Influence of COVID-19 on mental health of postpartum women, breastfeeding time and infant development.

BACKGROUND: The COVID-19 pandemic may have affected the mental health of pregnant and postpartum women, influencing the duration of exclusive breastfeeding and the child's neuropsychomotor development. RESEARCH AIM: To evaluate the influence of COVID-19 on the mental health of postpartum women, on the protein and antioxidant profile of breast milk, on the duration of exclusive breastfeeding and on the neuropsychomotor development of their infants. METHODS: Observational study, prospective cohort, with 180 postpartum women. Psychosocial status was assessed by changes in mood and lifestyle; trait and state anxiety, and postpartum depression. Breastfeeding time and neuropsychomotor development were determined at the three-month well-child consultation based on the child's health record and the WHO Anthro software. 5 ml of mature breast milk were collected from the full breast of the lactating women. RESULTS: There was no difference between the prevalence of anxious traits and states and postpartum depression among seropositive and negative postpartum women for COVID-19. There was no difference in the prevalence of time and type of breastfeeding, and of normal and delayed neuropsychomotor development between seropositive and negative postpartum women for COVID-19. The fact that the baby smiles and raises and keeps his head elevated were associated with lower chances of an anxious state among postpartum women (OR: 0.23; OR: 0.28 and OR: 0.20, respectively). CONCLUSIONS: The need for more studies to investigate the influence of the COVID-19 pandemic on the mental health of postpartum women, breastfeeding and the neuropsychomotor development of babies is highlighted, given the importance of breast milk for the growth and development of babies.

Influence of Maternal Dietary Pattern on the Pro-Oxidant and Antioxidant Status of Mother's Own Milk.

BACKGROUND: Human milk is essential for a child's best development. However, what a mother eats while breastfeeding can directly influence the composition of mother's milk. RESEARCH AIM: This study aimed to assess the antioxidant-oxidant profile of human milk and establish a connection between this profile and the dietary habits of the mothers. METHODS: A cross-sectional study was conducted at the Hospital Infantil e Maternidade Alzir Bernardino Alves (HIMABA), located in the municipality of Vila Velha-ES, Brazil. The sample included 98 participants. All volunteers completed a structured interview and a Food Frequency Questionnaire. Approximately 5-10 ml of colostrum, transitional milk, and mature milk were manually collected. The antioxidant activity of human milk was assessed using the colorimetric method for free radical scavenging with 2,2'-azinobis-3-ethylbenzothiazoline-6-sulfonic acid. Oxidative stress was determined by measuring lipid peroxidation through malondialdehyde concentration, evaluating advanced oxidation protein products, and assessing total protein content using the Bradford method. RESULTS: The antioxidant profile of colostrum was higher than that observed in later phases of milk, whereas pro-oxidants increased in later phases. Maternal dietary patterns influenced the pro-oxidant status of human milk. Participants with a higher daily intake of milk, dairy products, vegetable oils, olive oils, and legumes exhibited lower levels of lipid peroxidation in colostrum, transition milk, and mature milk, respectively. CONCLUSIONS: Our study highlights the vital role of a balanced maternal diet in shaping the pro-oxidant status of human milk, with implications for infant health.

Leveraging the use of ionic liquid capillary columns and GC×GC-MS for fatty acid profiling in human colostrum samples.

Lipids in human colostrum provide the majority of energy intake and essential fatty acids for developing infants. The fatty acid composition of human colostrum is highly variable and influenced by multiple factors. Human colostrum is a complex sample bringing challenges to fatty acid profiling. This work aimed to optimize the use of ionic liquid (IL) columns and flow-modulated comprehensive two-dimensional gas chromatography coupled to mass spectrometry (FM-GC×GC-MS) for fatty acid profiling in human colostrum. Derivatization strategies were optimized and the elution behavior of fatty acid methyl esters (FAME) on various 1D column phases (Solgel-WAX, SLB-IL60i, SLB-IL76i, and SLB-IL111i). Derivatization with sodium methoxide yielded a satisfactory recovery rate (90%) at milder conditions and reduced time. The use of IL60 as the 1D column provided superior separation, good peak shape, and better utilization of elution space. As a proof of concept, the developed method was applied to access the effects of the mode of neonatal delivery (vaginal vs. C-section) on the fatty acid profile of human colostrum samples. The integrated multidimensional gas chromatography strategy improved FAME detection and separation and can be a useful tool for accessing the effects of different factors on the fatty acid profiling of complex samples.

The Influence of Time and Temperature on Human Milk Storage Antioxidant Properties, Oxidative Stress, and Total Protein.

