Occurrence Of Abortion Research Articles

Sero-prevalence of bovine brucellosis and its risk factors in Jimma zone of Oromia Region, South-western Ethiopia

A cross sectional sero-prevalence study was conducted on 1,595 cattle in Jimma zone, Ethiopia to investigate the status of bovine brucellosis and identify potential risk factors. Sera samples were analyzed using Rose Bengal Plate Test (RBPT) and Complement Fixation Test (CFT). The overall individual and herd level sero-prevalences were 3.1% (n = 1,595) and 15.0% (n = 227), respectively. The sero-prevalence of bovine brucellosis at individual animal level was significantly higher in non-pregnant (11.18%) than pregnant (2.77%) and lactating (22.35%) than non-lactating animals (2.46%). Moreover, significantly higher sero-prevalence was observed in herds of larger sizes. Individual animal sero-prevalence was also positively associated with the occurrence of abortion (26.98 and 1.54% in those with and without previous history of abortion, respectively). Generally, the sero-prevalence of bovine brucellosis found in Jimma area was not high and the sero-prevalence was closely associated with some of the risk factors considered at individual animal and herd level.

Minors' Behavioral Responses to Parental Involvement Laws: Delaying Abortion Until Age 18

Prior research on the effect of laws mandating parental involvement in minors' abortions has failed to examine an important behavioral response to such laws: Older teenagers may delay an abortion until age 18; for some, this may mean terminating a pregnancy after the first trimester. Statewide data were obtained on abortions in Texas in 1997-2003. Analysis of relative rate ratios with narrowly defined comparison groups was used to evaluate the association between Texas's parental notification law and the occurrence of second-trimester abortions among minors who have responded to the law by delaying abortion until age 18. In the four years after the law went into effect, the proportion of abortions obtained at age 18 increased by six percentage points among minors who conceived at age 17 years and eight months, and by 13 points among those who did so at 17 years and nine months. As a result, the second-trimester abortion rate of these groups combined increased by 21%; by contrast, there was no evidence of an increase in this rate among younger minors, for whom delaying the abortion until age 18 was not feasible. Some minors postpone abortion until the second or even third trimester of pregnancy to circumvent parental notification requirements. Given the greater costs of and medical risks associated with late-term abortions, policymakers should not ignore this behavior.

Effects of restricted feeding on blood parameters in pregnant rabbits

The effects of restricted feeding (20 g/day from gestational day (GD) 6 to 28) on pregnancy outcome and blood parameters were examined in pregnant rabbits. As compared with the group which was allowed free access to diet throughout the gestational period (NT group), the group subjected to restricted feeding (R group) showed significantly lower values in many parameters such as total protein, albumin and triglyceride on GDs 22 and 28, reflecting low nutritive conditions. In addition, there were significant changes in blood coagulation-related parameters, suggesting an imbalance between coagulation and anti-coagulation factors. Moreover, abortions occurred in about half of the animals of the R group between GDs 23 and 27. When aborted rabbits were compared with those which could maintain pregnancy under restricted feeding, total protein, albumin, platelets and antithrombin III values and especially blood progesterone concentration were significantly lower in aborted rabbits on GD 22, prior to occurrence of abortion. These results suggested that abortions due to restricted feeding might be brought about by lower nutritive conditions, an imbalance of blood coagulation-related factors and lower blood progesterone concentrations.

Genomic and phylogenetic analysis of Argentinian Equid Herpesvirus 1 strains

Equid Herpesvirus 1 (EHV-1) has long been causally implicated in the occurrence of abortion, neonatal death, respiratory disease, and neurological disorders in horses. This study analyzed for the first time the characteristics of the genomic section of Argentinian EHV-1 strains and reconstructed the phylogeny in order to establish their origin. The phylogenetic dataset included 22 Argentinian strains and four additional reference strains isolated in other countries. The intergenic region between ORF 62 and ORF 63 was amplified by PCR and sequenced. The phylogenetic analysis carried out by parsimony algorithms showed that six of the Argentinian strains had the same origin as British and Japanese strains. The mapping of symptoms caused by EHV-1 suggested that neonatal disease developed through convergent evolution, which would constitute an adaptation mechanism of the virus. This study constitutes the first analysis carried out in South-American strains that establishes the phylogenetic relationship between Argentinian strains and rebuilds the evolutionary history of symptoms. This study focuses on a very important aspect of evolution of Herpesviridae infecting perissodactyls and attempts to shed light on the evolution of symptoms, an issue of high clinical interest.

