Choice and factors associated to the use of contraceptive methods among postpartum women: A prospective cohort study.

OBJECTIVES: To assess women's contraceptive preferences in the immediate postpartum period and identify factors associated with use of their desired contraceptive method six months later. MATERIAL AND METHODS: This prospective cohort study included women ≤48 h after delivery at a single public Brazilian hospital. The women's interview took place in two different momentsbefore hospital discharge (in-person interview) and six months after delivery (by telephone contact). For data collection and management, we used the REDCap electronic tool. Univariate and multivariate analyses (unadjusted and adjusted Odds Ratio and 95 % confidence intervals) were used to identify factors associated with higher use of their desired contraceptive method six months after delivery. RESULTS: A total of 294 women (166 adolescents) were included. Initial contraceptive preferences were especially intrauterine devices (IUDs) (39.1 %), implants (33.0 %) and injectable hormonal contraceptives (17.0 %). Six months later, 42.5 % (n = 125) were using their desired contraceptive method. Younger age, white race and contraceptive initiation prior to hospital discharge were associated with use of their desired contraceptive at six months. CONCLUSION: Long-acting reversible contraception (LARC) methods were the most desired contraceptives among women after delivery. Providing and initiating free contraception prior to discharge from a birthing unit is important with regard to use of their desired method.

Lipid profile and reproductive performance of female offspring of SWISS mouse females supplemented with resveratrol or canjiqueira (Byrsonima cydoniifolia A Juss) during gestation.

This study aimed to resveratrol supplementation (at 5 or 10 mg/kg) and a hydroethanolic extract of canjiqueira fruits (150 mg/kg) on female SWISS mice. Total cholesterol, high-density lipoprotein (HDL), triglyceride levels, gestation rates, and embryonic implantation rates in their female Offspring was evaluated. In conclusion, the consumption of canjiqueira fruit extract altered the lipid profile of their female offspring, and did not impact their reproductive performance. Supplementing female SWISS mice with 10 mg/kg of resveratrol increased total cholesterol, triglycerides, and HDL levels, thereby enhancing the reproductive efficiency of their offspring.

Óbitos neonatais por enterocolite necrosante: estudo de coorte retrospectiva / Neonatal deaths from necrotizing enterocolitis: a retrospective cohort study / Muertes neonatales por enterocolitis necrozante: estudio de cohorte retrospectivo

Introdução:A enterocolite necrosante é uma doença que pode afetar o trato gastrointestinal de recém-nascidos,cujas manifestações clínicas podem ser caracterizadas por vômitos biliosos, sangue nas fezes, distensão abdominal, além de alterações nos parâmetros hemodinâmicos e instabilidade térmica. As populações mais vulneráveis a essa enfermidade são recém-nascidos de baixo peso,expostos ao ambiente de terapia intensiva neonatal. Objetivos: Identificar o perfil de recém-nascidos e os fatores maternos e neonatais associados à ocorrência de óbitos por enterocolite necrosante, em maternidade de referência do Ceará-Brasil. Metodologia: Trata-se de coorte retrospectiva, estudo que objetiva a descrição da incidência de determinado evento ao longo do tempo, além do estabelecimento de relações causais entre os fatores associados ao acontecimento. Incluíram-serecém-nascidos que tiveram óbitos por enterocolite necrosante entre 2019 e 2021, comficha de investigação de óbitos neonatais preenchida corretamente, não sendo excluído nenhum recém-nascido, totalizando amostra de 29 óbitos.Resultados: Identificou-se que o perfil dos recém-nascidos foi,em maioria, deprematuros e com baixo peso e fatores de risco para outras doenças associadas,como a sepse, o que acarretourealização de procedimentos invasivos e internação em ambiente de terapia intensiva neonatal.Conclusões: A prematuridade e o baixo peso ao nascer foram as variáveis relevantes no estudo e podem estar associadas à piora das condições clínicas do recém-nascido e ao desenvolvimento de enterocolite necrosante (AU).

