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Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):267-275
DOI 10.1590/S0100-72032007000500008
Sweeteners are frequently used by women of reproductive age. This is a narrative review about the sweeteners currently sold in the Brazilian commerce. There is a few information on the use of saccharin and cyclamates in pregnancy and their effects on the fetus. Due to the limited information available and their carcinogenic potential in animal species, saccharin and cyclamates should be avoided during pregnancy (risk C). Aspartame has been extensively studied in animals and it is considered safe for use during pregnancy (risk B), except by women homozygous for phenylketonuria (risk C). Sucralose and acessulfame-K are not toxic, carcinogenic or mutagenic in animals, but there are no controlled studies in humans. However, since these two sweeteners are not metabolized, it is unlikely that their use during pregnancy could be harmful (risk B). Stevia, a substance extracted from a native Brazilian plant, is innocuous in animal pregnancies, but there are no controlled studies in humans (risk B). Body agents found in the composition of artificial sweeteners (mannitol, sorbitol, xylitol, erithrol, lactilol, isomalt, maltilol, lactose, fructose, maltodextrin, dextrin, and inverted sugar) are substances generally regarded as safe for human consumption. In conclusion, according to the currently available evidence, aspartame, sucralose, acessulfame-K and stevia can be safely used during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):267-275
DOI 10.1590/S0100-72032007000500008
Sweeteners are frequently used by women of reproductive age. This is a narrative review about the sweeteners currently sold in the Brazilian commerce. There is a few information on the use of saccharin and cyclamates in pregnancy and their effects on the fetus. Due to the limited information available and their carcinogenic potential in animal species, saccharin and cyclamates should be avoided during pregnancy (risk C). Aspartame has been extensively studied in animals and it is considered safe for use during pregnancy (risk B), except by women homozygous for phenylketonuria (risk C). Sucralose and acessulfame-K are not toxic, carcinogenic or mutagenic in animals, but there are no controlled studies in humans. However, since these two sweeteners are not metabolized, it is unlikely that their use during pregnancy could be harmful (risk B). Stevia, a substance extracted from a native Brazilian plant, is innocuous in animal pregnancies, but there are no controlled studies in humans (risk B). Body agents found in the composition of artificial sweeteners (mannitol, sorbitol, xylitol, erithrol, lactilol, isomalt, maltilol, lactose, fructose, maltodextrin, dextrin, and inverted sugar) are substances generally regarded as safe for human consumption. In conclusion, according to the currently available evidence, aspartame, sucralose, acessulfame-K and stevia can be safely used during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(4):277-281
DOI 10.1590/S0100-72032003000400009
PURPOSE: the aim of the present study was to evaluate the accuracy of microalbuminuria to predict preeclampsia. METHODS: a prospective study of 45 consecutive diabetic gestations that were tested for microalbuminuria before the 18th week, between the 18th and 24th week and between the 32nd and 36th week of gestation. All patients had their prenatal care done from January 2000 to December 2001. The DCA 2000 microalbumin/creatinine assay is a quantitative method for measuring low concentrations of albumin, creatinine and the albumin/creatinine ratio in urine. According to laboratory standards, an albumin/creatinine ratio >16 mg/g (1.8 mg/mmol) indicates incipient renal damage and risk for preeclampsia. The sensitivity, specificity, positive and negative predictive values of the albumin/creatinine ratio were determined to predict the occurrence or the absence of preeclampsia, diagnosed through clinical criteria. RESULTS: of all patients, 17% developed preeclampsia. The sensitivity of albumin/creatinine ratio increased from 12.5% at 18 weeks to 25% between the 18th and 24th week and to 87% after the 32nd week. On the other hand, specificity presented a decreasing value from 97 to 89 and 83%, respectively). The positive predictive value was relatively low in the three different periods of evaluation (50, 33 and 53%, respectively. The negative predictive value was increased in the three stages of gestational age (83, 84 and 96%, respectively). CONCLUSIONS: quantification of microalbuminuria could correctly predict the absence of preeclampsia but was less accurate to predict the occurrence of the disease in diabetic pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(4):277-281
DOI 10.1590/S0100-72032003000400009
PURPOSE: the aim of the present study was to evaluate the accuracy of microalbuminuria to predict preeclampsia. METHODS: a prospective study of 45 consecutive diabetic gestations that were tested for microalbuminuria before the 18th week, between the 18th and 24th week and between the 32nd and 36th week of gestation. All patients had their prenatal care done from January 2000 to December 2001. The DCA 2000 microalbumin/creatinine assay is a quantitative method for measuring low concentrations of albumin, creatinine and the albumin/creatinine ratio in urine. According to laboratory standards, an albumin/creatinine ratio >16 mg/g (1.8 mg/mmol) indicates incipient renal damage and risk for preeclampsia. The sensitivity, specificity, positive and negative predictive values of the albumin/creatinine ratio were determined to predict the occurrence or the absence of preeclampsia, diagnosed through clinical criteria. RESULTS: of all patients, 17% developed preeclampsia. The sensitivity of albumin/creatinine ratio increased from 12.5% at 18 weeks to 25% between the 18th and 24th week and to 87% after the 32nd week. On the other hand, specificity presented a decreasing value from 97 to 89 and 83%, respectively). The positive predictive value was relatively low in the three different periods of evaluation (50, 33 and 53%, respectively. The negative predictive value was increased in the three stages of gestational age (83, 84 and 96%, respectively). CONCLUSIONS: quantification of microalbuminuria could correctly predict the absence of preeclampsia but was less accurate to predict the occurrence of the disease in diabetic pregnancies.