A rapid and sensitive High-Performance Liquid Chromatography method with fluorescence detection for quantification of melatonin in small volume rat plasma samples: application to a preclinical study to determine the oral pharmacokinetics of melatonin under gestational conditions

Abstract A novel, simple and sensitive high-performance liquid chromatography with fluorescence detection method was developed and validated for the characterization of the preclinical pharmacokinetics of melatonin under pregnant conditions. Plasma samples (25 µL) were treated with 30 µL of ethanol absolute (containing the internal standard, IS). After a centrifugation process, aliquots of supernant (5 µL) were injected into the chromatographic system. Compounds were eluted on a Xbridge C18 (150 mm x 4.6 mm i.d., 5 µm particle size) maintained at 30°C. The mobile phase consisted in a mixture of aqueous solution of 0.4% phosphoric acid and acetonitrile (70:30 v/v). The wavelengths were set at 305 nm (excitation) and 408 nm (emission) and the total analysis time was 8 min/sample. All validation tests were obtained with accuracy and precision, according to FDA guidelines, over the concentration range of 0.005-20 µg/mL. Pharmacokinetic study showed that melatonin systemic exposure increased from day 14, with a significant difference at 19 days of gestation compared to the control group. Our findings suggest a decreased metabolism of melatonin as result of temporary physiological changes that occur throughout pregnancy. However, other maternal physiological changes cannot be ruled out.

Sífilis na gestação: conhecimento de gestantes e puérperas / Syphilis in pregnancy: knowledge of pregnant and puerperous women / Sífilis durante el embarazo: conocimientos de las mujeres embarazadas y puérperas

Objetivo: identificar o conhecimento de gestantes e puérperas acerca da sífilis. Método: pesquisa descritiva, com abordagem qualitativa. A coleta de dados ocorreu por meio de instrumento semiestruturado, entre abril a julho de 2021, com 18 gestantes/puérperas com diagnóstico de sífilis na gestação. As respostas foram gravadas e transcritas na íntegra, sendo utilizado para análise a técnica do Discurso do Sujeito Coletivo. Resultados: identificou-se três ideias centrais: 1) Conhecimento sobre a sífilis, 2) Buscando conhecimento sobre a sífilis e 3) Falsa prevenção. O conhecimento das participantes mostrou-se conflitante, pois algumas apresentaram algum conhecimento e outras nenhum, sendo que todas deveriam ter sido orientadas sobre a doença. Considerações finais: identificou-se uma falha no atendimento ofertado nos serviços de saúde. Assim, estratégias voltadas à educação em saúde devem ser incentivadas e implementadas no acompanhamento de pré-natal, ofertando a promoção e prevenção da saúde, a fim de reduzir os casos de sífilis na gestação.

Objective: to identify the knowledge of pregnant and postpartum women about syphilis. Method: descriptive research, with a qualitative approach. Data collection took place using a semi-structured instrument, between April and July 2021, with 18 pregnant/postpartum women diagnosed with syphilis during pregnancy. The responses were recorded and transcribed in full, using the Collective Subject Discourse technique for analysis. Results: three central ideas were identified: 1) Knowledge about syphilis, 2) Seeking knowledge about syphilis and 3) False prevention. The knowledge of the participants was conflicting, as some had some knowledge and others none, and all of them should have been educated about the disease. Final considerations: a flaw in the care offered in health services was identified. Therefore, strategies aimed at health education should be encouraged and implemented in prenatal care, offering health promotion and prevention, in order to reduce cases of syphilis during pregnancy.

Objetivos:identificar el conocimiento de las mujeres embarazadas y puérperas sobre la sífilis. Método: investigación descriptiva, con enfoque cualitativo. La recolección de datos se realizó mediante un instrumento semiestructurado, entre abril y julio de 2021, con 18 mujeres embarazadas/puérperas diagnosticadas con sífilis durante el embarazo. Las respuestas fueron grabadas y transcritas en su totalidad, utilizando para su análisis la técnica del Discurso del Sujeto Colectivo. Resultados: se identificaron tres ideas centrales: 1) Conocimiento sobre sífilis, 2) Búsqueda de conocimiento sobre sífilis y 3) Falsa prevención. El conocimiento de los participantes fue contradictorio, ya que algunos tenían algún conocimiento y otros ninguno, y todos deberían haber sido educados sobre la enfermedad. Consideraciones finales: se identificó una falla en la atención ofrecida en los servicios de salud. Por lo tanto, se deben fomentar e implementar estrategias orientadas a la educación en salud en la atención prenatal, ofreciendo promoción y prevención de la salud, con el fin de reducir los casos de sífilis durante el embarazo.

A cross-sectional study to assess hypothyroid status of pregnant women at 12–16 weeks of gestation

Background: Physiological changes occur during pregnancy. These changes include metabolic, hematologic, cardiovascular, renal, and respiratory changes. In some cases, these changes may alter and lead to complications which result in adverse pregnancy outcomes. In India, hypothyroidism in pregnancy has a prevalence of 4.8–11%. Aims and Objectives: The aim of this study was to estimate the prevalence of hypothyroidism in pregnant women at 12–16 weeks of gestation. Materials and Methods: A cross-sectional study was planned on pregnant women attending the ANC clinic of Outpatient Department of Obstetrics and Gynecology at K.L. E’S Dr Prabhakar Kore Hospital and Medical Research Center Belagavi. Serum thyroid stimulating hormone (TSH) was estimated in the study participants. Serum TSH levels >4.5 ?IU/ml were labeled as hypothyroid pregnant women. Results: In our study, the prevalence of hypothyroidism was observed to be 8.68%. Conclusion: Hence, we conclude that all pregnant women should be screened for hypothyroidism at earlier weeks of gestation.

