Gardnerella pickettii sp. nov. (formerly Gardnerella genomic species 3) and Gardnerella greenwoodii sp. nov. (formerly Gardnerella genomic species 8) isolated from female urinary microbiome.

During an ongoing female urinary microbiome research study, strains c17Ua_112T and c31Ua_26T isolated from urine samples of a patient diagnosed with overactive bladder and a healthy postmenopausal woman, respectively, could not be allocated to any Gardnerella species with valid names. In this work, we aimed to characterize these strains. The 16S rRNA gene sequences confirmed that these strains are members of the genus Gardnerella. Phylogenetic analysis based on cpn60 strongly supported two clades, one encompassing c17Ua_112T and nine other strains from the public database, and the other including c31Ua_26T and three other strains, which were distinct from currently recognized species of the genus Gardnerella. Likewise, the phylogenomic tree also showed that strains c17Ua_112T and c31Ua_26T formed independent and robust clusters. Average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) values between c17Ua_112T and c31Ua_26T were 79.27 and 27.4 %, respectively. Strain c17Ua_112T showed the highest ANI (94.8 %) and dDDH values (59.8 %) with Gardnerella piotii UGent 18.01T, and strain c31Ua_26T revealed highest ANI (84.2 %) and dDDH (29.1 %) values with Gardnerella swidsinskii GS 9838-1T. Based on the data presented here, the two strains c17Ua_112T and c31Ua_26T represent two novel species of the genus Gardnerella, for which the names Gardnerella pickettii (c17Ua_112T=DSM 113414T=CCP 71T) and Gardnerella greenwoodii (c31Ua_26T=DSM 113415T=CCP 72T) are proposed.

Antioxidant potential and cytotoxic activity of two red seaweed species, Amansia multifida and Meristiella echinocarpa, from the coast of Northeastern Brazil.

Natural antioxidants found in marine macroalgae are bioactive compounds known to play an important role in the prevention of diseases associated with aging cells protecting them against the oxidative damage. The purpose of this study was to evaluate the antioxidant and cytotoxic activity of ethanolic extracts of two species of red seaweeds, Amansia multifida and Meristiella echinocarpa. In vitro antioxidant activity was determined by DPPH radical scavenging assay, ferric-reducing antioxidant power (FRAP) assay, ferrous ion chelating (FIC) assay, ß-carotene bleaching (BCB) assay and total phenolic content (TPC) quantification. Cytotoxicity was evaluated with the brine shrimp Artemia sp. lethality test. The TPC values observed in the present study indicated that both species A. multifida and M. echinocarpa are rich in phenolic compounds, reaching values of 45.40 and 28.46 mg gallic acid equivalent (GAE) g-1 of ethanolic extract, respectively. DPPH radical scavenging and ferrous ion chelating showed values of 60% and 17%, respectively. Both seaweed extracts inhibited ß-carotene oxidation by approximately 40%. None of the algal extracts were potentially cytotoxic. The results have showed that extracts of both species of marine red algae exhibit antioxidant potential and low toxicity. They are sources of natural antioxidant compounds.

Resting-state fMRI functional connectivity and clinical correlates in Afro-descendants with schizophrenia and bipolar disorder.

Schizophrenia (SCZ) and bipolar disorder (BD) exhibited altered activation in several brain areas, including the prefrontal and temporal cortex; however, a less explored topic is how brain connectivity and functional disturbances occur in non-Caucasian samples of SCZ and BD. Individuals with SCZ (n=20), BD (n=21), and healthy controls (HC, n=21) from indigenous and African ethnicity were submitted to clinical screening and functional assessments. Mood, compulsive and psychotic symptoms were also correlated to network dysfunction in each group. Two distinct networks' subcomponents demonstrated significant lower global efficiency (GE) in SCZ versus HC, corresponding to left posterior dorsal attention and medial left ventral attention (VA) networks. Lower GE was found in BD versus controls in four subcomponents, including the left medial and right VA. Higher compulsion scores correlated in BD with lower GE in the left VA, whereas increased report of alcohol abuse was associated with higher GE in left default mode network. Although preliminary, differences in the activation of specific networks, notably the left hemisphere, in SCZ versus controls, and lower activation in VA areas, in BD versus controls. Results highlight default mode and salient network as relevant for the emotional processing of SCZ and BD of indigenous and black ethnicity. Abstract: schizophrenia, bipolar disorder, functional neuroimaging, ethnicity, default network.

