Papers by Alexandre Naujorks
Ultrasound in Obstetrics and Gynecology
Myocardial tissue Doppler (MTD) is a technique for the measurement of myocardial velocities in sy... more Myocardial tissue Doppler (MTD) is a technique for the measurement of myocardial velocities in systole and diastole. This study evaluates the use of MTD in the assessment of cardiac diastolic function in fetuses with intrauterine growth restriction (IUGR) with placental insufficiency and in appropriate-for-gestational age (AGA) fetuses with hypertensive mothers. This study included 14 IUGR fetuses with placental insufficiency (Group 1), 13 AGA fetuses with hypertensive mothers (Group 2), and 29 AGA fetuses with healthy mothers (Group 3). Patients with other diseases were excluded. All fetuses had a gestational age of at least 25 weeks. MTD assessment was performed with the sample volume placed at the basal segment of the left ventricular side wall (LV), the interventricular septum (IVS) and the right ventricular free wall (RV). E'/A' ratios were calculated for each location. Mitral and tricuspid flows were assessed by conventional spectral pulsed Doppler. Significant differe...
Congenital Heart Disease
INTRODUCTION: Diastolic dysfunction may occur in fetuses with intrauterine growth restriction (IU... more INTRODUCTION: Diastolic dysfunction may occur in fetuses with intrauterine growth restriction (IUGR) and may be assessed by myocardial tissue Doppler (MTD). We previously have shown that excursion index of the septum primum (EISP) is reduced in IUGR fetuses over 30 weeks because of a higher left atrial pressure. PATIENTS, SETTING, AND DESIGN: The sample was made up of 14 fetuses with IUGR. MTD examination was carried out with the sample volume placed at the basal lateral wall of the left ventricle (LV), interventricular septum (IVS), and free wall of the right ventricle (RV) to determine E'/A' ratios. EISP was calculated as the ratio between the maximal excursion of the septum primum into the left atrium during diastole and the maximal diastolic diameter of the left atrium. Mitral and tricuspid flows were assessed by the conventional Doppler method. OUTCOME MEASURES: Pearson's correlation test was used to analyze the correlations between the parameters. RESULTS: A positi...
To test the hypothesis that the aortic isthmus flow index (IFI) is lower in fetuses of diabetic m... more To test the hypothesis that the aortic isthmus flow index (IFI) is lower in fetuses of diabetic mothers than in fetuses of nondiabetic mothers.
OBJETIVOS: Considerando-se os recentes relatos de uma possível relação entre exposição precoce ao... more OBJETIVOS: Considerando-se os recentes relatos de uma possível relação entre exposição precoce ao leite bovino e diabetes mellitus do tipo (DM1), este estudo teve como objetivo pesquisar a idade de inicio de exposição alimentar ao leite bovino em indivíduos portadores de DM1, através de um estudo caso-controle; bem como correlacionar a idade de introdução do leite bovino na dieta com o desenvolvimento e a idade de aparecimento do DM1. MÉTODOS: O estudo foi baseado em entrevistas dirigidas às mães de indivíduos dos seguintes grupos: a) grupo de pacientes diabéticos insulino-dependentes (GDM1), com diagnóstico realizado até os 30 anos, com média de idade ao diagnóstico de 9,2+5,4 anos; b) grupo controle (GC): estudantes não-diabéticos. A amostra constitui-se de 124 indivíduos (47 do GDM1 e 77 do GC), sem diferença estatística em relação a sexo e idade cronológica entre os dois grupos. RESULTADOS: A média do tempo de aleitamento exclusivo foi significativamente menor para o GDM considerando o sexo feminino. Não houve diferença significante entre as médias dos grupos considerando o sexo masculino. Não houve correlação entre a idade de exposição ao leite bovino e a idade de início do DM1. CONCLUSÕES: Indivíduos com DM1 do sexo feminino foram expostos mais precocemente ao leite bovino comparados aos indivíduos controles, sugerindo um possível papel deste alimento na etiopatogenia da doença. A retirada precoce do leite materno da dieta dos lactentes e, consequentemente, dos fatores de proteção por ele oferecidos, podem ser considerados elementos potencialmente relacionados com o desencadeamento do processo autoimune. (Arq Bras Endocrinol Metab 1999;43/5: 360-365) Unitermos: Aleitamento materno; Diabetes mellitus do tipo 1; Leite; Lactente; Estudos caso-controle ABSTRACT OBJECTIVES: Considering the recent reports about a possible relationship between early exposure to bovine milk and type 1 diabetes mellitus (DM1), this study aimed to evaluate the initial age of feeding with bovine milk in DM1 subjects, through a case-control study; as well as to correlate the age at introduction of bovine milk on children's diet with the development and the age of onset of DM1. METHODS: The study was based in interviews directed to mothers of the following groups: a) insulin dependent diabetics patients (DM1G), with diagnosis done up to the mean age of 30 years, with an average age at the diagnosis of 9.2±5.4 years; b) Control group: non diabetic students (CG). The sample comprised 124 subjects (47 DM1G and 77 CG), without statistical difference related to sex and chronological age between both groups. RESULTS: The exclusive breast feeding rate time was significantly less for the female sex. There was no significant differences between the groups rate in relation to the male sex. Also, there was no relationship between the age of exposure to bovine milk and the age at the onset of DM1. CONCLUSIONS: DM1 female subjects were exposed earlier to bovine milk than control subjects, suggesting a possible role of the