Vértigo en gestantes: presentación clínica, impacto en la calidad de vida y factores asociados / Vertigo in pregnancy: clinical presentation, impact on quality of life and associated factors

OBJETIVO: Evaluar las características clínicas, el impacto en la calidad de vida y los factores asociados con vértigo en gestantes hospitalizadas en una institución de alta complejidad. MÉTODO: Estudio transversal. Se realizó una encuesta dirigida a la presencia de vértigo y sus características clínicas en 2020-2021. La calidad de vida se evaluó con el cuestionario Dizziness Handicap Inventory (DHI). El análisis estadístico incluyó un modelo lineal generalizado. RESULTADOS: De 103 mujeres, el 19,4% indicaron vértigo principalmente en el segundo trimestre de gestación (60%), con una mediana de 3,5 (rango intercuartil: 1,5-7,5) episodios. Fueron referidos vértigos episódicos asociados con cambios posicionales (40%), acompañados de inestabilidad (60%), cefalea (60%), fotopsias (55%) y tinnitus (45%). Las mujeres con vértigo presentaron mayor frecuencia de discapacidad moderada a grave en las dimensiones del DHI emocional (30 vs. 2,4%; p = 0,001), funcional (40 vs. 2,4%; p < 0,001) y física (55 vs. 2,4%; p < 0,001) en comparación con las mujeres sin la patología. La hospitalización durante el embarazo Razón de proporción (RP): 4,02; intervalo de confianza del 95% [IC95%]: 1,64-9,85; p = 0,002) y la presencia de vértigo pregestacional (RP: 2,37; IC95%: 1,15-4,88; p = 0,019) se identificaron como factores asociados. CONCLUSIONES: La alta frecuencia de vértigo en las gestantes sugiere la importancia de estudiar esta condición durante el embarazo, para lograr un manejo integral y generar acciones de prevención y control efectivas.

OBJECTIVE: To evaluate clinical characteristics, impact on quality of life and factors associated with vertigo in pregnant women hospitalized in a highly complex institution. METHOD: A cross-sectional study was conducted in 2021-2022. One focused survey including Dizziness Handicap Inventory (DHI) was performed. The statistical analysis was performed using a generalized lineal regression. RESULTS: 103 patients were included, 19.4% indicated vertigo mostly during the second semester (60%). A median of 3.5 episodes was obtained (RIC: 1.5-7.5). Positional and episodic vertigos (40%) associated with unsteadiness (60%), headache (60%), photopsia (55%) and tinnitus (45%) were described. DHI in pregnant females with vertigo compared to those without vertigo, presented higher rates of moderate to severe disability in the emotional (30 vs. 2.4%: p = 0.001), functional (40 vs. 2.4%; p < 0.001) and physical (55 vs. 2.4%; p < 0.001) dimensions. Hospitalizations during the pregnancy (RP: 4.02; 95%CI: 1.64-9.85; p = 0.002) and previous episodes before pregnancy (RP: 2.37; 95%CI: 1.15-4.88; p = 0.019) were identified as associated factors with current vertigo episodes. CONCLUSIONS: The high frequency of vertigo in pregnant women suggests the importance of studying this condition during pregnancy, to achieve comprehensive management and generate effective prevention and control actions.

Carcinoma adrenocortical en mujeres en edad fértil / Adrenocortical carcinoma in women of reproductive age

Resumen Los carcinomas adrenocorticales son tumores infre cuentes, habitualmente hiperfuncionantes y con una supervivencia global pobre. La edad frecuente de pre sentación se describe en adultos entre 40 a 60 años, con predominio en sexo femenino. Se presentan dos casos inusuales de carcinoma adrenal diagnosticados en mujeres en edad fértil. El primero de ellos se descubrió en el segundo trimestre de gestación, con un cuadro de hipercortisolismo y lesión adrenal localizada, que resolvió con resección completa hacia la semana 20. En el segundo, la paciente debutó con manifestaciones clínicas de virilización rápidamente progresiva, sien do el hiperandrogenismo puro el patrón bioquímico hallado. En ambos casos, a pesar de haberse realizado la resección completa, el Ki67 elevado como principal factor pronóstico condujo a categorizarlas como de "alto riesgo de recurrencia". Asimismo, se ha asociado a la gestación y al patrón secretor de glucocorticoides como factores adicionales de mayor riesgo de recurrencia. Este es particularmente elevado dentro de los dos primeros años posteriores al diagnóstico. Existe aún controversia sobre el uso de mitotane adyuvante en estos pacientes, y su inicio está recomendado hasta los tres meses del postquirúrgico. Sin embargo, la evidencia disponible no permite suponer la falta de eficacia si se utiliza fuera de ese período. Los limitantes, como fueron el curso de la gestación y el puerperio inmediato, así como la difi cultad para el acceso a la medicación en nuestro medio, impidieron el inicio precoz del tratamiento adyuvante en ambos casos, aunque surge la inquietud de si aún sería oportuna su instauración.

Abstract Adrenocortical carcinomas are rare tumors, usually hyperfunctioning, with poor overall survival. Frequent age of presentation is described in adults between 40 and 60 years of age, predominantly female. Two unusual cases of adrenal carcinoma diagnosed in young women are presented. The first one was discovered in the sec ond trimester of gestation, with signs and symptoms of hypercortisolism and localized adrenal lesion, which was resolved with complete resection by week 20 of pregnancy. In the second case, the patient begined with clinical manifestations of rapidly progressive virilization, the biochemical pattern being pure hyperandrogenism. In both cases, despite complete resection, the high Ki67 as the main prognostic factor leaded to categorization as "high risk of recurrence". In addition, pregnancy and glucocorticoid secretory pattern have been associated as additional risk factors of recurrence. This is particularly high within the first two years after diagnosis. There is controversy about the use of adjuvant mitotane in these patients, and the general recommendation is to be started no longer than 3 months after surgery. However, the available evidence does not suggest that its use is ineffective beyond that period. Limitations, such as the course of pregnancy and the immediate puerperium, as well as the difficulty of accessing this medication in our environment, prevented the early initiation of adjuvant treatment with mitotane in both cases, although there is still concern whether its administration would still be appropriate.

