21 research outputs found
Neurodevelopment of children exposed intra-uterus by Zika virus: A case series.
The main goal of this manuscript was to investigate the neurodevelopment of children exposed by Zika virus in the intrauterine period who are asymptomatic at birth. Newborns with documented Zika virus exposure during the intrauterine period who were asymptomatic at birth were followed in the first two years of life for neurodevelopment using Bayley III test. Children were classified as having normal or delayed neurodevelopment for age based on most recent Bayley III evaluation results. Eighty-four infants were included in the study. The first Bayley III evaluation was performed at a mean chronological age of 9.7±3.1 month; 13 children (15%) had a delay in one of the three domains, distributed as follow: 10 (12%) in the language domain and 3 (3.5%) in the motor domain. The most recent Bayley III evaluation was performed at a mean age 15.3±3.1 months; 42 children (50%) had a delay in one of the three domains: 4 (5%) in cognition, 31 (37%) in language, and 20 (24%) in motor performance. There were no statistical differences in Gender, Gestational Age, Birth Weight and Head Circurference at birth between children with normal and delayed neurodevelopment for age. A very high proportion of children exposed ZIKV during pregnancy who were asymptomatic at birth demonstrated a delay in neurodevelopment, mainly in the language domain, the first two years of life
Language delay was associated with a smaller head circumference at birth in asymptomatic infants prenatally exposed to the Zika virus
Aim
Our aim was to analyse 12-month outcomes of children who were prenatally exposed to the Zika virus and asymptomatic at birth.
Methods
This was an observational, exploratory study of infants exposed to the Zika virus during gestation and born between March 2016 and April 2017 without congenital Zika syndrome. They were followed until the age of 22Â months. The outcome measure was neurodevelopment at 12Â months of life, which was evaluated with the Bayley Scales of Infant and Toddler Development, Third edition (Bayley-III). The scores were adjusted for maternal education and prematurity.
Results
A total of 96 infants were included in the study and 35.4% scored below the normal range in at least one Bayley-III domain. The majority (91.2%) of the infants with delayed scores presented with language delay, which was not associated with the gestational age at exposure. Receptive language was more affected by exposure than expressive language (27.0% vs 19.8%). There was a direct, and significant, association between the head circumference Z-score at birth and language delay.
Conclusion
Language delay was associated with a smaller head circumference at birth in infants prenatally exposed to the Zika virus and born asymptomatic. This may indicate future learning difficulties
Insulin-like growth factor axis in pregnancies affected by fetal growth disorders
Background: Insulin-like growth factors 1 and 2 (IGF1 and IGF2) and their binding proteins (IGFBPs) are expressed in the placenta and known to regulate fetal growth. DNA methylation is an epigenetic mechanism which involves addition of methyl group to a cytosine base in the DNA forming a methylated cytosine-phosphate-guanine (CpG) dinucleotide which is known to silence gene expression. This silences gene expression, potentially altering the expression of IGFs and their binding proteins. This study investigates the relationship between DNA methylation of components of the IGF axis in the placenta and disorders in fetal growth. Placental samples were obtained from cord insertions immediately after delivery from appropriate, small (defined as birthweight the 90th percentile for the gestation [LGA]) neonates. Placental DNA methylation, mRNA expression and protein levels of components of the IGF axis were determined by pyrosequencing, rtPCR and Western blotting.
Results: In the placenta from small for gestational age (SGA) neonates (n = 16), mRNA and protein levels of IGF1 were lower and of IGFBPs (1, 2, 3, 4 and 7) were higher (p < 0.05) compared to appropriately grown neonates (n = 37). In contrast, in the placenta from large for gestational age (LGA) neonates (n = 20), mRNA and protein levels of IGF1 was not different and those of IGFBPs (1, 2, 3 and 4) were lower (p < 0.05) compared to appropriately grown neonates. Compared to appropriately grown neonates, CpG methylation of the promoter regions of IGF1 was higher in SGA neonates. The CpG methylation of the promoter regions of IGFBP1, IGFBP2, IGFBP3, IGFBP4 and IGFBP7 was lower in the placenta from SGA neonates as compared to appropriately grown neonates, but was unchanged in the placenta from LGA neonates.
