Edward Araujo Júnior

Universidade Federal de São Paulo, San Paulo, São Paulo, Brazil

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Publications (343)477.32 Total impact

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    ABSTRACT: To evaluate female runners' pelvic floor muscles using three-dimensional ultrasonography (3DUS) and surface electromyography (SEMG). A cross-sectional study was conducted on 24 female runners. SEMG was performed using surface electrodes inserted in the vagina. 3DUS was performed using perineal convex transducer. SEMG was evaluated at rest and with maximum voluntary contraction (MVC) and slow contraction. Levator ani muscle thickness, levator hiatus area and the angle between the levator muscles at rest and with MVC and Valsalva were evaluated using 3DUS. The women were divided into two groups (women running </= 25 km/week; women running > 25 km/week). Means, standard deviations and non-paired t tests were used for both groups. Among the 24 women, 11 ran </= 25 km/week (16.91 +/- 4.13 km/week) and 13 ran > 25 km/week (40.77 +/- 1.15 km/week). The mean SEMG at rest and with MVC and slow contraction were 16.25, 65.86 and 71.41 mV, respectively. For the levator hiatus area at rest and with MVC and Valsalva, the means were 12.54, 10.06 and 16.57 sqcm, respectively. Correlations between 3DUS and SEMG showed significant differences in SEMG at rest and levator thickness with Valsalva (r = 0.46; p = 0.04). 3DUS and SEMG are two feasible methods for evaluating female runners' pelvic floor. Correlations between 3DUS and SEMG showed significant differences in SEMG at rest and levator thickness with Valsalva.
    Medical ultrasonography 03/2014; 16(1):21-6.
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    ABSTRACT: Objective : To determine how parturient women tolerate the use of a perineal distensibility assessment technique using the EPI-NO device. Methods : An observational study with a total of 227 full-term parturient women was performed. During the evaluation with EPI-NO, parturient patients were asked about their sensation of discomfort. The degree of discomfort was measured using the Visual Analogue Scale, with a score from zero to 10. The Mann-Whitney test was applied to assess perineal distensibility measured by EPI-NO and the degree of discomfort caused by the test according to parity. The relation between perineal distensibility and discomfort was analyzed by using the Spearman correlation test (r). Results : The test with EPI-NO caused only slight discomfort (mean Visual Analogue Scale of 3.8), and primiparous women reported significantly greater discomfort (mean Visual Analogue Scale of 4.5) than did multiparous (mean Visual Analogue Scale=3.1), with p<0.001 women. A negative correlation was observed, in other words, the greater the perineal distensibility on the EPI-NO, the lower the pain reported by the patients (r=-0.424; p<0.001). Conclusion : The assessment of perineal distensibility with EPI-NO was well tolerated by the parturient women.
    03/2014; 12(1):22-6. DOI:10.1590/S1679-45082014AO2944
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    ABSTRACT: Technological innovations accompanying advances in medicine have given rise to the possibility of obtaining better-defined fetal images that assist in medical diagnosis and contribute toward genetic counseling offered to parents during the prenatal period. In this article, we show our innovative experience of diagnosing fetal malformations through correlating 3-dimensional ultrasonography, magnetic resonance imaging, and computed tomography, which are accurate techniques for fetal assessment, with a fetal image reconstruction technique to create physical fetal models.
    Ultrasound Quarterly 03/2014; 30(1):69-75. DOI:10.1097/RUQ.0000000000000048 · 1.40 Impact Factor
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    ABSTRACT: Abstract Objective: The aim of this study was to determine the reference range for amniotic fluid index (AFI) measurements in a large sample of the Brazilian population. Methods: This was a retrospective cross-sectional study on 3837 normal singleton pregnancies between 18+0 and 38+6 weeks of pregnancy. The AFI was measured from the largest vertical pockets of amniotic fluid in the four quadrants of the uterine cavity. To assess the correlation between AFI and gestational age (GA), polynomial equations were calculated, with adjustments using the determination coefficient (R2). Results: The mean maternal age and gestational age were 27.01±6.57 years and 30.43±5.29 weeks, respectively. The mean AFI ranged from 12.2±2.6 cm at 18 weeks to 11.6±6.0 cm at 38 weeks of pregnancy. The correlation between AFI and GA was best represented by a linear equation: AFI=17.78-0.153*GA (R2=0.027). Conclusion: We established the reference range for the AFI in a large sample of the Brazilian population. This reference range can be used to monitor deviations in the volume of amniotic fluid in fetuses at high risk for intrauterine growth disturbances.
