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[PMID]:29362796
[Au] Autor:Bouillon K; Bertrand M; Bader G; Lucot JP; Dray-Spira R; Zureik M
[Ad] Endereço:Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), Saint-Denis, France.
[Ti] Título:Association of Hysteroscopic vs Laparoscopic Sterilization With Procedural, Gynecological, and Medical Outcomes.
[So] Source:JAMA;319(4):375-387, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Safety of hysteroscopic sterilization has been recently questioned following reports of general symptoms such as allergy, tiredness, and depression in addition to associated gynecological results such as pelvic pain, perforation of fallopian tubes or uterus, and unwanted pregnancy. Objective: To compare the risk of reported adverse events between hysteroscopic and laparoscopic sterilization. Design, Setting, and Participants: French nationwide cohort study using the national hospital discharge database linked to the health insurance claims database. Women aged 30 to 54 years receiving a first hysteroscopic or laparoscopic sterilization between 2010 and 2014 were included and were followed up through December 2015. Exposures: Hysteroscopic sterilization vs laparoscopic sterilization. Main Outcomes and Measures: Risks of procedural complications (surgical and medical) and of gynecological (sterilization failure that includes salpingectomy, second sterilization procedure, or pregnancy; pregnancy; reoperation) and medical outcomes (all types of allergy; autoimmune diseases; thyroid disorder; use of analgesics, antimigraines, antidepressants, benzodiazepines; outpatient visits; sickness absence; suicide attempts; death) that occurred within 1 and 3 years after sterilization were compared using inverse probability of treatment-weighted Cox models. Results: Of the 105 357 women included (95.5% of eligible participants; mean age, 41.3 years [SD, 3.7 years]), 71 303 (67.7% ) underwent hysteroscopic sterilization, and 34 054 (32.3%) underwent laparoscopic sterilization. During the hospitalization for sterilization, risk of surgical complications for hysteroscopic sterilization was lower: 0.13% for hysteroscopic sterilization vs 0.78% for laparoscopic sterilization (adjusted risk difference [RD], -0.64; 95% CI, -0.67 to -0.60) and was lower for medical complications: 0.06% vs 0.11% (adjusted RD, -0.05; 95% CI, -0.08 to -0.01). During the first year after sterilization, 4.83% of women who underwent hysteroscopic sterilization had a higher risk of sterilization failure than the 0.69% who underwent laparoscopic sterilization (adjusted hazard ratio [HR], 7.11; 95% CI, 5.92 to 8.54; adjusted RD, 4.23 per 100 person-years; 95% CI, 3.40 to 5.22). Additionally, 5.65% of women who underwent hysteroscopic sterilization required gynecological reoperation vs 1.76% of women who underwent laparoscopic sterilization (adjusted HR, 3.26; 95% CI, 2.90 to 3.67; adjusted RD, 4.63 per 100 person-years; 95% CI, 3.38 to 4.75); these differences persisted after 3 years, although attenuated. Hysteroscopic sterilization was associated with a lower risk of pregnancy within the first year of the procedure but was not significantly associated with a difference in risk of pregnancy by the third year (adjusted HR, 1.04; 95% CI, 0.83-1.30; adjusted RD, 0.01 per 100 person-years; 95% CI, -0.04 to 0.07). Risks of medical outcomes were not significantly increased with hysteroscopic sterilization compared with laparoscopic sterilization. Conclusions and Relevance: Among women undergoing first sterilization, the use of hysteroscopic sterilization was significantly associated with higher risk of gynecological complications over 1 year and over 3 years than was laparoscopic sterilization. Risk of medical outcomes was not significantly increased over 1 year or over 3 years. These findings do not support increased medical risks associated with hysteroscopic sterilization.
