Lipid changes throughout pregnancy according to pre-pregnancy BMI: results from a prospective cohort.

OBJECTIVE: To evaluate the rate of change in serum lipids and the factors associated with their variations, stratifying for pre-pregnancy body mass index (BMI) categories. DESIGN: Prospective cohort. SETTING: Public Health centre, Rio de Janeiro, Brazil. POPULATION: Two hundred and twenty-five healthy pregnant women recruited between 2009 and 2011. METHODS: Women were evaluated during the three trimesters of pregnancy (5th-13th, 20th-26th and 30th-36th gestational weeks). Pre-pregnancy BMI (kg/m²) was classified as normal weight (NW = 18.5-24.9), overweight (OW = 25.0-29.9) or obese (OB ≥ 30.0). The independent variables included maternal socioeconomic, demographic, biochemical and lifestyle factors. We performed linear mixed-effects models adjusted for gestational age and body weight, reporting coefficient (ß) and 95% confidence interval (95% CI). MAIN OUTCOME MEASURES: Longitudinal total cholesterol (TC), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c) and triglyceride (TG) measurements. RESULTS: OW and OB women presented higher mean TG, TC and LDL-c compared with their NW counterparts (P < 0.05). The mean HDL-c concentrations were higher in NW than in OB women (P = 0.03). OW and OB women presented lower serum TC (ßOW  = -0.014; 95% CI = -0.026 to -0.002; P = 0.022; ßOB  = -0.015; 95% CI -0.015 to 0.001; P = 0.066) and LDL-c (ßOW  = -0.012; 95% CI = -0.021 to -0.002; P = 0.017; ßOB  = -0.018; 95% CI = -0.031 to -0.005; P = 0.005) rates of change (mmol/l per gestational week) compared with the NW. Pre-gestational BMI was the main factor associated with the rate of changes in TC and LDL-c concentrations. CONCLUSION: Pre-pregnancy BMI was the main factor associated with the rate of change in TC and LDL-c throughout pregnancy, and OW and OB women presented lower rates of change compared with NW controls.

The effect of leptin concentrations and other maternal characteristics on gestational weight gain is different according to pre-gestational BMI: results from a prospective cohort.

OBJECTIVE: To evaluate the effect of leptin and other selected variables on gestational weight gain (GWG) according to pre-gestational body mass index (BMI). DESIGN: Prospective cohort. SETTING: Public Health Center, Rio de Janeiro, Brazil. SAMPLE: Two hundred and twenty-eight pregnant women. METHODS: Women were followed at the 5-13, 20-26 and 30-36th gestational weeks. The effects of independent variables on GWG in normal weight (BMI 18.5-24.9 kg/m(2) ), overweight (BMI 25.0-29.9 kg/m(2) ) and obese (BMI ≥ 30.0 kg/m(2) ) women were assessed using longitudinal linear mixed-effects models. MAIN OUTCOME MEASURE: Maternal body weight (kg) throughout pregnancy. RESULTS: Leptin concentrations were associated with GWG in normal weight (ß = 0.048, P < 0.001) and overweight (ß = 0.023, P = 0.048) women, but not in obese ones (ß = 0.011, P = 0.308). Additionally, the number of hours slept per night decreased the effect of leptin on GWG in OW women (ß = -0.013, P = 0.002). The effect of other maternal characteristics on GWG was different depending on the BMI category. CONCLUSIONS: Leptin concentrations were positively associated with GWG in normal weight and overweight women, but not in obese ones. Maternal height was associated with GWG in all BMI categories, but other variables such as sleep duration, QUICKI values, HDL-c, smoking habit and marital status presented differential effects according to BMI. We encourage further studies to investigate the association between leptin and gestational weight gain, taking into account the pre-pregnancy weight and sleep duration, in order to compare and confirm our results. TWEETABLE ABSTRACT: Leptin is associated with weight gain in normal weight and overweight pregnant women, but not in obese ones.

