Ausência de transmissão vertical do HTLV-I em crianças não amamentadas

The most frequent pathway of vertical transmission of HTLV-I is breast-feeding, however bottle fed children may also become infected in a frequency varying from 4 to 14%. In these children the most probable routes of infection are transplacental or contamination in the birth canal. Forty-one bottle-fed children of HTLV-I seropositive mothers in ages varying from three to 39 months (average age of 11 months) were submitted to nested polymerase chain reaction analysis (pol and tax genes). 81.5% of the children were born by an elective cesarean section. No case of infection was detected. The absence of HTLV-I infection in these cases indicates that transmission by transplacental route may be very infrequent.A amamentação é o meio mais freqüente de transmissão vertical do HTLV-I. No entanto, crianças não amamentadas mostram-se infectadas em freqüências que variam de 4 a 14%. Nestes casos, os meios mais prováveis de infecção devem ser através da placenta ou por contaminação no canal de parto. Quarenta e um filhos de portadoras do HTLV-I aleitados artificialmente foram submetidos a pesquisa do vírus pela reação em cadeia da polimerase. 81,5% destas crianças nasceram através de cesária eletiva. Nenhum caso de infecção pelo HTLV-I foi detectado. Este fato indica que a infecção por via transplacentária é pouco freqüente e que é provável que o parto artificial tenha contribuído para a ausência de transmissão do vírus

Óbitos neonatais precoces associados à asfixia perinatal em neonatos ≥2.500 g no Brasil

Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing >= 2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight >= 2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases, 10th Revision (P20.0, P21.0, and P24.0). An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing >= 2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38%) of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001); the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight andwithout congenital malformations are still high, and meconium aspiration syndrome plays a major role. (c) 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda.Objetivo: Avaliar a taxa anual de óbitos neonatais precoces associados à asfixia perinatal em neonatos de peso ≥ 2.500 g no Brasil de 2005 a 2010. Métodos: A população do estudo envolveu todos os nascidos vivos de neonatos com peso ao nascer ≥ 2.500 g e sem malformações que morreram até seis dias após o nascimento por asfixia perinatal, definida como hipóxia intrauterina, asfixia no nascimento ou síndrome de aspiração de mecônio. A causa do óbito foi escrita em qualquer linha do atestado de óbito, de acordo com a Classificação Internacional de Doenças, 10a Revisão (P20.0, P21.0 e P24.0). Foi feita uma pesquisa ativa em 27 unidades federativas brasileiras. O teste qui-quadrado de tendência foi aplicado para analisar os índices de mortalidade neonatal associados a asfixia perinatal até o ano do estudo. Resultados: Morreram 10.675 neonatos com peso ≥ 2.500 g sem malformações até 0-6 dias após o nascimento por asfixia perinatal. Os óbitos ocorreram nas primeiras 24 horas após o nascimento em 71% dos neonatos. A síndrome de aspiração de mecônio foi relatada em 4.076 (38%) dos óbitos. O índice de mortalidade neonatal precoce relacionada à asfixia caiu de 0,81 em 2005 para 0,65 por 1.000 nascidos vivos em 2010 no Brasil (p < 0,001); o índice de mortalidade neonatal precoce relacionada a síndrome de aspiração de mecônio permaneceu entre 0,20-0,29 por 1.000 nascidos vivos durante o período do estudo. Conclusões: Apesar da redução nas taxas no Brasil de 2005 a 2010, as taxas de mortalidade neonatal precoce associadas à asfixia perinatal em neonatos no melhor espectro de peso ao nascer e sem malformações congênitas ainda são altas e a síndrome de aspiração de mecônio desempenha um importante papel.Fundacao Sociedade Brasileira de PediatriaUniv Fed Sao Paulo, UNIFESP, Escola Paulista Med, Dept Pediat, Sao Paulo, SP, BrazilUniv Fed Bahia UFBA, Dept Pediat, Salvador, BA, BrazilUniv Fed Rio Grande do Norte UFRN, Dept Pediat, Natal, RN, BrazilUniv Fed Minas Gerais, Dept Pediat, Belo Horizonte, MG, BrazilUniv Fed Sao Paulo, UNIFESP, Escola Paulista Med, Dept Pediat, Sao Paulo, SP, BrazilWeb of Scienc

