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Fontes JM, Oliveira EM, Monteiro de Melo Prazeres TC, Nisya de Oliveira Cruz G, Rizzini M, Passos SD, Lisboa LL, Ferreira de Araújo G, Azevedo de Almeida V, Malacarne J, Emília de Domenico Garcia M, Linhares Barreto LC, Calado AA, Fernandes da Nóbrega L, Moura Nascimento Santos MJ, Gonçalves RP, Farache L, Feliciano da Silva M, Rizzo FV, Dias da Silva L, Maria de Jesus Amorim N, Guedes Pinheiro HC, Suely de Oliveira Melo A, de Oliveira Melo F, Moreira RD, Santos da Costa BJ, de Almeida Melo Maciel Mangueira M, Varela MC, Costa Monteiro LM. Prevalence of urologic sequelae and bladder and bowel dysfunctions in patients with congenital Zika syndrome: A multicenter evaluation of the Zika virus bladder and bowel sequelae assistance network. J Pediatr Urol 2024; 20:220.e1-220.e9. [PMID: 38097421 DOI: 10.1016/j.jpurol.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Neurogenic bladder was first confirmed as a urological sequela of Congenital Zika Syndrome (CZS) in 2018. Further clinical-epidemiological evidence also confirmed neurogenic bowel dysfunction and cryptorchidism. To strengthen the care for these children, the Congenital Zika Virus Bladder and Bowel Sequelae Network (RASZ in Brazilian) was created, including six integrated centers in Brazil. This article represents the initial outcome of the efforts by RASZ. OBJECTIVE To evaluate the prevalence of bladder and bowel dysfunction, cryptorchidism and other urological sequelae related to CZS in cohorts attended in six Brazilian states. STUDY DESIGN Observational, prospective, multicenter study including children with CZS assisted in one of six RASZ collaborative centers between June 2016 and February 2023. Data were collected from patient's first assessment using the same protocols for urological and bowel evaluation. Categorical variables were analyzed by frequency of occurrence and numerical variables by mean, median, and standard deviation. The study was approved by the Research Ethics Committees of each center, all parents/caregivers provided written informed consent. RESULTS The study included 414 children aged 2 months to 7 years (mean 2.77 years, SD 1.73), 227 (54.8 %) were male and 140 (33,8 %) referred urological and bowel symptoms on arrival. Prevalence of both urological and bowel sequelae was 66.7 %, 51 % of children aged 4 years and older had urinary incontinence (UI). UTI was confirmed in 23.4 % (two presented toxemia) and among males, 18.1 % had cryptorchidism. Renal ultrasonography, performed in 186 children, was abnormal in 25 (13.4 %), 7 had hydronephrosis. Among the 287 children who performed urodynamics, 283 (98.6 %) were altered: 232 had a lower bladder capacity, 144 a maximum bladder pressure of ≥40 cm H2O, and 127 did not satisfactorily empty their bladder. DISCUSSION A higher prevalence of NLUTD, neurogenic bowel and cryptorchidism was confirmed in children with CZS. Early diagnosis and appropriate treatment, including a multidisciplinary approach, may reduce the risk of UTIs, UI and kidney damage. A limitation of the study was the inability of children to complete the protocol, specifically urodynamic evaluation, and ultrasonography. In both exams, the percentage of abnormal cases was higher than that expected in the normal population. CONCLUSION A 66,7 % prevalence of combined urological sequelae and bladder-bowel dysfunction related to CZS was confirmed in patients evaluated in six Brazilian cohorts. The most frequent changes were related to NLUTD, neurogenic bowel, and cryptorchidism. Prevalence may be underestimated due to access restrictions to diagnostic tests.
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Affiliation(s)
- Juliana Marin Fontes
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Ambulatório de Urodinâmica Pediátrica - Oswaldo Cruz Foundation, National Institute of Women, Children and Adolescents Health Fernandes Figueira, Pediatric Urodynamics Unit, Rio de Janeiro, RJ, Brazil.
| | | | | | - Glaura Nisya de Oliveira Cruz
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Ambulatório de Urodinâmica Pediátrica - Oswaldo Cruz Foundation, National Institute of Women, Children and Adolescents Health Fernandes Figueira, Pediatric Urodynamics Unit, Rio de Janeiro, RJ, Brazil
| | - Marta Rizzini
- Universidade Federal do Maranhão (UFMA) - Federal University of Maranhão, São Luís, MA, Brazil
| | - Saulo Duarte Passos
- Faculdade de Medicina de Jundiaí (FMJ) - Jundiai Medicine College, Jundiai, SP, Brazil
| | - Lilian Lira Lisboa
- Instituto Santos Dumont, Centro de Ensino e Pesquisa Anita Garibaldi (ISD/CEPs) - Santos Dumont Institute, Anita Garibaldi Teaching and Research Center (ISD/CEPs),Macaíba, RN, Brazil
| | - Grace Ferreira de Araújo
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Ambulatório de Urodinâmica Pediátrica - Oswaldo Cruz Foundation, National Institute of Women, Children and Adolescents Health Fernandes Figueira, Pediatric Urodynamics Unit, Rio de Janeiro, RJ, Brazil
| | - Valéria Azevedo de Almeida
- Instituto Santos Dumont, Centro de Ensino e Pesquisa Anita Garibaldi (ISD/CEPs) - Santos Dumont Institute, Anita Garibaldi Teaching and Research Center (ISD/CEPs),Macaíba, RN, Brazil
| | - Jociele Malacarne
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Ambulatório de Urodinâmica Pediátrica - Oswaldo Cruz Foundation, National Institute of Women, Children and Adolescents Health Fernandes Figueira, Pediatric Urodynamics Unit, Rio de Janeiro, RJ, Brazil
| | | | - Lilian Cagliari Linhares Barreto
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Ambulatório de Urodinâmica Pediátrica - Oswaldo Cruz Foundation, National Institute of Women, Children and Adolescents Health Fernandes Figueira, Pediatric Urodynamics Unit, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Rafael Pauletti Gonçalves
- Instituto Santos Dumont, Centro de Ensino e Pesquisa Anita Garibaldi (ISD/CEPs) - Santos Dumont Institute, Anita Garibaldi Teaching and Research Center (ISD/CEPs),Macaíba, RN, Brazil
| | - Luana Farache
- Instituto Santos Dumont, Centro de Ensino e Pesquisa Anita Garibaldi (ISD/CEPs) - Santos Dumont Institute, Anita Garibaldi Teaching and Research Center (ISD/CEPs),Macaíba, RN, Brazil
| | | | - Fábio Valente Rizzo
- Faculdade de Medicina de Jundiaí (FMJ) - Jundiai Medicine College, Jundiai, SP, Brazil
| | - Luiz Dias da Silva
- Faculdade de Medicina de Jundiaí (FMJ) - Jundiai Medicine College, Jundiai, SP, Brazil
| | | | - Hannah Cavalcante Guedes Pinheiro
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), - Professor Joaquim Amorim Neto Research Institute, Campina Grande, PB, Brazil
| | - Adriana Suely de Oliveira Melo
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), - Professor Joaquim Amorim Neto Research Institute, Campina Grande, PB, Brazil
| | - Fabiana de Oliveira Melo
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), - Professor Joaquim Amorim Neto Research Institute, Campina Grande, PB, Brazil
| | - Rômulo Dias Moreira
- Universidade Federal do Maranhão (UFMA) - Federal University of Maranhão, São Luís, MA, Brazil
| | | | | | - Margareth Catoia Varela
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional Infectologia (INI), Laboratório de Pesquisa em Imunização e Vigilância em Saúde - Oswaldo Cruz Foundation (Fiocruz), Health Surveillance and Immunization Research Unit - Rio de Janeiro, RJ, Brazil
| | - Lucia Maria Costa Monteiro
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Ambulatório de Urodinâmica Pediátrica - Oswaldo Cruz Foundation, National Institute of Women, Children and Adolescents Health Fernandes Figueira, Pediatric Urodynamics Unit, Rio de Janeiro, RJ, Brazil
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Soares AP, de Lima Neto DF, Pour SZ, Passos SD, Cunha MDP, Zanotto PMDA. Evaluation of renal markers and liver enzymes in patients infected with the Chikungunya virus. J Med Virol 2023; 95:e29276. [PMID: 38100636 DOI: 10.1002/jmv.29276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/03/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023]
Abstract
Chikungunya virus (CHIKV) is an arbovirus (Togaviridae family, Alphavirus genus) that was first identified in 1953 in Tanzania. In 2014, the Asian and East/Central/South/African (ECSA) genotypes were identified in Brazil, although the genotype that spread the most in the following years across the Brazilian territory was the ECSA. The clinical symptoms associated with the infection caused by CHIKV include mainly fever, myalgia, headache, and arthralgia. In infections caused by other arboviruses (such as the ones caused by Dengue and West Nile viruses), changes in biochemical markers are often observed. This study aims to evaluate the biochemical markers profile of kidney and liver injury in acute patients infected with CHIKV. Two groups of correlations were found between the variables analyzed, namely, one between liver enzymes (r = 0.91), and another for kidney markers (r = 0.54-0.66). A significant elevation in the percentage of altered creatinine in CHIKV-infected patients was observed, followed by uric acid and AST. Altogether, in 8 different comparisons, it was possible to observe statistically significant differences between the levels of the markers when compared to the manifestation of symptoms (presence and absence). These noticeable changes in marker measurements could potentially be connected to the range of clinical symptoms seen in the disease.
