Higher maternal age is associated with higher occurrence of cleft lip/palate in neonates under intensive care

Aim: To assess the prevalence of cleft lip and/or cleft palate (CL/P) and associated variables in neonates admitted to neonatal intensive care units (ICU). Methods: Medical charts for neonates born and admitted to the ICU between 2012 and 2018 were reviewed. Obstetric and neonatal variables were collected by a trained researcher. In the case group, all neonates with CL/P were included. The control group was formed by matching sex, prematurity and month of birth using random number generation. Neonates with congenital malformations were excluded from the control group. Adjusted logistic regression was used (p<0.05). Results: The prevalence of CL/P was 0.43% (n=15). Five cases were excluded, as pairing was not possible. Twenty neonates were included in the control group. In the final multivariate model, CL/P was only associated with increased maternal age. For each year of increase in maternal age, neonates had a 35.2% higher chance of presenting CL/P (95% confidence interval: 1.021­1.792). Conclusions: Higher maternal age was associated with higher occurrence of CL/P in neonates admitted to the ICU. No other neonatal or maternal independent variables were associated with CL/P. Due to missing data, interpretation of study results must be approached with caution

Nanoneedle-like zinc oxide as a filler particle for an experimental adhesive resin

Aim: The aim of this study was to develop an experimental adhesive resin with nanoneedle-like zinc oxide (N-ZnO), an inorganic filler, that could avoid particle agglomeration and lead to a homogeneous stress distribution within the material and characterize it. Materials and Methods: N-ZnO particles obtained by a thermal evaporation technique were characterized regarding size and surface area and added at 0 (control), 1, 2, 5, and 10 wt%, to an experimental adhesive resin. The following experimental adhesive resins' properties were assessed: radiopacity, contact angle to conditioned enamel and dentin, color, degree of conversion, flexural strength, resistance to degradation, and cytotoxicity. Statistical analysis was performed using one-way ANOVA and Tukey's post hoc test and paired Student's t-test. Results: Particles presented a mean particle size of 40 nm and a specific surface area of 16 m2/g. N-ZnO10%showed an increased radiopacity when compared to N-ZnO0%. Contact angles were significantly higher for N-ZnO10%at enamel and N-ZnO2%, N-ZnO5%, and N-ZnO10%at dentin. All groups showed color change when compared to N-ZnO0%. Higher the N-ZnO concentration, lower the degree of conversion. There were no significant differences between the groups for flexural strength and resistance to degradation. The addition of N-ZnO showed no difference in cytotoxicity when compared to positive control, N-ZnO0%, and all groups showed higher values than negative control. Conclusions: N-ZnO possibly exceeded potential limitations due to particles' agglomeration and improved the transference and distribution of stress within the material. It could be effectively used as a filler for adhesive resins.

Repair of bone defects using adipose-derived stem cells combined with alpha-tricalcium phosphate and gelatin sponge scaffolds in a rat model

Abstract Objectives This study aimed to evaluate the potential of adipose-derived stem cells (ASCs) combined with a modified α-tricalcium phosphate (α-TCP) or gelatin sponge (GS) scaffolds for bone healing in a rat model. Material and Methods Bone defects were surgically created in the femur of adult SHR rats and filled with the scaffolds, empty or combined with ASCs. The results were analyzed by histology and histomorphometry on days seven, 14, 30, and 60. Results Significantly increased bone repair was observed on days seven and 60 in animals treated with α-TCP/ASCs, and on day 14 in the group treated with GS/ASCs, when compared with the groups treated with the biomaterials alone. Intense fibroplasia was observed in the group treated with GS alone, on days 14 and 30. Conclusions Our results showed that the use of ASCs combined with α-TCP or GS scaffolds resulted in increased bone repair. The higher efficacy of the α-TCP scaffold suggests osteoconductive property that results in a biological support to the cells, whereas the GS scaffold functions just as a carrier. These results confirm the potential of ASCs in accelerating bone repair in in vivo experimental rat models. These results suggest a new alternative for treating bone defects.

Desfechos materno-fetais do diabetes gestacional em serviço terciário de atenção obstétrica / Maternal and fetal outcomes of gestational diabetes in a tertiary obstetric center

Introdução: Diabetes mellitus gestacional (DMG) é uma das principais complicações da gestação, sendo definida como intolerância à glicose reconhecida neste período. Considerando as implicações neonatais e maternas decorrentes dessa comorbidade, este estudo tem como objetivo descrever os desfechos materno-fetais de gestantes diabéticas. Métodos: Estudo descritivo, em que se investigou o prontuário de 86 gestantes internadas por DMG (e seus neonatos), entre 01/01/2012 e 30/08/2013, no Hospital Universitário da Universidade Luterana do Brasil (ULBRA). Resultados: A média de idade foi 31,9 ± 6,9 anos. Quanto ao parto, 60,5% foi por cesárea, sendo a idade gestacional média de 37 semanas e 6 dias. 55,8% das gestantes apresentaram algum desfecho adverso. O peso médio dos recém nascidos foi 3416 ± 528,2 gramas, 20,9% apresentaram hipoglicemia, 3,5% hiperbilirrubinemia, 12,8% disfunção respiratória e 10,5% necessitaram UTI Neonatal. As incidências de prematuridade e recém-nascido grande para idade gestacional foram de 25,5%. O tempo médio de internação foi de 67 horas. Conclusões: Os resultados suportam os achados esperados de morbidade neonatal associada ao DMG, com expressiva incidência de desfechos neonatais constatados na população estudada, em especial, prematuridade, hipoglicemia neonatal e recém-nascido grande para a idade gestacional. Nossos dados reforçam a importância do rastreamento e manejo adequado desta patologia devido à alta incidência de complicações neonatais e morbidade associado a essa condição (AU)

Introduction: Gestational diabetes mellitus (GDM) is a major complication of pregnancy, defined as glucose intolerance recognized in this period. Considering the neonatal and maternal implications of this comorbidity, this study aims to describe the maternal and fetal outcomes of pregnant diabetic women. Methods: Descriptive study, which investigated the medical records of 86 pregnant women hospitalized for DMG (and their newborns) between Jan 1, 2012 and Aug 30, 2013 at the University Hospital of the Lutheran University of Brazil (ULBRA). Results: Mean age was 31.9 ± 6.9 years. As for the birth, 60.5% was by caesarean section, with mean gestational age of 37 weeks and 6 days. 55.8% of the patients presented some adverse outcome. The mean weight of newborns was 3416 ± 528.2 grams, 20.9% had hypoglycemia, 3.5%, hyperbilirubinemia, 12.8% respiratory dysfunction, and 10.5% required neonatal ICU. The incidence of prematurity and large-for-gestational-age newborn was 25.5%. The mean hospital stay was 67 hours. Conclusion: Our results support the expected findings of neonatal morbidity associated with GDM, with a significant incidence of neonatal outcomes observed in the study population, especially prematurity, neonatal hypoglycemia and large-for-gestational-age newborn. Our data reinforce the importance of screening and appropriate management of this disease due to the high incidence of neonatal morbidity and complications associated with this condition