    Journal of Perinatal Medicine 01/2014; 42(4):1-5. DOI:10.1515/jpm-2013-0293 · 1.43 Impact Factor
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    ABSTRACT: Abstract Objective To describe the biometric and morphological characteristics of the uterus through ultrasound (US) and Doppler on the uterine arteries in the initial and late puerperium after normal delivery. Methods: This was a prospective longitudinal study on full-term singleton pregnancies without complications. The patients were divided into two groups: 31 primiparous and 28 multiparous women. Two US exams were carried out with Doppler evaluation: firstly, within the initial 48 hours; and secondly, between 31 and 50 days after childbirth. The US assessed the position and biometry of the uterus, appearance of the myometrium, measurement and content of the uterine cavity, and Doppler velocimetry indices of uterine arteries. To compare the groups at the two times, the paired Student t test, Fisher's exact test and chi-square test were used. Results: In the initial puerperium, the position of the uterus was retroversion (98.3%); the appearance of the myometrium was heterogeneous (96.6%); the uterine cavity was filled with some type of material (72.9%). After the 30(th) day, a position was anteversion (74.6%); the appearance of the myometrium was homogeneous (91.5%); and the uterine cavity was empty (81.3%). There was an evolution in the pulsatility index between the two US exams, with an increase of 52.03% among the primiparous and 53.13% among the multiparous for the right uterine artery. Conclusion: Significant changes were observed in the morphological and biometric characteristics of the uteruses evaluated through US, as well as in the uterine arteries Doppler, between the initial and late puerperium.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 01/2014; 27(18). DOI:10.3109/14767058.2014.882895 · 1.21 Impact Factor
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    ABSTRACT: Objective. To evaluate trophoblastic cell proliferation and angiogenesis in tubal pregnancy assessed by immunohistochemical study and their correlation with an average variation of β -hCG in an interval of 48 hours before surgery. Methods. A prospective study was conducted on 18 patients with a diagnosis of tubal pregnancy. The patients were divided into two groups of ectopic pregnancy of which 11 showed rise of β -hCG levels and 7 patients showed declining β -hCG levels in an interval of 48 hours prior to surgery. Trophoblastic cell proliferation and angiogenesis were assessed by Ki-67 and VEGF, respectively. Trophoblastic cell proliferation was assessed by Ki-67 and was classified into three groups (grade I: less than 1/3 of stained nuclei, grade II: 1/3 to 2/3 of the stained nuclei, and grade III: more than 2/3 of the nuclei stained). The cases analyzed for VEGF were divided into three groups (grade I: less than 1/3 of the stained cytoplasm; grade II: 1/3 to 2/3 of the stained cytoplasm; grade III: more than 2/3 of the stained cytoplasm). Statistical analysis was performed using the chi-square, ANOVA, and Kruskal-Wallis tests. Results. The mean variation in the serum β -hCG levels in 48 hours in tubal pregnancy patients correlated with trophoblastic cell proliferation assessed by Ki-67 and showed a decline of 13.46% in grade I, a rise of 45.99% in grade II, and ascension of 36.68% in grade III (P = 0.030). The average variation in the serum β -hCG in 48 hours, where angiogenesis was evaluated by VEGF, showed a decline of 18.35% in grade I, a rise of 32.95% in grade II, and ascension of 37.55% in grade III (P = 0.047). Conclusions. Our observations showed a direct correlation of increased levels of serum β -hCG in 48h period prior to surgery with higher trophoblastic cell proliferation assessed by Ki-67 and angiogenesis assessed by VEGF in tubal pregnancy.
    01/2014; 2014:302634. DOI:10.1155/2014/302634
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    ABSTRACT: to describe the epidemiological data of the population born with the diagnosis of Congenital Heart Disease (CHD); to compare diagnoses made using fetal echocardiography with the findings from postnatal echocardiography or anatomopathological examination of the heart; and to evaluate mortality among newborns that underwent surgical treatment.
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    ABSTRACT: Duplication of the renal collecting system is the commonest major congenital malformation of the urinary tract, with an incidence of 1% among live births. Antenatal diagnosing of renal duplication and an associated ureterocele is infrequent. We report four cases of prenatally diagnosed unilateral duplication of the renal collecting system. In two of them, the renal duplication was associated with an ectopic ureterocele.