BACKGROUND: Human milk is an essential source of nutrition for an infant's health. When breastfeeding working mothers or students, for example, are unable to breastfeed, storing their milk is recommended. Therefore, it is crucial to know the storage conditions to ensure their antioxidant capacity and avoid oxidative damage. RESEARCH AIM: To evaluate the stability of the antioxidant and pro-oxidant profiles and the amount of total protein in fresh human milk after different storage times (1, 2, 7, 14, and 21 days) and temperatures (4 ºC and -20 ºC). METHODS: This was a prospective, longitudinal, and observational study with milk samples grouped according to age for comparisons, which included 20 lactating women. The antioxidant activity was evaluated using the colorimetric methods of free radical scavenging 2,2'-azinobis-3-ethylbenzothiazoline-6-sulfonic acid and the decrease of ferric ion. Oxidative stress was determined by the lipid peroxidation product formation through malondialdehyde concentration, and the total protein content was assessed by the Bradford method. RESULTS: The antioxidant profile of human milk was maintained with minimal losses until the 14th day when stored at 4 ºC and -20 ºC. The evolution of malondialdehyde concentration over storage revealed significant changes only 21 days after human milk storage at 4 ºC. There was no change in the value of total protein content. CONCLUSIONS: To sum up, there is no difference in the storage of human milk at a temperature of 4 °C or -20 °C over 14 days. Therefore, the lactating woman may choose the most convenient way of storage.

Uso de modelo de olho não biológico na simulação de cirurgia de estrabismo: relato de experiência / Use of non-biological eye model in strabismus surgery simulation: experience report

Resumo: Introdução: Estrabismo é uma doença ocular caracterizada pelo desvio dos olhos cujo tratamento pode ser clínico ou cirúrgico. O ensino da cirurgia de estrabismo faz parte do programa de residência médica de oftalmologia, e seu treinamento é realizado mais frequentemente em sala de cirurgia, em situações reais. A aprendizagem ativa por experimentação ou simulação é cada vez mais utilizada na educação em saúde. Relato de experiência: O objetivo deste trabalho é descrever o relato de experiência da utilização de simulação como método de ensino de cirurgia de estrabismo para os médicos residentes do programa de residência de oftalmologia de um hospital universitário. Discussão: A simulação é um tipo de metodologia ativa que permite ao residente conquistar habilidades cirúrgicas por meio da repetição em ambiente seguro, de modo a diminuir as taxas de complicações cirúrgicas. Diferentemente de outros simuladores com tecnologia avançada para treinamento de cirurgia intraocular, nosso modelo de olho é uma ferramenta simples, de baixo custo e de fácil acesso e manuseio. A portabilidade e facilidade no manuseio permitem que o residente pratique as etapas com mais frequência desenvolvendo a memória com as etapas cirúrgicas. Conclusão: O ensino da cirurgia oftalmológica é uma tarefa desafiadora, e a utilização de métodos de aprendizagem ativa, como a simulação, é uma alternativa para o treinamento de habilidades cirúrgicas, com o propósito de diminuir as taxas de complicações.

Abstract: Introduction: Strabismus is an ocular condition characterized by eye misalignment. Its treatment can be clinical or surgical. The teaching of strabismus surgery is part of the medical residency program in ophthalmology. Its training is most often carried out in the operating theatre, in real situations. However, active learning through experimentation or simulation has been increasingly applied in health education. Experience Report: This study describes the use of simulation as a teaching method of strabismus surgery to ophthalmology residents. Discussion: Simulation is a type of active methodology that allows the resident to gain surgical skills through repetition in a safe environment. This can help reduce the risk of surgical complications. Unlike other simulators with advanced technology for intraocular surgery training, our model eye is a simple low-cost tool. It is easy to access and handle. The portability and ease of use allow the residents to practice the steps more frequently. Conclusion: The teaching of ophthalmic surgery is a challenging task and the use of active learning methods such as simulation is an alternative for training surgical skills.

EFFECT OF PASTEURIZATION ON THE ANTIOXIDANT AND OXIDANT PROPERTIES OF HUMAN MILK.

OBJECTIVE: To evaluate the effect of pasteurization on antioxidant and oxidant properties of human milk. METHODS: 42 samples of milk before and after pasteurisation were used to evaluate the antioxidant activity by the ferric reducing capacity and by scavenging the 2,2'-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid radical. Lipid peroxidation was estimated by the concentration of malondialdehyde product using the thiobarbituric acid reactive substances assay and by the evaluation of advanced oxidation protein products. RESULTS: No significant difference was observed in fresh human milk and after pasteurization in relation to antioxidant properties determined by the ferric reducing capacity (50.0±3.4% and 48.8±3.0%, respectively) and by scavenging the 2,2'-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid radical (28.9±1.5% and 31.2±1.3%, respectively). The results of malondialdehyde (62.6±4.1 and 64.3±3.6 µM/mg) and protein oxidation products (59.4±3.4 and 54.2±3.8 µM/L) of fresh and pasteurized milk, respectively, did not exhibited any significant difference. CONCLUSIONS: This data showed that human milk has an important antioxidant activity and that the pasteurizing process does not influence the antioxidant capacity, avoiding the peroxidation of breast milk lipids and the formation of advanced protein oxidation products.