Risk Factors Related to Gestational Trophoblastic Disease

Background: Gestational trophoblastic diseases (GTD) consist of a group of neoplastic disorders arising from placental trophoblastic tissue after normal or abnormal fertilization. The WHO classification of GTD includes hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor, and miscellaneous and unclassified trophoblastic lesions. This study aimed to analyze the risk factors related to the gestational trophoblastic disease. Material & Methods: This prospective study was conducted at the Department of Obstetrics & Gynecology in Uttara Adhunik Medical College & Hospital, Dhaka, Bangladesh for 1 year; from April 2020 to March 2021. A total of 100 subjects were included in this study. Informed written consent was taken from the study subjects. Data was collected using a pre-formed data sheet. Data processing and analysis were done by using SPSS version 17. The test statistics used to analyze the data were descriptive statistics, the McNemar Chi-square test, and Repeated Measure ANOVA statistics. All patients underwent necessary investigations. All information was kept confidential and used only for this study purpose. The ethical Clearance Certificate was obtained from Bangladesh Medical College. Results: The majority of the patients were more than of 38 years age (53, 53.0%). Out of these patients, 50 (50.0%) were para one, while 40 (40.0%) were para more than four, most of the patients (63, 63.9%) were illiterate and 5 (5.0%) were graduates, most of the subjects (73, 73.0%) belonged to the low socioeconomic group. The most common presenting symptom was bleeding per vagina (35, 35.0%) followed by pain in the lower abdomen (24, 24.0%), the passage of moles (16, 16.0%), hyperemesis gravidarum (14, 14.0%) and dyspnea in 11 (11.0%) subjects. Conclusion: The disease was common in extremes of ages, low para, and grand multiparous women. The hydatidiform mole was the commonest type of trophoblastic disease in these patients. The most common presenting complaint was bleeding per vagina followed by pain in the lower abdomen. The hydatidiform mole was diagnosed in 65 (65.0%) patients, the invasive mole in 28 subjects (28.0%), and choriocarcinoma in 7 (7.0%) patients. No patient had a placental site trophoblastic tumor.

Advances on associations of exposure to air pollutants during pregnancy with congenital heart disease in offspring / 环境与职业医学

Congenital heart disease (CHD) is the most common birth defect and one of the major causes of neonatal death, with an average prevalence of 9.4‰ worldwide. We reviewed recent epidemiological studies and found that exposure to air pollutants is associated with increased CHD risks, but the associations are inconsistent between exposure to air pollutants and different subtypes of CHD due to developmental and etiological heterogeneity among different subtypes of CHD. It has been reported that air pollutants are associated with increased risks of ventricular septal defect, patent ductus arteriosus, pulmonary stenosis, tetralogy of Fallot, and transposition of the great arteries. However, associations between maternal exposure to air pollutants and atrial septal defect (ASD) are contradictory, with significantly positive associations of inhalable particulate matter and nitrogen dioxide exposure, negative associations of fine particulate matter and carbon monoxide, and mixed associations of sulfur dioxide. Adverse effects of air pollutant on cardiac development cover a wide time window beyond 3-8 weeks during gestation; particulate matter and nitrogen oxide are more likely to affect fetal heart in early pregnancy, while the association strength of carbon monoxide shows a trough in early pregnancy, and sulfur dioxide and ozone affect cardiac health throughout pregnancy. In addition, we discussed the limitations of previous studies on the associations between maternal air pollutant exposure and CHD, and highlighted the application of precise assessment on exposure to air pollutants, the performance of prospective cohort studies and longitudinal studies, and the necessity of studies on CHD subtypes, in order to provide scientific evidence to control exposure to environmental pollutants and CHD occurrence.

Ansiedade na gestação em período de covid-19 / Pregnancy anxiety in covid-19 period / Ansiedad durante el embarazo en el período COVID-19

A gravidez é um momento de risco para alterações emocionais. Em período de covid-19, a ansiedade aumentou na população geral e, consequentemente, gestantes também se tornaram um grupo de maior risco. O objetivo deste estudo foi o de verificar a prevalência de sintomas de ansiedade em cada trimestre de gravidez em brasileiras em período de covid-19. Participaram 793 gestantes de todas as regiões do Brasil. Para avaliar os sintomas de ansiedade, foi utilizado o Instrumento de Rastreio de Sintomas de Ansiedade Gestacional e um questionário para informações sociodemográficas. Os resultados indicaram que 55% das gestantes no primeiro trimestre apresentavam ansiedade de moderada a alta e 52% apresentavam ansiedade no segundo e terceiro trimestre. Conclui-se que a prevalência de sintomas de ansiedade em gestantes no período de pandemia causada pela covid-19 superou a prevalência já identificada em estudos anteriores realizados fora do período de covid-19

El embarazo es una época de riesgo de cambios emocionales. En el período de COVID-19, la ansiedad aumentó en la población general y, en consecuencia, las mujeres embarazadas también se convirtieron en un grupo de mayor riesgo. El objetivo de este estudio fue verificar la prevalencia de síntomas de ansiedad en cada trimestre del embarazo en mujeres brasileñas durante el período de COVID-19. Participaron 793 mujeres embarazadas de todas las regiones de Brasil. Para evaluar los síntomas de ansiedad se utilizó el Instrumento de Cribado de Síntomas de Ansiedad Gestacional y un cuestionario de información sociodemográfica. Los resultados indicaron que el 55% de las mujeres embarazadas en el primer trimestre tenían ansiedad de moderada a alta y el 52% tenía ansiedad en el segundo y tercer trimestre. Se concluye que la prevalencia de síntomas de ansiedad en gestantes en el período de la Pandemia causada por (Covid-19) superó la prevalencia ya identificada en estudios previos realizados fuera del período de Covid-19

Pregnancy is a potential risk period for emotional changes in women. In the period of COVID-19, anxiety increased in population in geral and, consequently, pregnant women also became an even higher risk group. The aim of this study was to verify the prevalence of anxiety symptoms in each trimester of pregnancy in Brazilian women during the period of COVID-19. A total of 793 pregnant women from all Brazilian regions participated of this survey. To assess anxiety symptoms, the Gestational Anxiety Symptoms Screening Instrument and a questionnaire to collect sociodemographic information were used. The results indicated that 55% of pregnant women in the first trimester had moderate to high anxiety and 52% had anxiety in the second and third trimester.It is concluded that the prevalence of anxiety symptoms in pregnant women in the period of the Pandemic caused by (Covid-19), surpassed the prevalence already identified in previous studies carried out outside the period of Covid-19

Nivel de ansiedad según el trimestre del embarazo en un establecimiento de salud de atención primaria / Level of anxiety according to gestational trimester in a primary care health establishment

