Relationship between Borderline Personality Disorder, Emotional Availability, and Cortisol Output in Mother-Child Dyads.

BACKGROUND: Mothers with borderline personality disorder (BPD) often show altered emotional availability toward their own child and heightened stress vulnerability. The aims of the present study were (1) to examine total cortisol output in saliva during mother-child interaction in mothers with BPD and their children and (2) to test whether maternal nonhostility as a subscale of emotional availability mediates the relationship between maternal BPD and child total cortisol output. METHODS: We investigated 16 mothers with BPD and 30 healthy control mothers (HC) and 29 children of mothers with BPD and 33 children of HC mothers. Children were between 5 and 12 years old. Salivary cortisol was collected prior to and twice after an episode of a 21-min standardized play situation between mother and child. Nonhostility was rated using the emotional availability scales. Analyses of covariance were computed to test for group differences in total cortisol output (measured with area under the curve with respect to ground). Pearson's correlation was calculated to test the association between maternal and child total cortisol output. To test the second question, a mediation analysis according to Preacher and Hayes was conducted. RESULTS: Mothers with BPD and their children had lower total cortisol output. Maternal and child total cortisol output was significantly correlated. Contrary to our hypothesis, maternal nonhostility did not mediate the relationship between BPD and child total cortisol output. CONCLUSION: Results imply that the hormonal stress activity of mothers with BPD and their children is altered, which may reflect modified stress regulation and stress vulnerability in mother and child and may impact on mother-child interaction. The finding of a positive association between mother's and child total cortisol output could indicate an intergenerational transmission of these alterations.

Neurodevelopmental Syndrome with Intellectual Disability, Speech Impairment, and Quadrupedia Is Associated with Glutamate Receptor Delta 2 Gene Defect.

Bipedalism, speech, and intellect are the most prominent traits that emerged in the evolution of Homo sapiens. Here, we describe a novel genetic cause of an "involution" phenotype in four patients, who are characterized by quadrupedal locomotion, intellectual impairment, the absence of speech, small stature, and hirsutism, observed in a consanguineous Brazilian family. Using whole-genome sequencing analysis and homozygous genetic mapping, we identified genes bearing homozygous genetic variants and found a homozygous 36.2 kb deletion in the gene of glutamate receptor delta 2 (GRID2) in the patients, resulting in the lack of a coding region from the fifth to the seventh exons. The GRID2 gene is highly expressed in the cerebellum cortex from prenatal development to adulthood, specifically in Purkinje neurons. Deletion in this gene leads to the loss of the alpha chain in the extracellular amino-terminal protein domain (ATD), essential in protein folding and transport from the endoplasmic reticulum (ER) to the cell surface. Then, we studied the evolutionary trajectories of the GRID2 gene. There was no sign of strong selection of the highly conservative GRID2 gene in ancient hominids (Neanderthals and Denisovans) or modern humans; however, according to in silico tests using the Mfold tool, the GRID2 gene possibly gained human-specific mutations that increased the stability of GRID2 mRNA.

Analysis of sexually transmitted infections in PrEP users: population assessment in Curitiba, Brazil / Análise das infecções sexualmente transmissíveis em usuários de PrEP: avaliação de população em Curitiba

Introduction: The pre-exposure prophylaxis (PrEP) is a globally recognized pharmacological approach, consisting of a daily dose of antiretroviral drugs used to reduce the contamination rate by the human immunodeficiency virus (HIV). This combined prevention program was first offered by the Brazilian public health system in 2017 and was provided by Testing and Counseling Centers. Objective: To analyze the profile of pre-exposure prophylaxis users seen at Testing and Counseling Centers in Curitiba (state of Paraná, Brazil) and the presence of HIV and other sexually transmitted infections, such as syphilis, hepatitis B and C, in these users. Methods: This is an analytical, cross-sectional study, using database provided by the information system of the Testing and Counseling Center. Results: Users of HIV pre-exposure prophylaxis are mostly young, white, single men, and who are part of the group of men who have sex with other men. It was verified that, even though the HIV pre-exposure prophylaxis plays a major role in HIV prevention, it is paramount to encourage combined prevention, considering there is a significant relationship between the lack of barrier methods and positive results for syphilis. Conclusion: No connection between the use of HIV pre-exposure prophylaxis and increased incidence of sexually transmitted infections was established in the present study.

