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Data on the acceptability and usability of hepatitis C virus self-testing (HCVST) remain scarce. We estimated the pooled rates of acceptability/feasibility and re-reading/re-testing agreement of HCVST using oral fluid tests (PROSPERO-CRD42022349874). We searched online databases for studies that evaluated acceptability, usability and inter-reader/operator variability for HCVST using oral fluid tests. Pooled estimates of feasibility, agreement and post-testing perspectives were analysed. Sensitivity analyses were performed in men who have sex with men (MSM) and people who inject drugs (PWID). Heterogeneity was assessed using the I2 statistics. A total of six studies comprising 870 participants were identified: USA (n = 95 with liver disease), Kenya (n = 150 PWID), Egypt (n = 116 from the general population), Vietnam (n = 104 MSM and n = 105 PWID), China (n = 100 MSM) and Georgia (n = 100 MSM and n = 100 PWID)]. All studies used OraQuick® HCV Rapid Antibody Test. The pooled overall estimates for correct sample collection and for people who performed HCVST without needing assistance in any step (95% confidence interval [CI]) were 87.2% [76.0-95.3] (n = 755; I2 = 93.7%) and 62.6% [37.2-84.8] (n = 755; I2 = 98.0%), respectively. The pooled estimate of agreement for re-reading was 95.0% [95% CI 91.5-97.6] (n = 831; I2 = 74.0%) and for re-testing was 94.4% [90.3-97.5] (n = 726; I2 = 77.1%). The pooled estimate of those who would recommend HCVST was 94.4% [84.7-99.6] (n = 625; I2 = 93.7%). Pooled estimates (95% CI) of correct sample collection (72.8% [63.3-81.5] vs. 90.8% [85.9-94.8]) and performance of HCVST without needing assistance (44.1% [14.1-76.7] vs. 78.1% [53.4-95.3]) was lower in PWID compared to MSM. In summary, HCV testing with oral fluid HCVST was feasible and well-accepted. Oral fluid HCVST should be considered in key populations for uptake HCV testing.
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Infecções por HIV , Hepatite C , Minorias Sexuais e de Gênero , Abuso de Substâncias por Via Intravenosa , Masculino , Humanos , Hepacivirus , Homossexualidade Masculina , Abuso de Substâncias por Via Intravenosa/epidemiologia , Autoteste , Infecções por HIV/epidemiologia , Hepatite C/epidemiologia , Anticorpos Anti-Hepatite CRESUMO
A gas sensor array was developed and evaluated using four high-frequency quartz crystal microbalance devices (with a 30 MHz resonant frequency in fundamental mode). The QCM devices were coated with ethyl cellulose (EC), polymethylmethacrylate (PMMA), Apiezon L (ApL), and Apiezon T (ApT) sensing films, and deposited by the ultrasonic atomization method. The objective of this research was to propose a non-invasive technique for acetone biomarker detection, which is associated with diabetes mellitus disease. The gas sensor array was exposed to methanol, ethanol, isopropanol, and acetone biomarkers in four different concentrations, corresponding to 1, 5, 10, and 15 µL, at temperature of 22 °C and relative humidity of 20%. These samples were used because human breath contains them and they are used for disease detection. Moreover, the gas sensor responses were analyzed using principal component analysis and discriminant analysis, achieving the classification of the acetone biomarker with a 100% membership percentage when its concentration varies from 327 to 4908 ppm, and its identification from methanol, ethanol, and isopropanol.