Resumen OBJETIVO: Determinar el nivel de ansiedad de las embarazadas conforme al trimestre de la gestación. MATERIALES Y MÉTODOS: Estudio observacional, correlacional y transversal efectuado en mujeres en curso del primer, segundo y tercer trimestre del embarazo atendidas en el Centro de Salud Base San Martín de Porres, Lima, Perú, entre diciembre de 2021 y febrero de 2022, a quienes se les aplicó el instrumento de tamizaje de ansiedad prenatal (Perinatal Anxiety Screening Scale [PASS]) y su variación según el trimestre del embarazo con las pruebas de χ2, Kruskall-Wallis y ANOVA. RESULTADOS: Se estudiaron 153 pacientes en los tres trimestres del embarazo en quienes se encontró: ansiedad prenatal en el 69.9% (n = 107); ansiedad leve en 45.8% (n = 70) y ansiedad moderada-severa en 24.2% (n = 37). El porcentaje es mayor de 100% porque no en todos los trimestres se encontraron síntomas depresivos. Solo 30.1% (n = 46) de las embarazadas no tuvieron síntomas de ansiedad prenatal. La puntuación de ansiedad global mostró un comportamiento diferente según el trimestre de gestación (ANOVA: p = 0,006), con predominio de mayor ansiedad en el primer trimestre seguido del tercero. La comparación por parejas solo mostró diferencias significativas en la puntuación de ansiedad entre el primer y el tercer trimestre (test de Tukey: p > 0.05). CONCLUSIONES: Más de la mitad de las embarazadas cursó con ansiedad, sobre todo en el primer y tercer trimestre y menor en el segundo.

Abstract OBJECTIVE: To determine the anxiety level of pregnant women according to the trimester of gestation. MATERIALS AND METHODS: Observational, analytical and prospective study of a random sample of pregnant women attended in a first level facility of the Ministry of Health (MINSA). Anxiety was assessed with the Perinatal Anxiety Screening Scale (PASS) and its variation according to the trimester of pregnancy with the χ2, Kruskall-Wallis and ANOVA tests. RESULTS: The prevalence of anxiety during pregnancy was 69.9% (n = 107) in a sample of 153 patients. Except for the social anxiety dimension (p > 0.05), significant differences were found in the scores of the anxiety dimensions by trimester. They were highest in the first, followed by the third trimester (p < 0.05). The global anxiety score showed different behavior by trimester of pregnancy (ANOVA: p = 0.006), with predominance of higher anxiety in the first trimester followed by the third trimester. Comparison by couples only showed significant differences in anxiety score between the first and third trimester (Tukey test: p > 0.05). CONCLUSIONS: More than half of the pregnant women had anxiety, especially in the first and third trimester and less in the second trimester.

Humoral immunity is not altered in overweight pregnant Crioulo mares / Imunidade humoral não é alterada em éguas Crioulas gestantes com sobrepeso

Both pregnancy and obesity can influence significant changes in the immune system. On this basis, the present study proposes to evaluate the humoral immune response of overweight pregnant mares in response to a commercial vaccine. Thirty pregnant Crioulo mares were separated according to body condition score (BCS) into overweight (BCS≥7/9) or lean-control (BCS= 5-6/9). In each group, the animals were subdivided into vaccinated and controls. The mares were vaccinated against EHV-1 in two doses spaced 21 days apart and had their blood collected monthly, for five months, for antibody evaluation. Both vaccinated groups had an increase in specific neutralizing antibodies after the vaccine. However, after the second dose, there was no increase in antibodies in any of the groups. Vaccinated overweight and lean-control mares did not differ at any time point. Therefore, this study demonstrated that obesity does not influence the humoral immune response in pregnant Crioulo mares.(AU)

Tanto a gestação quanto a obesidade podem influenciar o desenvolvimento de alterações significativas no sistema imune, portanto, o presente estudo teve como objetivo avaliar a resposta imune humoral de éguas gestantes com sobrepeso em resposta a uma vacina comercial. Trinta éguas Crioulas gestantes foram separadas de acordo com o escore de condição corporal (ECC) em éguas com sobrepeso (ECC≥7/9) e éguas controles (ECC=5-6/9) e, ainda, em cada grupo, os animais também foram separados em vacinados e controles. As éguas foram vacinadas contra o EHV-1 em duas doses com intervalo de 21 dias, sendo realizadas coletas de sangue mensalmente durante cinco meses para avaliação de anticorpos neutralizantes. Ambos os grupos vacinados tiveram aumento de anticorpos neutralizantes específicos após a vacina, porém, após a segunda dose, não foi observado aumento de anticorpos em nenhum dos grupos. Nenhuma diferença foi observada entre éguas vacinadas com sobrepeso e as éguas controles em nenhum momento. Assim, este estudo demonstrou que a obesidade não é um fator que influencia a resposta imune humoral de éguas Crioulas gestantes.(AU)

Influência das fases da lua na ocorrência do parto de cadelas e gatas / Influence of the moon phases on the occurrence of parturition in bitches and cats / Influencia de las fases lunares en la aparición del parto en perras y gatas

A Lua é o satélite natural da Terra e sua participação em diversos aspectos da sociedade tem sido descrito há muitos anos. Nesse quesito, existe uma crença popular que afirma que esse astro possui influência direta sobre o ciclo reprodutivo de diversas espécies. Baseado nisso, estudos averiguaram que as mulheres apresentam maior número de partos durante determinadas fases da Lua. Porém, não há trabalhos com relação a estes aspectos na reprodução de pequenos animais. Assim, o objetivo do estudo foi verificar se as fases da Lua influenciam no parto de cadelas e gatas. Realizou-se um estudo retrospectivo coletando-se os dados de 100 fêmeas que passaram por acompanhamento gestacional no hospital veterinário da instituição. Utilizou-se a data do parto para posterior classificação da fase da Lua correspondente, bem como se o parto ocorreu em uma mudança de fase da Lua. Obteve-se maior incidência de partos durante a Lua crescente (porém sem significância estatística) e na transição entre as fases da Lua. Assim, conclui-se que a influência da Lua sobre os partos de pequenos animais ainda é uma incógnita, devendo-se considerar outros fatores para identificar se essa relação existe.

The Moon is the Earth's natural satellite and its participation in various aspects of society has been described for many years. In this regard, there is a popular belief that this star has a direct influence on the reproductive cycle of various species. Based on this, studies have shown that women give birth more often during certain phases of the Moon. However, there are no studies that analyze this in the reproduction of small animals. Thus, the aim of this study was to verify whether the moon phases influence births in female dogs and cats. A retrospective study was carried out, collecting data from 100 females that underwent gestational monitoring at the veterinary hospital of the institution. The date of parturition was used for further classification of the corresponding Moon phase, as well as whether the parturition occurred during a Moon phase change. We found a higher incidence of births during a crescent Moon (but without statistical significance) and during the transition between Moon phases. Thus, we conclude that the influence of the Moon on births in small animals is still unknown, and other factors should be considered to identify if this relationship exists.

