Wendel Mombaque dos Santos

Efeito do exercício físico sobre os parâmetros hemodinâmicos fetais

PURPOSE To assess the effects of aerobic physical exercise on the Doppler velocimetry of fetal vessels in pregnant women with no clinical or obstetrical complications. METHODS A cross-sectional study was conducted on 10 healthy low-risk pregnant women at 2 different gestational times: between the 26th and 29th week and 6 days, and at the end of pregnancy, between the 30th and 35th week. The patients were submitted to aerobic physical exercise on a treadmill until reaching fatigue. Ultrasonographic data were obtained at rest and after physical exercise (Doppler velocimetry indices for the umbilical artery, middle cerebral artery, ductus venosus, and uterine arteries). Data were analyzed statistically by the paired and independent Students t-test using the Statistical Package for the Social Sciences (SPSS) package, version 21.0. RESULTS A change in the pulsatility index was observed, with an indication of vasodilatation, with a median value of 1.1±0.1 before exercise and of 1.0±0.1 after exercise; the median value of the resistance index was 0.7±0.04 before exercise and 0.6±0.07 after exercise. The median systole/diastole ratio of the umbilical artery was 3.1±0.4 before exercise and 2.9±0.2 (p=0.03) after exercise at the beginning of pregnancy. No changes in the Doppler velocimetry parameters were observed for the uterine arteries, the middle cerebral artery or the ductus venosus after physical activity at either testing time. Paired analysis of pre- and post-activity data showed a reduction of resistance from the first to the second period (p<0.04). CONCLUSIONS Physical exercise does not lead to changes in systemic blood flow or fetal-placental flow in healthy pregnant women, confirming that exercises of mild to moderate intensity can be prescribed.

A five-year review of vertical HIV transmission in a specialized service: cross-sectional study

CONTEXT AND OBJECTIVE: Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it. DESIGN AND SETTING: Cross-sectional study developed at the University Hospital of Santa Maria (RS), Brazil. METHODS: A cross-sectional study was conducted on a sample of 198 notification forms and medical records of HIV-positive pregnant women and exposed children. RESULTS: The vertical transmission rate was 2.4%, and three children had been infected by vertical HIV transmission. The statistically significant risk factor was the use of injectable drugs. Delayed reporting of pregnancy, absence of antiretroviral therapy during pregnancy, lack of proper prenatal care, incapacity to perform viral load detection tests and CD4+ T cell counts and obstetric and maternal clinical complications were reported. CONCLUSIONS: The vertical transmission rate was high and the recommended intervention measures were not adopted in full. Adequate prophylactic measures need to be implemented in HIV-positive pregnant women prenatally and during the antenatal, delivery and postpartum periods.

Dietary and physical activity habits associated with risk for the development of cancer: prevalence in adolescents

AIMS: To evaluate the prevalence of dietary habits and of physical exercise with the potential risk for the development of cancer, in a sample of adolescents. METHODS: Cross-sectional study that recruited schoolers aged 12-15 years during the academic year 2011-2012 in the city of Uruguaiana (Brazil). Data collection was performed with a questionnaire containing 11 inquiries with demographic and behavioral variables. RESULTS: The sample included 956 adolescents, of whom 498 (52.1%) were boys. Among the 956 participants, 215 (22.7%) performed less than 30 minutes a day of physical activity; 781 (81.7%) consumed sugary drinks; 119 (12.4%) had at least two alcoholic drinks per day; 807 (84.4%) ate red meat; 342 (35.7%) ate high-sodium snacks; and 726 (75.9%) consumed fast-food. Girls practiced less physical activity, consumed less red meat and more fast-food than boys. Age was inversely associated to physical exercise and positively associated to consuming sugary drinks and alcohol. CONCLUSIONS: The young population we studied presented high-risk behaviors such as low level of physical activity, and consumption of salty foods, red meat, fast food, sugary drinks and alcohol, which are associated with the increase of prevalence of several types of cancer.

ALTERAÇÕES HEMODINÂMICAS MATERNAS E REPERCUSSÕES FETAIS APÓS EXERCÍCIO FÍSICO EM GESTANTES – NOTA PRÉVIA

Objetivo: avaliar as alteracoes metabolicas maternas bem como as repercussoes fetais ao estudo Doppler e a cardiotocografia em gestantes de baixo risco submetidas a exercicio fisico aerobico. Metodo: pesquisa longitudinal experimental a ser realizada com gestantes higidas entre a 26 e 34 semanas gestacionais, avaliando parâmetros hemodinâmicos maternos e fetais pre e pos exercicio fisico em esteira. Resultados Esperados: nao evidenciar alteracoes maternas e/ou fetais apos a atividade aerobica, garantindo maior seguranca na prescricao dessa durante o periodo gestacional.