Coxiella burnetii Shedding Routes and Antibody Response after Outbreaks of Q Fever-Induced Abortion in Dairy Goat Herds

Q fever is a zoonosis caused by Coxiella burnetii, a bacterium largely carried by ruminants and shed into milk, vaginal mucus, and feces. The main potential hazard to humans and animals is due to shedding of bacteria that can then persist in the environment and be aerosolized. The purpose of this study was to evaluate shedding after an outbreak of Q fever abortion in goat herds and to assess the relationship with the occurrence of abortions and antibody responses. Aborting and nonaborting goats were monitored by PCR for C. burnetii shedding 15 and 30 days after the abortion episodes. PCR analysis of all samples showed that 70% (n = 50) of the aborting and 53% (n = 70) of the nonaborting goats were positive. C. burnetii was shed into vaginal mucus, feces, and milk of 44%, 21%, and 38%, respectively, of goats that aborted and 27%, 20%, and 31%, respectively, of goats that delivered normally. Statistical comparison of these shedding results did not reveal any difference between these two groups. PCR results obtained for the vaginal and fecal routes were concordant in 81% of cases, whereas those for milk correlated with only 49% of cases with either vaginal or fecal shedding status. Serological analysis, using enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence assay (IFA), and complement fixation tests, showed that at least 24% of the seronegative goats shed bacteria. Positive vaginal and fecal shedding, unlike positive milk shedding, was observed more often in animals that were weakly positive or negative by ELISA or IFA. Two opposite shedding trends were thus apparent for the milk and vaginal-fecal routes. Moreover, this study showed that a nonnegligible proportion of seronegative animals that delivered normally could excrete C. burnetii.

Pregnancy Exposure to Serotonin Reuptake Inhibitors and the Risk of Spontaneous Abortions

A growing number of studies have suggested that maternal exposure to post-tricyclic antidepressants during pregnancy might be associated with an increased risk of poor birth, obstetrical, and neonatal outcomes. Among these complications, the occurrence of spontaneous abortions represents one of the most dramatic events for the pregnant woman. The purpose of this study was to review all studies reporting primary data investigating the rate of spontaneous abortions in women treated with selective serotonin reuptake inhibitors during pregnancy. Medical literature information published in English since 1980 was identified using MEDLINE/PubMed, TOXNET, EMBASE, and The Cochrane Library. Searches were performed using various combination of search terms and were last updated May 2008. No other limitations were imposed. Twelve articles reporting primary data on the rate of spontaneous abortions in women treated with selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors during early pregnancy outcome of pregnancies exposed to antipsychotics were selected for the review. The author was the only reviewer who performed selection and data extraction. Information from reviewed studies are scarce and methodologically inadequate to draw definitive conclusions about the hypothesized risk of spontaneous abortions associated with serotoninergic antidepressant exposure during early pregnancy. Alternative parameters may be considered in choosing the safest serotoninergic antidepressant for the pregnant woman. Such parameters are mainly represented by the teratogenic risk associated with some of such medications and their well-known liability of inducing perinatal complications.

Abortamento canino por Brucella canis

Este trabalho descreve a ocorrência de abortamento canino causado por Brucella canis e o isolamento de B. canis a partir de feto abortado. Os cultivos microbiológicos de fígado, rim e pulmão fetal resultaram positivos. Sangue e swab vaginal do animal resultaram negativos para o isolamento do agente. A presença do DNA de Brucella spp foi constatada no swab vaginal na reação em cadeia pela polimerase (PCR). As provas de soroaglutinação e imunodifusão em gel de ágar resultaram positivas.

