Quality traits and lipid composition of meat from Nellore young bulls fed with different oils either protected or unprotected from rumen degradation.

The qualitative characteristics, lipids and chemical composition of the meat of 35 Nellore young bulls were analyzed. These bulls had an average slaughter weight and fat thickness of 532.17±30.2 kg, and 7.00 mm, respectively. Significant differences were found only in the meat's water holding capacity (WHC), which was higher for animals fed with fresh linseed oil. More conjugated linoleic acid (CLA) was found in the meat of animals fed with unprotected soybean oil, while better omega-6/omega-3 ratios were noted for those fed unprotected linseed oil. The addition of different vegetable oils to the bulls' diet (soybean or linseed, either protected or not protected from rumen digestion) did not interfere with the qualitative characteristics of their meat while improving the lipid composition of the longissimus muscle. Of the oils examined, unprotected linseed oil most improved the omega-6/omega-3 ratio, thus producing the healthiest meat for human consumption.

Microbial contamination of "in use" bar soap in dental clinics.

Bar soap from 18 different dental clinics were investigated for microbial contamination, while it was "in-use". Of the 32 samples obtained from the bar soap, 100% yielded positive culture. A total of 8 different genera of organisms were isolated. Each bar soap was found to harbor 2-5 different genera of micro organisms. Heavily used soap had more micro organisms compared to less used soap. The microbial load of the "in-use" bar soap constituted a mixed flora of gram positive, gram negative, aerobes, anaerobes, and fungi. The results indicate that the bar soap under "in-use" condition is a reservoir of microorganisms and handwashing with such a soap may lead to spread of infection.

Phaeoacremonium krajdenii, a cause of white grain eumycetoma.

We describe the first case of white grain pedal eumycetoma caused by Phaeoacremonium krajdenii in a 41-year-old man from Goa, India. Based on histological examination of biopsy tissue showing serpentine granules, a culture of the granules yielding phaeoid fungal colonies, and morphological characteristics and sequence comparison of the partial beta-tubulin gene with the ex-type isolate of P. krajdenii, the causal agent was identified as P. krajdenii.

Assessment of menstrual blood loss in Brazilian users of the frameless copper-releasing IUD with copper surface area of 330 mm2 and the frameless levonorgestrel-releasing intrauterine system.

OBJECTIVE: This study was conducted to evaluate the effect of two types of IUDs on the amount of menstrual blood loss (MBL): the frameless copper-releasing intrauterine device (IUD) with copper surface area of 330 mm2 (GyneFix; Contrel Research, Ghent, Belgium) and the frameless levonorgestrel (LNG)-releasing intrauterine system (IUS) releasing 14 microg per day (FibroPlant-LNG; Contrel Research). Heavy and abnormal MBL is the main reason for discontinuation of intrauterine devices. METHODS: In 20 Brazilian women using GyneFix 330 and 32 using FibroPlant-LNG, respectively, MBL was measured by the quantitative alkaline hematin technique. In addition, ferritin levels were measured in GyneFix 330 and FibroPlant-LNG users. RESULTS: MBL with GyneFix 330, measured over a 24-month period, increased but was less when compared with TCu380A. Ferritin levels with GyneFix 330 were not affected in contrast with TCu380A. In FibroPlant-LNG users, mean MBL decreased by about 90% and ferritin levels increased significantly. CONCLUSIONS: The authors confirm earlier reports that, especially for women with low body iron stores and heavy menstrual bleeding, there is an order of preference for IUD use to minimize MBL. The choice should first be a progestin-releasing IUS, then a copper IUD, which has the least effect on menstrual bleeding, such as the frameless GyneFix IUD.

Effects of transdermal and oral estrogen replacement on lipids and glucose metabolism in postmenopausal women with type 2 diabetes mellitus.