    Urology journal 01/2014; 10(4):1142-6. · 0.71 Impact Factor
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    ABSTRACT: The aims of this study were to compare perineal distensibility between women with twin and singleton pregnancies and to correlate these women's perineal distensibility with anthropometric data. This prospective cross-sectional case-control study was conducted among nulliparous women, of whom 20 were pregnant with twins and 23 with a single fetus. Perineal distensibility was evaluated in the third trimester by means of Epi-no, which was introduced into the vagina and inflated up to the maximum tolerable limit. It was then withdrawn while inflated and its circumference was measured. The unpaired Student's t-test was used to compare perineal distensibility in the two groups and Pearson's correlation coefficient (r) was used to correlate the pregnant women's perineal distensibility with their anthropometric data. There was no difference in perineal distensibility between the twin group (16.51 ± 2.05 cm) and singleton group (16.13 ± 1.67 cm) (P = 0.50). There was a positive correlation between perineal distensibility and abdominal circumference (r = 0.36; P = 0.01). The greater the abdominal circumference was, the greater the perineal distensibility was, regardless of whether the pregnancy was twin or singleton.
    ISRN obstetrics and gynecology 01/2014; 2014:124206. DOI:10.1155/2014/124206
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    ABSTRACT: We report on a prenatal diagnosis of ring chromosome 15 in a fetus with left congenital diaphragmatic hernia (CDH) and severe intrauterine growth restriction (IUGR). A 31-year-old woman, gravida 2 para 1, was referred because of increased nuchal translucency at gestational age of 13 weeks. Comprehensive fetal ultrasound examination was performed at 19 weeks revealing an early onset IUGR, left CDH with liver herniation, and hypoplastic nasal bone. Three-dimensional ultrasound (rendering mode) showed low set ears and depressed nasal bridge. Amniocentesis was performed with a result of a 46,XX,r(15) fetus after a cytogenetic study. A 1,430 g infant (less than third percentile) was born at 36 weeks. The infant presented with respiratory failure and died at 2 h of life. Postnatal karyotype from the umbilical cord confirmed the diagnosis of 15-ring chromosome. We described the main prenatal 2D- and 3D-ultrasound findings associated with ring chromosome 15. The interest in reporting the present case is that CDH can be associated with the diagnosis of 15-ring chromosome because the critical location of the normal diaphragm development is at chromosome 15q26.1-q26.2.
    01/2014; 2014:495702. DOI:10.1155/2014/495702
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    ABSTRACT: Pena-Shokeir syndrome is a rare autosomal recessive disease, characterized by facial anomalies, arthrogryposis, polyhydramnios, fetal growth restriction, and pulmonary hypoplasia. This report describes the findings of this anomaly with two and three-dimensional ultrasound in a female in her 28(th) week of pregnancy, who was referred to us because the fetus presented arthrogryposis of unknown cause. These imaging methods allowed adequate evaluation of the fetal malformations and also enabled appropriate counseling of the couple.
    01/2014; 4:20. DOI:10.4103/2156-7514.131642
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    ABSTRACT: Objective. To describe the experience of a tertiary center in Brazil to which patients are referred whose fetuses are at increased risk for congenital heart diseases (CHDs). Methods. This was a cross-sectional observational study. The data was collected prospectively, during the year 2012, through a screening protocol of the fetal heart adapted from the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. We performed a fetal echocardiogram screening for all pregnant women who were referred to the fetal cardiology outpatient obstetrics clinic of a university hospital. The exams were classified as normal or abnormal. The cases considered abnormal were undergone to a postnatal echocardiogram. We categorized the abnormal fetal heart according to severity in "complex," "significant," "minor," and "others." Results. We performed 271 fetal heart screening. The incidence of abnormal screenings was 9.96% (27 fetuses). The structural CHD when categorized due to severity showed 48.1% (n = 13) of "complex" cases, 18.5% (n = 5) "significant" cases, and 7.4% (n = 2) "minor" cases. The most common referral reason was by maternal causes (67%) followed by fetal causes (33%). The main referral indication was maternal metabolic disease (30%), but there was just one fetus with CHD in such cases (1.2%). CHDs were found in 19/29 fetuses with suspicion of some cardiac abnormality by obstetrician (65.5%). Conclusion. We observed a high rate of CHD in our population. We also found that there was higher incidence of complex cases.
    01/2014; 2014:175635. DOI:10.1155/2014/175635
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    ABSTRACT: HELLP syndrome is a complication of severe forms of preeclampsia and occurs mainly in the third trimester of pregnancy. In extreme cases, it may evolve unfavorably and substantially increase maternal mortality. We present the case of an 18-year-old pregnant woman who was admitted to our emergency service in her 31st week, presenting with headache, visual disturbances, and epigastralgia, with progression to a severe condition of HELLP syndrome followed by posterior reversible encephalopathy syndrome (PRES) and hepatic infarction. We highlight the approach taken towards this patient and the case management, in which, in addition to the imaging examinations routinely available, we also used the sidestream dark field (SDF) technique to evaluate the systemic microcirculation.