[Mh] Termos MeSH primário: Histeroscopia/efeitos adversos
Laparoscopia/efeitos adversos
Complicações Pós-Operatórias/etiologia
Esterilização Tubária/métodos
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
França
Seres Humanos
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Gravidez
Gravidez não Planejada
Reoperação/estatística & dados numéricos
Esterilização Tubária/efeitos adversos
Falha de Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21269


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[PMID]:27770709
[Au] Autor:Wang B; Chen Q; Shen L; Zhao S; Pang W; Zhang J
[Ad] Endereço:MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
[Ti] Título:Perfluoroalkyl and polyfluoroalkyl substances in cord blood of newborns in Shanghai, China: Implications for risk assessment.
[So] Source:Environ Int;97:7-14, 2016 12.
[Is] ISSN:1873-6750
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are commonly used in industrial applications and consumer products, and their potential health impacts are of concern, especially for vulnerable population like fetuses. However, in utero exposure to PFASs and health implications are far from fully characterized in China. To fill in the gap, we analyzed 10 PFASs in cord plasma samples (N=687) collected in Shanghai between 2011 and 2012, one of the regions widely polluted with PFASs in China. A questionnaire survey on maternal and diet-related factors was conducted. Except for perfluoroheptanoic acid (PFHpA) and perfluorooctane sulfonamide (PFOSA), all other PFASs were detected in ˃90% of the samples. Perfluorooctanoic acid (PFOA) was the most predominant PFAS (median value: 6.96ng/mL), followed by perfluorooctane sulfonate (PFOS) (2.48ng/mL). PFOA and PFOS combined contributed to 80% of the total PFASs. The final multiple regression models showed that maternal factors including maternal age, body mass index, gestational age, economic status and educational level as well as consumption of fish and wheat were significantly related with concentrations of PFASs in cord blood. The risk assessment using the hazard quotients (HQs) approach on the basis of plasma PFAS levels indicated no potential concern for developmental toxicity in the local newborns. The results demonstrate the unique profiles of local prenatal exposure to PFASs, suggesting that PFOA has been the primary human exposure due to its widespread use and pollution. Special attention to high PFOA exposure and confirmation of potential determinants should be taken as a priority in the future plan for risk management and actions in this area.
[Mh] Termos MeSH primário: Poluentes Ambientais/sangue
Sangue Fetal/química
Hidrocarbonetos Fluorados/sangue
[Mh] Termos MeSH secundário: Animais
China
Feminino
Peixes
Alimentos
Seres Humanos
Gravidez
Medição de Risco
Sulfonamidas/sangue
Ácidos Sulfônicos/sangue
Inquéritos e Questionários
Triticum
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Environmental Pollutants); 0 (Hydrocarbons, Fluorinated); 0 (Sulfonamides); 0 (Sulfonic Acids)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


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[PMID]:29505532
[Au] Autor:Li J; Li J; Jiang S; Yu R; Yu Y
[Ad] Endereço:Department of Endocrinology and Metabolism.
[Ti] Título:Case report of a pituitary thyrotropin-secreting macroadenoma with Hashimoto thyroiditis and infertility.
[So] Source:Medicine (Baltimore);97(1):e9546, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Thyrotropin-secreting adenoma (TSHoma) is rare, diagnosis and treatment are often delayed if the condition coexists with Hashimoto thyroiditis. The enlarged pituitary adenoma may eventually induce panhypopituitarism, infertility, or the compression of optic nerves and optic chiasma. PATIENT CONCERNS: This patient was a 36-year-old man who had been referred to the pituitary disease multidisciplinary team (MDT) of the West China Hospital, due to infertility. DIAGNOSES: Examinations revealed pituitary thyrotropin-secreting macroadenoma. INTERVENTIONS: We conducted trans-sphenoidal surgery. Human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) were used for reproductive reconstruction after surgery. OUTCOMES: This patient successfully fathered a child. LESSONS: To date, the multidisciplinary team treatment of TSHoma was rare, TSHomas are often misdiagnosed as macroadenomas, because the clinical features are varied and it often takes a long time to be diagnosed. So the purpose of this case report is to attract attention to the manifestation of increased thyroid stimulating hormone (TSH) concentration and discuss MDT treatment for TSH-secreting adenoma.