OBJECTIVE: To compare the effects of oral and transdermal estrogen replacement on lipid and glucose metabolism in postmenopausal women with diabetes mellitus type 2. DESIGN AND METHODS: In an open, randomized, cross-over study, 21 diabetic postmenopausal women were treated with transdermal 17beta-estradiol 50 microg or oral conjugated equine estrogens (CEE) 0.625 mg daily, both associated with 300 mg/day of oral micronized progesterone for 12 days monthly during 6 months each. After a 12-h overnight fasting period, blood glucose, insulin, glycosylated hemoglobin (HbA1c) and lipoprotein profile were evaluated, at baseline and after 6 months of each schedule of hormone replacement therapy (HRT). Insulin sensitivity was determined by homeostasis model assessment (HOMA). RESULTS: HRT had no negative influence on glucose metabolism. After 6 months of CEE treatment, there was a significant increase in high-density lipoprotein (HDL) cholesterol, but also in triglycerides, of 9.0% and 20.7%, respectively (p = 0.04). The levels of total cholesterol and low-density lipoprotein (LDL) cholesterol were unaffected. Transdermal estradiol did not affect the lipid profile. CONCLUSIONS: Hormone replacement therapy with either oral or transdermal estrogen plus micronized progesterone has no harmful influence on glucose metabolism in type 2 diabetic postmenopausal women; whether the increase in HDL cholesterol, but also in triglyceride levels, makes oral CEE the better choice remains an open question.

Antimicrobial susceptibility of Salmonella typhi to quinolones & cephalosporins.

Antimicrobial sensitivity testing was carried out for 85 isolates of S. typhi by disc diffusion and microbroth dilution for estimation of minimum inhibitory concentration (MIC). The drugs used included amoxycillin, chloramphenicol, ciprofloxacin, ofloxacin, gentamicin, netilmicin, cefuroxime, ceftizoxime, cefoperazone and ceftazidime. Ninety three per cent of our isolates were resistant to amoxycillin and chloramphenicol but total susceptibility was seen to quinolones and aminoglycosides. We also found that 3 per cent of our isolates were resistant to cephalosporins and 23 per cent were in the intermediate range with an MIC of 12.5 or 25 micrograms/ml to these drugs. In spite of decreased efficacy, the strains continued to be fully susceptible to ciprofloxacin as could be seen from the extended dilutions in microbroth dilution tests. The study also revealed that there was lack of correlation between the two methods of sensitivity testing for cephalosporins. We feel that the development of resistance of S. typhi to third generation cephalosporins is a finding worth consideration for further studies.

[Comparative study of intrauterine devices: TCu380A and Flexigard]. / Estudo comparativo entre os dispositivos intrauterinos: TCu380A e Flexigard.

PIP: The Copper T 380A and the Flexigard intrauterine devices were evaluated for safety, efficacy, and continuation rates in parous women. The Flexigard is a new concept of IUD technology with regard to the affixing of the device to the uterine fundus, the flexibility of the device, and the total absence of a plastic frame. A total of 186 women were enrolled in the study: Group I contained 90 women using Flexigard, and Group II 96 women using TCu380A. All participants were healthy women with at least one living child, regular menstrual cycles, and without previous history of pelvic inflammatory disease and/or ectopic pregnancy. The IUDs were inserted in the first 10 days of the cycle, and subsequent examinations were carried out on day 15, and 3, 6, 9, 12, and 24 months after insertion. The patients were followed up for a total of 2622 and 2589 woman-months for TCu380A and Flexigard, respectively. There were 96 TCu380A and 95 Flexigard insertions. Medical reasons for discontinuation were: desire to get pregnant (1.1%), complaint of partner (1.1%), blood loss (1.1%) for Flexigard; and desire to get pregnant (5.2%), partner's complaint (1.9%), and loss of blood (1.0%) for TCu380A. There were five insertion failures out of 95 insertions with the Flexigard and none out of 96 insertions with TCu380A. The age, parity, and continuation rates showed no differences between devices. The main difference between the devices was that the complete expulsion rate for Flexigard was significantly higher (5.55%) than for the TCu380A (p 0.05). This high rate of complete expulsions for Flexigard was attributable to improper insertion of the device rather than to the expulsion of a properly fitted one.^ieng

[Information on advances in sciences and technology. Advances in contraceptive technology]. / Informacoes sobre avancos em ciencia e tecnologia. Avancos da tecnologia anticonceptiva.

