ANTONIO GOMES DE AMORIM FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
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- COL1A1, COL4A3, TIMP2 and TGFB1 polymorphisms in cervical insufficiency(2021) ALVES, Ana Paula V. D.; FREITAS, Amanda B.; LEVI, Jose Eduardo; AMORIM FILHO, Antonio G.; FRANCO, Lucas A. M.; HOSHIDA, Mara Sandra; PATINO, Elizabeth G.; V, Rossana P. Francisco; CARVALHO, Mario Henrique B.Objectives: To investigate the association between selected single nucleotide polymorphisms (SNPs) with cervical insufficiency and its relationship with obstetric history. Methods: Twenty-eight women with cervical insufficiency (case group) and 29 non-pregnant women (control group) were included. The SNPs sequenced included rs2586490 in collagen type I alpha 1 chain (COL1A1), rs1882435 in collagen type IV alpha 3 chain (COL4A3), rs2277698 in metallopeptidase inhibitor 2 (TIMP2), and rs1800468 in transforming growth factor beta 1 (TGFB1). Results: We found a higher frequency of the normal allele in the control group (65.5%) and the homozygous mutated genotype in the case group (64.3%) for rs2586490 in COL1A1 (p=0.023). An unplanned finding in the cervical insufficiency group was a higher gestational age of delivery (median >= 38 weeks) in the mutated allele than in the wildtype genotype (median of 28.2 weeks) for rs2857396, which is also in the COL1A1 gene (p=0.011). Conclusions: The findings of the present study corroborate the hypothesis that cervical insufficiency has a genetic component and probably involves genes encoding proteins in the extracellular matrix, in addition to inflammatory processes.
- Performance of a Multiplex Nested Polymerase Chain Reaction in Detecting 7 Pathogens Containing DNA in Their Genomes Associated With Congenital Infections(2020) YAMAMOTO, Lidia; AMORIM FILHO, Antonio G.; QUEIROZ, Joelma A.; CARVALHO, Mario H. B. de; RODRIGUES, Jonatas C.; KANUNFRE, Kelly A.; V, Rossana P. Francisco; OKAY, Thelma SuelyContext.-Infections are the leading cause of perinatal and infant mortality in low-income and low-resource countries, which have a higher prevalence of infections. Definitive diagnosis of congenital and perinatal infections is largely dependent upon the results of laboratory tests. Objective.-To develop a multiplex nested polymerase chain reaction (PCR) technique for the simultaneous detection of 7 pathogens containing DNA in their genomes in suspected cases of congenital infection. Design.-Eligible participants were pregnant women with positive immunoglobulin M antibodies raised to one of the pathogens in the prenatal serologic screening, associated or not with fetal ultrasound abnormalities or positive fetal serology. Neonates whose mothers did not attend prenatal care were included when they presented with symptomatology and laboratory parameters suggestive of infection. The detection rate of the multiplex nested PCR was compared with maternal, fetal, and neonatal serology, as well as placental immunohistochemistry and noncommercial amplifications. Results.-Of 161 suspected cases, the multiplex nested PCR detected 60 (37.3%), whereas the tests available in hospital laboratories detected 13 of 60 (21.7%) of the cases detected by the multiplex nested PCR, demonstrating a 4.6 times higher detection rate for the multiplex nested PCR (Fisher exact test, P < .001). Positive amplifications were to Toxoplasma gondii (32 cases), cytomegalovirus (14 cases), parvovirus B19 (5 cases), and adenovirus (5 cases). In 4 cases, 2 pathogens were simultaneously detected. All types of biological matrices were suitable for amplification. Sequencing of multiplex nested PCR products confirmed the molecular findings. Conclusions.-The multiplex nested PCR significantly increased the number of diagnosed congenital infections. Given the scarcity of DNA recovered from amniotic fluid and some neonatal samples, this multiplex nested PCR allows the simultaneous detection of 7 pathogens associated with congenital infections in a reliable, faster, cost-effective, and more sensitive way.
