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[PMID]:29505539
[Au] Autor:Kim HH; Choi SC; Chae MK; Min YG
[Ad] Endereço:Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
[Ti] Título:Neuroprotective effect of ethanol in acute carbon monoxide intoxication: A retrospective study.
[So] Source:Medicine (Baltimore);97(1):e9569, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In acute carbon monoxide (CO) intoxication, treatment of neurologic injury and prevention of neurological sequelae are primary concerns. Ethanol is the one of the frequent substances which is co-ingested in intentional CO poisoning. Neuroprotective effect of ethanol was highlighted and demonstrated in isolated brain injury recently. We assessed the neuroprotective effect of ethanol in acute CO intoxication using magnetic resonance imaging (MRI).We retrospectively reviewed medical records for patients who visited an emergency medical center of a university-affiliated hospital during a period of 73 months, from March 2009 to April 2015. Enrolled patients were divided into 2 groups, patients with or without abnormal brain lesion in brain MRI. Multivariate logistic regression analysis was performed to assess the factors associated with brain injury in MRI.A total of 109 patients with acute CO intoxication were evaluated of which 66 (60.55%) tested positive in brain MRI. MRI lesion-positive patients were more likely to have electrocardiogram change, elevation of serum troponin I and s100 protein level and lower serum ethanol level. Serum ethanol positivity was an independent factor for prevalence of brain injury in MRI in acute CO poisoning.This study revealed that ethanol which is co-ingested in acute CO intoxication may work the neuroprotective effect and could consequence more favorable neurological outcome in acute CO intoxication.
[Mh] Termos MeSH primário: Lesões Encefálicas/etiologia
Encéfalo/efeitos dos fármacos
Intoxicação por Monóxido de Carbono/complicações
Depressores do Sistema Nervoso Central/farmacologia
Etanol/farmacologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Encéfalo/diagnóstico por imagem
Lesões Encefálicas/sangue
Lesões Encefálicas/diagnóstico por imagem
Lesões Encefálicas/prevenção & controle
Intoxicação por Monóxido de Carbono/sangue
Intoxicação por Monóxido de Carbono/diagnóstico por imagem
Depressores do Sistema Nervoso Central/sangue
Etanol/sangue
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Central Nervous System Depressants); 3K9958V90M (Ethanol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009569


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[PMID]:29237531
[Au] Autor:Yue Y; Qu Y; Mu DZ
[Ad] Endereço:Department of Pediatrics, West China Second Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China. mudz@scu.edu.cn.
[Ti] Título:[Research advances in mesenchymal stem cell-derived exosomes in treatment of brain injury].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1285-1290, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Mesenchymal stem cell (MSC) transplantation is considered one of the most promising therapeutic strategies for the repair of brain injuries and plays an important role in various links of nerve repair. Recent studies have shown that MSC-derived exosomes may dominate the repair of brain injuries and help to promote angiogenesis, regulate immunity, inhibit apoptosis, and repair the nerves, and therefore, they have a great potential in the treatment of brain injuries in neonates. With reference to these studies, this article reviews the mechanism of action of exosomes in the repair of brain injuries and related prospects and challenges, in order to provide new directions for the treatment of brain injuries in neonates with stem cells.
[Mh] Termos MeSH primário: Lesões Encefálicas/terapia
Exossomos/fisiologia
Transplante de Células-Tronco Mesenquimais
[Mh] Termos MeSH secundário: Apoptose
Seres Humanos
Inflamação/prevenção & controle
Neovascularização Fisiológica
Linfócitos T/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:29237520
[Au] Autor:Mao J
[Ad] Endereço:Neonatologist Society, Chinese Medical Doctor Association.
