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SUMMARY OBJECTIVE: The aim of this study was to evaluate the success rate and predictors of labor induction using vaginal misoprostol in a low-risk pregnant women population. METHODS: A prospective cohort study was carried out with 196 pregnant women. Groups 2 and 4 of the Robson Classification admitted for induction of labor with vaginal misoprostol (25 μg tablets every 6 h, up to 4 tablets, for a maximum of 24 h). The success of labor induction was considered the achievement of vaginal delivery. Binary logistic regression was used to determine the best predictors of successful induction of labor with vaginal misoprostol. RESULTS: Of all the pregnant women analyzed, 140 (71.4%) were successful and 56 (28.6%) were unsuccessful. Pregnant women who achieved successful induction had a higher number of pregnancies (1.69 vs. 1.36, p=0.023), a higher number of deliveries (0.57 vs. 0.19, p<0.001), a higher Bishop score (2.0 vs. 1.38, p=0.002), and lower misoprostol 25 μg tablets (2.18 vs. 2.57, p=0.031). No previous deliveries [x2(1)=3.14, odds ratio (OR): 0.24, 95% confidence interval (CI): 0.10-0.57, R2 Nagelkerke: 0.91, p=0.001] and the presence of one previous delivery [x2(1)=6.0, OR: 3.40, 95% CI: 1.13-10.16, R2 Nagelkerke: 0.043, p=0.029] were significant predictors of successful induction of labor with vaginal misoprostol. CONCLUSION: A high rate of labor induction success using vaginal misoprostol in a low-risk population was observed, mainly in multiparous and with gestational age>41 weeks. No previous delivery decreased the success of labor induction, while one previous delivery increased the success of labor induction.
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Monovalent and divalent cations play a crucial role in living cells and for molecular techniques such as PCR. Here we evaluate DNA melting temperatures in magnesium (Mg2+) and magnesiumpotassium (Mg2++ K+) buffers with a mesoscopic model that allows us to estimate hydrogen bonds and stacking interaction potentials. The Mg2+ and Mg2++ K+ results are compared to previous calculations for sodium ions (Na+), in terms of equivalent sodium concentration and ionic strength. Morse potentials, related to hydrogen bonding, were found to be essentially constant and unaffected by cation conditions. However, for stacking interactions we find a clear dependence with ionic strength and cation valence. The highest ionic strength variations, for both hydrogen bonds and stacking interactions, was found at the sequence terminals. This suggests that end-to-end interactions in DNA will be strongly dependent on cation valence and ionic strength.
Assuntos
DNA , Magnésio , Ligação de Hidrogênio , Cátions , DNA/química , Sódio , Cátions Monovalentes/químicaRESUMO
Mesoscopic models can be used for the description of the thermodynamic properties of RNA duplexes. With the use of experimental melting temperatures, its parametrization can provide important insights into its hydrogen bonds and stacking interactions as has been done for high sodium concentrations. However, the RNA parametrization for lower salt concentrations is still missing due to the limited amount of published melting temperature data. While the Peyrard-Bishop (PB) parametrization was found to be largely independent of strand concentrations, it requires that all temperatures are provided at the same strand concentrations. Here we adapted the PB model to handle multiple strand concentrations and in this way we were able to make use of an experimental set of temperatures to model the hydrogen bond and stacking interactions at low and intermediate sodium concentrations. For the parametrizations we make a distinction between terminal and internal base pairs, and the resulting potentials were qualitatively similar as we obtained previously for DNA. The main difference from DNA parameters, was the Morse potentials at low sodium concentrations for terminal r(AU) which is stronger than d(AT), suggesting higher hydrogen bond strength.