bookPart Abortamento habitual(2013) AMORIM FILHO, Antonio Gomes de; CARVALHO, Mário Henrique Burlacchin de; ZUGAIB, Marcelo- Open fetal myelomeningocele repair at a university hospital: surgery and pregnancy outcomes(2021) ROCHA, Luana Sarmento Neves da; BUNDUKI, Victor; AMORIM FILHO, Antonio Gomes de; CARDEAL, Daniel Dante; MATUSHITA, Hamilton; FERNANDES, Hermann Santos; NANI, Fernando Souza; FRANCISCO, Rossana Pulcineli Vieira de; CARVALHO, Mario Henrique Burlacchini dePurpose Myelomeningocele (MMC) is an open neural tube defect that causes great morbidity. Prenatal open repair is the standard treatment; however, there are many complications related to the procedure. This study reports preliminary findings of open in utero repair of MMC in a public tertiary hospital in Brazil and describes factors that could be associated with increased surgical morbidity. Methods Thirty-nine patients underwent open in utero repair of MMC from October 2015 to August 2019. The Clavien-Dindo classification of surgical complications and a classification system with the preterm definitions of the World Health Organization were used, respectively, for maternal and fetal complications. Results A total of 28 mothers (71.8%) and 31 fetuses (79.5%) experienced at least one minor to major complication. Three mothers (7.7%) had a severe grade 4 complication. Fetal complications grades 3 to 5 occurred in 13 fetuses (33.3%). Gestational age at surgery and at birth were 24.88 +/- 1.16 weeks and 33.23 +/- 3.68 weeks, respectively. Preterm delivery occurred in 30 patients (76.9%), membrane rupture in 18 patients (46.2%) and chorioamnionitis in 13 patients (33.3%). Conclusion Open fetal surgery for MMC was performed at a Brazilian public tertiary care center, resulting in three grade 4 maternal complications. Relevant fetal complications were also present. The use of a standard classification system for complications renders studies more comparable and data more useful for counseling patients. Adjustments of perioperative procedures and long-term follow-up are needed to determine the real benefit of open in utero repair of MMC at our hospital.
- 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).
bookPart Toxoplasmose(2016) AMORIM FILHO, Antonio Gomes de; ANDRADE, Joelma QueirozbookPart Aborto Habitual(2016) AMORIM FILHO, Antonio Gomes de- Risk factors for shunting at 12 months following open fetal repair of spina bifida by mini-hysterotomy(2023) ROCHA, Luana Sarmento Neves da; BUNDUKI, Victor; CARDEAL, Daniel Dante; AMORIM FILHO, Antonio Gomes de; NANI, Fernando Souza; PERES, Stela Verzinhasse; CARVALHO, Werther Brunow de; FRANCISCO, Rossana Pulcineli Vieira de; CARVALHO, Mario Henrique Burlacchini deObjectives: Open spina bifida (OSB) is the most common neural tube defect. Prenatal repair reduces the need for ventriculoperitoneal shunting (VPS) due to hydrocephalus from 80-90% to 40-50%. We aimed to determine which variables work as risk factors for VPS at 12 months of age in our population. Methods: Thirty-nine patients underwent prenatal repair of OSB by mini-hysterotomy. The main outcome was occurrence of VPS in the first 12 months of life. Logistic regression was used to estimate the odds ratios (OR) between prenatal variables and the need for shunting. Results: VPS at 12 months occurred in 34.2% of the children. Larger ventricle size before surgery (62.5% >= 15 mm; 46.2% between 12 and 15 mm; 11.8% <12 mm; p=0.008), higher lesion level (80% >L2, vs. 17.9% <= L3; p=0.002; OR, 18.4 [2.96-114.30]), and later gestational age at surgery (25.25 +/- 1.18 vs. 24.37 +/- 1.06 weeks; p=0.036; OR, 2.23 [1.05-4.74]) were related to increased need for shunting. In the multivariate analysis, larger ventricle size before surgery (>= 15 mm vs. <12 mm; p=0.046; OR, 1.35 [1.01-1.82]) and higher lesion level (>L2 vs. <= L3; p=0.004; OR, 39.52 [3.25-480.69]) were risk factors for shunting. Conclusions: Larger ventricle size before surgery (>= 15 mm) and higher lesion level (>L2) are independent risk factors for VPS at 12 months of age in fetuses undergoing prenatal repair of OSB by mini-hysterotomy in the studied population.
bookPart Sífilis(2016) AMORIM FILHO, Antonio Gomes de