Nutritional profile of newborns with microcephaly and factors associated with worse outcomes

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student’s t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with po0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (po0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status

Antiviral activity of the green marine alga Ulva fasciata on the replication of human metapneumovirus

We evaluated the antiviral activity of the marine alga, Ulva fasciata, collected from Rasa beach and Forno beach, Búzios, Rio de Janeiro, Brazil on the replication of human metapneumovirus (HMPV). The algae extracts were prepared using three different methodologies to compare the activity of different groups of chemical composites obtained through these different methodologies. Four out of the six extracts inhibited nearly 100% of viral replication. The results demonstrated that the majority of the extracts (five out of six) possess virucidal activity and therefore have the ability to interact with the extracellular viral particles and prevent the infection. On the other hand, only two extracts (from Forno beach, obtained by maceration and maceration of the decoction) were able to interact with cell receptors, hindering the viral entry. Finally, only the extract of algae collected at Forno beach, obtained by maceration presented intracellular activity. To our knowledge, this is a pioneer study on antiviral activity of marine algae against HMPV. It is also the first on antiviral activity against HMPV ever done in Brazil. The study also shows the effect of different environment factors and different chemical procedures used to obtain the extract on its biological properties.Neste artigo, foi avaliada a atividade antiviral da alga marinha Ulva fasciata, coletada nas Praias do Forno e Rasa, em Búzios, Rio de Janeiro, Brasil, sobre a replicação do metapneumovírus humano (HMPV). Os extratos desta alga foram preparados utilizando três diferentes metodologias, visando a comparação da atividade de diferentes grupos de compostos químicos que são obtidos dependendo da metodologia empregada. Quatro, do total de seis extratos foram capazes de inibir praticamente 100% da replicação viral. Os resultados demonstram também que a maioria dos extratos (cinco, dos seis), possui atividade virucida e, portanto, possuem a habilidade de interagir com a partícula viral extracelularmente impedindo a infecção. Por outro lado, apenas dois extratos (coletado da Praia do Forno e, preparado através de maceração e maceração do decocto) foram capazes de se ligar a receptores celulares, impossibilitando assim a entrada das partículas virais nas células. Finalmente, apenas o extrato que foi preparado por maceração da alga coletada na Praia do Forno, demonstrou atividade intracelular. Até onde sabemos, este é um estudo pioneiro sobre a atividade antiviral de algas marinhas sobre o HMPV. É também o primeiro estudo sobre atividade antiviral sobre HMPV realizado no Brasil. O estudo também mostra o efeito de diferentes condições ambientais e procedimentos químicos utilizados na preparação do extrato sobre suas propriedades biológicas

Myosteatosis in a systemic inflammation-dependent manner predicts favorable survival outcomes in locally advanced esophageal cancer

Increased adiposity and its attendant metabolic features as well as systemic inflammation have been associated with prognosis in locally advanced esophageal cancer (LAEC). However, whether myosteatosis and its combination with systemic inflammatory markers are associated with prognosis of esophageal cancer is unknown. Our study aimed to investigate the influence of myosteatosis and its association with systemic inflammation on progression-free survival (PFS) and overall survival (OS) in LAEC patients treated with definitive chemoradiotherapy (dCRT). We retrospectively gathered information on 123 patients with LAEC submitted to dCRT at the University of Campinas Hospital. Computed tomography (CT) images at the level of L3 were analyzed to assess muscularity and adiposity. Systemic inflammation was mainly measured by calculating the neutrophil-to-lymphocyte ratio (NLR). Median PFS for patients with myosteatosis (n = 72) was 11.0 months vs 4.0 months for patients without myosteatosis (n = 51) (hazard ratio [HR]: 0.53; 95% confidence interval [CI], 0.34-0.83; P = .005). Myosteatosis was also independently associated with a favorable OS. Systemic inflammation (NLR > 2.8) was associated with a worse prognosis. The combination of myosteatosis with systemic inflammation revealed that the subgroup of patients with myosteatosis and without inflammation presented less than half the risk of disease progression (HR: 0.47; 95% CI: 0.26-0.85; P = .013) and death (HR: 0.39; 95% CI, 0.21-0.72; P = .003) compared with patients with inflammation. This study demonstrated that myosteatosis without systemic inflammation was independently associated with favorable PFS and OS in LAEC patients treated with dCRT81669676976FAPESP – Fundação de Amparo à Pesquisa Do Estado De São Paulo2018/23428-