La Luna es el satélite natural de la Tierra y desde hace muchos años se ha descrito su participación en diversos aspectos de la sociedad. Existe la creencia popular de que la Luna influye directamente en el ciclo reproductivo de varias especies. Basándose en ello, algunos estudios han demostrado que las mujeres dan a luz con más frecuencia durante determinadas fases de la Luna. Sin embargo, no existen estudios que analicen este hecho en la reproducción de pequeños animales. Así, el objetivo de este estudio fue comprobar si las fases lunares influyen en el nacimiento de perras y gatitos. Se realizó un estudio retrospectivo recogiendo los datos de 100 hembras que se sometieron a seguimiento gestacional en el hospital veterinario de la institución. La fecha del parto se utilizó para clasificar posteriormente la fase lunar correspondiente, así como si el parto se produjo durante un cambio de fase lunar. Se obtuvo una mayor incidencia de partos durante la luna creciente (pero sin significación estadística) y durante la transición entre fases lunares. Por lo tanto, se puede concluir que la influencia de la Luna en los partos en pequeños animales es aún desconocida y que deben considerarse otros factores para identificar si existe esta relación.

Impact of Maternal Folic Acid Supplementation on Descendants' Kidney in Adulthood / Impacto da suplementação materna com ácido fólico no rim dos descendentes na vida adulta

Abstract Supplementation with folic acid (FA) during gestation has been recommended by medical society all over the world, but some studies have shown that intake of high folic acid diet may unleash damages to the descendants. Objectives: Describing the effects of maternal supplementation with FA during gestation on offspring's kidney at late life stages. Data Source: It is a systematic review by which were consulted the following databases: Medline, through Pubmed, Lilacs, and SciELO. The research was performed using the keywords "Folic acid", "Gestation" and "Kidney". Study Selection: Eight studies were regarded for this systematic review. Data Collection: Only studies that evaluated folic acid consumption during gestation and its effects exclusively on descendants' kidney at several phases of life were regarded. Results: Gestational FA intake did not change the renal volume, glomerular filtration rate and the expression of some essential genes in the kidney of puppies whose dams were supplemented with FA. Maternal consumption of double FA plus selenium diet was effective in preserving antioxidant enzymes activity in the kidney of descendants from mothers exposed to alcohol. FA supplementation decreased some gross anomalies in the puppies caused by teratogenic drug despite of had not been effective in preventing some renal architectural damages. Conclusion: FA supplementation did not cause renal toxicity; it exerted an antioxidant protective effect and mitigated some renal disorders caused by severe aggressions.

Resumo A suplementação com ácido fólico (AF) durante a gestação tem sido recomendada pela sociedade médica em todo o mundo, mas alguns estudos têm mostrado que a ingestão de altas quantidades de ácido fólico na dieta pode desencadear danos aos descendentes. Objetivos: Descrever os efeitos da suplementação materna com AF durante a gestação no rim da prole em fases tardias da vida. Fonte de Dados: Trata-se de uma revisão sistemática realizada através da consulta das seguintes bases de dados: Medline, através da Plataforma Pubmed, Lilacs e Scielo. A pesquisa foi realizada utilizando-se as palavras-chave "Ácido Fólico", "Gestação" e "Rim". Seleção dos Estudos: Oito estudos foram considerados para esta revisão sistemática. Coleta de Dados: Foram incluídos estudos que abordaram o consumo de ácido fólico durante a gestação e seus efeitos exclusivamente no rim dos descendentes em diferentes fases da vida. Resultados: O consumo gestacional de AF não alterou o volume renal, a taxa de filtração glomerular e a expressão de alguns genes essenciais no rim dos filhotes de mães suplementadas com AF. A associação de AF e selênio na dieta materna foi eficaz na preservação da atividade de enzimas antioxidantes no rim da prole de mães expostas ao álcool. O consumo de AF diminuiu algumas anomalias importantes nos filhotes causadas por drogas teratogênicas, apesar de não ter sido eficiente na prevenção de alguns danos a arquitetura renal. Conclusão: A suplementação com AF não causou toxicicdade renal, exerceu efeito protetor antioxidante e mitigou algumas desordens renais causadas por agressões severas.

Aspects of the epidemiological dynamics of acquired syphilis and gestational syphilis between 2010 and 2021 in a state of the northeast region of Brazil / Aspectos da dinâmica epidemiológica da sífilis adquirida e da sífilis gestacional entre 2010 e 2021 em um estado da região nordeste do Brasil / Aspectos de la dinámica epidemiológica de la sífilis adquirida y la sífilis gestacional entre 2010 y 2021 en un estado de la región noreste de Brasil

To characterize the epidemiological dynamics of acquired syphilis and gestational syphilis in the state of Maranhão, between 2010 and 2021. Methods: Confirmed cases of acquired syphilis between 2010 and 2021 and of gestational syphilis between 2010 and 2020, in the state of Maranhão, available by the Sistema de Informação de Agravos de Notificação (SINAN) were analyzed. Results: The year 2018 had the highest number of reports of acquired syphilis (1.787 cases; p < 0.0001). The municipality of Duque Bacelar (East Mesoregion) had the highest incidence rate (285.5 per 100,000 inhabitants), for acquired syphilis, in the triennium 2016 to 2018. Regarding gestational syphilis, the year 2018 also stood out (1,892 cases; p < 0.0001) as the one with the highest number of records. The municipality of Buriticupu (West Mesoregion) had the highest detection rate of gestational syphilis (42.4 per 1,000 live births) in the biennium 2019 and 2020. Conclusions: The data presented showed municipalities with higher rates of acquired syphilis and gestational syphilis, concentrating located respectively in the East and West Mesoregions of the state of Maranhão. The findings obtained in the present study gather useful information for monitoring areas with a high incidence of the disease, thus contributing to the discussion and implementation of effective strategies to reduce cases.