[Mh] Termos MeSH primário: Adenoma/complicações
Doença de Hashimoto/complicações
Infertilidade Masculina/etiologia
Neoplasias Hipofisárias/complicações
Tireotropina/secreção
[Mh] Termos MeSH secundário: Adenoma/diagnóstico
Adenoma/secreção
Adenoma/cirurgia
Adulto
Feminino
Seres Humanos
Infertilidade Masculina/terapia
Masculino
Neoplasias Hipofisárias/diagnóstico
Neoplasias Hipofisárias/secreção
Neoplasias Hipofisárias/cirurgia
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
9002-71-5 (Thyrotropin)
[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.0000000000009546


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[PMID]:29474397
[Au] Autor:Cranmer JN; Dettinger J; Calkins K; Kibore M; Gachuno O; Walker D
[Ad] Endereço:Emory University, Atlanta, Georgia, United States of America.
[Ti] Título:Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness.
[So] Source:PLoS One;13(2):e0184252, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. OBJECTIVE-METHOD: We compare emergency readiness using the signal functions model and a novel clinical cascade. The cascades model readiness as the proportion of facilities with resources to identify the emergency (stage 1), treat it (stage 2) and monitor-modify therapy (stage 3). Data were collected from 44 Kenyan clinics as part of an implementation trial. FINDINGS: Although most facilities (77.0%) stock maternal signal function tracer drugs, far fewer have resources to practically identify and treat emergencies. In hypertensive emergencies for example, 38.6% of facilities have resources to identify the emergency (Stage 1 readiness, including sphygmomanometer, stethoscope, urine collection device, protein test). 6.8% have the resources to treat the emergency (Stage 2, consumables (IV Kit, fluids), durable goods (IV pole) and drugs (magnesium sulfate and hydralazine). No facilities could monitor or modify therapy (Stage 3). Across five maternal emergencies, the signal functions overestimate readiness by 54.5%. A consistent, step-wise pattern of readiness loss across signal functions and care stage emerged and was profoundly consistent at 33.0%. SIGNIFICANCE: Comparing estimates from the maternal signal functions and cascades illustrates four themes. First, signal functions overestimate practical readiness by 55%. Second, the cascade's intuitive indicators can support cross-sector health system or program planners to more precisely measure and improve emergency care. Third, adding few variables to existing readiness inventories permits step-wise modeling of readiness loss and can inform more precise interventions. Fourth, the novel aggregate readiness loss indicator provides an innovative and intuitive approach for modeling health system emergency readiness. Additional testing in diverse contexts is warranted.
[Mh] Termos MeSH primário: Parto Obstétrico
Serviços de Saúde Materna/organização & administração
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
Lactente
Mortalidade Infantil
Recém-Nascido
Quênia/epidemiologia
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180224
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184252


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[PMID]:29466360
[Au] Autor:Kaitu'u-Lino TJ; Brownfoot FC; Beard S; Cannon P; Hastie R; Nguyen TV; Binder NK; Tong S; Hannan NJ
[Ad] Endereço:Translational Obstetrics Group, The Department of Obstetrics and Gynaecology, University of Melbourne and Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
[Ti] Título:Combining metformin and esomeprazole is additive in reducing sFlt-1 secretion and decreasing endothelial dysfunction - implications for treating preeclampsia.