Introdução: A profilaxia pré-exposição é uma abordagem farmacológica global, que consiste no uso diário de antirretrovirais, utilizada para reduzir a contaminação pelo vírus da imunodeficiência humana. É uma estratégia de prevenção combinada que começou a ser ofertada no Brasil pelo Sistema Único de Saúde em 2017, por meio dos Centros de Testagem e Aconselhamento. Objetivo: Analisar o perfil dos usuários da profilaxia pré-exposição atendidos pelo Centro de Orientação e Aconselhamento de Curitiba, bem como analisar a presença do vírus da imunodeficiência humana e outras infecções sexualmente transmissíveis (sífilis, hepatite B e hepatite C) nesses usuários. Métodos: É um estudo analítico transversal, utilizando dados do Sistema de Informação do Centro de Testagem e Aconselhamento fornecidos pelo Centro de Orientação e Aconselhamento. Resultados: Foi observado que os usuários da profilaxia no estudo são majoritariamente jovens do sexo masculino, brancos e solteiros, que se enquadram no grupo homens que fazem sexo com homens. Verificou-se também que ainda que a profilaxia pré-exposição desempenhe um papel importante na prevenção do HIV, é fundamental o incentivo à prevenção combinada, pois há uma relação do não uso de métodos de barreira com os resultados positivos para sífilis nesses pacientes. Conclusão: Não foi possível, neste estudo, estabelecer uma relação do uso de profilaxia pré-exposição com o aumento da incidência de infecções sexualmente transmissíveis.

Prognostic capability of the Maximum Acute Gastrointestinal Injury Score and of caloric intake in patients requiring vasopressors: A multicenter prospective cohort study.

PURPOSE: Our main objective was to use the Maximum Acute Gastrointestinal Injury Score (AGImax) to evaluate the prognostic capability of gastrointestinal dysfunction (GID), on hospital mortality in patients on mechanical ventilation (MV) requiring vasopressors. A secondary goal was to analyze the relationship between AGImax and vasopressor dosage with increasing caloric intake. MATERIALS AND METHODS: Prospective multicenter cohort study in ten ICUs across Argentina. Consecutive adult patients on MV, requiring vasopressors and receiving enteral nutrition (EN) were included. AGImax was identified (I-IV) using a modified AGI score. Comparisons of clinical and outcome variables were performed in 3 predetermined EN-groups: <10 kcal/kg/d, ≥10 to <20 kcal/kg/d, or ≥ 20 kcal/kg/d. RESULTS: A total of 494 patients met all inclusion criteria. Forty-four percent of patients had severe AGImax and 17% received <10 kcal/kg/day, indicating more severity and higher mortality. Notable independent predictors of mortality were AGImax, vasopressors, and caloric intake. PN was the only factor which had an inverse relationship to mortality. CONCLUSIONS: In this population, patients with AGImax III-IV were significantly associated with lower caloric intake and greater hospital mortality, highlighting the importance of AGI as a prognostic tool. As PN was linked with lower mortality, it could be an option to explore in further studies.

[Oxytocin and maltreatment potential : Influence of maternal depression, borderline personality disorder and experience of early childhood maltreatment]. / Oxytocin und Misshandlungspotenzial : Einfluss von mütterlicher Depression, Borderline-Persönlichkeitsstörung und frühkindlicher Misshandlungserfahrung.

BACKGROUND: The "empathy hormone" oxytocin (OXT) is associated with social interaction and parent-child interaction. Mothers with mental stress factors, e.g., history of depression, borderline personality disorder or early life maltreatment in their own childhood often show distinct maternal behavior. The objectives of the study were (1) to examine the association between these three stress factors and maternal OXT within one analysis. (2) Moreover, OXT was tested as a potential mediator for the association between maternal experience of early childhood maltreatment and abuse potential against their own child. METHODS: Plasma OXT concentrations of 52 mothers during the follicular phase were collated (healthy control mothers n = 22, history of depression n = 23, borderline personality disorder n = 7). The maternal history of psychiatric disorders and experiences of early childhood maltreatment were examined via interviews. Regression and mediation analyses were applied to answer the research questions. RESULTS: Early childhood maltreatment was associated with reduced plasma OXT; however, maternal history of depression and borderline personality disorder were not related to OXT concentrations. In particular, having experienced parental antipathy in one's own childhood was associated with reduced OXT levels but OXT did not mediate the association between maternal early childhood experiences of maltreatment and abuse potential of their own child. CONCLUSION: In the present study alterations in plasma OXT concentrations were not associated with psychiatric disorders, such as a history of depression or borderline personality disorder but more with a potential etiological factor of these disorders, i.e. experience of maltreatment in their own childhood.

Lifetime and past-year prevalence of children's exposure to violence in 9 Balkan countries: the BECAN study.

