Modulação e composição de ácidos graxos do leite humano

O leite humano é um fluido complexo, considerado um alimento completo e suficiente para suprir as necessidades nutricionais de recém-nascidos durante os seis primeiros meses de vida. A fração lipídica do leite materno é a principal fonte de energia para o neonato e possui ácidos graxos essenciais; seus produtos poliinsaturados, como o ácido araquidônico e o ácido docosa-hexaenoico, são indispensáveis ao crescimento. Tanto o conteúdo lipídico quanto o tipo de ácido graxo do leite humano podem ser modulados por fatores inerentes ou não à mãe. Dentre esses fatores, destacam-se a adiposidade, o estilo de vida, o estado nutricional e a ingestão alimentar materna, que agem de forma concomitante e interdependente, dificultando as análises dos estudos que se propõem investigar tal modulação. Não se observam grandes diferenças entre as composições de ácidos graxos do leite materno de estudos realizados na América Latina e em países desenvolvidos. O leite das nutrizes de algumas regiões brasileiras apresenta os ácidos graxos essenciais, o ácido araquidônico, o ácido docosa-hexaenoico e um baixo percentual de ácidos graxos saturados e ácidos graxos trans. O presente trabalho avaliou, portanto, os principais fatores que modulam a composição do leite humano, em particular as diferenças na composição de ácidos graxos do leite de mulheres de diferentes nacionalidades e os efeitos desses componentes sobre a saúde do recém-nascido.Human milk is a complex fluid, considered a complete food and enough to meet the nutritional needs of an infant during the first six months of life. The lipid fraction of breastmilk is the newborn's main source of energy. It contains essential fatty acids and its polyunsaturated fats, such as arachidonic acid and docosahexaenoic acid, are essential for growth. Both the lipid content and the kind of fatty acids in human breastmilk can be modulated by factors inherent or not to the mother. Among these factors, adiposity, lifestyle, nutritional status and maternal food intake act in a concomitant and independent manner, making this modulation more difficult to analyze. Few differences have been observed between the fatty acid composition of human milk from studies carried out in Latin America and developed countries. Milk from some women from certain Brazilian regions has the essential fatty acids, arachidonic acid and docosahexaenoic acid, and a low percentage of saturated and trans fatty acids. Thus, the present study assessed the main factors that modulate the composition of human milk, in particular the differences in fatty acid composition among mothers of different nationalities, and the effects of these components on the newborn's health

Anti-Toxoplasma gondii antibodies in patients with beta-hemoglobinopathies: the first report in the Americas

Abstract\ud \ud Background\ud In Brazil, there have been no previous studies of Toxoplasma gondii infection in sickle cell anemia patients and carriers of severe forms of beta-thalassemia. This study evaluated T. gondii infection in patients with beta-hemoglobinopathies.\ud \ud \ud Methods\ud A total of 158 samples, 77 (48.7%) men and 81 (51.3%) women, were evaluated. Three groups were formed: G1 (85 patients with sickle cell disease); G2 (11 patients with homozygous beta-thalassemia; G3 (62 patients with heterozygous beta-thalassemia). ELISA was employed to identify anti-T. gondii IgM and IgG antibodies, and molecular analysis was performed to determine beta-hemoglobin mutations. Fisher’s exact test was used to compare frequencies of anti-T. gondii IgM and IgG antibodies in respect to gender and age.\ud \ud \ud Results\ud Anti-T. gondii IgG antibodies were found in 43.5% of individuals in G1, 18.1% in G2 and 50% in G3. All samples from G1 and G2 were seronegative for anti-T. gondii IgM antibodies, but 3.2% from G3 were seropositive. Considering anti-T. gondii IgG antibodies, no statistical significant differences were found between these groups nor in seroprevalence between genders within each group. Despite this, comparisons of the mean ages between G1, G2 and G3 were statistically significant (G2 vs. G1: p value = 0.0001; G3 vs. G1: p-value <0.0001; G3 vs. G2: p-value = 0.0001).\ud \ud \ud Conclusion\ud A comparison by age of patients with sickle cell anemia showed a trend of lower risk of infection among younger individuals. Therefore, this study demonstrates that T. gondii infection occurs in patients with beta-thalassemia and sickle cell anemia in Brazil as seen by the presence of anti-T. gondii IgM and IgG antibodies.This study was supported by grants from the FAPERP (Fundação de Apoio\ud à Pesquisa e Extensão de São José do Rio Preto) to CCBM and to MNF\ud and by FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo,\ud Brazil) 2011/15570-1 to GCSC; 2012/07716-9 to LCM; 2014/01706-7 to MNF;\ud 2015/04677-0 to CCBM). The opinions, assumptions, and conclusions or\ud recommendations expressed in this material are responsibility of the authors\ud and do not necessarily refect the views of FAPESP. The funders had no role in\ud study design, data collection and analysis, decision to publish, or preparation\ud of the manuscript

Influence of gender norms in relation to child’s quality of care: follow-up of families of children with SCD identified through NBS in Tanzania

Introducing newborn screening (NBS) services for sickle cell disease (SCD) in Africa has been proven to be one of the most cost-effective approach to reducing morbidity and mortality associated with this condition. In view of this evidence, efforts have been made by countries in Africa where SCD prevalence is high to pilot NBS programmes and to strengthen comprehensive care services for SCD. While it is important to reap the benefits of NBS for SCD in Africa in terms of overall quantitative measures, it is also important to understand how certain social and cultural conditions may disproportionately influence the outcomes of screening for some groups. The aim of this study was to analyse the role of gender norms before and after NBS for SCD in Tanzania, and to assess how they influence the quality of care of diagnosed children. Using qualitative methods, we did in-depth interviews with families of children with SCD identified through the NBS services and focus group sessions with nurses working in neonatal and postnatal sections of regional referral hospitals in Dar es Salaam. By analysing the experiences of both the families and nurses, we were able to provide evidence on, firstly, the gendered relations that undergird childcare and, secondly, how those relations influence the quality of care the child may potentially receive. The results emphasize the importance of studying the social implications of SCD in Africa, especially with regard to improving the quality of care for patients with SCD in the region. We propose simple interventions, including gender-conscious health education and genetic counselling, which can help to improve the community understanding of genetic diseases while also reducing gender-related inequalities related to SCD care in Africa