Protist species richness and soil microbiome complexity increase towards climax vegetation in the Brazilian Cerrado.

Biodiversity underlies ecosystem functioning. While aboveground biodiversity is often well studied, the belowground microbiome, in particular protists, remains largely unknown. Indeed, holistic insights into soil microbiome structures in natural soils, especially in hyperdiverse biomes such as the Brazilian Cerrado, remain unexplored. Here, we study the soil microbiome across four major vegetation zones of the Cerrado, ranging from grass-dominated to tree-dominated vegetation with a focus on protists. We show that protist taxon richness increases towards the tree-dominated climax vegetation. Early successional habitats consisting of primary grass vegetation host most potential plant pathogens and least animal parasites. Using network analyses combining protist with prokaryotic and fungal sequences, we show that microbiome complexity increases towards climax vegetation. Together, this suggests that protists are key microbiome components and that vegetation succession towards climax vegetation is stimulated by higher loads of animal and plant pathogens. At the same time, an increase in microbiome complexity towards climax vegetation might enhance system stability.

Less abundant bacterial groups are more affected than the most abundant groups in composted tannery sludge-treated soil.

The application of composted tannery sludge (CTS) has promoted shifts in soil chemical properties and, therefore, can affect the soil bacterial community. This study assessed the effect of the CTS on the soil bacterial community over time. The CTS was applied at five rates (0, 2.5, 5, 10 and 20 t/ha), and the bacterial community was evaluated for 180 days. The principal curve response (PRC) analysis showed that the most abundant phyla were not influenced by the CTS rates over time, while the analysis of the bacterial community showed that some of the less abundant phyla were influenced by the CTS rates. Similarly, the PRC analysis for the bacterial classes showed the significant effect of the CTS rates. The redundancy analyses for the bacterial phyla and classes showed the relationship between the significant chemical properties and the bacterial community of the soil after the CTS amendment over time. Therefore, there was a shift in the bacterial community over time with the application of the composted tannery sludge. Our study has shown that the less abundant bacterial groups were more influenced by the CTS than the most abundant bacterial groups and that these bacterial groups were driven by soil chemical properties, primarily chromium (Cr) and the soil pH.

Etonogestrel implant in adolescents: evaluation of clinical aspects.

BACKGROUND: This prospective noncomparative observational study evaluated the clinical aspects of adolescents who received an etonogestrel implant within 6 months of delivery. STUDY DESIGN: The study population comprised 44 adolescents managed at the Family Planning Sector of São Paulo Federal University. The implant was inserted, on average, 102 days after delivery and patients were followed during 1 year. At each monthly visit to the clinic, the participants were weighed, had their blood pressure measured and were asked to report on symptoms experienced during the last 30 days. RESULTS: Approximately one-third (38.6%) of the participants reported symptoms, mostly headaches. There were no complaints of dysmenorrhea, breast tenderness or lower leg edema throughout the 12 months of follow-up. Mean body weight dropped 1.2 kg on average, from 56.4 kg at implant insertion to 55.3 kg at the end of the 1-year period. Body mass index also decreased 0.5 kg/m(2) on average, although these changes did not reach statistical significance. Systolic and diastolic blood pressure remained unchanged throughout the study period. There were no pregnancies and none of the participants discontinued the method (528 women-months). CONCLUSION: These findings suggest that the etonogestrel implant is a safe and effective contraceptive method that is well accepted by adolescents after a pregnancy.

Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis.

INTRODUCTION: Chronic pelvic pain (CPP) is one of the most frequent symptoms in women of reproductive age. This is an enigmatic clinical condition that results from the complex interactions of physiological and psychological factors with direct impact on the social, marital, and professional lives of women. AIM: To evaluate the quality of life and sexual satisfaction of women who suffer from CPP with or without endometriosis. METHOD: Forty-nine patients who had been diagnosed with endometriosis and 35 patients with CPP diagnosed with another gynecological condition, all 84 of whom were treated at the Chronic Pelvic Pain and Endometriosis Clinic at Universidade Federal de São Paulo (UNIFESP) from January to July of 2008. The controls were 50 healthy women from the Family Planning Clinic at UNIFESP. MAIN OUTCOME MEASURES: World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) quality of life questionnaire and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). RESULTS: No statistically significant differences were observed between the groups with CPP symptoms, in either the results from the WHOQOL-BREF or in the GRISS questionnaire. In both questionnaires, differences were observed when the two groups of symptomatic women were compared with the group of healthy women. CONCLUSION: CPP caused by endometriosis or other gynecological conditions leads to a significant reduction of quality of life and sexual satisfaction.

Etonogestrel implant in postpartum adolescents: bleeding pattern, efficacy and discontinuation rate.

BACKGROUND: The increasing rate of teenage pregnancies is a challenge to health professionals. New contraceptive methods have been developed to try to improve adherence in this group of patients. The study was conducted to evaluate the bleeding pattern, efficacy and discontinuation rate of etonogestrel implant (68 mg) inserted in postpartum adolescents. STUDY DESIGN: The study population comprised 44 postpartum adolescents managed at the Family Planning Sector of São Paulo Federal University. The implant was inserted, on average, 102 days after delivery. Patients were followed prospectively during four 90-day periods. RESULTS: All 44 patients completed the 12 months of follow-up, resulting in a study discontinuation rate of 0%. No implants were removed. There were no pregnancies during the study. After 1 year of use, frequent and prolonged bleeding were reported by less than 5% of the patients and amenorrhea occurred in 38.6% of the users. Laboratory parameters indicated a significant increase in hemoglobin and hematocrit among users. CONCLUSION: These findings suggest that the etonogestrel implant is a safe and effective contraceptive method that is well accepted by adolescents after a pregnancy.

