Profile analysis of emerging respiratory virus in children.

Acute respiratory infections (ARIs) are caused by a variety of microorganisms. Of all ARIs, 80% are caused by viruses such as human respiratory syncytial virus, metapneumovirus, influenza, parainfluenza, rhinovirus, and, more recently, Sars-CoV-2, which has been responsible for the COVID-19 pandemic. The objective of our study was to evaluate clinical data from a viral panel performed in children hospitalized with SARS or COVID-19 in the infirmary or ICU of 5 pediatric hospitals in the city of Goiânia, Goiás, Brazil. Demographic, clinical, and laboratory data were collected for analysis, and data on the outcomes underwent statistical treatment. A total of 128 patients were selected for the study, 54% of whom were male and 46% female. The viral panel included rhinovirus, COVID-19, metapneumovirus, adenovirus, and parainfluenza. Descriptive analyses of age profile showed differences in the involvement of particular viruses. The percentage of patients who required hospitalization in the ICU, infirmary, as well as individuals who were discharged after therapy or who died, were described. Our work shows that epidemiological surveillance measures are indispensable, especially if used in the continued analysis of viral panels in all pediatric patients with SARS.

Characterization of T Helper 1 and 2 Cytokine Profiles in Newborns of Mothers with COVID-19.

An infectious disease caused by SARS-CoV-2, COVID-19 greatly affects the pediatric population and is 3 times more prevalent in newborns than in the general population. In newborns, the overexpression of immunological molecules may also induce a so-called cytokine storm. In our study, we evaluated the expression of cytokines in newborns admitted to a neonatal ICU whose mothers had SARS-CoV-2 and symptoms of SARS. The blood of newborns of infected and healthy mothers was collected to identify their Th1 and Th2 cytokine profiles, and via flow cytometry, the cytokines TNF-α, IFN-γ, IL-2, IL-6, and IL-10 were identified. Overexpression was observed in the Th1 and Th2 cytokine profiles of newborns from infected mothers compared with the control group. Statistical analysis also revealed significant differences between the cellular and humoral responses of the infected group versus the control group. The cellular versus humoral responses of the newborns of infected mothers were also compared, which revealed the prevalence of the cellular immune response. These data demonstrate that some cytokines identified relate to more severe symptoms and even some comorbidities. IL-6, TNF-α, and IL-10 may especially be related to cytokine storms in neonates of mothers with COVID-19.

Viral Coinfection of Children Hospitalized with Severe Acute Respiratory Infections during COVID-19 Pandemic.

The main pathogens of severe respiratory infection in children are respiratory viruses, and the current molecular technology allows for a rapid and simultaneous detection of a wide spectrum of these viral pathogens, facilitating the diagnosis and evaluation of viral coinfection. METHODS: This study was conducted between March 2020 and December 2021. All children admitted to the ICU with a diagnosis of SARI and who were tested by polymerase chain reaction on nasopharyngeal swabs for SARS-CoV-2 and other common respiratory viral pathogens were included in the study. RESULTS: The result of the viral panel identified 446 children, with one infected with a single virus and 160 co-infected with two or more viruses. This study employed descriptive analyses, where a total of twenty-two coinfections among SARI-causing viruses were identified. Thus, the five most frequent coinfections that were selected for the study are: hRV/SARS-CoV-2 (17.91%), hRV/RSV (14.18%), RSV/SARS-CoV-2 (12.69%), hRV/BoV (10.45%), and hRV/AdV (8.21%). The most significant age group was 38.1%, representing patients aged between 24 and 59 months (61 individuals). Patients older than 59 months represented a total of 27.5%, comprising forty-four patients. The use of oxygen therapy was statistically significant in coinfections with Bocavirus, other CoVs, Metapneumovirus, and RSV. Coinfections with SARS-CoV-2 and the other different coinfections presented a similar time of use of oxygen therapy with a value of (p > 0.05). In the year 2020, hRV/BoV was more frequent in relation to other types of coinfections, representing a total of 35.1%. The year 2021 presented a divergent profile, with hRV/SARS-CoV-2 coinfection being the most frequent (30.8%), followed by hRV/RSV (28.2%). Additionally, 25.6% and 15.4% represented coinfections between RSV/SARS-CoV-2 and hRV/AdV, respectively. We saw that two of the patients coinfected with hRV/SARS-CoV-2 died, representing 9.52% of all deaths in the study. In addition, both hRV/hBoV and hRV/RSV had death records for each case, representing 8.33% and 6.67% of all deaths, respectively. CONCLUSION: Coinfections with respiratory viruses, such as RSV and hBoV, can increase the severity of the disease in children with SARI who are admitted to the ICU, and children infected with SARS-CoV-2 have their clinical condition worsened when they have comorbidities.

