Periodontal disease and oral health-related behavior as factors associated with preterm birth: a case-control study in south-eastern Brazil.

BACKGROUND AND OBJECTIVE: Several studies have suggested a link between periodontal disease and preterm birth, but the mechanism of how this occurs remains controversial. Therefore, this study aimed to investigate whether periodontal disease, defined according to two commonly used clinical definitions, is associated with preterm birth and to examine the association regarding oral health-related behaviors during pregnancy. MATERIAL AND METHODS: This case-control study included women 18-40 years of age. Demographic and socio-economic data, information on current and previous pregnancies, and data on dental health-related behaviors and periodontal clinical parameters were collected within 48 h postpartum. Periodontal disease was assessed according to two definitions: four or more teeth with at least one site showing a probing depth of ≥ 4 mm and clinical attachment level of ≥ 3 mm (Definition 1); or at least one site with probing depth and clinical attachment level of ≥ 4 mm (Definition 2). The chi-square test was used to examine differences in the proportion of categorical variables. Bivariate analysis was performed to analyze the proportion of preterm births with respect to independent variables. Multiple logistic regression analyses were used to assess the association between periodontal disease and preterm birth. Odds ratios (ORs) were calculated with a 95% confidence interval (95% CI). RESULTS: A total of 296 postpartum women met the inclusion criteria. The case group included 74 women who delivered a preterm neonate (< 37 wk of gestation) and the control group included 222 women with deliveries at term (≥ 37 wk). Periodontal disease according to Definition 1 was not associated with fewer weeks of gestation (adjusted OR (OR adjusted ) = 1.62; 95% CI = 0.80-3.29; p = 0.178). However, a significant association was found between periodontal disease, according to Definition 2, and preterm birth (OR adjusted = 1.98; 95% CI = 1.14-3.43; p = 0.015). Increased appetite and a low number of daily toothbrushings were associated with preterm birth, regardless of the definition of periodontal disease used. CONCLUSION: Periodontal disease defined according to Definition 2 and unfavorable oral health-related behavior were factors associated with preterm birth.

Caracterização farmacognóstica de Polygonum hydropiperoides Michaux e P. spectabile (Mart.) (Polygonaceae) / Pharmacognostic characterization of Polygonum hydropiperoides Michaux and P. spectabile (Mart.) (Polygonaceae)

Polygonum hydropiperoides e P. spectabile são espécies conhecidas como "ervade-bicho" e utilizadas como antiinflamatórias, anti-hemorroidais e antidiarréicas. As análises farmacognósticas indicaram teores de perda por dessecação, de cinzas totais e de cinzas insolúveis que variaram de 4,0 a 6,5 por cento; 5,0 a 10,0 por cento e 0,1 a 0,4 por cento, respectivamente. Através de cromatografia em camada delgada, foram detectados triterpenos e/ou esteróides, cumarinas, flavonóides, polifenóis, taninos e saponinas nas quatro amostras. Os teores de polifenóis totais, taninos e flavonóides foram de 7,0 por cento; 5,5 por cento e 0,4 por cento, respectivamente, para P. spectabile, e diferiram das três amostras de P. hydropiperoides, observando-se valores em torno de 5,0 por cento; 4,0 por cento e 0,6 por cento para duas delas e de 12,5 por cento; 11,3 por cento e 0,3 por cento para a outra. Estas espécies, morfologicamente muito semelhantes, são empregadas, indiscriminadamente, na produção de medicamentos fitoterápicos. Este estudo mostrou variações nos teores de polifenóis e taninos nas amostras de P. hydropiperoides, coletadas no outono e na primavera. Estes resultados representam os primeiros parâmetros obtidos para o controle de qualidade de P. hydropiperoides e P. spectabile.