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Diabetes Mellitus , Técnicas de Microbalança de Cristal de Quartzo , Humanos , Acetona/análise , 2-Propanol , Metanol , Biomarcadores , Etanol , Quartzo/química , Diabetes Mellitus/diagnósticoRESUMO
BACKGROUND: Myeloid-derived suppressor cells (MDSCs) are relevant in prostate cancer microenvironment collaborating in tumor development. The main tumor marker used in this disease, prostate-specific antigen (PSA), does not provide information related to this tumor microenvironment. Cancer cells secrete exosomes carrying bioactive molecules contributing to MDSCs recruitment and induction. The aim of this study was to characterize the perioperative changes of exosomal cytokines relevant in MDSCs recruitment induced by prostatectomy in prostate cancer patients. METHODS: Blood was drawn from 26 early-stage prostate cancer patients before and after radical prostatectomy and from 16 healthy volunteers. Serum exosomes were separated by precipitation. Cytokines related with MDSC cell recruitment and activation CCL2, CXCL2, CXCL5, CXCL8, CXCL12, MIF, S100A9 and TGF-ß were measured in serum and serum-derived exosomes using immunometric assays. RESULTS: All cytokines were detected both in serum and exosomes, except for CXCL12, which was detected only in serum. Exosomes were enriched specially in MIF, TGF-ß and CXCL2. Presurgical MIF levels in exosomes correlated negatively with serum PSA. Also, presurgical TGF-ß decreased both in serum and exosomes as Gleason score rises. Patients presurgical exosomes had increased CCL2, CXCL5 and TGF-ß levels than exosomes from healthy controls. These differences were not observed when cytokines were analyzed in serum, except for TGF-ß. Cytokine levels of CCL2, CXCL5 decreased in patients' postsurgical exosomes, while TGF-ß further increased. On the contrary, S100A9 levels were lower in patients presurgical exosomes but increased after radical prostatectomy. CONCLUSIONS: Blood exosomal content in cytokines constitute an attractive source to evaluate MDSCs immunomodulators providing additional information related to tumor microenvironment in prostate cancer.
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Quimiocinas/imunologia , Exossomos/imunologia , Células Supressoras Mieloides/imunologia , Proteínas de Neoplasias/imunologia , Prostatectomia , Neoplasias da Próstata , Microambiente Tumoral/imunologia , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Período Perioperatório , Neoplasias da Próstata/imunologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgiaRESUMO
Y chromosomes are widely believed to evolve from a normal autosome through a process of massive gene loss (with preservation of some male genes), shaped by sex-antagonistic selection and complemented by occasional gains of male-related genes. The net result of these processes is a male-specialized chromosome. This might be expected to be an irreversible process, but it was found in 2005 that the Drosophila pseudoobscura Y chromosome was incorporated into an autosome. Y chromosome incorporations have important consequences: a formerly male-restricted chromosome reverts to autosomal inheritance, and the species may shift from an XY/XX to X0/XX sex-chromosome system. In order to assess the frequency and causes of this phenomenon we searched for Y chromosome incorporations in 400 species from Drosophila and related genera. We found one additional large scale event of Y chromosome incorporation, affecting the whole montium subgroup (40 species in our sample); overall 13% of the sampled species (52/400) have Y incorporations. While previous data indicated that after the Y incorporation the ancestral Y disappeared as a free chromosome, the much larger data set analyzed here indicates that a copy of the Y survived as a free chromosome both in montium and pseudoobscura species, and that the current Y of the pseudoobscura lineage results from a fusion between this free Y and the neoY. The 400 species sample also showed that the previously suggested causal connection between X-autosome fusions and Y incorporations is, at best, weak: the new case of Y incorporation (montium) does not have X-autosome fusion, whereas nine independent cases of X-autosome fusions were not followed by Y incorporations. Y incorporation is an underappreciated mechanism affecting Y chromosome evolution; our results show that at least in Drosophila it plays a relevant role and highlight the need of similar studies in other groups.
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Drosophila/classificação , Drosophila/genética , Cromossomo Y/genética , Animais , Evolução Molecular , Feminino , Duplicação Gênica , Genes de Insetos , Ligação Genética , Masculino , Modelos Genéticos , Filogenia , Seleção Genética , Especificidade da Espécie , Translocação Genética , Cromossomo X/genéticaRESUMO
The discrimination improvement of an array of four highly sensitive 30 MHz gas quartz crystal microbalance (QCM) sensors was performed and compared to a similar system based on a 12-MHz QCM. The sensing polymeric films were ethyl cellulose (EC), poly-methyl methacrylate (PMMA), Apiezon L (ApL), and Apiezon T (ApT) and they were coated over the AT-cut QCM devices by the drop casting technique. All the sensors had almost the same film thickness (0.2 µm). The fabricated QCM sensor arrays were exposed to three different concentrations, corresponding to 5, 10, and 15 µL, of ethanol, ethyl acetate, and heptane vapors. The steady state sensor responses were measured in a static system at a temperature of 20 °C and relative humidity of 22%. Our results showed that the 30-MHz sensors have a higher sensitivity than 12-MHz ones (around 5.73 times), independently of the sensing film and measured sample. On the other hand, principal component analysis and discriminant analysis were performed using the raw data of the responses. An improvement of the classification percentage between 12 MHz and 30 MHz sensors was found. However, it was not sufficient, especially for low concentrations. Furthermore, using partition coefficient and discriminant analysis (DA), an improvement of 100% classification of the three samples was achieved for the case of the 30-MHz sensor array.
