Rational use of antimicrobials in dentistry during pregnancy

The use of medicines during pregnancy deserves special attention from dentists due to the potential risks to fetal development. The prescription of antimicrobial drugs during this period must be based not only on the etiology of the disease but also on the drug's effect on the embryo, which may be toxic, possibly leading to irreversible lesions. Interest in studies of the teratogenic effects of drugs increased in response to reports of the high incidence of phocomelia in patients treated with thalidomide. Although teratogenicity has long been known, pregnant women today are still exposed to this risk. The effects of drugs depend on the level of susceptibility of the fetus and on the period of exposure during pregnancy. In this context, and considering the paucity of studies on this subject in dentistry, the aim of this review was to offer an up-to-date compilation of data on the antimicrobial drugs most frequently used during pregnancy and the effects of their use.

Hematological values and total protein of Brasileiro de Hipismo and Breton mares during pregnancy

Estudaram-se as variáveis eritrométricas, leucométricas e a concentração de proteína total (PT) de éguas gestantes das raças Brasileiro de Hipismo (BH) e Bretão. Utilizaram-se 175 éguas sadias, com 3 a 13 anos de idade. Dentre as éguas utilizadas, 89 foram da raça BH, divididas em 14 não-prenhes e 75 prenhes, e 86 éguas da raça Bretão divididas em 11 não-prenhes e 75 prenhes. As éguas foram subdivididas em quatro grupos por raça: grupo controle (éguas não-prenhes, n=14 para BH e n=11 para Bretão); grupo I (primeiro período de gestação, 25-110 dias, n=25 para BH e Bretão), grupo II (segundo período de gestação, 111-210 dias, n=25 para BH e Bretão); e grupo III (terceiro período de gestação, 211-340 dias, n=25 para BH e Bretão). Os valores médios de cada variável eritrométrica, leucométrica e de proteína total foram obtidos para cada raça e, posteriormente, realizou-se comparação entre as mesmas. O número de hemácias (He), volume globular (VG) e teor de hemoglobina (Hb) aumentaram no segundo período de gestação e diminuíram no último período tanto para a raça BH, como para a raça Bretão. Além disso, essas mesmas variáveis apresentaram diferença estatística significativa tanto nas éguas não-prenhas como nas prenhes durante os três períodos gestacionais. Os valores médios obtidos de leucócitos e neutrófilos segmentados aumentaram a partir do segundo período de gestação para as duas raças estudadas.

Feelings and Perceptions of Women in the Pregnancy-Puerperal Cycle Who Survived Severe Maternal Morbidity

Objetivou-se compreender a experiência relativa à morbidade materna grave, a partir de um grupo de mulheres que vivenciou esse problema. Adotaram-se os preceitos metodológicos da pesquisa qualitativa, sendo o Discurso do Sujeito Coletivo o referencial metodológico. Foram entrevistadas 16 mulheres que vivenciaram a morbidade materna grave. Os resultados foram discutidos a partir de quatro temas: descrevendo o desejo e o planejamento para ter um filho, percebendo seu problema de saúde, sua influência na gestação e para o concepto, passando pelo choque inicial no pós-parto e experienciando a situação de risco: desejos, frustrações e superação. Espera-se que este trabalho possa contribuir para qualificar a assistência de enfermagem, especialmente para reconhecer a diversidade e amplitude de necessidades que mulheres apresentam em situações de morbidade grave, durante o ciclo gravídico puerperal.

Handling of female pacas (Agouti paca, Linnaeus, 1766) for ultrasound pregnancy detection

A paca é um roedor sul-americano cujo manejo, tranqüilização ou anestesia oferece um grande campo de pesquisa devido aos poucos artigos existentes. Doze pacas fêmeas adultas foram utilizadas, mantidas separadas em seis baias, sendo capturadas com um puçá de polipropileno e levadas a uma sala na qual se realizava a tricotomia abdominal. Após, os animais eram colocados em uma gaiola de ferro de compressão lateral. A sessão de ultra-sonografia era realizada em modo B com um transdutor setorial eletrônico de 5,0 e 7,5 MHz. Para a diminuição do estresse causado pelos procedimentos, a tranqüilização das fêmeas era realizada com diazepam e maleato de midazolam por via oral. Ambos demonstraram-se efetivos na tranqüilização das pacas previamente e durante as sessões, sendo que o maleato de midazolam proporcionou um melhor manejo dos animais.

