Insect repellents: recommendations for use in children

OBJETIVO: Apresentar uma revisão bibliográfica sobre o uso de repelentes de insetos em crianças, com ênfase especial na proteção contra mosquitos. FONTES DE DADOS: Realizou-se uma pesquisa bibliográfica nas bases de dados Pubmed e Lilacs, cujos artigos incluíam produtos comercialmente disponíveis no Brasil. Foram selecionados artigos publicados nos últimos dez anos em língua inglesa ou portuguesa, referentes a crianças, obtidos com as seguintes palavras-chave: "insect repellents", "children", "mosquitoes", "N,N-dietil-metatoluamida (DEET)". SÍNTESE DOS DADOS: Entre os repelentes tópicos, DEET, icaridina e óleo natural de eucalipto-limão apresentam, em concentrações adequadas, perfil de segurança favorável e são eficazes na prevenção de picadas de mosquitos em crianças e adultos. Em geral, são indicados para crianças acima de dois anos de idade. Medidas físicas são fundamentais para proteger lactentes jovens, especialmente menores de seis meses, com destaque para o uso de telas com permetrina. CONCLUSÕES: Os mosquitos são vetores de doenças infectoparasitárias que acometem, anualmente, milhões de pessoas no mundo e causam milhares de mortes. O combate aos mosquitos inclui medidas ambientais e de proteção individual. O uso de repelentes tópicos para proteção individual da criança exige cuidados específicos e conhecimento quanto ao produto ideal para cada idade, especialmente quando consideradas sua eficácia e segurança.OBJECTIVE: To present a literature review about the use of insect repellents on children, highlighting the protection against mosquitoes. DATA SOURCES: Pubmed and Lilacs databases were searched for articles in English and Portuguese published in the last ten years with the following key-words: "insect repellents", "children", "mosquitoes", "N,N-dietil-metatoluamida (DEET)". DATA SYNTHESIS: Concerning topical repellents, DEET, icaridine and natural oil of lemon eucalyptus are effective to prevent mosquito bites in children and adults and have favorable safety profile when used in appropriate concentration. They are generally recommended for children older than two years-old. Physical barriers are essential for infant protection, especially if they are six months old or less, with special interest in the permethrin-treated nets. CONCLUSIONS: Mosquitoes are vectors of a variety of infectious and parasitic diseases which annually affect millions of people and cause thousands of deaths worldwide. The combat to mosquitoes includes individual and environmental measures. Topic repellents for children's individual protection demand specific handling attention and knowledge about the ideal product for each age, especially regarding their efficacy and safety

The Extended Clinical Phenotype of 26 Patients with Chronic Mucocutaneous Candidiasis due to Gain-of-Function Mutations in STAT1

PURPOSE: Gain-of-function (GOF) mutations in the signal transducer and activator of transcription 1 (STAT1) result in unbalanced STAT signaling and cause immune dysregulation and immunodeficiency. The latter is often characterized by the susceptibility to recurrent Candida infections, resulting in the clinical picture of chronic mucocutaneous candidiasis (CMC). This study aims to assess the frequency of GOF STAT1 mutations in a large international cohort of CMC patients. METHODS: STAT1 was sequenced in genomic DNA from 57 CMC patients and 35 healthy family members. The functional relevance of nine different STAT1 variants was shown by flow cytometric analysis of STAT1 phosphorylation in patients' peripheral blood cells (PBMC) after stimulation with interferon (IFN)-α, IFN-γ or interleukin-27 respectively. Extended clinical data sets were collected and summarized for 26 patients. RESULTS: Heterozygous mutations within STAT1 were identified in 35 of 57 CMC patients (61 %). Out of 39 familial cases from 11 families, 26 patients (67 %) from 9 families and out of 18 sporadic cases, 9 patients (50 %) were shown to have heterozygous mutations within STAT1. Thirteen distinct STAT1 mutations are reported in this paper. Eight of these mutations are known to cause CMC (p.M202V, p.A267V, p.R274W, p.R274Q, p.T385M, p.K388E, p.N397D, and p.F404Y). However, five STAT1 variants (p.F172L, p.Y287D, p.P293S, p.T385K and p.S466R) have not been reported before in CMC patients. CONCLUSION: STAT1 mutations are frequently observed in patients suffering from CMC. Thus, sequence analysis of STAT1 in CMC patients is advised. Measurement of IFN- or IL-induced STAT1 phosphorylation in PBMC provides a fast and reliable diagnostic tool and should be carried out in addition to genetic testing