Antenatal diagnosis of unilateral congenital cystic adenomatoid malformation associated with Taussig-Bing syndrome: case report

Aims: To report a rare case of antenatal diagnosis of unilateral congenital cystic adenomatoid malformation associated with Taussig-Bing syndrome. Case description: Patient aged 40 years, four pregnancies with three previous vaginal deliveries, black skin, married, housewife, without prior conditions, was referred to the Fetal Medicine Unit of the University Hospital of Santa Maria due to changes in the thoracic region of the fetus found in routine obstetric ultrasound examination performed at 30 weeks and three days of gestation. At the Doppler ultrasound assessment performed in the reference center, perimembranous ventricular septal defect and transposition of the great vessels were found, characterizing the Taussig-Bing syndrome. Additionally, a unilateral pulmonary congenital cystic adenomatoid malformation type 2 was found. The medical staff decided by a cesarean delivery in a referral center for cardiology, with 37 weeks of gestation. The neonate, weighing 3 kg, presented since the first hours acute respiratory distress with severe cyanosis, and underwent lobectomy. The neonate died within two weeks of life due to respiratory failure during the performance of a surgical procedure to correct the cardiac malformation. Conclusions: There is no description in the literature of association between Taussig-Bing syndrome and congenital cystic adenomatoid malformation. Early ultrasound diagnosis and monitoring in a Fetal Medicine unit is important for planning pre and post-natal interventions and family counseling by a multiprofessional team.

FATORES DE RISCO À SAÚDE NA ADOLESCÊNCIA

Objetivo: este estudo visa analisar a prevalencia de comportamentos de risco a saude tais como: sedentarismo, ma alimentacao, etilismo, adicao em drogas, envolvimento em brigas e relacoes sexuais sem protecao; em adolescentes no Municipio de Uruguaiana, Rio Grande do Sul – Brasil. Metodo: A coleta de sera realizada a partir de um questionario aplicado em escolares sobre comportamento de risco e estilo de vida, composto de 13 questoes, com variaveis demograficas, socioeconomicas e comportamentais. Resultados Esperados: determinar os comportamento de risco prevalentes, auxiliando na realizacoes de acoes para a reducao dos mesmos.

A ÁRVORE DO CONHECIMENTO COMO INSTRUMENTO PARA A PROMOÇÃO DA SAÚDE DE ADOLESCENTES DE UM CENTRO DE ATENDIMENTO SOCIOEDUCATIVO (CASE)

Experience report of the actions of a university extension project, focusing on health promotion for adolescents of a Centre Socio - Education (Case). Highlights the dynamics of the tree of knowledge , the creative method - sensitive , as a tool that emphasizes group discussion , as well as the promotion of adolescent health and the construction of collective knowledge . The dynamics of creativity and sensibility called tree of knowledge, gave teens the opportunity to reflect on the multidimensional aspects that directly influence social violence, as well as possibilities to change this framework through implementation and cultivating a culture of peace. The integration between the university and the Centre for Socio -Educational enabled the creation of a space that encouraged listening and understanding the experiences brought by adolescents, and favored the development of new extension actions with a view to promoting the health of this group.

Efeito do exercício físico sobre os parâmetros hemodinâmicos

PURPOSE To assess the effects of aerobic physical exercise on the Doppler velocimetry of fetal vessels in pregnant women with no clinical or obstetrical complications. METHODS A cross-sectional study was conducted on 10 healthy low-risk pregnant women at 2 different gestational times: between the 26th and 29th week and 6 days, and at the end of pregnancy, between the 30th and 35th week. The patients were submitted to aerobic physical exercise on a treadmill until reaching fatigue. Ultrasonographic data were obtained at rest and after physical exercise (Doppler velocimetry indices for the umbilical artery, middle cerebral artery, ductus venosus, and uterine arteries). Data were analyzed statistically by the paired and independent Students t-test using the Statistical Package for the Social Sciences (SPSS) package, version 21.0. RESULTS A change in the pulsatility index was observed, with an indication of vasodilatation, with a median value of 1.1±0.1 before exercise and of 1.0±0.1 after exercise; the median value of the resistance index was 0.7±0.04 before exercise and 0.6±0.07 after exercise. The median systole/diastole ratio of the umbilical artery was 3.1±0.4 before exercise and 2.9±0.2 (p=0.03) after exercise at the beginning of pregnancy. No changes in the Doppler velocimetry parameters were observed for the uterine arteries, the middle cerebral artery or the ductus venosus after physical activity at either testing time. Paired analysis of pre- and post-activity data showed a reduction of resistance from the first to the second period (p<0.04). CONCLUSIONS Physical exercise does not lead to changes in systemic blood flow or fetal-placental flow in healthy pregnant women, confirming that exercises of mild to moderate intensity can be prescribed.