Navegando por Palavras-chave "doppler"

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    Avaliação do padrão hemodinâmico da artéria oftálmica em gestantes portadoras de fetos com restrição do crescimento
    (Universidade Federal de São Paulo (UNIFESP), 2015-07-31) Melo, Nayana Alves de Brito [UNIFESP]; Nardozza, Luciano Marcondes Machado Nardozza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To assess the Doppler parameters of the ophthalmic artery of pregnant women carrying fetuses with growth restriction (FGR) comparing with normal fetuses. Compare AO Doppler and uterine artery Doppler in FGR group. Methods: A prospective case-control cross-sectional study was conducted on 120 pregnant women between 32 and 40 weeks of gestation; 60 women were carrying FGR and 60 were carrying normal fetuses. FGR diagnosis was based on an estimated fetal weight below the 10th percentile of the Hadlock curve. Ophthalmic artery Doppler images were obtained with a linear transducer, with color Doppler examination of the region medial to the optic nerve. The following indices were obtained: pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), second peak velocity (P2), end diastolic velocity (EDV), and P2 / PSV ratio (RPV). The Mann?Whitney and Student?s t-tests were used to compare the groups with regard to quantitative variables, and the chi-square test was used for categorical variables. In FGR group, 17 showed uterine artery Doppler abnormal and 43 was normal. Results: PI and RI were significantly lower in pregnant women with FGR than in those with normal fetuses, with p <0.001 in both indices. P2 and EDV were significantly higher in pregnant women with FGR than in those with normal fetuses (p=0.002 and p=0.004, respectively). RPV was significantly higher in the FGR group than in the control group (p<0.001). In FGR subgroups, with and without uterine artery abnormality, no significant change was observed in AO Doppler between the groups. Conclusion: In the third trimester of pregnancy, we observed significant differences in the ophthalmic artery Doppler parameters of pregnant women with FGR compared with those with normal fetuses.
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    Avaliação do volume de estruturas cranianas por meio da ultrassonografia tridimensional em fetos com restrição do crescimento
    (Universidade Federal de São Paulo (UNIFESP), 2015-04-30) Caetano, Ana Carolina Rabachini [UNIFESP]; Nardozza, Luciano Marcondes Machado Nardozza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To assess the Doppler parameters of the ophthalmic artery of pregnant women carrying fetuses with growth restriction (FGR) comparing with normal fetuses. Compare AO Doppler and uterine artery Doppler in FGR group. Methods: A prospective case-control cross-sectional study was conducted on 120 pregnant women between 32 and 40 weeks of gestation; 60 women were carrying FGR and 60 were carrying normal fetuses. FGR diagnosis was based on an estimated fetal weight below the 10th percentile of the Hadlock curve. Ophthalmic artery Doppler images were obtained with a linear transducer, with color Doppler examination of the region medial to the optic nerve. The following indices were obtained: pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), second peak velocity (P2), end diastolic velocity (EDV), and P2 / PSV ratio (RPV). The Mann?Whitney and Student?s t-tests were used to compare the groups with regard to quantitative variables, and the chi-square test was used for categorical variables. In FGR group, 17 showed uterine artery Doppler abnormal and 43 was normal. Results: PI and RI were significantly lower in pregnant women with FGR than in those with normal fetuses, with p <0.001 in both indices. P2 and EDV were significantly higher in pregnant women with FGR than in those with normal fetuses (p=0.002 and p=0.004, respectively). RPV was significantly higher in the FGR group than in the control group (p<0.001). In FGR subgroups, with and without uterine artery abnormality, no significant change was observed in AO Doppler between the groups. Conclusion: In the third trimester of pregnancy, we observed significant differences in the ophthalmic artery Doppler parameters of pregnant women with FGR compared with those with normal fetuses.