BACKGROUND: Children's exposure to violence is a major public health issue. The Balkan epidemiological study on Child Abuse and Neglect project aimed to collect internationally comparable data on violence exposures in childhood. METHODS: A three stage stratified random sample of 42,194 school-attending children (response rate: 66.7%) in three grades (aged 11, 13 and 16 years) was drawn from schools in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Former Yugoslavian Republic of Macedonia (FYROM), Greece, Romania, Serbia and Turkey. Children completed the ICAST-C questionnaire, which measures children's exposure to violence by any perpetrator. RESULTS: Exposure rates for psychological violence were between 64.6% (FYROM) and 83.2% (Greece) for lifetime and 59.62% (Serbia) and 70.0% (Greece) for past-year prevalence. Physical violence exposure varied between 50.6% (FYROM) and 76.3% (Greece) for lifetime and 42.5% (FYROM) and 51.0% (Bosnia) for past-year prevalence. Sexual violence figures were highest for lifetime prevalence in Bosnia (18.6%) and lowest in FYROM (7.6%). Lifetime contact sexual violence was highest in Bosnia (9.8%) and lowest in Romania (3.6%). Past-year sexual violence and contact sexual violence prevalence was lowest in Romania (5.0 and 2.1%) and highest in Bosnia (13.6 and 7.7% respectively). Self-reported neglect was highest for both past-year and lifetime prevalence in Bosnia (48.0 and 20.3%) and lowest in Romania (22.6 and 16.7%). Experiences of positive parental practices were reported by most participating children in all countries. CONCLUSIONS: Where significant differences in violence exposure by sex were observed, males reported higher exposure to past-year and lifetime sexual violence and females higher exposure to neglect. Children in Balkan countries experience a high burden of violence victimization and national-level programming and child protection policy making is urgently needed to address this.

Gynecologic and andrologic dermatology and the metabolic syndrome.

The relationship of sex hormones to obesity and inflammation has been extensively studied. Research on endogenous and exogenous sex steroids, including studies on animal models of metabolic syndrome (MetS), has indicated that sex hormones are involved in metabolic pathways relevant to MetS. Lower testosterone levels in men and higher levels in women increase risks of MetS and type 2 diabetes mellitus (T2DM). Lower levels of sex hormone-binding globulin increase risks of MetS and T2DM in both sexes. Skin diseases that are sex hormone mediated, such as polycystic ovary syndrome, acanthosis nigricans, acne vulgaris, and pattern alopecia, have been associated with insulin resistance. Insulin resistance increases the risk for metabolic and potentially cardiovascular complications, and patients with such skin diseases should be followed for a prolonged time to determine whether they develop these complications. Early intervention may help delay or prevent the onset of T2DM and decrease cardiovascular risks.

Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: Facts and controversies.

Prurigo (PP) and pruritic folliculitis of pregnancy (PFP) are poorly characterized entities. Traditionally classified under specific dermatoses of pregnancy, they were reclassified under a new umbrella entity, atopic eruption of pregnancy (AEP), which also includes atopic dermatitis (AD) that can worsen or present for the first time in pregnancy. Still, several aspects of AEP have not been adequately elucidated. It needs to be clarified whether it is the intrinsic ("nonallergic" or "atopiform dermatitis") or extrinsic (immunoglobulin E-associated) AD that is affected by pregnancy. Future studies need to examine the postpartum prognosis of AD that develops for the first time during gestation. A revision of diagnostic criteria of AEP will allow a more accurate estimate of its prevalence, as well as clarification of the relationship between AD and specific dermatoses, such as PP and PFP. In this context, this review discusses the history, epidemiologic data, clinicopathologic features, and management of these entities.

Condições de saúde e risco de internação hospitalar em idosas praticantes de hidroginástica / Health conditions and admission hospital risk in elderly women practicing waters aerobics

O envelhecimento populacional traz uma nova realidade ao sistema de saúde, visto que estes são mais propensas a doenças crônicas, as quais demandam um alto custo. Objetivou-se analisar a prevalência de dispneia e fadiga e sua correlação com medidas antropométricas, além de condições de risco de internação hospitalar em idosas praticantes de hidroginástica. Trata-se de estudo transversal, quantitativo, com 94 idosas praticantes de hidroginástica. Realizou-se coleta de dados por meio de questionários de avaliação de risco de internação hospitalar e função pulmonar e dispneia, além de medidas antropométricas. Os resultados apontaram valor da média do IMC, CC e RCQ acima do ideal (28,6/ 93,6/ 0,87 respectivamente). A autopercepção de saúde foi positiva para 74,3% das idosas e cerca de 90% não tiveram internações nos últimos doze meses. Ainda, há correlação negativa, significativa, entre o tempo de prática de hidroginástica e fadiga. Portanto, percebe-se os efeitos positivos da pratica de hidroginástica, visto que mesmo com resultados antropométricos alterados, a grande maioria das idosas relataram boas condições de saúde, baixo número de consultas para tratamento e internações hospitalares. Quanto a dispneia e fadiga, percentual em torno de 5% referiram possuir dispneia e fadiga grave/muito grave, os quais necessitam de cuidados adequados.

