Author
João Luiz Pinto e Silva
Bio: João Luiz Pinto e Silva is an academic researcher from State University of Campinas. The author has contributed to research in topics: Pregnancy & Population. The author has an hindex of 25, co-authored 93 publications receiving 1738 citations.
Topics: Pregnancy, Population, Preeclampsia, Maternal near miss, Maternal death
Papers published on a yearly basis
Papers
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TL;DR: This trial failed to demonstrate a benefit of antioxidant supplementation in reducing the rate of preeclampsia among patients with chronic hypertension and/or prior preeClampsia.
138 citations
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TL;DR: The pregnant teenagers showed to have adequate knowledge of contraceptive methods and agreed to use them throughout their teenage years, and religion, age group, and socioeconomic status were directly related to their knowledge on contraceptive methods.
Abstract: OBJECTIVE: To describe the knowledge, attitudes and practices related to previous contraceptive methods used among pregnant teenagers as well as to outline some sociodemographic characteristics and sexual practices. METHODS: An observational study associated to the KAP (Knowledge, Attitudes, and Practices) survey was carried out in 156 pregnant teenagers aged 19 years or more. A structured questionnaire was applied before their first prenatal visit from October 1999 to August 2000. Univariate and bivariate analyses were performed using Pearson's and Yates' chi-square test and logistic regression. RESULTS: The adolescents had an average age of 16.1 years and most were in their first pregnancy (78.8%). Average age of menarche was 12.2 years and their first sexual intercourse was at the age of 14.5 years. Condoms (99.4%) and oral contraceptives (98%) were the most common contraceptive methods known. Of all, 67.3% were not using any contraceptive method before getting pregnant. The main reason reported for not using any contraceptive method was wanting to get pregnant (24.5%). The older ones who reported having religious beliefs and had a higher socioeconomic status had better knowledge on contraceptive methods. Teenagers who had had previous pregnancies reported more often use of contraceptive methods before getting pregnant. CONCLUSIONS: The pregnant teenagers showed to have adequate knowledge of contraceptive methods and agreed to use them throughout their teenage years. Religion, age group, and socioeconomic status were directly related to their knowledge on contraceptive methods, and multiple pregnancies brought more awareness on that. Of all, 54% had used any contraceptive on first sexual intercourse but their use decreased over time and shortly after their first intercourse the studied teenagers got pregnant.
91 citations
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01 Aug 2004
87 citations
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TL;DR: Inhibin A and circulating angiogenic factors levels obtained at 12-0/7 to 19-6/7 weeks have significant associations with onset of PE at less than 27 weeks, as do levels obtained from 704 patients with previous PE and/or chronic hypertension enrolled in a randomized trial for the prevention of PE.
85 citations
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TL;DR: This systematic review indicates a trend toward a protective effect of physical activity in the prevention of pre‐eclampsia.
Abstract: Exercise and physical activity have been studied and suggested as a way to reduce or minimize the effects of pre-eclampsia. Our aim was to evaluate the association between exercise and/or physical activity and occurrence of pre-eclampsia. We conducted electronic searches without year of publication and language limitations. This was a systematic review designed according to PRISMA. Different databases accessed were as follows: PubMed®; Latin-American and Caribbean Literature in Health Sciences (LILACS); Scientific Electronic Library On-line (SciELO); Physiotherapy Evidence Database (PEDro); and ISI web of Knowledge(SM) . The Medical Subject Headings (MeSH) were as follows: ("exercise" OR "motor activity" OR "physical activity") AND ("pre-eclampsia" OR "eclampsia" OR "hypertension, pregnancy-induced"). Inclusion criteria were studies conducted in adults who were engaged in some physical activity. The selection and methodological evaluation were carried out by two independent reviewers. Risk assessment was made by the odds ratio (OR) and incidence of pre-eclampsia in the population who performed physical activity/exercise. A total of 231 articles were found, 214 of which were excluded based on title and full-text, so that 17 remained. Comparison of six case-control studies showed that physical activity had a protective effect on the development of pre-eclampsia [OR 0.77, 95% confidence interval (CI) 0.64-0.91, p < 0.01]. The 10 prospective cohort studies showed no significant difference (OR 0.99, 95% CI 0.93-1.05, p= 0.81). The only randomized clinical trial showed a protective effect on the development of pre-eclampsia in the stretching group (OR 6.34, 95% CI 0.72-55.37, p= 0.09). This systematic review indicates a trend toward a protective effect of physical activity in the prevention of pre-eclampsia.
77 citations
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TL;DR: Recommendations for the prevention and management of venous thrombo-embolism in pregnancy and puerperium and the associated risk groups according to risk factors: definition and preventive measures are presented.