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    Patients with sickle cell disease are frequently excluded from the benefits of transcranial doppler screening for the risk of stroke despite extensive and compelling evidence
    (Assoc Arquivos Neuro- Psiquiatria, 2017) Rodrigues, Daniela Laranja Gomes [UNIFESP]; Adegoke, Samuel Ademola [UNIFESP]; Campos, Rejane de Souza Macedo [UNIFESP]; Braga, Josefina Aparecida Pellegrini [UNIFESP]; Figueiredo, Maria Stella [UNIFESP]; Silva, Gisele Sampaio [UNIFESP]
    Transcranial doppler (TCD) is a strategic component of primary stroke prevention in children with sickle cell disease (SCD). This study was conducted to examine the TCD characteristics of children with SCD in nine different medical centers in Brazil. Methods: Transcranial doppler was performed in accordance with the Stroke Prevention Trial in Sickle Cell Anemia Protocol. Results: Of the 396 patients, 69.5% had homozygous SS hemoglobin. The TCD result was abnormal in 4.8%, conditional in 12.6%, inadequate in 4.3% and abnormally low in 1% of patients. The highest mean flow velocities were 121 +/- 23.83cm/s and 124 +/- 27.21cm/s in the left and right middle cerebral artery respectively. A total of 28.8% patients (mean age 9.19 +/- 5.92 years) were evaluated with TCD for the first time. Conclusions: The SCD patients were evaluated with TCD at an older age, representing an important missed opportunity for stroke prevention. Since TCD screening in patients with SCD is important to detect those at high risk for stroke, it is recommended that this screening should be made more readily available.
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    Predição da pré-eclâmpsia pela dopplervelocimetria das artérias uterinas e pelos biomarcadores papp-a e plgf, entre 11 e 14 semanas de gestação
    (Universidade Federal de São Paulo (UNIFESP), 2015-11-27) Lobo, Guilherme Antonio Rago [UNIFESP]; Pares, David Baptista da Silva Pares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: 1) To examine predictive value of uterine artery doppler, PAPP-A and PLGF, between 11-14 weeks gestation, in the prediction of preeclampsia (PE). 2) To validate first trimester FMF algorithm which combines maternal characteristics, mean arterial pressure (MAP), uterine artery doppler and biochemical markers in a Brazilian population. Method: Prospective observational study. 701 patients were recruited by the time of 11-14 weeks anomaly scan. 617 pregnant women comprised final sample (84 were excluded). In all of them demographic characteristics were recorded, MAP and mean pulsatility index (PI) obtained and PAPP-A and PLGF measured. Biophysical and biochemical markers were converted into MoM. All data was inserted on FMF software in order to calculate PE risk for each participant. Groups were formed on the basis of gestational age at delivery. Group 1 (n=7); delivery before 34 weeks. Group 2 (n=18); delivery before 37 weeks (includes group 1 patients plus delivery between 34-37 weeks). Group 3 (n=34); delivery before 42 weeks (includes group 2 patients plus delivery after 37 weeks). Control group (no PE / no GH) was composed by 517 women. Results: Mean PI MoM, PAPP-A MoM and PLGF MoM isolated performed equally in group 1 achieving a detection rate (DR) of 28,6%, for a 10% false positive rate (FPR). Markers performance in group 2 was 22,2%, 16,7% and 38,9%, respectively (10% FPR). Markers performance in group 3 was 20,6%, 11,8% and 26,5%, respectively (10% FPR). Combination markers that yelded highest area under the curve (AUC) for group 1 was mean PI MoM + PAPP-A MoM (AUC = 0,757) with a DR of 42,9% for 10% FPR. The combination of mean PI MoM + PAPP-A MoM + PLGF MoM had the best performance in group 2 and 3 (AUC = 0,711 and 0,682, respectively) with a DR of 38,9% and 35,3%, respectively, for 10% FPR. Detection rate achieved by FMF algorithm was 85,7%, 66,7% and 52,9% for groups 1,2 and 3, respectively, for a 10% FPR. Conclusion: First trimester mean PI, PAPP-A and PLGF performs poorly both isolated or in combination in the prediction of PE. FMF algorithm performance is quite good, particularly for the early onset subtype, comparable to the one obtained in the reference population.