Introduction: Necrotizing Enterocolitis is a disease that can affect the gastrointestinal tract of newborns, whose clinical manifestations can be characterized by bilious vomiting, blood in stool, abdominal distension, in addition to changes in hemodynamic parameters and thermal instability. The populations most vulnerable to this disease are low birth weight newborns exposed to the neonatal intensive care environment. Objectives: This study aimed to identify the profile of newborns and maternal and neonatal factors associated with the occurrence of deaths from necrotizing enterocolitis in a reference maternity hospital in Ceará, Brazil. Methodology: This is a retrospective cohort study seeking to describe the incidence ofa particular event over time, as well as establish causal relationships between the factors associated with the event. The study population comprised newborns who died from necrotizing enterocolitis between 2019 and 2021, who had neonatal death investigation forms filled out correctly, with no newborns being excluded, totaling a sample of 29 deaths. Results: It was identified that the profile of newborns was mostly premature, of low birth weight and with risk factors for other associated diseases such as sepsis, leading to invasive procedures and hospitalization in a neonatal intensive care environment. Conclusions: Prematurity and low birth weight were relevant variables in the study and may be associated with worsening of the newborn's clinical conditionsand development of necrotizing enterocolitis (AU).

ntroducción:La Enterocolitis Necrotizante es enfermedad que puede afectar el tracto gastrointestinal del recién nacido, cuyas manifestaciones clínicas pueden caracterizarse por vómitos biliosos, sangre en las heces, distensión abdominal, además de cambios en los parámetros hemodinámicos e inestabilidad térmica.Las poblaciones más vulnerables a esta enfermedad son recién nacidos con bajo peso expuestos al entorno de cuidados intensivos neonatales.Objetivos: Identificar el perfil de recién nacidos y los factores maternos y neonatales asociados a la ocurrencia de muertes por enterocolitis necrotizante, en maternidad de referencia en el Ceará-Brasil.Metodología: Estudio de cohorte retrospectivo, para describir la incidencia de determinado evento a lo largo del tiempo, además de establecer relaciones causales entre los factores asociados al evento.Se incluyeron recién nacidos fallecidos por enterocolitis necrotizante entre 2019 y 2021, quienes tuvieron formulario de investigación de muerte neonatal correctamente diligenciado, no excluyéndose ningún recién nacido, totalizando muestra de 29 defunciones.Resultados:El perfil de los recién nacidos fue mayoritariamente prematuro y de bajo peso al nacer y con factores de riesgo para otras enfermedades asociadas, como sepsis, con procedimientos invasivos y hospitalización en ambiente de cuidados intensivosneonatales.Conclusiones:La prematuridad y el bajo peso al nacer fueron variables relevantes en el estudio y pueden estar asociados con empeoramiento de las condiciones clínicas de recién nacidos y desarrollo de enterocolitis necrotizante (AU).

Structural and molecular bases of angiotensin-converting enzyme inhibition by bovine casein-derived peptides: an in silico molecular dynamics approach.

The angiotensin-converting enzyme (ACE) plays a key role in blood pressure regulation process, and its inhibition is one of the main drug targets for the treatment of hypertension. Though various peptides from milk proteins are well-known for their ACE-inhibitory capacity, research devoted to understand the molecular bases of such property remain scarce, specifically for such peptides. Therefore, in this work, computational molecular docking and molecular dynamics calculations were performed to enlighten the intermolecular interactions involved in ACE inhibition by six different casein-derived peptides (FFVAPFPEVFGK, FALPQYLK, ALNEINQFYQK, YLGYLEQLLR, HQGLPQEVLNENLLR and NAVPITPTLNR). Two top ranked docking poses for each peptide (one with N- and the other C-terminal peptide extremity oriented towards the ACE active site) were selected for dynamic simulations (50 ns; GROMOS53A6 force field), and the results were correlated to in vitro ACE inhibition capacity. Two molecular features appeared to be essential for peptides to present high ACE inhibition capacity in vitro: i) to interact with the S1 active site residues (Ala354, Glu384, and Tyr523) by hydrogen bonds; ii) to interact with Zn2+ coordinated residues (His383, His387, and Glu411) by short-lenght hydrogen bonds, as observed in the cases of ALNEINQFYQK (IACE = 80.7%), NAVPITPTLNR (IACE = 80.7%), and FALPQYLK (IACE = 79.0%). Regardless of the temporal stability of these strong interactions, they promoted some disruption of Zn2+ tetrahedral coordination during the molecular dynamics trajectories, and were pointed as the main reason for the greatest ACE inhibition by these peptides. On the other hand, peptides with intermediate inhibition capacity (50% < IACE < 45%) interacted mainly by weaker interactions (e.g.: electrostatic and hydrophobic) with the Zn2+ coordinated residues, and were not able to change significantly its tetrahedral coordination structure. These findings may: i) assist the discrimination in silico of "good" and "bad" ACE-inhibitory peptides from other food sources, and/or ii) aid in designing de novo new molecules with ACE-inhibitory capacity. Communicated by Ramaswamy Sarma.