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Affiliation(s)
- Anderson Pereira Soares
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Daniel Ferreira de Lima Neto
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Shahab Zaki Pour
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Saulo Duarte Passos
- Department of Pediatrics, Jundiaí School of Medicine, Jundiaí, São Paulo, Brazil
| | - Marielton Dos Passos Cunha
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Paolo Marinho de Andrade Zanotto
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
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Prestes R, Pandini VCM, Pereira T, Pomilio MCA, Andrade AND, Mizani RM, Fajardo TCG, Gazeta RE, Bertozzi APAP, Lourenço EA, Passos SD. Assessing the hearing of children exposed to zika virus with an initially normal newborn hearing screen: a longitudinal cohort study. Acta Otolaryngol 2023; 143:31-36. [PMID: 36661392 DOI: 10.1080/00016489.2023.2165145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Zika virus (ZIKV) infection can result in hearing loss in babies, consequently, audiological monitoring is necessary. AIMS This study aimed to evaluate the frequency of hearing impairment in neonates and children exposed to ZIKV during the intrauterine period. MATERIALS AND METHODS A cohort of 30 children born to mothers infected with ZIKV during pregnancy (March 2016-January 2017) underwent repeated hearing assessments performed 48 h after birth. Universal Newborn Hearing Screening revealed normal results in all children at 6, 13, 24, and 36 months. Children were divided into two subgroups based on real-time polymerase chain reaction: RT-PCR(+) and RT-PCR(-). RESULTS At 24 months, the cumulative incidence of hearing alteration was 57.1%. There was no significant difference in the detection of hearing alteration between RT-PCR(+) and (-) groups. None of the children had sensorineural hearing loss. CONCLUSIONS AND SIGNIFICANCE None of the children had sensorineural hearing loss. Total incidence conductive type (per 1000 live births), RT-PCR ZIKV (-) 2.2, prevalence 20% and RT-PCR ZIKV 3.1, prevalence 35.7%.The incidence of hearing alteration was highest at 24 months of age (57.1%, n = 8; only conductive type).
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Affiliation(s)
- Raquel Prestes
- Student pós graduation, Medicine College of Jundiai, Jundiai, Brazil
| | | | - Tânia Pereira
- Therapeutic Association for Language and Hearing Stimulation, Jundiai, Brazil
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Arraes de Alencar Ximenes R, de Barros Miranda-Filho D, Brickley EB, Barreto de Araújo TV, Montarroyos UR, Abtibol-Bernardino MR, Mussi-Pinhata MM, Duarte G, Coutinho CM, Biason de Moura Negrini SF, Alecrim MDGC, Albuquerque de Almeida Peixoto LDF, Lopes Moreira ME, Zin A, Pereira Júnior JP, Nielsen-Saines K, Turchi Martelli CM, Rodrigues LC, Vieira de Souza W, Ventura LO, Silva de Oliveira C, de Matos H, Furtado Serra EM, Souza Gomes LT, Nogueira ML, Estofolete C, Vaz-Oliani DC, Passos SD, Moron A, Duarte Rodrigues MM, Pereira Sarmento SG, Turchi MD, Pela Rosado LE, de Sene Amâncio Zara AL, Franco Gomes MB, Schuler-Faccini L, Herrero-Silva J, Amorim MM, Melo AO, Ledo Alves da Cunha AJ, Prata-Barbosa A, Amim J, Rezende-Filho J, Calcagno JI, Júnior Alcântara LC, Lima de Almeida B, Hofer CB, Machado ES, de Siqueira IC, Martinez-Espinosa FE, Brasil P. Risk of adverse outcomes in offspring with RT-PCR confirmed prenatal Zika virus exposure: An individual participant data meta-analysis of 13 cohorts in the Zika Brazilian Cohorts Consortium. Lancet Reg Health Am 2023; 17:100395. [PMID: 36714276 PMCID: PMC9880800 DOI: 10.1016/j.lana.2022.100395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Knowledge regarding the risks associated with Zika virus (ZIKV) infections in pregnancy has relied on individual studies with relatively small sample sizes and variable risk estimates of adverse outcomes, or on surveillance or routinely collected data. Using data from the Zika Brazilian Cohorts Consortium, this study aims, to estimate the risk of adverse outcomes among offspring of women with RT-PCR-confirmed ZIKV infection during pregnancy and to explore heterogeneity between studies. Methods We performed an individual participant data meta-analysis of the offspring of 1548 pregnant women from 13 studies, using one and two-stage meta-analyses to estimate the absolute risks. Findings Of the 1548 ZIKV-exposed pregnancies, the risk of miscarriage was 0.9%, while the risk of stillbirth was 0.3%. Among the pregnancies with liveborn children, the risk of prematurity was 10,5%, the risk of low birth weight was 7.7, and the risk of small for gestational age (SGA) was 16.2%. For other abnormalities, the absolute risks were: 2.6% for microcephaly at birth or first evaluation, 4.0% for microcephaly at any time during follow-up, 7.9% for neuroimaging abnormalities, 18.7% for functional neurological abnormalities, 4.0% for ophthalmic abnormalities, 6.4% for auditory abnormalities, 0.6% for arthrogryposis, and 1.5% for dysphagia. This risk was similar in all sites studied and in different socioeconomic conditions, indicating that there are not likely to be other factors modifying this association. Interpretation This study based on prospectively collected data generates the most robust evidence to date on the risks of congenital ZIKV infections over the early life course. Overall, approximately one-third of liveborn children with prenatal ZIKV exposure presented with at least one abnormality compatible with congenital infection, while the risk to present with at least two abnormalities in combination was less than 1.0%.
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Affiliation(s)
- Ricardo Arraes de Alencar Ximenes
- Postgraduate Program in Tropical Medicine, Federal University of Pernambuco, Recife, PE, Brazil,Post-Graduation in Health Sciences, University of Pernambuco, Recife, PE, Brazil,Corresponding author. Professional address: Postgraduate Program in Tropical Medicine, Federal University of Pernambuco, Av. Prof. Moraes Rego, s/n., Cidade Universitária, Recife, PE 50670-901, Brazil; University of Pernambuco, Rua Arnóbio Marques, n. 310, Santo Amaro, Recife, PE 50100-130, Brazil.
| | | | - Elizabeth B. Brickley
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Marília Rosa Abtibol-Bernardino
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil,Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | | | - Geraldo Duarte
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil
| | - Conrado Milani Coutinho
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil
| | | | - Maria das Graças Costa Alecrim
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil,Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | - Lucíola de Fátima Albuquerque de Almeida Peixoto
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil,Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil
| | | | - Andrea Zin
- Clinical Research Unit, Instituto Fernandes Figueira, Oswaldo Cruz Foundation, Fiocruz, Rio de Janeiro, RJ, Brazil
| | | | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen University of California at Los Angeles School of Medicine, LA, United States
| | | | - Laura Cunha Rodrigues
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Liana O. Ventura
- Department of Ophthalmology, Altino Ventura Foundation, Recife, PE, Brazil,Pernambuco Eyes Hospital, Recife, PE, Brazil
| | | | - Haroldo de Matos
- Department of Epidemiology, Evandro Chagas Institute, Ananindeua, PA, Brazil
| | | | - Luna Thais Souza Gomes
- Department of Arbovirology and Hemorrhagic Fever, Evandro Chagas Institute, Ananindeua, PA, Brazil
| | - Maurício L. Nogueira
- Department of Infectious Disease, Medicine School of São José do Rio Preto, São José do Rio Preto, SP, Brazil
| | - Cassia Estofolete
- Department of Infectious Disease, Medicine School of São José do Rio Preto, São José do Rio Preto, SP, Brazil
| | - Denise Cristina Vaz-Oliani
- Department of Gynecology and Obstetrics, Medicine School of São José do Rio Preto, São José do Rio Preto, SP, Brazil
| | - Saulo Duarte Passos
- Infectious Pediatric Laboratory, Medicine School of Jundiaí, Jundiaí, SP, Brazil
| | - Antonio Moron
- Department of Fetal Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Marília Dalva Turchi
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil
| | | | | | | | - Lavínia Schuler-Faccini
- Departamento de Genética, Hospital das Clinicas de Porto Alegre, Universidade Federal do Rio Grandedo Sul, Porto Alegre, RS, Brazil
| | - Juliana Herrero-Silva
- City Hall of Tangará da Serra, Municipal Health Department, Tangará da Serra, MT, Brazil
| | - Melania M. Amorim
- Medical Academic Unit, Federal University of Campina Grande, Campina Grande, PB, Brazil
| | - Adriana Oliveira Melo
- Medical Academic Unit, Federal University of Campina Grande, Campina Grande, PB, Brazil
| | | | - Arnaldo Prata-Barbosa
- Department of Pediatrics, D’Or Institute for Research & Education, Rio de Janeiro, RJ, Brazil
| | - Joffre Amim
- Department of Obstectrics, Federal University of Rio de Janeiro Maternity School, Rio de Janeiro, RJ, Brazil
| | - Jorge Rezende-Filho
- Department of Obstectrics, Federal University of Rio de Janeiro Maternity School, Rio de Janeiro, RJ, Brazil
| | - Juan Ignacio Calcagno
- Reference Maternity Prof. José Maria de Magalhães Netto, Bahia Health Department, Salvador, BA, Brazil
| | | | | | - Cristina Barroso Hofer
- Department of Infecitous Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Elizabeth S. Machado
- Department of Infecitous Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Flor Ernestina Martinez-Espinosa
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus, AM, Brazil,Postgraduate Program in Tropical Medicine, Doctor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Brazil,Leonidas and Maria Deane Institute, Fiocruz, Manaus, AM, Brazil
| | - Patrícia Brasil
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation, Fiocruz, Rio de Janeiro, Brazil
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de Moraes AG, Ayo CM, Elpídio LNS, de Souza VH, Yamanaka AHU, Nogueira ML, Passos SD, Brandão CC, de Mattos LC, do Amaral GC, Neto QADL, Visentainer JEL. HLA-G, LILRB1 and LILRB2 Variants in Zika Virus Transmission from Mother to Child in a Population from South and Southeast of Brazil. Curr Issues Mol Biol 2022; 44:2783-2793. [PMID: 35877415 PMCID: PMC9317030 DOI: 10.3390/cimb44070191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 12/04/2022] Open
Abstract
During the 2015–2016 epidemic, Brazil was the country with the highest rate of Zika virus (ZIKV) infection in the Americas. Twenty-nine percent of pregnant women positive for ZIKV exhibited ultrasound scans with fetus anomalies. Human leukocyte antigen-G (HLA-G) exerts immunoregulatory effects by binding to inhibitory receptors, namely LILRB1 and LILRB2, thus preventing mother–fetus rejection and vertical pathogen transmission. The binding of HLA-G to one of its receptors modulates both innate and adaptive immunity. However, in a viral infection, these molecules may behave as pathogenic mediators shifting the pregnancy environment from an anti-inflammatory profile to a pro-inflammatory phenotype. Genetic mutations might be associated with the change in phenotype. This study aimed to explore the possible role of polymorphic sites in HLA-G, LILRB1 and LILRB2 in mother–fetus ZIKV transmission. Polymorphisms were detected by direct sequencing. Differences in allele and/or genotype frequencies for each SNP analyzed among ZIKV non-transmitting and transmitting mother–child pairs, among ZIKV-transmitting and non-transmitting mothers and between ZIKV-infected and non-infected children were compared by Mid-P exact test or Yates’ correction. Significant susceptibility of ZIKV vertical transmission is suggested in ZIKV-transmitting and non-transmitting mothers and ZIKV-infected and non-infected children for LILRB1_rs1061684 T/T (p = 0.03, Pc = 0.06, OR = 12.4; p = 0.008, Pc = 0.016, OR = 16.4) and LILRB1_rs16985478 A/A (p = 0.01, Pc = 0.02, OR = 19.2; p = 0.008, Pc = 0.016, OR = 16.4). HLA-G_rs1710 (p = 0.04, Pc = 0.52, OR = 4.30) was also a susceptibility factor. LILRB2_rs386056 G/A (p = 0.02, Pc = 0.08, OR = 0.07), LILRB2_rs7247451 G/G (p = 0.01, Pc = 0.04, OR = 0.04) and HLAG_rs9380142 T/T (p = 0.04, Pc = 0.52, OR = 0.14) were suggested as protective factors against vertical transmission. The current study suggests that polymorphic sites in the LILRB1 and HLA-G genes might be associated with mother-to-child ZIKV transmission while LILRB2 might be associated with protection against ZIKV transmission in the womb in a population from the south and southeast of Brazil.