Assuntos
Modelos Químicos , RNA/química , Cloreto de Sódio/química , Ligação de Hidrogênio , Sais/química , TermodinâmicaRESUMO
RESUMEN OBJETIVO: Comparar la longitud cervical con el puntaje de Bishop en la predicción de parto pretérmino inminente en pacientes sintomáticas. MÉTODOS: Se seleccionaron mujeres con embarazos simples de 24 - 35 semanas, con amenaza de parto pretérmino y membranas integras. Antes del inicio de cualquier tratamiento, todas fueron sometidas a examen digital del cuello uterino y determinación ecográfica transvaginal de la longitud cervical. La principal variable de estudio fue la frecuencia de parto inminente (en los 7 días siguientes a la evaluación). Se evaluaron las características generales, puntaje de Bishop y valores de la longitud cervical RESULTADOS: Fueron seleccionadas 481 mujeres, 119 participantes presentaron parto pretérmino inminente (grupo A) y 362 pacientes presentaron partos más allá de los 7 días (grupo B). El intervalo entre la evaluación y el parto fue de 4,3 +/- 1,6 días en el grupo A y 56,3 +/- 27,2 días en el grupo B (p < 0,0001). Las pacientes del grupo A tenían valores más bajos de longitud cervical comparado con las pacientes del grupo B (p < 0,0001). Este grupo también presentó valores más elevados de puntaje de Bishop (p < 0,0001). La longitud cervical tenía un área bajo la curva mayor para la predicción (0,972, intervalo de confianza 95%, 0,772 - 1,000) comparado con el puntaje de Bisho (0,825, intervalo de confianza 95%, 0,783 - 0,870; p = 0,0137). CONCLUSIÓN: La longitud cervical es más útil en la predicción de parto pretérmino inminente en pacientes sintomáticas comparado con el puntaje de Bishop.
ABSTRACT OBJECTIVE: To compare the cervical length with Bishop score in prediction of imminent preterm delivery in symptomatic patients. METHODS: Women with single pregnancies of 24-35 weeks were selected, with the diagnosis of threatened preterm labor and intact membranes. Before the start of any treatment, all were submitted to the cervical digital examination and transvaginal ultrasound determination of cervical length. The main variable of the study was the frequency of imminent delivery (in the 7 days following evaluation). General characteristics, Bishop score, and cervical length values were evaluated. RESULTS: A total of 481 women were selected, 119 patients presented imminent delivery (group A) and 362 patients delivered after 7 days (group B). the interval between evaluation and delivery was 4.3 +/- 1.6 days in group A and 56.3 +/- 27.2 days in group B (p <0.0001). Patients in group A had lower values of cervical length compared with patients in group B (p <0.0001). This group also presented higher values of Bishop score (p <0.0001). Cervical length had a mayor area under for prediction (0.972, 95% confidence interval, 0.772-1.000) compared with Bishop score (0.825, 95% confidence interval, 0.783-0.870, p = 0.0137). CONCLUSION: Cervical length is more useful in the prediction of imminent preterm delivery in symptomatic patients compared to the Bishop score.n.
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Humanos , Feminino , Gravidez , Adulto , Colo do Útero , Medida do Comprimento Cervical , Trabalho de Parto Prematuro , Valor Preditivo dos Testes , Ultrassonografia Pré-NatalRESUMO
Cy3 and Cy5 dyes linked to the 5' end of a double stranded DNA molecule are known to attach to both strands in a way that is very similar to an additional base pair and has a stabilizing effect on the oligonucleotide. Here we adapt the Peyrard-Bishop mesoscopic model to incorporate cyanine dyes and use the technique of thermal equivalence to obtain the appropriate parameters from existing melting temperatures. We have found that the stacking parameters are in the same range of ordinary AT and CG base pairs, in particular Cy3-A was found to be most rigidly stacked. While the cyanines stabilize the AT hydrogen bonds quite strongly the CG bonds are mostly unaffected.