Food frequency questionnaire as an indicator of the serum composition of essential n-3 and n-6 polyunsaturated fatty acids in early pregnancy, according to body mass index.

BACKGROUND: We investigated whether food frequency questionnaire (FFQ) may be indicative of the serum composition of essential n-3 and n-6 polyunsaturated fatty acids (PUFAs) in early pregnancy and if correlations are affected by body mass index (BMI). METHODS: The present study comprised a prospective cohort conducted in Rio de Janeiro, Brazil. The sample was composed of 248 women, aged 20-40 years, between 6 and the 13 weeks of gestation. Dietary intake was assessed using a validated FFQ. Fatty acid serum compositions were determined in fasting serum samples, employing a high-throughput robotic direct methylation coupled with fast gas-liquid chromatography. Spearman's correlation (r(s)) was used to assess the relationship between fatty acid intake and corresponding serum composition. Women were classified according to BMI (kg m(-2) ) as underweight/normal weight (BMI < 25 kg m(-2) ; n = 139) or excessive weight (BMI ≥ 25 kg m(-2) ; n = 109). RESULTS: In the total sample, dietary report was significantly correlated with the serum composition of total polyunsaturated fatty acid (PUFA; r(s) = 0.232, P < 0.001), linoleic acid (LA; 18:2n-6; r(s) = 0.271, P < 0.001), eicosapentaenoic acid (EPA; 20:5n-3; r(s) = 0.263, P < 0.001) and docosahexaenoic acid (DHA; 22:6n-3; r(s) = 0.209, P = 0.001). When analyses were stratified by BMI, significant correlations between FFQ and serum composition among underweight/normal weight women were observed for total PUFA (r(s) = 0.323, P < 0.001), LA (r(s) = 0.322, P < 0.001), EPA (r(s) = 0.352, P < 0.001) and DHA (r(s) = 0.176, P = 0.039). Among women of excessive weight, significant correlations were observed only for alpha linolenic acid (ALA; 18:3n-3; r(s) = 0.199, P = 0.040) and DHA (r(s) = 0.236, P = 0.014). CONCLUSIONS: FFQ in early pregnancy may be used as a possible indicator of serum concentrations of fatty acids. Higher correlations were observed among underweight/normal weight women.

Readmission of known MRSA carriers and MRSA colonization pressure in hospital.

Readmission of asymptomatic methicillin-resistant Staphylococcus aureus (MRSA) carriers may contribute to the hospital reservoir. Using an electronic alert system, we assessed the weight of readmission of known MRSA carriers on MRSA colonization pressure in a hospital setting. During the 2004-2010 period, 2058 alerts were generated for 1060 inpatients. A total of 486/1060 patients (46%) were readmitted at least once, and 330/486 (64·4%) were readmitted <3 months after discharge. A mean of 20 MRSA patients were present on the same day (from 40 in 2004 to eight in 2010). The number of MRSA patient-days was 34 575, i.e. 2·5% of the 1 366 277 patient-days of the study period, and 17 737 (51·3%) MRSA patient-days were due to readmission of known MRSA carriers. The number of new MRSA cases was partly correlated with the number of MRSA patients hospitalized (R 2 = 0·49). Rapid electronic identification of these patients proved essential in decreasing the global burden of MRSA in our hospital.

Translating research into practice: the introduction of the INTERGROWTH-21st package of clinical standards, tools and guidelines into policies, programmes and services.

The INTERGROWTH-21(st) Project has generated a package of international clinical standards, tools and guidelines. It is now necessary to plan for the next phase of the project: the translation of the research findings into practice through its global dissemination. The plan is to pre-empt barriers to implementation by drawing from the published literature; gathering views and perspectives from policy makers, programmers and practitioners; incorporating input from local 'champions', and collecting and analysing data generated by a monitoring and evaluation system. Working at the global, regional, national and local levels will enable wide dissemination of the package, as well as increase the scope for adaptation and integration in diverse clinical contexts. We seek maximum uptake of the package in policies, guidelines and clinical practice to improve the quality of care offered to mothers and newborns. The strategy will also enhance our understanding of the effectiveness of different approaches to the translation of evidence into practice.

