ROSSANA PULCINELI VIEIRA FRANCISCO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
52 resultados
Resultados de Busca
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- Variant rs17619600 in the gene encoding serotonin receptor 2B (HTR2B) increases the risk of gestational diabetes mellitus: a case-control study(2023) PENNO, Juliana Regina Chamlian Zucare; SANTOS-BEZERRA, Daniele Pereira; CAVALEIRO, Ana Mercedes; SOUSA, Ana Maria da Silva; ZACCARA, Tatiana Assuncao; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli Vieira; CORREA-GIANNELLA, Maria LuciaBackgroundDuring pregnancy, the increase in maternal insulin resistance is compensated by hyperplasia and increased function of maternal pancreatic beta cells; the failure of this compensatory mechanism is associated with gestational diabetes mellitus (GDM). Serotonin participates in beta cell adaptation, acting downstream of the prolactin pathway; the blocking of serotonin receptor B (HTR2B) signaling in pregnant mice impaired beta cell expansion and caused glucose intolerance. Thus, given the importance of the serotoninergic system for the adaptation of beta cells to the increased insulin demand during pregnancy, we hypothesized that genetic variants (single nucleotide polymorphisms [SNPs]) in the gene encoding HTR2B could influence the risk of developing GDM.MethodsThis was a case-control study. Five SNPs (rs4973377, rs765458, rs10187149, rs10194776, and s17619600) in HTR2B were genotyped by real-time polymerase chain reaction in 453 women with GDM and in 443 pregnant women without GDM.ResultsOnly the minor allele C of SNP rs17619600 conferred an increased risk for GDM in the codominant model (odds ratio [OR] 2.15; 95% confidence interval [CI] 1.53-3.09; P < 0.0001) and in the rare dominant model (OR 2.32; CI 1.61-3.37; P < 0.0001). No associations were found between the SNPs and insulin use, maternal weight gain, newborn weight, or the result of postpartum oral glucose tolerance test (OGTT). In the overall population, carriers of the XC genotype (rare dominant model) presented a higher area under the curve (AUC) of plasma glucose during the OGTT, performed for diagnostic purposes, compared with carriers of the TT genotype of rs17619600.ConclusionsSNP rs17619600 in the HTR2B gene influences glucose homeostasis, probably affecting insulin release, and the presence of the minor allele C was associated with a higher risk of GDM.
bookPart Placenta, sistema amniótico e cordão umbilical(2020) PAGANOTI, Cristiane de Freitas; CABAR, Fábio Roberto; MIKAMI, Fernanda Cristina Ferreira; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor- Influência da amamentação nos resultados do teste oral de tolerância à glicose pós-parto de mulheres com diabetes mellitusgestacional(2015) DIJIGOW, Fernanda Borges; PAGANOTI, Cristiane de Freitas; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloPURPOSE: To determine the influence of breastfeeding on the results of a postpartum oral glucose tolerance test in women recently diagnosed with gestational diabetes mellitus. METHODS: The data were obtained from the electronic medical records of the Endocrinopathy Sector during pregnancy, HCMED laboratory system ofHospital das Clínicas of São Paulo , and by telephone. According to the inclusion criteria adopted, 132 patients were eligible for the study. For statistical analysis, the patients were divided into two groups according to whether or not they breastfed. The results were analyzed by the Student t-test and by the Mann-Whitney, Chi-square and Fisher's exact tests, depending on the variable analyzed, with the level of significance set at p<0.05. RESULTS: Of the 132 patients included in the study, 114 breastfed and 18 did not. Most of the patients in both groups were overweight or obese. The breastfeeding group had a lower pre-pregnancy Body Mass Index than the non-breastfeeding group (p=0.006). Insulin was introduced earlier in the group that did not breastfeed (23.21±4.33 versus 28.84±6.17; p=0.04). The group that did not breastfeed had a higher mean postpartum fasting glucose value in the oral glucose tolerance test than the group that breastfed (91.3±8.7 versus 86.5±9.3; p=0.01). Breastfeeding acted as a protective factor against the development of glucose intolerance in the postpartum oral glucose tolerance test (OR=0.27; 95%CI 0.09-0.8). By logistic regression, breastfeeding was shown to be an independent protective factor. CONCLUSION: There was a statistically significant relationship between breastfeeding and a decreased risk of developing glucose intolerance. Breastfeeding should be encouraged because it is an effective, low cost intervention easily accessible to all patients during the postpartum period.
