Rat visceral yolk sac cells: viability and expression of cell markers during maternal diabetes

The function of the visceral yolk sac (VYS) is critical for embryo organogenesis until final fetal development in rats, and can be affected by conditions such as diabetes. In view of the importance of diabetes during pregnancy for maternal and neonatal health, the objective of this study was to assess fetal weight, VYS cell markers, and viability in female Wistar rats (200-250 g) with induced diabetes (alloxan, 37 mg/kg) on the 8th gestational day (gd 8). At gd 15, rats from control (n=5) and diabetic (n=5) groups were anesthetized and laparotomized to remove the uterine horns for weighing of fetuses and collecting the VYS. Flow cytometry was used for characterizing VYS cells, and for determining mitochondrial activity, cell proliferation, DNA ploidy, cell cycle phases, and caspase-3 activity. Fetal weight was reduced in the diabetic group. Expression of the cell markers CD34, VEGFR1, CD115, CD117, CD14, CCR2, CD90, CD44, STRO-1, OCT3/4, and Nanog was detected in VYS cells in both groups. In the diabetic group, significantly decreased expression of CD34 (P<0.05), CCR2 (P<0.001), and OCT3/4 (P<0.01), and significantly increased expression of CD90 (P<0.05), CD117 (P<0.01), and CD14 (P<0.05) were observed. VYS cells with inactive mitochondria, activated caspase-3, and low proliferation were present in the rats with diabetes. Severe hyperglycemia caused by maternal diabetes had negative effects on pregnancy, VYS cell viability, and the expression of cell markers.

Nutritional factors in milk from Brazilian mothers delivering small for gestational age neonates

The composition of breast milk from brazilian mothers delivering low birthweight infants and its adequacy as a source of nutrients for this group has not yet been fully elucidated. A total of 209 milk samples from 66 women were analysed. The mothers were divided into three groups: G1, mothers delivering term babies of low birthweight (TSGA, n=16); G2, mothers delivering preterm babies of appropriate birthweight (PTAGA, n=20); G3, mothers delivering term babies of appropriate birthweight (TAGA, n=30). The following factors were analysed: osmolarity, total proteins and protein fractions, creamatocrit, sodium, potassium, calcium and magnesium. Milk samples were collected 48 h and 7, 15, 30 and 60 days after delivery. The groups did not differ significantly in terms of osmolarity, total proteins and fractions, creamatocrit, calcium, magnesium or potassium throughout the study period. Sodium levels were higher in all samples from mothers of TSGA infants and in samples from mothers of PTAGA infants on the 7th, 15th and 30th days than in milk from the TAGA group. The authors consider the needs of the low birthweight and TAGA infants and that these high sodium levels may be necessary for growth of low birthweight infants.

Obesity and gestational weight gain: cesarean delivery and labor complications

OBJECTIVE: To assess the association between pre-gestational obesity and weight gain with cesarean delivery and labor complications. METHODS: A total of 4,486 women 20-28 weeks pregnant attending general prenatal care clinics of the national health system in Brazil from 1991 to 1995 were enrolled and followed up through birth. Body mass index categories based on prepregnancy weight and total weight gain were calculated. Associations between body mass index categories and labor complications were adjusted through logistic regression analysis. RESULTS: Obesity was present in 308 (6.9%) patients. Cesarean delivery was performed in 164 (53.2%) obese, 407 (43.1%) pre-obese, 1,045 (35.1%) normal weight and 64 (24.5%) underweight women. The relative risk for cesarean delivery in obese women was 1.8 (95% CI: 1.5-2.0) compared to normal weight women. Greater weight gain was particularly associated with cesarean among the obese (RR 4th vs 2nd weight gain quartile 2.2; 95% CI: 1.4-3.2). Increased weight at the beginning of pregnancy was associated with a significantly higher adjusted risk of meconium with vaginal delivery and perinatal death and infection in women submitted to cesarean section. Similarly, greater weight gain during pregnancy increased the risk for meconium and hemorrhage in women submitted to vaginal delivery and for prematurity with cesarean. CONCLUSIONS: Pre-gestational obesity and greater weight gain independently increase the risk of cesarean delivery, as well as of several adverse outcomes with vaginal delivery. These findings provide further evidence of the negative effects of prepregnancy obesity and greater gestational weight gain on pregnancy outcomes.

An estimation of the frequency of gestational toxoplasmosis in the Brazilian Federal District

Acute infections by the protozoan Toxoplasma gondii during pregnancy (gestational toxoplasmosis) are known to cause serious health problems to the fetus (congenital toxoplasmosis). In Brasília, there have been few studies on the incidence of toxoplasmosis. This report summarizes a retrospective study performed on 2,636 selected pregnant women attended by the public health system of Guará, a satellite-city of Brasília. In this survey, 17 cases of gestational toxoplasmosis were detected; 15 of which were primary maternal infection and the remaining 2 were consistent with secondary maternal infection. These results suggest an annual seroconversion rate of 0.64 percent (90 percent confidence interval: 0.38, 0.90).

