Protective measures feasibility for infants of low income SARS-CoV-2 positive breastfeeding mothers: a prospective multicenter cohort study.

AIM: The aim was to evaluate the feasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers. BACKGROUND: Breastfeeding mothers with SARS-CoV-2 positive should avoid exposing the infant through protective measures (PM), but it could be challenging in a low-income population. METHODS: A prospective, multicenter study was conducted between July and October 2020 (BRACOVID). The participants were recruited at birth and interviewed through a structured questionnaire at seven and 14 days in the home environment. The feasibility of PM during breastfeeding at home was defined by guidelines recommendations (mask using, handwashing, and distancing from newborn when not breastfeeding). Three groups according to the feasibility of guidelines: complete guidelines feasibility (CG): all PM; partial guidelines feasibility (PG): at least one PM feasible; no guidelines (NG): infeasibility to all of PM. Flu-like neonatal symptoms, mothers' breastfeeding practices. We evaluated the association between PM feasibility and socioeconomic factors. RESULTS: 117 infected mothers from 17 Brazilian hospitals were enrolled. 47 (40%) mothers followed all recommendations, 14 (11.9%) could not practice at least one recommendation, and 50 (42.7%) did not execute any of them. The breastfeeding rate was 98%. Factors associated with infeasibility were monthly family income < 92.7 dollars/person, high housing density (>1 inhabitant/room), teenage mothers, responsive feeding, and poor schooling. Regarding infants' flu-like symptoms, 5% presented symptoms at fourteen days (NG group). CONCLUSION: The guidelines were not applied to infants of SARs-CoV-positive mothers in 54.6% of the dyads since the recommendations were unviable in their environments. During pandemics, we should look for feasible and effective guidelines to protect neonates from low-income populations. IMPLICATIONS FOR NURSING MANAGEMENT: Poor socioeconomic conditions lead to the unfeasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers during the isolation period in the pandemics. The orientations and the support provided to dyad should consider the socioeconomic factors to guide feasible measures in the home environment and promote adequate protections; only an individual approach will allow a safe environment for low-income infants.

Induction of Expression of CD271 and CD34 in Mesenchymal Stromal Cells Cultured as Spheroids.

Cultured mesenchymal stromal cells (MSCs) are cells that can be used for tissue engineering or cell therapies owing to their multipotency and ability to secrete immunomodulatory and trophic molecules. Several studies suggest that MSCs can become pericytes when cocultured with endothelial cells (ECs) but failed to use pericyte markers not already expressed by MSCs. We hypothesized ECs could instruct MSCs to express the molecules CD271 or CD34, which are expressed by pericytes in situ but not by MSCs. CD271 is a marker of especial interest because it is associated with multipotency, a characteristic that wanes in MSCs as they are culture expanded. Consequently, surface expression of CD271 and CD34 was detected in roughly half of the MSCs cocultured with ECs as spheroids in the presence of insulin-like growth factor 1 (IGF-1). Conversely, expression of CD271 and CD34 was detected in a similar proportion of MSCs cultured under these conditions without ECs, and expression of these markers was low or absent when no IGF-1 was added. These findings indicate that specific culture conditions including IGF-1 can endow cultured MSCs with expression of CD271 and CD34, which may enhance the multipotency of these cells when they are used for therapeutic purposes.

Aspectos relacionados à preferência pela via de parto em um hospital universitário / Aspects regarding childbirth delivery preferences at a university hospital

O índice de cesarianas vem aumentando progressivamente nos últimos anos. O presente estudo trata sobre preferência de puérperas em relação à via de parto. Objetiva identificar a via de parto de preferência das mulheres que tiveram filho na maternidade do HU/ULBRA; verificar fatores que influenciam a escolha; e comparar a indicação médica da cesariana com o entendimento sobre a justificativa da intervenção. Métodos: Estudo descritivo de amostra consecutiva no período de 01/05/2010 a 30/06/10. Foi aplicado um questionário em 400 puérperas internadas no Alojamento Conjunto do Hospital Universitário da ULBRA. Resultados: O parto vaginal foi a via de preferência em 72,8% das mulheres. Recuperação mais rápida, menor dor e sofrimento, procedimento mais rápido e menor risco de morte materna foram as principais justificativas dadas pelas puérperas para suas preferências pela via de parto. Interferiu significativamente na decisão ter companheiro, grau de instrução, renda familiar e tempo de ruptura de membranas. A principal indicação médica de cesárea foi a desproporção cefalopélvica (22,6%). E 35% das mulheres acreditam ter sido a falha na indução a razão da indicação por via abdominal. Conclusão: O parto vaginal é o preferido da maioria das mulheres entrevistadas (n=291). O perfil das pacientes que tem preferência por parto vaginal foi: mulheres mais jovens, com maior grau de instrução, menor renda familiar, com companheiro fixo e menor tempo de ruptura de membranas. Percebemos discordância entre as causas alegadas pelas puérperas e a indicação médica da cesárea.

The cesarean section rate has been increasing steadily in recent years. This study focuses on mothers’ preferences concerning mode of delivery. It was designed to identify the preferred route of delivery among women who gave birth at the maternity ward of HU/ULBRA; to identify factors that influence their choice, and to compare medical indications for cesarean section with mothers’ perception of the reasons for the intervention. Methods: A descriptive study of a consecutive sample from May 1 2010 to June 30 2010. A questionnaire was responded by 400 postpartum women admitted to the Quarters of ULBRA University Hospital . Results: The vaginal route was preferred by 72.8% of mothers. Faster recovery, less pain and suffering, quicker procedure, and lower risk of death were the main reasons reported by pregnant women for their preference for delivery route. Having a partner, level of education, family income, and time of rupture of membranes were reported as significantly influential in the decision. The main medical indications for cesarean section was cephalopelvic disproportion (22.6%). And 35% of women believed that failure in induction was the reason for the abdominal route. Conclusion: Vaginal delivery is preferred for most of the women interviewed (n = 291). Patients who prefer vaginal delivery had the following profile: younger women with higher levels of education, lower family income, with a steady partner and shorter duration of membrane rupture. We noticed a discrepancy between the causes reported by pregnant women and the medical indications for cesarean section.

Juventude e AIDS: conhecimento entre os adolescentes de uma escola pública em Canoas, RS / Youth and AIDS: knowledge among adolescents of a public school in Canoas, RS

Introdução: A Síndrome da Imunodeficiência Adquirida (AIDS) é uma pandemia com alto nível de letalidade, sendo que os adolescentes constituem-se num preocupante grupo de risco. O objetivo deste estudo foi avaliar o conhecimento da AIDS em adolescentes de uma escola pública, no município de Canoas, Rio Grande do Sul, comparando as diferenças e semelhanças entre gêneros. Metodologia: Estudo descritivo, transversal, de caráter quantitativo, do tipo inquérito. Na análise foram utilizados os testes t-Student, qui-quadrado de Pearson ou Exato de Fisher. As análises foram realizadas no programa SPSS (Statistical Package for the Social Sciences) versão 10.0. Resultados: Foram estudados 221 alunos de 7a e 8a séries. Não houve predomínio de gênero. A média de idade foi de 14,4 ± 1,39 anos. Quanto ao conhecimento dos adolescentes sobre AIDS, 91% respondeu afirmativamente. Em relação à transmissão vertical do HIV, as adolescentes negaram conhecer esse modo de transmissão, muito mais que os meninos (p=0,028). Por outro lado, julgaram necessário o teste anti-HIV para usuários de drogas injetáveis e para quem fez transfusão de sangue. Conclusão: A maioria dos adolescentes dessa escola possui um conhecimento adequado, porém conceitos errôneos ainda existem e precisam ser trabalhados.

Introduction: The Acquired Immunodeficiency Syndrome (AIDS) is a pandemic with a high level of lethality, and the adolescents are a worrying risk group. The aim of this study was to evaluate knowledge of AIDS among adolescents in a public school in the municipality of Canoas, Rio Grande do Sul, comparing gender differences and similarities. Methods: A descriptive, transversal study of the quantitative, inquiry type. The statistical analysis was done with the Student’s t-test, Persons’s Chi-square test or Fisher’s Exact Test. Data were processed with software SPSS (Statistical Package for the Social Sciences, version 10.0). Results: 221 7th and 8th grade students were investigated. There was no gender predominance. The mean age was 14.4 ± 1.39 years. Concerning adolescent’s awareness about AIDS, 91% answered in the affirmative. As for mother-to-child HIV transmission, the girls said they were unaware of this mode of transmission, much more than the boys did (=0.028). On the other hand, they recognized the need to test intravenous drug users and individuals submitted to blood transfusions for HIV. Conclusion: Most adolescents of this school have an appropriate knowledge about AIDS, but misconceptions still exist and should be worked at.

Trabalho precoce e riscos à saúde / Early work and health risks

O trabalho de crianças e adolescentes é um grave problema social que atinge toda a humanidade, e está estreitamente vinculado à condiçäo econômica, näo sendo, porém, restrito aos países pobres. Este trabalho tem como objetivo fazer uma revisäo bibliográfica sobre aspectos epidemiológicos, culturais, legais e socioeconômicos do trabalho precoce, bem como estabelecer os principais riscos e suas eventuais conseqüências à saúde do menor trabalhador. Para tanto, levamos em consideraçäo os tipos de trabalho mais prevalentemente exercidos por menores no Brasil e no Estado do Rio Grande do Sul