Caracterizar a dinâmica epidemiológica da sífilis adquirida e da sífilis gestacional no Maranhão, entre 2010 e 2021. Métodos: Foram analisados os casos confirmados de sífilis adquirida entre 2010 e 2021 e de sífilis gestacional entre 2010 e 2020, no Maranhão, disponíveis pelo Sistema de Informação de Agravos de Notificação (SINAN). Resultados: O ano de 2018 teve o maior número de notificações de sífilis adquirida (1.787 casos; p < 0,0001). O município de Duque Bacelar (Mesoregião Oriental) teve a maior taxa de incidência (285,5 por 100.000 habitantes), para a sífilis adquirida, no triênio 2016 a 2018. Em relação à sífilis gestacional, o ano de 2018 também se destacou (1.892 casos; p < 0,0001) como o com o maior número de registros. O município de Buriticupu (Mesoregião Ocidental) teve a maior taxa de detecção de sífilis gestacional (42,4 por mil nascidos vivos) no biênio 2019 e 2020. Conclusões: Os dados apresentados mostraram municípios com maiores taxas de sífilis adquirida e sífilis gestacional, concentrando-se localizados respectivamente nas Mesoregiões Leste e Oeste do Estado do Maranhão. Os achados obtidos no presente estudo reúnem informações úteis para o monitoramento de áreas com alta incidência da doença, contribuindo assim para a discussão e implementação de estratégias eficazes para a redução de casos.

Caracterizar la dinámica epidemiológica de la sífilis adquirida y la sífilis gestacional en el estado de Maranhão, entre 2010 y 2021. Métodos: Se analizaron casos confirmados de sífilis adquirida entre 2010 y 2021 y de sífilis gestacional entre 2010 y 2020, en el estado de Maranhão, disponibles por el Sistema de Informação de Agravos de Notificação (SINAN). Resultados: El año 2018 tuvo el mayor número de reportes de sífilis adquirida (1,787 casos; p < 0,0001). El municipio de Duque Bacelar (Mesorregión Este) tuvo la mayor tasa de incidencia (285,5 por 100.000 habitantes), por sífilis adquirida, en el trienio 2016 al 2018. En cuanto a la sífilis gestacional, también se destacó el año 2018 (1.892 casos; p < 0,0001) como el de mayor número de registros. El municipio de Buriticupu (Mesorregión Oeste) tuvo la tasa más alta de detección de sífilis gestacional (42,4 por 1.000 nacidos vivos) en el bienio 2019 y 2020. Conclusiones: Los datos presentados mostraron municipios con mayores tasas de sífilis adquirida y gestacional, concentrándose respectivamente en las Mesorregiones Este y Oeste del estado de Maranhão. Los hallazgos obtenidos en el presente estudio reúnen información útil para el seguimiento de áreas con alta incidencia de la enfermedad, contribuyendo así a la discusión e implementación de estrategias efectivas para disminuir los casos.

Tumor trofoblástico de sitio placentario secundario a mola parcial. Reporte de un caso / Placental site trophoblastic tumor secondary to partial mole. Report of a case

Resumen ANTECEDENTES: La enfermedad trofoblástica gestacional es un padecimiento que incluye un grupo de tumores placentarios, consecuencia de una proliferación anormal del tejido del trofoblasto. Se caracteriza por una excesiva elevación de la gonadotrofina coriónica humana que se considera diagnóstica y un predictor pronóstico. CASO CLÍNICO: Paciente de 23 años con hiperémesis gravídica y aumento del tamaño del útero mayor para las siete semanas de gestación y cuantificación de las concentraciones de HGC anormalmente elevadas en comparación con su valor basal. Se descartaron los diagnósticos diferenciales de mola parcial hidatiforme, mola completa y embarazo múltiple. Se concluyó que se trataba de enfermedad trofoblástica gestacional. Se procedió a la evacuación de la cavidad uterina de la que se extrajeron abundantes porciones de tejido ovoconformacional y molariforme. El informe de Patología fue: útero arcuato con tumor de sitio placentario, endometritis crónica, cervicitis con metaplasia escamosa, quiste de Nabot y endometrio proliferativo tardío. CONCLUSIÓN: Puesto que las pacientes con enfermedad trofoblástica gestacional suelen tener un pronóstico sombrío se sugiere la histerectomía simple para llegar a la curación. Por la agresividad del tumor y resistencia a otros tratamientos es indispensable el monitoreo riguroso semanal de la cuantificación de la HCG.

Abstract BACKGROUND: Gestational trophoblastic disease is a condition that includes a group of placental tumors resulting from abnormal proliferation of trophoblast tissue. It is characterized by an excessive elevation of human chorionic gonadotropin which is considered diagnostic and a prognostic predictor. CLINICAL CASE: 23-year-old patient with hyperemesis gravidarum and uterine enlargement greater than 7 weeks' gestation and abnormally elevated HGC levels compared to baseline. The differential diagnoses of hydatidiform partial mole, complete mole and multiple pregnancy were ruled out. It was concluded that it was gestational trophoblastic disease. The uterine cavity was evacuated and abundant portions of ovoconformal and molariform tissue were extracted. The pathology report was: arcuate uterus with placental site tumor, chronic endometritis, cervicitis with squamous metaplasia, Nabot's cyst and late proliferative endometrium. CONCLUSION: Since patients with gestational trophoblastic disease usually have a dismal prognosis simple hysterectomy is suggested to reach cure. Because of the aggressiveness of the tumor and resistance to other treatments, rigorous weekly monitoring of HCG quantification is indispensable.

Association of pre-pregnancy body mass index and gestational weight gain with macrosomia / 中华健康管理学杂志