PIP: Hormonal contraceptives include oral pills with lower steroid concentrations such as the triphasic gestodene. A dose of less than 20 mcg of ethinyl estradiol in the combined pill is effective. The use of RU-486 or mifepristone to inhibit ovulation or as a postcoital method is still being investigated. The vaginal rings that release 20 mcg of levonorgestrel (LNG) have a 97% rate of efficacy. There are newer types that release 30 mcg of LNG or desogestrel. A progesterone-releasing ring used during lactation is being studied. Among implants Norplant has been approved in many countries, including by the US Food and Drug Administration, with excellent results. In Brazil it continues to be banned. Studies have been initiated about implants, such as Norplant 11 and UNIPLANT. The studies conducted by the World Health Organization on injectables such as Cyclofem (which contains 5 mg of estradiol cypionate and 25 mg of medroxyprogesterone acetate) as well as Mesigyna (5 mg of estradiol valerate and 50 mg of norethindrone enanthate) are awaited. These two monthly injectables have minor side effects, produce regular cycles, and are highly effective. The use of GnRH analogues for ovulation inhibition are held back because of cost, dosage, and routes of administration The hormonal IUD releasing 20 mcg of LNG holds promise for high efficacy, probable protection against inflammations, and pronounced reduction of menstrual bleeding, particularly in long-term use. The frameless IUD, called Flexigard, consists of 6 fixed copper cylinders placed in the myometrium, which causes less endometrial irritation and less incidence of inflammation, pain, and bleeding. It has been in an experimental testing phase for some years. The female condom helps prevent STDs and is under the woman's control. Among male contraceptives, a hormonal method awaits development, while gossypol with the ability to inhibit HIV proliferation and the Chinese method of scalpel-free vasectomy are effective methods.^ieng

Menstrual blood loss and body iron stores in Brazilian women.

Menstrual blood loss (MBL) studies are relevant for developing world women as this could be an important cause of anemia. Whenever a contraceptive method is to be used by such women, consideration should be given to the method which least affects the volume of MBL. In 309 women considered as clinically healthy, MBL, serum ferritin, serum iron and hemoglobin levels were measured: a mean MBL of 23 ml was found. Age, weight, height and previous oral contraceptive use did not affect MBL. Higher parity women may have higher MBL levels but their hematologic indices are not altered. While body iron stores (as judged by serum ferritin levels) are depleted in women who bleed more than 60 ml per cycle, clinical anemia may not be present until their blood loss exceeds 80 ml per menstruation. Brazilian women who lose more than 60 ml of menstrual blood associated with multiple pregnancies without adequate iron supplementation may have a depletion of their body iron stores.

[Menstrual blood loss and body iron stores: comparative study between a Multiload-375 IUD and a levonorgestrel vaginal ring]. / Perda sanguinea menstrual e estoques de ferro do organismo -- estudo comparativo entre o DIU Multiload-375 e o anel vaginal de levonorgestrel.

PIP: 107 users of vaginal rings and 74 users of Multiload-375 (ML-375) IUDs aged 18-40 years with more than 1 parity were studied. In the city of Santiago, Chile, 57 patients and at the University of Juiz de Fora, Brazil, 124 users were enrolled. The vaginal ring releases about 20 mcg/day of levonorgestrel (LNG). It was used continuously for 12 months with replacement every 3 months. The ML-375 was used continuously for 24 months or more. Menstrual blood loss (MBL) was determined before insertion; 3, 6, 9 and 12 months after insertion in both groups; and after 24 months in the IUD users. Serum ferritin measurement was done before use: 6 and 12 months after use in the vaginal ring group and 6, 12, and 24 after IUD insertion. Hemoglobin also was measured. It was observed that MBL always increased with IUD use and decreased with vaginal ring use. The measurements concerning IUD were significant in Santiago up to 24 months with a value of MBL of + 17.9 +or- 7.8 ml, while in Juiz de Fora they were significant up to 12 months returning to the value of preinsertion at 24 months (+ 3.1 +or- 4.6 ml). In vaginal ring users a small decrease of MBL was ascertained, but the only statistical difference occurred up to 12 months in Santiago (- 9 +or- 4.4 ml). In IUD use, in inverse correlation to MBL, serum ferritin dropped significantly at 6 months in Chile (- 7.7 +or- 2.9 ng.ml) and 6, 12, and 24-month follow-ups in Brazil (-5.2, -6 and-7.7 ng/ml, respectively). With the vaginal ring serum ferritin did not change significantly. These findings confirm previous research that ML IUDs increased MBL much less than other IUDs causing less change in iron stores even in patients with ferritin lower than 15 ng/ml, considered under the normal value. Yet for users in developing countries, the use of vaginal rings with LNG would be more suitable than the IUD ML-375 because of slighter alterations in the iron balance of the system.^ieng

