Eating disorders are associated with adverse obstetric and perinatal outcomes: a systematic review

Objective: To systematically review the literature focusing on obstetric and perinatal outcomes in women with previous or current eating disorders (EDs) and on the consequences of maternal EDs for the offspring. Methods: The study was performed following the systematic review and meta-analysis (PRISMA) statement. PubMed, SciELO, and Cochrane databases were searched for non-interventional studies published in English or Portuguese from January 1980 to December 2020. Risk of bias was assessed using the Methods guide for effectiveness and comparative effectiveness reviews (American Agency for Healthcare Research and Quality). Results: The search yielded 441 records, and 30 articles were included. The psychiatric outcome associated with EDs in women was mainly perinatal depression. The most prevalent obstetric outcomes observed in women with EDs were vomiting, hyperemesis, bleeding, and anemia. Most studies found maternal anorexia nervosa and bulimia nervosa to be associated with low birth weight and slow fetal growth. Women with binge EDs delivered children with increased birth weight. Of the 30 studies included, methodological quality was good in seven, fair in eight, and poor in 15 studies. Conclusion: A considerable body of evidence was reviewed to assess obstetric and perinatal outcomes in EDs. Acute and lifetime EDs, especially if severe, correlated with poor perinatal, obstetric, and neonatal outcomes. Obstetricians and general practitioners should be vigilant and screen for EDs during pregnancy.

Pseudomonas Aeruginosa: Virulence Factors and Antibiotic Resistance Genes

Abstract In this review, we explore some aspects of Pseudomonas aeruginosa virulence factors that are related to disease development in healthy organisms and resistance to antibiotics. This pathogen is one of the most clinically and epidemiologically important bacteria in Brazil, being the major cause of opportunistic infections. Among the virulence factors, biofilm formation acting of manner different in the organism. Furthermore, we review several P. aeruginosa genes that act in antimicrobial resistance, such as β-lactamases against β-lactamers. The resistance to pied-lactamases in P. aeruginosa is associated to resistance to the broad-spectrum cephalosporin. On the other hand, there is a group of synthetic broad-spectrum antibiotics acting on DNA synthesis is the quinolones that destroy the microorganism. We also explore the occurence of super bacterium: P. aerufinosa carrying genes blaKPC and blaNDM, which are associated with patient death above the average of other bacterial infections in hospitals. Those genes encode carbapenemases that can potentially hydrolyse all β-lactam antibiotics