Assuntos
Carbocianinas/química , DNA/química , Pareamento de Bases , Carbocianinas/metabolismo , DNA/metabolismo , Ligação de Hidrogênio , Modelos Moleculares , Desnaturação de Ácido Nucleico , TemperaturaRESUMO
Objetivo: Evaluar la puntuación Bishop que predice el parto vaginal en nulíparas inducidas con oxitocina de 41 y 42 semanas de gestación, atendidas en el Hospital Docente Madre Niño San Bartolomé - 2014. Metodología: Estudio de tipo observacional, descriptivo correlacional, retrospectivo, longitudinal. Para el estudio se trabajó con el total de gestantes atendidas en el Hospital Docente Madre Niño San Bartolomé de enero a diciembre del 2014, lo cual fue de 152 pacientes. Los datos se registraron en el programa Statistics SPSS v.21. Para el análisis descriptivo de las variables cuantitativas se estimó medidas de tendencia central (media) y medidas de dispersión (desviación estándar) y para el análisis de variables cualitativas (nominal) se estimó frecuencias absolutas y porcentajes (frecuencias relativas). Para el análisis inferencial se utilizaron pruebas paramétricas (T Student) y no paramétricas (Chi cuadrado). Asimismo para obtener el punto de corte de mayor rendimiento se elaboró la curva ROC. Resultados: El 55.9 por ciento de la población gestante con 41 y 42 semanas de gestación finalizó en cesárea y el 44.1 por ciento culminó por parto vaginal. La duración promedio de la fase latente en el grupo de gestantes que finalizó en parto vaginal con puntuación Bishop >= a 7 puntos fue 8.35 horas y en el grupo de gestantes con puntuación Bishop = 7 fue 5.73 horas similar a la duración de la fase activa promedio en las gestantes con puntuación Bishop = 7 puntos fue 19.86 minutos y en el grupo con puntuación Bishop = 7, el 67.2 por ciento culminaron en parto vaginal y 60 por ciento de las gestantes finalizó en cesárea. Asimismo, en el grupo de gestantes con puntuación Bishop < 7,...
Objective: To evaluate the Bishop score that predicts the vaginal delivery in nulliparous induced with oxytocin of 41 and 42 weeks gestation, treated at the Teaching Hospital Mother Child San Bartolome - 2014. Methodology: Observational study, descriptive correlational retrospective longitudinal. For the study it worked with the total of pregnant women at the Hospital Teacher Mother Child San Bartolome from January to December 2014, which was 152 patients. Data was recorded in SPSS Statistics v.21 program. For the descriptive analysis of quantitative variables was estimated measures of central tendency (mean) and dispersion measures (standard deviation) and the analysis of qualitative variables (nominal) were estimated by absolute frequencies and percentages (relative frequencies). For the inferential analysis, were used parametric tests (T Student) and nonparametric (Chi square). Also to get the cutoff point of higher performance COR curve was prepared. Results: 55.9 per cent of the pregnant population with 41 and 42 weeks ended in cesarean section and 44.1 per cent completed vaginally. The average duration of the latent phase in the group of pregnant that ended in vaginal delivery with Bishop score >= 7 points was 8.35 hours and the group of pregnant women with Bishop score = 7 was 5.73 hours similar to the average duration of active phase in pregnant women with Bishop Score = 7 points was 19.86 minutes and in the group with Bishop Score = 7, 67.2 per cent resulted in vaginal delivery and 60 per cent of pregnant women ended in cesarean. Also in the group of pregnant women with Bishop Score < 7, 32.8 per cent of pregnant women finished in delivered vaginally in contrast to the 40 per cent of...
Assuntos
Feminino , Humanos , Gravidez , Adolescente , Adulto Jovem , Adulto , Curva ROC , Ocitocina , Parto Obstétrico , Valor Preditivo dos Testes , Estudos Longitudinais , Estudos Observacionais como Assunto , Estudos RetrospectivosRESUMO
Este trabalho se propõe a analisar o enlace entre clínica e pesquisa no campo da Psicanálise e suas consequências na leitura do sujeito do inconsciente. Partimos, pois, da constatação de que, além dos casos clínicos, Freud também se valeu do estudo de artistas e de produções culturais. Em especial, no estudo da psicose, a contribuição precursora de Freud se deu a partir da leitura das Memórias publicadas por Schreber. Foi pela leitura e análise desse livro que o psicanalista baseou suas principais teses acerca da paranoia. Neste artigo, destacamos sua proposição de que o delírio é uma tentativa de reconstrução do mundo, abalado pela crise psicótica. A partir dessa leitura de Freud, buscamos analisar como, de modo similar, a obra de um louco genial, Arthur Bispo do Rosário, demonstra a atualidade do método freudiano e a importância de apreender a psicose, especificamente, nesse enlace com a produção cultural.(AU)
