1,721,000 research outputs found
Profilo nutrizionale e sintomatologia gastrointestinale in gravidanza in donne a rischio di complicanze metaboliche
No full textBACKGROUND
Sono stati studiati due campioni di donne costituiti da un totale di 180 gravide afferenti alla Clinica di Ginecologia ed Ostetricia dell’Ospedale Vittore Buzzi di Milano, reclutate durante il periodo gestazionale.
Il primo campione è costituito da 110 donne che formano il gruppo di controllo (donne con BMI normale, senza fattori di rischio e con gravidanze fisiologiche).
Il secondo campione è costituito da 70 donne a rischio di complicanze metaboliche o con patologia metabolica già diagnosticata.
OBIETTIVO
La ricerca effettuata mette a confronto gli stili di vita nutrizionali di due campioni di donne: le donne ritenute fisiologiche e quindi senza predisposizioni a patologie, sindromi o disordini metabolici, e le donne ritenute patologiche, alle quali è stata diagnosticata una ipertensione, una preeclampsia, un diabete gestazionale, o perché hanno familiarità per questi disturbi.
Lo scopo della ricerca è proprio quello di identificare nell’alimentazione e nella cultura nutrizionale, l’insorgenza delle patologie prese in esame.
MATERIALI E METODI
Studio longitudinale su un campione di 180 donne, divise in due gruppi, i cui dati sono stati raccolti in maniera anonima, ma in cui sono state indagate le variabili anagrafiche.
Alle partecipanti veniva richiesto di rispondere a domande di due questionari: il primo riguardo le loro abitudini alimentari ed il secondo riguardo disturbi e disordini intestinali in gravidanza ed i cambiamenti che erano avvenuti con lo stato gestazionale rispetto a quello pregestazionale.
I dati rilevati dai questionari sono stati trattati separatamente per i due gruppi, mantenendo l’anonimato, e i risultati sono stati comparati ed analizzati tramite l’utilizzo del programma Excel.
RISULTATI
Analizzando i risultati appare che le donne affette da patologie si alimentano in maniera meno equilibrata delle donne fisiologiche; il 12% mangia verdura meno di una volta al giorno (percentuale doppia rispetto alle fisiologiche), più facilmente saltano la colazione o fanno una colazione scarsa per permettersi poi una cena abbondante, una buona parte si concede dei dolci dopo cena e dato più significativo ed importante è che il 27% sul totale di donne affette da patologie, arriva a termine di gravidanza con un BMI > 30.0 (obesità), mentre il 28.5% presenta un BMI compre so tra 25.5 e 29.9 (sovrappeso).
CONCLUSIONI
L’alimentazione può interferire in maniera dannosa sul nostro genoma e sul nostro microbioma intestinale, andando ad alterare i trilioni di batteri buoni che vivono con noi, che producono vitamine, che completano la digestione e che ci proteggono da batteri e virus che al contrario sono dannosi per la nostra salute.
Ad aggravare tutto questo si ha un aumento di peso e una inattività sempre maggiore che portano a un rischio aumentato del 45% di sviluppare diabete gestazionale in future gravidanze
Esiste una stretta correlazione tra l’insorgenza di sindromi metaboliche, come il diabete, e alimentazione e microbioma intestinale, ma la gravidanza offre una opportunità: la gravidanza è una occasione di salute, poiché avendo un profondo impatto sulla digestione e sulla funzione intestinale, offre una possibilità alla donna di identificare comportamenti alimentari scorretti o non appropriati e disturbi gastrointestinali latenti, che nelle 40 settimane di gestazione si rendono evidenti
Endometrial sampling during sonohysterography (SHGes) in the management of abnormal uterine bleeding
No full textAre girls more at risk of intrauterine acquired HIV infection than boys?