Gastric myoelectrical activity in neonates of different gestational ages by means of electrogastrography

PURPOSE: to describe the patterns of the gastric myoelectrical activity, pre-and postprandially, in clinically stable neonates of different gestational ages, during their first two weeks of life by means of Electrogastrography. PATIENTS AND METHODS: Electrogastrography was recorded in forty-five clinically stable neonates of different gestational ages (group I: 15 neonates of > 37 weeks, group II: 15 premature neonates of 32-37 weeks; Group III: 15 premature neonates of 28-31 weeks) receiving intermittent enteral feedings during their first two weeks of life. Electrogastrography recordings were performed for 1 hour pre-and postprandially. The Electrogastrography signal was recorded using the portable MicroDigitrapper Electrogastrography recording device and after motion artifacts were deleted, the remaining Electrogastrography data were submitted to quantitative analysis based on the "Running Spectrum Analysis". RESULTS: The percentages of normogastria, pre-and postprandially were greater than the percentages of gastric dysrythmias in all three studied groups. Furthermore, all neonates had the mean values of the Electrogastrography dominant frequency predominantly within the normogastria range, in both periods analyzed. There were no significant differences in the relative change of the Electrogastrography dominant power among the groups. CONCLUSION: This study demonstrates that the Electrogastrography patterns are similar between premature and full term neonates during the pre-and postprandial periods. The results of this study also indicate that the gastric myoelectrical activity in premature and full term neonates is immature, as compared to that described for older neonates, children and adults.

Blood Pressure Variation Throughout Pregnancy According to Early Gestational BMI: A Brazilian Cohort

Background: The maternal cardiovascular system undergoes progressive adaptations throughout pregnancy, causing blood pressure fluctuations. However, no consensus has been established on its normal variation in uncomplicated pregnancies. Objective: To describe the variation in systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels during pregnancy according to early pregnancy body mass index (BMI). Methods: SBP and DBP were measured during the first, second and third trimesters and at 30-45 days postpartum in a prospective cohort of 189 women aged 20-40 years. BMI (kg/m2) was measured up to the 13th gestational week and classified as normal-weight (<25.0) or excessive weight (≥25.0). Longitudinal linear mixed-effects models were used for statistical analysis. Results: A decrease in SBP and DBP was observed from the first to the second trimester (βSBP=-0.394; 95%CI: -0.600- -0.188 and βDBP=-0.617; 95%CI: -0.780- -0.454), as was an increase in SBP and DBP up to 30-45 postpartum days (βSBP=0.010; 95%CI: 0.006-0.014 and βDBP=0.015; 95%CI: 0.012-0.018). Women with excessive weight at early pregnancy showed higher mean SBP in all gestational trimesters, and higher mean DBP in the first and third trimesters. Excessive early pregnancy BMI was positively associated with prospective changes in SBP (βSBP=7.055; 95%CI: 4.499-9.610) and in DBP (βDBP=3.201; 95%CI: 1.136-5.266). Conclusion: SBP and DBP decreased from the first to the second trimester and then increased up to the postpartum period. Women with excessive early pregnancy BMI had higher SBP and DBP than their normal-weight counterparts throughout pregnancy, but not in the postpartum period.

Neopolystoma fentoni n. sp. (Monogenea: Polystomatidae) a parasite of the conjunctival sac of freshwater turtles in Costa Rica

Neopolystoma fentoni n. sp. is described from the conjunctival sac of Kinosternon leucostomum (Duméril, Bibron, and Duméril 1851) and Rhinoclemmys pulcherrima (Gray 1855) from the Guanacaste Conservation Area in Costa Rica. The new species differs from all other species of Neopolystoma, except N. elizabethae Platt 2000 in possessing a circle of eight genital spines that are recurved and possess a crescent-shaped base. N. fentoni n. sp. differs from N. elizabethae in lacking cecal diverticula and in a number of morphometric criteria.

Preliminary results on the effects of CD40/CD40L interactions and SAC-induction on IFN-gamma expression in human schistosomiasis

In this communication the authors analyzed the pattern of expression of IFN-gamma as a surrogate type 1 response in different clinical forms of schistosomiasis in response to stimulation involving T-cell dependent and T-cell independent pathways, to investigate which pathways were functional in human schistosomiasis, and to further characterize the nature of Th1 response impairment in this parasitic disease.