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    Preserved flow-mediated dilation but delayed time-to-peak diameter in individuals with metabolic syndrome
    (Wiley-Blackwell, 2014-07-01) Fernandes, Igor A.; Sales, Allan R. K.; Rocha, Natalia G.; Silva, Bruno M. [UNIFESP]; Vianna, Lauro C.; Nobrega, Antonio C. L. da; Universidade Federal Fluminense (UFF); Universidade Federal de São Paulo (UNIFESP)
    Introduction: Inconsistent evidences of the metabolic syndrome (MetS) impact on vascular reactivity raise questions on flow-mediated dilation (FMD) discriminatory power for disturbances induced by this clustering of risk factors. Previous reports, however, suggest that covariates such as the follow-up of the artery diameter changes, the arterial size and shear stress affect FMD responses and consequently its discriminatory power for distinctive clinical profiles.Objective: To determine the impact of MetS on traditional, arterial size-and shear-rate-adjusted FMD, the follow-up-derived time-to-peak diameter (TP), as well as their power for discriminating subjects with this clustering of risk factors from a sample of healthy individuals.Methods: Twenty-one MetS and ten healthy subjects underwent an assessment of endothelial function via FMD.Results: Traditional and allometrically scaled FMD did not differ between groups (P>0.05) as well as the approach in which the covariate was the peak diameter shear rate. in the existence of MetS, TP was longer (67.7 +/- 16.4 s versus healthy 42.1 +/- 16.3 s, P = 0.001). ROC curve analysis indicated that TP (AUC = 0.871 [95% CI, 0.718-1.000]) had greater power of discrimination for MetS than FMD approaches. in addition, TP presented a moderate and significant association with sE-selectin (r = 0.458, P = 0.048).Conclusion: Time-to-peak diameter (TP) rather than FMD distinguished MetS from a healthy profile. Therefore, at least in subjects with MetS, TP may provide insights into the impact of this clustering of risk factors on the vascular phenotype.
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    Valor preditivo do resultado fetal da dopplervelocimetria de ducto venoso entre a 11ª e a 14ª semanas de gestação
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2008-01-01) Gollo, Carlos Alberto; Murta, Carlos Geraldo Viana; Bussamra, Luiz Cláudio [UNIFESP]; Santana, Renato Martins [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal do Espírito Santo; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: to study the value of Doppler velocimetry of the ductus venosus, between the 11th and 14th weeks of pregnancy, associated to the nuchal translucency thickness measurement, in the detection of adverse fetal outcome. METHODS: a transversal and prospective study in which a total of 1,268 fetuses were studied consecutively. In 56 cases, a cytogenetic study was performed on material obtained from a biopsy of the chorionic villus and, in 1,181 cases, the postnatal phenotype was used as a basis for the result. In addition to the routine ultrasonographic examination, all the fetuses were submitted to measurement of the nuchal translucency thickness and to Doppler velocimetry of the ductus venosus. Aiming at prevalence and accuracy indices, sensitivity, specificity, positive predictive value, negative predictive value, probability of false-positive, probability of false-negative, reason of positive probability and reason of negative probability were calculated and analyzed. RESULTS: from the total of 1,268 fetuses, 1,183 cases were selected for analysis. From this number, 1,170 fetuses were normal (98.9%) and 13 fetuses presented adverse outcome at birth (1.1%), including fetal death (trisomy 21 and 22) in two cases; genetic syndrome (Nooman) in one case; two cases of polymalformed fetuses; cardiopathy in three cases; and other structural defects in five cases. The prevalence of the modified ductus venosus (wave A zero/reverse) in the studied population was of 14 cases (1.2%), with a false-positive rate of 0.7%. CONCLUSIONS: there is a significant correlation between the alteration of the ductus venosus Doppler velocimetry and the thickness of the nuchal translucency as an ultrasonographic marker for the first trimester of gestation, in the detection of adverse fetal outcome, especially serious malformations. The ductus venosus was able to diminish the false-positive result in comparison to the isolated use of the nuchal translucency thickness, improving considerably the positive predictive value of the test.