Gestational diabetes mellitus, pre-pregnancy body mass index, and gestational weight gain as risk factors for increased fat mass in Brazilian newborns.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It may predispose offspring to increased fat mass (FM) and the development of obesity, however few data from Latin America exist. OBJECTIVE: To investigate the influence of GDM on newborn FM in mother-newborn pairs recruited from a public maternity care center in São Paulo, Brazil. METHODS: Data were collected cross-sectionally in 2013-2014 from 72 mothers diagnosed with GDM, and 211 mothers with normal glucose tolerance (NGT). Newborn FM was evaluated by air-displacement plethysmography (PEA POD), and relevant demographic and obstetric data were collected from hospital records. Associations between maternal GDM status and newborn FM were investigated by multiple linear regression analysis, with adjustment for maternal age, pre-pregnancy BMI, gestational weight gain, type of delivery, sex of the child, and gestational age. RESULTS: FM was greater in GDM versus NGT newborns in a bivariable model (Median (IQR), GDM: 0.35 (0.3) kg vs. NGT: 0.27 (0.2) kg, p = 0.02), however GDM status was not a significant predictor of FM with adjustment for other variables. Rather, pre-pregnancy BMI (coefficient (ß) 1.46; 95% confidence interval (CI) 0.66, 2.27), gestational weight gain (ß 1.32; 95% CI 0.49, 2.15), and male sex (ß -17.8; 95% CI -27.2, -8.29) predicted newborn FM. Analyzing GDM and NGT groups separately, pre-pregnancy BMI (ß 6.75; 95% CI 2.36, 11.1) and gestational weight gain (ß 5.64; 95% CI 1.16, 10.1) predicted FM in the GDM group, while male sex alone predicted FM in the NGT group (ß -12.3; 95% CI -18.3, -6.34). CONCLUSIONS: Combined model results suggest that in our cohort, pre-pregnancy BMI and gestational weight gain are more important risk factors for increased neonatal FM than GDM. However, group-specific model results suggest that GDM status may contribute to variation in the relationship between maternal/offspring factors and FM. Our use of a binary GDM variable in the combined model may have precluded clearer results on this point. Prospective cohort studies including data on maternal pre-pregnancy BMI, GWG, and glycemic profile are needed to better understand associations among these variables and their relative influence on offspring FM.

The possible role of selenium status in adverse pregnancy outcomes.

The present study reviews the possible role of Se status during pregnancy regarding adverse pregnancy outcomes, with emphasis on those related to diminished antioxidant activity and increased oxidative stress. Studies have reported that Se could play an important role in adverse outcomes such as miscarriages, neural tube defects, diaphragmatic hernia, premature birth, low birth weight, pre-eclampsia, glucose intolerance and gestational diabetes. Also, low Se status has been associated with adverse outcomes among HIV-infected pregnant women and their offspring. Nevertheless, the function of Se in the aetiology of pregnancy complications is yet to be elucidated. Available evidence presents the following limitations: most study designs do not allow conclusions about causal relationships; study populations, selection of subjects, research setting, procedures for defining sample size and analytical methods are often poorly described; many studies fail to adjust for important confounding variables. In addition, population studies assessing the relationship between Se intake during pregnancy and health outcomes are scarce. Further research is still needed to clarify the role of Se status in adverse pregnancy outcomes, especially those related to augmented oxidative stress.

Vitamin A supplementation for postpartum women.