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Affiliation(s)
- Amarilis Giaretta de Moraes
- Post Graduation Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá 87020-270, PR, Brazil; (L.N.S.E.); (V.H.d.S.); (A.H.U.Y.); (Q.A.d.L.N.)
- Laboratory of Immunogenetics, Department of Basic Health Sciences, State University of Maringá, Maringá 87020-270, PR, Brazil
- Correspondence: (A.G.d.M.); (J.E.L.V.)
| | - Christiane Maria Ayo
- Laboratory of Immunogenetics, Department of Molecular Biology, Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil; (C.M.A.); (C.C.B.); (L.C.d.M.)
| | - Laise Nayana Sala Elpídio
- Post Graduation Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá 87020-270, PR, Brazil; (L.N.S.E.); (V.H.d.S.); (A.H.U.Y.); (Q.A.d.L.N.)
- Laboratory of Immunogenetics, Department of Basic Health Sciences, State University of Maringá, Maringá 87020-270, PR, Brazil
| | - Victor Hugo de Souza
- Post Graduation Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá 87020-270, PR, Brazil; (L.N.S.E.); (V.H.d.S.); (A.H.U.Y.); (Q.A.d.L.N.)
- Laboratory of Immunogenetics, Department of Basic Health Sciences, State University of Maringá, Maringá 87020-270, PR, Brazil
| | - Aléia Harumi Uchibaba Yamanaka
- Post Graduation Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá 87020-270, PR, Brazil; (L.N.S.E.); (V.H.d.S.); (A.H.U.Y.); (Q.A.d.L.N.)
- Laboratory of Immunogenetics, Department of Basic Health Sciences, State University of Maringá, Maringá 87020-270, PR, Brazil
| | - Maurício Lacerda Nogueira
- Virology Research Laboratory, Department of Infectious and Parasitic Diseases, Medical School of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil;
| | - Saulo Duarte Passos
- Department of Pediatrics, Faculty of Medicine of Jundiai (FMJ), Jundiaí 13202-550, SP, Brazil;
| | - Cinara Cássia Brandão
- Laboratory of Immunogenetics, Department of Molecular Biology, Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil; (C.M.A.); (C.C.B.); (L.C.d.M.)
| | - Luiz Carlos de Mattos
- Laboratory of Immunogenetics, Department of Molecular Biology, Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil; (C.M.A.); (C.C.B.); (L.C.d.M.)
| | | | - Quirino Alves de Lima Neto
- Post Graduation Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá 87020-270, PR, Brazil; (L.N.S.E.); (V.H.d.S.); (A.H.U.Y.); (Q.A.d.L.N.)
- Laboratory of Immunogenetics, Department of Basic Health Sciences, State University of Maringá, Maringá 87020-270, PR, Brazil
| | - Jeane Eliete Laguila Visentainer
- Post Graduation Program in Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá 87020-270, PR, Brazil; (L.N.S.E.); (V.H.d.S.); (A.H.U.Y.); (Q.A.d.L.N.)
- Laboratory of Immunogenetics, Department of Basic Health Sciences, State University of Maringá, Maringá 87020-270, PR, Brazil
- Correspondence: (A.G.d.M.); (J.E.L.V.)
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de Souza TG, Bagne E, Mizani R, Rotob AA, Gazeta RE, de Sene Amâncio Zara AL, Jundiaí CZV, Passos SD. Accuracy of the Hammersmith infant neurological examination for the early detection of neurological changes in infants exposed to Zika virus: A case-cohort study. Medicine (Baltimore) 2022; 101:e29488. [PMID: 35758386 PMCID: PMC9276139 DOI: 10.1097/md.0000000000029488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/05/2022] [Indexed: 11/26/2022] Open
Abstract
The Hammersmith infant neurological examination (HINE) is a highly predictive tool for the easy and low-cost detection of cerebral palsy. Between 2015 and 2016, the rapid spread of the Zika virus (ZIKV) in Brazil was responsible for an increase in microcephaly cases. This study aimed to verify the accuracy of the HINE for the early detection of neurological problems in Brazilian babies exposed to ZIKV.This was a cross sectional case-control study of children exposed to ZIKV. This study was part of the Jundiaí ZIKV Cohort. Of a total sample of 782 children, 98 were evaluated (26 in the exposed group and 63 in the control group). We included late preterm infants and term infants who were exposed to the ZIKV and were participants in the ZIKV Cohort study. Student's t-test and stepwise multivariate logistic regression were used to compare groups.Of the 26 items evaluated in the five scored categories of the HINE (cranial nerve function, posture, movements, tone, reflexes, and reactions), only the difference in ankle dorsiflexion between the exposed and the control groups was statistically significant. However, some items showed a significant trend in relation to the control group.Our results demonstrated the importance of early neurological assessment of infants exposed to ZIKV, even in those without a microcephaly diagnosis.
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Affiliation(s)
| | - Eduardo Bagne
- Faculdade de Medicina de Jundiaí, Departamento de Pediatria, Jundiaí, SP, Brazil
- Universidade Paulista, UNIP, Jundiaí, SP, Brazil
| | - Renata Mizani
- Faculdade de Medicina de Jundiaí, Departamento de Pediatria, Jundiaí, SP, Brazil
| | | | - Rosa Estela Gazeta
- Faculdade de Medicina de Jundiaí, Departamento de Pediatria, Jundiaí, SP, Brazil
| | - Ana Laura de Sene Amâncio Zara
- Universidade Federal de Goiás, Departamento de Saúde Coletiva, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brazil
| | | | - Saulo Duarte Passos
- Faculdade de Medicina de Jundiaí, Departamento de Pediatria, Jundiaí, SP, Brazil
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Fajardo TCG, Gazeta RE, Catalan DT, Mello AS, da Silva ACB, Bertozzi APAP, Santos GRD, Pinto CAL, Monteiro CO, Machado RRG, Oliveira DBL, Durigon EL, Passos SD. Neonatal consequences of maternal exposure to the chikungunya virus: Case reports. Medicine (Baltimore) 2021; 100:e25695. [PMID: 33907147 PMCID: PMC8084008 DOI: 10.1097/md.0000000000025695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
RATIONALE The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV. PATIENT CONCERNS In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth. DIAGNOSIS In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children. INTERVENTIONS The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection. OUTCOMES There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth. LESSONS Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Cairo Oliveira Monteiro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Saulo Duarte Passos
- Laboratory of Paediatric Infectology, Jundiaí School of Medicine
- Department of Paediatric, Jundiaí School of Medicine
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Alecrim MDGC, de Amorim MMR, de Araújo TVB, Brasil P, Brickley EB, Castilho MDC, Coelho BP, da Cunha AJLA, Duarte G, Estofolete CF, Gurgel RQ, Herrero-Silva J, Hofer CB, Lopes ASA, Martelli CMT, Melo ASDO, Miranda-Filho DDB, Montarroyos UR, Moreira ME, Mussi-Pinhata MM, de Oliveira CS, Passos SD, Prata-Barbosa A, dos Santos DN, Schuler-Faccini L, da Silva AAM, de Siqueira IC, Sousa PDS, Turchi MD, Ximenes RADA, Zara ALDSA. Zika Brazilian Cohorts (ZBC) Consortium: Protocol for an Individual Participant Data Meta-Analysis of Congenital Zika Syndrome after Maternal Exposure during Pregnancy. Viruses 2021; 13:v13040687. [PMID: 33923434 PMCID: PMC8072625 DOI: 10.3390/v13040687] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/31/2022] Open
Abstract
Despite great advances in our knowledge of the consequences of Zika virus to human health, many questions remain unanswered, and results are often inconsistent. The small sample size of individual studies has limited inference about the spectrum of congenital Zika manifestations and the prognosis of affected children. The Brazilian Zika Cohorts Consortium addresses these limitations by bringing together and harmonizing epidemiological data from a series of prospective cohort studies of pregnant women with rash and of children with microcephaly and/or other manifestations of congenital Zika. The objective is to estimate the absolute risk of congenital Zika manifestations and to characterize the full spectrum and natural history of the manifestations of congenital Zika in children with and without microcephaly. This protocol describes the assembly of the Consortium and protocol for the Individual Participant Data Meta-analyses (IPD Meta-analyses). The findings will address knowledge gaps and inform public policies related to Zika virus. The large harmonized dataset and joint analyses will facilitate more precise estimates of the absolute risk of congenital Zika manifestations among Zika virus-infected pregnancies and more complete descriptions of its full spectrum, including rare manifestations. It will enable sensitivity analyses using different definitions of exposure and outcomes, and the investigation of the sources of heterogeneity between studies and regions.