Abstract: Table 1. Classes of recommendation
Table 2. Levels of evidence
Table 3. Estimated fetal and maternal effective doses for various diagnostic and interventional radiology procedures
Table 4. Predictors of maternal cardiovascular events and risk score from the CARPREG study
Table 5. Predictors of maternal cardiovascular events identified in congential heart diseases in the ZAHARA and Khairy study
Table 6. Modified WHO classification of maternal cardiovascular risk: principles
Table 7. Modified WHO classification of maternal cardiovascular risk: application
Table 8. Maternal predictors of neonatal events in women with heart disease
Table 9. General recommendations
Table 10. Recommendations for the management of congenital heart disease
Table 11. Recommendations for the management of aortic disease
Table 12. Recommendations for the management of valvular heart disease
Table 13. Recommendations for the management of coronary artery disease
Table 14. Recommendations for the management of cardiomyopathies and heart failure
Table 15. Recommendations for the management of arrhythmias
Table 16. Recommendations for the management of hypertension
Table 17. Check list for risk factors for venous thrombo-embolism
Table 18. Prevalence of congenital thrombophilia and the associated risk of venous thrombo-embolism during pregnancy
Table 19. Risk groups according to risk factors: definition and preventive measures
Table 20. Recommendations for the prevention and management of venous thrombo-embolism in pregnancy and puerperium
Table 21. Recommendations for drug use
ABPM
: ambulatory blood pressure monitoring
ACC
: American College of Cardiology
ACE
: angiotensin-converting enzyme
ACS
: acute coronary syndrome
AF
: atrial fibrillation
AHA
: American Heart Association
aPTT
: activated partial thromboplastin time
ARB
: angiotensin receptor blocker
AS
: aortic stenosis
ASD
: atrial septal defect
AV
: atrioventricular
AVSD
: atrioventricular septal defect
BMI
: body mass index
BNP
: B-type natriuretic peptide
BP
: blood pressure
CDC
: Centers for Disease Control
CHADS
: congestive heart failure, hypertension, age (>75 years), diabetes, stroke
CI
: confidence interval
CO
: cardiac output
CoA
: coarction of the aorta
CT
: computed tomography
CVD
: cardiovascular disease
DBP
: diastolic blood pressure
DCM
: dilated cardiomyopathy
DVT
: deep venous thrombosis
ECG
: electrocardiogram
EF
: ejection fraction
ESC
: European Society of Cardiology
ESH
: European Society of Hypertension
ESICM
: European Society of Intensive Care Medicine
FDA
: Food and Drug Administration
HCM
: hypertrophic cardiomyopathy
ICD
: implantable cardioverter-defibrillator
INR
: international normalized ratio
i.v.
: intravenous
LMWH
: low molecular weight heparin
LV
: left ventricular
LVEF
: left ventricular ejection fraction
LVOTO
: left ventricular outflow tract obstruction
MRI
: magnetic resonance imaging
MS
: mitral stenosis
NT-proBNP
: N-terminal pro B-type natriuretic peptide
NYHA
: New York Heart Association
OAC
: oral anticoagulant
PAH
: pulmonary arterial hypertension
PAP
: pulmonary artery pressure
PCI
: percutaneous coronary intervention
PPCM
: peripartum cardiomyopathy
PS
: pulmonary valve stenosis
RV
: right ventricular
SBP
: systolic blood pressure
SVT
: supraventricular tachycardia
TGA
: complete transposition of the great arteries
TR
: tricuspid regurgitation
UFH
: unfractionated heparin
VSD
: ventricular septal defect
VT
: ventricular tachycardia
VTE
: venous thrombo-embolism
WHO
: World Health Organization
Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes but are complements for textbooks and cover the European Society of Cardiology (ESC) Core Curriculum topics. Guidelines and recommendations should help the …
1,502 citations
01 Jan 2011
TL;DR: In this paper, the authors presented a list of risk factors for venous thrombo-embolism in pregnancy and puerperium in women with heart disease, including the following risk factors: hypertension, congestive heart failure, hypertension, age (>75 years), diabetes, stroke, and atrial septal defect.