Upregulation of TGF-beta 1 in neonates of mothers receiving Influenza A (H1N1) vaccination during pregnancy

Background: Engineered nanomaterials such as metal oxide nanoparticles (NPs) offer unique physico-chemical properties and are widely used in sunscreen formulations and personal care products. NPs become coated with proteins when exposed to biological fluids, forming the 'nanoparticle-protein corona' (NP-PC), which may affect its overall bioactivity in vivo. Information regarding the interaction of NPs with biomolecules and the associated risks of exposure to NPs is limited and needs further investigation. Exposure to NPs via inhalation is an important concern especially in the occupational setting. This study aimed to characterize the NP-PC formation on zinc oxide NPs (ZnO-NPs) with fetal bovine serum (FBS) proteins and the immunotoxic effects on human lung epithelial cells (A549). \ud \ud Method: NP-PC of pristine or surfactantdispersed (sZnO-NP) particles (30, 80 and 200 nm) were incubated in cell culture media (RPMI-1640 with 10% FBS). Proteins forming the corona were quantified using Bradford protein assay, separated by SDS gel electrophoresis and identified by MALDI-TOF mass spectrometry (MS). \ud \ud Result: Protein binding studies indicate that pristine ZnO-NP (30 > 80 > 200 nm) bind significantly more proteins then surfactantdispersed. Pristine ZnO-NP and sZnO-NP (30 and 80 nm) selectively bound proteins of either 11 or 14 kDa, respectively. MS analysis revealed most binding proteins to be derived from larger proteins (i.e. hemoglobin, albumin and histone). However, small intact proteins were also enriched on sZnONP surfaces, such as glucagon (3.4 kDa), apolipoprotein A-II (17 kDa) and apolipoprotein C-III (8.7 kDa), which are major constituents of high-density lipoproteins. Preliminary immunotoxicity data on human epithelial cells demonstrated increased IL-8 release for 30 nm ZnO-NP; with sZnO-NP causing a lesser stimulatory effect. \ud \ud Conclusion: In summary, we have demonstrated that, when compared to pristine ZnO-NP, the surfactant-dispersed NPs bind less protein and elicit a reduced proinflammatory IL-8 release in human lung epithelial cells. However, small physiological- important proteins such as apolipoproteins are enriched on sZnO-NP, which needs further investigation

Evolution of milk-specific IgE antibody levels and its fractions during tolerance development in cow's milk allergic patients

Univ Sao Paulo, Dept Pediat, Allergy & Immunol Div, Sao Paulo, BrazilWeb of Scienc

Eosinophilic esophagitis associated to esophagus achalasia - case report

Univ Sao Paulo, Fac Med, Dept Pediat, Allergy & Immunol Unit, Sao Paulo, BrazilUniv Sao Paulo, Fac Med, Dept Pediat, Pediat Surg Unit, Sao Paulo, BrazilWeb of Scienc

Obesidade e asma: associação ou epifenômeno?

OBJETIVO: Avaliar a associação entre obesidade e asma pela comparação entre idade, gênero, classificação inicial e controle da asma, valores de volume expiratório forçado no primeiro segundo (VEF1) e fluxo expiratório forçado entre 25 e 75% (FEF25-75%) basais com os índices de massa corpórea (IMC) em adolescentes asmáticos. MÉTODOS: Estudo transversal envolvendo 120 pacientes (1,9 masculino:1 feminino) asmáticos com mediana de idade de 14,1 anos (9 a 20,1 anos), classificados quanto ao controle e gravidade da asma e avaliados pela espirometria utilizando VEF1 e FEF25-75% basais. Esses dados foram descritos pela frequência, médias e desvio padrão ou medianas e variação, sendo analisados pelos testes de ANOVA, teste t não pareado, teste exato de Fisher, Kruskal-Wallis e pela correlação de Pearson, considerando-se significante p<0,05. RESULTADOS: Não houve diferença entre os gêneros em relação à classificação inicial da asma e ao nível de controle. Receberam classificação inicial persistente 91,7% (100 casos), sendo que 106 casos (88,3%) encontravam-se parcial ou totalmente controlados. Não houve diferença estatística entre os pacientes controlados e os demais em relação ao IMC. Não foram encontradas correlações significantes entre zIMC e VEF1 e entre zIMC e FEV25-75%, analisando-se todos os pacientes e apenas pacientes com sobrepeso ou obesos. CONCLUSÕES: Neste estudo, não foi encontrada correlação significante entre sobrepeso/obesidade e asma, utilizando-se parâmetros clínicos, antropométricos e espirométricos