    01/2014; 2014:389680. DOI:10.1155/2014/389680
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    Brazilian Journal of Cardiovascular Surgery 12/2013; 28(4):v-vii. DOI:10.5935/1678-9741.20130070
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    ABSTRACT: To evaluate the influence of the crown-rump length and body mass index on sonographic evaluation of the fetal heart using abdominal and vaginal routes in the first trimester of pregnancy. We conducted a cross-sectional study with 57 pregnant women between 12-14 weeks (CRL< 84 mm). We evaluated the following fetal cardiac plans using the abdominal and vaginal routes: four-chamber view, right ventricle outflow tract, left ventricle outflow tract and aortic arch. We used the B-mode, color Doppler and four-dimensional ultrasonography (spatio-temporal image correlation). To evaluate the influence of crown-rump length and body mass index in the assessment of fetal cardiac planes, we used the t test unpaired. There were no statistically significant differences in the rates of success and failure between abdominal and vaginal routes in relation to body mass index, however, there was a higher failure rate in vaginal assessment using B mode associated with color Doppler (P<0.01). The crown-rump length and body mass index had no interference in fetal cardiac assessment in the first trimester of pregnancy.
    Brazilian Journal of Cardiovascular Surgery 12/2013; 28(4):477-481. DOI:10.5935/1678-9741.20130078
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    ABSTRACT: Beckwith-Wiedemann syndrome is a genetic syndrome characterized by macroglossia, omphalocele, fetal gigantism and neonatal hypoglycemia. The authors report a case of Beckwith-Wiedemann syndrome diagnosed in a 32-year-old primigravida in whom two-dimensional ultrasonography revealed the presence of abdominal wall cyst, macroglossia and polycystic kidneys. Three-dimensional ultrasonography in rendering mode was of great importance to confirm the previous two-dimensional ultrasonography findings.
    Radiologia Brasileira 12/2013; 46(6):379-381. DOI:10.1590/S0100-39842013000600012
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    ABSTRACT: Congenital heart diseases are common in foetuses, with an incidence greater than six times that of chromosomal abnormalities; however, experts in cardiac anatomy have evaluated only the foetuses of pregnant women with increased risk for congenital heart disease. Over the years, it has become clear that congenital heart disease occur in foetuses of low-risk women. In the mid-1980s, a proposal to expand the assessment of cardiac anatomy was presented to obstetricians in order to improve prenatal screening. With the aim to systematise and improve the diagnosis of congenital heart disease in foetuses, the International Society of Ultrasound in Obstetrics and Gynecology established an ultrasound heart examination guideline. In this review, we have described the important features of this guideline and discussed the applications of this tool in clinical practice. We performed a literature search of the National Library of Medicine for publications released between 2000 and 2012; we used search terms pertinent to congenital heart disease, such as foetal echocardiography, foetal heart and cardiac screening examination. The guidelines serve as a standard and help to systematise the screening for congenital heart diseases, but we think that some topics may be added to design the most appropriate screening method. However, we cannot expand the topics to be evaluated in this examination without good training of sonographers who undergo this screening. Although the screening standardisation is a good tool to be used in day-to-day practice, the increment of aortic and ductal archs and colour Doppler to heart screening could be useful to detect further cardiac defects.
    Cardiology in the Young 11/2013; 24(3):1-8. DOI:10.1017/S1047951113001558 · 0.86 Impact Factor
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    ABSTRACT: Abstract Objective: To determine the reference values of nuchal translucency (NT) thickness at 11-14 weeks of gestation in a sample of the Brazilian population. Methods: A retrospective cross-sectional study was carried out with singleton gestations and fetuses with a crown-rump length (CRL) of 45-84 mm. NT thickness was performed according to the guidelines of the Fetal Medicine Foundation (FMF), London, UK. To evaluate the correlation between NT thickness and gestational age (GA), polynomial equations were calculated, with determination coefficient (R2) adjustments, as proposed by Altman-Chitty. Results: A total of 1420 pregnancies were assessed. The mean of the gestational age was 12.69±0.78 weeks. The mean maternal age was 28.78±6.81 years. The mean NT thickness (mm) for the CRL intervals of 45├50; 50├55; 55├60; 60├65; 65├70; 70├75; 75├80; 80├85 was 1.30±0.74; 1.34±0.60; 1.48±0.48; 1.56±0.68; 1.71±0.67; 1.78±0.69; 1.67±0.43; 1.67±0.58; respectively. The following second-order equation best represented the correlation between NT thickness and GA: NT=-1.2570+0.0765×GA-0.0005×GA2 (R2=0.05). Conclusion: The reference values for NT thickness were determined for a sample of the Brazilian population. Further studies are required to evaluate the real need for including these values in first-trimester screening for chromosomal defects in Brazil.