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Affiliation(s)
| | - Melania Maria Ramos de Amorim
- Universidade Federal de Campina Grande, Campina Grande 58428-830, Brazil; (M.M.R.d.A.); (A.S.d.O.M.)
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife 50070-902, Brazil
| | | | - Patrícia Brasil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil;
| | | | - Marcia da Costa Castilho
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus 69040-000, Brazil; (M.d.G.C.A.); (M.d.C.C.)
| | - Bernadete Perez Coelho
- Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife 50670-901, Brazil;
| | | | - Geraldo Duarte
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto 14049-900, Brazil; (G.D.); (M.M.M.-P.)
| | | | | | | | - Cristina Barroso Hofer
- Departamento de Pediatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-971, Brazil; (A.J.L.A.d.C.); (C.B.H.)
| | | | | | - Adriana Suely de Oliveira Melo
- Universidade Federal de Campina Grande, Campina Grande 58428-830, Brazil; (M.M.R.d.A.); (A.S.d.O.M.)
- Instituto Paraibano de Diagnóstico (EMBRION), Campina Grande 58400-506, Brazil
| | | | | | | | - Marisa Marcia Mussi-Pinhata
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto 14049-900, Brazil; (G.D.); (M.M.M.-P.)
| | | | | | | | | | | | | | | | - Patrícia da Silva Sousa
- Centro de Referência em Neurodesenvolvimento, Assistência e Reabilitação de Crianças, Secretaria de Saúde do Estado do Maranhão, São Luís 65076-820, Brazil;
| | - Marília Dalva Turchi
- Departamento de Saude Coletiva, Universidade Federal de Goiás, Goiânia 74605-050, Brazil; (M.D.T.); (A.L.d.S.A.Z.)
| | - Ricardo Arraes de Alencar Ximenes
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife 50100-130, Brazil;
- Departamento de Medicina Tropical da Universidade Federal de Pernambuco, Recife 50670-901, Brazil
- Correspondence:
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Trani MTD, Zanchetta LAB, Artuso LR, Moraes ML, Teixeira MS, Passos SD, Machado MB. RELATO DE CASO ‐ SÍNDROME DE KAWASAKI LIKE EM PACIENTE COM SUSPEITA DE MENINGITE. Braz J Infect Dis 2021. [PMCID: PMC7936818 DOI: 10.1016/j.bjid.2020.101166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sanchez Clemente N, Brickley EB, Furquim de Almeida M, Witkin SS, Duarte Passos S. Can Zika Virus Infection in High Risk Pregnant Women Be Differentiated on the Basis of Symptoms? Viruses 2020; 12:v12111263. [PMID: 33167566 PMCID: PMC7694531 DOI: 10.3390/v12111263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/12/2020] [Accepted: 10/23/2020] [Indexed: 12/16/2022] Open
Abstract
Zika virus (ZIKV) infection in pregnancy is associated with congenital neurological abnormalities. Our understanding of the full clinical spectrum of ZIKV infection is incomplete. Using data from this prospective cohort study consisting of 650 women attending a high-risk pregnancy clinic during the Zika virus outbreak in Brazil, we investigated the extent to which specific symptoms can be utilized to differentiate ZIKV-infected pregnant women from those with other pregnancy-related problems. All were tested for ZIKV in urine by RT-qPCR. Demographic and clinical data including physical symptoms during follow-up were recorded and analyzed with respect to Zika virus exposure status. Forty-eight (7.4%) women were positive for ZIKV by RT-qPCR. The majority (70.8%) were asymptomatic, and only four ZIKV-positive women (8.3%) reported symptoms during pregnancy that met the WHO case definition. Zika-positive and -negative women reported similar frequencies of ZIKV-like symptoms (as per the WHO definition): fever (16.7% vs. 13.6%), arthralgia/arthritis (10.4% vs. 11.3%), rash (4.2% vs. 5.3%), and conjunctivitis (2.1% vs. 3.2%). Most pregnant women positive for ZIKV in urine are asymptomatic and do not deliver a baby with microcephaly. Physical symptoms alone did not differentiate between high-risk pregnant women positive or negative for ZIKV.
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Affiliation(s)
- Nuria Sanchez Clemente
- Department of Epidemiology, University of São Paulo School of Public Health, São Paulo 01246-904, Brazil;
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
- Correspondence:
| | - Elizabeth B. Brickley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Marcia Furquim de Almeida
- Department of Epidemiology, University of São Paulo School of Public Health, São Paulo 01246-904, Brazil;
| | - Steven S. Witkin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY 10065, USA;
| | - Saulo Duarte Passos
- Jundiaí Medical School, Jundiaí University, Jundiaí, São Paulo 13202-550, Brazil;
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Lima DDS, Baran LCP, Hamer RD, Costa MFD, Vidal KS, Damico FM, Barboni MTS, França VDCRDM, Martins CMG, Tabares HS, Dias SL, Silva LA, Decleva D, Zatz M, Bertozzi APAP, Gazeta RE, Passos SD, Ventura DF. Longitudinal visual acuity development in ZIKV-exposed children. J AAPOS 2020; 24:23.e1-23.e6. [PMID: 31926367 DOI: 10.1016/j.jaapos.2019.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/11/2019] [Accepted: 11/03/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To follow the visual acuity development of children exposed to or infected with the Zika virus (ZIKV) during gestation and to relate potential visual acuity deficits to their clinical condition. METHODS In this prospective study, visual acuity was measured via Teller Acuity Cards in three groups of children: (1) those with confirmed ZIKV exposure (ZE) through the mother only, (2) those with confirmed infection (ZI), and (3) unaffected controls. Visual acuity was measured 2-4 times in each child during the first 30 months of age. RESULTS The study included 22 children in the ZE group, 11 in the ZI group, and 27 controls. Visual acuity developed normally in both patient groups, including infected patients (ZI) that did not manifest clinical symptoms. In a small subgroup of patients with characteristics consistent with congenital Zika syndrome (CZS), visual acuity was within normative values, with the exception of single child with chorioretinal atrophy. CONCLUSIONS In this southeastern Brazil study cohort, visual acuity development seemed to progress normally in infected children without CZS symptoms.
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Affiliation(s)
- Diego da Silva Lima
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil.
| | - Luiz Claudio Portnoi Baran
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Russell David Hamer
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil; Department of Psychology, Florida Atlantic University, Boca Raton, Florida
| | - Marcelo Fernandes da Costa
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Kallene Summer Vidal
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Francisco Max Damico
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil; Department of Ophthalmology, São Paulo Medical School, University of São Paulo, São Paulo, Brazil
| | - Mirella Telles Salgueiro Barboni
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil; Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | | | | | - Heydi Segundo Tabares
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Sarah Leonardo Dias
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Leonardo Aparecido Silva
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Diego Decleva
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Mayana Zatz
- Stem Cell and Human Genome Research Center, Biosciences Institute, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Dora Fix Ventura
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
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12
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Portnoi Baran LC, Fernades da Costa M, Summer Vidal K, Damico FM, Telles Salgueiro Barboni M, da Silva Lima D, de Cássia Rodrigues de Matos França V, Gomes Martins CM, Segundo Tabares H, Leonardo Dias S, Aparecido Silva L, Decleva D, Hamer RD, Zatz M, A P Bertozzi AP, Gazeta RE, Duarte Passos S, Fix Ventura D. Alterations in visual acuity and visual development in infants 1-24 months old either exposed to or infected by Zika virus during gestation, with and without microcephaly. J AAPOS 2019; 23:215.e1-215.e7. [PMID: 31229606 DOI: 10.1016/j.jaapos.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/27/2019] [Accepted: 03/31/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate visual acuity and visual acuity development in children from the state of São Paulo, Brazil, who were exposed to the Zika virus (ZIKV) gestationally. METHODS Children who had been exposed to ZIKV during gestation and age-matched control subjects received visual acuity and funduscopic examination. ZIKV exposure was confirmed by maternal quantitative polymerase chain reaction testing or serology assay. The ZIKV group was divided into two subgroups: exposed (ZE), with only the mother having confirmed ZIKV infection, and infected (ZI), with confirmed infection. Visual acuity development was compared with prior norms and quantified by measuring visual acuity correlation with age. RESULTS A total of 110 children were included: 47 who had been exposed to ZIKV (ZE, 23; ZI, 24) and 63 controls. Abnormal visual acuity was found in 5 of 24 ZI children. Of the 4 children with microcephaly, only 2 had visual acuity loss (only 1 also had abnormal funduscopic findings). There was significant correlation between age and visual acuity in both the control group (R2 = 0.8; P < 0.0000) and the ZE subgroup (R2 = 0.6; P < 0.0000). However, visual acuity did not correlate with age in the ZI subgroup (R2 = 0.04; P = 0.38). Furthermore, the increment in octaves/month was much lower in the ZI subgroup. CONCLUSIONS Our data indicate that visual acuity losses only occur in infants who suffered gestational-infection, not simply exposure. Lack of correlation between age and visual acuity in the ZI subgroup suggests a slowing of visual development even in the absence of microcephaly. This result may have broad implications for the deleterious effects of ZIKV on the central nervous system.
