Paulo Roberto Bezerra de Mello

The influence of smoking on fertility, pregnancy and lactation

OBJECTIVE: To decribe the influence of smoking on different phases of the reproductive process, fecundation, pregnancy and lactation, drawing special attention to the mechanisms of action of the main toxic components found in cigarettes. To suggest prophylactic measures for environmental control and how to reduce childreńs exposure to tobacco smoke. METHODS: Nonsystematic literature review using MEDLINE database. RESULTS: Smoking has a negative effect on different phases of the reproduction process, by direct action of main toxic components, nicotine and carbon monoxide. Smoking reduces fertility, compromises the length of gestation and infant birthweight. Smoking mothers also have reduced breast milk production and shorter lactation, which affects infant weight gain through unclear mechanisms in which prolactin may probably be involved. CONCLUSIONS: Smoking compromises reproductive function quality in different phases, acting mainly on intrauterine and extrauterine development of infants. Since during pregnancy and lactation women are in closer contact with health professionals, antismoking campaigns should be especially addressed to this period.

Perioperative administration of probiotics: effects on immune response, anastomotic resistance and colonic mucosal trophism

PURPOSE To investigate the effects of perioperative administration of diet containing probiotics on the immune response, anastomotic resistance, and colonic mucosal trophism in rats underwent left-sided colonic anastomosis. METHODS Sixty adults Wistar rats were randomized to two groups (A and B) with 30 animals each to receive or not a diet supplemented with probiotics (Streptococcus thermophilus e Lactobacillus helveticus) during pre- and postoperative period. They underwent laparotomy followed by left colon section and immediate anastomosis. Groups of 15 animals were killed either on the 4th (groups A1 and B1) or 7th PO (groups A2 and B2) days. The outcome variables were serum proteins, albumin, globulins and IgA, length and weight of the colon, mucosal weight, DNA content and anastomotic bursting pressure. RESULTS Colonic weight was greater in probiotic group compared to controls (1.69+/-0.34 g vs 1.48+/-0.26 g; p<0.05). Total serum proteins and globulin were higher in probiotic animals (proteins = 7.05+/-0.97 g/dl vs 6.57+/-0.66 g/dl e globulins = 5.1+/-0.62 g/dl vs 4.68+/-1.1 g/dl; p<0.05). Serum IgA increased from basal to post-operative days only in the probiotic group (p<0.01). CONCLUSIONS Perioperative probiotics enhanced the immune response and colonic weight. Probiotics failed to increase anastomotic resistance.

Desempenho nas habilidades da linguagem em crianças nascidas prematuras e com baixo peso e fatores associados

Purpose: To examine the language development at chronological age 2 to 3 years of children born preterm with low birth weight and its associated risk factors. Methods In this cross-sectional study, children were assessed using the Denver Developmental Screening Test (Denver II test) and Early Language Milestone Scale (ELM scale). The chi-square test was used and all variables with p<0.20 were entered in a binary logistic regression model; statistical significance was set at p<0.05. Results Among the 77 children studied, 36.4% had abnormal Denver II test performance in its four sectors and 37.6% had cautions and delays in the area of language specifically. On assessment of language ability by the ELM scale, 32.5% of the children showed altered responses. The abnormal performance of the four sectors of the Denver II and language in the ELM scale, after logistic regression, remained associated with suspected developmental abnormalities by parents (Denver II and ELM), weight less than 1500 g and caesarean section (Denver II only), and intracranial hemorrhage and family per capita income less than half the minimum wage (ELM only). Conclusion Children born preterm with low birth weight showed delayed language development, with greater impairment in the expressive auditory function associated with socioeconomic risk factors and child’s history.