bookPart Obesidade e gravidez(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Doenças endócrinas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira- Low back pain, pelvic pain, and associated factors in type 1 diabetic pregnant women(2024) BATISTA, Patricia Andrade; OLIVEIRA, Claudia de; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli Vieira; CABAR, Fabio RobertoIntroduction: Pregnancy and diabetes mellitus promote several musculoskeletal changes predisposing this population to complaints of Lower Back (LB) and Pelvic Pain (PP). Objective: To assess the frequency of LB and PP and associated factors in type 1 Diabetic (DM1) pregnant women. Method: An observational analytical cross-sectional study. Thirty-six pregnant women with DM1 were evaluated through a postural assessment with a focus on pelvic positioning and what patients reported. The associated factors were assessed using the State-Trait Anxiety Inventory (STAI), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Female Sexual Function Index (FSFI). Results: The frequency of LB and PP was 55.6 % and 30.6 %, respectively. The presence of anxiety was not associated with a higher prevalence of pain. The incidence of sexual dysfunctions was higher in the GD. DM1 duration had a mean of 14.9 years (+/- 8.2 SD) in the GD and 9.0 years (+/- 6.9 SD) in the GSD, which was statistically significant (p <= 0.050). In the multiple binary regression analysis for the occurrence of pain, the independent factor was DM1 duration >= 17 years (OR = 11.2; 95 % CI = 1.02-124.75). The association between DM1 duration >= 17 years and being overweight showed a probability of 95 % for the studied population in the analysis of the probabilities of occurrence of the pain event. Conclusion: There was a high frequency of LB and PP related to pregnancy in DM1 pregnant women in the second trimester of pregnancy. The incidence of sexual dysfunction and DM1 duration >= 17 years increases the chance that DM1 pregnant women will experience pain. There was no association between anxiety. urinary incontinence and pain in DM1 pregnant women.
bookPart Doenças tromboembólicas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Estatísticas vitais(2015) GALLETTA, Marco Aurélio Knippel; CARVALHO, Mário Henrique Burlacchini de; COSTA, Rafaela Alkmin da; BITTAR, Roberto Eduardo; FRANCISCO, Rossana Pulcineli Vieira; MARTINELLI, Silvio; ASSUNçãO, Tatiana Silva de- Pregnancy in women living with perinatally acquired HIV: Perinatal outcomes and drug resistance profile(2023) JR, Gilmar de Souza Osmundo; COSTA, Rafaela Alkmin da; RUOCCO, Rosa Maria Aveiro; FRANCISCO, Rossana Pulcineli VieiraObjectives: To analyze the perinatal outcomes of Perinatally acquired HIV Infection (PHIV) in pregnant women.Method: This retrospective cohort study included singleton pregnancies in Women Living with HIV (WLH) between 2006 and 2019. Patient charts were revised, and maternal characteristics, type of HIV infection (perinatal vs. behavioral), Antiretroviral Therapy (ART) exposure, and obstetric and neonatal outcomes were assessed. The HIV-related aspects considered were: Viral Load (VL), CD4+ cell count, opportunistic infections, and genotype testing. Laboratory analyses were performed at baseline (first appointment) and 34 weeks of gestation.Results: There were 186 WLH pregnancies, and 54 (29%) patients had PHIV. Patients with PHIV were younger (p < 0.001), had less frequently stable partnerships (p < 0.001), had more commonly serodiscordant partners (p < 0.001), had a longer time on ART (p < 0.001), and had lower rates of undetectable VL at baseline (p = 0.046) and at 34 weeks of gestation (p < 0.001). No association was observed between PHIV and adverse perinatal outcomes. Among patients with PHIV, third trimester anemia was associated with preterm birth (p = 0.039). Genotype testing was available only for 11 patients with PHIV, who presented multiple mutations related to ART resistance.Conclusions: PHIV did not seem to increase the risk of adverse perinatal outcomes. However, PHIV pregnancies have a higher risk of viral suppression failure and exposure to complex ARTs.
bookPart Anatomia da pelve feminina(2020) PAGANOTI, Cristiane de Freitas; CABAR, Fábio Roberto; MIKAMI, Fernanda Cristina Ferreira; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor