RESUMO
OBJECTIVES: To evaluate the effects of transdermal nitroglycerin (GTN) and sildenafil citrate on Doppler velocity waveforms of the uterine (UtA), umbilical (UA) and fetal middle cerebral (MCA) arteries in pregnancies with intrauterine growth restriction (IUGR). METHODS: This was a prospective study of 35 singleton pregnancies (gestational age, 24-31 weeks) with IUGR and abnormal UtA and UA Doppler waveforms. We compared maternal arterial blood pressure and Z-scores of the pulsatility index (PI) of UtA, UA and fetal MCA before and after application of a transdermal GTN patch (average dose, 0.4 mg/h), oral sildenafil citrate (50 mg) or placebo. Statistical analysis was performed by ANOVA for paired samples. RESULTS: There was a significant decrease in UtA-PI after application of GTN (21.0%) and sildenafil citrate (20.4%). A significant reduction in UA-PI was also observed for both GTN (19.1%) and sildenafil citrate (18.2%). There was no difference in UtA- and UA-PI when the GTN and sildenafil groups were compared. No changes in Doppler velocimetry were observed in the placebo group and no significant change in MCA-PI was observed in any group. Maternal arterial blood pressure decreased with administration of both GTN and sildenafil citrate in those with pre-eclampsia. CONCLUSION: The use of transdermal GTN or sildenafil citrate in pregnancies with IUGR is associated with a significant reduction in both UtA and UA Doppler PI, as well as maternal arterial blood pressure. Neither drug affected the MCA-PI. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Assuntos
Nitroglicerina/farmacologia , Insuficiência Placentária/tratamento farmacológico , Citrato de Sildenafila/farmacologia , Vasodilatadores/farmacologia , Administração Cutânea , Adulto , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos , Método Duplo-Cego , Feminino , Retardo do Crescimento Fetal/diagnóstico por imagem , Retardo do Crescimento Fetal/tratamento farmacológico , Retardo do Crescimento Fetal/fisiopatologia , Humanos , Artéria Cerebral Média/efeitos dos fármacos , Artéria Cerebral Média/embriologia , Artéria Cerebral Média/fisiologia , Nitroglicerina/administração & dosagem , Insuficiência Placentária/diagnóstico por imagem , Insuficiência Placentária/fisiopatologia , Gravidez , Estudos Prospectivos , Fluxo Pulsátil/efeitos dos fármacos , Citrato de Sildenafila/administração & dosagem , Resultado do Tratamento , Ultrassonografia Pré-Natal , Artérias Umbilicais/efeitos dos fármacos , Artérias Umbilicais/fisiologia , Artéria Uterina/efeitos dos fármacos , Artéria Uterina/fisiologia , Vasodilatadores/administração & dosagem , Adulto JovemRESUMO
The meiotic sex chromosomes of the American marsupials Monodelphis dimidiata and Didelphis albiventris were studied with electron microscopy (EM) and with immunofluorescence localization of meiotic proteins SYCP1 and SYCP3, and proteins essential for meiotic sex chromosome inactivation (MSCI), gamma-H2AX and BRCA1. The chromatin of the non-synaptic X and Y chromosomes contains gamma-H2AX, first as foci and then as homogeneous staining at late stages. The thick and split X and Y axes are labelled with BRCA1 except at one terminus. The bulgings of the axes contain SYCP1 as well as the inner side of the dense plate. The evenly spaced and highly packed chromatin fibres of the conjoined XY body in these species have the same behaviour and the same components (gamma-H2AX in the chromatin, BRCA1 in the axes) as in the XY body of eutherian species. These observations and recent data from the literature suggest that XY body formation is ancestral to the metatherian-eutherian divergence.
Assuntos
Proteína BRCA1/genética , Histonas/genética , Cromossomos Sexuais/ultraestrutura , Animais , Cromatina/metabolismo , Coloração Cromossômica , Masculino , Marsupiais , Meiose , Proteínas Nucleares/metabolismo , Cromatina Sexual/metabolismo , Especificidade da Espécie , Espermatócitos/metabolismoRESUMO
La homeopatía es un sistema terapéutico que consiste en administrar sustancias en dosis infinitesimales y que, en un sujeto sano, producirán los mismos síntomas que La enfermedad que vamos a tratar. Cada tratamiento exige una individualización meticulosa. La práctica de la homeopatia consiste en buscar los puntos de contacto existentes entre los síntomas que experimentalmente produce un remedio y los síntomas que presenta el enfermo. Em múltiples ensayos clínicos la homeopatia difiere del placebo, aunque su efecto no sea explicable por la medicina tradicional.
Assuntos
Terapêutica HomeopáticaRESUMO
La homeopatía es un sistema terapéutico que consiste en administrar sustancias en dosis infinitesimales y que, en un sujeto sano, producirán los mismos síntomas que La enfermedad que vamos a tratar. Cada tratamiento exige una individualización meticulosa. La práctica de la homeopatia consiste en buscar los puntos de contacto existentes entre los síntomas que experimentalmente produce un remedio y los síntomas que presenta el enfermo. Em múltiples ensayos clínicos la homeopatia difiere del placebo, aunque su efecto no sea explicable por la medicina tradicional.