Polygonum hydropiperoides and P. spectabile are, commonly known as "erva-de-bicho", and traditionally used as anti-inflammatory, antihaemorrhoidal and anti-diarrhea. The pharmacognostic analysis indicated the content of loss on drying, of total ash and acid-insoluble ash ranged from 4.0 to 6.5 percent, 5.0 to 10.0 percent and 0.1 to 0.4 percent, respectively. The TLC analysis revealed the presence of triterpenes and/or steroids, coumarins, flavonoids, polyphenols, tannins and saponins in the four samples. The content of total polyphenols, tannins and flavonoids were 7.0 percent, 5.5 percent and 0.4 percent, respectively for P. spectabile. They were different from the three samples of P. hydropiperoides. The values observed were around 5.0 percent, 4.0 percent and 0.6 percent for two of them and 12.5 percent, 11.3 percent and 0,3 percent for the other one. These species are morphologically very similar and they are used indiscriminately for the production of herbal medicines. This study showed variations on the contents of polyphenols and tannins in samples of P. hydropiperoides collected in autumn and spring. These results represent the first parameters obtained for the quality control of P. hydropiperoides and P. spectabile.

Effect of CCK-OP and intraduodenal administration of essential amino acids on intraluminal pressures of sigmoid and rectum in patients with Chagasic megacolon.

The motility of the sigmoid colon and rectum was studied by manometry in patients with Chagasic megacolon and in control individuals using two different experimental procedures: (1) intravenous infusion of saline, followed by intravenous infusion of cholecystokinin octapeptide (OP-CCK) at the dose of 20 ng/kg/hr; and (2) intraduodenal instillation of saline followed by a solution of essential amino acids at a flow of 10 ml/min. CCK-OP induced an increase in motility index in the sigmoid colon (P less than 0.05) and rectum (P less than 0.05) in the controls, whereas intraduodenal infusion of amino acids produced a significant increase in motility index exclusively in the sigmoid colon (P less than 0.005). A significant increase (P less than 0.05) in sigmoid colon motility also occurred in the control group after duodenal saline infusion was interrupted. The release of other substances in addition to CCK must have been responsible for the different behavior of sigmoid colon and rectum in response to the stimuli used. Neither procedure caused significant changes in the motility of the sigmoid colon or the rectum of the Chagasic patients. The extensive intramural denervation occurring in Chagasic megacolon probably destroys the neural pathway through which OP-CCK and the substances released by the duodenum by the infusion of essential amino acids activate the motor cells of the human terminal intestine.

Basal motility of dilated and non-dilated sigmoid colon and rectum in Chagas' disease.

The basal motility of the sigmoid colon and rectum was evaluated manometrically over 3 consecutive 10-minute periods in 29 control subjects, 14 chagasic patients without megacolon, and 32 chagasic patients with megacolon. The results indicated that the sigmoid colon of both chagasic groups had a lower motility index and lower wave frequency than that of the controls. Reduced wave frequency was observed in the rectum of patients with megacolon, out the rectum of the chagasic patients without megacolon showed manometric characteristics similar to those for the controls. The abnormalities observed were attributed to intramural denervation of the viscera under study. Waves of long duration were observed very frequently in megacolon, and were assumed to be caused by dilatation in itself and not by abnormal contraction of muscle fibers.

Basal motility of dilated and non-dilated sigmoid colon and rectum in Chagas' disease.

A atividade motora basal desenvolvida pelo sigmoide e pelo reto em 3 periodos consecutivo de 10 minutos foi avaliada pelo metodo manometrico em 29 individuos tomados como controles, 14 chagasicos sem megacolon e 32 chagasicos com megacolon. Os resultados indicaram que nos chagasicos com e sem magacolon o sigmoide mostrou menor indice de motalidade e menor frequencia de ondas que o dos controles. No reto dos pacientes com megacolon foi observada reducao da frecuencia de ondas, mas o reto dos chagasicos sem megacolon mostrou caracteristicas manometricas semelhantes a dos controles. As anormalidades observadas foram atribuidas a desnervacao intramural das visceras consideradas. Ondas de longa duracao foram observadas com elevada frequencia no megacolon. Admite-se que este tipo de onda resulta da dilatacao em si e nao reflete anormalidades da contracao da fibra muscular do orgao dilatado