Adenomas hipofisários não-secretores: avaliações clínica, laboratorial, neuro-radiológica e evolução após tratamento

OBJECTIVE: This study is an updated review of a Southeast Brazilian experience NFPA, emphasizing clinical features, laboratorial and imaging assessment, therapeutic management and outcome. DESIGN AND METHODS: Retrospective study, in which 104 patients with NFPA were evaluated by the same team of endocrinologists and neurosurgeon. Patients underwent biochemical evaluation, radiological studies and visual field assessment. RESULTS: Hypopituitarism and neuro-ophthalmological defects were observed in 89%. We observed GH deficiency (81.4%), hypogonadism (63.3%), adrenal hypofunction (59.5%), hypothyroidism (20.4%), high (38.5%) and low (16.7%) prolactin levels. Preoperative imaging classified 93% of the tumors as macroadenomas. Extra-sellar expansion was observed in 83.8%. Varying degrees of visual disturbance were observed in 74%. Primary treatment was transsphenoidal surgery (75%). Clinical control was achieved with one surgery in 37.5 % of patients. The majority of patients needed a second therapeutic approach, radiotherapy or other surgeries. Immunohistochemistry resulted negative for pituitary hormones in 43%. Improvement of neuro-ophthalmological symptoms was observed in 61% of the patients after treatment. CONCLUSIONS: Our data confirm elevated prevalence of mass effect and hypopituitarism in patients harboring NFPA. Recurrence due to invasion or incomplete resection of the tumor is quite common, which frequently leads to a second therapeutic option.OBJETIVOS: Esse estudo é uma revisão atualizada em adenomas hipofisários não-secretores (AHNS), enfatizando características clínicas, avaliações laboratorial e neuro-radiológica, manejo terapêutico e desfecho. MÉTODOS: Estudo retrospectivo, em que 104 pacientes com AHNS foram avaliados pela mesma equipe de endocrinologistas e neurocirurgião. Os pacientes foram submetidos à avaliação bioquímica, a estudos radiológicos e à avaliação de campo visual. RESULTADOS: Hipopituitarismo e distúrbios neuro-oftalmológicos foram observados em 89%. Observou-se deficiência de GH (81,4%), hipogonadismo (63,3%), hipofunção adrenal (59,5%), hipotireoidismo (20,4%), concentrações elevadas (38,5%) e baixas (16,7%) de prolactina. Imagens pré-operatórias classificaram os tumores em sua maioria como macroadenomas (93%). Expansão extra-selar foi observada em 83,8%. Graus variados de distúrbios visuais foram observados em 74%. O tratamento de escolha foi a cirurgia transesfenoidal (75%). O controle clínico foi alcançado com cirurgia em 37,5% dos pacientes. A maioria dos pacientes precisou de segunda abordagem terapêutica, radioterapia ou outras cirurgias. A imunoistoquímica resultou negativa para hormônios hipofisários em 43%. Melhora de sintomas neuro-oftalmológicos foi observada em 61% dos pacientes após o tratamento. CONCLISÕES: Os dados do estudo confirmam elevada prevalência de efeitos de massa e hipopituitarismo em pacientes com AHNS. Recorrência causada por invasão ou ressecção incompleta do tumor é comum, levando frequentemente à segunda opção terapêutica

Utilização de Bacillus subtilis como promotor de crescimento na cultura do tomate e alface