Antimicrobial consumption in pediatric intensive care units during the first year of COVID-19 pandemic / Consumo antimicrobiano em unidades de cuidados intensivos pediátricos durante o primeiro ano da pandemia de COVID-19

Introduction: The absence of standardized treatment for critical children admitted in pediatric intensive care units (PICUs) with COVID could lead to an increase in antimicrobial consumption, as indirect effect. Aim: To describe trends of antimicrobial consumption in two PICUs before and during the COVID pandemic year.Methods: We did a retrospective study in children admitted in two PICUs of Rio de Janeiro city, between March 2019 and March 2021. The first year represented the pre-pandemic period and the last one the pandemic period. Trends of antimicrobial consumption were measured by days of therapy (DOT/1000 patient-days) and analyzed by linear regression for antibiotics, antivirals and antifungals Results: Number of patients-days in the PICU 1 was 3495 in the pre-pandemic period and 3600 in the pandemic period. The overall DOT/1000 PD of antibiotics, antivirals and antifungal was 15,308.1, 942.8 and 1,691.1, respectively in the pre-pandemic period and 13,481.5, 1,335.4 and 1,243.7, respectively in pandemic period. It was verified trend of reduction of antibiotic and antifungals and increase in antivirals consumption. Number of patients-days in the PICU 2 was 5029 in the pre-pandemic period and 4557 in the pandemic period and the overall DOT/1000 PD of antibiotics, antivirals and antifungal was 16,668.5, 1,385 and 1,966.7, respectively in the pre-pandemic period and 10,896.5, 830.7 and 677.3 in pandemic period. It was verified trend of reduction of antibiotic, antivirals and antifungals consumption. Conclusion: Trends of antimicrobial consumption reduction were verified for antibiotics and antifungals in two PICUs and reduction for antiviral in one of them

HFMEA-Fuzzy: evaluation of the main lean wastes in an Emergency Care Unit (ECU) in Rio de Janeiro

The aim of the article was to use HFMEA-Fuzzy modeling to evaluate the eight lean wastes and identify critical processes related to them. To achieve this, data was collected from an Emergency Care Unit (ECU) in Rio de Janeiro. The results showed that the Processing/Creativity waste was the most frequent, followed by Defects, Waiting/Inventory, and Overproduction waste. Additionally, it was possible to identify critical processes related to each waste and suggest improvements to reduce or eliminate these wastes

IDENTIFICATION OF CANINE VISCERAL LEISHMANIASIS IN A PREVIOUSLY UNAFFECTED AREA BY CONVENTIONAL DIAGNOSTIC TECHNIQUES AND CELL-BLOCK FIXATION

After the report of a second case of canine visceral leishmaniasis (CVL) in São Bento da Lagoa, Itaipuaçu, in the municipality of Maricá, Rio de Janeiro State, an epidemiological survey was carried out, through active search, totaling 145 dogs. Indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and rapid chromatographic immunoassay based on dual-path platform (DPP(r)) were used to perform the serological examinations. The parasitological diagnosis of cutaneous fragments was performed by parasitological culture, histopathology, and immunohistochemistry. In the serological assessment, 21 dogs were seropositive by IFA, 17 by ELISA, and 11 by DPP(r), with sensitivity of 66.7%, 66.7% and 50%, and specificity of 87.2%, 90.2% and 94%, respectively for each technique. The immunohistochemistry of bone marrow using the cell-block technique presented the best results, with six positive dogs found, three of which tested negative by the other parasitological techniques. Leishmania sp. was isolated by parasitological culture in three dogs. The detection of autochthonous Leishmania infantum in Itaipuaçu, and the high prevalence of seropositive dogs confirm the circulation of this parasite in the study area and alert for the risk of expansion in the State of Rio de Janeiro

