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
2 resultados
Resultados de Busca
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- Quantitative analysis of renal vascularization in fetuses with urinary tract obstruction by three-dimensional power-Doppler(2011) BERNARDES, Lisandra Stein; FRANCISCO, Rossana P. V.; SAADA, Julien; SALOMON, Remi; RUANO, Rodrigo; LORTAD-JACOB, Stephen; ZUGAIB, Marcelo; BENACHI, AlexandraOBJECTIVE: To evaluate the applicability of 3-dimensional evaluation of renal vascularization for predicting postnatal renal function in fetuses with suspected urinary obstruction. STUDY DESIGN: Fetuses were evaluated by 3-dimensional power-Doppler histogram, and vascular indices were estimated. Depth between the probe and the renal cortex was also evaluated. Postnatal follow-up was obtained in all cases and the main outcome was renal impairment. RESULTS: Twenty-three fetuses with urinary dilatation (cases) and 73 with normal renal morphology (controls) were included in the current study. Five (21.7%) cases developed renal impairment. Vascularization index and vascularization and flow index were significantly lower in fetuses that developed renal impairment compared with those with normal renal function (P = .009 and P = .036, respectively). The 3 vascular indexes correlated with depth. Percentage of depth-corrected vascularization index and vascularization flow index were lower in fetuses developing postnatal renal failure. CONCLUSION: Fetal renal vascularity (vascularization index and vascularization and flow index) was significantly lower in fetuses that developed renal impairment.
- Randomized trial of metformin vs insulin in the management of gestational diabetes(2013) SPAULONCI, Cristiane Pavao; BERNARDES, Lisandra Stein; TRINDADE, Thatianne Coutheux; ZUGAIB, Marcelo; FRANCISCO, Rossana Pulcineli VieiraOBJECTIVE: To evaluate glycemic control in women receiving metformin or insulin for gestational diabetes, and to identify factors predicting the need for supplemental insulin in women initially treated with metformin. STUDY DESIGN: Women with gestational diabetes who failed to achieve glycemic control with diet and exercise were randomized to receive metformin (n = 47) or insulin (n = 47). Criteria for inclusion were singleton pregnancy, diet, and exercise for a minimum period of 1 week without satisfactory glycemic control, absence of risk factors for lactic acidosis, and absence of anatomic and/or chromosome anomalies of the conceptus. Patients who were lost to prenatal follow-up were excluded. RESULTS: Comparison of mean pretreatment glucose levels showed no significant difference between groups (P = .790). After introduction of the drug, lower mean glucose levels were observed in the metformin group (P = .020), mainly because of lower levels after dinner (P = .042). Women using metformin presented less weight gain (P = .002) and a lower frequency of neonatal hypoglycemia (P = .032). Twelve women in the metformin group (26.08%) required supplemental insulin for glycemic control. Early gestational age at diagnosis (odds ratio, 0.71; 95% confidence interval, 0.52-0.97; P = .032) and mean pretreatment glucose level (odds ratio, 1.061; 95% confidence interval, 1.001-1.124; P = .046) were identified as predictors of the need for insulin. CONCLUSION: Metformin was found to provide adequate glycemic control with lower mean glucose levels throughout the day, less weight gain and a lower frequency of neonatal hypoglycemia. Logistic regression analysis showed that gestational age at diagnosis and mean pretreatment glucose level were predictors of the need for supplemental insulin therapy in women initially treated with metformin.