Amniocentesis and biochemical evaluation of amniotic fluid in ewes at 70, 100 and 145 days of pregnancy

The objectives of this study were to determine the technical viability of amniocentesis in sheep and to observe biochemical changes in the amniotic fluid components. Amniotic fluid samples were collected by puncture in the greatest curvature of the uterine hum at days 70, 100, and 145 of pregnancy. The surgical procedure for collection of amniotic fluid samples was safe and efficient. For three stages of pregnancy, the following results were obtained: pH values 8.36, 7.34 and 7.37; glucose concentrations, 16.06. 8.58, and 3.79 g/dl; urea values, 42.68, 33.53, and 25.49 mg/dl; creatinine, 0.85, 5.04, and 11.25 g/dl; Gama-GT enzyme, 12.58, 14.20, and 12.30 UI/l; sodium concentrations, 146.60, 129.42, and 103.8 mmol/l: potassium concentrations, 9.79, 6.15, and 8.65 mmol/l; chloride, 96.59, 85.28, and 65.35 mmol/l; total protein, 0.14, 0.23, and 0.24 g/dl, respectively. (C) 2001 Elsevier B.V. B.V. All rights reserved.

Genetic evaluation of the probability of pregnancy at 14 months for Nellore heifers

To estimate the heritability for the probability that yearling heifers would become pregnant, we analyzed the records of 11,487 Nellore animals that participated in breeding seasons at three farms in the Brazilian states of São Paulo and Mato Grosso do Sul. All heifers were exposed to a bull at the age of about 14 mo. The probability of pregnancy was analyzed as a categorical trait, with a value of 1 (success) assigned to heifers that were diagnosed pregnant by rectal palpation about 60 d after the end of the breeding season of 90 d and a value of 0 (failure) assigned to those that were not pregnant at that time. The estimate of heritability, obtained by Method 9, was 0.57 with standard error of 0.01. The EPD was predicted using a maximum a posteriori threshold method and was expressed as deviations from 50% probability. The range in EPD was -24.50 to 24.55%, with a mean of 0.78% and a SD of 7.46%. We conclude that EPD for probability of pregnancy can be used to select heifers with a higher probability of being fertile. However, it is mainly recommended for the selection of bulls for the production of precocious daughters because the accuracy of prediction is higher for bulls, depending on their number of daughters.

Reduction in size of the ovulatory follicle reduces subsequent luteal size and pregnancy rate

We hypothesized that reducing the size of the ovulatory follicle using aspiration and GnRH would reduce the size of the resulting CL, reduce circulating progesterone concentrations, and alter conception rates. Lactating dairy cows (n=52) had synchronized ovulation and AI by treating with GnRH and PGF(2 alpha) as follows: Day -9, GnRH (100 mug); Day -2, PGF(2 alpha) (25 mg); Day 0, GnRH (100 mug); Day 1, AI. Treated cows (aspirated group; n=29) had all follicles > 4 mm in diameter aspirated on Days -5 or -6 in order to start a new follicular wave. Control cows (nonaspirated group; n=23) had no follicle aspiration. The size of follicles and CL were monitored by ultrasonography. The synchronized ovulation rate (ovulation rate to second GnRH injection; 42/52=80.8%) and double ovulation rate of synchronized cows (6/42=14.3%) did not differ (P > 0.05) between groups. Aspiration reduced the size of the ovulatory follicle (P < 0.0001; 11.5 +/- 0.2 vs 14.5 +/- 0.4 mm), and serum estradiol concentrations at second GnRH treatment (P < 0.0002; 2.5 +/- 0.4 vs 5.7 +/- 0.6 pg/mL). The volume of CL was less (P < 0.05) for aspirated than nonaspirated cows on Day 7 (2,862 +/- 228 vs 5,363 +/- 342 mm(3)) or Day 14 (4,652 +/- 283 vs 6,526 +/- 373 mm(3)). Similarly, serum progesterone concentrations were less on Day 7 (P < 0.05) and Day 14 (P < 0.10) for aspirated cows. Pregnancy rate per AI for synchronized cows was lower (P < 0.05) for aspirated (3/21=14.3%) than nonaspirated (10/21=47.6%) cows. In conclusion, ovulation of smaller follicles produced lowered fertility possibly because development of smaller CL decreased circulating progesterone concentrations. (C) 2001 by Elsevier B.V.

A comparative-analysis of glycosaminoglycans from human umbilical arteries in normal subjects and in pathological conditions affecting pregnancy