Severe Neurological Manifestation in a Child with Multisystem Inflammatory Syndrome.

BACKGROUND AND OBJECTIVES: During the COVID-19 pandemic, we followed with concern the evolution of several children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). The purpose of this study is to describe the evolution of MIS-C in a previously healthy 3-year-old girl. METHODS: We tracked the daily medical report of all children admitted with suspected MIS-C to the five largest regional hospitals. RESULTS: Our screening identified a child who had several neurological complications associated with MIS-C. We report hematological alterations, transient cardiac dysfunction, and cerebral involvements such as laminar cortical necrosis caused by ischemic stroke. We present the course of treatment and clinical outcome, and other complications such as a severe subglottic stenosis occurring after extubation. CONCLUSION: Subglottic stenosis is an expected complication after prolonged intubation, and the presence of dysphonia and/or stridor is an important predictive factor. MIS-C with severe neurological alteration may occur in a healthy child, and early diagnosis and treatment with a pulse of corticoid with immunoglobulin are essential for a favorable outcome.

Profile of Enterobacteria Resistant to Beta-Lactams.

A serious emerging problem worldwide is increased antimicrobial resistance. Acquisition of coding genes for evasion methods of antimicrobial drug mechanisms characterizes acquired resistance. This phenomenon has been observed in Enterobacteriaceae family. Treatment for bacterial infections is performed with antibiotics, of which the most used are beta-lactams. The aim of this study was to correlate antimicrobial resistance profiles in Enterobacteriaceae by phenotypic methods and molecular identification of 14 beta-lactamase coding genes. In this study, 70 exclusive isolates from Brazil were used, half of which were collected in veterinary clinics or hospitals Phenotypic methodologies were used and real-time PCR was the molecular methodology used, through the Sybr Green system. Regargding the results found in the tests it was observed that 74.28% were resistant to ampicillin, 62.85% were resistant to amoxicillin associated with clavalunate. The mechanism of resistance that presented the highest expression was ESBL (17.14%). The genes studied that were detected in a greater number of species were blaGIM and blaSIM (66.66% of the samples) and the one that was amplified in a smaller number of samples was blaVIM (16.66%). Therefore, high and worrying levels of antimicrobial resistance have been found in enterobacteria, and a way to minimize the accelerated emergence of their resistance includes developing or improving techniques that generate diagnoses with high efficiency and speed.

Fadiga em Mulheres com Câncer de Mama Submetidas à Radioterapia / Fatigue in Women with Breast Cancer Submitted to Radiotherapy / Fatiga en Mujeres con Cáncer de Mama Sujeto a Radioterapia

Introdução: A fadiga em mulheres com câncer de mama após a radioterapia é um dos efeitos colaterais mais debilitantes, sendo um sintoma subjetivo, multidimensional e multifatorial. Objetivo: Caracterizar a fadiga em pacientes com câncer de mama em radioterapia que realizam o tratamento no Serviço de Radioterapia de um hospital de referência em tratamento oncológico do Estado de Goiás. Método: Trata-se de um estudo longitudinal. A Escala de Fadiga de Piper - revisada foi utilizada para avaliação de fadiga no início (T1), meio (T2) e final (T3) da radioterapia. Resultados: A amostra foi composta por 89 mulheres. A prevalência de fadiga em T1 foi de 26,9%. Houve aumento significativo da fadiga ao longo da radioterapia, sendo que, em T3, 50,8% das mulheres apresentavam fadiga. Houve predomínio da fadiga moderada em T2 e T3, e o aumento mais significativo da intensidade da fadiga foi verificado do momento T1 para T2. A dimensão afetiva da fadiga apresentou escore mais alto comparado às dimensões sensorial/psicológica. Conclusão: A presença e a intensidade da fadiga durante a radioterapia aumentaram significativamente, predominando a fadiga moderada na última semana do tratamento. A magnitude da fadiga exibiu escores mais altos na dimensão afetiva nas avaliações. Portanto, atenção maior à fadiga durante a radioterapia precisa ser dada pelos profissionais de saúde.