    Journal of Perinatal Medicine 11/2013; 42(2):1-5. DOI:10.1515/jpm-2013-0141 · 1.43 Impact Factor
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    ABSTRACT: Objectives To compare the variability in vascularization flow index (VFI) seen in serial acquisitions obtained using spatiotemporal image correlation (STIC) and using conventional static three-dimensional (3D) power Doppler (PD), for both in-vitro and in-vivo models, and to evaluate whether the curves formed by VFI values obtained from successive frames' in a STIC dataset are consistent and resemble the waveforms obtained by spectral Doppler analysis. Methods The study was divided into two parts: in the first part (the in-vitro model) we scanned a flow phantom, while in the second part (the in-vivo model) we scanned a common carotid artery. Conventional static 3D and STIC-PD datasets were alternately acquired from these two models. VFI values were assessed from 0.38-cm(3) spherical samples of the main flow region in the static 3D datasets and in every frame of the STIC datasets. The variance of the minimum, mean and maximum VFI values from each STIC dataset was compared with the variance of VFI values from the static 3D datasets. ResultsTen static 3D and 10 STIC datasets were acquired from each model. Analysis of the in-vitro and in-vivo models showed a significant reduction in the variance of VFI values obtained using STIC as compared to static datasets. Additionally, we observed that the curves formed by VFI values obtained from successive frames in each STIC dataset were consistent across different datasets and that they resembled the waveforms obtained by spectral Doppler in both models. Conclusions3D-PD indices derived from STIC are more stable than those obtained from conventional static 3D-PD datasets. The curves of VFI throughout a reconstructed cardiac cycle using STIC are repeatable and resemble those obtained by spectral Doppler analysis of the vessel. Copyright (c) 2013 ISUOG. Published by John Wiley & Sons Ltd.
    Ultrasound in Obstetrics and Gynecology 11/2013; 42(5). DOI:10.1002/uog.12419 · 3.14 Impact Factor
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    ABSTRACT: Objective: To determine reference values for the fetal cisterna magna volume by three-dimensional ultrasonography (3DUS) using the virtual organ computer-aided analysis (VOCAL) method. Methods: A cross-sectional study was conducted with 224 healthy pregnant women between 17 and 29 completed weeks. Measurement of the fetal cisterna magna volume was performed in the standard axial plane of the transverse diameter of the cerebellum through the VOCAL method with a 30° angle. For the determination of reference values, polynomial regressions with adjustments by the coefficient of determination (R2) were held. The reliability and agreement were made by the intra-class correlation coefficient (ICC) and limits of agreement of the Bland-Altman graph. Results: The average of the fetal cisterna magna volume ranged from 0.73 ± 0.25 to 3.79 ± 1.10 cm3 between 17 and 29 weeks, respectively. Correlation was observed between the fetal cisterna magna volume and the gestational age (GA), best represented by a quadratic equation: −1.918+0.0284 × GA + 0.0065 × GA2 (R2 = 0.67). It was observed good reliability and intra-observer agreement, with ICC = 0.92 and 95% limits of agreement (−49.7; 48.4). There was low inter-observer reliability and agreement, with ICC = 0.58 and 95% limits of agreement (−114.0; 80.2). Conclusion: Reference values for the fetal cisterna magna volume by 3DUS using the VOCAL method were determined and showed good agreement and intra-observer reliability.
    Journal of Maternal-Fetal and Neonatal Medicine 10/2013; 27(10). DOI:10.3109/14767058.2013.847419 · 1.21 Impact Factor

Publication Stats

569 Citations
477.32 Total Impact Points

Institutions

  • 2006–2015
    • Universidade Federal de São Paulo
      • Departamento de Obstetrícia
      San Paulo, São Paulo, Brazil
  • 2014
    • University of Melbourne
      • Department of Obstetrics and Gynaecology
      Melbourne, Victoria, Australia
  • 2008–2011
    • Santa Casa Medicine School, São Paulo
      San Paulo, São Paulo, Brazil