Extended regimens of the contraceptive vaginal ring: evaluation of clinical aspects.

BACKGROUND: Oral contraceptives used for extended periods of time have been extensively studied because of their potential benefits; however, there have been few publications on extended regimens of vaginal contraceptive rings. The aim of this study was to evaluate the clinical symptoms, body weight and blood pressure changes in women using the vaginal ring continuously over a 1-year period. STUDY DESIGN: This prospective cohort evaluated clinical aspects (dysmenorrhea, headache, breast tenderness, leg pain and irritability), body weight and blood pressure changes in 75 women (18-37 years of age) using a vaginal ring releasing 120 mcg of etonogestrel and 15 mcg of ethinyl estradiol daily, over a continuous period of 84 days, followed by a 7-day ring-free interval, during 1 year. The chi-square, Wilcoxon and paired t tests were used to analyze differences in the outcomes of interest. RESULTS: Compared to pre-enrollment status, at the end of the study period, the patients reported significantly less dysmenorrhea and irritability, a nonsignificant decrease in breast tenderness, leg pain and headaches. Blood pressure measurements remained unchanged. Although weight and body mass index increased significantly among users, they remained within the expected biological variation range. CONCLUSION: The vaginal ring used on an extended regimen is a well-tolerated contraceptive method and also offers noncontraceptive benefits.

Extended regimens of the vaginal contraceptive ring: cycle control.

BACKGROUND: Oral contraceptives used for extended periods of time have been extensively studied because of their potential benefits; however, there have been few publications on extended regimen of vaginal rings. The aim of this study was to compare the bleeding patterns of women using extended regimens of the vaginal ring or oral contraceptives. STUDY DESIGN: Prospective cohort involving 150 women: 75 used vaginal rings that release 120 mcg of etonogestrel and 15 mcg of ethinyl estradiol daily, and 75 took oral contraceptives containing ethinyl estradiol 0.3 mcg and desogestrel 150 mcg. Both groups used their respective contraceptive method over continuous periods of 84 days, followed by a 7-day pause, during 1 year. RESULTS: The total number of scheduled bleeding and spotting days decreased significantly during the 1-year period of the study for both methods (p=.001), and this decrease was significantly higher for oral contraceptive users. Similarly, during the study period, there was a significant reduction in the total number of unscheduled bleeding and spotting days for both methods (p=.01), but this decrease was significantly higher among vaginal ring users (p=.003). CONCLUSION: Vaginal ring used on an extended regimen is a contraceptive method that offers good cycle control.

The T 380A intrauterine device: a retrospective 5-year evaluation.

BACKGROUND: The undue resistance to intrauterine device (IUD) use seen in several settings does not seem to occur in the Family Planning Unit of UNIFESP-EPM (São Paulo Federal University, Brazil). In fact, the Copper T 380A IUD in this clinic has reached an outstanding importance and this motivated us to present our differing experience. The prevalence of this method in this clinic is as high as 40%. This contrasts to the low use in the rest of the country, where tubal ligation is by far the most used contraceptive method (40%) and where IUD is inexpressive (1.1%). STUDY DESIGN: This is a retrospective study of the records of 118 users of Copper T 380A IUD inserted at the clinic and who were followed during 5 years. RESULTS: The cumulative pregnancy rate was 0.8%. The main cause for discontinuation of the study was loss to follow-up (21.3%). Other reasons for the withdrawal of the device were personal option (13.6%), dislocation (11.7%) and pregnancy wish (3.4%). There was no withdrawal by pelvic inflammatory disease. Bleeding (0.8%) was not an important cause for withdrawal, and there were no withdrawals due to pain. The continuation rate at 5 years was 46.7%. The structured service and an adequate educative program perhaps could explain at least partially the good performance of IUD use in this clinic. There was an amazing prevalence of the components of the metabolic syndrome. This could represent contraindications for hormonal contraception, and, in consequence, it could influence the increased option for and continuation of the IUD. CONCLUSION: These data show a good performance of the IUD for long duration, in relation to other studies, and this should be considered as a reliable alternative to the high prevalence of female sterilization in this country.

Bleeding patterns of women using extended regimens of the contraceptive vaginal ring.

INTRODUCTION: This prospective observational study evaluated the bleeding patterns of women using a vaginal ring releasing 120 microg of etonogestrel and 15 microg of ethinyl estradiol daily, over a continuous period of 84 days followed by 7 ring-free days. METHODS: The study enrolled 75 volunteers aged 18 to 37 years. Sixty-two (82.8%) recorded their menstrual cycles during 1 year. RESULTS: At the end of the study, 85.5% had adequate menstrual patterns (two to four bleeding episodes, none lasting 10 days or more, with a range of bleeding-free intervals not exceeding 17 days), 9.7% had infrequent bleeding, 1.6% reported prolonged bleeding episodes, 1.6% had frequent bleeding and 1.6% had irregular bleeding. CONCLUSION: Only 5 of the initial 75 patients discontinued the method due to bleeding. Among these 75 women, dissatisfaction with bleeding patterns was not a frequent reason given for discontinuation of the contraceptive vaginal ring.

Evaluation of lipid profile in adolescents during long-term use of combined oral hormonal contraceptives.

The study evaluated the effects of the long-term use of a combined oral hormonal contraceptive containing 30 microg ethinyl estradiol and 75 microg gestodene in adolescents. Thirty-three volunteers, aged from 14 to 19 years, who used the oral contraceptive for three consecutive years, were studied. Evaluation of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides was made before use and after 1, 2 and 3 years. During the 3-year study period, total cholesterol, HDL-C, LDL-C and triglyceride levels were significantly higher than previous measurements, but average values did not exceed the normal range. Compared to the first year, the second- and third-year cholesterol, HDL-C, LDL-C and triglyceride levels were not significantly different.