A Discrepância de Bolton e seu tratamento multidisciplinar / Bolton’s Discrepancy: multidisciplinary treatment

Um número significante de pacientes apresenta discrepância de tratamento dentário, conhecida como Discrepância de Bolton, que pode acarretar diastemas, ao término do tratamento ortodôntico. É possível e importante prever, de forma relativamente precisa, o quanto vai haver de espaço no final do tratamento ortodôntico, para que seja planejada, junto com a Dentística, a distribuição dos espaços e a melhor forma de fechá-los. Este artigo explica detalhadamente ao clínico geral a análise de Bolton, exemplificada por um caso clínico em que um paciente foi submetido a tratamento ortodôntico com extração de quatro pré-molares, e necessitou de fechamento de diastemas por meio de restaurações em resina composta.

A significant amount of patients present problems related to tooth dimension, i.e. Bolton discrepancies, which can compromise the outcome of the orthodontic treatment resulting in dental diastema. In most cases, it is possible and important to predict in a relatively precise manner, the amount of reminiscent space at the end of the orthodontic treatment, to plan with the restorative dentist the space distribution on the best way to close them. The aim of this article is to describe in detail the Bolton analysis, showing a case report where the patient has been submitted to orthodontic treatment with four bicuspids extractions and also needed diastemata closure using direct composite resins.

The influence of two home-applied bleaching agents on enamel microhardness: an in situ study.

OBJECTIVE: This in situ study evaluated the influence of two home-applied bleaching agents (10% carbamide peroxide and 7.5% hydrogen peroxide) on enamel microhardness. METHODS: Ninety enamel slabs were obtained from human third molars and baseline Knoop hardness measurements were recorded under a 50 g load for 5s. The specimens were attached to intra-oral devices delivered to 10 volunteers (donor of the teeth) who used the devices 24h/day throughout the experiment. The specimens were divided in three groups, two experimental and one control; in the last group, enamel slabs were not submitted to bleaching agents, but exposed only to the action of saliva. Two custom-made trays were made for each volunteer to recover the teeth and the appliances containing the enamel slabs. The bleaching regimen was 1h/day for 21 consecutive days. Subsequently, additional hardness measurements were recorded. RESULTS: The mean values of the baseline and final microhardness were: 348 and 352.2; 346.6 and 354.5; 342 and 340.8, for control, 10% carbamide peroxide and 7.5% hydrogen peroxide groups, respectively. One-way ANOVA of the microhardness mean values revealed no statistically significant differences among groups, the specimens treated with 7.5% hydrogen peroxide has shown a tendency (p=0.056) to microhardness decrease. CONCLUSIONS: Data suggested that the tested home bleaching agents did not change the superficial enamel microhardness.

A importância do diagnóstico da erosão dental / Importance of dental erosion diagnoses

A erosão dental é uma perda progressiva da superfície dos tecidos duros do dente, provocada por ácidos, sem envolvimento de bactérias. O ácido pode ser de origem intrínseca, como o suco gástrico, e de origem extrínseca, proveniente de alimentos e bebidas ácidas, exposição a fumaças ácidas em certos processos industriais e cloro de piscina não tratada de forma correta. Este artigo tem como objetivo alertar o cirurgião-dentista sobre as causas da erosão dental, assim como informar sobre suas formas de tratamento. Também são apresentadas sugestões de ficha de anamne-se e de anotações das características clínicas, a fim de auxiliar o profissional no diagnóstico, na escolha do tratamento e no acompanhamento do paciente.

Computational approach for the design of AP1867 analogs: aiming at new synthetic routes for potential immunosuppressant agents.

Molecular modelling and synthetic arguments are valuable tools for the design of potential immunosuppressant agents. In this paper, eight proline-based compounds related to the AP1867 structure are studied and at least one of them is found to be a structurally good candidate for the inhibition of FKBP protein. Theoretical calculations were carried out to locate the most energetically favorable chemical substituent group relative to a core skeleton group on interaction with the FKBP binding cavity. Connolly accessible surface calculations have complemented the molecular mechanics and dynamics approaches. Calculated results were also analyzed on the basis of hydrogen bond interactions, relative energies of interaction, root-mean square deviations of amino acid residues of the crystallized protein, and orientation of the substituent groups within the active site. The results show a significant reduction in the relative interaction energies and very good shape complementarities between our final analog compound and the FKBP binding pocket.