Expression of human spindle mitosis arrest deficiency gene in spontaneous abortion embryo tissues

To investigate the expression of human spindle mitosis arrest deficiency gene (hsMAD2) in spontaneous abortion embryos and the relationship between low expression of hsMAD2 and numerical chromosomal aberration. METHODS Spontaneous abortion embryo tissues were collected, including 23 cases of once spontaneous abortion tissue and 10 cases of twice or more spontaneous abortion tissue and induced abortion embryos (35 cases) from the Department of Gynaecology and Obstetrics of the Affiliated Hospitals of Chongqing University of Medical Science during the period of March 2006 to March 2007. FQ-PCR and western blot were used to evaluate the endogenous expression level of hsMAD2 mRNA and hsMAD2 protein; primary culturing of cells from the induced abortion embryos was conducted and 5 embryonic cells were selected by chromosomes karyotype analysis. Recombinant shRNA plasmids targeting hsMAD2 gene were constructed to inhibit the expression of endogenous hsMAD2 genes in embryonic cells which have normal karyotypes; the groups were defined as the first experimental group (transfected with pshRNA-hsMAD2-1) , the second experimental group (transfected with pshRNA-hsMAD2-2), the third experimental group (transfected with pshRNA-hsMAD2-3), the first control group (transfected with nothing), the second control group (transfected with pTZU6 + 1) and the independent group (transfected with pshRNA-N1). Interference efficiency was demonstrated by FQ-PCR and western blot; cell proliferation was measured by methyl thiazolyl tetrazolium (MTT) assay; cell-cycle was assessed by flow cytometry (FCM); the chromosome numbers were calculated to analyze the variation of chromosomes. (1) The mRNA levels of hsMAD2 in the once spontaneous abortion tissue, twice or more spontaneous abortion tissue and induced abortion tissue were 0.00879 +/- 0.00035, 0.00901 +/- 0.00033 and 0.00941 +/- 0.00026 respectively, and there was no significant difference (P > 0.05) compared with each other; however, the protein levels of hsMAD2 in three groups were 0.2791 +/- 0.0311, 0.0431 +/- 0.0020 and 0.5790 +/- 0.0331 respectively, and there were significant differences (P < 0.05) compared with each other. (2) Recombinant shRNA plasmids could significantly and specifically inhibit hsMAD2 gene expression in embryonic cells. Compared with the first control group (4%) and the second control group (3%), the recombinant shRNA could inhibit embryonic cell proliferation to 54% at 48 h after transfection (P < 0.05); compared with the first control group (8.2%) and the second control group (8.0%), the ratios of G2/M phase cells in the experimental group (17.9%)was significantly increased (P < 0.05); compared with the first control group (4.8%), the ratios of abnormal chromosomes in the experimental group was increased to 30.0% (P < 0.05). Down-expression of hsMAD2 gene may be one of the mechanisms inducing numerical chromosome aberration, abnormal embryo development and the occurrence of spontaneous abortion.

Systemic lupus erythematosus and pregnancy

Systemic Lupus Erythematosus (SLE) is a disease primarily targeting fertile women. The odds of spontaneous miscarriage, preeclampsia, intrauterine growth restriction is higher in pregnant women with SLE as well as there are increased risks of preterm delivery and perinatal fetal death. The occurrence of spontaneous abortion is closely related to the presence of antiphospholipid antibodies. The disease on its own is not a contraindication of pregnancy but at least a six-month remission is suggested prior conception. The physiological changes in the course of pregnancy might have close resemblance to the symptoms of lupus, therefore these changes should be differentiated from symptoms caused by lupus. For mothers suffering from SLE, regular visits not only to their obstetricians but also to a rheumatologist are also recommended in order to allow at proper time recognition of potential complications and their appropriate treatment. Thorough check of the maternal disease is of high importance not only during but also prior to and following pregnancy. An overview is given of the opportunities of recent diagnosis and opportunities of therapeutic approaches including biological as well as stem cell treatments. The antithrombotics treatment increases the chance of survival and healthy child birth in the case of pregnant women suffering from antiphospholipid syndrome. Although occurring rarely, neonatal SLE has significantly higher morbidity and mortality compared to healthy births. Recent studies show positive results in the case of prophylactic treatment of neonatal lupus. Prenatal care is recommended to be conducted at an institute where the obstetrician is experienced in the possible complications of lupus and where consultation with a rheumatologist, and the treatment of neonates with low birth weight are ensured.