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Affiliation(s)
- Luiz Claudio Portnoi Baran
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil.
| | - Marcelo Fernades da Costa
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
| | - Kallene Summer Vidal
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
| | - Francisco Max Damico
- Department of Ophthalmology, University of São Paulo College of Medicine, São Paulo, SP, Brazil
| | - Mirella Telles Salgueiro Barboni
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil; Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Diego da Silva Lima
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
| | | | - Cristiane Maria Gomes Martins
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
| | - Heydi Segundo Tabares
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
| | - Sarah Leonardo Dias
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil
| | - Leonardo Aparecido Silva
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
| | - Diego Decleva
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
| | - Russell David Hamer
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil; Department of Psychology, Florida Atlantic University, Boca Raton, Florida
| | - Mayana Zatz
- Human Genome and Stem Cells Center, Bioscience Institute, University of São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Dora Fix Ventura
- Department of Experimental Psychology, University of São Paulo Institute of Psychology, São Paulo, SP, Brazil; Nucleus of Neurosciences and Behavior, University of São Paulo, São Paulo, SP, Brazil
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Abstract
Objective: Through a systematic review, this essay aimed at revising the concepts of
severe pertussis, updating the epidemiology,
pathophysiology, clinical presentation, antibiotic therapy and auxiliary
therapeutic options for symptomatology and complications. Data sources: This review considered publications from the last 30years in the databases US
National Library of Medicine (PubMed), Scientific Electronic Library Online
(SciELO), Literatura Latino-americana e do Caribe em Ciências da Saúde
(LILACS), Cochrane, Google Scholar, as well as protocols of the Ministry of
Health and recommendations of the Centers for Disease Control and
Prevention, related to childhood pertussis (whooping
cough), with emphasis on its severe form. This research was based on
keywords derived from the terms “pertussis”,
“azithromycin”, “antitussives”, “leukocyte reduction” in Portuguese and
English. Duplicate studies and those with unavailable full-text were
excluded. Data synthesis: Among 556 records found, 54 were selected for analysis.
Pertussis, as a reemerging disease, has affected all
age groups, evidencing the transient immunity conferred by infection and
vaccination. Severe cases occur in neonates and infants, with secondary
viral and bacterial complications and malignant pertussis,
a longside hyperleukocytosis, respiratory failure and shock. Macrolides
continue to be the chosen antibiotics, while antitussives for coughing
remain without efficacy. The prompt treatment in Intensive Care Units
improved the prognostic in severe cases, and transfusion was promising among
procedures for leukoreduction. Conclusions: Approaching severe pertussis in childhood remains a challenge for diagnostic
and therapy, as the available therapeutic options are still unsatisfactory.
Strategies of prevention are expected to reduce the occurrence of severe
cases, while new studies should confirm the role of auxiliary therapies.
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Caires-Júnior LC, Goulart E, Melo US, Araujo BHS, Alvizi L, Soares-Schanoski A, de Oliveira DF, Kobayashi GS, Griesi-Oliveira K, Musso CM, Amaral MS, daSilva LF, Astray RM, Suárez-Patiño SF, Ventini DC, Gomes da Silva S, Yamamoto GL, Ezquina S, Naslavsky MS, Telles-Silva KA, Weinmann K, van der Linden V, van der Linden H, de Oliveira JRM, Arrais NMR, Melo A, Figueiredo T, Santos S, Meira JGC, Passos SD, de Almeida RP, Bispo AJB, Cavalheiro EA, Kalil J, Cunha-Neto E, Nakaya H, Andreata-Santos R, de Souza Ferreira LC, Verjovski-Almeida S, Ho PL, Passos-Bueno MR, Zatz M. Discordant congenital Zika syndrome twins show differential in vitro viral susceptibility of neural progenitor cells. Nat Commun 2018; 9:475. [PMID: 29396410 PMCID: PMC5797251 DOI: 10.1038/s41467-017-02790-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/28/2017] [Indexed: 12/28/2022] Open
Abstract
Congenital Zika syndrome (CZS) causes early brain development impairment by affecting neural progenitor cells (NPCs). Here, we analyze NPCs from three pairs of dizygotic twins discordant for CZS. We compare by RNA-Seq the NPCs derived from CZS-affected and CZS-unaffected twins. Prior to Zika virus (ZIKV) infection the NPCs from CZS babies show a significantly different gene expression signature of mTOR and Wnt pathway regulators, key to a neurodevelopmental program. Following ZIKV in vitro infection, cells from affected individuals have significantly higher ZIKV replication and reduced cell growth. Whole-exome analysis in 18 affected CZS babies as compared to 5 unaffected twins and 609 controls excludes a monogenic model to explain resistance or increased susceptibility to CZS development. Overall, our results indicate that CZS is not a stochastic event and depends on NPC intrinsic susceptibility, possibly related to oligogenic and/or epigenetic mechanisms. Zika virus (ZIKV) infection can cause congenital Zika syndrome (CZS), but the underlying mechanisms are poorly understood. Here, the authors generate neural progenitor cells from dizygotic twins with a discordant phenotype regarding CZS and study their response to ZIKV infection.
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Affiliation(s)
- Luiz Carlos Caires-Júnior
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Ernesto Goulart
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Uirá Souto Melo
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Bruno Henrique Silva Araujo
- Brazilian Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas - SP, 13083-970, Brazil.,Neuroscience laboratory, Department of Neurology and Neurosurgery, Federal University of São Paulo-UNIFESP/EPM, São Paulo - SP, 04039-002, Brazil
| | - Lucas Alvizi
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | | | - Danyllo Felipe de Oliveira
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Gerson Shigeru Kobayashi
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Karina Griesi-Oliveira
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil.,Albert Einstein Hospital, São Paulo - SP, 05652-900, Brazil
| | - Camila Manso Musso
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | | | - Lucas Ferreira daSilva
- Department of Biochemistry, Institute of Chemistry, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | | | | | | | - Sérgio Gomes da Silva
- Albert Einstein Hospital, São Paulo - SP, 05652-900, Brazil.,Universidade de Mogi das Cruzes, Mogi das Cruzes - SP, 08780-911, Brazil
| | - Guilherme Lopes Yamamoto
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Suzana Ezquina
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Michel Satya Naslavsky
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Kayque Alves Telles-Silva
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Karina Weinmann
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | | | | | - João Ricardo Mendes de Oliveira
- Neuropsychiatry Department and KeizoAsami Laboratory, Federal University of Pernambuco (UFPE), Recife - PE, 50670-901, Brazil
| | | | | | - Thalita Figueiredo
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Silvana Santos
- Department of Biology, Paraíba State University (UEPB), Campina Grande - PB, 58429-500, Brazil
| | | | - Saulo Duarte Passos
- Infectious pediatric laboratory, Medicine School of Jundiaí, Jundiaí - SP, 13202-550, Brazil
| | - Roque Pacheco de Almeida
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe (UFS), Aracaju - SP, 49100-000, Brazil
| | - Ana Jovina Barreto Bispo
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe (UFS), Aracaju - SP, 49100-000, Brazil
| | - Esper Abrão Cavalheiro
- Neuroscience laboratory, Department of Neurology and Neurosurgery, Federal University of São Paulo-UNIFESP/EPM, São Paulo - SP, 04039-002, Brazil
| | - Jorge Kalil
- Butantan Institute, São Paulo - SP, 05503-900, Brazil
| | - Edécio Cunha-Neto
- Heart Institute, Faculty of Medicine, University of São Paulo (USP), São Paulo - SP, 05403-900, Brazil
| | - Helder Nakaya
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Robert Andreata-Santos
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Science, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Luis Carlos de Souza Ferreira
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Science, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Sergio Verjovski-Almeida
- Butantan Institute, São Paulo - SP, 05503-900, Brazil.,Department of Biochemistry, Institute of Chemistry, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Paulo Lee Ho
- Butantan Institute, São Paulo - SP, 05503-900, Brazil
| | - Maria Rita Passos-Bueno
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil
| | - Mayana Zatz
- Department of Genetics and Evolutionary Biology, Human Genome and Stem Cell Research Center, Biosciences Institute, University of São Paulo (USP), São Paulo - SP, 05508-900, Brazil.