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OBJECTIVE: To determine the prevalence of and modifiable factors associated with prediabetes in the Comcáac Indians. DESIGN: Cross-sectional study where prediabetes was defined using fasting plasma glucose, 2 h plasma glucose and glycated Hb (HbA1c). Physical, anthropometric and biochemical measurements, medical record, socio-economic, dietary and physical activity information were collected. The modifiable factors associated with prediabetes were assessed using multiple logistic regression. Settings Comcáac Indian communities of Punta Chueca and El Desemboque, Sonora, Mexico. SUBJECTS: Adults (n 227) aged 20 years or older. RESULTS: The sex- and age-adjusted prevalence (95 % CI) of prediabetes was 47·1 (40·8, 53·5) % in the overall population; age-adjusted prevalence was 47·3 (35·6, 59·0) % in men and 46·7 (39·1, 54·3) % in women. The modifiable factors associated with a risk of prediabetes (OR; 95 % CI) were light-intensity physical activity (per 1 h/week increase: 1·04; 1·01, 1·07) and insulin resistance (homeostasis model assessment of insulin resistance score >6·1 v. <4·1: 4·62; 1·37, 15·51). Increased consumption of a traditional dietary pattern based on fish and seafood, low-fat cereals, fruits and vegetables was a protective factor (0·49; 0·31, 0·79). All variables were modelled together and adjusted for age and sex. CONCLUSIONS: The high prediabetes prevalence found in the Comcáac community is alarming because it represents a large number of people who are at risk for type 2 diabetes. The identification of modifiable factors associated with prediabetes that are specific to this population may be useful for designing effective strategies to prevent prediabetes.
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Indígenas Centro-Americanos , Estado Pré-Diabético/etnologia , Adulto , Antropometria , Glicemia/metabolismo , Estudos Transversais , Exercício Físico , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , México/epidemiologia , Avaliação Nutricional , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto JovemRESUMO
Glass distillation equipment from an early modern alchemical laboratory was analyzed for its technology of manufacture and potential origin. Chemical data show that the assemblage can be divided into sodium-rich, colorless distillation vessels made with glass from Venice or its European imitation, and potassium-rich dark-brown non-specialized forms produced within the technological tradition of forest glass typical for central and north-western Europe. These results complete our understanding of the supply of technical apparatus at one of the best-preserved alchemical laboratories and highlight an early awareness of the need for high-quality instruments to guarantee the successful outcome of specialized chemical operations. This study demonstrates the potential of archaeological science to inform historical research around the practice of early chemistry and the development of modern science.
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Great Zimbabwe (CE1000-1600) is world famous for outstanding cultural innovations and localised and globalised entanglement with trans-Africa and trans-Indian Ocean exchange. New excavations yielded fragments of over a hundred gold processing vessels comprising reused pottery and purpose-made crucibles from stratified contexts in the Eastern Ridge Ruins and adjacent areas. Selected samples were studied using archaeological, microscopic, and compositional (SEM-EDS) techniques. All ceramics were made of alumina-rich clays and contain minerals common to granite-derived lithologies typical of the area, although it is possible that particularly refractory clays were selected to make crucibles locally. These technical ceramics were used for refining and collecting gold at high temperature, most likely producing not only relatively standardised ingots but also finished objects. The composition of the gold prills set in crucible slag is consistent with that of natural, unalloyed gold, while the variability in silver levels and minor impurities point to heterogeneous sources of the gold. Considering these finds in their multiple site and regional contexts, and together with complementary threads of information from early reports of antiquarians and looters, we argue that local agency and gold consumption were much more significant than generally assumed. The conclusion to the paper is that Great Zimbabwe's famous participation in local and global exchanges was backed by internally driven but improvisation laden production and consumption occurring in homesteads located throughout its various settlements. We end by raising a word of caution about oversimplified narratives of globalisation and their archaeological expressions (see Supplementary Material S0 for the abstract in Shona). Supplementary Information: The online version contains supplementary material available at 10.1007/s12520-023-01811-7.