Perda sanguínea menstrual e estoques de ferro do organismo: estudo comparativo entre o DIU Multiload-375 e o anel vaginal de Levonorgestrel / Menstrual blood loss and body iron stores: comparative study with the use of a Multiload-375 IUD and a Levonorgestrel vaginal ring

Setenta e quatro usuárias do DIU Multiload-375 foram estudadas comparativamente com 107 usuárias de anel vaginal de Levonorgestrel (20 micra g/dia) no Brasil e Chile, relativamente à sua perda sanguínea menstrual (PSM) e estoques de ferro do organismo através de medidas da hemoglobina (HGB) e ferritina sérica (FS). As medidas foram feitas antes e após a inserçäo do DIU por 24 meses e do anel vaginal por 12 meses. Enquanto näo houve alteraçöes com o uso do anel vaginal nas medidas de PSM, HGB e FS, as mulheres que usaram o DIU tiveram o aumento significativo na PSM por pelo menos um ano depois da inserçäo e uma queda também significativa da FS até 24 meses depois da inserçäo. Em conclusäo, sugere-se que dos dois métodos estudados, o anel vaginal seria o mais adequado para indivíduos com baixos estoques de ferro do organismo.

Microdose intravaginal levonorgestrel contraception: a multicentre clinical trial. I. Contraceptive efficacy and side effects. World Health Organization. Task Force on Long-Acting Systemic Agents for Fertility Regulation.

A multicentre clinical trial, including 19 centres in 13 countries, assessed the contraceptive efficacy and clinical acceptability of a Silastic 382 vaginal ring releasing 20 micrograms of levonorgestrel for at least 90 days. A total of 1005 women entered the study and 8176.74 woman-months of experience was gathered. The rate of intrauterine pregnancy at one year of use was 3.6 per 100 women (95% confidence interval 2.2-5.0), and of ectopic pregnancy, 0.2% (one case). The principal reasons for discontinuation were menstrual disturbances (17.2% at one year), vaginal symptoms (6.0%) and repeated expulsion of the ring (7.1%). The pregnancy rate with this 20 micrograms levonorgestrel-releasing vaginal ring compares favourably with that of a low estrogen combination oral contraceptive tested by WHO and is less than half that of a progestogen-only oral contraceptive in a WHO randomized study. It is concluded that the WHO intravaginal ring releasing an average of 20 micrograms of levonorgestrel per 24 hours is an effective method of contraception for at least one year of use.

Microdose intravaginal levonorgestrel contraception: a multicentre clinical trial. II. Expulsions and removals. World Health Organization. Task Force on Long-Acting Systemic Agents for Fertility Regulation.

This paper investigates the relationship between expulsions and removals, and demographic characteristics of 1005 women from 19 centres using a vaginal ring releasing 20 micrograms levonorgestrel per 24 hours. Emphasis is placed on discontinuations of method use due to expulsions, on the number and rate of expulsions, and the time at which the first expulsion occurred. The overall life-table discontinuation rate due to expulsion was 7.1% at one year. Life-table discontinuation rates increased with parity and were highest in Asian and lowest in European women. In respect to the number of expulsions experienced by women (expulsions did not necessarily lead to discontinuation), the women of high parity and those from Asia and Europe have the highest rates. The life-table first expulsion rate is 29% at one year. Such rates are highest in Chinese and Asian women. Following a first expulsion, the second expulsion rate is 45% by the end of the subsequent six months. The majority of first expulsions occur at defaecation (134 or 57% of 234 women), urination (12%) and during menstruation (17%). Rings were removed by 121 (12%) women on 201 occasions and for a variety of reasons. The main medical reasons were vaginal discharge and irritation, bleeding pain and dyspareunia. Others removed the ring during defaecation, intercourse or because the ring came out of place. Women also removed rings for curiosity, to show their husbands and to clean.

Microdose intravaginal levonorgestrel contraception: a multicentre clinical trial. III. The relationship between pregnancy rate and body weight. World Health Organization. Task Force on Long-Acting Systemic Agents for Fertility Regulation.