Is soft drink consumption associated with gestational hypertension? Results from the BRISA cohort.

It is still unknown whether excessive consumption of sugar-sweetened beverages may be linked to gestational hypertensive disorders, other than preeclampsia. This study investigated the association between soft drink consumption and hypertension during pregnancy, analyzing the relationship from the perspective of counterfactual causal theory. Data from pregnant women of the BRISA cohort were analyzed (1,380 in São Luis and 1,370 in Ribeirão Preto, Brazil). The explanatory variable was the frequency of soft drink consumption during pregnancy obtained in a prenatal interview. The outcome was gestational hypertension based on medical diagnosis, at the time of delivery. A theoretical model of the association between soft drink consumption and gestational hypertension was constructed using a directed acyclic graph. Marginal structural models (MSM) weighted by the inverse of the probability of soft drink consumption were also employed. Using Poisson regression analysis, high soft drink consumption (≥7 times/week) was associated with gestational hypertension in São Luís (RR=1.48; 95%CI: 1.03-2.10), in Ribeirão Preto (RR=1.51; 95%CI: 1.13-2.01), and in the two cohorts combined (RR=1.45; 95%CI: 1.16-1.82) compared to lower exposure (<7 times/week). In the MSM, the association between high soft drink consumption and gestational hypertension was observed in Ribeirão Preto (RR=1.63; 95%CI: 1.21-2.19) and in the two cohorts combined (RR=1.51; 95%CI: 1.15-1.97), but not in São Luís (RR=1.26; 95%CI: 0.79-2.00). High soft drink consumption seems to be a risk factor for gestational hypertension, suggesting that it should be discouraged during pregnancy.

Birth weight and adult bone mass: a systematic literature review.

SUMMARY: This systematic literature review comprised 16 studies. The association of birth weight with bone parameters was much more evident for bone mineral content (BMC) rather than bone mineral density (BMD). This is an important finding since a reduction in BMC is strongly associated with an increased risk of fractures. INTRODUCTION: The purpose of this study was to conduct a systematic literature review of studies that have investigated the association between birth weight (BW) and adult bone mass. METHODS: The search included English language articles, indexed in MEDLINE, using the key words: ("birth size" OR "birth weight" OR birthweight) AND (osteoporosis OR "bone mass" OR "bone density" OR "bone mineral density" OR "bone mineral content" OR "bone area"). A methodological quality appraisal of the reviewed studies was performed. RESULTS: Sixteen articles were reviewed. Eleven of 13 studies that measured BMC verified a positive effect of BW on this parameter, and nine even after adjustment for adult body size. Among the ten studies that found an unadjusted association between BW and BMD, two reported that the significance remained after adjustment for current body size. Interaction between prenatal and postnatal variables on the determination of adult bone mass was only tested by two studies. The results must be interpreted with caution due to the existence of few papers on the issue, as well as heterogeneous sample characteristics, investigated bone sites, and implemented analysis procedures. The aspects of methodological quality that frequently fail are as follows: representativeness of the planned and actually measured sample as well as proper adjustment for confounding. CONCLUSION: Based on the amount of accumulated evidence, it is probable that BW have a positive association with adult BMC rather than BMD, which is an important finding for clinical and public health policies since a reduction in BMC is strongly associated with an increased fracture risk.

Evaluation of a new disinfection procedure for ultrasound probes using ultraviolet light.