Urinary Microbiome of Reproductive-Age Asymptomatic European Women.

The knowledge of bacterial species diversity within the female urinary microbiome (FUM) is essential for understanding the role of the FUM in urinary tract health and disease. This study aimed to characterize the bacterial species diversity of the FUM of asymptomatic reproductive-age European women by combining extended culturomics and long-read sequencing of the near-full-length 16S rRNA gene. A total of 297 bacterial species (median of 53 species/sample) were identified, yet only 22% of the species were detected by both culture and sequencing methods. Recently recognized Gardnerella, Lactobacillus, and Limosilactobacillus species and 5 new putative Corynebacterium species were identified by culturomics, while anaerobic species (e.g., 11 Peptoniphilus spp.) were mostly detected by amplicon sequencing. Notably, there was not a single species common to all samples, although members of the genus Lactobacillus were detected in all. Lactobacillus crispatus, Lactobacillus iners, and Lactobacillus mulieris were observed in high relative abundance in several samples, as well as other species (e.g., Streptococcus agalactiae, Fannyhessea vaginae, Gardnerella vaginalis, Gardnerella swidsinskii), while low-abundance members (e.g., Finegoldia magna) were often more prevalent. A moderate correlation (Mantel test; r = 0.5) between community structure types captured by culturomics and amplicon sequencing was observed, highlighting the benefit of combining both methodologies. This study provided a detailed FUM structure at the species level, which is critical to unveil the potential relationship between specific microbiome members and urinary diseases/disorders. Moreover, the different capacity to characterize microbiome profiles of culturomic and amplicon sequencing is described, providing valuable insights for further urinary microbiome studies. IMPORTANCE The bacterial species diversity within the female urinary microbiome (FUM) has been insufficiently characterized. This study demonstrated that complementarity between optimized culture-dependent and -independent approaches is highly beneficial for comprehensive FUM species profiling by detecting higher FUM species diversity than previously reported, including identification of unreported species belonging to the genera Lactobacillus, Limosilactobacillus, and Latilactobacillus and putative novel Corynebacterium species. Although some species were present in high relative abundance, low-abundance members were more prevalent. FUM classification into community structure types demonstrated high interindividual differences in urinary microbiome composition among asymptomatic women. We also report moderate correlation between culture-dependent and -independent derived data-highlighting drawbacks of each methodological approach. Our findings suggest that FUM bacterial diversity reported from previous studies may be underestimated. Finally, our results contribute to the fundamental knowledge of the FUM required for further exploration of the urinary microbiome role in urinary tract diseases.

Dramatic secukinumab-mediated improvements in refractory leprosy-related neuritis via the modulation of T helper 1 (Th1) and T helper 17 (Th17) immune pathways.

A 39-year-old woman was diagnosed with relapsed multibacillary leprosy and refractory neuritis. Here, we describe an evident loss of therapeutic effectiveness after the third pulse of corticosteroids, which may be attributed to tachyphylaxis and the posterior modulation of interferon- γ (IFN-γ), tumor necrosis factor- α (TNF-α,) interleukin-17A (IL-17A), and IL-12/23p40 after the induction phase of secukinumab. In this case, plasma cytokine analysis showed that secukinumab induced a reduction in IL-17 concomitant with impressive clinical improvements in the patient's neural function. Interestingly, secukinumab induced reductions in cytokines related to Th1 responses and earlier stages of the Th17 response, including IL-23/12.

Antinociceptive Effect of the Essential Oil of Schinus terebinthifolius (female) Leaves on Adult Zebrafish (Danio rerio).