The aging brings a new reality to the health system, since they are more prone to chronic diseases, which demand a high cost. This study aimed to analyze the prevalence of dyspnea and fatigue and its correlation with anthropometric measurements, and hospitalization risks in elderly women engaged in water aerobics. This cross-sectional, quantitative study with 94 elderly women engaged in water aerobics. Held data collection through risk assessment questionnaires hospitalization and pulmonary function and dyspnea, and anthropometric measurements. The results showed average value of BMI, WC and WHR above the ideal (28.6 / 93.6 / 0.87 respectively). The self-rated health was positive for 74.3% of the women and about 90% had no hospitalizations in the last twelve months. Still, there are significant negative correlation between the water aerobics practice time and fatigue. Therefore, we can see the positive effects of practicing gymnastics since even with altered anthropometric results, the vast majority of older reported good health, low number of visits for treatment and hospitalization. As dyspnea and fatigue, percentage around 5% reported having dyspnea and severe/very severe fatigue, which require appropriate care.

Efeito do treinamento concorrente sobre a curva de agregação plaquetária em adultos hipertensos / Effect of concurrent training on platelet aggregation curve in adults with hypertension

Fundamentos: A hipertensão arterial sistêmica é relacionada com o aumento da agregação plaquetária. Nessa perspectiva, a prática de exercícios físicosregulares pode atuar de maneira benéfica, porém os efeitos do treinamento concorrente sobre a curva de agregação plaquetária não estão estabelecidos. Objetivo: Verificar o efeito de um programa de treinamento concorrente sobre o comportamento dacurva de agregação plaquetária em adultos hipertensos controlados com medicação. Métodos: Foram selecionados voluntariamente17 indivíduos, homens e mulheres adultos: GH (n=8)indivíduos hipertensos controlados com medicação e GN (n=9) indivíduos normotensos com média deidade de 54,0±3,0 anos. Ambos os grupos realizaram treinamento concorrente três vezes por semana, emdias alternados, durante 28 semanas. Foram avaliados os parâmetros antropométricos, hemodinâmicos,metabólicos e a curva de agregação plaquetária. Resultados: Nos grupos GH e GN, no pré-teste, as variáveis: índice de massa corporal (p=0,01), pressãoarterial sistólica (p=0,009) e pressão arterial diastólica (p=0,03) apresentaram diferenças estatisticamente significativas. Nos grupos GH e GN houve reduçãoda agregação plaquetária após o período de treinamento concorrente, entretanto os valores encontrados não foram estatisticamente significativos.Conclusão: As plaquetas apresentaram maior tendência à ativação e à agregação em indivíduos hipertensos. Embora as alterações na agregaçãoplaquetária não tenham sido significativas, a tendência de redução dos valores em ambos os grupos indicoua eficiência do treinamento concorrente.

Background: Hypertension is associated with increased platelet aggregation, meaning that regular exercise may be beneficial, although the effects ofconcurrent training on platelet aggregation curves have not been not established. Objective: To ascertain the effects of a concurrent training program on the behavior of plateletaggregation curves in adults with hypertension controlled thru medication.Methods: We selected 17 adult men and women voluntarily: HG (n=8) hypertensive group controlledwith medication and NG (n=9) normotensive group with a mean age of 54.0±3.0 years. Both groupsengaged in concurrent training three times a week on alternate days for 28 weeks. We evaluated theanthropometric, hemodynamic and metabolic parameters, together with platelet aggregation curves.Results: During the pre-test phase for the HG and NG groups, the following variables showed statisticallysignificant differences: body mass index (p= 0.01), systolic blood pressure (p= 0.009) and diastolic blood pressure (p= 0.03). Although both groups presentedlower platelet aggregation after the concurrent training period, the values were not statistically significant.Conclusion: Platelets are more prone to activation and aggregation in hypertensive individuals. Althoughalterations in platelet aggregation were not significant, the downtrend in the values for both groups indicatedthe efficiency of concurrent training.

Transgenerational consequences of PTSD: risk factors for the mental health of children whose mothers have been exposed to the Rwandan genocide.