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Japanese craftspeople have dominated the art of patinating copper-alloys since the 15th century, using precise alloy compositions and complicated patination processes in different hot solutions to create a variety of colours on swords fittings such as tsuba. While this complex tradition is increasingly popular in the East, the reasons behind the choices made by craftspeople in the selection of the components of the alloys and are still not fully understood. This paper investigates the effect of different alloying elements (tin, gold, and silver) on the resulting patina. Experimental results are compared with optical and compositional analyses on historical Japanese artefacts, confirming the effects of the different alloying elements on the patina characteristics and colour. The absence of tin and the presence of gold limit the growth of an oxide layer and promote the formation of a thin patina characterised by a smooth appearance without visible grains. Therefore, a limited thickness of the patinas is a key aspect for the production of the desired colour and appearance of the patinas. The first colorimetric analysis on historical Japanese artefacts demonstrates the influence of gold, silver and tin in the final patina colour, validating the observations in the experimental replicas.
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The casts of Pompeii bear witness to the people who died during the Vesuvius 79 AD eruption. However, studies on the cause of death of these victims have not been conclusive. A previous important step is the understanding of the post-depositional processes and the impact of the plaster in bones, two issues that have not been previously evaluated. Here we report on the anthropological and the first chemical data obtained from the study of six casts from Porta Nola area and one from Terme Suburbane. A non-invasive chemical analysis by portable X-ray fluorescence was employed for the first time on these casts of Pompeii to determine the elemental composition of the bones and the plaster. Elemental profiles were determined providing important data that cross-referenced with anthropological and stratigraphic results, are clearly helpful in the reconstruction of the perimortem and post-mortem events concerning the history of these individuals. The comparative analyses carried out on the bone casts and other collections from burned bones of the necropolis of Porta Nola in Pompeii and Rome Sepolcreto Ostiense, and buried bones from Valencia (Spain), reveal the extent of high temperature alteration and post-depositional plaster contamination. These factors make bioarchaeological analyses difficult but still allow us to support asphyxia as the likely cause of death.
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Lepidópteros , Contenções , Humanos , Animais , Antropologia , Asfixia , Cromatografia Gasosa , Contaminação de Medicamentos , NitroargininaRESUMO
This paper is based on the archaeological and analytical study of the laboratory remains from the Officina Chimica of the Old Ashmolean Museum in Oxford. Following a contextualisation of this laboratory, founded in the wake of Bacon's utopian idea of Solomon's Temple, it is argued that the assemblage is likely to date from the late seventeenth century and thus be connected to the work of Robert Plot, Christopher White, and, indirectly, Robert Boyle. The analytical study of the equipment reveals that the chymists at the Old Ashmolean obtained crucibles from the best manufacturers in Europe, and that they used these and other utensils for experiments involving mercury, sulphur, zinc, lead glass, manganese, and antimony. The importance of these elements for early modern chymistry is discussed in the light of relevant historical sources, including some of Boyle's chymical texts. Altogether, these finds illustrate some of the rich diversity of experiments that took place in one of the most prominent laboratories of the period, showing strong connections with longstanding alchemical concerns as well as with cutting-edge research and development ventures.
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Arqueologia , Química/história , Inglaterra , Vidro/química , História do Século XVII , História do Século XVIII , Laboratórios/história , Chumbo/química , Mercúrio/química , Espectrometria por Raios X , Enxofre/química , Zinco/químicaRESUMO
Towards the end of the seventeenth century, Oxford's chymical community came together in the Ashmolean Museum. Founded in 1683, the institution was part of Oxford University and home to the first official chair of chymistry in the country, with practical teaching directed by Robert Plot in the basement laboratory. The information at our disposal is scarce and Plot did not leave us detailed accounts of his laboratory work. However, a large assemblage of ceramic crucibles and distillation apparatus was recovered from the site where the laboratory once operated, an invaluable material perspective on the experimental agenda of one of the most important chymical laboratories in early modern Europe. The scientific analysis of the materials indicates that the work focused on technological innovation in the fields of glassmaking, specialised pottery, and zinc metallurgy, and shows how the laboratory kept close contact with some renowned artisan-entrepreneurs of the time. We argue that material culture offers an informative perspective on chymical practice in and beyond Oxford. The results provide fresh insight into the Old Ashmolean Museum, an institution that grew out of the Baconian spirit, where doing chymistry meant working at the intersection of artisanal and scholarly worlds.