Schinus terebinthifolius Raddi (Anacardiaceae) is popularly known in Brazil as aroeira-da-praia and has pharmacological use as an astringent, antidiarrheal, anti-inflammatory, depurative, diuretic, and antifebrile agent. Although the neuropathic antinociceptive potential of S. terebinthifolius fruits has already been investigated, this study is the first one to analyze the acute antinociceptive effect of the essential oil of S. terebinthifolius (female) leaves (EOFSt) on adult zebrafish. EOFSt was submitted to antioxidant activity evaluation by two methods (ferrous ion-chelating capacity [FIC] and ß-carotene). The animals (n = 6/group) were treated orally (20 µL) with EOFSt (0.1, 0.5, or 1.0 mg/mL) or vehicle (0.9% sodium chloride [NaCl]; 20 µL), and submitted to nociception (formalin, cinnamaldehyde, capsaicin, glutamate, acidic saline, and hypertonic saline). Possible neuromodulation mechanisms, as well motor alterations and toxicity were also evaluated. In the FIC assay, EOFSt showed ferrous ion-chelating capacity in ∼40% to 90%. Regarding the ß-carotene bleaching assay, EOFSt showed inhibition in a 58% to 80% range. Oral administration of EOFSt showed no acute toxicity and did not alter the locomotor system of aZF, and reduced the nociceptive behavior in all tested models. These effects of EOFSt were significantly similar to those of morphine, used as a positive control. The antinociceptive effect of EOFSt was inhibited by naloxone, L-NAME, ketamine, camphor, ruthenium red, and amiloride. The antinociceptive effect of the EOFSt cornea was inhibited by capsazepine. EOFSt has the pharmacological potential for acute pain treatment and this effect is modulated by the opioid system, NMDA receptors, and transient receptor potential ankyrin 1 (TRPA1), transient receptor potential vanilloid 1 (TRPV1), and acid-sensing ion channels. The EOFSt also has the pharmacological potential for corneal pain treatment and this effect is modulated by the TRPV1 channel.

Genotoxic endpoints in a Pb-accumulating pea cultivar: insights into Pb2+ contamination limits.

Lead (Pb) persists among the most hazardous contaminant metals. Pb-induced genotoxic effects remain a matter of debate as they are a major cause of plant growth impairment, but assessing Pb genotoxicity requires the selection of Pb-sensitive genotoxic biomarkers. Seedlings of the ecotoxicological model species Pisum sativum L. were exposed to Pb2+ (≤ 2000 mg L-1). Flow cytometry (FCM) revealed that 28 days after, Pb2+ arrested root cell cycle at G2 but no eu/aneuploidies were found. Comet assay and FCM-clastogenicity assays showed that Pb2+ increased DNA breaks in roots at concentrations as low as 20 mg L-1. Leaves showed no variation in DNA-ploidy or cell cycle progression but had increased DNA breaks at the highest Pb2+ dose. We conclude that both Comet assay and the full-peak coefficient of variation (FPCV) were the most relevant endpoints of Pb-phytogenotoxicity. Also, the Pb-induced DNA breaks may be related with the arrest at the G2-checkpoint. Data will be relevant to better define Pb2+ ecogenotoxicological effects and their measuring tools and may contribute to a regulatory debate of this pollutant limits.

Radiolucent image in lower third molar: hidden caries or pre-eruptive resorption?: a case report / Imagem radiolucente em terceiro molar inferior: cárie oculta ou reabsorção pré-eruptiva?: um relato de caso

ABSTRACT Caries is a multifactorial disease due to the imbalance of the de/re-mineralization process. Complementary radiographic examinations are able to detect hidden caries. The purpose of this short communication was to investigate the radiolucent image suggestive of hidden caries in lower third molar. The extraction of the tooth, decalcification, inclusion and preparation were performed for histological analysis of the lesion. Histological findings revealed a pre-eruptive resorption, and the etiological factors of this coronary resorption were undefined. The professional should be aware of the occurrences of these lesions to early diagnose and propose appropriate treatment to avoid future complications to the patient.

RESUMO A cárie é conceituada como uma doença multifatorial condicionada ao desequilíbrio no processo de desmineralização e remineralização das estruturas dentárias. O propósito desse trabalho foi investigar a imagem radiolúcida sugestiva de cárie oculta em terceiro molar. Foi realizado a exodontia do elemento dentário, descalcificação e confecção de lâminas para posterior estudo histológico da lesão. O achado histológico conclui-se tratar de uma reabsorção pré-eruptiva. O profissional deve estar atento às ocorrências dessas lesões para diagnosticar precocemente e propor o tratamento adequado, evitando complicações futuras ao paciente.

Dramatic secukinumab-mediated improvements in refractory leprosy-related neuritis via the modulation of T helper 1 (Th1) and T helper 17 (Th17) immune pathways

Abstract A 39-year-old woman was diagnosed with relapsed multibacillary leprosy and refractory neuritis. Here, we describe an evident loss of therapeutic effectiveness after the third pulse of corticosteroids, which may be attributed to tachyphylaxis and the posterior modulation of interferon- γ (IFN-γ), tumor necrosis factor- α (TNF-α,) interleukin-17A (IL-17A), and IL-12/23p40 after the induction phase of secukinumab. In this case, plasma cytokine analysis showed that secukinumab induced a reduction in IL-17 concomitant with impressive clinical improvements in the patient's neural function. Interestingly, secukinumab induced reductions in cytokines related to Th1 responses and earlier stages of the Th17 response, including IL-23/12.

