LISANDRA STEIN BERNARDES CIAMPI DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Palliative Care After Prenatal Diagnosis of Life-limiting Malformations: A Model of Care(2018) BERNARDES, Lisandra Stein; GIBELLI, Maria Augusta B. C.; FIGUEIREDO, Fernanda; BERTOLASSI, Nathalia; BARBOSA, Tercilia; BOLIBIO, Renata; GOMES, Ana; JESUS, Roberta; VILHEGAS, Andresa; ROCHA, Luana; ROSA, Gladys; SETUBAL, Maria Silvia; BENUTE, Glaucia; FRANCISCO, Rossana
- On the feasibility of accessing acute pain-related facial expressions in the human fetus and its potential implications: A case report(2018) BERNARDES, L. S.; OTTOLIA, J. F.; CECCHINI, M.; FILHO, A. G. D. A.; TEIXEIRA, M. J.; FRANCISCO, R. P. V.; ANDRADE, D. C. DeIntroduction: Although pain facial assessment is routinely performed in term and preterm newborns by the use of facial expression-based tools such as the Neonatal Facial Coding System, the assessment of pain during the intrauterine life has not been extensively explored. Objective: Describe for the first time, an experimental model to assess and quantify responses due to acute pain in fetuses undergoing anaesthesia for intrauterine surgery recorded by high-resolution 4D ultrasound machines. Methods/results-case report: A 33-year-old pregnant woman had congenital left diaphragmatic hernia of poor prognosis diagnosed, and her fetus was treated by fetoscopic endotracheal occlusion. Later, during the removal of the fetal endotracheal balloon by ultrasound-guided puncture, we have recorded facial expressions of the foetus before and after the anaesthetic puncture by the use of 4D ultrasound recordings, which were presented to 3 blinded coders instructed to use the Neonatal Facial Coding System for acute pain facial coding. The procedure was safe and feasible. Conclusion: This is the first description of a recordable acute pain model in the human fetus by the use of a facial expression-based tool. The possibility to assess pain-related intrauterine behaviours would allow not only for the monitoring of the efficacy of anaesthetic procedures in the fetus but would also open the way to explore the evolution of pain-related facial responses during the fetal neurodevelopment. This method may pave the way for objective assessments of pain in fetuses, should it endure the steps of formal validation studies. © Copyright © 2018 The Author(s).
- An unfavorable intrauterine environment may determine renal functional capacity in adulthood: a meta-analysis(2018) SENRA, Janaina Campos; CARVALHO, Mariana Azevedo; RODRIGUES, Agatha Sacramento; KREBS, Vera Lucia Jornada; GIBELLI, Maria Augusta Bento Cicaroni; FRANCISCO, Rossana Pulcineli Vieira; BERNARDES, Lisandra SteinSince studies show that an unfavorable environment during intrauterine development predisposes individuals to several diseases in adulthood, our objective is to assess the relation between fetal growth restriction and chronic renal disease in adults. We searched four different electronic databases through November 2017: CENTRAL, EMBASE, LILACS and MEDLINE. We selected studies with longitudinal or transversal designs associating kidney function in adulthood with low birth weight. Two reviewers evaluated the inclusion criteria and the risk of bias and extracted data from the included papers. Thirteen studies were selected for the systematic review and meta-analysis. We observed increased risks of presenting end-stage renal disease (risk ratio 1.31, 95% confidence interval: 1.17, 1.47), a lower glomerular filtration rate (ml/min) (mean difference 7.14; 95% confidence interval: -12.12, -2.16), microalbuminuria (risk ratio 1.40; 95% confidence interval: 1.28, 1.52) and a small increase in the albumin/creatinine ratio (mean difference 0.46; 95% confidence interval: 0.03, 0.90) in the low birth weight patients, compared with control group. These findings suggest that low birth weight is associated with renal dysfunction in adults.
- Spontaneous prematurity in fetuses with congenital diaphragmatic hernia: a retrospective cohort study about prenatal predictive factors(2018) BARBOSA, Bruna Maria Lopes; RODRIGUES, Agatha S.; CARVALHO, Mario Henrique Burlacchini; BITTAR, Roberto Eduardo; FRANCISCO, Rossana Pulcineli Vieira; BERNARDES, Lisandra SteinBackground: To evaluate possible predictive factors of spontaneous prematurity in fetuses with congenital diaphragmatic hernia (CDH). Methods: A retrospective cohort study was performed. Inclusion criteria were presence of CDH; absence of fetoscopy; absence of karyotype abnormality; maximum of one major malformation associated with diaphragmatic hernia; ultrasound monitoring at the Obstetrics Clinic of Clinicas Hospital at the University of Sao Paulo School of Medicine, from January 2001 to October 2014. The data were obtained through the electronic records and ultrasound system of our fetal medicine service. The following variables were analyzed: maternal age, primiparity, associated maternal diseases, smoking, previous spontaneous preterm birth, fetal malformation associated with hernia, polyhydramnios, fetal growth restriction, presence of intrathoracic liver, invasive procedures performed, side of hernia and observed-to-expected lung to head ratio (o/e LHR). On individual analysis, variables were assessed using the Chi-square test and the Mann-Whitney test. A multiple logistic regression model was applied to select variables independently influencing the prediction of preterm delivery. A ROC curve was constructed with the significant variable, identifying the values with best sensitivity and specificity to be suggested for use in clinical practice. Results: Eighty fetuses were evaluated, of which, 21 (26.25%) were premature. O/e LHR was the only factor associated with prematurity (rho= 0.020). The ROC curve showed 93% sensitivity with 48.4% specificity for the cutoff of 40%. Conclusion: O/e LHR was the only predictor of prematurity in this sample.