Objective:To analyze the association of pre-pregnancy body mass index (BMI) and gestational weight gain with macrosomia.Methods:In this retrospective cohort study, data of all puerperae and newborns in the Obstetrics Center of Peking Union Medical College Hospital from July 2020 to June 2021 were collected, including basic maternal information, pregnancy complications and neonatal conditions. A total of 2 422 pregnant women with full-term singleton live birth and their newborns were included in the analysis. The incidence of macrosomia (≥4 000 g) was calculated according to the birth weight of the newborns. Logistic regression and heat map were used to analyze the associations of pre-pregnancy BMI and gestational weight gain with macrosomia.Results:The incidence of macrosomia was 4.00% (97/2 422) in full-term singleton live birth newborns. Pre-pregnancy body weight, pre-pregnancy BMI, pre-pregnancy overweight/obesity rate, pre-delivery body weight, total weight gain during pregnancy, mean weekly weight gain during pregnancy, the proportion of excessive weight gain during pregnancy, duration of pregnancy, and the proportion of primiparity and education level of junior college or below were all significantly higher in the puerperae of the macrosomia group than those in the non-macrosomia group [(63.87±8.27) vs (58.14±7.86) kg, (23.33±2.97) vs (21.60±2.72) kg/m2, 35.1% vs 17.3%, (77.48±9.11) vs (70.02±8.79) kg, (13.61±4.56) vs (11.88±4.40) kg, (0.34±0.11) vs (0.30±0.11) kg, 58.8% vs 31.1%, (280.47±7.79) vs (276.14±7.83) d, 34.1% vs 23.7%, 18.6% vs 7.5%] (all P<0.05). Pre-pregnancy BMI ( OR=1.227, 95% CI: 1.145-1.314), mean weekly weight gain during the whole pregnancy ( OR=33.453, 95% CI: 5.172-217.947), duration of pregnancy ( OR=1.083, 95% CI: 1.055-1.112), primiparity ( OR=1.969, 95% CI: 1.232-3.101) and education level of junior college or below ( OR=2.525, 95% CI: 1.325-4.668) were all positively associated with occurrence of macrosomia (all P<0.05). The incidence of macrosomia increased with the pre-pregnancy body mass index and mean weekly weight gain during the whole pregnancy. Conclusions:High pre-pregnancy BMI and mean weekly weight gain during the whole pregnancy are associated with the increased risk of macrosomia. Appropriate weight management during pregnancy may help to reduce the incidence of adverse pregnancy outcomes.

Exposição aos agrotóxicos em cidade de intensa atividade do agronegócio e desfechos gestacionais adversos / Exposure to pesticides in a city with intense agribusinessactivity and adverse gestational outcomes / Exposición a plaguicidas en una ciudad con intensa actividad agroindustria y resultados gestacionales adversos

Objetivo: analisar a prevalência e os efeitos da exposição aos agrotóxicos sobre a ocorrência de desfechos gestacionais adversos. Método: estudo transversal de base populacional, constituído de 275 mulheres selecionadas a partir das áreas de cobertura das Estratégia da Saúde da Família, com idade igual ou maior que 18 anos. A coleta de dados ocorreu por meio da aplicação de um questionário estruturado, construído a partir da junção e adaptação de dois instrumentos validados, sendo um de condições de saúde autorreferida e um questionário de identificação do perfil de exposição familiar aos agrotóxicos. A análise de dados se deu por meio de análise bivariada, estratificada e regressão multivariada de Poisson. Resultados: houve uma incidência de aborto e natimortos de 20,73% na amostra, cujas variáveis associadas a estes desfechos de gravidez foram, contato atual com agrotóxicos, intoxicação prévia pelos agroquímicos e cor não branca, sendo observado a interação entre as mulheres que lavam roupas utilizadas na manipulação de agrotóxicos. Conclusão: há evidências de que a exposição materna a agrotóxicosse encontrapossivelmente associada a maior ocorrência de óbito fetal (aborto e natimorto).

Objective: to analyzethe prevalence and effects of exposure to pesticides on the occurrence of adverse pregnancy outcomes. Method: population-based cross-sectional study, consisting of 275 women selected from the areas covered by the Family Health Strategy, aged 18 years or older. Data collection took place through the application of a structured questionnaire, constructed from the combination and adaptation of two validated instruments, one of which is self-reported health conditions and a questionnaire to identify the profile of family exposure to pesticides. Data analysis was performed using bivariate and stratified analysis and multivariate Poisson regression. Results: there was an incidence of miscarriage and stillbirths of 20.73% in the sample, whose variables associated with these pregnancy outcomes were current contact with pesticides, previous intoxication by agrochemicals and non-white color, observing the interaction between women who wash clothes used in handling pesticides. Conclusion: there is evidence that maternal exposure to pesticides is possibly associated with a higher occurrence of fetal death (abortion and stillbirth).

Objetivo: analizar la prevalencia y los efectos de la exposición a plaguicidas en la ocurrencia de resultados adversos del embarazo. Método: estudio transversal de base poblacional, compuesto por 275 mujeres seleccionadas de las áreas de cobertura de la Estrategia Salud de la Familia, con edad igual o superior a 18 años. La recolección de datos se realizó mediante la aplicación de un cuestionario estructurado, construido a partir de la combinación y adaptación de dos instrumentos validados, uno de los cuales es el autoinforme de condiciones de salud y un cuestionario para identificar el perfil de exposición familiar a plaguicidas. El análisis de datos se realizó mediante análisis bivariado y estratificado y regresión de Poisson multivariada. Resultados: hubo una incidencia de abortos y mortinatos de 20,73% en la muestra, cuyas variables asociadas a estos desenlaces de embarazos fueron contacto actual con plaguicidas, intoxicaciones previas por agroquímicos y color no blanco, observándose la interacción entre mujeres que lavan ropa usada en manejo de pesticidas. Conclusión: existe evidencia de que la exposición materna a pesticidas posiblemente esté asociada con una mayor ocurrencia de muerte fetal (aborto y muerte fetal).

Reproductive Traits for Identifying Prolific Black Bengal Goat (Capra hircus bengalensis)

The present investigation recorded that the average litter size was 2.03 per doe and the prolificacy rate being 202.92%. The result indicates that the litter size proportion for single, twin and triplet were 28.3%, 40.4% and 31.3% respectively. There was a tendency of increasing body weight with higher litter size and such variation was highly significant (P<0.01). The result revealed that the overall mean age of first estrus was 209.08±2.06 days. Maximum age of first conception was 226.18±5.39 days when the animal gave single birth and the minimum AC was 216.65±4.9 days when it produced triplet indicating that failure of conception was more in single bearing does. Service period were recorded to very significantly (P<0.01) among different litter bearing groups, the highest value was observed in triplet producing does (80.88±4.68 days). This is an important finding to understand that, less Age of Puberty (AP), Age at 1stConception (AC), Days Open (DO) & Kidding Interval (KI) has prominent benefit for multiple foetuses and thus achieving economic benefit.