The higher incidence of cardiovascular events in the morning is accompanied by an increased vascu... more The higher incidence of cardiovascular events in the morning is accompanied by an increased vascular tone. However, there are few published studies designed to evaluate the diurnal variation of vascular and endothelial parameters in healthy subjects. In the present investigation, we evaluated the diurnal variation in brachial artery diameter (BAD), flow-mediated dilation (FMD) and endothelium-independent dilation (NFMD) in a homogeneous sample of healthy non-smoker young men. Fifty subjects aged 20.8 +/- 0.3 years (range: 18 to 25 years) were investigated by brachial artery ultrasound. Exclusion criteria were female gender and evidence of clinically significant health problems, including obesity. Volunteers were asked to rest and avoid fat meals as well as alcoholic beverages 48 h before and until completion of the evaluations. BAD, FMD and NFMD were measured at 7 am, 5 pm, and 10 pm and tested by repeated measures ANOVA. BAD was smaller at 7 am (mean +/- SEM, 3.8 +/- 0.1 mm) in comparison with 5 pm (3.9 +/- 0.1) and 10 pm (4.0 +/- 0.1 mm; P < 0.001). FMD values did not change significantly during the day, while NFMD increased more at 7 am (18.5 +/- 1.1%), when compared to 15.5 +/- 0.9% at 10 pm and 15.5 +/- 0.9% at 5 pm (P = 0.04). The physiological state of vasoconstriction after awakening, with preserved capability to dilate in the morning, should be considered to be part of the healthy cardiovascular adaptation before considering later life risk factors and endothelial dysfunction.
Prenatal Diagnosis, 2011
Objective Because fetal respiratory movements increase left ventricular compliance, we hypothesiz... more Objective Because fetal respiratory movements increase left ventricular compliance, we hypothesized that the left atrial shortening fraction increases during fetal respiratory motions.
Clinics, 2011
INTRODUCTION: Echocardiographic, electrocardiographic and other cardiorespiratory variables can c... more INTRODUCTION: Echocardiographic, electrocardiographic and other cardiorespiratory variables can change during weaning from mechanical ventilation.
Ultrasound in Obstetrics and Gynecology, 2009
Methods This study included 14 IUGR fetuses with placental insufficiency (Group 1), 13 AGA fetuse... more Methods This study included 14 IUGR fetuses with placental insufficiency (Group 1), 13 AGA fetuses with hypertensive mothers (Group 2), and 29 AGA fetuses with healthy mothers (Group 3). Patients with other diseases were excluded. All fetuses had a gestational age of at least 25 weeks. MTD assessment was performed with the sample volume placed at the basal segment of the left ventricular side wall (LV), the interventricular septum (IVS) and the right ventricular free wall (RV). E /A ratios were calculated for each location. Mitral and tricuspid flows were assessed by conventional spectral pulsed Doppler. Results Significant differences were found between groups for E /A at the IVS (P < 0.001) and LV (P = 0.009), with a higher mean (± SD) value in Group 1 (IVS: 0.92 ± 0.28; LV: 0.85 ± 0.19) than in Groups 2 (IVS: 0.62 ± 0.09; LV: 0.68 ± 0.14) and 3 (IVS: 0.71 ± 0.14; LV: 0.69 ± 0.15). In the RV, there was no statistically significant difference in the E /A ratio (P = 0.2). No differences were observed for mitral and tricuspid flow velocities and ratios.
Ultrasound in Obstetrics and Gynecology, 2008
Objectives: Myocardial strain measures fractional change in ventricular wall dimension and allows... more Objectives: Myocardial strain measures fractional change in ventricular wall dimension and allows quantification of myocardial performance. Quintero scoring for twin-twin transfusion syndrome (TTTS) cannot predict those who progress rapidly from stage 1 to intrauterine demise. We used vector-velocity imaging (VVI) which tracks natural myocardial speckles to calculate ventricular strain and determine whether this might aid risk stratification. Methods: We captured VVI images at about 100 Hz from a four chamber view during routine fetal echocardiograms in a pilot study of uncomplicated monochorionic twin pregnancies (MCDA) and ones with TTTS. Ventricular strain was calculated off-line and compared with our singleton reference range. Results: 33 MCDA pregnancies were studied at gestational age 21 + 5 (13 + 3 to 32 + 2) weeks. 20 pregnancies had TTTS (stages
Prenatal diagnosis, 2011
To test the hypothesis that the aortic isthmus flow index (IFI) is lower in fetuses of diabetic m... more To test the hypothesis that the aortic isthmus flow index (IFI) is lower in fetuses of diabetic mothers than in fetuses of nondiabetic mothers.