Following 183 ultrasound examinations, a randomized trial was conducted to compare three procedures for disinfection of probes under routine conditions: dry wiping with a soft, dry, non-sterile paper towel, antiseptic wiping with a towel impregnated with disinfectant spray and dry wiping followed by a 10 min ultraviolet C (UVC) cycle in a disinfection chamber. After ultrasonography, swabs were taken from transducer heads before and after cleaning and streaked onto plates that were then cultured. The number of colonies per plate was counted and organisms identified. The median microbial reduction was 100% for UVC, 98.4% for antiseptic wiping and 87.5% for dry wiping (P<0.001). The percentage of negative specimens was 88% for UVC, 16% for antiseptic wiping and 4% for dry wiping (P<0.0001). Microbial flora was isolated from 12 probes (6.6%) before cleaning, whereas specimens obtained after cleaning contained no pathogens except in one case after antiseptic wiping. UVC disinfection of ultrasound probe may provide a useful method for reducing the bacterial load under routine conditions.

Serum n-3 polyunsaturated fatty acids are inversely associated with longitudinal changes in depressive symptoms during pregnancy.

BACKGROUNDS: N-3 polyunsaturated fatty acids (PUFAs) have been hypothesised to be protective for depression during pregnancy. However, there are few data and no consensus regarding this association. In this line, we aim to evaluate if the concentration of n-3 and n-6 PUFAs, and their ratio, are associated with depressive symptoms throughout pregnancy. METHOD: A prospective cohort of 172 Brazilian women was followed at 5-13th, 20-26th and 30-36th weeks of gestation. The presence of depressive symptoms was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) at each pregnancy trimester. Depression was defined as an EPDS score ≥11. The concentrations of n-3 [α-linolenic acid; eicosapentaenoic acid (EPA); docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA)] and n-6 PUFAs [linoleic acid; γ linolenic acid; eicosadienoic acid; eicosatrienoic acid; arachidonic acid; docosatetraenoic acid and docosapentaenoic acid] were expressed as absolute (µg/ml) values. The total n-6/n-3 ratio was calculated. Statistical analyses were performed using univariate and adjusted random intercept logistic model for each fatty acid (FA) considering the longitudinal nature of data. Covariates were selected as potential confounders based on their biological plausibility of having an association with the concentration of FA and depressive symptoms during pregnancy. RESULTS: The prevalence of depressive symptoms was high in all pregnancy trimesters (1st = 33.7%; 2nd = 18.9%; 3rd = 17.4%). We did not find differences in means FA concentrations by depressive symptom classification, for each follow-up visit. The women presented a 5% decrease in the odds of having depressive symptoms for each one-week increase in the gestational age. As individual women progressed through pregnancy, higher concentrations of EPA (odds ratio (OR) = 0.92; 95% CI: 0.86-0.99), DHA (OR = 0.96; 95% CI: 0.93-0.99), DPA (OR = 0.87; 95% CI: 0.77-0.99) and total n-3 (OR = 0.98; 95% CI: 0.96-0.99) were associated with a lower odds of depressive symptoms, while higher total n-6/n-3 ratio were associated with greater odds of depressive symptoms (OR = 1.40; 95% CI: 1.09-1.79). We detected a decrease in the probability of depressive symptoms as concentrations of total n-3 FA, α-linolenic acid, DPA, and DHA increased. We also observed a sharper decline for women with initial greater chance of depressive symptoms compared with those with lower chance of having these symptoms. CONCLUSIONS: We found a high prevalence of depressive symptoms in low-income Brazilian pregnant women and no significant associations between n-6 FA and depressive symptoms. Lower serum concentrations of DHA, EPA and DPA and a higher n-6/n-3 ratio at each pregnancy trimester were associated with higher odds of depressive symptoms throughout pregnancy.