This work intends to analyze the link between clinical and research in the field of psychoanalysis and its aftermath in reading the subject of the unconscious. Therefore we started at the realization that, in addition to clinical cases, Freud also used the study of artists and cultural productions. In particular, in studying psychosis, Freud's precursor contribution came from reading the published Memoirs of Schreber. It was by reading and analysing this book that the psychoanalyst based his main theses about paranoia. In this article, we highlight his proposition that delusion is an attempt to rebuild the world, shaken by the psychotic break. From this reading of Freud, we seek to examine how, in a similar way, the work of a mad genius, Arthur Bispo do Rosario, demonstrates the actuality of Freudian method and the importance of apprehending psychosis, specifically, this link with cultural production.(AU)
Este trabajo se propone analizar el enlace entre clínica y pesquisa en el campo del Psicoanálisis y sus consecuencias en la lectura del sujeto del inconsciente. Partimos, pues, de la constatación de que además de los casos clínicos, Freud también se valió del estudio de artistas y de producciones culturales. En especial, en el estudio de la psicosis, la contribución precursora de Freud se dio a partir de la lectura de las Memorias publicadas por Schreber. Fue por la lectura y análisis de ese libro que el psicoanalista basó sus principales tesis acerca de la paranoia. En este artículo, destacamos su proposición de que el delirio es una tentativa de reconstrucción del mundo, sacudido por la crisis psicótica. A partir de esa lectura de Freud, buscamos analizar cómo, de modo similar, la obra de un loco genial, Arthur Bispo do Rosário, demuestra la actualidad del método freudiano y la importancia de aprender la psicosis, específicamente, en ese enlace con la producción cultural.(AU)
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Humanos , Masculino , Feminino , Psicanálise , Transtornos Psicóticos , Arte , Transtornos ParanoidesRESUMO
Este trabalho se propõe a analisar o enlace entre clínica e pesquisa no campo da Psicanálise e suas consequências na leitura do sujeito do inconsciente. Partimos, pois, da constatação de que, além dos casos clínicos, Freud também se valeu do estudo de artistas e de produções culturais. Em especial, no estudo da psicose, a contribuição precursora de Freud se deu a partir da leitura das Memórias publicadas por Schreber. Foi pela leitura e análise desse livro que o psicanalista baseou suas principais teses acerca da paranoia. Neste artigo, destacamos sua proposição de que o delírio é uma tentativa de reconstrução do mundo, abalado pela crise psicótica. A partir dessa leitura de Freud, buscamos analisar como, de modo similar, a obra de um louco genial, Arthur Bispo do Rosário, demonstra a atualidade do método freudiano e a importância de apreender a psicose, especificamente, nesse enlace com a produção cultural...
This work intends to analyze the link between clinical and research in the field of psychoanalysis and its aftermath in reading the subject of the unconscious. Therefore we started at the realization that, in addition to clinical cases, Freud also used the study of artists and cultural productions. In particular, in studying psychosis, Freud's precursor contribution came from reading the published Memoirs of Schreber. It was by reading and analysing this book that the psychoanalyst based his main theses about paranoia. In this article, we highlight his proposition that delusion is an attempt to rebuild the world, shaken by the psychotic break. From this reading of Freud, we seek to examine how, in a similar way, the work of a mad genius, Arthur Bispo do Rosario, demonstrates the actuality of Freudian method and the importance of apprehending psychosis, specifically, this link with cultural production...
Este trabajo se propone analizar el enlace entre clínica y pesquisa en el campo del Psicoanálisis y sus consecuencias en la lectura del sujeto del inconsciente. Partimos, pues, de la constatación de que además de los casos clínicos, Freud también se valió del estudio de artistas y de producciones culturales. En especial, en el estudio de la psicosis, la contribución precursora de Freud se dio a partir de la lectura de las Memorias publicadas por Schreber. Fue por la lectura y análisis de ese libro que el psicoanalista basó sus principales tesis acerca de la paranoia. En este artículo, destacamos su proposición de que el delirio es una tentativa de reconstrucción del mundo, sacudido por la crisis psicótica. A partir de esa lectura de Freud, buscamos analizar cómo, de modo similar, la obra de un loco genial, Arthur Bispo do Rosário, demuestra la actualidad del método freudiano y la importancia de aprender la psicosis, específicamente, en ese enlace con la producción cultural...