Correlation between nutritional, hematological and infectious characteristics and classification of the type of epidermolysis bullosa of patients assisted at the Dermatology Clinic of the Hospital Universitário de Brasília.

Epidermolysis bullosa comprises a group of phenotypically different genodermatosis, hereditary or acquired, characterized by skin fragility and subsequent formation of blisters in response to mechanical trauma, and which may also affect mucous membranes. This study aimed to analyze the relation between the nutritional, hematologic, infectious characteristics and the type of epidermolysis bullosa, through a descriptive case study based on data from medical records of 10 patients with epidermolysis bullosa assisted regularly at the Dermatology Clinic of the Hospital Universitário de Brasília. The old classification of the type of epidermolysis bullosa, weight and height, blood count, white blood cell count, platelet count and description of the type and frequency of secondary infections during the service were considered. We verified a predominance of iron deficiency anemia, chronic leukocytosis, thrombocytosis, chronic malnutrition, low height for age and thinness, and people with epidermolysis bullosa simplex exhibited appropriate relation between height/age and BMI/age. The non-specific skin infection was the most prevalent in both sexes. The severity of the type of epidermolysis bullosa and frequency of secondary infections did not form a directly proportional relation. The absence of direct proportion in all cases between the type of epidermolysis bullosa and the analysis parameters suggest a possible significant interference from other aspects such as the extent of the affected skin area, extracutaneous type of engagement and specific genetic mutation. The inclusion of these factors in the new classification proposed by Fine et al can contribute significantly to a better correlation of clinical parameters and appropriate preventive and therapeutic approaches.

Práticas interdisciplinares no enfrentamento da COVID-19 na estratégia saúde da família / Interdisciplinary practices in coping with covid-19 in the family health strategy

Objetivo: Descrever as experiências de residentes multiprofissionais na Estratégia Saúde da Família acerca da aplicação de ações interdisciplinares no enfrentamento do novo Coronavírus. Método: Estudo descritivo, do tipo relato de experiência realizado por residentes multiprofissionais do núcleo Saúde da Família em uma Estratégia Saúde da Família. O estudo foi desenvolvido em três fases: levantamento das problemáticas enfrentadas pela equipe; formulação do plano de contingência local com base a teoria da interdisciplinaridade e implementação das ações. Resultados: Evidenciou-se uma maior adesão da população as recomendações da equipe de saúde, observados na demarcação do fluxo de indivíduos que mostrou bons resultados, reduzindo o risco da transmissão viral entre pacientes e os profissionais da saúde, bem como possibilitou uma diminuição significativa da permanência dos usuários na unidade de modo que a população continuasse a ser assistida, garantindo a segurança de todos os atores envolvidos. Considerações finais: As práticas interdisciplinares têm se destacado nos mais diversos serviços de saúde como método de ascensão essencial para gestores, profissionais de saúde e estudantes na produção de relações mais atuantes de forma integrada no campo da saúde como um todo, principalmente no enfrentamento da pandemia. (AU)

Objective: To describe the experiences of multiprofessional residents in the Family Health Strategy regarding the application of interdisciplinary actions for coping with the new Coronavirus. Method: This is an experience report by multiprofessional Family Health residents. The descriptive study was developed in three phases: the first, the survey of the problems faced by the team; the second stage was the formulation of a local contingency plan based on the theory of interdisciplinarity and the third was the implementation of these actions. Results: The population adherence to the recommendations from the health team was observed in the demarcation of the flow of individuals. Which showed good results, reducing the risk of viral transmission among patients and health professionals, as consequence of a significant decreased in permanence of users in the unit. Additionally, the population continues to be assisted, ensuring the safety of all actors involved. Conclusion: Interdisciplinary practices have stood out in the most diverse health services as an essential ascension method for managers, health professionals and students in the production of more active relationship in an integrated manner in the field of health as a whole, especially of coping with the pandemic. (AU)

