Hepatopancreatic metabolic disorders and their implications in the development of Alzheimer's disease and vascular dementia.

Dementia has been faced with significant public health challenges and economic burdens that urges the need to develop safe and effective interventions. In recent years, an increasing number of studies have focused on the relationship between dementia and liver and pancreatic metabolic disorders that result in diseases such as diabetes, obesity, hypertension and dyslipidemia. Previous reports have shown that there is a plausible correlation between pathologies caused by hepatopancreatic dysfunctions and dementia. Glucose, insulin and IGF-1 metabolized in the liver and pancreas probably have an important influence on the pathophysiology of the most common dementias: Alzheimer's and vascular dementia. This current review highlights recent studies aimed at identifying convergent mechanisms, such as insulin resistance and other diseases, linked to altered hepatic and pancreatic metabolism, which are capable of causing brain changes that ultimately lead to dementia.

Movement Behavior during Pregnancy and Adverse Maternal-Fetal Outcomes in Women with Gestational Diabetes: A Pilot Case-Control Study.

Gestational diabetes mellitus (GDM) is a major complication in pregnancy. GDM is associated with a higher risk for adverse maternal-fetal outcomes. Associations between movement behavior, including physical activity (PA) and sedentary behavior (SB), and maternal-fetal outcomes are still unclear. The objective of this study was to investigate associations between movement behavior and adverse maternal-fetal outcomes in women with GDM. A total of 68 women with GDM (20-35 weeks, 32.1 ± 5.8 years) were included in this pilot case-control study. The cases were defined by the presence of an adverse composite maternal-fetal outcome (preterm birth, newborn large for gestational age, and neonatal hypoglycemia). Controls were defined as no adverse maternal-fetal outcome. PA intensities and domains, steps/day (pedometer), and SB were analyzed. A total of 35.3% of participants showed adverse maternal-fetal outcomes (n = 24). The controls showed a higher moderate-intensity PA level than the cases (7.5, 95%CI 3.6-22.9 vs. 3.1, 95%CI 0.4-10.3 MET-h/week; p = 0.04). The moderate-intensity PA level was associated with a lower risk for adverse maternal-fetal outcomes (OR 0.21, 95%CI 0.05-0.91). No significant associations were observed for other PA and SB measures (p > 0.05). In conclusion, moderate-intensity PA during pregnancy seems to have a protective role against adverse maternal-fetal outcomes in women with GDM.

Treatment of bacterial vaginosis before 28 weeks of pregnancy to reduce the incidence of preterm labor.

BACKGROUND: Controversy exists regarding the benefits of treating bacterial vaginosis (BV) during pregnancy to reduce the incidence of preterm labor (PTL). OBJECTIVES: To evaluate whether treatment of BV with vaginal clindamycin or oral metronidazole before 28 weeks of pregnancy reduces PTL incidence. SEARCH STRATEGY: PubMed, Scopus, Web of Science, Science Direct, CENTRAL, and SciELO databases were searched until December 30, 2017. Search terms included "bacterial vaginosis" and "preterm labor." No language restrictions were applied. SELECTION CRITERIA: Randomized clinical trials that evaluated treatment of BV with clindamycin or metronidazole to reduce PTL incidence. DATA COLLECTION AND ANALYSIS: The risk of PTL was evaluated by the odds ratio (OR) and 95% confidence interval (CI). Dichotomous data from each study were combined for meta-analysis using the Mantel-Haenszel model. MAIN RESULTS: Nine reports were included in the systematic review, with eight reports included in the meta-analysis. No reduction in the incidence of PTL was found for either metronidazole (OR 0.94, 95% CI 0.71-1.25) or clindamycin (OR 1.01, 95% CI 0.75-1.36). CONCLUSIONS: Use of oral metronidazole or vaginal clindamycin to treat BV before 28 weeks of pregnancy did not reduce the incidence of PTL. PROSPERO registration: CRD42018086173.

Gestação e câncer de colo de útero: relato de caso / Uterine cervix carcinoma and pregnancy: a case-report

O carcinoma invasivo da cérvice uterina associado à gestação é situação infrequente. Os autores apresentam um caso de carcinoma de colo de útero estádio IIIb, associado à gravidez. O estudo analisa as características dessa patologia, os meios diagnósticos e o tratamento (AUï)