Comparison of the plasminogen activator inhibitor-1 4G/5G gene polymorphism in females with venous thromboembolism during pregnancy or spontaneous abortion

Genetic polymorphisms in plasminogen activator inhibitor-1 gene-675 4G/5G (PAI-1 4G/5G) are claimed to contribute to an increased risk of venous thromboembolism. Inherited thrombophilia, on the other hand, is associated with the occurrence of spontaneous abortions. The objective of this study was, to explore the significance of genetic polymorphisms of PAI-1 4G/5G with particular emphasis on 4G alleles in pregnant women suffering from venous thromboembolism or early spontaneous abortion, respectively. Therefore genetic PAI-1 4G/5G polymorphisms were studied in 108 pregnant females suffering from venous thromboembolism (n=69) or from spontaneous abortion (<20 week, n=39), respectively. Healthy volunteers (n=238) were taken as controls. The frequencies of 4G alleles (4G/4G or 4G/5G genotypes) of PAI-1 were significantly higher in venous thromboembolism (OR: 3.40, p=0.0088) and slightly higher, but not significantly, in abortions (RR: 2.33; p=0.1162) compared to controls. The incidence of 4G-carriers in females with abortion was 0.68 (-32%) compared to women suffering from venous thromboembolism alone. We conclude from these data, that the occurrence of PAI-1 4G/4G or 4G/5G genotypes, respectively, is clinically significant for the pathogenesis of venous thromboembolism in pregnancy but not for early abortion.

Resultados adversos en la procreación en mujeres trabajadoras en la floricultura colombiana: un resumen de la evidencia mediante metanálisis

Workers in floriculture are exposed to pesticides and other risk factors. Work in these occupational environments is suspected to be associated with adverse reproductive outcomes. However, epidemiological studies in Colombia, a country that has a long tradition with this occupation, have not been consistent or conclusive. To quantify the effect of womens work in Colombian floriculture in the occurrence of spontaneous abortion, prematurity, and birth defects, using the results of two previous studies. The results of two previous studies among Colombian floriculture worker populations were summarized with metaanalysis techniques. A critical evaluation of each of the studies identified potential biases and methodological limitations. The pooled estimator of spontaneous abortion was 2.24 (95CI: 1.87-2.68); that of premature infant birth was 1.49 (95%CI: 0.91-2.43), and of birth defects 1.31 (95%CI: 1.95-1.64). The analyses suggested that work in floriculture is associated with a higher occurrence of spontaneous abortion and birth defects. However, these effects are not necessarily associated with pesticide exposure. Other risk factors requiring further study are levels of physical activity and high temperature in greenhouses. Data from countries which have initiated occupations in floriculture more recently will add valuable evidence for this controversial association.

Spontaneous abortions in female populations occupationally exposed to ionizing radiation

Exposure to radioisotopes of metals and halogen elements occurring in medical practice may cause spontaneous abortions. The potential role of occupational exposure to X-rays and internal radioisotopes on pregnancy outcome in childbearing age women employed in hospital departments were analyzed in order to estimate miscarriage risk. Over a period of 16 years, the occurrence of miscarriages in 61 women exposed to radioisotopes was compared to that reported in 170 X-ray exposed women. Chromosomal aberrations (CA) were measured in both radiation-exposed groups and in 53 non-exposed women. Women exposed to radioisotopes experienced at least a threefold higher rate of spontaneous abortions than those exposed to X-ray (OR = 3.68, 95% CI = 1.39-9.74, P < 0.01). Although X-ray and radioisotopes exposed women had significantly higher levels of chromosome type frequency (0.51 +/- 0.82, and 0.63 +/- 0.99, respectively) than referents (0.17 +/- 0.34), there was no clear difference between radiation-exposed women. For exposure levels within standard recommended guidelines, radioisotopes are far more likely to play a role in the occurrence of spontaneous abortions than X-rays. Such biological effect is not detectable by deviations in CA frequency.

Efficacy of bovine herpesvirus-1 inactivated vaccine against abortion and stillbirth in pregnant heifers

To evaluate the efficacy of an inactivated bovine herpesvirus-1 (BHV-1) vaccine to protect against BHV-1 challenge-induced abortion and stillbirth. Prospective study. 35 beef heifers. Before breeding, heifers were vaccinated with a commercially available BHV-1 inactivated vaccine SC or IM. The estrous cycle was then synchronized, and heifers were artificially inseminated 30 to 60 days after vaccination. Heifers (n = 21) were challenge inoculated IV at approximately 180 days of gestation with virulent BHV-1. Fourteen control heifers were not vaccinated. Clinical signs of BHV-1 infection were monitored for 10 days following challenge; serologic status and occurrence of abortion or stillbirth were evaluated until time of calving. 18 of 21 (85.7%) heifers that received vaccine were protected from abortion following challenge, whereas all 14 control heifers aborted. Results indicated that an inactivated BHV-1 vaccine can protect against abortion resulting from a substantial challenge infection, with efficacy similar to that of modified-live BHV-1 vaccines.