Is soft drink consumption associated with gestational hypertension? Results from the BRISA cohort

It is still unknown whether excessive consumption of sugar-sweetened beverages may be linked to gestational hypertensive disorders, other than preeclampsia. This study investigated the association between soft drink consumption and hypertension during pregnancy, analyzing the relationship from the perspective of counterfactual causal theory. Data from pregnant women of the BRISA cohort were analyzed (1,380 in São Luis and 1,370 in Ribeirão Preto, Brazil). The explanatory variable was the frequency of soft drink consumption during pregnancy obtained in a prenatal interview. The outcome was gestational hypertension based on medical diagnosis, at the time of delivery. A theoretical model of the association between soft drink consumption and gestational hypertension was constructed using a directed acyclic graph. Marginal structural models (MSM) weighted by the inverse of the probability of soft drink consumption were also employed. Using Poisson regression analysis, high soft drink consumption (≥7 times/week) was associated with gestational hypertension in São Luís (RR=1.48; 95%CI: 1.03-2.10), in Ribeirão Preto (RR=1.51; 95%CI: 1.13-2.01), and in the two cohorts combined (RR=1.45; 95%CI: 1.16-1.82) compared to lower exposure (<7 times/week). In the MSM, the association between high soft drink consumption and gestational hypertension was observed in Ribeirão Preto (RR=1.63; 95%CI: 1.21-2.19) and in the two cohorts combined (RR=1.51; 95%CI: 1.15-1.97), but not in São Luís (RR=1.26; 95%CI: 0.79-2.00). High soft drink consumption seems to be a risk factor for gestational hypertension, suggesting that it should be discouraged during pregnancy.

Monitoring air sampling in operating theatres: can particle counting replace microbiological sampling?

Microbiological contamination of air in the operating room is generally considered to be a risk factor for surgical site infections in clean surgery. Evaluation of the quality of air in operating theatres can be performed routinely by microbiological sampling and particle counting, but the relationship between these two methods has rarely been evaluated. The aim of this study was to determine whether particle counting could be predictive of microbiological contamination of air in operating rooms. Over a three-month period, air microbiological sampling and particle counting were performed simultaneously in four empty operating rooms belonging to two surgical theatres equipped with conventional ventilation via high-efficiency particulate air filters. Correlation between the two methods was measured with Spearman's correlation coefficient. The ability of particle counting to discriminate between microbiological counting values higher and lower than 5 colony-forming units (CFU)/m3 was evaluated using receiver-operating characteristic (ROC) analysis. Microbiological counting ranged from 0 to 38CFU/m3, while the particle counts ranged from 0 to 46 262/m3. Methods of microbiological and particle counting did not correlate (Spearman correlation coefficient=0.06, P=0.6). Using the ROC curve, no particle count value could be predictive of a microbiological count higher than 5CFU/m3. The results of the current study suggest that there is no reason to replace microbiological sampling with particle counting for routine evaluation of microbiological contamination in conventionally ventilated operating theatres.

Microbiological evaluation of two hand hygiene procedures achieved by healthcare workers during routine patient care: a randomized study.

The aim of this study was to evaluate the comparative microbiological efficacy of hand rubbing and handwashing in healthcare workers from different wards, with particular emphasis on transient flora, and to assess predisposing factors for hand contamination after patient care in everyday practice. Over a six-month period, 50 healthcare workers were randomly assigned, using a crossover design, to perform handwashing with unmedicated soap and hand rubbing with an alcoholic solution following a healthcare procedure. Imprints of palms and fingertips were taken separately before and after each hand hygiene procedure. The number of colonies per plate was counted and transient pathogens were identified. Risk factors for hand contamination were determined. Hand rubbing produced a significantly greater reduction in microbiological load than handwashing (P<0.0001 for palms and P=0.0003 for fingertips). In multivariate analysis, working in a medical ward rather than in an intensive care unit was significantly associated with increased hand contamination (P=0.03 for palms and P=0.02 for fingertips). Transient pathogens were found on 15% of healthcare workers' hands before hand hygiene. The only factor associated with hand contamination by transient pathogens was the absence of gloving during the healthcare procedure (odds ratio 4.8; 95% confidence interval 1.2-19; P=0.03). After hand rubbing, no transient pathogens were recovered, while these were found in two cases after handwashing. Hand rubbing is more efficacious than handwashing for the decontamination of healthcare workers' hands following contact with patients and patients' environments. Gloving may reduce microbiological hand contamination by transient pathogens.