No full textTo investigate whether previously described sex differences in virological and immunological markers in vertically infected children are preceded by sex differences in the overall risk or timing of mother-to-child transmission (MTCT) we analysed 3231 mother-child pairs enrolled in the European Collaborative Study. Girls were at a 1.5 times increased risk of MTCT overall, but the sex effect was limited to elective caesarean section deliveries, suggesting that girls may have an increased risk of intrauterine transmission compared with boys
Does exposure to antiretroviral therapy affect growth in the first 18 months of life in uninfected children born to HIV-infected women?
No full textUninfected children born to HIV-infected women are exposed antenatally to antiretroviral therapy, but it is uncertain whether this affects growth in early life. We analyzed weight, height, and occipitofrontal circumference (OFC) in 1912 children from a cohort study: 1304 had no or monotherapy exposure and 608 had combination therapy exposure. The mean z-score for birth weight or OFC did not differ by exposure category in 1513 term children or in 78 born at <34 weeks; the 266 born from 34 to 36 weeks were heavier if exposed to combination therapy. Children with combination therapy exposure born at 34 to 36 weeks reached the 25th centile for weight and OFC earlier than those not exposed born at 34 to 36 weeks (median: birth vs. 3 months; P = 0.003 [weight], P = 0.004 [OFC]), whereas children exposed to combination therapy born at <34 weeks reached the 25th centile for OFC later than those born at <34 weeks not exposed (median: 15 vs. 7 months; P = 0.004). Gestational age and maternal illicit drug use were strongly associated with growth, but the effect of combination therapy exposure was marginal (adjusted coefficients: weight, -0.10 [P = 0.019]; height, -0.12 [P = 0.008]; and OFC, -0.14 [P = 0.001]). Although the effect of combination therapy exposure is minimal, long-term monitoring of these children is important. Copyrigh
Age related standards for total lymphocyte, CD4+ and CD8+ cell counts in children born in europe
No full textOBJECTIVE: Currently used reference values for immunologic markers in children are largely derived from cross-sectional data from historic, small sample size studies in predominantly white children. There is a lack of reliable age-related standards for immunologic markers, such as CD4+ cell counts, in particular in black children whose values according to recent reports may differ from those in white children. Standards are essential for diagnosing and monitoring childhood diseases such as pediatric human immunodeficiency virus (HIV) infection. DESIGN: Prospective cohort study with data on 1781 uninfected children born to HIV-infected mothers in the European Collaborative Study. METHODS: Age-related standards (centiles) for immunologic markers (CD4+ and CD8+ cell counts and total lymphocyte counts) up to 5 years in black and up to 10 years in white children were constructed using Generalized Additive Models for Location, Scale and Shape method, which allows for variability and skewness of the data. The optimal model was chosen according to the Akaike Information Criterion. RESULTS: Patterns and values of total lymphocyte, CD4+ and CD8+ cell counts varied with age, especially in the first 3 years of life, but less so thereafter. Values of all 3 immunologic markers were substantially and significantly lower in black than in white children of the same age. CONCLUSIONS: We present age-related standards separately for black and white children to aid clinicians in the monitoring of childhood diseases. These standards may also contribute to the decision on an accurate cutoff for CD4+ cell counts for initiating treatment of HIV-infected children
Uterine doppler velocimetry predicts normotensive preeclampsia in pregnancies with fetal growth retrdation : evidencs from placental pathology and perinatal outcome
No full textThe hypothesis is that the typical presclamptic ischemic-haemerragic lesions of the placenta can be predicted by uterine Doppler veiocimatry in normotensive pregnancies with growth retarded fetuses.
Study design: Detailed macroscopic and microscopic placental pathology was studied in 80 pregnancies with fetal growth retardation (FGR) and in 20 normal pregnancies. In 25 patients FGR was associated with pregnancy induced hypertension (PIH). Pregnancies with FGR were classified into four groups according to the presence of PIH and of abnormal Doppler velocimetry of the ascending uterine artery (Uter-DV) measured within 5 days from delivery, The frequency and the severity of lachemic-heamorragic lesions, fetal growth pattern, DV of the umbilical arteries and perinatal outcome were compared in these four groups and in the control group.