BACKGROUND: In vitamin A deficient populations, the amount of vitamin A may be insufficient for maintenance of maternal health and levels in breast milk may be insufficient for breastfeeding infants' needs. OBJECTIVES: To assess the effects of postpartum maternal vitamin A supplementation on maternal and infant health. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2010), LILACS (1982 to July 2010), Web of Science (1945 to July 2010) and Biological Abstracts (1998 to July 2010). SELECTION CRITERIA: Randomised controlled trials evaluating the effects of postpartum maternal vitamin A supplementation. DATA COLLECTION AND ANALYSIS: Two review authors assessed the studies independently. MAIN RESULTS: We included 12 trials at moderate risk of bias, enrolling 25,465 mother-baby pairs and comparing several postpartum doses (200,000-400,000 IU) of vitamin A or 7.8 mg daily beta-carotene, with placebo, iron or no supplement; or higher (400,000 IU) versus lower dose (200,000 IU). The majority of infants in all studies were at least partially breastfed for six months.Maternal: we observed no impact of vitamin A on maternal mortality (two trials of 9,126 women), morbidity (one trial of 50 women) or adverse effects (subset of 786 women in one trial). Vitamin A enhanced serum and breast milk retinol at three months in five trials, but these improvements were generally not sustained.Infant: we observed no significant differences for infant mortality RR 1.14 95% CI 0.84 to 1.57 (five trials (6,170 infants) or morbidity (three trials) except for fewer episodes of fever with vitamin A in one small trial. No significant differences in infant vitamin A status were seen with maternal vitamin A supplementation (five trials).No beneficial effects for maternal or infant health were associated with higher compared to lower doses of vitamin A in two trials. AUTHORS' CONCLUSIONS: The lack of effect on maternal and infant mortality and morbidity, with exception of some improved infant morbidity in one small study, and the improvement in maternal vitamin A status, suggest that maternal postpartum vitamin A supplementation offers limited benefits.

Infestation of Aedes aegypti estimated by oviposition traps in Brazil.

OBJECTIVE: To assess infestation levels of Aedes aegypti using the oviposition trap (ovitrap) method and to compare these results with data obtained with the use of indices traditionally applied in public programs aimed at fighting this vector. METHODS: Nine sentinel areas in Northeastern, Brazil, were assessed and infestation levels were measured for a nine-month period. Egg density and container indices were estimated and compared with previous results found using the house index and Breteau index. RESULTS: The results indicated that the area studied was infested with this vector during the entire study period and that the infestation was widespread in all areas. Different results were found with the different indices studied. There were areas in which the house index and the Breteau index were negative or close to zero, whereas the container index for the same area was 11% and the egg density index was 8.3%. CONCLUSIONS: The container and egg density indices allow better assessment of infestation rates in a city than the conventionally used indices (house index and Breteau index). At lower operational costs and easier standardization, these indices can be applied as a measurement tool for assessing infestation rates during entomological surveillance in programs to fight Aedes aegypti.

Infestation of Aedes aegypti estimated by oviposition traps in Brazil

OBJETIVO: Estimar os índices de infestação do Aedes aegypti, utilizando ovitrampa com atrativo e comparar esse método com os tradicionalmente utilizados nos programas oficiais de combate ao vetor. MÉTODOS: Foram analisadas nove áreas sentinelas de Salvador, Estado da Bahia, durante nove meses. Foram calculados os índices de densidade de ovos e positividade de ovitrampa, e levantamento dos índices de infestação predial e de Breteau para comparação. RESULTADOS: Observou-se que o município apresentou infestação pelo vetor durante todo o período de estudo em todas as áreas sentinelas. Os índices nem sempre apresentaram resultados de infestação semelhantes. Em algumas áreas os índices de infestação predial e de Breteau foram negativos ou próximos de zero, enquanto que o índice de positividade de ovitrampa apresentou valor de 11 for cent e o índice de densidade de ovos 8,3 for cent. CONCLUSÕES: O índice de positividade de ovitrampa e o índice de densidade de ovos permitem avaliar melhor o quadro de infestação de uma cidade com custo operacional bastante reduzido e com maior facilidade de padronização do que os índices tradicionais (infestação predial e de Breteau). Recomenda-se, assim, sua utilização nas fases de levantamento de índices e de vigilância entomológica desenvolvidas pelo programa de combate ao Aedes aegypti.

Saude reprodutiva e sexualidade em mulheres HIV positivas / Reproductive health and sexuality in HIV positive women