Fulminant invasive pulmonary aspergillosis in immunocompetent patients--a two-case report.

Two cases of invasive aspergillosis (IA) in immunocompetent patients with a fulminant fatal outcome are reported. Both patients were elderly and had a history of chronic lung disease treated with prolonged inhaled corticosteroids and a short course of systemic corticosteroids. They presented with dyspnea and fever, their respiratory function deteriorated rapidly, and they died 7 days after admission. Aspergillus fumigatus was cultured from respiratory samples. IA was confirmed in one case by necropsy that showed diffuse bilateral necrotizing pneumonitis and myocarditis. In the other case, IA diagnosis was established by thoracic CT scan plus detection of Aspergillus antigen in two blood samples. These two cases demonstrate that short-term corticosteroid therapy in immunocompetent patients with underlying chronic lung conditions is a risk factor for IA, and that its evolution can be fulminant.

Methicillin-resistant Staphylococcus aureus. Nosocomial acquisition and carrier state in a wound care center.

OBJECTIVE: To assess methicillin-resistant Staphylococcus aureus (MRSA) nosocomial acquisition and carrier state in a wound care center. DESIGN AND SETTING: The results of an intervention to control MRSA were compared with those of historical controls at the wound care center of university-based Hôpital Broussais, Paris, France. PATIENTS: Patients admitted for specific care of chronic ulcers and surgical wounds. MAIN OUTCOME MEASURES: Incidence rates of MRSA carriers and acquisition in wounds. RESULTS: Of 88 patients admitted during a 3-month preintervention period in 1993, 18 (21%) were MRSA carriers. Of 334 patients admitted in 1994 and 395 in 1996, 65 (19.5%) and 81 (20.5%) were MRSA carriers, respectively (P=.80). In 1993, 6 (9%) of 70 patients without MRSA acquired MRSA wound infections; the corresponding numbers were 6 (2.2%) of 269 in 1994 and 3 (0.9%) of 314 in 1996. Despite that the number of MRSA carriers remained stable at admission to the wound care center, the rate of MRSA infections in wounds per 100 noncarriers decreased significantly between the preintervention period and subsequent years: 1994 (P=.02) and 1996 (P=.002). CONCLUSIONS: Although our results are limited by the use of historical controls, they showed that simple infection control measures, such as the use of soap and water and barrier precautions associated with staff education, seemed to significantly reduce MRSA infection rates in patients with chronic skin breaks.

[Secular height trend: a literature review]. / Tendência secular em estatura: uma revisão da literatura.

This paper presents a literature review of secular height trends. The principal topics included were definition of the phenomenon, use of historical data sets on height as an alternative approach for monitoring economic changes, the main theoretical explanations of the phenomenon, the beginning of military anthropometry, and past and current use in measuring secular height trends in recruits and children. The most important results showed that the positive secular trend can be attributed to environmental influences, especially improvements in health, economic, and social conditions. The mean reported rates in height increases varied with age, socioeconomic status, and country, so one must exercise caution in drawing inferences. World War II slowed the trend in several countries, including Brazil, but the trend was stronger in the post-war period than in the beginning of the century. Finally, we observed that data from military anthropometry are the most common source for estimating secular height trends.

[Secular trends in the stature of Brazilian Navy recruits born from 1940 and 1965]. / Tendência secular em estatura em recrutas da Marinha do Brasil nascidos entre 1940 e 1965.