Introduction: Fatigue in women with breast cancer after radiotherapy is one of the most debilitating side effects, being a subjective, multidimensional, multifactorial symptom. Objective: To characterize fatigue in patients with breast cancer in radiotherapy who undergo treatment in the radiotherapy service of a reference hospital in cancer treatment in the State of Goiás. Method: This is a longitudinal study. The Piper Fatigue Scale - revised was used to evaluate fatigue at the beginning (T1), middle (T2) and final (T3) of the radiotherapy. Results: The sample consisted of 89 women. The prevalence of T1 fatigue was 26.9%. There was a significant increase in fatigue during radiotherapy, and in T3, 50.8% of the women presented fatigue. There was a predominance of moderate fatigue in T2 and T3, and the most significant increase in fatigue intensity was verified from T1 to T2. The affective dimension of fatigue presented a higher score compared to the sensorial/psychological dimensions. Conclusion: The presence and intensity of fatigue during radiotherapy increased significantly, with moderate fatigue predominating in the last week of treatment. The magnitude of fatigue exhibited higher scores in the affective dimension of the evaluations. Therefore, health professionals must focus more attention to fatigue during radiotherapy.

Introducción: La fatiga en mujeres con cáncer de mama después de la radioterapia es uno de los efectos colaterales más debilitantes, siendo un síntoma subjetivo, multidimensional, multifactorial. Objetivo: caracterizar la fatiga en pacientes con cáncer de mama en radioterapia que realizan el tratamiento en el servicio de radioterapia de un hospital de referencia en tratamiento oncológico del Estado de Goiás. Método: Se trata de un estudio longitudinal. La Escala de Fatiga de Piper - revisada fue utilizada para evaluación de fatiga al inicio (T1), medio (T2) y final (T3) de la radioterapia. Resultados: La muestra fue compuesta por 89 mujeres. La prevalencia de fatiga en T1 fue de 26,9%. Se observó un aumento significativo de la fatiga a lo largo de la radioterapia siendo que, en T3, el 50,8% de las mujeres presentaban fatiga. Se observó un predominio de la fatiga moderada en T2 y T3, y el aumento más significativo de la intensidad de la fatiga fue verificado del momento T1 para T2. La dimensión afectiva de la fatiga presentó una puntuación más alta en comparación con las dimensiones sensorial/psicológica. Conclusión: La presencia e intensidad de la fatiga durante la radioterapia aumentó significativamente, predominando la fatiga moderada en la última semana del tratamiento. La magnitud de la fatiga exhibió escores más altos en la dimensión afectiva en las evaluaciones. Por lo tanto, los profesionales de la salud deben prestar mayor atención a la fatiga durante la radioterapia.

Genes involved in translation of Mycoplasma hyopneumoniae and Mycoplasma synoviae

This is a report on the analysis of genes involved in translation of the complete genomes of Mycoplasma hyopneumoniae strain J and 7448 and Mycoplasma synoviae. In both genomes 31 ORFs encoding large ribosomal subunit proteins and 19 ORFs encoding small ribosomal subunit proteins were found. Ten ribosomal protein gene clusters encoding 42 ribosomal proteins were found in M. synoviae, while 8 clusters encoding 39 ribosomal proteins were found in both M. hyopneumoniae strains. The L33 gene of the M. hyopneumoniae strain 7448 presented two copies in different locations. The genes encoding initiation factors (IF-1, IF-2 and IF-3), elongation factors (EF-G, EF-Tu, EF-Ts and EF-P), and the genes encoding the ribosome recycling factor (frr) and one polypeptide release factor (prfA) were present in the genomes of M. hyopneumoniae and M. synoviae. Nineteen aminoacyl-tRNA synthases had been previously identified in both mycoplasmas. In the two strains of M. hyopneumoniae, J and 7448, only one set of 5S, 16S and 23S rRNAs had been identified. Two sets of 16S and 23S rRNA genes and three sets of 5S rRNA genes had been identified in the M. synoviae genome.