatación mediada por flujo en el diagnóstico diferencial del síndrome de preeclampsia

BACKGROUND The preeclampsia syndrome is associated with endothelial dysfunction and the differential diagnosis between pure preeclampsia (PE) and superimposed preeclampsia (SPE) can be only be attained 12 weeks after delivery. OBJECTIVE To compare the assessment of endothelial function through flow-mediated dilatation in pregnant women with pure preeclampsia and superimposed preeclampsia. METHODS The flow-mediated dilatation of the brachial artery was carried out according to the recommendations of the International Brachial Artery Reactivity Task Force in pregnant women with preeclampsia syndrome. PE (n=14) and SPE (n=13) were diagnosed in the postpartum period according to the definitions of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTS The median of the flow-mediated dilatation (FMD) in SPE (6.0%; 1.9-10.3) was decreased in comparison with the PE (13.6%;4.4-17.1), an apparently relevant difference , but not statistically significant (p = 0.08). The FMD < 10% was detected in 30.8% of the PE cases and in 69.2% of the SPE cases (p = 0.057). Significant differences could not be detected in the morphology of the uterine arteries between the PE and SPE cases through the Doppler spectrum. CONCLUSION The FMD of the brachial artery of patients with preeclampsia syndrome was not capable of differentiating between PE and SPE. However, the data suggest that SPE is associated with worse endothelial function I comparison to PE.FUNDAMENTO: El sindrome de preeclampsia se asocia con la disfuncion endotelial y el diagnostico diferencial entre preeclampsia pura (PE) y sobreagregada (PES) solo puede realizarse 12 semanas despues del parto. OBJETIVO: Comparar la evaluacion de la funcion endotelial a traves de dilatacion mediada por flujo en gestantes con preeclampsia pura y sobreagregada. METODOS: La dilatacion mediada por flujo de la arteria braquial se realizo utilizando las recomendaciones de la International Brachial Artery Reactivity Task Force en gestantes con Sindrome de Preeclampsia. La Preeclampsia (n = 14) y preeclampsia sobreagregada (n = 13) fueron diagnosticadas en el posparto segun las definiciones del National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTADOS: El promedio de la dilatacion mediada por flujo (DMF) en la PES (6,0%; 1,9-10,3) fue reducido en comparacion con la PE (13,6%; 4,4-17,1), una disparidad aparentemente relevante, pero sin diferencia estadisticamente significativa (p = 0,08). Una DMF inferior al 10% se detecto en el 30,8% de las PE y en el 69,2% de las PES (p = 0,057). No aparecieron diferencias significativas en la comparacion entre la morfologia de las arterias uterinas de PE y PES a traves del espectro del Doppler. CONCLUSION: La DMF de la arteria braquial de pacientes con Sindrome de Preeclampsia no demostro ser un metodo capaz de diferenciar PE de PES. No obstante, los datos sugieren que la PES se asocia a una peor funcion endotelial en comparacion con la PE.