BACKGROUND: Vascular cells express different phenotypes in adult and fetal vessels, and the extracellular matrix they synthesize should reflect these differences. Alterations of vascular proteoglycan/glycosaminoglycan is verified in disorders such as hypertension and diabetes, and when occurring during pregnancy, they bring about structural changes to fetal vessels that often lead to impaired fetus growth. Yet there is little data about the extracellular matrix of an important human fetal vessel, the umbilical artery.EXPERIMENTAL DESIGN: This study involved the biochemical characterization of the extracellular matrix of normal umbilical arteries, umbilical arteries from complicated pregnancies (maternal hypertension and diabetes and intrauterine growth retardation syndrome), and, for purpose of comparison, normal adult arteries (aorta and iliac and pulmonary arteries). Although the collagen types I:III ratio was determined in some cases, emphasis was placed on analysis of glycosaminoglycans.RESULTS: Normal umbilical arteries differ from normal adult arteries in that they contain greater concentrations of hyaluronic acid and lesser concentrations of heparan sulfate and chondroitin 4-and 6-sulfate. The umbilical artery also differs from adult arteries in the disaccharide composition of its chondroitin and heparan sulfates and in the molecular weight of this latter glycosaminoglycan. The glycosaminoglycan distribution in umbilical arteries derived from complicated pregnancies is roughly similar to that of controls. However, total glycosaminoglycan and collagen were significantly reduced, and the collagen I:III ratio was increased in the umbilical arteries from hypertension-complicated pregnancies.CONCLUSIONS: the glycosaminoglycan composition of the normal umbilical artery, a fully differentiated tissue, differs in many aspects from that of normal adult arteries. of the cases of complicated pregnancies studied, the extracellular matrix of umbilical arteries was altered only in maternal hypertension. The changes, notably a mild fibrosis, were not very pronounced and should not impair hemodynamic properties of the vessel.

EFFECT OF EXERCISE DURING PREGNANCY AND DAM AGE ON MATERNAL BLOOD-CHEMISTRY AND FETAL GROWTH

In order to determine the effect of maternal exercise on maternal nutritional status and fetal growth, young (Y = 45-50 days old) Wistar rats were divided into 4 groups of 5 to 8 animals: control pregnant (CP), control non-pregnant (CNP), exercise-trained (swimming 1 h/day, 5 days/week, for 19 days) pregnant (TP) and exercise-trained non-pregnant (TNP). Four equivalent groups of adult rats (A - 90-100 days old) were also formed. Serum glucose, total protein, albumin, hematocrit and liver glycogen were determined in female rats and pups. There were no statistical differences in serum glucose, total protein and albumin levels, litter size ot birth weight among exercise-trained animals, controls and their respective pups. Hematocrit was significantly lower in pups of exercise-trained young rats than in all other groups (YCP = 38.6 +/- 3.0; YTP = 32.6 +/- 2.1; ACP = 39.0 +/- 2.5; ATP = 39.2 +/- 2.9%). Liver glycogen levels were lower in pregnant than in non-pregnant rats but similar in exercise-trained and control rats of the same age and physiological status (YCNP = 4.1 +/- 0.2; YCP = 2.7 +/- 0.9; YTNP = 4.9 +/- 0.8; YTP = 2.7 +/-0.4; ACNP = 6.1 +/- 0.6; ACP = 3.1 +/- 0.8; ATNP = 6.6 +/- 0.8; ATP = 2.2 +/- 0.9 mg/100 mg). We conclude that pups of adult female rats are spared from the effects of this kind of exercise training during pregnancy. on the other hand, it appears that maternal adaptations to exercise training in young rats are able to preserve only some aspects of pup metabolism.

Synchronization rate, size of the ovulatory follicle, and pregnancy rate after synchronization of ovulation beginning on different days of the estrous cycle in lactating dairy cows

Recently a protocol was developed that precisely synchronizes the time of ovulation in lactating dairy cows (Ovsynch; GnRH-7d-PGF(2 alpha)-2d-GnRH). We evaluated whether initiation of Ovsynch on different days of the estrous cycle altered the effectiveness of this protocol. The percentage of cows (n=156) ovulating to the first GnRH was 64% and varied (P<0.01) by stage of estrous cycle. Treatment with PGF(2 alpha) was effective, with 93% of cows having low progesterone at second GnRH. The overall percentage of cows that ovulated after second GnRH (synchronization rate) was 87% and varied by response to first GnRH (92% if ovulation to first GnRH vs 79% if no ovulation; P<0.05). There were 6% of cows that ovulated before the second injection of GnRH and 7% with no detectable ovulation by 48 h after second GnRH. Maximal diameter of the ovulatory follicle varied by stage of estrous cycle, with cows in which Ovsynch was initiated at midcycle having the smallest follicles. In addition, milk production and serum progesterone concentration on the day of PGF(2 alpha) affected (P<0.05) size of the ovulatory follicle. Using these results we analyzed pregnancy rate at Days 28 and 98 after Al for cows (n=404) in which Ovsynch was initiated on known days of the estrous cycle. Pregnancy rate was lower for cows expected to ovulate larger follicles than those expected to ovulate smaller follicles (P<0.05; 32 vs 42%). Thus, although overall synchronization rate with Ovsynch was above, 85%, there were clear differences in response according to day of protocol initiation. Cows in which Ovsynch was initiated near midcycle had smaller ovulatory follicles and greater pregnancy rates. (C) 1999 by Elsevier B.V.