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Laboratórios , Museus , Antropologia Cultural , Europa (Continente) , Humanos , ZincoRESUMO
This paper considers copper production in the Niari Basin, Republic of the Congo, during a period dated to the mid-fifteenth-mid-seventeenth centuries CE. Using a combination of pXRF, OM, SEM-EDS, and FTIR, it assesses the microstructure and composition of slags and technical ceramics from sites associated with two different regional pottery traditions: Moubiri-type at the site of Kingoyi near Mindouli and Kindangakanzi-type at Kindangakanzi near Boko-Songho. Both sites are characterised by the use of refractory domestic pottery as crucibles for copper smelting. Moubiri-type pottery is alumina-rich, while Kindangakanzi-type pottery is formed from a magnesia-rich clay, a crucible type unique in sub-Saharan Africa. Similarities in chaînes opératoires at Kingoyi and Kindangakanzi suggest sharing of knowledge at mining and smelting sites, interactions we reconstruct as a metallurgical constellation of practice comprised of the distinct potting communities of practice (see Supplementary information for abstract in Lingala and French). Supplementary Information: The online version contains supplementary material available at 10.1007/s12520-022-01653-9.
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The COVID-19 pandemic has challenged authorities at different levels of government administration around the globe. When faced with diseases of this severity, it is useful for the authorities to have prediction tools to estimate in advance the impact on the health system as well as the human, material, and economic resources that will be necessary. In this paper, we construct an extended Susceptible-Exposed-Infected-Recovered model that incorporates the social structure of Mar del Plata, the 4°most inhabited city in Argentina and head of the Municipality of General Pueyrredón. Moreover, we consider detailed partitions of infected individuals according to the illness severity, as well as data of local health resources, to bring predictions closer to the local reality. Tuning the corresponding epidemic parameters for COVID-19, we study an alternating quarantine strategy: a part of the population can circulate without restrictions at any time, while the rest is equally divided into two groups and goes on successive periods of normal activity and lockdown, each one with a duration of τ days. We also implement a random testing strategy with a threshold over the population. We found that τ=7 is a good choice for the quarantine strategy since it reduces the infected population and, conveniently, it suits a weekly schedule. Focusing on the health system, projecting from the situation as of September 30, we foresee a difficulty to avoid saturation of the available ICU, given the extremely low levels of mobility that would be required. In the worst case, our model estimates that four thousand deaths would occur, of which 30% could be avoided with proper medical attention. Nonetheless, we found that aggressive testing would allow an increase in the percentage of people that can circulate without restrictions, and the medical facilities to deal with the additional critical patients would be relatively low.
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COVID-19 , Argentina/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Humanos , Pandemias/prevenção & controle , Quarentena , SARS-CoV-2RESUMO
The number of researchers and publications devoted to the history of alchemy has seen exponential growth and diversification in recent decades, to such an extent that some scholars speak of a "New Historiography of Alchemy". On the occasion of the seventy-fifth anniversary of the Society for the History of Alchemy and Chemistry, this paper outlines some highlights of the literature since 1990, with a view to identify current trends but also challenges for the future. Some of the most important changes identified are a marked awareness of the risks of presentism, a shift from ambitious histories to contextualised microhistories, a heightened recognition of the internal diversity of historical alchemy, and a greater emphasis on its practical dimensions and its role in the Scientific Revolution. Among the challenges, the paper underscores the potential risks of an excessive historiographical fragmentation, the need for further interdisciplinary training and cooperation, and the responsibilities of alchemy historians towards students and the general public alike.
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Alquimia , Historiografia , Publicações Periódicas como Assunto/tendências , Estudos InterdisciplinaresRESUMO
Traditional studies of archaeological ceramics in Colombia have been largely based on visual and stylistic analyses. Here we introduce frameworks and concepts of reverse engineering as a complementary strategy to develop hypotheses about ceramic manufacture, as a first step to the address possible cross-craft relationships and broader sociocultural parameters affecting technical traditions. Our case study is focused on ceramic figurines recovered from two archaeological sites in southwest Colombia (Inguapí and La Cocotera), both dated to the period of greatest cultural and technological development of the Tumaco tradition (350 BC-AD 350). The results of the analyses including microscopy, XRF, SEM-EDS and XRD revealed two manufacturing pathways within the broader tradition, developed locally and adapted to the natural resources available to each site. These are shown through chemical and mineralogical differences in the raw materials, as well as differences in their preparation and shaping, molding, and modeling processes as observed at the microstructural level. Estimated firing temperatures are under 600°C for La Cocotera, and under 800°C for those of Inguapí, with an inhomogeneous, oxidizing atmosphere probably related to firing in a pit. The superficial characterization shows that all the figurines were painted, with those from Inguapí externally smoothed and polished, and those from La Cocotera covered with a slip. Notwithstanding differences between sites, the ceramic figurines illustrate a particular technical style that undoubtedly conveyed a shared ideological message of cultural affiliation. These results contribute in an innovative way to archaeological ceramic studies in Colombia from a different perspective that is complementary to the more common typological studies.
