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Introduction: To analyze the factors (socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures) associated with the birth of small for gestational age newborns. Methods: A cross-sectional study was performed with 15 years old or younger postpartum adolescents divided into small-for-gestational-age newborn (SGA) and non-small-for-gestational age newborn groups (NSGA). Socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures (triceps skinfold (TS), and mid-arm circumference, (MAC)) were collected. Results: 8,153 women gave birth at the obstetric ward and 364 (4.46%) = 15 years old adolescents were enrolled in the study. The proportion of SGA newborns was 34.61%. The SGA group attended fewer prenatal visits (p = 0.037), had a higher prevalence of nutritional status classified as "very low weight" (p < 0.001) and vaginal delivery (p = 0.023), compared to the NSGA group. The nutritional status and vaginal delivery remained significant even after adjustment for confounders. The prevalence risk for SGA birth was 30% higher in the group of mothers with nutritional status classified as "very low weight" (odds ratio 1.30, 95% confidence interval 1.13 to 1.50) (p < 0.001). Conclusions: 15.4% of adolescents ≤ 15 years of age had an arm circumference compatible with the "very low weight" condition, demonstrating the high prevalence of poor maternal nutritional status in this group. The birth of SGA among adolescents ≤ 15 years of age is independently associated with maternal nutritional status classified as "very low weight" by the mid-arm circumference measures (MAC). [ABSTRACT FROM AUTHOR]

Summary: Human verbal expression requires coordinated interaction among cortical, neuromuscular, and peripheral events. It is affected by hormonal factors and shows different characteristics in reproductive age and postmenopausal women. The [...]

Purpose: To evaluate the efficiency/safety of Brilliant Cresyl Blue (BCB) staining as a selection method of developmentally competent immature human oocytes.Materials and Methods: Immature oocytes of 32 pregnant women were recovered during cesarean section (CS). After retrieval, 92 oocytes were randomly divided into two groups: control (directly disposed to in vitro maturation - IVM) and treated - exposed to BCB 26 μM during 60 min. After staining, the treated group was classified as cytoplasm coloration, BCB positive (blue) or negative (colorless), and then disposed to IVM. Nuclear status was checked after 24 and 48 h of IVM. Nuclear maturation (polar body extrusion), meiosis resumption (absence of germinal vesicle) and degeneration rates were evaluated among the three groups (control, BCB positive and BCB negative) using Generalized Estimating Equations, followed by Bonferroni's correction for multiple comparisons.Results: Nuclear maturation was higher in BCB positive compared to BCB negative, after 24 and 48 h of IVM (p = .004 and p = .032). The control group was equal to BCB positive. There was no difference among groups analyzing meiosis resumption and degeneration rates.Conclusion: The BCB test can be a good marker in pre-selection procedures of developmentally competent human oocytes aspirated during CS. [ABSTRACT FROM AUTHOR]

Introduction: The prevention strategies for MTCT of HIV proposed by the World Health Organization (WHO) and other agencies have significantly reduced the number of infected children, child morbidity and mortality associated with HIV, and have improved maternal health. However, the detection rate of pregnant women with HIV in Brazil significantly increased in the last decade10. Objective: To evaluate factors that may interfere in mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Methods: A historical cohort study with a sample of 299 HIV-infected mothers and their newborns who delivered at the Obstetric Center of the Hospital de Clínicas de Porto Alegre, southern Brazil, from January 2010 to December 2014. Results: Of the 299 newborns of HIV-infected mothers, 3.7% (n = 11) were infected. Of those, 90.9% (n = 10) were born by cesarean section; 90.9% (n = 10) had ≥ 37 weeks; 54.6% (n = 6) received zidovudine starting within the first 4 hours after birth; and 45.4% (n = 5) received zidovudine and nevirapine. Four women whose newborns were infected with HIV had syphilis during pregnancy (36.4%). Poor adherence to highly active antiretroviral therapy (HAART) (p < 0.003), viral load ≥ 1000 copies/mL or ignored in the third trimester (p < 0.000), and CD4 count < 500 cells/mm3 in the third trimester (p < 0.046) were significantly associated with an increased risk of MTCT. Conclusions: Lack of control of risk factors may contribute to unfavorable rates of MTCT of HIV. [ABSTRACT FROM AUTHOR]