Postpartum depression: a case-control study.

BACKGROUND: Postpartum depression (PPD) is a mild to severe mood disorder, starting at 6 weeks after birth and with an incidence of approximately 25% in Brazilian puerperae. Its occurrence induce significant aggravations to maternal and child health, however, its risk factors, although known, are little explored for the appropriate diagnosis. PURPOSE: To correlate PPD with anxiety, smoking, alcoholism, parity, type of birth, gestational and maternal age, identifying the possible risk factors that increase the probability of a puerpera developing a depressive episode. MATERIALS AND METHODS: A case-control study performed at the Alzir Bernardino Alves Infant and Maternity Hospital in the city of Vila Velha, Espirito Santo, Brazil. The sample consisted of 227 puerperae. The cutoff point for depression was defined as >10 points according to the Edinburgh Postnatal Depression Scale (EPDS), and cutoff points for anxiety were defined as <33 points for low anxiety, between 33 and 49 for moderate anxiety and >49 for high anxiety according to the State - Trait Anxiety Inventory (STAI-T). RESULTS: 29.1% of the 227 interviewed puerperae presented PPD and were considered "cases", with the remaining being considered as "control". There was a positive correlation between PPD and anxiety. No significant correlation was observed for the other risk factors. Women with moderate anxiety presented 17.38 times more probability to develop depressive episodes, and puerperae with high anxiety presented 273 times more chance of developing PPD. CONCLUSIONS: Our results evidenced a high percentage of puerperae with PPD related to maternal anxiety, demonstrating the importance and the necessity of increasing care for women's mental health in the gestational and puerperal periods.

Effect of pasteurization on the antioxidant and oxidant properties of human milk / Efeito da pasteurização nas propriedades antioxidantes e oxidantes do leite humano

ABSTRACT Objective: To evaluate the effect of pasteurization on antioxidant and oxidant properties of human milk. Methods: 42 samples of milk before and after pasteurisation were used to evaluate the antioxidant activity by the ferric reducing capacity and by scavenging the 2,2'-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid radical. Lipid peroxidation was estimated by the concentration of malondialdehyde product using the thiobarbituric acid reactive substances assay and by the evaluation of advanced oxidation protein products. Results: No significant difference was observed in fresh human milk and after pasteurization in relation to antioxidant properties determined by the ferric reducing capacity (50.0±3.4% and 48.8±3.0%, respectively) and by scavenging the 2,2'-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid radical (28.9±1.5% and 31.2±1.3%, respectively). The results of malondialdehyde (62.6±4.1 and 64.3±3.6 µM/mg) and protein oxidation products (59.4±3.4 and 54.2±3.8 µM/L) of fresh and pasteurized milk, respectively, did not exhibited any significant difference. Conclusions: This data showed that human milk has an important antioxidant activity and that the pasteurizing process does not influence the antioxidant capacity, avoiding the peroxidation of breast milk lipids and the formation of advanced protein oxidation products.

RESUMO Objetivo: Avaliar o efeito da pasteurização nas propriedades antioxidantes e oxidantes do leite humano. Métodos: Foram utilizadas 42 amostras de leite cru e após a pasteurização, para avaliação da atividade antioxidante pelos métodos da capacidade redutora do ferro e sequestro dos radicais derivados do ácido 2,2'-azino-bis (3-etilbenzotiazolina-6-sulfônico). A peroxidação lipídica (PL) foi estimada pela determinação das substâncias reativas ao ácido tiobarbitúrico e pela avaliação dos produtos proteicos de oxidação avançada. Resultados: Não se observou diferença significante no leite humano cru nem após a pasteurização em relação às propriedades antioxidantes determinadas pelo método da redução do ferro (50,0±3,4% e 48,8±3,0%, respectivamente) e pelo sequestro dos radicais derivados do ácido 2,2'-azino-bis (3-etilbenzotiazolina-6-sulfônico) (28,9±1,5% e 31,2±1,3%, respectivamente). Os resultados médios de malondialdeído [MDA] (62,6±4,1 e 64,3±3,6 µM/mg) e produtos de oxidação proteica (59,4±3,4 e 54,2±3,8 µM/L) entre os grupos leite fresco e leite pasteurizado, respectivamente, não evidenciaram diferença significante. Conclusões: Os dados demonstraram que o leite humano possui importante atividade antioxidante e que o processo de pasteurização não interfere nessa propriedade, evitando assim a peroxidação dos lipídios e a formação de produtos avançados de oxidação proteica.