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Passos SD, Maziero FF, Antoniassi DQ, Souza LTD, Felix AF, Dotta E, Orensztejn ME, Marchi E, Gazeta RE. DOENÇAS RESPIRATÓRIAS AGUDAS EM CRIANÇAS BRASILEIRAS: OS CUIDADORES SÃO CAPAZES DE DETECTAR OS PRIMEIROS SINAIS DE ALERTA? Rev paul pediatr 2018; 36:7. [PMID: 29412428 PMCID: PMC5849373 DOI: 10.1590/1984-0462/;2018;36;1;00008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 04/04/2017] [Indexed: 12/20/2022]
Abstract
RESUMO Objetivo: Avaliar o nível de conhecimento do cuidador em relação aos sinais e sintomas respiratórios de Infecções Respiratórias Agudas (IRA) e a percepção dos mesmos em relação às crianças que necessitam de assistência médica. Métodos: Estudo prospectivo e transversal, no qual um questionário padronizado com itens relacionados à percepção da gravidade dos sinais e sintomas de IRA foi administrado a cuidadores de pacientes pediátricos admitidos no serviço de emergência de um hospital universitário no período de agosto de 2011 a maio de 2012. A análise estatística foi realizada com os testes do qui-quadrado e t-Student para determinar quais variáveis contribuíram para o reconhecimento pelos cuidadores da gravidade das doenças respiratórias agudas. Resultados: Foram entrevistados 499 cuidadores. As causas de IRA mais citadas foram Síndrome gripal (78,6%), Resfriado comum (73,9%), Faringites (64,1%) e Pneumonia (54,5%). Febre (34,1%) e Tosse (15,8%) foram as principais razões para a procura de atendimento. Os sinais de gravidade mais citados pelos cuidadores foram: febre (99,6%), dispneia (91,4%), sibilância (86,4%), adinamia (80,2%), tosse (79,8%) e taquipneia (78,6%). O histórico de doença respiratória anterior do paciente (p=0,002), a idade (p=0,010) e o estado civil do cuidador (p=0,014) foram as variáveis significativamente associadas com taquipneia, o sintoma mais grave de IRA. Conclusões: Embora cuidadores pediátricos possam perceber os principais sinais de IRA, eles não são capazes de reconhecer a gravidade destes, o que pode atrasar os cuidados médicos e impedir o tratamento precoce.
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Cunha MDP, Santos CAD, Neto DFDL, Schanoski AS, Pour SZ, Passos SD, Souza MSFD, Costa DD, Zanotto PMDA. Outbreak of chikungunya virus in a vulnerable population of Sergipe, Brazil-A molecular and serological survey. J Clin Virol 2017; 97:44-49. [PMID: 29100064 DOI: 10.1016/j.jcv.2017.10.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/03/2017] [Accepted: 10/24/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chikungunya virus (CHIKV) is a re-emerging arbovirus that is causing outbreaks in several countries of the Americas. The virus was introduced in Brazil in 2014, and since then, several Brazilian states have notified autochthonous cases. OBJECTIVES Provide additional evidence on a CHIKV outbreak and an outline of the laboratory and clinical profile of symptomatic patients in Sergipe, Brazil. STUDY DESIGN In February 2016, we collected 142 serum samples from symptomatic patients for arboviruses in Sergipe, Brazil. All samples were submitted to qRT-PCR for the emerging arboviruses circulating in Brazil - ZIKV, CHIKV, and DENV - and later submitted to the immunoenzymatic assay. RNA positive samples were randomly selected and sequenced for characterization of the genotype involved in the outbreak. RESULTS Our study had 75.35% (107/142) positivity for CHIKV infection, with all age groups and genera being equally infected. The virus was identified in 11 of the 13 cities studied in that state, including the ECSA genotype. Importantly, fever was the only statistically significant symptoms for CHIKV infection (p<0.05), while asthenia was significantly associated with symptomatic patients that were CHIKV-negative (p<0.05). CONCLUSIONS Our findings support the importance of fever as a clinical marker and contribute to molecular and serological surveillance data, which may help in the understanding of CHIKV circulation, emergence and clinical description.
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Affiliation(s)
- Marielton Dos Passos Cunha
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | - Cliomar Alves Dos Santos
- Health Foundation Parreiras Horta (FSPH), Central Laboratory of Public Health (LACEN/SE), State Secretary for Health, Sergipe, Brazil
| | - Daniel Ferreira de Lima Neto
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | | | - Shahab Zaki Pour
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | | | | | - Danuza Duarte Costa
- Health Foundation Parreiras Horta (FSPH), Central Laboratory of Public Health (LACEN/SE), State Secretary for Health, Sergipe, Brazil
| | - Paolo Marinho de Andrade Zanotto
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil.
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Rodrigues AAN, Pinheiro TC, Alcadipane FAMC, Passos SD. Carcinoma mucoepidermoide: caso raro em paciente jovem. Rev Fac Ciênc Méd Sorocaba 2016. [DOI: 10.5327/z1984-4840201625342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
Purpose: To compare two kinds of polymer-coated tantalum stents with bare tantalum stents (control) to determine if the coatings can improve thromboresistance. Methods: Twenty-seven Fontaine-Dake stents were balloon expanded in three 8-mm × 80-cm.polytetrafluoroethylene (PTFE) grafts; 9 stents were bare tantalum (T); 9 were coated with polyetherurethane (PL); and 9 were coated with parylene (PA). There were 9 stents placed in each graft as follows: 3 tantalum, 3 polyetherurethane, and 3 parylene. In swine whose platelets had been radiolabeled with indium 111, the ends of each stented graft were connected to 14F femoral and venous sheaths to create an ex vivo fistula. Each graft was exposed to blood for 30, 60, and 120 minutes. At the end of each test period, the stented grafts were disconnected from the sheaths, flushed with saline until clear, and then flushed with formalin. The stents were removed from the grafts, and a radionuclide well counter recorded radionuclide counts from each stent type at each period of blood contact. These values were converted to platelet density per 1000 mUm2. Stents were then photographed and scanned with electron microscopy (EM) for qualitative analysis. Possible significant differences in platelet adhesion with the three types of stents (both between stent groups and within stent groups) were examined using a two-tailed Student's f-test. Results: There were significantly fewer platelets adsorbed on PA versus T at all time periods (p < 0.005); on PL versus T at 60 and 120 minutes (p < 0.005); and on PA versus PL at 30 and 120 minutes (p < 0.0005). There was no significant difference in platelet density within each stent group (p = 0.1). Mean platelet density (number of platelets per 1000 mUm2 ± SD) was as follows: at 30 minutes: T = 1891 ± 965; PL = 373 ± 193; and PA = 27 ± 3; at 60 minutes: T = 6226 ± 1621; PL = 1573 ± 793; and PA = 1185 ± 710; at 120 minutes: T = 5307 ± 591; PL = 3164 ± 318; and PA = 180 ± 100. Gross inspection of the 120-minute groups demonstrated focal areas of thrombus on T, less on PL, and none on PA. Scanning EM demonstrated extensive platelet accumulation covering T at all time periods, less on PL, and even less on PA. Conclusions: Polymeric surface modification of tantalum stents with parylene and/or polyetherurethane can improve the acute thromboresistance of these devices; parylene appears to be the more thromboresistant of the two coatings.
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Affiliation(s)
- A B Fontaine
- Division of Vascular and Interventional Radiology, Ohio State University Hospitals, Columbus, USA
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Lourenço EA, Caldeira EJ, Carvalho CAF, Cunha MR, Carvalho MVH, Passos SD. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis. Int Arch Otorhinolaryngol 2015; 20:6-12. [PMID: 26722338 PMCID: PMC4688001 DOI: 10.1055/s-0035-1564437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 07/05/2015] [Indexed: 01/30/2023] Open
Abstract
Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions.
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Affiliation(s)
- Edmir Américo Lourenço
- Department of Otorhinolaryngology, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
| | - Eduardo José Caldeira
- Department of Morphology, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
| | | | | | | | - Saulo Duarte Passos
- Department of Pediatrics, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
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Pecchini R, Berezin EN, Souza MC, Vaz-de-Lima LDA, Sato N, Salgado M, Ueda M, Passos SD, Rangel R, Catebelota A. Parainfluenza virus as a cause of acute respiratory infection in hospitalized children. Braz J Infect Dis 2015; 19:358-62. [PMID: 25922290 PMCID: PMC9427530 DOI: 10.1016/j.bjid.2015.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 03/30/2015] [Accepted: 03/31/2015] [Indexed: 11/29/2022] Open
Abstract
Background Human parainfluenza viruses account for a significant proportion of lower respiratory tract infections in children. Objective To assess the prevalence of Human parainfluenza viruses as a cause of acute respiratory infection and to compare clinical data for this infection against those of the human respiratory syncytial virus. Methods A prospective study in children younger than five years with acute respiratory infection was conducted. Detection of respiratory viruses in nasopharyngeal aspirate samples was performed using the indirect immunofluorescence reaction. Length of hospital stay, age, clinical history and physical exam, clinical diagnoses, and evolution (admission to Intensive Care Unit or general ward, discharge or death) were assessed. Past personal (premature birth and cardiopathy) as well as family (smoking and atopy) medical factors were also assessed. Results A total of 585 patients were included with a median age of 7.9 months and median hospital stay of six days. No difference between the HRSV+ and HPIV+ groups was found in terms of age, gender or length of hospital stay. The HRSV+ group had more fever and cough. Need for admission to the Intensive Care Unit was similar for both groups but more deaths were recorded in the HPIV+ group. The occurrence of parainfluenza peaked during the autumn in the first two years of the study. Conclusion Parainfluenza was responsible for significant morbidity, proving to be the second-most prevalent viral agent in this population after respiratory syncytial virus. No difference in clinical presentation was found between the two groups, but mortality was higher in the HPIV+ group.