[Ti] Título:[Patterns of brain injury in neonatal hypoxic-ischemic encephalopathy on magnetic resonance imaging: recommendations on classification].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1225-1233, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Although there are unified criteria for the clinical diagnosis and grading of neonatal hypoxic-ischemic encephalopathy (HIE), clinical features and neuropathological patterns vary considerably among the neonates with HIE due to birth asphyxia in the same classification. The patterns and progression of brain injury in HIE, which is closely associated with long-term neurodevelopment outcomes, can be well shown on magnetic resonance imaging (MRI), but different sequences may lead to different MRI findings at the same time. It is suggested that diffusion-weighted imaging sequence be selected at 2-4 days after birth, and the conventional MRI sequence at 4-8 days. The major patterns of brain injury in HIE on MRI are as follows: injury of the thalamus and basal ganglia and posterior limbs of the internal capsules; watershed injury involving the cortical and subcortical white matter; focal or multifocal minimal white matter injury; extensive whole brain injury. Severe acute birth asphyxia often leads to deep grey matter injury (thalamus and basal ganglia), and the brain stem may also be involved; the pyramidal tract is the most susceptible white matter fiber tract; repetitive or intermittent hypoxic-ischemic insults, with inflammation or hypoglycemia, usually cause injuries in the watershed area and deep white matter. It is worth noting that sometimes the pattern of brain injury among those described above cannot be determined exactly, but rather a predominant one is identified; not all cases of HIE have characteristic MRI findings.
[Mh] Termos MeSH primário: Lesões Encefálicas/classificação
Encéfalo/diagnóstico por imagem
Hipóxia-Isquemia Encefálica/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Lesões Encefálicas/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética/métodos
Seres Humanos
Recém-Nascido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:28749699
[Au] Autor:Herrington L; Alarifi S; Jones R
[Ad] Endereço:Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK.
[Ti] Título:Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction.
[So] Source:Am J Sports Med;45(12):2812-2816, 2017 Oct.
[Is] ISSN:1552-3365
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patellofemoral joint pain and degeneration are common in patients who undergo anterior cruciate ligament reconstruction (ACLR). The presence of patellofemoral joint pain significantly affects the patient's ability to continue sport participation and may even affect participation in activities of daily living. The mechanisms behind patellofemoral joint pain and degeneration are unclear, but previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear whether this process occurs after ACLR. PURPOSE: To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to the noninjured knee and matched control knees. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-four elite sports practitioners who had undergone ACLR and 34 age- and sex-matched controls participated in the study. The participants' running gait was assessed via 3D motion capture, and knee loads and forces were calculated by use of inverse dynamics. RESULTS: A significance difference was found in knee extensor moment, knee flexion angles, patellofemoral contact force (about 23% greater), and patellofemoral contact pressure (about 27% greater) between the ACLR and the noninjured limb ( P ≤ .04) and between the ACLR and the control limb ( P ≤ .04); no significant differences were found between the noninjured and control limbs ( P ≥ .44). CONCLUSION: Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared with the noninjured and control knees. CLINICAL RELEVANCE: Altered levels of patellofemoral stress in the ACLR knee during running may predispose individuals to patellofemoral joint pain.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/fisiopatologia
Lesões do Ligamento Cruzado Anterior/cirurgia
Reconstrução do Ligamento Cruzado Anterior
Artralgia/fisiopatologia
Articulação Patelofemoral/fisiopatologia
Volta ao Esporte
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Fenômenos Biomecânicos
Feminino
Marcha/fisiologia
Seres Humanos
Masculino
Articulação Patelofemoral/fisiologia
Corrida/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1177/0363546517716632


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[PMID]:28744672
[Au] Autor:Jayaraman MV; McTaggart RA; Goyal M
[Ad] Endereço:Department of Diagnostic Imaging, Warren Alpert School of Medicine at Brown University, Rhode Island Hospital, 593 Eddy Street, Room 377, Providence, RI, 02903, USA. mahesh.jayaraman@gmail.com.
[Ti] Título:Unresolved Issues in Thrombectomy.
[So] Source:Curr Neurol Neurosci Rep;17(9):69, 2017 Sep.
[Is] ISSN:1534-6293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: Trials demonstrating marked benefit of mechanical thrombectomy (MT) for acute stroke caused by large vessel occlusion (LVO) in the anterior circulation have been the most significant advance in acute ischemic stroke in the past 20 years. However, despite this marked advance, there are still many hurdles to improving access to thrombectomy worldwide. Additionally, despite these advances, a substantial portion of patients with LVO still are left disabled. RECENT FINDINGS: The major randomized trials focused on patients within 6 h from symptom onset, with occlusion of the ICA or proximal MCA, small amount of permanently damaged brain, and a moderate to large clinical deficit. We will explore the role of thrombectomy outside of these areas, but also explore larger issues as they pertain to re-organization of stroke systems of care to improve access to this remarkable therapy. Now that we have proven, without a shadow of doubt, that rapid revascularization with mechanical thrombectomy improves outcomes in LVO stroke, we must reorganize our systems of care to improve access and assess the role for MT outside of the patients who meet trial criteria.
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/normas
Trombólise Mecânica/normas
Acidente Vascular Cerebral/terapia
Tempo para o Tratamento/normas
[Mh] Termos MeSH secundário: Lesões Encefálicas/diagnóstico
Lesões Encefálicas/terapia
Serviços Médicos de Emergência/métodos
Seres Humanos
Trombólise Mecânica/métodos
Acidente Vascular Cerebral/diagnóstico
Trombectomia/métodos
Trombectomia/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s11910-017-0776-4


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[PMID]:29351558
[Au] Autor:Costa LA; Foni NO; Antonioli E; Teixeira de Carvalho R; Paião ID; Lenza M; Ferretti M
[Ad] Endereço:Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
[Ti] Título:Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register.
[So] Source:PLoS One;13(1):e0191414, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aims of this study are to describe the epidemiological characteristics of anterior cruciate ligament reconstructions in a private hospital in Brazil and to determine trends in medical practice for comparison with previous studies. METHODS: We retrospectively reviewed the anterior cruciate ligament institutional register to obtain data from all patients who underwent primary anterior cruciate ligament reconstruction from July 2014 to June 2016. Descriptive statistics were used to summarize the sample. Specific statistical tests were used to assess associations between the meniscal lesion and other variables. RESULTS: During the study period, 72.6% out of 500 patients were male. The mean age at surgery was 35.1 years. The mean age was higher among females than among males (37.3 ± 12.1 vs 34.3 ± 10.8 years). The median time from injury to surgery was 44 days. The most common femoral and tibial fixations used were suspensory fixation (60.8%) and interference screw (96%), respectively. The most commonly used graft was hamstring tendon (70.2%), followed by bone-patellar tendon-bone (28.8%). A meniscal lesion was noted in 44.8% of cases. Partial meniscectomy was performed in 69.5% of meniscal lesions, and meniscal repair was performed in 14.1% of lesions. The mean length of hospital stay was 1.4 days. The proportion of men in the group of patients with an associated meniscal lesion was higher than that in the group of patients without a meniscal lesion (p = 0.007). CONCLUSIONS: In this study, we identified that the vast majority of surgeries were performed in male patients in all age groups, and patients older than 30 years and with a short time from injury to surgery predominated. Concerning surgical technique, we noted a low rate of meniscal repair and a higher preference for the use of hamstring graft and suspensory fixation on the femoral side.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/cirurgia
Reconstrução do Ligamento Cruzado Anterior
[Mh] Termos MeSH secundário: Adulto
Reconstrução do Ligamento Cruzado Anterior/métodos
Reconstrução do Ligamento Cruzado Anterior/estatística & dados numéricos
Brasil
Feminino
Seres Humanos
Masculino
Meia-Idade
Sistema de Registros
Estudos Retrospectivos
Fatores Sexuais
Lesões do Menisco Tibial/cirurgia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191414


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[PMID]:27778377
[Au] Autor:Kyyriäinen J; Ekolle Ndode-Ekane X; Pitkänen A
[Ad] Endereço:Department of Neurobiology, A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland.
[Ti] Título:Dynamics of PDGFRß expression in different cell types after brain injury.
[So] Source:Glia;65(2):322-341, 2017 02.