BACKGROUND: Understanding how parental Posttraumatic Stress Disorder (PTSD) may or may not affect the development and mental health in the offspring is particularly important in conflict regions, where trauma-related illness is endemic. In Rwanda, organised atrocities and the genocide against the Tutsi of 1994 have left a significant fraction of the population with chronic PTSD. The aim of the present investigation was to establish whether PTSD in mothers is associated with symptoms of depression, anxiety, and aggressive and antisocial behaviour in their children. METHODS: A community sample of 125 Rwandan mothers who experienced the genocide of 1994 and their 12-year-old children were interviewed. Using a structured interview, symptoms of maternal PTSD and children's depression, anxiety, and aggressive and antisocial behaviour were assessed by trained and on-site supervised local B.A. psychologists. The interview also included a detailed checklist of event types related to family violence. RESULTS: In showing that a maternal PTSD was not associated with child's psychopathology, the results contradict the assumption of straight "trans-generational trauma transmission". Instead, a child's exposure to maternal family violence posed a significant risk factor for a negative mental health outcome. Furthermore, it was not maternal PTSD-symptoms but mother's exposure to family violence during her own childhood that was associated with the magnitude of adversities that a child experiences at home. CONCLUSIONS: Contrary to a simple model of a trans-generational transmission of trauma, neither maternal PTSD nor maternal traumatic experiences were directly associated with symptoms of anxiety, depression, or antisocial and aggressive behaviour in the children. Instead, the present results suggest a relationship between parental child rearing practices and children's mental health. Furthermore, the study details the "cycle of violence", showing a significant link between maternal violence against a child and its mother's experience of childhood maltreatment.

Efeito do treinamento resistido em parâmetros cardiovasculares de adultos normotensos e hipertensos / Effect of resistance training on cardiovascular parameters in normotensive and hypertensive adults

Fundamentos: A utilização do treinamento resistido (TR) como terapia para a população hipertensa é pouco investigado, mas ainda assim a literatura indica efeitos benéficos desse tipo de treinamento sobre o sistema cardiovascular. São escassos os estudos que avaliam as adaptações cardiovasculares, como a estrutura cardíaca e sua função, na população hipertensa após período prolongado de TR.Objetivo: Analisar o efeito de 48 semanas de treinamento resistido (TR) sobre os diâmetros diastólico (DDVE) e sistólico (DSVE) e a massa do ventrículo esquerdo (MVE), fração de ejeção (FE) e parâmetros hemodinâmicos de indivíduos hipertensos controlados e normotensos.Métodos: Quinze indivíduos foram estratificados em dois grupos: hipertenso (GH, n=8) e normotenso (GN, n=7). Ambos os grupos realizaram treinamento resistido (TR) por um período de 48 semanas. Foram avaliados os parâmetros antropométricos, hemodinâmicos e cardiovasculares.Resultados: Os parâmetros cardiovasculares DDVE e DSVE, assim como a MVE e a FE de ambos os grupos estão de acordo com os valores de referência. A MVE e a FE do GH apresentaram reduções favoráveis do pré para o pós-teste. Conclusão: O TR, de longa periodização, é eficiente como terapia de controle, já que não foi observada evolução no grau da hipertensão. Além disso, não apresenta efeito adverso durante as sessões de treinamento resistido.

Background: Although the use of resistance training (RT) as therapy for the hypertensive population is still poorly investigated, the literature nevertheless indicates the beneficial effects of this training on the cardiovascular system. But there are still only a few studies assessing cardiovascular adaptations – such as the cardiac structure and its functions – in the hypertensive population after a prolonged period of RT.Objective: To analyze the effect of 48 weeks of resistance training (RT) on the diastolic diameter (LVEDD), systolic diameter (LVSD), left ventricular mass (LVM), ejection fraction (EF) and hemodynamic parameters in controlled hypertensive and normotensive subjects.Methods: 15 subjects were divided into two groups: hypertensive (GH, n=8) and normotensive (GN, n=7). Both groups performed RT for a period of 48 weeks. The anthropometric, hemodynamic and cardiovascular parameters were evaluated. Results: The LVDD and LVSD cardiovascular parameters, and the EF and LVM of both groups are compliant with the reference values. The GH LVM and EF levels decreased favorably pre- to post-test.Conclusion: Long-duration resistance training is effective as a control therapy, as no changes were noted in hypertension levels, with no adverse effects presented during the training sessions.

The HUman MicroNucleus project on eXfoLiated buccal cells (HUMN(XL)): the role of life-style, host factors, occupational exposures, health status, and assay protocol.