This paper investigates the relationship between pregnancy rates and body weight of 1005 women using a vaginal ring releasing 20 micrograms levonorgestrel per 24 hours. While the overall pregnancy rate at one year was 3.7%, it was found that women have an increasing risk of pregnancy with increasing body weight. For example, a woman of 40 kg has an estimated pregnancy rate of 1.7% in contrast to 9.8% for a woman of 80 kg weight.

Microdose intravaginal levonorgestrel contraception: a multicentre clinical trial. IV. Bleeding patterns. World Health Organization. Task Force on Long-Acting Systemic Agents for Fertility Regulation.

A multicentred clinical trial was conducted in 12 countries to assess the contraceptive efficacy and side effects of a low-dose levonorgestrel-releasing vaginal ring. Contraceptive efficacy and side effects, expulsions and removals, and the relation between pregnancy rate and admission body weight of the women have been reported previously. The effect of ring use on vaginal bleeding patterns as observed from daily menstrual diaries kept by the women is the object of this paper. A total of 1005 women were fitted with the ring and 702 of them provided a menstrual diary suitable for analysis. The description of the bleeding patterns is made using a 90-day reference period approach and following the guidelines published by WHO. In addition the longest bleeding/spotting episode and longest bleeding/spotting-free interval are calculated over the entire diary length. Half of the ring users have vaginal bleeding patterns similar to normal untreated patterns. A quarter experience irregular bleeding, 10% have prolonged cycles and 10% have shortened cycles. Over one year of continuous use, there appears to be no significant trend in these patterns. Users with the worst bleeding patterns tend to discontinue first during the clinical trial and are influenced by their more recent experience of vaginal bleeding irregularities. Life-table analysis of discontinuation rates gives an underestimation of the true incidence of bleeding irregularities. Some comments are made on the limitations of the methods of analysis of menstrual diaries.

[AIDS and reproduction -- some aspects]. / AIDS e reproducao -- alguns aspectos.

PIP: At present probably about 1/2 million people have AIDS in the world. About 10 million may be infected with HIV without showing symptoms. By 2000 at least 5 million new cases of AIDS are expected. In Latin America AIDS was first concentrated among urban male homosexuals. Lately AIDS has increased rapidly among heterosexuals especially among bisexuals. In Sao Paulo and Rio de Janeiro 28% of bisexuals were infected with HIV in 1987. In Rio about 1/2 of male or female prostitutes were infected. The number of partners, the frequency of coitus, simultaneous infection with genital ulcers, and anal sex increases the chances of heterosexual transmission. 25-50% of the children of infected pregnant women are born infected with HIV. By the end of 1992 at least 1 million babies will be born to infected mothers of whom 250,000 will be HIV positive. Vertical transmission from the mother to the fetus by decidual leukocytes (especially trophoblasts) via transplacental passage was verified by identifying HIV in aborted fetuses in the 2nd and 3rd trimester. HIV infection can also occur during delivery. The virus can also be transmitted via mother's milk: there have been reports of HIV in milk since 1985. The US Centers for Disease Control advised against breast feeding by HIV infected mothers. Up to 15 months of age it is difficult to assess whether HIV antibodies are derived from the mother's infection or from the infant itself. A polymerase chain reaction test could resolve this problem by amplifying the genetic chain in the blood and detecting HIV in the DNA of the child. Recent studies have indicated that there is no additional risk posed by breast feeding for those infants who have been exposed to HIV during pregnancy or delivery. Mothers infected with HIV in developing countries may breast feed their infants because it is crucial in reducing infant mortality.^ieng

Consequences of uterine blood loss caused by various intrauterine contraceptive devices in South American women. World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction.