[Is] ISSN:1098-1136
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Platelet-derived growth factor receptor ß (PDGFRß) is upregulated after brain injury and its depletion results in the blood-brain barrier (BBB) damage. We investigated the time-window and localization of PDGFRß expression in mice with intrahippocampal kainic acid-induced status epilepticus (SE) and in rats with lateral fluid-percussion-induced traumatic brain injury (TBI). Tissue immunohistochemistry was evaluated at several time-points after SE and TBI. The distribution of PDGFRß was analyzed, and its cell type-specific expression was verified with double/triple-labeling of astrocytes (GFAP), NG2 cells, and endothelial cells (RECA-1). In normal mouse hippocampus, we found evenly distributed PDGFRß+ parenchymal cells. In double-labeling, all NG2+ and 40%-60% GFAP+ cells were PDGFRß+. After SE, PDGFRß+ cells clustered in the ipsilateral hilus (178% of that in controls at fourth day, 225% at seventh day, P < 0.05) and in CA3 (201% at seventh day, P < 0.05), but the total number of PDGFRß+ cells was not altered. As in controls, PDGFRß-immunoreactivity was detected in parenchymal NG2+ and GFAP+ cells. We also observed PDGFRß+ structural pericytes, detached reactive pericytes, and endothelial cells. After TBI, PDGFRß+ cells clustered in the perilesional cortex and thalamus, particularly during the first post-injury week. PDGFRß immunopositivity was observed in NG2+ and GFAP+ cells, structural pericytes, detached reactive pericytes, and endothelial cells. In some animals, PDGFRß vascular staining was observed around the cortical glial scar for up to 3 months. Our data revealed an acute accumulation of PDGFRß+ BBB-related cells in degenerating brain areas, which can be long lasting, suggesting an active role for PDGFRß-signaling in blood vessel and post-injury tissue recovery. GLIA 2017;65:322-341.
[Mh] Termos MeSH primário: Astrócitos/classificação
Astrócitos/metabolismo
Lesões Encefálicas/patologia
Células Endoteliais/metabolismo
Molécula-1 de Adesão Celular Endotelial de Plaquetas/metabolismo
Receptor alfa de Fator de Crescimento Derivado de Plaquetas/metabolismo
[Mh] Termos MeSH secundário: Animais
Antígenos/metabolismo
Modelos Animais de Doenças
Proteína Glial Fibrilar Ácida/metabolismo
Proteínas de Fluorescência Verde/genética
Proteínas de Fluorescência Verde/metabolismo
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Camundongos Transgênicos
Pericitos/metabolismo
Pericitos/patologia
Proteoglicanas/metabolismo
Ratos
Ratos Sprague-Dawley
Receptor alfa de Fator de Crescimento Derivado de Plaquetas/genética
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antigens); 0 (Glial Fibrillary Acidic Protein); 0 (Platelet Endothelial Cell Adhesion Molecule-1); 0 (Proteoglycans); 0 (chondroitin sulfate proteoglycan 4); 147336-22-9 (Green Fluorescent Proteins); EC 2.7.10.1 (Receptor, Platelet-Derived Growth Factor alpha)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1002/glia.23094


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[PMID]:29244046
[Au] Autor:O'Reilly K
[Ad] Endereço:Western Sydney University, Sydney, Australia.
[Ti] Título:Humor-A Rehabilitative Tool in the Post-Intensive Care of Young Adults With Acquired Brain Injury.
[So] Source:Rehabil Nurs;42(4):230-234, 2017 Jul/Aug.
[Is] ISSN:2048-7940
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of the study was to describe how paid carers use humor in providing compassionate post-intensive rehabilitation care to young adults with acquired brain injury (ABI) who are unable to perform or direct their own care. DESIGN: This is a qualitative study underpinned by symbolic interactionism. METHODS: Paid carers in a residential aged care facility were interviewed. Interview data were analyzed using grounded theory methods of coding, comparative analysis, memoing, and theoretical sampling. FINDINGS: With young adult's assent, paid carers appropriately used humor, at times even crude humor, as a rehabilitative tool to activate and elicit responses from young people with ABI who could not perform or direct their own care. The use of humor while caring for this population demonstrated that compassion still exists within nursing; however, it may not always be reverent. CONCLUSIONS/CLINICAL RELEVANCE: Humor may be an effective way to provide compassionate care and can be used as a rehabilitative tool to elicit responses from young people with ABI who have no means of verbal communication.
[Mh] Termos MeSH primário: Lesões Encefálicas/reabilitação
Enfermagem em Reabilitação/métodos
Senso de Humor e Humor como Assunto/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Lesões Encefálicas/enfermagem
Empatia
Feminino
Teoria Fundamentada
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Masculino
Meia-Idade
Pesquisa Qualitativa
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE
[do] DOI:10.1097/rnj.0000000000000015


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[PMID]:27775164
[Au] Autor:Wilson HJ; Dasgupta K; Michael K
[Ti] Título:Implementation of the Agitated Behavior Scale in the Electronic Health Record.
[So] Source:Rehabil Nurs;43(1):21-25, 2018 Jan/Feb.