Influência da exposição a fumaça lateral do cigarro sobre o ganho de peso e o consumo alimentar de ratas gestantes: análise do peso e do comprimento dos filhotes ao nascimento

OBJETIVOS: analisar o efeito do tabagismo sobre o ganho ponderal e o consumo alimentar de ratas durante a gestacao, e o peso e comprimento dos filhotes ao nascimento. METODOS: foram estudadas 51 ratas (Wistar) do 2o dia ate o final da gestacao, divididas em tres grupos: Grupo F: 15 ratas expostas a fumaca de dois cigarros/animal/dia + ar comprimido (10 L/min); Grupo Ar: 18 ratas expostas ao ar comprimido (10 L/min); Grupo C: 18 ratas nao manipuladas e nao expostas. Os parâmetros aferidos foram: peso das ratas e seu consumo alimentar e comprimento e peso dos filhotes ao nascer. Foi aplicado o teste de Lavene para verificacao do comportamento da distribuicao das variaveis numericas, e para analises parametricas utilizou-se o ANOVA ou teste t de Student, conforme o caso. O nivel de significância adotado foi p<0,05. RESULTADOS: as ratas expostas ao tabaco consumiram menos alimentos por dia [Grupo F=18,9 (±1,2) vs Grupo Ar=21,7 (±1,6) vs Grupo C=24,2 (±1,7); (p<0,05)] e apresentaram menor ganho ponderal ao final da gestacao em relacao as ratas expostas ao ar comprimido e ao grupo controle: peso no vigesimo dia de gestacao: Grupo F=338,9 g (±13,8) vs Grupo Ar=352,3g (±15,9) vs Grupo C=366,3 g (±13,1); p<0,001). O peso dos filhotes ao nascimento [(Grupo F=5,5 g (±0,3); Grupo Ar=5,9 g (±0,5); Grupo C=5,9 g (±0,4) p<0,01] e o comprimento ao nascer [Grupo F=6,8 cm (±0,2); Grupo Ar=6,9 cm (±0,2); Grupo C=6,9 cm (±0,1) p<0,05] foram significativamente menores no grupo de ratas expostas ao tabaco em relacao aos outros dois grupos, que nao diferiram entre si. CONCLUSOES: a exposicao ao tabaco reduziu o ganho ponderal e o consumo alimentar das ratas durante a gestacao e produziu reducao do peso e do comprimento dos filhotes ao nascimento.

Late preterm infants’ motor development until term age

OBJECTIVES: To analyze the motor development of late preterm newborn infants (LPI) from birth to term-corrected age using the Test of Infant Motor Performance (TIMP) and to compare the obtained results with those of term infants at birth. METHODS: Prospective cohort study, 29 late preterm newborn infants were evaluated by the TIMP at birth and every two weeks until term-corrected age. The TIMP was administered to 88 term infants at birth. RESULTS: The mean TIMP score of late preterm newborn infants was 51.9±5.8 at 34–35 weeks and 62.6±5.2 at 40 weeks. There was a significant increase at 38–39 weeks in the LPI group (p<0.05). There were no significant differences in the motor evaluations between term infants at birth and LPI at the equivalent age. CONCLUSION: The LPI presented a gradual progression of motor development until the term-corrected age, but differences with term infants at birth were not detected.

The agreement between two screening tests for language evaluation in premature and low weight children

Objetivos: avaliar a concordância dos resultados da linguagem de dois testes de triagem do desenvolvimento infantil - Denver II e Early Language Milestone Scale (ELM) em criancas de dois a tres anos de idade cronologica, nascidas prematuras e com baixo peso. Metodos: estudo observacional descritivo transversal atraves da aplicacao dois instrumentos de triagem de desenvolvimento: Denver II e a ELM (Early Language Milestone Scale). A concordância entre o teste de Denver II e seu setor de linguagem e a ELM foi avaliada pelo coeficiente Kappa. Resultados: das 77 criancas avaliadas, 36,3% tiveram prejuizo global do desenvolvimento pelo Denver II e 32,5% prejuizo da linguagem pela ELM. A concordância entre os resultados do teste de Denver II considerando todos os setores versus ELM mostrou coeficiente Kappa de 0,856 (p<0,001) e considerando somente o setor da linguagem do Denver II versus ELM o coeficiente Kappa foi de 0,886 (p<0,001). Conclusoes: o comprometimento do desenvolvimento observado nas criancas estudadas atraves da avaliacao do Denver II e atraves do seu setor de linguagem mostrou concordância com as alteracoes de habilidades de linguagem observadas na ELM.