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Affiliation(s)
| | | | | | | | - Neuza Sato
- Center for Immunology, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | | | - Mirthes Ueda
- Center for Immunology, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | | | - Raphael Rangel
- Irmandade da Santa Casa de Misericórdia de São Paulo, SP, Brazil
| | - Ana Catebelota
- Irmandade da Santa Casa de Misericórdia de São Paulo, SP, Brazil
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Passos SD, Gazeta RE, Felgueiras AP, Beneli PC, Coelho MDSZS. Do pollution and climate influence respiratory tract infections in children? Rev Assoc Med Bras (1992) 2015; 60:276-82. [PMID: 25004275 DOI: 10.1590/1806-9282.60.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 01/09/2014] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED To review if pollution and climate changes can influence respiratory tract infections in children. DATA SOURCE Articles published on the subject in PubMed, SciELO, Bireme, EBSCO and UpTodate were reviewed. The following inclusion criteria were considered: scientific papers between 2002 and 2012, study design, the pediatric population, reference documents such as the CETESB and World Health Organization Summary of the data: We analyzed research that correlated respiratory viruses and climate and/or pollution changes. Respiratory syncytial virus has been the virus related most to changes in climate and humidity. Other "old and new" respiratory viruses such as Human Bocavirus, Metapneumovirus, Parechovirus and Parainfuenza would need to be investigated owing to their clinical importance. Although much has been studied with regard to the relationship between climate change and public health, specific studies about its influence on children's health remain scarce.
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Passos SD. [Diagnosing streptococcal pharyngotonsillitis in children and adolescents: the limitations of the clinical features]. Rev Paul Pediatr 2014; 32:283-4. [PMID: 25510989 PMCID: PMC4311779 DOI: 10.1016/j.rpped.2014.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Passos SD. Diagnosing streptococcal pharyngotonsillitis in children and adolescents: the limitations of the clinical features. Rev paul pediatr 2014. [DOI: 10.1590/s0103-05822014000400001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Biill Primo OV, Lourenço EA, Passos SD. Detection of respiratory viruses in nasopharyngeal swab and adenoid tissue from children submitted to adenoidectomy: pre- and postoperative analysis. Int Arch Otorhinolaryngol 2014; 18:150-4. [PMID: 25992082 PMCID: PMC4296995 DOI: 10.1055/s-0034-1368135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 12/02/2013] [Indexed: 11/25/2022] Open
Abstract
Introduction The presence of respiratory viruses in lymphoid tissues of the nasopharynx and oropharynx and its impact on recurrent infections and hypertrophy of these tissues are not yet fully understood. Objective To identify and determine the prevalence of major respiratory viruses in nasopharyngeal secretions and adenoid tissue pre- and postoperatively of children undergoing adenoidectomy. Methods A prospective observational study was conducted in 36 patients under 12 years of age with upper airway lymphoid hypertrophy who were undergoing adenoidectomy, in which various respiratory viruses were investigated using real-time polymerase chain reaction in adenoid tissue and nasopharyngeal secretions collected preoperatively and 30 days postoperatively. Results At least 1 viral agent was isolated in any of the samples collected in 58.3% of children and 25.9% of total samples. Respiratory viruses were identified in 33.8% of preoperative nasopharyngeal specimens and in 19.8% of postoperative secretion. Of the 21 patients with positive results for any respiratory virus, 6 (28.6%) had more than 1 virus. Considering all 36 respiratory viruses found, the main agent isolated was rhinovirus (27.8%), followed by bocavirus (22.2%). Conclusion The virus found more frequently in all samples was rhinovirus. After removal of adenoid tissue, there was a decrease in the prevalence of the virus contained in nasopharyngeal secretion 30 days after surgery.
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Affiliation(s)
| | - Edmir Américo Lourenço
- Department of Otorhinolaryngology, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
| | - Saulo Duarte Passos
- Department of Pediatrics, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
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Villabona-Arenas CJ, de Oliveira JL, Capra CDS, Balarini K, Loureiro M, Fonseca CRTP, Passos SD, Zanotto PMDA. Detection of four dengue serotypes suggests rise in hyperendemicity in urban centers of Brazil. PLoS Negl Trop Dis 2014; 8:e2620. [PMID: 24587454 PMCID: PMC3937275 DOI: 10.1371/journal.pntd.0002620] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Christian Julián Villabona-Arenas
- Laboratório de Evolução Molecular e Bioinformática, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Jessica Luana de Oliveira
- Laboratório de Evolução Molecular e Bioinformática, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Carla de Sousa Capra
- Laboratório de Saúde Pública, Secretaria da Saúde, Prefeitura Municipal de Guarujá, Guarujá, São Paulo, Brazil
| | - Karime Balarini
- Itapema Laboratório de Análises Clínicas, Guarujá, São Paulo, Brazil
| | - Mauricio Loureiro
- Laboratório de Infectologia Pedriátrica, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
| | | | - Saulo Duarte Passos
- Laboratório de Infectologia Pedriátrica, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
| | - Paolo Marinho de Andrade Zanotto
- Laboratório de Evolução Molecular e Bioinformática, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
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Villabona Arenas CJ, Botelho AV, Botelho AC, Passos SD, Andrade Zanotto PMD. The burden of dengue: Jundiaí, Brazil – January 2010. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1590/s0104-42302012000400020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Arenas CJV, Botelho AV, Botelho AC, Passos SD, Zanotto PMDA. The burden of dengue: Jundiaí, Brazil - January 2010. Rev Assoc Med Bras (1992) 2012; 58:477-480. [PMID: 22930028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 03/17/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To study the antibody prevalence against dengue in the municipality of Jundiaí, São Paulo, Brazil, due to the low number of official confirmed autochthonous cases. METHODS A serological study on dengue infection was conducted during January 2010 and previous reports on dengue and entomological surveillance during that period were reviewed. RESULTS A prevalence of 7.8% IgG positive (68:876) was found. Furthermore, based on the detection of IgM antibodies in five samples, it was observed that the incidence of dengue in the city at the time of the survey contrasts with the absence of notifications by local health authorities over the same period of time. CONCLUSION These results highlight the discrepancies between the actual and the detected number of dengue infections, possibly due to significant numbers of asymptomatic infections aggravated by difficulties with dengue clinical diagnosis.
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Affiliation(s)
- Christian Julián Villabona Arenas
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, Universidade de São Paulo, Brazil.
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Passos SD, Gazeta RE, Latorre MDR, Durigon EL, Gauditano G, Yoshinari NH. [Epidemiological characteristics of Lyme-like disease in children]. Rev Assoc Med Bras (1992) 2010; 55:139-44. [PMID: 19488647 DOI: 10.1590/s0104-42302009000200015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Accepted: 09/17/2008] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND To determine the prevalence, age distribution, seasonality and clinical characteristics of Lyme-simile disease in Brazilians less than 15 years of age. METHODS. From July, 1998 to November, 2000, a cross-sectional study was conducted in 333 patients with skin rash and fever. Paired blood samples were collected for identification of the pathogens. Only 193 samples which were negative for other pathogens (Parvovirus B19 Human, Herpesvirus 6 Human, Measles, Rubella, Dengue, Scarlet fever and Enterovirus), were tested for borreliosis by Enzyme-Linked Immunosorbent Assay and Western-blotting. Other clinical, socioeconomic, demographic and climatic variables were studied. RESULTS Prevalence of the disease was 6.2%(12/193). Of the variables studied, there was predominance in: <6 years old (83.2%); females (66.7%); being from the city of Franco da Rocha (58.3 %); and a summer/fall seasonality. The duration of care was 4 days. Signs and symptoms with statistical significance were itching; absence of lip notch and ocular pain; irritability and good clinical condition. Other clinical data presented were: pruritus (90%), irritability (80%) and fever (38 masculineC) (58.3%) with a duration of 1 to 3 days. Erythema was maculo-papular (40%), urticaria-like (25%) and scarlatiniform (16.7%), occurring predominately on the trunk (60%). There were no primary clinical evidences of Lyme-simile disease in the patients under study. The sensitivity and specificity of the clinical diagnosis as opposed to the laboratory diagnosis was zero. There was no initial clinical suspicion of the disease in the 10 cases studied and followed up for two years that showed no evidence of cardiologic or neurological complications. This is the first study of Lyme-simile in Brazilian children. CONCLUSION Prevalence of Lyme-simile disease was low, and it was not remembered at the initial diagnosis of those with skin rash. However, practical knowledge is necessary, demanding increased medical attention.
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De Oliveira MI, Curti SP, Sardinha Afonso AM, Figueiredo CA, Azevedo RS, Passos SD, Stewien KE, Durigon EL. PARVOVIRUS B19 FREQUENCY IN EXANTHEMATIC CASES INITIALY SUSPECTED AS MEASLES OR RUBELLA INFECTIONS IN SÃO PAULO, BRAZIL. VR&R 2009. [DOI: 10.17525/vrr.v14i1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Vaz-de-Lima LRA, Souza MCO, Matsumoto T, Hong MA, Salgado MM, Barbosa ML, Sato NS, Requejo HI, Oliveira CAF, Pecchini R, Berezin E, Passos SD, Schvartsman C, Pasmanick A, Durigon EL, Ueda M. Performance of indirect immunofluorescence assay, immunochromatography assay and reverse transcription-polymerase chain reaction for detecting human respiratory syncytial virus in nasopharyngeal aspirate samples. Mem Inst Oswaldo Cruz 2008; 103:463-7. [PMID: 18797759 DOI: 10.1590/s0074-02762008000500009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Accepted: 07/07/2008] [Indexed: 11/22/2022] Open
Abstract
Comparison of the use of indirect immunofluorescence assay (IFA), immunochromatography assay (ICA-BD) and reverse transcription-polymerase chain reaction (RT-PCR) for detecting human respiratory syncytial virus (HRSV) in 306 nasopharyngeal aspirates samples (NPA) was performed in order to assess their analytical performance. By comparing the results obtained using ICA-BD with those using IFA, we found relative indices of 85.0% for sensitivity and 91.2% for specificity, and the positive (PPV) and negative (NPV) predictive values were 85.0% and 91.2%, respectively. The relative indices for sensitivity and specificity as well as the PPV and NPV for RT-PCR were 98.0%, 89.0%, 84.0% and 99.0%, respectively, when compared to the results of IFA. In addition, comparison of the results of ICA-BD and those of RT-PCR yielded relative indices of 79.5% for sensitivity and 95.4% for specificity, as well as PPV and NPV of 92.9% and 86.0%, respectively. Although RT-PCR has shown the best performance, the substantial agreement between the ICA-BD and IFA results suggests that ICA-BD, also in addition to being a rapid and facile assay, could be suitable as an alternative diagnostic screening for HRSV infection in children.