The present paper reports data on secular trends in the stature of Brazilian Navy recruits born from 1940 to 1965. The final sample included 3269 individuals aged 18.00-18.99. Statistics performed were: ANOVA (one-way and two-way), Sheffe test, simple linear regression between stature and year of birth, and multiple linear regression adjusting for level of schooling (beta coefficient) and chi-square. Results indicated a progressive growth trend in stature of 0.1 cm/yr. for the country as a whole. The trend was also observed for nearly all regions and two out of three levels of schooling and can be explained by improvement in some of the country's health indicators. One important characteristic was a higher level of schooling observed among Navy recruits, suggesting that these individuals represent a highly select group, and that therefore data on the Navy cannot be applied directly to the Brazilian population as a whole.

[Determinant factors of postpartum weight retention: a literature review]. / Fatores determinantes da retenção de peso no pós-parto: uma revisão da literatura.

This study is a literature review of factors determining postpartum weight gain retention. According to the literature, the main factors include gestational weight gain and intensity of lactation. Various studies show that the greater the weight gain during pregnancy, the greater the postpartum weight retention. Smoking was associated with lower retention, while lactation only demonstrated a protective effect against weight retention in some studies. Various factors, like physical activity, food consumption, age at menarche, number of abortions, and mother's work status have still not been properly studied. The conclusion is that there are few studies on postpartum weight changes, suggesting the need for new research on the theme, especially in developing countries where obesity has been insufficiently researched thus far.

[The influence of selection and measurement bias on secular trend in height estimates from Brazilian Navy data]. / Influência do viés de seleção e de aferição em estimativas de tendência secular da estatura baseadas em dados da Marinha do Brasil.

Data of bias occurrence of secular height trend estimates based on Brazilian Navy data are presented. Three data sets were analyzed; one for the 1940-65 period and two for the 70s.

[Factors associated with abdominal obesity among childbearing-age women]. / Fatores associados à obesidade abdominal em mulheres em idade reprodutiva.

OBJECTIVE: To investigate variables potentially associated with abdominal obesity among childbearing-age women. METHODS: A total of 781 women were studied based on data from the Nutrition and Health Survey conducted in 1996 in the municipality of Rio de Janeiro, Brazil. Abdominal obesity was defined as waist girth (WG) > 80 cm or waist:hips girth ratio (WHR) > 0.85. Statistical analysis involved calculation of central trend measures. Calculating the odds ratio using multivariate logistic regression tested the association between abdominal obesity and BMI, age, parity, and tobacco use. RESULTS: The highest frequencies of abdominal obesity were observed in women over 35 years of age and those with two or more children (50.7%). OR showed the effect of interaction between parity and age for WG>80 cm when only the effect of these two variables was controlled. Based on the logistic regression models, the study showed that when the population was categorized into women with and without overweight, schooling was the only factor associated with WHR, while the association with age and parity disappeared for WG>80 cm. CONCLUSIONS: Abdominal obesity in this population group is independent of age and parity when adjusted by relative weight, with overall adiposity and schooling as the greatest determinant. Having more schooling meant having a smaller WHR. It is crucial to implement strategies to prevent the development of obesity in childbearing-age women.

[Contribution of Trichrome Blue in the diagnosis of microsporidiosis]. / Apport du trichrome bleu dans le diagnostic des microsporidioses.

Detection of microsporidia belongs to the usual coprologic and urine detection of parasites from HIV seropositive patients. To improve the identification of microsporidial spores, several stains have been used. Trichrome Blue stain has been evaluated in this study. We first compared Trichrome Blue stain to Weber's trichrome for the detection of microsporidia in smears of stools received from HIV seropositive patients. No difference of sensibility has been demonstrated between the two stains, and Uvitex 2B used on the same samples has confirmed these results. Then, Trichrome Blue stain has been used for the detection of microsporidial spores in other specimens (40 samples of nasal mucus, conjonctival samples, duodenal biopsy and urine), also Giemsa and Uvitex 2B. The advantage of Trichrome Blue stain is its ready-to-use presentation, and faster realisation at higher temperature. Trichrome Blue stain is interesting as a confirmation technique or for laboratories which do not have fluorescent microscopy equipment.