Objetivo: Describir las experiencias del equipo de profesionales multidisciplinario en la Estrategia de Salud Familiar con respecto a la aplicación de acciones interdisciplinarias para enfrentar el nuevo Coronavirus. Método: Un estudio descriptivo, un informe de experiencia realizado por profesionales de la Unidad de Salud de la Familia. El estudio fue desarrollado en tres fases: la primera, la encuesta de los problemas que enfrenta el equipo; la segunda etapa fue la formulación del plan de contingencia local basado en la teoría de la interdisciplinariedad y la tercera fue la implementación de acciones. Resultados: Se observó una mayor adherencia de la población a las recomendaciones del equipo de salud, observada en la demarcación del flujo de individuos que mostró buenos resultados, reduciendo el riesgo de transmisión viral entre pacientes y profesionales de la salud, así como permitiendo una disminución significativa en permanencia de los usuarios en la unidad para que la población continúe siendo asistida, garantizando la seguridad de todos los actores involucrados. Conclusión: Las prácticas interdisciplinarias se han destacado en los servicios de salud más diversos como un método esencial para los gerentes, profesionales de la salud y estudiantes en la producción de relaciones más activas de manera integrada en el campo de la salud en general, y especialmente en este contexto para enfrentar la pandemia. (AU)

Compliance with hepatitis B virus vaccination and risk of occupational exposure to blood and other body fluids in intensive care department personnel in Brazil.

BACKGROUND: Hepatitis B virus (HBV) vaccine has been recommended to health care workers because of their frequent exposure to patient blood and other body fluid. METHODS: A cross-sectional study was done to determine the compliance with HBV vaccination, and the risk of occupational exposure to blood or other body fluids in intensive care unit (ICU) personnel (n=458) in Goiânia, Brazil. RESULTS: The vast majority (95.5%) of ICU personnel reported HBV vaccination. Among those who did not, housekeepers were statistically associated with nonvaccination (P<.05). They had a 19.1-fold (95% confidence interval: 2.07-444.5) greater risk of nonvaccination compared with physicians. A total of 220 participants reported an incident with biologic fluids. Physician and nursing staff had a higher risk for occupational exposure to blood, other body fluids, or both when compared with housekeepers. CONCLUSIONS: This study showed a high frequency of HBV vaccination in ICU personnel in Brazil. Nevertheless, more efforts are necessary to increase compliance with vaccination in housekeepers. Physician and nursing staffs showed high risk of occupational exposure to blood, other body fluids, or both, ratifying the importance of continuous education programs concerning prevention of bloodborne pathogen transmission for all ICU personnel.

Pyoderma gangrenosum leading to bilateral involvement of ears.

Pyoderma gangrenosum is a destructive inflammatory disease that commonly occurs in an idiopathic way. Its occurrence in the auricular area is very rare, although this fact does not seem to determine a different behavior of the disease with regard to ulcer aspects and response to treatment. The authors report the case of a patient with pyoderma gangrenosum affecting both earlobes. The patient responded well to treatment with oral prednisone and has not shown relapses after a six-month follow-up.

The use of ablative lasers in the treatment of facial melasma.

Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens.

Sequential anaerobic/aerobic treatment of dye-containing wastewaters: colour and COD removals, and ecotoxicity tests.

Colour and COD removals of the azo dyes Congo Red (CR) and Reactive Black 5 (RB5) were individually evaluated in a sequential anaerobic/aerobic treatment system. Additionally, dye toxicity was assessed by using acute ecotoxicity tests with Daphnia magna as the indicator-organism. The anaerobic reactor was operated at approximately 27 °C and with hydraulic retention times of 12 and 24 h. The aerobic reactor was operated in batch mode with a total cycle of 24 h. During anaerobic step, high colour removals were obtained, 96.3% for CR (400 mg/L) and 75% for RB5 (200 mg/L). During the aerobic phase, COD effluent was considerably reduced, with an average removal efficiency of 52% for CR and 85% for RB5, which resulted in an overall COD removal of 88% for both dyes. Ecotoxicity tests with CR revealed that the anaerobic effluent presented a higher toxicity compared with the influent, and an aerobic post-treatment was not efficient in reducing toxicity. However, the results with RB5 showed that both anaerobic and aerobic steps could decrease dye toxicity, especially the aerobic phase, which removed completely the toxicity in D. magna. Therefore, the anaerobic/aerobic treatment is not always effective in detoxifying dye-containing wastewaters, sometimes even increasing dye toxicity.