Subsistema Chile crece contigo, antes y durante la pandemia COVID-19 / Chile Grows With You Subsystem, Before and During the COVID-19 Pandemic

La situación sanitaria creada por la COVID-19 obligó a tomar medidas según criterios autónomos y de la Organización Mundial de la Salud, como la suspensión de las prestaciones esenciales a la gestante y el recién nacido, que impactó directamente en el proceso de la gestación y el parto, el posparto y los primeros meses de vida del recién nacido. Con el objetivo de evaluar los principales indicadores en los servicios de obstetricia y neonatología de Chile se realizó un análisis de las fuentes secundarias del registro estadístico mensual de la visita guiada a maternidad, el acompañamiento en el preparto y parto, el contacto piel a piel con el recién nacido y los egresos hospitalarios con lactancia materna exclusiva y de los cuatro indicadores del subsistema Chile crece contigo que se aplican en los 29 servicios de salud existentes, entre 2019 y 2020. Como resultado, se observó un descenso considerable en todos, apenas la lactancia materna exclusiva fue la menos afectada al egreso de la maternidad. La pandemia también perjudicó a los procesos obstétricos y neonatales, por ende, a la triada madre, hijo y padre o persona significativa(AU)

The health situation created by COVID-19 forced measures to be taken by autonomous decisions and according to criteria of the World Health Organization, such as the suspension of essential benefits to pregnant women and newborns, which directly impacted the process of gestation and delivery, postpartum and the first months of life of the newborns. With the objective of evaluating the main indicators in the obstetrics and neonatology services of Chile, it was carried out between 2019 and 2020 an analysis of the secondary sources of the monthly statistical record of the guided visit to maternity, the accompaniment in the prepartum and delivery stages, the skin-to-skin contact with the newborn and the hospital discharges with exclusive breastfeeding, and of the four indicators of Chile grows with you subsystem that are applied in the 29 existing health services,. As a result, a considerable decrease was observed in all; only exclusive breastfeeding was the least affected at maternity discharge. The pandemic also harmed obstetric and neonatal processes, therefore, also to the mother, child and father triad or significant person(AU)

A study on histopathological changes in ectopic tubal gestation

Background: Ectopic pregnancy is a serious cause of maternal morbidity and mortality. Fallopian tube is the most common site. Ectopic pregnancy is often the consequence of chronic salpingitis. The aim of the study was to identify the various histopathological changes in the fallopian tube, which are removed following an ectopic tubal gestation. The prevalence of various risk factors in ectopic tubal pregnancy was also investigated.Methods: This descriptive study included 160 cases of ectopic tubal gestation received in the department during the study period. Slides were studied for various changes like chronic salpingitis, acute salpingitis, salpingitis isthmica nodosa, endometriosis, tuberculosis etc. Patient’s clinical details were obtained from the medical records.Results: The most frequent pathological finding was chronic salpingitis followed by salpingitis isthmica nodosa. It was noted that all cases with a positive history of pelvic inflammatory disease (PID), showed evidence of chronic salpingitis during histopathological examination. Chronic salpingitis was also noted in 45% cases who did not give a history of PID. Among the risk factors, a history of tubal sterilization was the most frequent one.Conclusions:Even though the mortality has reduced, ectopic pregnancy causes significant morbidity and affects the fertility of women. The rise in incidence could be due to increase in prevalence of sexually transmitted diseases, increase in tubal sterilization practices and frequent use of assisted reproduction technology. Itis evident from the study that many cases of PIDs are left unidentified.

Fatores associados a candidíase vaginal em gestantes: O que exibem as publicações / Factores asociados a la candidiasis vaginal en mujeres embarazadas: Lo que muestran las publicaciones / Factors associated with vaginal canediasis in pregnant women: What the publications exhibit

Objetivo: analisar os fatores associados a candidíase vaginal em gestantes. Método: Trata-se de uma revisão integrativa de literatura realizado na PubMed. Utilizou-se os descritores: "pregnant women", pregnancy, candidiasis, "candidiasis, vulvovaginal". Foram selecionados ao final 07 estudos e o período de busca aconteceu entre os meses de novembro a dezembro de 2021. Resultados: a candidíase vulvovaginal teve uma média da prevalência geral de candidíase foi de 51,71% dos casos mencionados nos estudos. Dentre as manifestações clínicas da candidíase, destaca-se o corrimento alterado, prurido intenso, disúria, irritação ou queimação e dor pélvica Conclusão: A Candida albicans foi a cepa de levedura mais frequentemente identificada, mas, outras espécies também foram descritas, como a C. krusei, C.glabrata, Candida parapsilosis e C. tropicalis. A candidiasé não é letal, mas os sintomas podem definir o diagnóstico clínico da candidíase, na gestação o diagnóstico precoce norteia o tratamento eficiente e contribui para a melhora do prognóstico da gestante.(AU)

Objective: to analyze the factors associated with vaginal candidiasis in pregnant women. Method: This is an integrative literature review carried out at PubMed. The descriptors were used: "pregnant women", pregnancy, candidiasis, "candidiasis, vulvovaginal". At the end, 07 studies were selected and the search period took place between the months of November and December 2021. Results: vulvovaginal candidiasis had an average general prevalence of candidiasis of 51.71% of the cases mentioned in the studies. Among the clinical manifestations of candidiasis, there is an altered discharge, intense itching, dysuria, irritation or burning and pelvic pain. Conclusion: Candida albicans was the most frequently identified yeast strain, but other species were also described, such as C krusei, C. glabrata, Candida parapsilosis and C. tropicalis. Candidiasis is not lethal, but the symptoms can define the clinical diagnosis of candidiasis, in pregnancy, early diagnosis guides efficient treatment and contributes to improving the prognosis of the pregnant woman.(AU)

Objetivo: analizar los factores asociados a la candidiasis vaginal en gestantes. Métodos: Esta es una revisión integradora de la literatura realizada en PubMed. Fueron utilizados los descriptores: "embarazadas", embarazo, candidiasis, "candidiasis, vulvovaginal", al final fueron seleccionados 07 estudios. Resultados: la candidiasis vulvovaginal tuvo una prevalencia general promedio de candidiasis del 51,71% de los casos mencionados en los estudios. Entre las manifestaciones clínicas de la candidiasis se encuentran secreción alterada, prurito intenso, disuria, irritación o ardor y dolor pélvico. Conclusión: Candida albicans fue la cepa de levadura más frecuentemente identificada, pero también se han descrito otras especies, como C. krusei, C. glabrata, Candida parapsilosis y C. tropicalis. Se infiere que la VVC no es letal, pero los síntomas pueden definir el diagnóstico clínico de candidiasis, en el embarazo, el diagnóstico precoz orienta un tratamiento eficaz y contribuye a mejorar el pronósticode la gestante.(AU)