Background: A cohort study was performed to identify ovarian reserve markers (ORM) that predicts amenorrhea or oligomenorrhea 6 months after cyclophosphamide CTX in women with breast cancer. Methods: 52 eumenorrheic patients with breast cancer were enrolled. FSH, anti-Müllerian hormone (AMH), antral follicles count (AFC) were measured before and 6 months after CTX. A logistic regression for independent samples and determination of the ROC curve were performed. Results: The age of 32 years presented 96 % of sensitivity and 39 % of specificity to predict amenorrhea or oligomenorrhea with ROC area under the curve (AUC) of 0.77. ovarian reserve marker (ORM) with power to predict amenorrhea or oligomenorrhea in women after CTX were AMH <3.32 ng/mL (sensitivity of 85 %, specificity of 75 % and AUC 0.87), AFC <13 follicles (sensitivity 81 %, specificity 62 %, AUC 0.81). AMH cutoff to predict amenorrhea was 1.87 ng/mL (sensitivity 82 %, specificity 83 %, AUC 0.84) and AFC cutoff was 9 follicles (sensitivity 71 %, specificity 78 %, AUC 0.73). Conclusions: =32-years-old women, AMH <3.32 ng/mL and AFC <13 follicles determined significantly higher risk of amenorrhea or oligomenorrhea after CTX with cyclophosphamide. The ORM age (≥32 years) analyzed together with AMH or AFC increases sensitivity and specificity in predicting amenorrhea or oligomenorrhea. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The use of a postcoital hormonal contraception regimen has been described and is known as emergency contraception (EC) or "the morningafter pill". The aim of this study was to evaluate the use and level of knowledge about emergency oral contraception (EC) among women attending the gynecology outpatient clinic of the Hospital Fundação Santa Casa de Misericórdia of the State of Pará, the second largest state in the Brazilian Amazon. METHODS: A cross-sectional study was conducted with 316 sexually active women, aged 18 to 50 years, who attended the gynecology outpatient clinic. Participants were included based on spontaneous demand between June and July 2012. Patients answered a questionnaire with 29 questions, including: age in years, educational attainment, knowledge about EC, and previous use of the method. The primary outcome was knowledge on EC use. RESULTS: Participants' mean age was 31.84 years (SD ± 8.00). As for their educational level, 46.84% of them had completed high school, and only 8.55% had higher education. Most of the women obtained information about EC through friends (48.61%, n = 152), and only 7.30% from their doctors. Although most participants (83.54%) reported to be aware of the method, only 0.63% reported that EC could be used up to 5 days after unprotected intercourse; 57.59% did not know how to use it; and 76.58% (n = 242) had never used the method. CONCLUSION: The women in our study seem to have a high level of knowledge and prevalence of use of emergency contraception, although few of them knew about the time limit for its use. They should receive more information about emergency contraception. [ABSTRACT FROM AUTHOR]

Background: To develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control and evaluate the safety and feasability of monopolar cauterization to cause ovarian injury using female cattle of reproductive age as an experimental model. Method: Experimental study in a university research center was performed. Eleven female bovines of reproductive age were submitted to monopolar transvaginal ovarian cauterization. The right ovary (RO) was punctured at four sites and 40 W was applied for 5 s at each point, resulting in a total of 800 J (Joules) of thermal energy. In the left ovary (LO), the procedure was similar, with the same time and 80 W, resulting in a thermal energy of 1600 J. Macroscopic and microscopic lesions were assessed. Results: Of 22 ovaries punctured, 20 were cauterized and exhibited macroscopic and typical microscopic lesions. No lesions could be found in the needle path. The measures of the areas of microscopic electrocautery lesions calculated estimating a cylindrical volume showed a median of 1.12% in the right ovary and 1.65% in the left ovary. When the estimate was calculated by spherical shape, the medians were 1.77% in the right ovary and 3.06% in the left ovary. There was a statistically significant difference in these two estimates (sphere, p = 0.008; cylinder, p = 0.021). Conclusion: The experimental animal model described for transvaginal ultrasound-guided ovarian needle cauterization seems to be feasible. The ovaries were successfully cauterized without injuries in needle path and more energy resulted in significantly more thermal lesion. The safety and effectiveness of this technique, theoretically less invasive than current ovarian drilling methods, could be tested in anovulatory women with PCOS. [ABSTRACT FROM AUTHOR]

Background/aim: Granulosa cells are the source of the most important ovarian steroids. Even in patients without significant improvement in metabolic parameters, metformin has apparently an important effect on the ovary. The aim of this study was to evaluate gene and protein expression of an insulin receptor (IR), insulin-like growth factor-1 (IGF1) receptor (IGF1R) and aromatase in granulosa cells treated with metformin and insulin., Methods: Luteinized granulosa cells were collected from 27 patients during in vitro fertilization procedures. Cells were isolated, stored in culture for 24 h and divided into four groups: control; metformin for 30 min, and metformin for 30 min plus insulin for 30 or 60 min., Results: IR and IGF1R mRNA expression was significantly enhanced by metformin but was not affected by insulin. Aromatase mRNA expression was significantly reduced in metformin-incubated cells following stimulation with insulin for 30 min. No statistical differences were found in IGF1R and aromatase protein expression, and IR expression was not detected., Conclusion: A direct effect of metformin on the gene expression of IGF1R, IR and aromatase was observed. Further studies should investigate the role of IGF1R, IR and aromatase in ovarian physiology for a better understanding of the effect of metformin., (© 2014 S. Karger AG, Basel.)

Objective: The aim of this study was to analyze the association between glucose infusion during intermittent physical exercise and its metabolic effects on rats., Design: Forty male rats were divided into eight groups based on training (intermittent), exercise and carbohydrate intake (glucose 20%): TEC (trained exercised with carbohydrate), TES (trained exercised without carbohydrate), TNC (trained non-exercised with carbohydrate), TNS (trained non-exercised without carbohydrate), UEC (untrained exercised with carbohydrate), UES (untrained exercised without carbohydrate), UNC (untrained non-exercised with carbohydrate) and UNS (untrained non-exercised without carbohydrate). The training and/or exercise protocol consisted of the rats running on a treadmill for 1 min above the lactate threshold, or running below the lactate threshold for 30s, intermittently for 30 min. Blood was analyzed for glycemia, lactate and IGF-1. Muscle and liver glycogen were measured (T2)., Results: Glycemia was found to be different in T2 compared to T1 in the TEC, TNC, UEC and UNC groups. Lactate was higher in T2 than in T1, but remained within the lactate threshold. Glycogen showed higher concentrations in the trained groups and, whether trained or not, in the supplemented groups. IGF-1 levels were higher in exercised rats independent of supplementation or glycogen levels. Trained rats showed lower IGF-1 when exercising than did the untrained animals., Conclusions: We conclude that intermittent exercise is beneficial in preventing a trained lactate pool, and that, in association with glucose supplementation, intermittent exercise will be efficient both in preventing a trained lactate pool and in maintaining sufficient glycemia levels. Exercise raises IGF-1 levels, whereas training inverts this relationship.

During the female vital cycle verbal processes are influenced by secondary effects of steroid hormones. Verbal expression abilities favor more effective interpersonal communications. Verbal motor fluency is produced by the synchronization among voice, resonance and articulation. The present study compared phono-articulatory characteristics between women in reproductive age and postmenopause. Acoustic variations in vocal intonation, speed of the speech and the pause pattern were measured. Forty-five reproductive age women with regular menstrual cycles and taking no hormonal contraceptives and 45 postmenopause women receiving no hormonal replacement therapy for at least 3 years were interviewed and their verbal productions were recorded. Acoustic analyses were performed using the Kay Elemetrics Motor Speech Profile. Student's t-test was employed to compare data between the two groups when they presented normal distribution, and Mann-Whitney test when they were asymmetrical. Results showed that in the postmenopause group pause pattern was longer, the speed of the speech was slower, there was a vocal deepening without reduction of the vocal extension and there was also less vocal stability. A better understanding in this field will make possible to elaborate strategies to offer a better life quality for postmenopausal women.