Seasonal changes of α-tocopherol in green marine algae (Caulerpa genus).

Marine algae are a promising source of beneficial compounds for human use. Among these, pro-vitamin A carotenoids and vitamins B, C, and E stand out. The objective of this study was to investigate seasonal variation of α-tocopherol levels in 5 species of green marine algae of the Caulerpa genus. This research was carried out with both fresh and dry specimens; and, in addition, differences arising as a result of the drying process were examined. Analyses were carried out by high-performance liquid chromatography (HPLC) using an isocratic system and a reversed-phase C-18 column. The distribution of α-tocopherol throughout the year in Caulerpa genus was variable. All samples of both fresh and dried algae contained α-tocopherol, except for the dried C. racemosa from March 2006. The drying process was responsible for losses of α-tocopherol ranging from 21% to 93%.

[Association of pregnancy in adolescence and prematurity]. / Associação de gravidez na adolescência e prematuridade.

PURPOSE: To analyze the association of pregnancy in adolescence and prematurity. METHODS: The study included all the patients who delivered at a teaching hospital in Maranhão State, from July to December 2006. The patients were divided into two groups: adolescents (10 to 19 years old) and adults (20 to 34 years old). The variables studied were: educational level, marital status, number of prenatal visits, gestational age at the onset of prenatal care, duration of gestation, delivery route and birth weight. Statistical analysis was performed using the Epi-Info software, version 3.4.1, and the associations between variables were analyzed by the odds ratio (OR), with a 95% confidence interval (CI). Models of logistic regression were also used. The level of significance adopted was 0.05. RESULTS: The study evaluated 1,978 patients. The frequency of deliveries in adolescents was 25.4%. This group presented low educational level, no mates, low number of prenatal visits, late onset of prenatal care, low birth weight and prematurity. In the analysis of prematurity as the outcome variable, there was a clear association with low number of prenatal visits (OR 3.0; 95%CI 2.2-4.0) and late onset of prenatal care (OR 1.9; 95%CI 1.3-2.6) and low educational level (OR 1.9; 95%CI 1.4-2.5) related to adolescence (OR 1.5; 95%CI 1.1-1.9). The incidence of caesarean delivery was significantly lower among adolescents (33.3%) than among adults (49.4%), with a lower association with pre-eclampsia and cephalo-pelvic disproportion. CONCLUSIONS: Pregnancy in adolescence was associated with late onset of prenatal care and low number of visits, as well as low educational level, low birth weight, prematurity and a lower incidence of cephalo-pelvic disproportion and pre-eclampsia.

[Impact of maternal age on perinatal outcomes and mode of delivery]. / Impacto da idade materna sobre os resultados perinatais e via de parto.

PURPOSE: to analyze the association of the mother's age, the perinatal outcome and the delivery route. METHODS: information about all the patients attended at the Service of Obstetrics and Gynecology of a tertiary university hospital in Maranhão, from July to December 2006, was analyzed. Patients have been allocated in three groups: adolescents (10 to 19 years old), adults (20 to 34 years old), and aged women (>35 years old). Variables studied were: skin color, schooling, marital status, family income, parity, number of appointments during pre-natal care, gestational age at the onset of pre-natal care, delivery route, Apgar index at the fifth minute and birth weight. Data were processed by the Epi-info program, version 3.4.1, and the association among the variables was analyzed by the Odds Ratio (OR) or the cross product ratio, with confidence intervals (CI) of 95%. The significance level was 0.05. RESULTS: among 2,196 patients, 25% of deliveries occurred in adolescents, 69% in adults and 6% in aged women. Among the adolescents, there was higher risk of prematurity (OR=1.46; CI 95%=1.14-1.88), and low birth weight (OR=1.47; CI 95%=1.13- 1.90), higher incidence of normal delivery as compared to the other groups (65.2%), besides the association with late onset of pre-natal care (OR=1.86; CI 95%=1.43-2.43), lower number of appointments (OR=2.03; CI 95%=1.57-2.63), and use of abortive procedures at the onset of gestation (OR=2.34; CI 95%=1.38-3.98). Among aged women, there was strong association with diabetes mellitus (OR=9.00; CI 95%=3.18-25.19), pre-eclampsia (OR=4.38; CI 95%=3.02-6.34), premature membrane rupture (OR=5.81; CI 95%=3.08-10.89), besides a higher chance of presenting Apgar index lower than seven at the fifth minute (OR=2.90; CI 95%=1.37-6.01), and higher ratio of cesarean section (60.3%). CONCLUSIONS: pregnancy in adolescence is associated to late onset of pre-natal care and few appointments along it, use of abortive procedures at the onset of gestation, low schooling, no mates, low birth weight, prematurity, and lower incidence of cephalo pelvic disproportion and pre-eclampsia. Among aged pregnant women, there was association with diabetes, pre-eclampsia, premature membrane rupture, Apgar index lower than seven at the fifth minute and higher ratio of cesarean section.