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Cerâmica , Engenharia , Arqueologia , Colômbia , PinturaRESUMO
Debates on early metallurgy in Western Europe have frequently focused on the social value of copper (between utilitarian and symbolic) and its purported role in the emergence and consolidation of hierarchies. Recent research shows that generalisations are increasingly untenable and highlights the need for comparative regional studies. Given its location in an intermediate area, the early metallurgy of Northeast Iberia provides an interesting case in point to explore the interaction between the well-characterised traditions of southern Iberia and southern France during the 3rd and 2nd millennia BCE. Here the analytical study of seven Bell Beaker (decorated and undecorated) vessels reused as crucibles at Bauma del Serrrat del Pont (Tortellà, Girona) are presented. We employed pXRF, metallography, SEM-EDS and lead isotope analyses. The results show evidence for copper smelting employing a remarkable variety of ore sources, including Solana del Bepo, Turquesa and Les Ferreres mines, and an extra unknown area. The smelting vessels were manufactured using the same clay, which contained both mineral and organic inclusions. Our results are discussed with reference to all the evidence available for metals and metallurgy in the Northeast, and more broadly in comparison to southern Iberia and southern France, with special emphasis on issues of production organisation and social complexity. Taken together, our results support the notion that copper metallurgy played a predominantly utilitarian role in Bell Beaker societies and highlight idiosyncratic aspects of the metallurgical trajectory in the Northeast. Differences between territories challenge unilinear explanations of technological and social development after the introduction of metallurgy. Separate trajectories can only be explained in relation to area-specific socio-cultural and environmental factors.
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Cobre , Metalurgia , Metais , MineraçãoRESUMO
The present study aimed to describe the perinatal outcomes of newborns of mothers with 2019 coronavirus infection identified before delivery in a level III hospital in Peru. Sociodemographic variables, obstetric complications, and neonatal morbidities were evaluated in the births that occurred between April 1 and June 30, 2020, at the National Maternal Perinatal Institute of Peru. 43 newborns were registered: 93% came from asymptomatic mothers, the most frequent obstetric complications were premature rupture of membranes (18.6%) and pre-eclampsia (11.6%), 65.1% of the births were vaginally, only one of the newborns had a positive result to RT-PCR for COVID-19, the comorbidities of the newborns were prematurity (11.3%) and low birth weight (9.3%); four were admitted to intermediate care and two to intensive care. It is concluded that 2.4% of newborns born to mothers with COVID-19 presented positive molecular test of RT-PCR, 14% of newborns presented morbidity as prematurity, low birth weight, sepsis and pneumonia that required ventilation. Neonatal morbidity was found in newborns whose RT-PCR test was negative for COVID-19.
El presente estudio tuvo como objetivo describir los resultados materno-perinatales de gestantes con infección por SARS-CoV-2 identificadas antes del parto, en un hospital nivel III del Perú. Se evaluaron variables sociodemográficas, complicaciones obstétricas y morbilidades neonatales en los nacimientos ocurridos entre el 1 de abril y el 30 de junio de 2020, en el Instituto Nacional Materno Perinatal del Perú. Se registraron 43 recién nacidos, 93% de las madres fueron asintomáticas. Las complicaciones obstétricas más frecuentes fueron rotura prematura de membranas (18,6%) y preeclampsia (11,6%). El 65,1% de nacimientos fue por parto vaginal, solo uno de los recién nacidos presentó resultado positivo a la prueba de reacción en cadena de polimerasa con transcriptasa inversa (RT-PCR) para COVID-19, las comorbilidades de los recién nacidos fueron prematuridad (11,3%), bajo peso al nacer (9,3%), cuatro ingresaron a cuidados intermedios y dos a cuidados intensivos. Se concluye que el 2,4% de los recién nacidos hijos de madres con COVID-19 presentó prueba molecular positiva de RT-PCR, el 14% de recién nacidos presentó morbilidad como prematuridad, bajo peso al nacer, sepsis y neumonía que requirió ventilación. La morbilidad neonatal se encontró en recién nacidos cuya prueba de RT-PCR fue negativa para COVID-19.