Pharmacokinetic interactions between clopidogrel and rosuvastatin: Effects on vascular protection in subjects with coronary heart disease

Universidade Federal de São Paulo, Dept Med, Div Cardiol, São Paulo, BrazilUniv São Paulo, Inst Phys, Natl Inst Complex Fluids, São Paulo, BrazilGaleno Lab, Campinas, SP, BrazilUniversidade Federal de São Paulo, Dept Med, Div Cardiol, São Paulo, BrazilWeb of Scienc

AVALIAÇÃO DE SITUAÇÃO VACINAL DE CRIANÇAS ADSCRITAS NA UBS DO BAIRRO DE FÁTIMA NO MUNICÍPIO DE VALENÇA- RJ

Introdução: A vacinação de rotina consiste no estabelecimento de um calendário vacinal que deve ser aplicado ao indivíduo desde o nascimento, visando garantir prevenção específica das doenças imunopreveníveis e indução da imunidade de massa. Objetivo: Caracterizar a cobertura vacinal da população infantil adscrita na UBS Bairro de Fátima - Valença – RJ. Materiais e Métodos: Trata-se de um estudo quantitativo, do tipo coorte transversal, que produz resultados “instantâneos” da situação de saúde de um local. O método utilizado foi coleta de dados a partir da caderneta vacinal. O estudo fora realizado com base em dados vacinais de 100 crianças, de 0 a 5 anos de idade, incluindo ambos os sexos. A partir dos dados obtidos, foram separados em grupos com vacinação completa e incompleta, bem como as vacinas com maior índice de inadimplência. Resultados: De 100 crianças, 52% eram do sexo masculino e 48% do sexo feminino e a taxa de vacinação incompleta, foi respectivamente, 23% e 27%. A maior taxa de falta de cobertura está entre as vacinas contra Difteria, Tétano, Coqueluche e Varicela. Conclusão: A taxa de falta da cobertura vacinal condiz com a média dos estudos nacionais. Contudo, nos estudos base as principais vacinas não realizadas foram Hepatite A e Poliomielite, diferente do nosso estudo em que as de menor cobertura foram tríplice e tetra virais. Apesar de estar dentro da meta esperada pelo Ministério da Saúde, a cobertura vacinal local deve ser estimulada para redução de ocorrência de doenças

PREVALÊNCIA DE SINDROME METABÓLICA EM CRIANÇAS E ADOLESCENTES OBESOS DO MUNICÍPIO DE RIO DAS FLORES – RJ

Introdução: A obesidade é um problema pediátrico de saúde pública, com prevalência em fase de crescimento, tornando sua prevenção e tratamento essenciais para diminuir futuras complicações. Destaca-se a Síndrome Metabólica como reconhecido fator de risco para o desenvolvimento de doença cardiovascular e fortemente associada ao excesso de peso. Objetivo: Caracterizar os pacientes obesos, pelo IMC e medida da circunferência abdominal e realizar exames físico-laboratoriais que confirmem o diagnóstico de Síndrome Metabólica. Materiais e Métodos: Foi realizado um estudo quantitativo, do tipo coorte transversal, no município de Rio das Flores - RJ, envolvendo 34 crianças entre 10 e 16 anos. Utilizou-se o método de medida de peso e altura de todas as crianças, a fim de obter o valor do índice de massa corporal (IMC), além das medidas dos níveis pressóricos arteriais, medida de cintura abdominal e coleta de material para exames laboratoriais. Resultados: Foram classificadas 8,8% das crianças como apresentando SM, dessas, 66,7% eram meninos. A grande maioria das alterações encontradas foi no critério de PA, o equivalente a 92,3%. Conclusão: A obesidade na infância e adolescência é um importante fator de risco para o desenvolvimento de síndrome metabólica, tornando-se necessária a implementação de medidas intervencionistas e de prevenção no combate a este distúrbio nutricional, tais como a promoção do aumento da atividade física e o incentivo à aquisição de hábitos alimentares saudáveis