Health-related quality of life in patients with adolescent idiopathic scoliosis after treatment: short-term effects after brace or surgical treatment, a comment

We have read with great interest the article published by Bunge EM and colleagues [1] about short-term effects regarding health-related quality of life (HRQoL) in patients affected by adolescent idiopathic scoliosis (AIS) after a brace or surgical treatment. Recently, we performed a similar study about long-term effects on HRQoL in surgically or conservatively treated patients affected by scoliosis between 45°–60° Cobb and we believe we can provide a further contribution to this important topic. We have reviewed 840 clinical histories of patients treated for scoliosis (between 45°–60° Cobb) from 1975 to 1985 at the Fondazione Don C. Gnocchi (Rome). Of the initial population (840 patients), 98 showed a scoliosis with 45°–60° Cobb, 13 out of these 98 refused to participate in this study, 64 were untraceable, and the remaining 21 patients agreed to participate in this study giving their informed consent. Ten patients were surgically treated (SURG) and 11 received a conservative treatment (CONS). In terms of gender, 20 of the patients were women and 1 was man; and the mean age at follow-up was 36.7 ± 4.7 years (range 20–31 years). The conservative treatment consisted of the use of: plaster cast in one patient; plaster cast and Lyonnais in three patients; plaster cast, Lyonnais and Milwaukee brace in five; plaster cast and Milwaukee in one; Lyonnais in two patients; Milwaukee brace in one; and all treatments presented in eight patients. All the patients were instructed to wear their braces for about 20 h per day. In addition, all CONS patients underwent a rehabilitation program based on a postural re-education method. Wearing over was initiated when the patient’s curve had not progressed on two successive visits and the patient was judged skeletally mature. The brace period was mean 5.2 years (range ±3.4). With regard to SURG cases, after surgery, all patients wore a plaster brace and performed a rehabilitation program based on a postural re-educational method. Note that, the surgical treatment was always indicated in patients with a documented progression (Cobb angle between 45° and 60°) and expected remaining skeletal growth. Our 11 CONS patients had refused the surgical treatment and they chose the conservative management. At follow-up each patient underwent a multidimensional protocol including an anamnestic evaluation (school abandonment, current employment, sport practices, occurrence of pregnancy, menarche and abortions, cervicalgy and headache) physical examination (rib-hump measuring, sagittal and coronal alignment), radiological evaluation (using the Cobb technique), disability evaluation (Barthel Index and Deambulation Index), HRQoL and back pain evaluation (the Short Form-36 Health Survey [SF-36], NASS scale, Backill Scale and Visual Analogue Scale). As expected, comparing the two groups, we have observed: (1) an higher brace period in CONS group (P = 0.005); (2) a more severe pre-therapy scoliosis degree in SURG group (mean value 59.2° in SURG group versus 50.4° in CONS group, P = 0.005) and (3) a more severe post-therapy scoliosis degree in CONS group (mean value: 54.4° in CONS group versus 37.5° in SURG group, P = 0.005). Moreover, we recorded an higher school abandonment in SURG group (P = 0.04) since the global treatment duration (about 25 years ago) resulted to be longer in SURG group. Regarding HRQoL, disability and pain, the comparison of the two groups at follow-up did not show statistical differences. Table 1 shows mean, SD and statistical results of disability and patient-oriented measures recorded in the two groups. Table 1 Mean, SD and statistical results of disability and patient-oriented measures recorded in the CONS and SURG groups With respect to the Bunge’s study we have reported a long-term follow-up. We have studied HRQoL aspects using the SF-36 showing significant correlation with the Scoliosis Research Society-22 Patient Questionnaire [2], adopted by Bunge in his study. Bunge and colleagues enrolled a larger sample of patients including also patients with scoliosis lower of 45° Cobb, and they divided their surgery patients into two subgroups: brace before surgery and only surgery (not possible in our for small sample). Our study, even if on a little sample, focuses the attention on patients with 45–60 Cobb degree. As Bunge observed in short-term follow-up, we did not found in long-term follow-up any significant differences in disability, HRQoL and pain in patients undergoing conservative or surgical treatment. In scoliosis patients, the curve between 40° and 50° is a issue still discussed during the therapy decision (bracing or surgery) and Bunge’s and our results can not support the preference of surgical treatment above the conservative treatment and viceversa.

Application of embryo rescue after interspecific crosses in the genus Rhododendron

Interspecific hybridization between evergreen pot azalea (Tsutsusi) cultivars and genotypes of other Rhododendron subgenera or sections (Rhododendron, Hymenanthes, Pentanthera, Vireya) is significantly hampered by many prezygotic and postzygotic barriers. The objective of our work was to overcome spontaneous abortion and lack of endosperm formation and to increase germination rates by establishing an embryo rescue protocol. The optimal germination medium for immature Rhododendron seeds was a basal medium supplemented with 145 μM GA3. This medium induced germination of fertilized ovules after several sexual combinations of subgenera. Its use was clearly more efficient than in vivo sowing. The direction of the cross significantly influenced the occurrence of abortion, germination and albinism. The obtained seedlings were multiplied on Woody Plant Medium + 4.5 μM 2iP, and rooted afterwards. Finally, about 9% of the germinated ovules resulted in vigorously growing seedlings that were successfully acclimatized.

PREVALÊNCIA DE ANTICORPOS ANTILEPTOSPIRA EM MACHOS BOVINOS NA MICRORREGIÃO DE GOIÂNIA

The aim of this experiment was to study the prevalence of sera agglutinins anti-leptospira in bulls in Goiânia Micro-Region. Sixty farms were chosen randomly in according to sorovars presented and the tax of prevalence of them. The correlation of the prevalence of the leptospirosis were establish with the type of herd (beef or dairy) and the occurrence of abortions in farms. One hundred forty samples bulls from “Goiânia Micro-Region” were analyzed (MG) regarding 60 properties. The sera reagents prevalence was 74.28% and . presented titles with variation of dilution from 1:100 to 1:800. The prevalence of the sera varieties, presents in this “Goiania Micro-Region”, was the following: wolffi (19.23%); hardjo (15.38%); djasiman and grippotyphosa (5.76%); shermani (4.80%); patoc (1.92%); andamana, castellonis, copenhageni, hebdomadis, sentot and tarassovi (0.96%). According to these results, it was possible to conclude that leptospirosis is an endemic agent in this part of Goias State and there were not any relationship with production system or abortions and prevalence. KEY WORDS: Leptospirosis, cattle, bull, prevalence.

Investigação epidemiológica da brucelose bovina em um estrato do Estado de Mato Grosso do Sul

O objetivo deste estudo foi estimar a prevalência da brucelose bovina nos 22 municípios que compõem a região denominada Estrato 1 do Estado de Mato Grosso do Sul, e identificar os fatores de risco associados à infecção. A região amostrada constitui uma área de 70.214,1 km², que representa 19,7% do Estado. O rebanho de região estudada é de, aproximadamente, 5,7 milhões de cabeças, correspondente a 23% do efetivo de 24,9 milhões de bovinos de Mato Grosso do Sul. Nas 210 propriedades amostradas, no período de dezembro de 2003 a março de 2004, foram colhidas 2.376 amostras de sangue de fêmeas com idade igual ou superior a 24 meses, submetidas a testes diagnósticos em série. A triagem, realizada por meio do teste do antígeno acidificado tamponado, foi seguida pelo teste confirmatório 2-mercaptoetanol. Na mesma ocasião da colheita das amostras, foi preenchido um questionário com informações de identificação, tipo de criação e práticas de manejo. Em animais, a prevalência real foi estimada em 5,6%, e em rebanhos, 37,3%. As variáveis que apresentaram associação, por meio da análise univariada odds ratio (OR) e intervalo de confiança (IC) de 95%, com a soropositividade à brucelose foram: o tipo de exploração corte (OR = 2,82, IC 95% = 1,49-5,34), a raça Zebu (OR = 2,62, IC 95% = 1,40-4,88) e o aborto (OR= 1,83, IC 95% = 1,01-3,33). Os resultados demonstram que, além da brucelose ser prevalente no estrato estudado em Mato Grosso do Sul, o controle da doença pode consistir na adoção de programa com especial atenção à exploração do tipo corte, à raça Zebu e à presença do aborto.

Maternal smoking predicts the risk of spontaneous abortion

Few studies have examined smoking prior to pregnancy and the occurrence of spontaneous abortion, as most studies have addressed the risk of spontaneous abortion in relation to smoking during pregnancy. However, results are not entirely consistent. The aim of the present study was to assess the risk of spontaneous abortion considering smoking prior to pregnancy. We performed a nested case-control study using prospective data from a population-based cohort comprising 11,088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n=343) or who gave birth (n=1,578) during follow-up were selected. Associations between self-reported smoking at enrollment and subsequent spontaneous abortion were analyzed by means of multiple logistic regression. The risk of spontaneous abortion in relation to pre-pregnancy smoking showed a clear dose-response effect. The adjusted odds ratio (95% confidence interval) for spontaneous abortion among current smokers prior to conception was 1.20 (1.04-1.39) per every extra five cigarettes smoked per day. The increased risk was only present for current smokers. The duration of smoking prior to pregnancy was not a significant predictor for subsequent spontaneous abortion. The amount of daily smoking prior to pregnancy seems to be associated with an increased risk of spontaneous abortion, whereas the duration of smoking does not seem to be related to an increased risk of spontaneous abortion.

Spontaneous abortion: A prospective cohort study of younger women from the general population in Denmark. Validation, occurrence and risk determinants

To assess the occurrence of spontaneous abortion, comparing two different data sources. To estimate the rate of spontaneous abortion over a 2-year period, and examine potential predictors of the risk for incident spontaneous abortion. We used interview data from a population-based prospective cohort study comprising 11,088 women and data from a linkage of the cohort with the Hospital Discharge Register to compare spontaneous abortions as reported in the interview with those identified in the register. Based on interview data, we estimated the rate of spontaneous abortion during the two-year follow-up. Finally, risk determinants for incident spontaneous abortion were analyzed by means of logistic regression. A total of 654 spontaneous abortions before enrolment in the study were reported by the women compared to 531 abortions found in the register. More than 80% of the spontaneous abortions identified from both sources were recorded in the same year. During follow-up a total of 20.9% of pregnancies intended to be carried to term ended as a spontaneous abortion. In the risk factor analysis, we found that previous spontaneous abortion, being single, never having used oral contraceptives, and use of intrauterine device were associated with increased risk of subsequent spontaneous abortion. In addition, it was indicated that a short interpregnancy interval following a spontaneous abortion may confer an increased risk of abortion in the subsequent pregnancy. We found a high rate of spontaneous abortion in the present study and an acceptable agreement between information obtained by interview and register information. More than 25% of the spontaneous abortions were only reported by the women, and this could not be explained by erroneously reported induced abortions, and may be early, nonhospitalized abortions. We confirm that number of previous spontaneous abortions is a strong determinant, and our data may also indicate a role of previous contraceptive habits. A role of the length of interpregnancy interval in the risk of spontaneous abortion cannot be ruled out.

High prevalence of abnormal acid gastro-oesophageal reflux in idiopathic pulmonary fibrosis

The aim of this prospective study was to determine the prevalence and characteristics of acid gastro-oesophageal reflux (GER) in patients with idiopathic pulmonary fibrosis (IPF). Sixty-five consecutive patients with well-defined IPF were subjected to 24-h pH monitoring and oesophageal manometry. A total of 133 consecutive patients with intractable asthma and symptoms of GER were used as comparisons. The prevalence of abnormal acid GER in IPF patients was 87%, with 76% and 63% demonstrating abnormal distal and proximal oesophageal acid exposures, respectively. Abnormal acid GER was significantly more common in IPF patients than asthma patients. Only 47% of IPF patients experienced classic GER symptoms. Despite treatment with standard doses of proton pump inhibitors (PPIs), 12 out of 19 patients receiving PPIs during the 24-h pH monitoring had abnormal oesophageal acid exposures by pH probe. There was no correlation between IPF severity and acid GER severity. In conclusion, abnormal acid gastro-oesophageal reflux is highly prevalent, but often clinically occult in patients with idiopathic pulmonary fibrosis. Standard doses of proton pump inhibitors may not suppress the acid gastro-oesophageal reflux in this population. Therefore, further studies are needed to determine if acid abnormal gastro-oesophageal reflux represents an important risk factor for idiopathic pulmonary fibrosis development or progression, and if optimal suppression of acid gastro-oesophageal reflux slows the progression of idiopathic pulmonary fibrosis and/or decreases episodic exacerbations of idiopathic pulmonary fibrosis.