The human buccal micronucleus cytome assay (BMCyt) is one of the most widely used techniques to measure genetic damage in human population studies. Reducing protocol variability, assessing the role of confounders, and estimating a range of reference values are research priorities that will be addressed by the HUMN(XL) collaborative study. The HUMN(XL) project evaluates the impact of host factors, occupation, life-style, disease status, and protocol features on the occurrence of MN in exfoliated buccal cells. In addition, the study will provide a range of reference values for all cytome endpoints. A database of 5424 subjects with buccal MN values obtained from 30 laboratories worldwide was compiled and analyzed to investigate the influence of several conditions affecting MN frequency. Random effects models were mostly used to investigate MN predictors. The estimated spontaneous MN frequency was 0.74‰ (95% CI 0.52-1.05). Only staining among technical features influenced MN frequency, with an abnormal increase for non-DNA-specific stains. No effect of gender was evident, while the trend for age was highly significant (p<0.001). Most occupational exposures and a diagnosis of cancer significantly increased MN and other endpoints frequencies. MN frequency increased in heavy smoking (≥40cig/day, FR=1.37; 95% CI 1.03-.82) and decreased with daily fruit consumption (FR=0.68; 95% CI 0.50-0.91). The results of the HUMN(XL) project identified priorities for validation studies, increased the basic knowledge of the assay, and contributed to the creation of a laboratory network which in perspective may allow the evaluation of disease risk associated with MN frequency.

Pregnancy dermatoses: diagnosis, management, and controversies.

Some aspects regarding the etiology and the nosologic classification of various pregnancy dermatoses are highly controversial. While some authors highlight the existence of premises allowing several skin disorders to be re-grouped within broader disease concepts, others underline the absence of clear, undisputed etiopathogenetic data that could support such classifications. This review exhaustively analyzes the various pregnancy dermatoses (pemphigoid gestationis, intrahepatic cholestasis of pregnancy, impetigo herpetiformis, polymorphic eruption of pregnancy, and the papular dermatoses of pregnancy [prurigo of pregnancy, pruritic folliculitis of pregnancy, and the new classification, atopic eruption of pregnancy]) in an attempt to shed light over this confusing and disputed domain, while subsequently offering an algorithmic approach to their diagnosis and management. While for pemphigus gestationis, intrahepatic cholestasis of pregnancy, and impetigo herpetiformis, specific diagnostic tests such as histopathology, immunofluorescence, or laboratory investigations will confirm the diagnosis, the identification of the other types of pregnancy dermatoses is based only on clinical criteria. In this context, the review argues for the inclusion of the whole group represented by the papular dermatoses of pregnancy within the broad spectrum of polymorphic eruption of pregnancy, separating each of these entities by focusing on their onset: early-onset polymorphic eruption of pregnancy (comprising prurigo of pregnancy, pruritic folliculitis of pregnancy, and atopic eruption of pregnancy) and late-onset polymorphic eruption of pregnancy. In light of the same practical approach guiding it, the review provides updated treatment strategies for each of these conditions.

Avaliação da atividade mutagênica e antimutagênica da Aloe vera em teste de Allium cepa e teste de micronúcleo em linfócitos humanos binucleados / Evaluation mutagenic and antimutagenic activity of Aloe vera in Allium cepa test and micronucleus test in human binucleated lymphocytes

Algumas das substâncias presentes nos vegetais podem ter efeitos mutagênicos, enquanto outras podem atenuar ou anular estes efeitos. Estima-se que mais de 200 substâncias ativas façam parte do gel de Aloe vera, sendo que os polissacarídeos chegam a 30 por cento, e muitos dos benefícios terapêuticos, nutricionais e cosméticos são a eles atribuídos. O objetivo deste trabalho foi determinar o efeito mutagênico e antimutagênico da solução de Aloe vera, em teste de Allium cepa e teste de micronúcleos em linfócitos humanos binucleados. Para as soluções, as folhas de Aloe vera foram trituradas, filtradas e esterilizadas. O teste de Allium cepa foi constituído de oito tratamentos e o de linfócitos, de cinco (com quatro repetições). Observou-se que na dose usual, a solução de Aloe vera não foi mutagência para o sistema de teste vegetal e nem para o humano. Já na dose dez vezes mais concentrada provocou um efeito citotóxico e mutagênico em Allium cepa. Em células vegetais a solução foi antimutagênica apenas quando colocada depois do paracetamol, enquanto que nas células humanas, essa ação se manifestou quando a solução foi utilizada ao mesmo tempo com o paracetamol.

Some of the substances in plant may have mutagenic effects, while others may cancel or mitigate these effects. It is estimated that more than 200 active substances compose the gel of Aloe vera, and the polysaccharides increases in 30 percent, and many of the therapeutic benefits, nutrition and cosmetics are allocated to them. The objective of this study was to determine the mutagenic and antimutagenic effects of the Aloe vera solution in Allium cepa test and the micronuclei test in human binucleated lymphocytes. For solutions, the leaves of Aloe vera were crushed, filtered and sterilized. The Allium cepa test was composed of eight treatments, and the lymphocytes of five (with four repetitions). It was observed that at the usual dose, the solution of Aloe vera was not mutagenic for the plant test system and not for humans. At a dose ten times more concentrated caused a cytotoxic and mutagenic effect in Allium cepa. In plant cells the solution was antimutagenic only when placed after paracetamol, while in human cells, this action was manifested when the solution was used at the same time with paracetamol.

