Biomedical subjects
Publications and source records attributed to L Camano.
Reports of dermatomyositis (DM) and polymyositis complicating pregnancy are rare. Only nineteen cases have been published. We describe the first case in which juvenile DM appeared during pregnancy. An emergency cesarean section had to be performed due to fetal distress at 37 weeks of gestation. Patient and infant are doing well after 8 months of followup.
In pregnancy there is a rise in glomerular filtration rate (GFR), plasma aldosterone levels, uric acid clearance and urinary kallikrein excretion. In toxemia all the above parameters tend to decrease. Progesterone has a diuretic effect which is usually related to aldosterone antagonism. We administered progesterone to normal women and observed that GFR, uric acid clearance and kallikrein excretion increased significantly, GFR from 103.0 +/- 13.7 ml/min to 118.0 +/- 18.0 ml/min (P less than 0.01), uric acid clearance from 9.0 +/- 3.6 ml/min to 14.3 +/- 4.0 ml/min (P less than 0.01), and urinary kallikrein excretion from 165 +/- 156 mU to 432 +/- 220 mU (P less than 0.01). Natriuresis and potassium excretion also increased from 15.9 +/- 6.4 mEq to 33.4 +/- 10.9 mEq (P less than 0.01) and from 7.6 +/- 2.7 mEq to 14.0 +/- 5.4 mEq, (P less than 0.01), respectively, suggesting that in this situation aldosterone antagonism is not relevant to explain the diuretic effects of progesterone.
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Between January 1980 and December 1989, at Escola Paulista de Medicina, a referral centre, 75 patients with hydatiform mole were assisted. The frequency of the hydatiform mole was calculated in 65 patients, whose treatment was performed in our Hospital, out of 13,986 pregnancies, which had occurred in this period of study. Thus, the incidence was 1:215 pregnancies, similar to that found in Asian and African countries.
The objective of the present study was to determine the presence of risk factors for the occurrence of neural tube defects. Data for 33,535 births which occurred at Hospital do Servidor Público Estadual de São Paulo from July 1973 to December 1986 were collected in a prospective manner as recommended by "Estudo Colaborativo Latino-Americano de Malformações Congênitas" (ECLAMC, Collaborative Latin American Study on Congenital Malformations). Twenty-six cases of neural tube defects were detected (0.77/1000 births). Of these, 11 were cases of spina bifida (0.39/1000 births), 9 of anencephaly (0.27/1000 births) and 6 of encephalocele (0.18/1000 births). We observed a higher frequency of polyhydramnios, premature labor, Apgar scores of less than 7 at the first and fifth minutes, low birth weight and intrauterine growth retardation.
Ninety-one occurrences of abruptio placentae were analyzed by the Department of Obstetrics of the São Paulo School of Medicine in São Paulo, Brazil during a ten-year period, from 1979 to 1988. The purpose was to analyze perinatal prognosis and its relation to hypertensive states. The authors observed that arterial hypertension was present in 75% of the cases, most of which chronic arterial hypertension; they also observed that perinatal mortality increased in the presence of high arterial blood pressure.
This is a retrospective study of 189 chronic hypertension patients seen at the Discipline of Obstetrics of the São Paulo Medical School at Hospital São Paulo. The data were fed into a computer and several selected variables and established interrelations were run to have a statistical study by means of non-parametric tests. Hypotheses were rejected at a level of 5.0 percent. Results allow to conclude that there is an association of obesity and chronic hypertensive women to obstetrical occurrences such as delayed intra-uterus growth and pregnancy-specific hypertensive disease. With respect to development during pregnancy, a higher number of newborn mortality was observed and correlated to metabolic disorders, infectious diseases, and problems of the respiratory system. However, the authors did not see a high incidence of congenital malformation. All such results lead to the conclusion that the incidence of fetus death, neonatal mortality, and perinatal mortality are five times more frequent in this group than in the control group.
Although pregnancy in women who are forty years old or more is considered a high risk pregnancy, it has occurred more frequently in recent years. This paper reports an analysis of 205 cases of patients over forty years of age seen at the Obstetrics Department of the São Paulo School of Medicine at the São Paulo Hospital. A control group of 1,153 pregnant women ages ranging from 20 to 29--such age range being considered the proper age for reproduction--was formed for the purpose of comparison. Data were stored in computer and lists of many variables were settled to provide a statistical overview through non-parametric testing based on the nature of the variables. 5% was the level of significance set to reject a null hypothesis. The results permit authors to conclude that pregnant women who are forty years old or over present inadequate biological characteristics for a proper obstetric development, based on the advanced age and on the association of many other adverse factors.
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