A new species of Homalocerus Schoenherr from the Atlantic coast of the State of São Paulo, Brazil (Coleoptera, Belidae, Belinae), with notes on color pattern and on the sclerites of the internal sac

A new species of Homalocerus Schoenherr from the Atlantic coast of the State of São Paulo, Brazil (Coleoptera, Belidae, Belinae), with notes on color pattern and on the sclerites of the internal sac. Homalocerus bimaculatus sp. nov. (type locality: Brazil, São Paulo) is described and illustrated, and comments on the sclerites of the internal sac of aedeagus and on color pattern are provided. The new species is compared to other similar species of the genus, being distinguished by having three clusters of carmine pubescence on pronotum and two lateral whitish oval spots located slightly before the middle of each elytron. Six species of Homalocerus, including the new one, are known from the State of São Paulo. The previously published identification key for species of Homalocerus is updated to include H. bimaculatus.

Unidades combinadas RAFA-SAC para tratamento de água residuária de suinocultura – parte II nutrientes

RESUMO Neste trabalho, avaliou-se o efeito combinado de duas unidades de tratamento na remoção de nitrogênio total Kjeldahl (NTK) e fósforo total (PT). As unidades avaliadas receberam alimentação contínua, sendo um reator anaeróbio de manta de lodo e fluxo ascendente tipo RAFA, com volume útil de 96 L, seguido de um sistema alagado construído (SAC) com capacidade para 237 L. O experimento foi conduzido em três fases, variando o tempo de detenção hidráulica (TDH) no reator anaeróbio de: 59 h, 19,5 h e 5 h, e no SAC 146 h, 48 h e 13 h, respectivamente, nas fases I, II e III. A carga orgânica volumétrica (COV) aplicada foi de 1,2; 1,3 e 13,0 kg m-3 d-1 de DQO no RAFA, e as taxas de aplicação superficial (TAS) no SAC foram de 120, 130 e 464 kg ha-1d-1 de NTK e 13; 51 e 240 kg ha-1 d-1de PT e de 850; 656 e 6.335 kg ha-1 d-1 de DQO. As eficiências de remoção de NTK e PT no sistema como um todo foram de, aproximadamente, 35%, não havendo diferença significativa entre as fases. Porém, em termos de COV removida, houve maior remoção com o aumento da carga aplicada. As características apresentadas pelo efluente do sistema nas diferentes fases não alcançaram os padrões ambientais para lançamento em cursos de água no Estado de Minas Gerais, dentre as variáveis avaliadas, mas seu potencial nutricional deve ser utilizado para produção agrícola.

Unidades combinadas RAFA-SAC para tratamento de água residuária de suinocultura – parte I carga orgânica removida

RESUMO Na pecuária brasileira, tem-se destacado a suinocultura, cuja produção de carne foi apontada como a terceira maior do mundo, e como contrapartida os sistemas produtivos são, potencialmente, poluidores do ambiente. Os sistemas anaeróbios têm sido utilizados para tratamento de água residuária suinícola, necessitando de complementação para diminuir as cargas de nutrientes e reúso agrícola. Neste trabalho, avaliou-se o efeito combinado de duas unidades de tratamento na remoção de matéria orgânica, na forma de demanda química de oxigênio (DQO), sendo um reator anaeróbio de manta de lodo e fluxo ascendente tipo RAFA com volume útil de 96 L, seguido de um sistema alagado construído (SAC) com capacidade para 237 L. O experimento foi conduzido em três fases, variando-se o tempo de detenção hidráulica (TDH) no reator anaeróbio, de 59 h, 19,5 h e 5 h, e no SAC, 146 h, 48 h e 13 h, respectivamente, nas fases 1, 2 e 3. A carga orgânica volumétrica (COV) aplicada foi de 1,2; 1,3 e 13,0 kg m-3d-1 de DQO, e as taxas de aplicação superficial (TAS) no SAC foram de 850; 656 e 6335 kg ha-1 d-1 de DQO. As unidades combinadas removeram 0,07; 0,07 e 0,96 kg d-1 de DQO total e 0,03; 0,07 e 0,14 kg d-1 de DQO solúvel. As características apresentadas pelo efluente do sistema, nas diferentes fases, não alcançaram os padrões ambientais para lançamento em cursos de água, dentre as variáveis avaliadas.

Uterine Doppler velocimetry of the uterine arteries in the second and third trimesters for the prediction of gestational outcome

PURPOSE: The aim of this longitudinal study was to investigate the value of uterine artery Doppler sonography during the second and third trimesters in the prediction of adverse pregnancy outcome in low-risk women. METHODS: From July 2011 to August 2012, a total of 205 singleton pregnant women presenting at our antenatal clinic were enrolled in this prospective study and were assessed for baseline demographic and obstetric data. They underwent ultrasound evaluation at the time of second and third trimesters, both included Doppler assessment of bilateral uterine arteries to determine the values of the pulsatility index (PI) and resistance index (RI) and presence of early diastolic notch. The endpoint of this study was assessing the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasonography of the uterine artery, for the prediction of adverse pregnancy outcomes including preeclampsia, stillbirth, placental abruption and preterm labor. RESULTS: The mean age of cases was 26.4±5.11. The uterine artery PI and RI values for both second (PI: 1.1±0.42 versus 1.53±0.59, p=0.002; RI: 0.55±0.09 versus 0.72±0.13, p=0.000 respectively) and third-trimester (PI: 0.77±0.31 versus 1.09±0.46, p=0.000; RI: 0.46±0.10 versus 0.60±0.14, p=0.010 respectively) evaluations were significantly higher in patients with adverse pregnancy outcome than in normal women. Combination of PI and RI >95th percentile and presence of bilateral notch in second trimester get sensitivity and specificity of 36.1 and 97% respectively, while these measures were 57.5 and 98.2% in third trimester. CONCLUSIONS: According to our study, it seems that uterine artery Doppler may be a valuable tool for the prediction of a variety of adverse outcomes in second and third trimesters.

Diagnosis, classification and treatment of gestational trophoblastic neoplasia

Gestational trophoblastic neoplasia (GTN) is the term to describe a set of malignant placental diseases, including invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. Both invasive mole and choriocarcinoma respond well to chemotherapy, and cure rates are greater than 90%. Since the advent of chemotherapy, low-risk GTN has been treated with a single agent, usually methotrexate or actinomycin D. Cases of high-risk GTN, however, should be treated with multiagent chemotherapy, and the regimen usually selected is EMA-CO, which combines etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine. This study reviews the literature about GTN to discuss current knowledge about its diagnosis and treatment.

Treatment of low-risk gestational trophoblastic neoplasia comparing biweekly eight-day Methotrexate with folinic acid versus bolus-dose Actinomycin-D, among Brazilian women

PURPOSE: To compare two single-agent chemotherapy (ChT) regimens evaluating, in first-line treatment, response and side effects and, in final single-agent treatment, the outcomes, among Brazilian patients with low-risk gestational trophoblastic neoplasia (GTN), according to International Federation of Gynecology and Obstetrics (FIGO) 2002. METHODS: Retrospective analysis of two concurrent cohorts with 194 low-risk GTN patients: from 1992 to 2012, as first-line treatment, 115 patients received 4 intramuscular doses of methotrexate alternated with 4 oral doses of folinic acid (MTX/FA) repetead every 14 days and, since 1996, 79 patients received an endovenous bolus-dose of actinomycin D (Act-D), biweekly. At GTN diagnosis, patient opinion was taken into consideration when defining the initial single-agent ChT regimen, and when there was resistance or toxicity to one regimen, the other drug was used preferentially. This study was approved by the Irmandade da Santa Casa de Misericórdia de Porto Alegre Ethical Committee. RESULTS: Both groups were clinically similar (p>0.05). In first-line treatments, frequency of complete response was similar (75.7% with MTX/FA and 67.1% with bolus Act-D); the number of ChT courses -median 3 (range: 1-10) with MTX/FA and 2 (range: 1-6) with bolus Act-D - and the time to remission -median 9 weeks (range: 2-16) with MTX/FA and 10 weeks (range: 2-16) with bolus Act-D) - were not different between the groups. In both groups, first-line side effects frequency were high but intensity was low; stomatitis was higher with MTX/FA (p<0.01) and nausea and vomit with Act-D (p<0.01). Final single-agent ChT responses were high in both groups (94.8% with MTX/FA and 83.5% with bolus Act-D; p<0.01) and 13% higher in the group initially treated with MTX/FA. Rates of hysterectomy and of GTN recurrence were low and similar. No patient died due to GTN. CONCLUSION: The two regimens had similar first-line ChT response. Final single-agent response rates were high and similar in both groups but the final single-agent remission rate was higher in the MTX/FA group.

Ovule ontogeny of Tabebuia pulcherrima Sandwith (Bignoniaceae): embryo sac development

The chalazal megaspore develops in a Polygonum-type embryo sac. The amyloplast-rich endothelium is partially degraded during the expansion of the micropylar portion of the megagametophyte. Organization of the mature embryo sac is determined by the patterns of vacuolation, nuclear migration, spindle orientation and cellularization. The egg cell is slightly chalazal in relation to the synergids, and its micropylar end does not touch the micropylar channel. At the chalazal pole of the egg apparatus, the common walls between the synergids, the egg and central cells, despite their tenuity, are present in the mature megagametophyte. The polar nuclei do not fuse before fertilization and the antipodals are persistent until the first stages of endosperm formation. The taxonomic significance of some embryological characters for the Bignoniaceae is discussed.