Congenital Heart Disease, 2014
Diastolic dysfunction may occur in fetuses with intrauterine growth restriction (IUGR) and may be... more Diastolic dysfunction may occur in fetuses with intrauterine growth restriction (IUGR) and may be assessed by myocardial tissue Doppler (MTD). We previously have shown that excursion index of the septum primum (EISP) is reduced in IUGR fetuses over 30 weeks because of a higher left atrial pressure. The sample was made up of 14 fetuses with IUGR. MTD examination was carried out with the sample volume placed at the basal lateral wall of the left ventricle (LV), interventricular septum (IVS), and free wall of the right ventricle (RV) to determine E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; ratios. EISP was calculated as the ratio between the maximal excursion of the septum primum into the left atrium during diastole and the maximal diastolic diameter of the left atrium. Mitral and tricuspid flows were assessed by the conventional Doppler method. Pearson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s correlation test was used to analyze the correlations between the parameters. A positive correlation was observed between UARI and E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; ratios for RV (r = 0.63, P = .02), IVS (r = 0.59, P = .03), and LV (r = 0.41, P = .15). There was a negative correlation between EISP and IVS E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; ratios (r = -0.58, P = .03), and a positive correlation for LV (r = 0.49, P = .08). At the RV position, a weak negative correlation was observed (r = -0.32, P = .26). A higher left atrial pressure in fetuses with IUGR, indicated by the lower mobility of the septum primum, is accompanied by higher ratios between early and late diastolic myocardial velocities. Placental dysfunction was correlated to septal E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; ratios. Fetal MTD can be a useful method to assess severity of placental dysfunction and fetal distress.
Arquivos Brasileiros de Endocrinologia & Metabologia, 1999
... A. Naujorks Andrea Tercziany Fabiano JB da Costa Heléia C. De David Lenise L. Nascimento Taci... more ... A. Naujorks Andrea Tercziany Fabiano JB da Costa Heléia C. De David Lenise L. Nascimento Taciana de O. Dal&#x27;Forno Theniza M ... Estudando diferenças nas taxas de incidência da doença e prevalência de aleitamento materno em 18 países, Scott (16) observou que países ...
Arquivos Brasileiros de Cardiologia, 2013
Background: We have recently demonstrated reversal of fetal ductal constriction after dietary mat... more Background: We have recently demonstrated reversal of fetal ductal constriction after dietary maternal restriction of polyphenol-rich foods (PRF), due to its inhibitory action on prostaglandin synthesis.
Alcohol, 2005
Previous investigations have shown a biphasic effect of alcohol on blood pressure (BP). However, ... more Previous investigations have shown a biphasic effect of alcohol on blood pressure (BP). However, there are no studies on possible simultaneous influences in endothelial function. This study aims to evaluate the early and late effects of alcohol ingestion on vascular and endothelial function parameters in healthy young men. The diameter of brachial artery (DBA), endothelium-dependent flow-mediated dilatation, endothelium-independent nitroglycerin-mediated dilatation, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate were measured 30 min before intake, 4 h after intervention (when there is a reported hypotensive effect of alcohol), and after 13 h (subsequent increase in BP). The study group consisted of 100 males aged 18-25 years who were evaluated by brachial artery ultrasound. Subjects were randomized to drink either an alcoholic (60 g of ethanol) or a similar nonalcoholic beverage. Alcohol induced a biphasic effect on SBP and DBP, with a 4-h decrease followed by an increase after 13 h. After 4 h, the alcohol-drinking group presented a DBA increase that was significant at baseline and after hyperemia but not after nitroglycerin administration. There were no DBA differences between the intervention and control groups 13 h after drinking. This study replicates the initial reports of alcohol-induced biphasic alteration in BP. Our results showed that despite the late increase in BP, there were no accompanying changes in endothelial function.
Revista Andaluza de Medicina del Deporte
Objective To investigate the influence of a concurrent physical training (CT) on the carotid inti... more Objective To investigate the influence of a concurrent physical training (CT) on the carotid intima-media thickness (IMT) and vascular age (VA) of individuals with metabolic syndrome (MS). Method Twelve sedentary volunteers (51,50 ± 6,52 years old) were submitted to a CT during 30 weeks, three times per week. Before and after the CT, were analyzed anthropometric, functional and biochemical variables. It was performed a two-dimensional ultrasound for carotid IMT and the quantification and comparison of carotid IMT of participants was named VA. The difference between VA and chronological age was named age's delta and the Framingham risk score was calculated. Furthermore, it was calculated the modified Framingham risk score (MFS), replacing chronological age for VA. Results The carotid IMT, the VA, the age's delta and the Framingham score did not decrease significantly after 30 weeks of CT. However, the scoring in MFS decreased after the intervention (p < 0.05). Besides, the...
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Papers by Alexandre Naujorks