Conclusions: Our results suggest that changes in CpG methylation contribute to the changes in gene expression of components of the IGF axis in fetal growth disorders. Differential methylation of the IGF1 gene and its binding proteins is likely to play a role in the pathogenesis of SGA neonates
Overweight among adolescents in rural area and school meals offered
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Previous issue date: 2013Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Objetivo: Avaliar a composição nutricional e a aceitabilidade da alimentação escolar, o estado nutricional e a segurança alimentar
dos adolescentes das escolas municipais da zona rural de Carmo no Rio de Janeiro. MĂ©todos: Participaram 121 adolescentes
de 7 escolas pĂşblicas em um municĂpio do interior do Rio de Janeiro. Foi utilizado o mĂ©todo de pesagem direta dos
alimentos, calculando-se as porções médias oferecidas. A segurança alimentar e a aceitabilidade da alimentação escolar
foram avaliadas a partir de questionários validados. O estado nutricional foi determinado pelo Índice de Massa Corporal por
Idade (IMC/I) e estatura/idade e sexo. Resultados: A prevalĂŞncia de sobrepeso/obesidade foi de 28,9%, baixo peso 1,7% e
baixa estatura por idade 0,8%. Todas as escolas ofereceram valores de nutrientes superiores à recomendação, exceto para
fibras, vitamina C, magnésio e cálcio. A oferta de alimentos de elevada densidade calórica foi alta. A maioria dos alunos
(92%) com insegurança alimentar consumia a alimentação escolar e nenhum destes possuĂa baixo peso ou estatura. ConclusĂŁo:
Os alunos apresentaram um bom estado nutricional, mas sendo as prevalĂŞncias de sobrepeso/obesidade prĂłximas
àquelas de áreas urbanas. É necessária maior ênfase na educação nutricional e planejamento da alimentação escolar sobre
os grupos de alimentos oferecidos.Objective: To evaluate the nutricional composition and the acceptability of the school meals, nutritional status, and food
security of adolescents in rural public schools in Carmo, Rio de Janeiro. Methods: One hundred and twenty-one adolescents
from the 7 public schools of a country side city of Rio de Janeiro, participated in the study. The method of food direct weighing
was utilized, where the offered average portions were calculated. Food security and school meals acceptability were evaluate
by validated questionnaires. The nutricional status was determined by Body mass index (BMI for age) and height for age and
gender. Results: The occurrence of overweight/obesity was 28.9%, underweight 1.7% and low height-for-age 0.8%. All school
menus offered higher nutritional values than the recommended, except for fiber, vitamin C, magnesium, and calcium. The offered
of high energetic density food was high. The majority of the students (92%) with food insecurity ate the meals offered
by the school and none of them were low weight-for-age or low height-for-age. Conclusion: The students presented a good
nutritional status, but the prevalence of overweight/obesity was similar to those in urban areas. It is required more emphasis
on nutrition education, and planning of the school meals of the group of food to be selected
Desempenho mental de bebês pré-termo de muito baixo peso ao nascer: avaliação da estabilidade nos dois primeiros anos de vida e fatores associados ao desempenho mental
O objetivo do estudo foi investigar a estabilidade do desempenho mental de bebĂŞs prematuros de muito baixo peso ao nascer ao longo dos dois primeiros anos de vida e identificar os fatores associados ao seu desempenho mental. Estudo de coorte com 109 crianças. A Escala Mental da Bayley Scales of Infant Development - Second Edition foi aplicada aos 6, aos 12 e entre 18-24 meses de idade corrigida. A estabilidade dos escores entre as avaliações foi investigada atravĂ©s de análise de variância para medidas repetidas. A associação entre as caracterĂsticas neonatais e sociais no desenvolvimento mental foi verificada por análise multivariada atravĂ©s de regressĂŁo linear, considerando como desfechos os ĂŤndices de Desenvolvimento Mental aos 6 meses, 12 meses e entre 18-24 meses de idade corrigida. A mĂ©dia do ĂŤndice de Desenvolvimento Mental aos 6 meses foi 83,4 (DP: 12,4), aos 12 meses foi 86,4 (DP: 13,9) e aos 18-24 meses foi 73,4 (DP: 14,5). Observou-se uma diminuição significativa de 13 pontos no escore aos 18-24 meses de idade corrigida. O ĂŤndice de Desenvolvimento Mental nĂŁo apresentou estabilidade ao longo dos dois primeiros anos de vida nesta população de prematuros, exceto para as crianças que tiveram pneumonia neonatal, cujo desempenho foi insatisfatĂłrio em todas as avaliações. Dos fatores de risco investigados, apenas o sexo masculino e a pneumonia neonatal estiveram associados aos desfechos