[So] Source:PLoS One;13(2):e0188845, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The discovery of new treatments that prevent or treat preeclampsia would be a major advance. Antiangiogenic factors soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sENG) are secreted in excess from the placenta, causing hypertension, endothelial dysfunction, and multiorgan injury. We recently identified metformin and esomeprazole as potential treatments for preeclampsia. Both reduce placental and endothelial secretion of sFlt-1 and soluble endoglin, and reduce endothelial dysfunction. OBJECTIVES: We set out to assess whether combining metformin and esomeprazole would additively reduce sFlt-1 and soluble endoglin secretion and reduce endothelial dysfunction (verses drug alone). Metformin and esomeprazole were added to primary placental cells and tissues, and endothelial cells and their effects on sFlt-1 and soluble endoglin secretion were assessed in vitro. Tumor necrosis factor-α (TNF-α) was added to endothelial cells to induce dysfunction in vitro. We examined the ability of metformin + esomeprazole to rescue TNF-α induced vascular cell adhesion molecule-1 (VCAM-1) and Endothelin-1 (ET-1) expression, leukocyte adhesion (markers of endothelial dysfunction). RESULTS: Combining metformin and esomeprazole was additive at reducing sFlt-1 secretion and expression of sFlt-1 e15a mRNA isoform in primary cytotrophoblast, placental explants and endothelial cells. In contrast, no additive reduction in sENG was observed with combined metformin and esomeprazole. The low-dose combination of metformin + esomeprazole additively reduced TNF-α-induced VCAM-1 mRNA, but not VCAM-1 protein expression. There was no additive reduction when combining metformin and esomeprazole on TNF-α induced PBMC adhesion to endothelial cells. However, combining metformin and esomeprazole additively reduced ET-1 mRNA expression. CONCLUSIONS: In conclusion combining metformin and esomeprazole additively reduced secretion of sFlt-1, and markers of endothelial dysfunction. The combination of metformin and esomeprazole may provide a more effective treatment or prevention for preeclampsia compared to either as single agents.
[Mh] Termos MeSH primário: Endotélio Vascular/efeitos dos fármacos
Esomeprazol/administração & dosagem
Metformina/administração & dosagem
Pré-Eclâmpsia/tratamento farmacológico
Receptor 1 de Fatores de Crescimento do Endotélio Vascular/secreção
[Mh] Termos MeSH secundário: Endotélio Vascular/fisiopatologia
Feminino
Células Endoteliais da Veia Umbilical Humana
Seres Humanos
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
9100L32L2N (Metformin); EC 2.7.10.1 (FLT1 protein, human); EC 2.7.10.1 (Vascular Endothelial Growth Factor Receptor-1); N3PA6559FT (Esomeprazole)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188845


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[PMID]:29462152
[Au] Autor:Treacy L; Bolkan HA; Sagbakken M
[Ad] Endereço:Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
[Ti] Título:Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study.
[So] Source:PLoS One;13(2):e0188280, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sierra Leone has one of the highest maternal mortality ratios in the world. Efforts to reduce maternal mortality have included initiatives to encourage more women to deliver at health facilities. Despite the introduction of the free health care initiative for pregnant women, many women still continue to deliver at home, with few having access to a skilled birth attendant. In addition, inequalities between rural and urban areas in accessing and utilising health facilities persist. Further insight into how and why women make decisions around childbirth will help guide future plans and initiatives in improving maternal health in Sierra Leone. The objective of this study was to explore the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone. METHODS AND FINDINGS: Data were collected through seven focus group discussions and 22 in-depth interviews with recently pregnant women and their community members in two rural villages. Data were analysed using systematic text condensation. Findings revealed that decision-making processes during childbirth are dynamic, intricate and need to be understood within the broader social context that they take place. Factors such as distance and lack of transport, perceived negative behaviour of hospital staff, direct and indirect financial obstacles, as well as the position of women in society all interact and influence how and what decisions are made. CONCLUSIONS: Pregnant women face multiple interacting vulnerabilities that influence their healthcare-seeking decisions during pregnancy and childbirth. Future initiatives to improve access and utilisation of safe healthcare services for pregnant women need to be based on adequate knowledge of structural constraints and health inequities that affect women in rural Sierra Leone.
[Mh] Termos MeSH primário: Tomada de Decisões
Custos de Cuidados de Saúde
Acesso aos Serviços de Saúde
População Rural
[Mh] Termos MeSH secundário: Feminino
Grupos Focais
Seres Humanos
Masculino
Gravidez
Pesquisa Qualitativa
Serra Leoa
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188280


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[PMID]:29447176
[Au] Autor:Svefors P; Selling KE; Shaheen R; Khan AI; Persson LÅ; Lindholm L
[Ad] Endereço:International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
[Ti] Título:Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh.