Results: The frequency of infarctions and extensive histological ischemic damage of placental tissue was not significantly different between cases with FGR, PIH and abnormal Uter-DV (group 1) (100%) and cases with FGR and abnormal Uter-OV without PIH (group 2) (88%) (p<O.2). The frequency of these same lesions was significantly lower in cases with FGR but with normal Uter-DV (p<O,OOO7) and in cases with FGR, hypertension but normal Uter-DV (p<O.O(X)). Identical results were obse~ed for large
infarctions, abruptio and the most severe ischemic damages.Umbilical S/D ratio (5.8 _+2.9 vs. 6.1 _+2.6), the prevalence of esymmatdcel growth (42 vs. 56%), gestational age (33 +4 vs. 31 +_3) and weight at birth (1297 t-644 vs. 1264 -+525) were not significantly different between group 1 and 2. These perinatal parameters were significantly better in pregnancies with FGR, with or without hypertension, but normal Uter-DV, than in groups 1 and 2.
Conclusions: The frequency, severity and extension of typical presciamptic
ischemic-haemorragio lesions of the placenta is not significantly different in
hypertensive and normotensive patients with FGR and abnormal Doppler velocimetry of the ascending uterine arteries
Blood flow volume of uterine arteries in human pregnancies determined using 3D and bidimensional imaging, angio-Doppler and fluid-dynamic modeling
No full textThe primary aim of this pilot study was to study uterine artery (UtA) blood flow volume in uneventful human pregnancies delivered at term, at mid and late gestation by means of 3D and bi-dimensional ultrasound imaging with angio-Doppler combined with fluid-dynamic modeling. Secondary aims were to correlate flow volume to placental site and to UtA Pulsatility Index (PI). Women with singleton, low-risk pregnancies were examined at mid and late gestation. The structure and course of the uterine artery (UtA) was studied in each patient by means of 3D-angio-Doppler and included vessel diameter D, blood flow velocity and PI (measured along the UtA). Fetal weight estimation and placental insertion site were assessed by ultrasound. A robust fluid-dynamic modeling was applied to calculate absolute flow and flow per unit fetal weight. Mean UtA diameter and blood flow velocity increased significantly (p < 0.0001) from mid-gestation to late gestation from 2.6 mm and 67.5 cm/s, to 3.0 mm and 85.3 cm/s, respectively, yielding an increasing absolute flow troughout gestation. h coefficient, derived by fluid-dynamic modeling to calculate mean velocity, increased significantly from 0.52 at mid-gestation to 0.57 at late gestation. UtA blood flow volume ml/min/kg-fetal weight was significantly higher at mid-gestation than at late gestation (535 ml/min/kg vs 193 ml/min/kg; p < 0.0001). In cases with strictly lateral placentas the ipsilateral UtA accommodates at mid and late gestation 63% and 67% of the total UtA flow. In central placentas UtA flow was evenly distributed between the two vessels. An inverse correlation was observed between PI and blood flow volume ml/min/kg (Pearson's coefficient r = -0.54). Our work confirms the technological and methodological limitations in the measurement of uterine artery blood flow. However, Doppler measurements supported by three-dimensional angio imaging of the uterine vessel, high resolution imaging and diameter measurement, and a robust mathematical model of local circulation adds a genuine new area of investigation into human uterine circulation during pregnancy
Monitoring hormone replacement therapy
No full textBiochemical markers of bone metabolism are divided into two groups: formation and resorption markers. Bone turnover is a dynamic process, which increases in postmenopausal period. Hormone replacement therapy (HRT) can diminish this increased bone turnover. Biochemical markers reflect acute changes in bone metabolism. Therefore, they may be very useful for the prediction of subsequent bone mineral density changes after HRT in menopausal women. Both oral and transdermal routes of HRT are efficacious in decreasing the levels of biochemical markers. However, markers do not replace bone mineral density measurement. Collagen type I cross linked N-telopeptide, collagen type I cross linked C-telopeptide, and osteocalcin are the most promising markers
- …