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COVID-19 , Complicações Infecciosas na Gravidez , Feminino , Hospitais , Humanos , Recém-Nascido , Peru/epidemiologia , Gravidez , Resultado da Gravidez , Gestantes , SARS-CoV-2RESUMO
INTRODUCTION: COVID-19 disease affects newborns, but its middle and long-term effects are still unclear. OBJECTIVE: To describe the clinical and epidemiological characteristics and follow-up of newborns infected with SARS-CoV-2. METHODS: An observational and descriptive study. We included newborns with SARS-CoV-2 positive RT-PCR born from SARS-CoV-2 seropositive mothers. Delivery and newborn care were provided at the 'Instituto Nacional Materno Perinatal' from Peru between June 1 and September 30, 2020. Perinatal information was collected from medical records. Remote follow-up and face-to-face evaluations gathered epidemiological and clinical information, in addition to serological and RT-PCR tests for SARS-CoV-2. Descriptive statistics were used for analysis. RESULTS: During the study period, 4733 neonates were born at the institution. We found that 1488 (31.4%) were born from seropositive for SARS-CoV-2 mothers. Finally, we included the 34 (2.3%) newborns with positive RT-PCR for SARS-CoV-2. Regarding the included newborns, 29.4% were delivered by cesarean section, 26.5% had low birth weight, 11.8% were preterm, 26.5% were hospitalized, and one died. Twenty-eight had a remote follow-up, and 18 also had a face-to-face follow-up. A total of 64.3% were exclusively breastfed, 28.6% were mixed breastfed, and 7.1% used a substitute formula. The face-to-face evaluation was performed between one and four months of chronological age. We found that 100% had negative control RT-PCR test for COVID-19, 38.9% had a negative serological test (IgM, IgG), and 61.1% positive IgG. CONCLUSIONS: Neonatal SARS-CoV-2 infection is rare, and most infected infants are asymptomatic. Vaginal delivery, breastfeeding, and joint isolation did not related with complications during hospital care. Infants under remote and in-person follow-up showed favorable clinical evolution during the study period.
INTRODUCCIÓN: La enfermedad por COVID-19 ha sido reportada en recién nacidos; sin embargo, aún no son claros sus efectos en el seguimiento de neonatos. OBJETIVO: Describir las características clínicas, epidemiológicas y el seguimiento de recién nacidos infectados con SARS-CoV-2. MÉTODOS: Estudio observacional y descriptivo. Participaron recién nacidos que tuvieron PCR-TR positivo a SARS-CoV-2, hijos de madres seropositivas a SARS-CoV-2. La atención del parto y del recién nacido fueron en el Instituto Nacional Materno Perinatal de Perú, entre el 1 de junio y el 30 de septiembre de 2020. Se recogió información perinatal de registros médicos. Se realizó seguimiento remoto y evaluación presencial para descripción epidemiológica, clínica y resultados de pruebas serológicas y PCR-TR para SARS-CoV-2. En el análisis se usó estadística descriptiva. RESULTADOS: Durante el período de estudio nacieron 4733 recién nacidos. De estos niños, 1488 (31,4%) procedieron de gestantes seropositivas a SARS-CoV-2 y de ellos 34 (2,3%) tuvieron PCR-TR positivo a SARS-CoV-2. De los 34 recién nacidos 29,4% nació por cesárea, 26,5% tuvo bajo peso, 11,8% fue prematuro 26,5% tuvo indicación de hospitalización por patología y un neonato falleció. De los 34 neonatos, 28 tuvieron seguimiento remoto y de ellos 18 tuvieron además seguimiento presencial post alta. El 64,3% recibía lactancia materna exclusiva, 28,6% lactancia mixta y 7,1% usaba un sucedáneo. La evaluación presencial se realizó entre uno a cuatro meses de edad cronológica. El 100% tuvo prueba de PCR-TR de control para coronavirus negativa y 38,9% tuvo prueba serológica (IgM, IgG) negativa y 61,1% IgG positiva. CONCLUSIONES: La infección neonatal por SARS-CoV-2 es poco frecuente, la mayoría de infectados fueron asintomáticos. El parto vaginal, la lactancia materna y aislamiento conjunto no reportaron complicaciones en la evolución durante la atención hospitalaria. Los infantes en seguimiento remoto y presencial mostraron evolución clínica favorable durante el período de estudio.