[So] Source:PLoS One;13(2):e0191260, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Nutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat), with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS) supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality) and unfavourable (increased stunting) outcomes. METHOD: Pregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E) or usual (U) invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 µg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 µg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs), a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality) and years lived with disability (stunting). Incremental cost effectiveness ratios were calculated using cost data from already published studies. RESULTS: By incrementing UFe60 (standard practice) to EMMS, one DALY could be averted at a cost of US$24. CONCLUSION: When both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective.
[Mh] Termos MeSH primário: Transtornos do Crescimento/etiologia
Fenômenos Fisiológicos da Nutrição do Lactente/economia
Micronutrientes/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Bangladesh/epidemiologia
Pré-Escolar
Análise Custo-Benefício/métodos
Suplementos Nutricionais
Feminino
Ácido Fólico
Abastecimento de Alimentos
Transtornos do Crescimento/tratamento farmacológico
Transtornos do Crescimento/mortalidade
Seres Humanos
Lactente
Mortalidade Infantil
Fenômenos Fisiológicos da Nutrição do Lactente/efeitos dos fármacos
Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia
Recém-Nascido
Ferro
Masculino
Micronutrientes/administração & dosagem
Política Nutricional
Gravidez
Cuidado Pré-Natal
Fenômenos Fisiológicos da Nutrição Pré-Natal
Oligoelementos
Vitaminas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Micronutrients); 0 (Trace Elements); 0 (Vitamins); 935E97BOY8 (Folic Acid); E1UOL152H7 (Iron)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191260


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[PMID]:29431328
[Au] Autor:Vokina VA; Sosedova LM; Filippova TM
[Ti] Título:[The study of neurotoxicity of toluene in conditions of experimental modeling of prenatal hypoxic damage of the brain].
[So] Source:Gig Sanit;95(9):895-9, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:There was executed the study of the impact of toluene on indices of behavior, cognitive capabilities and bioelectric activity of the brain in white rats with normal course of the period of antenatal development and against background ofprenatal hemic hypoxia Prenatal hypoxia was modeled in pregnant female rats by subcutaneous injection of sodium nitrite in a dose of 50 mg/kg at from the 10 to the 19 day of gestation. At the age of 3 months the males from the obtained offspring were exposed to inhalation exposure of toluene (150 ppm, 4 weeks). After exposure to toluene in animals there was evaluated the pattern of individual behavior, indices of cognitive capabilities and also bioelectric activity of the brain. There were revealed such common consistencies of transformations in the behavior of exposed to toluene animals with normal and impaired embryogenesis as disturbed motor activity, reduction of exploratory behavior and cognitive functions, impaired bioelectric potentials of the brain. Features of changes in behavior and EEG indices in toluene-exposed rats with prenatal hypoxia are characterized by inhibition of motor activity, increased anxiety and latency of main peaks of auditory and visual evoked potentials. Prenatal hypoxic damage of the central nervous system was shown to be an aggravating factor in toluene intoxication in rats.
[Mh] Termos MeSH primário: Comportamento Animal
Encéfalo
Cognição
Hipóxia-Isquemia Encefálica
Complicações na Gravidez/fisiopatologia
Tolueno/farmacologia
[Mh] Termos MeSH secundário: Animais
Comportamento Animal/efeitos dos fármacos
Comportamento Animal/fisiologia
Encéfalo/efeitos dos fármacos
Encéfalo/fisiopatologia
Mapeamento Encefálico/métodos
Cognição/efeitos dos fármacos
Cognição/fisiologia
Modelos Animais de Doenças
Feminino
Hipóxia-Isquemia Encefálica/complicações
Hipóxia-Isquemia Encefálica/fisiopatologia
Neurotoxinas/farmacologia
Gravidez
Ratos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Neurotoxins); 3FPU23BG52 (Toluene)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE


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[PMID]:29420535
[Au] Autor:Lau Y; Htun TP; Kwong HKD
[Ad] Endereço:Department of Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
[Ti] Título:Sociodemographic, obstetric characteristics, antenatal morbidities, and perinatal depressive symptoms: A three-wave prospective study.