[Is] ISSN:2048-7940
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of the study was to implement an Agitated Behavior Scale through an electronic health record and to evaluate the usability of the scale in a brain injury unit at a rehabilitation hospital. DESIGN: A quality improvement project was conducted in the brain injury unit at a large rehabilitation hospital with registered nurses as participants using convenience sampling. METHODS: The project consisted of three phases and included education, implementation of the scale in the electronic health record, and administration of the survey questionnaire, which utilized the system usability scale. FINDINGS: The Agitated Behavior Scale was found to be usable, and there was 92.2% compliance with the use of the electronic Electronic Agitated Behavior Scale. CONCLUSION: The Agitated Behavior Scale was effectively implemented in the electronic health record and was found to be usable in the assessment of agitation. CLINICAL RELEVANCE: Utilization of the scale through the electronic health record on a daily basis will allow for an early identification of agitation in patients with traumatic brain injury and enable prompt interventions to manage agitation.
[Mh] Termos MeSH primário: Escala de Avaliação Comportamental
Registros Eletrônicos de Saúde/tendências
Agitação Psicomotora/psicologia
[Mh] Termos MeSH secundário: Adulto
Lesões Encefálicas/complicações
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Melhoria de Qualidade
Enfermagem em Reabilitação/métodos
Enfermagem em Reabilitação/tendências
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1002/rnj.297


  10 / 55863 MEDLINE  
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[PMID]:28464913
[Au] Autor:Nakabuye B; Bahendeka S; Byaruhanga R
[Ad] Endereço:Department Obstetrics and Gynaecology, St. Francis Hospital Nsambya, P.O.Box 7146, Kampala, Uganda. lizanakabuye@yahoo.com.
[Ti] Título:Prevalence of hyperglycaemia first detected during pregnancy and subsequent obstetric outcomes at St. Francis Hospital Nsambya.
[So] Source:BMC Res Notes;10(1):174, 2017 May 02.
[Is] ISSN:1756-0500
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Women with hyperglycaemia detected during pregnancy are at greater risk for adverse pregnancy outcomes. Data on hyperglycaemia in pregnancy in sub-Saharan Africa is scanty and varied depending on the populations studied and the methodologies used to define hyperglycaemia in pregnancy. With the recent 2013 World Health Organisation (WHO) diagnostic criteria and classification, there is yet no sufficient data on the prevalence of hyperglycaemia in sub-Saharan Africa. The objective was to determine the prevalence of Hyperglycaemia first detected during pregnancy and subsequent obstetric outcomes among patients attending antenatal care (ANC) at St. Francis Hospital Nsambya. METHODS: A prospective cohort study. All women with no history of diabetes mellitus attending at or after 24 weeks gestation were eligible to participate in the study. Participants underwent a standard 75 g oral glucose tolerance test (OGTT) after an informed written consent. The primary outcome was diagnosis of hyperglycaemia. Enrolled participants were followed up to delivery to assess obstetric outcomes (secondary outcomes were birth weight, neonatal admission, maternal genital trauma, delivery mode, neonatal and maternal status at discharge). RESULTS: 251 women were screened between December 2013 and February 2014. The prevalence of hyperglycaemia first detected in pregnancy was 31.9%. We found 23.8 % of women with hyperglycaemia had no known risk factor. Macrosomia was the only obstetric outcome that was significantly associated with hyperglycaemia. CONCLUSION: The prevalence of hyperglycaemia first detected in pregnancy was high in the studied population. Clinicians, therefore, should become more vigilant to screen for the condition. Selective screening may miss 23.8% of pregnant women with hyperglycaemia. However the cost/benefit implications of screening strategy and the recent 2013 WHO diagnostic criteria need to be studied in our setting.
[Mh] Termos MeSH primário: Diabetes Gestacional/epidemiologia
Macrossomia Fetal/epidemiologia
Hiperglicemia/epidemiologia
Lacerações/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Diabetes Gestacional/sangue
Feminino
Macrossomia Fetal/sangue
Genitália Feminina/lesões
Teste de Tolerância a Glucose
Seres Humanos
Hiperglicemia/sangue
Nascimento Vivo/epidemiologia
Gravidez
Cuidado Pré-Natal
Diagnóstico Pré-Natal/estatística & dados numéricos
Prevalência
Estudos Prospectivos
Natimorto/epidemiologia
Uganda/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s13104-017-2493-0



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