Avaliação da atividade mutagênica da infusão de Baccharis trimera (Less.) DC. em teste de Allium cepa e teste de aberrações cromossômicas em linfócitos humanos / Evaluation of mutagenic activity resulting from the infusion Baccharis trimera (Less.) DC. using the Allium cepa test and a chromosomal test for aberrations in human lymphocytes

A carqueja (Baccharis trimera(Less.) DC.) é uma planta medicinal da família Asteraceae muito utilizada como chá no sul do Brasil no tratamento de doenças renais, intestinas, estomacais e principalmente como emagrecedora. O objetivo desde trabalho foi de avaliar a mutagenicidade in vivoe in vitrodo chá e para isso foi realizado o teste de Allium cepaL. e o de aberrações cromossômicas em linfócitos humanos utilizando quatro tratamentos: T1 (água); T2 (20 g/L de carqueja); T3 (200 g/L de carqueja), e T4 (paracetamol, a 400 mg/L). Ambos os procedimentos foram analisados pelo teste Mann-Whitney U. Este estudo evidencia um efeito mutagênico do chá em células vegetais (Allium cepa) e em células humanas (aberrações cromossômicas) cultivadas, pois em ambos os testes, T2 e T3 obteve-se uma média mais elevada que nos outros tratamentos. Este estudo demonstra que o efeito é dependente da dose, portanto recomenda-se que o chá de carqueja seja consumido com moderação.

Broom (Baccharis trimera(Less.) DC.) is a medicinal plant from Asteraceae that is commonly used as a tea in the south of Brazil for the treatment of renal, intestinal and stomach diseases. It is also used as a slimming agent. The aim of this study was to evaluate the mutagenicity of the tea in vivoand in vitro. In order to do this, the Allium cepatest was carried out and the chromosomal aberrations in human lymphocytes were tested using four treatments: T1 (water); T2 (20 g/L of broom); T3 (200 g/L of broom) and T4 (paracetamol at 400 mg/L). Both procedures were analyzed using the Mann-Whitney U test. This study provided evidence of a mutagenic effect of the tea in vegetable cells (Allium cepa) and in cultivated human cells. In tests T2 and T3 there was a higher average than the other treatments. This study shows that the effect is dependent on the dose. It is therefore recommended that broom tea be consumed with moderation.

Avaliação da força muscular e ativação pressórica do assoalho pélvico de mulheres climatéricas com incontinência urinária de esforço / Assessment of muscle strength and pressure activation of pelvic floor

Comparar os valores obtidos de força muscular do assoalho pélvico em mulheres com incontinência urinária de esforço, entre os grupos de força muscular 1 (menor força) e 2 (maior força), com os resultados do questionário de qualidade de vida e anamnese, bem como descrever os valores de ativação pressórica atingidos através do biofeedback. Métodos: Estudo transversal com 70 mulheres com incontinência urinária, divididas em 2 grupos, de acordo com a força muscular obtida, 40 mulheres no grupo 1(menor força) e 30 no grupo 2 (maior força). Todas as mulheres com diagnóstico prévio de incontinência urinária de esforço, no período do climatério. Foram excluídas pacientes com problemas neurológicos e grávidas. As pacientes foram submetidas ao teste bidigital e medidas de ativação pressórica para fibras de contração fásicas, além da aplicação do questionário de qualidade de vida KHQ e anamnese. Os dados obtidos foram descritos em frequências, médias e desvios padrões, medianas, mínimos e máximos. Resultados: Ocorreu maior frequência de mulheres que apresentaram força muscular diminuída, 57,1% (40 mulheres). As queixas mais frequentes de perda urinária deram-se na tosse e no espirro em ambos os grupos analisados, grupo 1(92,5%) e grupo 2(96,7%). No grupo 2 (maior força), somente 1 mulher relatou perda urinária completa. Todas as medidas de ativação pressórica foram superiores no grupo1(menor força), em relação ao grupo 2 (maior força). No questionário KHQ foram evidenciados maiores escores dos domínios, nas pacientes com maior força muscular (grupo 2), resultando em pior percepção individual da qualidade de vida. Conclusão: Para uma intervenção fisioterapêutica objetiva, a avaliação da força muscular do assoalho pélvico torna-se primordial, já que, na maioria das pacientes, esta pode estar alterada. Além disso, a qualidade de vida deve ser analisada, pois a mesma pode não estar relacionada com dados objetivos como: idade, número de partos e tempo de perda urinária por exemplo.