[So] Source:PLoS One;13(2):e0188365, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study aimed (1) to investigate the pattern of perinatal depressive symptoms, and (2) to determine the relationships between sociodemographic characteristics, obstetric factors, antenatal morbidities, postnatal conditions, and perinatal depressive symptoms using a structural equation model (SEM). METHOD: A three-wave prospective longitudinal design was used for 361 women in their second trimester, third trimester, and at six weeks postpartum. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. RESULTS: The intensity of depressive symptoms was the highest in the second trimester among the three waves. The SEM showed that unmarried status, unplanned pregnancy, gestational diabetes, and headache were significantly associated with EPDS in the first and second waves. The EPDS in the first wave was able to predict the EPDS in the second and third waves. The SEM has satisfactorily fit with the data (chi-square/degree of freedom = 1.42, incremental fit index = 0.91, Tucker-Lewis index = 0.90, comparative fit index = 0.91, and root mean square error of approximation = 0.03). CONCLUSION: The findings highlight the significance of monitoring depressive symptoms in the second trimester. Findings from this study could be useful in the design of effective intervention among women with unmarried status, unplanned pregnancy, gestational diabetes, and headache in order to reduce risk of perinatal depressive symptoms.
[Mh] Termos MeSH primário: Demografia
Depressão/complicações
Complicações na Gravidez/diagnóstico
Fatores Socioeconômicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Seres Humanos
Macau
Gravidez
Estudos Prospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188365


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[PMID]:29389995
[Au] Autor:Dalinjong PA; Wang AY; Homer CSE
[Ad] Endereço:Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
[Ti] Título:Has the free maternal health policy eliminated out of pocket payments for maternal health services? Views of women, health providers and insurance managers in Northern Ghana.
[So] Source:PLoS One;13(2):e0184830, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The free maternal health policy was implemented in Ghana in 2008 under the National Health Insurance Scheme (NHIS). The policy sought to eliminate out of pocket (OOP) payments and enhance the utilisation of maternal health services. It is unclear whether the policy had altered OOP payments for services. The study explored views on costs and actual OOP payments during pregnancy. The source of funding for payments was also explored. METHODS: A convergent parallel mixed methods design, involving quantitative and qualitative data collection approaches. The study was set in the Kassena-Nankana municipality, a rural area in Ghana. Women (n = 406) who utilised services during pregnancy were surveyed. Also, 10 focus groups discussions (FGDs) were held with women who used services during pregnancy as well as 28 in-depth interviews (IDIs) with midwives/nurses (n = 25) and insurance managers/directors (n = 3). The survey was analysed using descriptive statistics, focussing on costs from the women's perspective. Qualitative data were audio recorded, transcribed and translated verbatim into English where necessary. The transcripts were read and coded into themes and sub-themes. RESULTS: The NHIS did not cover all expenses in relation to maternal health services. The overall mean for OOP cost during pregnancy was GH¢17.50 (US$8.60). Both FGDs and IDIs showed that women especially paid for drugs and ultrasound scan services. Sixty-five percent of the women used savings, whilst twenty-two percent sold assets to meet the OOP cost. Some women were unable to afford payments due to poverty and had to forgo treatment. Participants called for payments to be eliminated and for the NHIS to absorb the cost of emergency referrals. All participants admitted the benefits of the policy. CONCLUSION: Women needed to make payments despite the policy. Measures should be put in place to eliminate payments to enable all women to receive services and promote universal health coverage.
[Mh] Termos MeSH primário: Pessoal Administrativo/psicologia
Atitude
Financiamento Pessoal
Pessoal de Saúde/psicologia
Serviços de Saúde Materna/economia
Programas Nacionais de Saúde/economia
[Mh] Termos MeSH secundário: Adulto
Antimaláricos/economia
Feminino
Gana
Seres Humanos
Cobertura do Seguro
Gravidez
Inquéritos e Questionários
Ultrassonografia Pré-Natal/economia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antimalarials)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184830



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