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Affiliation(s)
- L R A Vaz-de-Lima
- Divisão de Biologia Médica, Rede Diversidade Genômica de Vírus, Instituto Adolfo Lutz, São Paulo, Brasil
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Huatuco EMM, Durigon EL, Lebrun FLAS, Passos SD, Gazeta RE, Azevedo Neto RS, Massad E. Seroprevalence of human parvovirus B19 in a suburban population in São Paulo, Brazil. Rev Saude Publica 2008. [DOI: 10.1590/s0034-89102008000300008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Huatuco EMM, Durigon EL, Lebrun FLAS, Passos SD, Gazeta RE, Azevedo Neto RS, Massad E. Seroprevalence of human parvovirus B19 in a suburban population in São Paulo, Brazil. Rev Saude Publica 2008; 42:443-9. [PMID: 18425294 DOI: 10.1590/s0034-89102008005000019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Accepted: 12/06/2007] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the prevalence of IgG antibodies to human parvovirus B19. METHODS Cross-sectional study in a suburban community in São Paulo, Southeastern Brazil, between November 1990 and January 1991. Randomly selected (N=435) representative samples of sera were collected from healthy children older than 15 days old and adults up to 40 years old. IgG antibodies were detected using ELISA. RESULTS High prevalence of IgG antibodies to B19 parvovirus was found in 87% of newborns. The prevalence of maternally derived IgG antibodies exponentially plunged up to the 19th month of age. Low prevalence of antibodies was found in the first 4 years of life, increasing up to 72% in those aged 31-40 years. It was estimated that the average age of first infection in this population is 21 +/- 7 years old and the optimal age for vaccination with a hypothetical vaccine would be 1 year of age. CONCLUSIONS Parvovirus B19 IgG antibody prevalence was high in newborns and those aged 31-40 years. The analysis by age groups showed a pattern similar to that found in previous studies, i.e., low prevalence of infection in children that increases with age.
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Affiliation(s)
- E M M Huatuco
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil
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Vanzelli AS, Castro CTD, Pinto MDS, Passos SD. Prevalência de sobrepeso e obesidade em escolares da rede pública do município de Jundiaí, São Paulo. Rev paul pediatr 2008. [DOI: 10.1590/s0103-05822008000100008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Determinar a prevalência de obesidade de acordo com o nível socioeconômico e o sexo, em escolares do ensino fundamental, segundo dois critérios diagnósticos. MÉTODOS: Realizou-se um estudo transversal nas escolas públicas de ensino fundamental de Jundiaí, São Paulo, com 662 alunos de quinta a oitava séries, com idades entre dez e 18 anos, em 2005. A amostra foi selecionada por meio de procedimento sistemático, de acordo com a série e o sexo. Calculou-se o índice de massa corpórea (IMC). Os pontos de corte para classificação do estado nutricional foram escolhidos de acordo com dois critérios antropométricos: valores de IMC em percentil e valor numérico de IMC como ponto de corte. RESULTADOS: A prevalência de sobrepeso foi 17% quando se utilizou o critério de percentil e 13% ao usar o corte por valor numérico. A prevalência de obesidade foi 8 e 9%, respectivamente. Houve diferença quanto ao sexo, quando se utilizou a classificação por percentil, com maior percentual de magreza encontrado no sexo masculino. O sobrepeso e a obesidade foram mais observados em adolescentes de melhor condição socioeconômica. CONCLUSÕES: A prevalência de sobrepeso e obesidade foi elevada, sendo maior nas classes mais favorecidas. A medida do IMC por percentil detectou maior número de adolescentes com sobrepeso e obesidade, comparada à classificação por valor numérico.
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Abstract
PURPOSE To compare two kinds of polymer-coated tantalum stents with bare tantalum stents (control) to determine if the coatings can improve thromboresistance. METHODS Twenty-seven Fontaine-Dake stents were balloon expanded in three 8-mm x 80-cm polytetrafluoroethylene (PTFE) grafts; 9 stents were bare tantalum (T); 9 were coated with polyetherurethane (PL); and 9 were coated with parylene (PA). There were 9 stents placed in each graft as follows: 3 tantalum, 3 polyetherurethane, and 3 parylene. In swine whose platelets had been radiolabeled with indium 111, the ends of each stented graft were connected to 14F femoral and venous sheaths to create an ex vivo fistula. Each graft was exposed to blood for 30, 60, and 120 minutes. At the end of each test period, the stented grafts were disconnected from the sheaths, flushed with saline until clear, and then flushed with formalin. The stents were removed from the grafts, and a radionuclide well counter recorded radionuclide counts from each stent type at each period of blood contact. These values were converted to platelet density per 1000 microns 2. Stents were then photographed and scanned with electron microscopy (EM) for qualitative analysis. Possible significant differences in platelet adhesion with the three types of stents (both between stent groups and within stent groups) were examined using a two-tailed Student's t-test. RESULTS There were significantly fewer platelets adsorbed on PA versus T at all time periods (p < 0.005); on PL versus T at 60 and 120 minutes (p < 0.005); and on PA versus PL at 30 and 120 minutes (p < 0.0005). There was no significant difference in platelet density within each stent group (p = 0.1). Mean platelet density (number of platelets per 1000 microns 2 +/- SD) was as follows: at 30 minutes: T = 1891 +/- 965; PL = 373 +/- 193; and PA = 27 +/- 3; at 60 minutes: T = 6226 +/- 1621; PL = 1573 +/- 793; and PA = 1185 +/- 710; at 120 minutes: T = 5307 +/- 591; PL = 3164 +/- 318; and PA = 180 +/- 100. Gross inspection of the 120-minute groups demonstrated focal areas of thrombus on T, less on PL, and none on PA. Scanning EM demonstrated extensive platelet accumulation covering T at all time periods, less on PL, and even less on PA.
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Affiliation(s)
- A B Fontaine
- Division of Vascular and Interventional Radiology, Ohio State University Hospitals, Columbus, USA
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de Azevedo Neto RS, Richards A, Nokes DJ, Silveira AS, Cohen BJ, Passos SD, de Souza VA, Brown DW, Pannuti CS, Massad E. Salivary antibody detection in epidemiological surveys: a pilot study after a mass vaccination campaign against rubella in São Paulo, Brazil. Trans R Soc Trop Med Hyg 1995; 89:115-8. [PMID: 7747294 DOI: 10.1016/0035-9203(95)90680-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The sensitivity and specificity of salivary rubella antibody detection was investigated using samples collected from 301 children after a mass vaccination campaign in the state of São Paulo, Brazil. Saliva samples were collected by 2 different methods: directly dribbling into a container or using a commercial collecting device. Corresponding finger-prick blood samples were collected on filter paper. Rubella specific immunoglobulin G (IgG) was measured in saliva by antibody capture radioimmunoassay and in blood samples by indirect enzyme-linked immunosorbent assay. The detection of salivary rubella specific IgG showed good correlation with the detection of rubella antibody in the blood samples. For both collecting techniques the predictive value for a positive saliva test was > 99% compared with the results from the blood tests. However, the predictive value for a negative saliva test was only 58.3% for a dribbled sample, compared to 100% for saliva collected using the commercial device. Moreover, collecting saliva by dribbling from children less than 4 years old was difficult. The detection of rubella specific IgG in saliva collected using a commercial device proved to be sensitive and specific in this epidemiological study, encouraging its more widespread application as a means of surveillance after mass vaccination.
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Affiliation(s)
- R S de Azevedo Neto
- Department of Pathology, Faculty of Medicine, University of São Paulo, Brazil
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De Azevedo Neto RS, Silveira AS, Nokes DJ, Yang HM, Passos SD, Cardoso MR, Massad E. Rubella seroepidemiology in a non-immunized population of São Paulo State, Brazil. Epidemiol Infect 1994; 113:161-73. [PMID: 8062873 PMCID: PMC2271213 DOI: 10.1017/s095026880005158x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A rubella serological survey of 476 individuals selected by cluster sampling technique from Caieiras, a small town located in the outskirts of São Paulo city, southeastern Brazil, was carried out over the period November 1990-January 1991. The aim of the study was to characterize rubella epidemiology in a representative non-immunized community in south east Brazil. The survey comprised a seroprevalence study, stratified by age (0-40 years) and a seroconversion study of rubella vaccine in non-infected children below 2 years of age. Mathematical techniques were applied to resultant data sets to determine the age dependent rates of decay in the proportion of individuals with maternally derived antibodies, vaccine seroconversion, and infection of susceptibles, termed the force of infection, and to estimate the average age at first infection.
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