Clareamento em dentes vitais: estágio atual / Vital bleaching: satate of the art

O sucesso do tratamento clareador depende de inúmeros fatores, como etiologia da alteração de cor, colaboração do paciente, grau de descoloração dental, idade do paciente, se o dente é vital ou não, e agente clareador. Considerando que praticamente todos os clareadores dentais são à base de peróxido, a escolha do clareador está relacionada à concentração do produto. Entender a atuação dos agentes clareadores é essencial para utilizá-los com segurança, principalmente em relação aos dentes vitais em que a sensibilidade transclareamento é muito freqüente. Este artigo visa, a partir das técnicas atualmente utilizadas, a esclarecer as diferenças entre os tratamentos clareadores para dentes vitais, que utilizam ou não a moldeira, discutindo os seus principais pontos de divergência.

Interactions of 5-deazapteridine derivatives with Mycobacterium tuberculosis and with human dihydrofolate reductases.

There are major differences between the structures of human dihydrofolate reductase (hDHFR) and Mycobacterium tuberculosis dihydrofolate reductase (mtDHFR). These differences may allow us to design more selective mtDHFR inhibitors. In this paper we study the reactions of six different compounds derived from 5-deazapteridine with human and bacterial enzymes. Results suggest that the addition of hydrophobic groups to the aminophenyl ring would increase mtDHFR-inhibitor affinity and selectivity.

Tooth fragment reattachment: fundamentals of the technique and two case reports.

Coronal fractures must be approached in a methodical and clinically indicated way to achieve successful restoration. One option for treatment is reattachment of the dental fragment. Reattachment creates a very positive emotional response in the patient and simplifies the maintenance of the patient's original occlusion. This article discusses dental fragment reattachment techniques and presents clinical cases of coronal fracture involving enamel, dentin, and pulpal exposure.

Prevalecência das desordens temporomandibulares. Uma abordagem sobre a influência do estresse / Prevalence of the temporomandibular disorders. An approach about the influence of the stress

Prevalecência de desordens temporomandibulares(DTMs). Apresenta-se uma avaliação sobre a influência do estresse no desenvolvimento das DTMs, e pesquisa-se a prevalência das DTMs em 215 indivíduos, através deum questionário anamnésico e de uma avaliação psicológica. A prevalência de sinais e sintomas da DTM foi de 60,93 por cento, enquanto que a necessidade de tratamento foi de 14,88 por cento. Destes, 81,25 por cento relataram estar sob estesse emocional, oque evidencia a influência deste fator no desenvolvimento da DTM

Diagnosis and management of maxillary incisors affected by incisal wear: an interdisciplinary case report.

UNLABELLED: In the attempt to restore anterior teeth affected by erosion and bruxism, many clinicians have been frustrated with the constant restorative failures. Frequently, these failures are attributed to the restorative materials employed, especially in cases in which composite resins are used. However, some flaws of the restorations are related to the oversight of occlusal principles. The purpose of this article is to discuss the etiology, signs, and symptoms of incisal wear, with special attention to that caused by bruxism and chemical erosion. Relatively simple management techniques (e.g., occlusal adjustment, adhesive restorations) are proposed, and the diagnosis and management of a representative clinical case is presented. CLINICAL SIGNIFICANCE: In some cases of bruxism and/or dental erosion, it is possible to acquire space to recuperate the esthetics and function of maxillary incisors affected by incisal wear through a conservative treatment associated with the control of the etiologic factors.

Prevalência das desordens têmporo-mandibulares. Uma abordagem sobre a influência do estresse / Prevalence of the temporomandibular disorders. An approach about the influence of the stress

Prevalência das Desordens Têmporo-mandibulares (DTMs). Apresenta-se uma avaliaçäo sobre a influência do estresse no desenvolvimento das DTMs e pesquisa-se a prevalência das DTMs em 215 indivíduos, através de um questionário anamnésio e de uma avaliaçäo psicológica. Concluiu-se que a prevalência de sinais e sintomas da DTM foi de 60,93 por cento, enquanto que a necessidade de tratamnento foi de 14,88 por cento. Destes, 81,25 por cento relataram estar sob estresse emocional, o que evidencia a influência deste fator no desenvolvimento da DTM