Assuntos
COVID-19 , Complicações Infecciosas na Gravidez , Cesárea , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , SARS-CoV-2RESUMO
INTRODUCTION: SARS-CoV-2 has spread rapidly throughout the world. However, its ability to cause severe disease is not homogeneous according to sex and the different age groups. OBJECTIVE: To determine perinatal characteristics, morbidity, mortality, and serological results in neonates from seropositive pregnant women to SARS-CoV-2. METHODS: We did a retrospective, descriptive, cross-sectional study. We included all newborns from positive pregnant women to SARS-CoV-2, between April 15 and May 10, 2020, who delivered in the National Perinatal Maternal Institute of Peru. The study extracted maternal and neonatal variables collected from the medical charts. The data were analyzed using descriptive statistics and Fischer's exact test. RESULTS: One hundred fourteen neonates were identified, 36.8% IgM/IgG positive for SARS-CoV-2, 7% IgG, and 56.2% had negative serology. The obstetric complications were premature rupture of membranes (14.9%) and preterm birth (8,8%). 8.8% of newborns had an Apgar score of less than or equal to six minutes, and of those, only one persisted after five minutes; three newborns died. There was an association between the type of maternal immunoglobulin and the serology of the newborn (p < 0.05). No association was observed between perinatal results and maternal immunoglobulin type (p > 0.05) or serological results in the newborn for SARS-CoV-2 (p > 0.05). CONCLUSION: 43.9% of seropositive mothers' neonates to SARS-CoV-2 had a positive serological result, more frequently type IgM/IgG. 10.5% of the neonates had some morbidity, more frequent prematurity, low birth weight, and 2.6% died. Perinatal results were not associated with the type of immunoglobulin of mothers seropositive to SARS-CoV-2; similarly, perinatal results were not associated with serological results in the newborn.
INTRODUCCIÓN: El SARS-CoV-2 tiene una rápida expansión por todo el mundo, sin embargo, su capacidad para causar enfermedad grave no es homogénea según sexo y edad. OBJETIVO: Determinar las características perinatales, morbilidad, mortalidad y resultados serológicos en neonatos de gestantes seropositivas para SARS-CoV-2. MÉTODOS: Estudio transversal, descriptivo y retrospectivo. Participaron todos los neonatos cuyas madres presentaron resultado seropositivo para SARS-CoV-2 antes del parto, entre el 15 de abril y 10 de mayo de 2020 en el Instituto Nacional Materno Perinatal de Perú. Se recogió información materna y neonatal a partir de sus historias clínicas. En el análisis se usó estadística descriptiva y prueba exacta de Fisher. RESULTADOS: Se identificaron 114 neonatos, el 36,8% presentó inmunoglobulinas M y G positivas para SARS-CoV-2; el 7% inmunoglobulinas G y 56,2% fue no reactivo. Las complicaciones obstétricas más frecuentes fueron rotura prematura de membranas (14,9%) y parto pretérmino (8,8%). El 8,8% de los neonatos presentaron un puntaje Apgar al minuto menor o igual a seis, y de ellos solo uno persistió a los cinco minutos; tres neonatos fallecieron. Se evidenció asociación entre el tipo de inmunoglobulina materna y la serología de su recién nacido (p < 0,05). No se observó asociación entre resultados perinatales y el tipo de inmunoglobulinas materna (p > 0,05), ni con los resultados serológicos en el neonato para SARS-CoV-2 (p > 0,05). CONCLUSIÓN: El 43,9% de neonatos de madre seropositiva a SARS-CoV-2 tuvo un resultado serológico positivo, siendo más frecuente de tipo Inmunoglobulinas M e Inmunoglobulinas G. El 10,5% de los neonatos presentó alguna morbilidad, siendo más frecuente prematuridad y bajo peso al nacer y el 2,6% falleció. Los resultados perinatales no estuvieron asociadas al tipo de inmunoglobulina de las madres seropositivas a SARS-CoV-2. De igual modo, los resultados perinatales no estuvieron asociados a los resultados serológicos en el neonato.