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
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Association between maternal exposure to air pollution before conception and sex determination in the city of Sao Paulo(2020) CARVALHO, Mariana Azevedo; HETTFLEISCH, Karen; RODRIGUES, Agatha S.; BENACHI, Alexandra; VIEIRA, Sandra Elisabete; SALDIVA, Silvia R. D. M.; SALDIVA, Paulo Hilario N.; FRANCISCO, Rossana Pulcineli Vieira; BERNARDES, Lisandra SteinIt has been widely demonstrated that air pollution can affect human health and that some pollutant gases can have negative impacts on female fertility rates and cause adverse obstetric outcomes, such as premature birth and low birth weight. Few studies have evaluated the impact of maternal exposure to urban air pollution on the number of female births. To evaluate the association between maternal exposure to air pollution during the year before conception and sex determination. This was a prospective study using low-risk pregnant women living in Sao Paulo, Brazil. The pollutants were measured by a fixed station during a 1-year period before conception. Sex was confirmed after birth. We used multiple logistic regression models to evaluate the association between the pollutants and the sex determination and to estimate the odds ratio (OR) and the 95% confidence interval (CI) of being female based on a quantitative increase in pollutant concentration. We evaluated 371 patients. Elevated exposure to nitrogen dioxide (NO2) and particulate matter lower than 10 mu m (PM10) prior to conception were associated with increased odds of being female. Each unit increase of NO(2)exposure increased the odds of being female by 8% (OR = 1.08, 95% CI = 1.02, 1.15,p = 0.008), and each unit increase of PM(10)increased the odds of being female by 14% (OR = 1.14, 95% CI 1.02 to 1.28,p = 0.021). In Sao Paulo, maternal exposure to pollutants was significantly associated with the odds of being female.
bookPart Procedimentos invasivos(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorbookPart Rastreamento das anomalias cromossômicas(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor- Breaking Bad News: A Study on Formal Training in a High-Risk Obstetrics Setting(2020) OLIVEIRA, Fernanda F.; BENUTE, Glaucia R. G.; GIBELLI, Maria Augusta B.; NASCIMENTO, Nathalia B.; BARBOSA, Tercilia V. A.; BOLIBIO, Renata; JESUS, Roberta C. A.; GAIOLLA, Paula V. V.; SETUBAL, Maria Silvia V.; GOMES, Ana L.; FRANCISCO, Rossana P.; BERNARDES, Lisandra SteinBackground: Breaking bad news is a frequent task in high-risk obstetrics clinics. Few studies have examined the role of training in improving such a difficult medical task. Aim: To evaluate the influence of a training program on the participants' perceptions of bad news communication at a high-risk obstetrics center. Design: This prospective study was conducted at the Department of Obstetrics/Gynecology, Hospital das Clinicas, from March 2016 to May 2017. Setting/Participants: Maternal-fetal health specialists were invited to complete an institutional questionnaire based on the SPIKES protocol for communicating bad news before and after training. The training consisted of theoretical lectures and small group practice using role play. The questionnaire responses were compared using nonparametric tests to evaluate the differences in physicians' perceptions at the two timepoints. The questionnaire items were evaluated individually and in groups following the communication steps of the SPIKES protocol. Results: In total, 110 physicians were invited to participate. Ninety completed the pretraining questionnaire and 40 answered the post-training questionnaire. After training, there were significant improvements in knowing how to prepare the environment before delivering bad news (p=0.010), feeling able to transmit bad news (p<0.001), and to discuss the prognosis (p=0.026), feeling capable of discussing ending the pregnancy (p=0.003), and end-of-life issues (p=0.007) and feeling confident about answering difficult questions (p=0.004). The comparison of the grouped responses following the steps of the SPIKES protocol showed significant differences for ""knowledge"" (p<0.001), ""emotions,"" (p=0.004) and ""strategy and summary"" (p=0.002). Conclusion: The implementation of institutional training in breaking bad news changed the perception of the physicians in the communication setting.
bookPart Malformações fetais(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorbookPart Cirurgia fetal(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorbookPart Diagnóstico pré-natal de malformações congênitas(2020) SILVA, Marcos Marques da; STEFANI, Luciana Francine Bocchi de; BERNARDES, Lisandra SteinbookPart Infecções congênitas(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor- Family Conferences in Prenatal Palliative Care(2020) BERNARDES, Lisandra Stein; OLIVEIRA, Fernanda Figueiredo; JESUS, Roberta Carolina de Almeida; BENUTE, Glaucia Rosana Guerra; GIBELLI, Maria Augusta Bento Cicaroni; NASCIMENTO, Nathalia Bertolassi; BOLIBIO, Renata; BARBOSA, Tercilia Virginia Aparecida; SETUBAL, Maria Silvia Vellutini; GOMES, Ana Lucia; ROCHA, Luana Sarmento Neves; ROSA, Gladys Ribeiro; FRANCISCO, Rossana PulcinelliBackground: Fetal malformations are diagnosed prenatally in nearly 3% of pregnancies, and similar to 1.2% are major malformations. After prenatal diagnosis, it is imperative to consider families' values and to support their decision-making process. Prenatal palliative care is a growing field mainly based on family conferences. The prenatal care setting is unique and differs from postnatal and adult care. There are no descriptions of family conferences in prenatal palliative care. The descriptions of themes that emerge from the prenatal care conference charts may guide professionals in this delicate task, and help determine the causes of suffering and identify family values before the birth of the infant. Aim: To perform a content analysis of medical records of family conferences and to describe the main themes observed during prenatal palliative care follow-up after the diagnosis of a life-limiting fetal condition. Design: This is a retrospective study of medical records of family conferences from a perinatal palliative care group, the GAI group, between May 2015 and September 2016. Setting/Participants: Families with estimated perinatal mortality >50% and eligibility for follow-up at our tertiary fetal medicine center were enrolled. We included women who participated in at least one family conference with the GAI group and who had given birth at the clinic or delivered at another center and returned for the postnatal family conference. Results: Fifty women met the inclusion criteria. Five main themes and 18 categories emerged from the charts and are described in detail. A model of follow-up in prenatal palliative care is proposed based on the themes and categories identified. Conclusions: This analysis may guide health professionals who seek to better identify family needs and values and organize follow-up during prenatal palliative care.
bookPart Aconselhamento genético(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor