Objective: To systematically review the literature focusing on obstetric and perinatal outcomes in women with previous or current eating disorders (EDs) and on the consequences of maternal EDs for the offspring. Methods: The study was performed following the systematic review and meta-analysis (PRISMA) statement. PubMed, SciELO, and Cochrane databases were searched for non-interventional studies published in English or Portuguese from January 1980 to December 2020. Risk of bias was assessed using the Methods guide for effectiveness and comparative effectiveness reviews (American Agency for Healthcare Research and Quality). Results: The search yielded 441 records, and 30 articles were included. The psychiatric outcome associated with EDs in women was mainly perinatal depression. The most prevalent obstetric outcomes observed in women with EDs were vomiting, hyperemesis, bleeding, and anemia. Most studies found maternal anorexia nervosa and bulimia nervosa to be associated with low birth weight and slow fetal growth. Women with binge EDs delivered children with increased birth weight. Of the 30 studies included, methodological quality was good in seven, fair in eight, and poor in 15 studies. Conclusion: A considerable body of evidence was reviewed to assess obstetric and perinatal outcomes in EDs. Acute and lifetime EDs, especially if severe, correlated with poor perinatal, obstetric, and neonatal outcomes. Obstetricians and general practitioners should be vigilant and screen for EDs during pregnancy.

Resumo: Introdução: Embora a saúde mental seja uma condição essencial para o desenvolvimento humano, a literatura científica mostra alta frequência de depressão e ansiedade em universitários, principalmente entre estudantes de Medicina. Para contribuir para um melhor entendimento sobre a saúde mental de estudantes de Medicina, esta pesquisa teve os seguintes objetivos: 1. estimar a prevalência de escores indicativos de ansiedade, depressão e ansiedade e depressão simultâneas, e 2. analisar os fatores associados com tais condições em estudantes de Medicina de uma universidade federal do Brasil. Métodos: Trata-se de um estudo do tipo transversal realizado com 355 estudantes de uma faculdade de medicina do Rio de Janeiro. Os participantes foram recrutados durante o primeiro semestre do ano de 2015. As desordens mentais foram avaliadas com o uso da Hospital Anxiety and Depression Scale (Hads). A magnitude dos transtornos mentais e os fatores associados foram analisados com a obtenção de estimativas de prevalência e de razão de prevalência (RP) não ajustada e ajustada e de intervalos de confiança de 95% (IC 95%). Resultados: Analisaram-se 355 estudantes. Ansiedade foi a condição mais comum (41,4%), seguida de depressão (8,2%) e de depressão e ansiedade simultâneas (7,0%). Depois do ajustamento dos modelos multivariados e considerando tanto gênero quanto idade como variáveis de confusão, nossos resultados mostraram um padrão de risco diferenciado em relação aos três desfechos analisados. O risco de ansiedade aumentou com o fato de se “sentir sozinho” (RP ajustada: 1,59; IC 95%: 1.123; 2,259), “ter histórico de acompanhamento psiquiátrico/psicológico antes de ingressar na universidade” (RP ajustada: 1,63; IC 95%: 1,052; 2,542) e “se sentir moralmente lesado na faculdade” (RP ajustada: 1,66; IC 95%: 1,168; 2,364). O risco de depressão aumentou com se “sentir sozinho” (RP ajustada: 6,84; IC 95%: 2,047; 22,894) e “ter histórico de acompanhamento psiquiátrico/psicológico antes de ingressar na universidade” (RP ajustada: 4,74; IC 95%: 1,790; 12,579). Ansiedade e depressão simultâneas foram associadas com se “sentir sozinho” (RP ajustada: 8,90; IC 95%: 2,075; 38,208) e “ter histórico de acompanhamento psiquiátrico/psicológico durante (RP ajustada: 3,16; IC 95%: 1,061; 9,439) e antes (RP ajustada: 6,01; IC 95%: 2,000; 18,098) de ingressar na universidade”. Conclusão: Ansiedade e depressão são comuns em estudantes de Medicina. Os principais fatores associados foram tratamentos para desordens mentais antes do ingresso na universidade, solidão e relações interpessoais problemáticas durante a graduação. Dessa maneira, um melhor acolhimento e uma redução de situações conflituosas podem ajudar a minimizar essas condições frequentes em escolas médicas, uma vez que impactam não apenas a própria qualidade de vida, como também a forma de lidar com os seus pacientes no futuro.

Abstract: Introduction: Although mental health is an essential condition for the human development, the scientific literature shows a high frequency of depression and anxiety in university students, mainly among medical students. To contribute to a better understanding concerning medical students’ mental health, this study had the following objectives: (a) to estimate the prevalence of indicative scores for anxiety, depression, and for simultaneous anxiety and depression, and (b) to analyze factors associated with these conditions in medical students at a federal university in Brazil. Methods: This is a cross-sectional study including students from a federal medical school in the state of Rio de Janeiro. Participants were enrolled during the first semester of 2015. Mental disorders were assessed with Hospital Anxiety and Depression Scale (HADS). The magnitude of mental disorders and its associated factors were analyzed calculating prevalence rates and unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI). Results: We analyzed 355 students. Anxiety was the most common condition (41.4%), followed by depression (8.2%), and both anxiety and depression simultaneously (7.0%). After adjustment of multivariate models and considering both gender and age as confounding variables, our results showed a differentiated risk pattern in relation to three outcomes analyzed. Anxiety risk increased with ‘feeling alone’ (adjusted PR: 1.59; 95% CI: 1.123; 2.259), ‘having a history of psychological and/or psychiatric treatment before entering university’ (adjusted PR: 1.63; 95% CI: 1.052; 2.542), and ‘feeling morally harmed at college’ (adjusted PR: 1.66; (95% CI: 1.168; 2.364). Depression risk increased with ‘feeling alone’ (adjusted PR: 6.84; 95% CI: 2.047; 22.894) and ‘having a history of psychological and/or psychiatric treatment before entering university’ (adjusted PR: 4.74; 95% CI: 1.790; 12.579). Simultaneous anxiety and depression were associated with ‘feeling alone’ (adjusted PR: 8.90; 95%CI: 2.075; 38.208) and ‘having a history of psychological and/or psychiatric treatment during the medical course (adjusted PR: 3.16; 95% CI: 1.061; 9.439) and before (adjusted PR: 6.01; 95% CI: 2.000; 18.098) entering university’. Conclusion: Anxiety and depression are common conditions in medical students. The main associated factors were therapies for mental health before entering in university, loneliness and lack of respect in interpersonal relationships during the medical course. Therefore, initiatives aiming at better welcoming students and reducing conflicting situations can help minimizing these mental problems during university career, once they have a large impact not only in their quality of life, but also in the way they will deal with their patients in the future.

The bioinert surface of silicon nitride ceramics led us to investigate the additions of SiO2, CaO and Al2O3 in order to aid the liquid phase sintering and improve the mechanical properties and biological behavior of the final materials. The sintered materials reached ca. 97% of theoretical density and total α→β-Si3N4 transformation. The samples had relatively high values of fracture toughness while their elastic modulus values were lower than those of conventional silicon nitride ceramics. Apatite deposits were observed on the surfaces analyzed after SBF (simulated body fluid) immersions, suggesting their bioactivity. Osteoblasts proliferation and calcified matrix were also detected as response to cells/materials contact. This combination of properties suggests that all studied compositions are promising for applications in biomedical devices. Moreover, compositions with alumina additions and higher silica content had better in vitro biological behavior, densification and mechanical properties, suggesting greater potential to be used in bone substitute devices.

The aim of this study was to evaluate the effects of dengue virus infection during pregnancy and its correlation with low birth weight, prematurity, and asphyxia. A non-concurrent cohort study reveals the association of dengue during pregnancy with prematurity and low birth weight, when birth occurred during the maternal-fetal viremia period (p = 0.016 and p < 0.0001, respectively).

The aim of this study was to characterize calcium phosphate ceramics with different Ca/P ratios and evaluate cell response of these materials for use as a bone substitute. Bioceramics consisting of mixtures of hydroxyapatite (HAp) and β-tricalcium phosphate (β-TCP) powders in different proportions were pressed and sintered. The physical and chemical properties of these bioceramics were then characterized. Characterization of the biological properties of these materials was based on analysis of cell response using cultured fibroblasts. The number of cells attached to the samples was counted from SEM images of samples exposed to cell culture solution for different periods. These data were compared by analysis of variance (ANOVA) complemented by the Tukey's test. The TCP sample had higher surface roughness and lower density. The adherence and growth of FMM1 cells on samples from all groups was studied. Even though the different calcium based ceramics exhibited properties which made them suitable as bone substitutes, those with higher levels of β-TCP revealed improved cell growth on their surfaces. These observations indicated two-phase calcium phosphate based materials with a β-TCP surface layer to be a promising bone substitute.

In many 'in-vivo' and 'in-vitro' studies, the behavior of calcium phosphate ceramics like beta - tricalcium phosphate in biological environments has been reported to be predictive and positive. In terms of bone tissue growth, these ceramics are attractive biomaterials due to their porous microstructures. To obtain biomaterial quality ceramics, in this investigationbeta- TCP porous ceramics were prepared by a special consolidation method with albumin as a foam generating agent. This technique enables a variety of formats with complex geometries to be prepared. To obtain porous samples using albumin, heat had to be introduced into the system during the consolidation stage. After consolidation, the samples were sintered at 1250 °C for 30 minutes and characterized using X ray diffractometry, scanning electron microscopy and mercury porosimetry. The foams that were obtained by this method exhibited spherical and interconnected pores, characteristics desirable in biomedical implants.