Increased menstrual blood loss (MBL) associated with intrauterine device (IUD) use may precipitate or aggravate iron deficiency anaemia, adversely affecting the health of women particularly those from developing countries. Studies were conducted to define the association of MBL and iron status in South American women; to determine the level of MBL induced by IUD use which would result in iron depletion, the length of time for this depletion to occur and, comparing various IUDS, to determine if any currently tested IUDs are suited to long-term use in South American women. A total of 395 women received one of 5 types of IUDs in Santiago, Chile, and Juiz de Fora, Brazil: Lippes Loop, Multiload-250 and Multiload-375 were used in both centres; in Santiago some subjects received the Copper-7 or ProgestasertR devices and in Juiz de Fora, the TCu 200 and the T-Chloroquin IUDs were also tested. MBL and haemoglobin (HGB) were measured for 3 menstrual cycles before insertion, and following insertion, at one, two, four, six, nine, twelve, eighteen and twenty-four months in the majority of cases. Serum ferritin was measured before insertion and at intervals of six months. Mean values of MBL prior to IUD insertion in both centres varied from 21-30 ml. As with previous publications, the use of the Lippes Loop was associated with the greatest increase in MBL which was sustained throughout the 24 months of observation. Women who had one of the two types of Multiload devices inserted also had increased MBL and reduced ferritin for at least 12 months of use. TCu 200 and Copper-7 IUD users had an initial increase in MBL of 1 to 17 ml in the first six months of observation returning to normal levels beyond six months. Serum ferritin levels were lower for one year and then returned to admission values. ProgestasertR users confirmed previous reports of a reduction of 40-50% in MBL and an increase in serum ferritin. Few significant changes in haemoglobin (HGB) concentrations were found. Serum ferritin levels on admission ranged from 7.1 to 16.4 ng/ml in Santiago and from 15.8 to 23.2 ng/ml in Juiz de Fora. Many women were in a marginal state of iron balance as evidenced by lower serum ferritin values. Changes in serum ferritin were very closely related to those in MBL.(ABSTRACT TRUNCATED AT 400 WORDS)

Quantitative studies on menstrual blood loss in IUD users.

Despite the introduction of new intrauterine devices (IUDs), the most important complication involving their use continues to be excessive menstrual bleeding. IUD use in developing countries with women who are already depleted in body iron stores may prove to be deleterious to their health. Mean amounts of menstrual blood loss (MBL) for women not using contraception in the western world is about 32 ml. This mean is increased to 52-72 ml with use of the Lippes loop and other non-medicated devices up to 24 months after insertion. For the Copper-7 and Copper-T-200 devices this mean increase is to 37-40 ml in the first month, decreasing to 30-38 ml at 12 months after IUD insertion. In the users of the Multiload-250 IUD at one month post-insertion the MBL is from 56 to 63 ml and from 36 to 39 ml at 24 months of use. The mean Multiload-375 device users at one month after insertion lose a mean of 45-73 ml at 24 months, 35-50 ml. With the progestogen-releasing IUD mean MBL is 27-36 ml at 1 month and 9-13 ml at 12 months post-insertion. Intermenstrual blood loss is significant only in the first month of use for all IUDs. Discontinuation rates for pain and bleeding with non-medicated IUDs are from 11.0-19.6 per 100 women per year, and for the copper IUDs 4.4 to 6.8 per 100 women in the first year of use. The main problem with prolonged menstrual bleeding is depletion of the body iron stores; this is highly significant with non-medicated devices, less important with copper devices and conversely, iron stores are increased in users of progestogen-releasing devices. This is based on serum ferritin measured up to 24 months after insertion. The ferritin values correlated well with the volumes of MBL. It is suggested, especially for women with low body iron stores, that there is an order of preference for IUDs to be used. This should be: firstly, the progestogen-releasing devices; secondly, the Copper-T and Copper-7 IUDs; thirdly the larger surface copper devices (Cu-T-220C, Multiload 250 and 375, Cu-T-380). Non-medicated devices are not to be recommended for these women.

[IUD mode of action]. / Mecanismo de acao do dispositivo intrauterino.

PIP: The IUD is the best contraceptive method for women around 30 years of age that do not desire to have any more children. The method is reversible with the highest practical efficacy and low risk of infertility in women that have at least 1 child. In spite of the advantages, the IUD has been a matter of controversy and the literature about the subject has increased. The IUD's mode of action theories are reviewed according to the following: the local inflammatory process; uterine-tubal motility; changes in endometrial biochemical, immunological and hormonal changes; alterations in sperm capacity and in the copper itself; early pregnancy test; and inhibition of the fertilization. The author concluded that the IUD was a contraceptive and not an abortive method, because the fertilization is complicated or completely inhibited due to alterations in sperm capacitation and motility, in oocyte transport and morphophysiology, cervical, endometrial and tubal change. There is total absence of scientific evidence of disruption of ovum implantation related with the IUD use.^ieng