Objetivo: Estudar questoes relativas a sexualidade e a saude reprodutiva de mulheres HIV positivas, praticas de prevencao e opcoes quanto a gravidez. METODOS: Estudo exploratorio realizado em 1997, em um ambulatorio de um centro de referencia na area de Doencas Sexualmente Transmissiveis e Aids localizado na cidade de Sao Paulo, Brasil. Foi estudada uma amostra constituida de 148 mulheres HIV positivas. Foram excluidas as menores de 18 anos e as fisicamente debilitadas. Os dados foram colhidos por meio de entrevistas estruturadas e analisados de modo univariado e multivariado utilizando-se regressao logistica com variavel resposta querer ter filhos. RESULTADOS: A media de idade das mulheres pesquisadas foi de 32 anos. 62,2 porcento das mulheres tinham ate o primeiro grau de escolaridade. O numero mediano de parceiros na vida foi quatro e metade das entrevistadas mantiveram vida sexual ativa apos a infeccao pelo HIV. Do total das mulheres 76 porcento tem filhos e 20,9 porcento ainda pensa em te-los. Pela analise multivariada obteve-se que mulheres com menos idade, sem religiao e com menor numero de filhos vivos tendem mais a querer filhos. Os metodos contraceptivos mudam, sensivelmente, na presenca da infeccao pelo HIV. CONCLUSOES: Mulheres HIV positivas precisam ter seus direitos reprodutivos e sexuais discutidos e respeitados em todos os servicos de atencao a sua saude. Sao necessarios servicos que promovam um ambiente de suporte para estas discussoes as mulheres e a seus parceiros, propiciando as pessoas vivendo com HIV/AIDS condicoes de realizar opcoes conscientes no que concerne as decisoes reprodutivas e a sua sexualidade

Saude reprodutiva e sexualidade em mulheres HIV positivas / Reproductive health and sexuality in HIV positive women

Objetivo: Estudar questoes relativas a sexualidade e a saude reprodutiva de mulheres HIV positivas, praticas de prevencao e opcoes quanto a gravidez. METODOS: Estudo exploratorio realizado em 1997, em um ambulatorio de um centro de referencia na area de Doencas Sexualmente Transmissiveis e Aids localizado na cidade de Sao Paulo, Brasil. Foi estudada uma amostra constituida de 148 mulheres HIV positivas. Foram excluidas as menores de 18 anos e as fisicamente debilitadas. Os dados foram colhidos por meio de entrevistas estruturadas e analisados de modo univariado e multivariado utilizando-se regressao logistica com variavel resposta querer ter filhos. RESULTADOS: A media de idade das mulheres pesquisadas foi de 32 anos. 62,2 porcento das mulheres tinham ate o primeiro grau de escolaridade. O numero mediano de parceiros na vida foi quatro e metade das entrevistadas mantiveram vida sexual ativa apos a infeccao pelo HIV. Do total das mulheres 76 porcento tem filhos e 20,9 porcento ainda pensa em te-los. Pela analise multivariada obteve-se que mulheres com menos idade, sem religiao e com menor numero de filhos vivos tendem mais a querer filhos. Os metodos contraceptivos mudam, sensivelmente, na presenca da infeccao pelo HIV. CONCLUSOES: Mulheres HIV positivas precisam ter seus direitos reprodutivos e sexuais discutidos e respeitados em todos os servicos de atencao a sua saude. Sao necessarios servicos que promovam um ambiente de suporte para estas discussoes as mulheres e a seus parceiros, propiciando as pessoas vivendo com HIV/AIDS condicoes de realizar opcoes conscientes no que concerne as decisoes reprodutivas e a sua sexualidade

Reproducibility of alkaline antigens of Leishmania major-like and Leishmania (V.) braziliensis evaluated by IgG-ELISA: comparison of antigens added of a protein inhibitor (PMSF) or not

Neste trabalho estudou-se o comportamento de 10 partidas de antigenos alcalinos de L. major-like e L. (V.) braziliensis adicionados ou nao de um inibidor de protease (PMSF) avaliados em tres dias consecutivos por meio de ELISA-IgG empregando soros padrao positivo de pacientes com diagnostico de leishmaniose mucocutanea previamente testados para a presenca de anticorpos anti-leishmania por ELISA. A analise estatistica mostrou que para o antigeno de L. (V.) braziliensis adicionado de PMSF nao houve diferenca significante entre as partidas ou dias de teste. Para o antigeno sem PMSF houve diferenca entre as partidas mas nao entre os dias de teste. Uma ANOVA bi-caudal mostrou diferencas entre os antigenos com e sem PMSF. Os antigenos de L. major-like preparados com e sem adicao de PMSF mostraram diferencas significativas entre as partidas; os tres dias de teste foram significativamente diferentes para o antigeno preparado com PMSF mas somente os dias 1 e 2 o foram com o antigeno sem adicao de inibidor...