Objective: Comparing strength scores of pelvic floor musclesbetween women groups of muscle strenght 1 (less strength) and 2 (more strength) with questionnaire and clinical anamnesis findings,and describing biofeedback values found. Methods: Transversal clinical trial with 70 women with eff ort urinary incontinence, dividedinto 2 groups according to muscle strength, being 40 women inthe fi rst group and 30 in the second. All the women had previous diagnosis of eff ort urinary incontinence in the climacteric period.Patients with neurological problems and pregnant women wereexcluded. The participants were subjected to the bi-digital test andbiofeedback measures for phasic contraction fibers, as well as a lifequality questionnaire KHQ (King’s Health Questionnaire) and clinical anamnesis. Data found were described as frequencies, meansand standard deviations, minimum and maximum median scores. Results: A higher frequency of women presenting low muscle strengthwas found, for 57.1% (40 women). The most frequent complaints ofurinary loss occurred during coughing and sneezing for both groups, group 1 (92.5%) and group 2 (96.7%). In group 2, only 1 woman reported total urinary loss. All biofeedback measures were higherin group 1. In the questionnaire (KHQ), higher domain-specifi cscores were found in patients with more muscle strength (group1), resulting in lower quality of life. Conclusion: The assessment of muscle strength is crucial for any physical therapy intervention. The quality of life must be analyzed, because it could not be related withobjective data like age, urinary time loosing and delivery numbers.

Monitoramento da ação genotóxica em trabalhadores de sapatarias através do teste de micronúcleos, Pelotas, Rio Grande do Sul / Monitoring the genotoxic action in shoe workers by micronucleus test, Pelotas, Rio Grande do Sul State

Neste trabalho, investigou-se a frequência de micronúcleos em células esfoliadas da mucosa bucal de trabalhadores de sapatarias, na cidade de Pelotas (RS). O estudo constou de 54 trabalhadores de sapatarias expostos à cola e solventes e 54 controles. Avaliou-se a incidência de células com micronúcleos(CMN), binucleadas(CBN), núcleos ligados(CNL) e total de anomalias(TA), em 2.000 células por indivíduo. Elaborou-se um banco de dados no programa SPSS "for Windows" pelo teste de Mann-Whitney U, p<0,05. A média de anomalias entre os sapateiros foi 8.69±6.49CMN; 8,85±4,92CBN; 5,78±4,78CNL; 23,31±10,01TA, e nos controles 4,00±61617; 5,05CMN; 4,63±61617; 4,35CBN; 4,76±61617; 5,00CNL; 13,39±61617; 9,43TA (p=0,0001; p=0,0001; p=0,144 e p=0,0001, respectivamente). Avaliou-se a influência da idade, sexo, tempo de trabalho, renda familiar, fumo, bebida alcoólica, doenças dermatológicas, oftalmológicas, respiratórias e sistema nervoso central (SNC) no número de anomalias celulares. Esses não influenciaram; apenas observou-se que, na faixa etária de 15 a 29, foi maior o número de CNL do que em 45 a 72 anos e no tempo de trabalho de 0,1 a 10 anos apresentou mais CMN do que as outras faixas.

In this paper it was investigated the micronuclei frequency in exfoliated oral mucosa cells in shoe shop workers in the city of Pelotas, RS. The study counted on 54 shoe workers exposed to glue and solvents and 54 controls. It was evaluated the incidence of cells with micronucleus (CMN), bi-nucleus (CBN), linked nucleus (CLN) and total amount of anomalies (TAA), in 2000 cells per person. A database was created in the SPSS "for Windows" software using the Mann-Whitney U, p<0.05 test. The average of anomalies among shoe workers was 8.69±6.49CMN; 8.85±4.92CBN; 5.78±4.78CNL; 23.31±10.01TA, in the controlled 4.00±5.05CMN; 4.63±4.35CBN; 4.76±5.00CNL; 13.39±9.43TA (p=0.0001; p=0.0001; p=0.144 and p=0.0001 respectively). It was also evaluated the age, gender, time of work, family income, smoke, alcohol beverages, the influence of dermatological, ophthalmological, respiratory and central nervous system (CNS) diseases in the number of cell anomalies. These items did not have any influence. It was only observed that among the age group of 15 to 29 years old the number of CNL was bigger than among the age group of 45 to 72. Among those with time of work of 0.1 and 10 years presented a higher CNM than in the other group range.

Specific pregnancy dermatoses.

The specific dermatoses of pregnancy are a rare group of skin diseases specifically related to pregnancy. Diagnostic clues are outlined in a diagrammatic way that can facilitate the recognition between dermatoses of pregnancy in daily dermatology clinic practice.