Abstract: Table 1. Classes of recommendation
Table 2. Levels of evidence
Table 3. Estimated fetal and maternal effective doses for various diagnostic and interventional radiology procedures
Table 4. Predictors of maternal cardiovascular events and risk score from the CARPREG study
Table 5. Predictors of maternal cardiovascular events identified in congential heart diseases in the ZAHARA and Khairy study
Table 6. Modified WHO classification of maternal cardiovascular risk: principles
Table 7. Modified WHO classification of maternal cardiovascular risk: application
Table 8. Maternal predictors of neonatal events in women with heart disease
Table 9. General recommendations
Table 10. Recommendations for the management of congenital heart disease
Table 11. Recommendations for the management of aortic disease
Table 12. Recommendations for the management of valvular heart disease
Table 13. Recommendations for the management of coronary artery disease
Table 14. Recommendations for the management of cardiomyopathies and heart failure
Table 15. Recommendations for the management of arrhythmias
Table 16. Recommendations for the management of hypertension
Table 17. Check list for risk factors for venous thrombo-embolism
Table 18. Prevalence of congenital thrombophilia and the associated risk of venous thrombo-embolism during pregnancy
Table 19. Risk groups according to risk factors: definition and preventive measures
Table 20. Recommendations for the prevention and management of venous thrombo-embolism in pregnancy and puerperium
Table 21. Recommendations for drug use
ABPM
: ambulatory blood pressure monitoring
ACC
: American College of Cardiology
ACE
: angiotensin-converting enzyme
ACS
: acute coronary syndrome
AF
: atrial fibrillation
AHA
: American Heart Association
aPTT
: activated partial thromboplastin time
ARB
: angiotensin receptor blocker
AS
: aortic stenosis
ASD
: atrial septal defect
AV
: atrioventricular
AVSD
: atrioventricular septal defect
BMI
: body mass index
BNP
: B-type natriuretic peptide
BP
: blood pressure
CDC
: Centers for Disease Control
CHADS
: congestive heart failure, hypertension, age (>75 years), diabetes, stroke
CI
: confidence interval
CO
: cardiac output
CoA
: coarction of the aorta
CT
: computed tomography
CVD
: cardiovascular disease
DBP
: diastolic blood pressure
DCM
: dilated cardiomyopathy
DVT
: deep venous thrombosis
ECG
: electrocardiogram
EF
: ejection fraction
ESC
: European Society of Cardiology
ESH
: European Society of Hypertension
ESICM
: European Society of Intensive Care Medicine
FDA
: Food and Drug Administration
HCM
: hypertrophic cardiomyopathy
ICD
: implantable cardioverter-defibrillator
INR
: international normalized ratio
i.v.
: intravenous
LMWH
: low molecular weight heparin
LV
: left ventricular
LVEF
: left ventricular ejection fraction
LVOTO
: left ventricular outflow tract obstruction
MRI
: magnetic resonance imaging
MS
: mitral stenosis
NT-proBNP
: N-terminal pro B-type natriuretic peptide
NYHA
: New York Heart Association
OAC
: oral anticoagulant
PAH
: pulmonary arterial hypertension
PAP
: pulmonary artery pressure
PCI
: percutaneous coronary intervention
PPCM
: peripartum cardiomyopathy
PS
: pulmonary valve stenosis
RV
: right ventricular
SBP
: systolic blood pressure
SVT
: supraventricular tachycardia
TGA
: complete transposition of the great arteries
TR
: tricuspid regurgitation
UFH
: unfractionated heparin
VSD
: ventricular septal defect
VT
: ventricular tachycardia
VTE
: venous thrombo-embolism
WHO
: World Health Organization
Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes but are complements for textbooks and cover the European Society of Cardiology (ESC) Core Curriculum topics. Guidelines and recommendations should help the …
1,336 citations
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1,238 citations
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862 citations
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TL;DR: Preeclampsia is a systemic vascular disorder that may also affect the liver and the brain in the mothers and is named not only for the liver involvement, but also for the disorder of the coagulation system that develops.
Abstract: Preeclampsia is a clinical syndrome defined as the new onset of hypertension and proteinuria during the second half of pregnancy1 It afflicts 3% to 5% of pregnancies and is a leading cause of maternal mortality, especially in developing countries2,3 Because the only known remedy is delivery of the placenta, in developed countries preeclampsia is an important cause of premature delivery, usually medically indicated for the benefit of the mother This results in infant morbidity and substantial healthcare expenditure4 Despite the considerable morbidity and mortality, the cause of preeclampsia has remained enigmatic
Both hypertension and proteinuria implicate the endothelium as the target of the disease The hypertension of preeclampsia is characterized by peripheral vasoconstriction and decreased arterial compliance5,6 The proteinuria of preeclampsia is associated with a pathognomonic renal lesion known as glomerular endotheliosis, in which the endothelial cells of the glomerulus swell and endothelial fenestrations are lost7,8 Podocyturia has been recently associated with preeclampsia during clinical disease9; however, whether this is the cause or effect of proteinuria is unknown The glomerular filtration rate is decreased compared with normotensive pregnant women; in rare cases, acute renal failure may develop
Preeclampsia is a systemic vascular disorder that may also affect the liver and the brain in the mothers When the liver is involved, women may present with abdominal pain, nausea, vomiting, and elevated liver enzymes Pathological examination of the liver reveals periportal and sinusoidal fibrin deposition and, in more extreme cases, hemorrhage and necrosis10 The severe preeclampsia variant HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) occurs in ≈20% of women with severe preeclampsia,11 and is named not only for the liver involvement, but also for the disorder of the coagulation system that develops12 Approximately 20% of …
853 citations