[Teenage pregnancy and factors associated with low birth weight]. / Gravidez na adolescência e fatores associados com baixo peso ao nascer.

PURPOSE: to analyze the association of pregnancy in adolescence with low birth weight (LBW). METHODS: all the patients who gave birth in a teaching Hospital at Maranhão State from July to December 2006 were included in the study and were split in two groups: adolescents (ten to 19 years old) and adults (20 to 34 years old). The variables studied were: skin color, schooling, marital status, family income, number of pre-natal appointments, gestational age at the onset of pre-natal assistance, place where they spend that period, gestation duration, delivery route and birth weight. Data were processed by the Epi-Info program, 3.4.1 version, and the associations between variables were analyzed by the Odds Ratio (OR), with a confidence interval (CI) of 95%. Models of logistic regression were also used. The significance level adopted was 0.05. RESULTS: 1,978 patients were evaluated. A ratio of 25.4% of deliveries in adolescents was observed; they presented low level of schooling, no mates, low number of pre-natal appointments, late onset of pre-natal assistance, low birth weight and prematurity. In the analysis of LBW as end variable, associated to prematurity (OR=29.0), it was clear the association with low number of pre-natal appointments (OR=2.98; 95%CI=2.23-4.00), pre-natal late onset (OR=1.91; 95%CI=1.3-2.6) and low schooling (OR=1.95; 95%CI=1.4-2.5) related to adolescence (OR=1.50; 95%CI=1.1-1.9). Similar results were obtained when the prematurity variable was excluded. Adolescents showed lower incidence of caesarean section (33.3%) than adults (49.4%), a significant difference, besides lower association with pre-eclampsia and cephalo-pelvic disproportion. CONCLUSIONS: pregnancy in adolescence was associated to pre-natal late onset and low number of appointments, besides low schooling, low birth weight and a lower incidence of cephalo pelvic disproportion and pre-eclampsia.

Gerenciamento de riscos e segurança no trabalho em unidades de saúde da família / Risk management and work safety in family health units

Objetivo: Caracterizar os riscos ocupacionais existentes no ambiente de trabalho que interferem na segurança e saúde de profissionais que atuam na rede de Unidades de Saúde da Família no município de João Pessoa-PB, Brasil. Material e Métodos: Estudo exploratório realizado em nove unidades de saúde do Distrito Sanitário III, no período de novembro de2011 a janeiro de 2012, envolvendo 36 profissionais. Na coleta de dados, utilizou-se um roteiro de entrevista semi estruturado. Para análise do material empírico, adotaram se procedimentos de estatística descritiva. Resultados: Constou-se que 66% dos riscos ocupacionais segundo os participantes são biológicos e físicos e 44% das causas de acidentes são atribuídas a riscos psicossociais, mecânicos e ergonômicos. Conclusão: Os profissionais estão expostos às situações de risco de diferentes naturezas pela não utilização de medidas adequadas de biossegurança, sendo necessário desenvolver um programa de gestão de risco e segurança para vencer os obstáculos a adesão de precauções padrão.

Objective: To characterize existing occupational hazards inthe workplace that might affect the safety and health ofprofessionals working in the Family Health Units Network inthe city of João Pessoa, Brazil. Material and Methods: Thiswas an exploratory study performed in nine health units ofthe Sanitary District III from November 2011 to January 2012, For data collection, we used a semi-structured interview script. For the empirical analysis,we adopted descriptive statistics procedures. Results: We verified that according to participants 66% of the occupational hazards were of biological and physical nature, and 44% of the causes of accidents were attributed to psycho social, mechanical and ergonomic risks. Conclusion: The professionals are exposed to hazards of different nature bynot following appropriate biosecurity measures. Thus, it is necessary to develop a program for risk management and work security to overcome such barriers hindering compliance to default precautions.