Rhizobacteria of the genus Bacillus, which are found in the rhizosphere, live in colonies, promote plant growth and have the potential to control phytopathogens through the release of volatile compounds. Therefore, the objective of the study was to evaluate the efficiency of Bacillus subtilis Bs10 in promoting the growth of tomato and lettuce plants. The experiment was carried out in trays with 25 plants per treatment. B. subtilis inoculation was carried out at the time of planting using 1 mL of suspension in each cell. A completely randomized design was used with two treatments, with and without Bacillus inoculation. Assessments for both crops were carried out 28 days after germination, where plant height, shoot dry mass (SDM) and root dry mass (RDM) were determined. The hypothesis of equality between the means of the two evaluated treatments was made by the F test of the analysis of variance for p = 0.05, using the SISVAR statistical program. During the evaluations, the treatment with B. subtilis obtained the best results in all aspects, presenting significant differences in relation to the control. The treatment with inoculation of B. subtilis Bs10 showed higher MSPA in lettuce and tomato seedlings, obtaining a significant difference in relation to the control without inoculation, with a greater difference in lettuce with 21.67% more MSPA compared to the control, and in tomatoes with 18.61%. Therefore, according to the results obtained, B. subtilis Bs10 is efficient in promoting the growth of tomato and lettuce plants.Rizobácterias do gênero Bacillus que são encontrados na rizosfera vivem em colônias, promovem o crescimento vegetal e apresentam potencial para o controle de fitopatógenos através da liberação de compostos voláteis. Diante disso o objetivo do estudo foi avaliar a eficiência do Bacillus subtilis Bs10 na promoção de crescimento de plantas de tomate e alface. O experimento foi realizado em bandejas com 25 plantas por tratamento. A inoculação de B. subtilis foi realizada no momento do plantio utilizando 1 mL de suspensão em cada célula. Foi utilizado o delineamento inteiramente casualizado com dois tratamentos, com e sem a inoculação de Bacillus. As avaliações para ambas as culturas foram realizadas aos 28 dias após a germinação onde foram determinadas a altura de plantas, massa seca da parte aérea (MSPA) e massa seca da raiz (MSR). A hipótese de igualdade entre as médias dos dois tratamentos avaliados foi feita pelo teste F da análise de variância para p = 0,05, utilizando o programa estatístico SISVAR. Durante as avaliações o tratamento com B. subtilis obteve os melhores resultados em todos os quesitos apresentando diferenças significativas com relação a testemunha. O tratamento com a inoculação de B. subtilis Bs10 apresentou maior MSPA nas mudas de alface e tomate, obtendo diferença significativa com relação a testemunha sem inoculação, sendo uma diferença superior, na alface com 21,67% a mais de MSPA comparando com a testemunha, e no tomate com 18,61%. Por tanto, de acordo com os resultados obtidos, o B. subtilis Bs10 é eficiente na promoção de crescimento de plantas de tomate e alface

Global assessment of marine plastic exposure risk for oceanic birds

Plastic pollution is distributed patchily around the world’s oceans. Likewise, marine organisms that are vulnerable to plastic ingestion or entanglement have uneven distributions. Understanding where wildlife encounters plastic is crucial for targeting research and mitigation. Oceanic seabirds, particularly petrels, frequently ingest plastic, are highly threatened, and cover vast distances during foraging and migration. However, the spatial overlap between petrels and plastics is poorly understood. Here we combine marine plastic density estimates with individual movement data for 7137 birds of 77 petrel species to estimate relative exposure risk. We identify high exposure risk areas in the Mediterranean and Black seas, and the northeast Pacific, northwest Pacific, South Atlantic and southwest Indian oceans. Plastic exposure risk varies greatly among species and populations, and between breeding and non-breeding seasons. Exposure risk is disproportionately high for Threatened species. Outside the Mediterranean and Black seas, exposure risk is highest in the high seas and Exclusive Economic Zones (EEZs) of the USA, Japan, and the UK. Birds generally had higher plastic exposure risk outside the EEZ of the country where they breed. We identify conservation and research priorities, and highlight that international collaboration is key to addressing the impacts of marine plastic on wide-ranging species

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks