ABSTRACT
Se ha considerado que el útero gestante es un lugar inmunológicamente privilegiado, donde el feto es protegido del rechazo por el sistema inmune materno, mediante un amplio repertorio de estrategias de evasión que contribuye a la sobrevivencia del feto. La gestación en sí misma constituye un acontecimiento de equilibrio inmunológico y la tolerancia inmunológica permite la progresión del embarazo, donde participan una secuencia sincronizada de eventos que se inicia desde la concepción y fertilización para dar lugar a la implantación y progresa hasta alcanzar un embarazo a término. El sistema inmune es la principal barrera que poseemos para protegernos de las infecciones. Durante la vida intrauterina, el feto está protegido por la madre de las agresiones externas, por lo que no necesita que su sistema inmunológico sea operativo, sin embargo, al nacer, recibe una avalancha de elementos extraños, por lo que necesitará disponer de cierta protección, así como una preparación para ejecutar las defensas necesarias para su protección inmunológica. La inmunidad sérica durante la vida fetal queda limitada a la transferencia a través de la placenta de IgG materna, a pesar de que el feto tiene la facultad de sintetizar inmunoglobulinas desde las primeras etapas de la gestación. Al nacimiento, el niño tiene su sistema inmunológico completo, aunque inmaduro, pero es capaz de responder a los estímulos antigénicos. Tiene múltiples anormalidades en el desarrollo de su sistema inmune, que involucran a los anticuerpos/inmunoglobulinas, complemento y granulocitos pudiendo contribuir a la alta incidencia de sus infecciones. El recién nacido carece de memoria inmunológica debido a que, en condiciones normales, el feto está exento de estímulos producidos por antígenos extraños. Dicha memoria se va adquiriendo a medida que entra en contacto con los diferentes antígenos. Se obtendrá cierta protección a las infecciones entéricas gracias a las IgA que aporta la lactancia materna. La exposición prenatal y postnatal a productos microbianos ambientales que pueden activar la inmunidad innata, puede acelerar el proceso de maduración del sistema inmune.(AU)
It has been considered the pregnant women`s womb as an immunological exceptional place, where fetus is protected against been rejected because of maternal immune system by means of a wide groups of evasive strategies that help in its survival. Pregnancy itself is an immunological equilibrium state and the immunological tolerance allow the progression of this event, where participate a synchronized sequence of biological events started from conception and fertilization to allow the implantation, and progress until to reach the pregnancy end. The immune system is our main barrier against infections. During intrauterine life fetus is protected by the mother against external aggressions, therefore he don`t need an operative immune system, nevertheless, at birth the new organisms receive an avalanche of strange elements needing some kind of protection as well as a preparation to carry out the necessary defense for his immunological protection. Serum immunity during fetal life is limited to the transference of maternal IgG through placenta, despite fetus capability to synthesize immunoglobulins from first stages of gestation. At birth the babe has a complete immunological system although immature but capable to respond to antigenic stimulus. He has multiples abnormalities in the immune system development that take account antibodies/immunoglobulin, complement and granulocytes contributing to his high incidence of infections. Newborn lack immunological memory because in normal conditions fetus is not stimulated by odd antigens. This memory is acquired through the contact with different antigens. It will be obtained some protection against enteric infections because IgA from maternal lactation. The prenatal and postnatal exposition to environmental microbial products that activate the innate immunity can accelerate the immune system maturing process.(AU)
Subject(s)
Female , Pregnancy , Infant, Newborn , Immunoglobulins/immunology , Infant, Newborn/immunology , Infant, Premature/immunology , Fetus/immunology , Immunity, Maternally-Acquired/immunology , Antibodies/immunology , Pregnancy/immunology , B-Lymphocytes/immunology , Adaptive Immunity/immunology , Microbiological Phenomena/immunology , Milk, Human/immunologyABSTRACT
Introducción: la toxoplasmosis es una zoonosis que afecta a un tercio de la población mundial. Se asocia con infecciones congénitas y aborto. Objetivo: describir un caso clínico de una paciente con toxoplasmosis asociada al embarazo. Métodos: paciente de 36 años de edad que a las 21 sem de embarazo es valorada por el Departamento de Genética Provincial de La Habana por determinación de IgM para toxoplasma positivo. Se le realizan determinaciones de IgG e IgM y reacción en cadena de la polimerasa (PCR) en líquido amniótico para toxoplasma, la cual resultó positiva. Se ofrece asesoramiento genético a la pareja y se comienza tratamiento específico. A las 32 sem ingresa en nuestro servicio con el diagnóstico de amenaza de parto pretérmino. Se realizó cesárea segmento corpórea y esterilización quirúrgica con el diagnóstico de sufrimiento fetal agudo. Resultados: se obtiene un recién nacido vivo masculino, peso 1 800 g, Apgar 9/9. Se le comienza al recién nacido tratamiento con sulfadiacina, pirimetamina y ácido folínico. Posteriormente se le realizan determinaciones de IgG e IgM los cuales fueron negativos. Se le da alta a los 42 días con 2 520 g de peso y evolución favorable. Valoración por oftalmología al alta. Se orienta seguimiento serológico del recién nacido. Conclusiones: la tasa de transmisión en la seroconversión se incrementa por semana de edad gestacional, lo cual hace necesario comenzar una terapéutica precoz para evitar las complicaciones y realizar un seguimiento a largo plazo de estos recién nacidos para evaluar el pronóstico de la enfermedad
Introduction: The toxoplasmosis is a zoonosis involving a third of world population. It is associated with congenital infections and abortion. Objective: To describe a clinical case of a patient presenting with toxoplasmosis associated with pregnancy. Methods: Patient aged 36 who at 21 weeks of pregnancy is assessed by the Provincial Genetics Department of La Habana by determination of IgM for positive toxoplasmosis. IgG and IgM determinations were performed and polymerase chain reaction (PCR) in amniotic fluid for Toxoplasm, which was positive. The couple received genetic advice and started a specific treatment. At 32 weeks is admitted in our service diagnosed with preterm delivery threat. A cesarean section of corporeal segment was carried out as well as surgical sterilization with a diagnosis of acute fetal suffering. Results: The conception was a male newborn weighing 1 800 g, a 9/9 Apgar scale. The newborn receive treatment with sulfadiazine, pirimetamine and folinic acid. Later, IgE and IgM determinations were made being negatives. She is discharged at 42 days weighing 2 520 g, a favorable evolution and ophthalmic assessment. Serologic follow-up of newborn was prescribed. Conclusions: Transmission rate in the seroconversion increases by week of gestational age, thus it is necessary to start an early therapy to avoid the complications and to carry out the long-term follow-up of these newborns to assess the disease prognosis
Subject(s)
Humans , Female , Pregnancy , Adult , Infant, Newborn/immunology , Toxoplasmosis/drug therapy , Toxoplasmosis , Immunoglobulin G/blood , Immunoglobulin M/bloodABSTRACT
Objetivo: Avaliar o estado sorológico contra rubéola de uma amostra, representativa e randomizada de puérperas e seus filhos durante a campanha de vacinação. Métodos: Estudo transversal de amostr representativa e randomizada de puérperas e recém-nascidos, durante campanha de vacinação e inquérito sobre antecedente de doença e vacinas. Nas crianças, a dosagem em IgG contra rubéola foi repetida aos 9 meses de vida. Resultados: Noventa e duas, puérperas e 51 recém-nascidos foram avaliados. A menor positividade (66,6%), foi encontrada entre as mulheres com menos de 20 anos, e a maior (90,4%), entre as com 30 ou mais anos de idade. Houve forte correlação entre IgG da mãe e do recém-nascido. Entre as mulheres com antecedentes de doença exantemática, os valores médios de IgG foram significativamente maiores. A maioria das mães (62,0%) não sabia informar se tinha recebido vacina anteriormente. Aos nove meses, nenhuma das crianças avaliada apresentou IgG detectável.
Subject(s)
Humans , Male , Female , Infant, Newborn , Mass Vaccination , Rubella , Infant, Newborn/immunology , Seroepidemiologic Studies , Rubella Vaccine/administration & dosage , Cross-Sectional Studies , Immunoglobulin G/administration & dosage , Stochastic ProcessesABSTRACT
Objetivos: Estudiar los niveles de las inmunoglobulinas IgM, IgG e IgA y las proteínas del complemento C3 y C4 en sangre del cordón umbilical de recién nacidos de la provincia de Villa Clara. Material y Método: Se estudiaron 80 recién nacidos sanos a término con peso adecuado para la edad gestacional procedentes de madres sanas, cuyos embarazos y partos se desarrollaron sin complicaciones ni signos de infección. Resultados: Los valores medios encontrados fueron: en las inmunoglobulinas IgM, IgG e IgA: 0,155 g/L, 10,656 g/L y 0,051 g/L respectivamente; y en la proteína C3: 0,887 g/L y la C4: 0,127 g/L. Conclusiones: Permitió la caracterización inmunológica de esta población y constituyó un aporte importante para nuestra región.
Objectives: In order to asses immunologic parameters in new born of Villa Clara, IgM, IgG and IgA inmunoglobulins and C3 and C4 complement proteins were quantified in umbilical cord blood. Material and Method: 80 full term apparently healthy new born with weight according to the gestational age were studied. They were delivered by healthy mothers whose pregnancies and childbirths were developed without complications or infection signs. Results: The inmunoglobulins means values in our environment were 0,155 g/L, 10,656 g/L and 0,051 g/L (to IgM, IgG and IgA respectively); and for proteins C3: 0,887 g/L and C4: 0,127 g/L. Conclusions: The present work allowed this population's immunologic characterization and showed up relevance for our region.
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , /analysis , /analysis , Immunoglobulin A/blood , Immunoglobulin G/blood , Immunoglobulin M/blood , Infant, Newborn/immunology , Cuba , Data Interpretation, Statistical , Fetal Blood , Immunoglobulins/analysis , Immunoglobulins/blood , Complement System Proteins/analysis , Reference Values , Umbilical CordABSTRACT
Neonates reaction to pain is more severe than adults. Therefore, recognition and application of pain control strategies by health care workers is necessary. Immunization is a common painful event during infancy, which is typically performed without pain control. The aim of this study was to examine the effect of distraction technique and oral sucrose on reducing vaccination pain. this randomized clinical trial was performed on healthy infants referring to the health centers of Tehran University of Medical Sciences in west of Tehran by their mother for DPT technique vaccination. Healthy infants groups [n=l14] were randomly assigned to distraction [n=38], oral sucrose [n=38] and routine care [n=38] groups. Infants in distraction group, were provided with a [rattle], 30 seconds before, during, and 15 seconds after the injection. Infants in sucrose group received 2 ml oral sucrose 2 minutes before injection and the control group received routine care [just lying on examination table]. Pain symptoms were measured by Modified Behavioral Pain Scale [MBPS] during 5 seconds before to 15 seconds after vaccination. Descriptive and inferential statistics [independent T-test] were used to analyze data using SPSS-PC. MBPS scores in distraction group and sucrose group were significantly lower than the control group [P= 0.0001]. No significant difference was seen between oral sucrose group and distraction group [P= 0.581]. Distraction technique and oral sucrose are recommended as easy to use, inexpensive and effective measures for immunization pain management of neonates
Subject(s)
Humans , Pain/etiology , Pain/prevention & control , Sucrose/pharmacology , Sucrose , Pain Measurement/methods , Injections , Delivery of Health Care , Infant, Newborn/immunologyABSTRACT
CONTEXT AND OBJECTIVE: Toxoplasmosis transmission during pregnancy can cause severe sequelae in fetuses and newborns. Maternal antibodies may be indicators of risk or immunity. The aim here was to evaluate seropositivity for anti-Toxoplasma gondii (anti-T. gondii) immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies and IgG avidity in pregnant women and their newborn infants. DESIGN AND SETTING: Cross-sectional study in a high-risk pregnancy outpatient clinic. METHODS: Serum samples from pregnant women (n = 87) and their respective newborns (n = 87) were evaluated for anti-T. gondii antibodies using indirect immunofluorescence (IIF) (IgM and IgG), enzyme-linked immunosorbent assay (ELISA) (IgG) and an avidity test. RESULTS: Anti-T. gondii antibodies were identified in 64.4 percent of the serum samples from the mothers and their infants (56/87). Except for two maternal serum samples (2.3 percent), all others were negative for anti-T. gondii IgM antibodies, using IIF. The results showed that 92.9 percent of the pregnant women had high IgG avidity indexes (> 30 percent) and four samples had avidity indexes between 16 and 30 percent. Two women in the third trimester of pregnancy were positive for anti-T. gondii IgM antibodies; their babies had avidity indexes between 16 and 30 percent. The avidity indexes of serum from the other 83 newborns were similar to the results from their mothers. CONCLUSIONS: The results showed that 2 percent of the pregnant women were at risk of T. gondii transmission during the gestational period. These data seem to reflect the real situation of gestational toxoplasmosis in the northwestern region of the state of São Paulo.
CONTEXTO E OBJETIVOS: A toxoplasmose, quando transmitida durante a gestação, pode causar graves sequelas em fetos e neonatos. Anticorpos maternos podem ser indicadores de risco ou de imunidade. O objetivo foi avaliar a positividade dos anticorpos das classes imunoglobulina M (IgM) e imunoglobulina G (IgG) anti-Toxoplasma gondii (anti-T. gondii), bem como a avidez de IgG em gestantes e seus neonatos. TIPO DE ESTUDO E LOCAL: Estudo transversal em ambulatório de gestação de alto risco. MÉTODOS: Anticorpos anti-T. gondii foram avaliados em amostras de soro de gestantes (n = 87) e seus respectivos neonatos (n = 87) com o uso dos métodos imunofluorescência indireta (IFI) (IgM e IgG), ensaio imunoenzimático (ELISA) (IgG) e avidez. RESULTADOS: Anticorpos anti-T. gondii foram identificados em 64,4 por cento das amostras de soro das mães e seus bebês (56/87). Com exceção de duas amostras de soro materno (2,3 por cento), todas as demais foram negativas anticorpos IgM anti-T. gondii determinado pela IFI. Os resultados mostraram que 92,9 por cento das gestantes tinham índices elevados de avidez de IgG (> 30 por cento) e 4 amostras apresentaram índices de avidez entre 16-30 por cento. Duas gestantes no terceiro trimestre da gravidez eram positivas IgM anti-T. gondii; seus bebês apresentaram índices de avidez entre 16 e 30 por cento. Os índices de avidez dos soros dos outros 83 recém-nascidos foram semelhantes àqueles encontrados nas amostras maternas. CONCLUSÕES: Os resultados mostraram que 2 por cento das gestantes estavam sob risco de transmissão de T. gondii durante o período gestacional. Estes dados parecem refletir a real situação da toxoplasmose gestacional na região noroeste do Estado de São Paulo.
Subject(s)
Female , Humans , Antibodies, Protozoan/immunology , Immunoglobulin G/blood , Immunoglobulin M/blood , Infant, Newborn/immunology , Pregnancy/immunology , Toxoplasma/immunology , Antibody Affinity , Brazil/epidemiology , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Fluorescent Antibody Technique, Indirect , Gestational Age , Risk Factors , Toxoplasmosis/transmissionABSTRACT
La hipoglicemia es el trastorno metabólico más frecuente y precoz en los recién nacidos durante el periodo neonatal, ya que existe un momento de transición, entre el aporte constante de glucosa provista por la circulación materna placentaria y la homeostasis independiente del recién nacido. La presente investigación surge de la inquietud por conocer los factores que más predisponen al recién nacido a padecer hipoglucemia, además de poder determinar la prevalencia de la patología en el Servicio de Neonatología Intensiva e Intermedia del Hospital Maternologico Germán Urquidi de julio a diciembre del 2008.La investigación es cuantitativa, descriptiva transversal. Para la recolección de datos se revisaron 150 historias clínicas, con determinación de glicemia central entre los recién nacidos estudiados, encontrándose una prevalencia del 40% de hipoglucemia; entre los factores predisponentes más relevantes se encontraron en la madre, la diabetes gestacional; en el recién nacido, hipotermia, sepsis, hipoxia y la prematuridad.
Subject(s)
Infant, Newborn , Bolivia , Hypoglycemia/epidemiology , Infant, Newborn/immunologyABSTRACT
Demostrar que la velocidad de crecimiento en recién nacidos pre término que se encuentran en undeterminado periodo de tiempo es mayor en nido térmico que en incubadora.
Subject(s)
Infant, Newborn/growth & development , Infant, Newborn/physiology , Infant, Newborn/immunology , Infant, Newborn/metabolismABSTRACT
An infant is usually born with a deficient immune system, and the long chain polyunsaturated fatty acids (LC-PUFA) in breast milk plays an important role in the development and maturation of infant’s immune system. This article reviews the role of LC-PUFA in breast milk in the development of immunity and prevention of atopic manifestations in infants. The review also attempts to assess the correct proportion of these nutrients that needs to be present in infant formulae for babies in whom breast milk is unavailable and formula milk is unavoidable. It was concluded that LC-PUFA plays a vital role in overall development of immunity in the infant. Clinicians should ensure that LC-PUFA are supplied to the term and preterm infant in the form of breastmilk or provided in right proportions in formula, if breast milk is unavailable.
Subject(s)
Fatty Acids, Unsaturated/immunology , Humans , Immune System/growth & development , Infant , Infant, Low Birth Weight/growth & development , Infant, Low Birth Weight/immunology , Infant, Newborn/immunology , Milk, Human/immunologyABSTRACT
ACKGROUND: There is a consensus among many authors that the newborn (NB) is particularly prone to infections of the gastrointestinal tract for multiple factors, such as the hypoxia and the artificial milk. These factors facilitate the abnormal bacterial colonization and promote a drawback in the destruction of the toxins of such bacterias.AIM: To identify the microorganisms in the breast milk, after its storage in the refrigerator at 4°C, as well as after heating and to relate the eventual clinical NB signs with the microbiologic laboratory results of the breast milk which was offered.METHODS: The samples collected contemplated the three phases of post-natal breast milk. In 16 cases, the colostrum type was obtained as yellowish milky secretion, up to the beginning of the second week after the birth. In 14 cases, the transition type was obtained as intermediate product of the mother's milk, between colostrum and the mature milk, between the 7th and the 15th day after the birth. In 14 cases, the mature type was obtained as a white opaque liquid, of light smell and sweet taste, from the 15th day after birth. The milk types obtained in the three presentations were subdivided according to the period of conservation and heating in the group colostrums, transition and mature.RESULTS: The microorganisms which did not present growth were: Salmonella sp, Molds/leavens and Pseudomonas aeruginosa. The total coliforms and fecal coliforms were observed. There was no significant microorganisms growth. The aerobic mesophiles, Staphilococcus aureus and Bacillus cereus were also observed. These microorganisms presented growth, but the NBs did not present damage in their clinical status...
RACIONAL: Existe consenso que os recém-natos são particularmente propensos a desenvolverem infecções gastrointestinais devido a múltiplos fatores dentre eles a hipóxia. Há facilidade de colonização anormal e destruição de bactérias com absorção de toxinas.OBJETIVO: Identificar micro-organismos no leite materno depois de estocado em refrigerador a 4°C e também depois do aquecimento, e pesquisar se os sinais laboratoriais encontrados teem alguma correlação clínica.MÉTODOS: As amostras coletadas contemplaram as três fases do leite materno. Em 16 casos, colostro foi obtido como amarelado até a segunda semana do nascimento. Em 14 casos o tipo transicional, entre colostro e leite maduro, ocorreu de sete e 15 dias depois do nascimento. Em 14 casos o leite maduro foi obtido também entre sete e 15 dias. Os diversos tipos foram subdivididos de acordo com o período de conservação e de aquecimento.RESULTADOS: Os micro-organismos que não cresceram foram: Salmonella sp, Molds/leavens e Pseudomonas aeruginosa. Foram observados coliformes totais e fecais. Não ocorreu crescimento bacteriano significativo. Cresceram mesófilos aeróbicos, Staphilococcus aureus e Bacillus cereus. Embora com esses crescimentos, não houve repercussão clínica nos recém-nascidos...
Subject(s)
Humans , Infant, Newborn , Infant Nutritional Physiological Phenomena , Milk, Human/microbiology , Child Nutrition , Infant, Newborn/immunologySubject(s)
Humans , Infant, Newborn , Neonatology , Infant, Newborn/immunology , Infant, Newborn/metabolism , Infant, Newborn/blood , Blood Transfusion/methods , Blood Transfusion/standards , Anemia, Neonatal , Hematologic Agents/pharmacology , Blood Volume , Erythropoiesis , Extracorporeal Membrane Oxygenation , Histocompatibility Testing , Blood Component Transfusion/methodsABSTRACT
The neutrophils and complement system are the critical elements of innate immunity mainly due to participation in the first line of defense against microorganisms by means of phagocytosis, lysis of bacteria and activation of naive B-lymphocytes. In this report we provide an overview of the up to date information regarding the neutrophil and complement system's functional ability in newborn infants in association with the maternal conditions that exist during the intrauterine stage, gestational age and post-neonatal pathology. The neonates' capacity to control the neutrophil and complement protein activation process has also been discussed because of the evidence that uncontrolled activation of these immune elements provides a significant contribution to the tissue damage and subsequent pathology. The authors are confident that despite the many unanswered questions this review updates their knowledge and points the need for further research to clarify the role of the age-associated dysfunction of neutrophils and complement system in the infection and inflammation related pathology of newborn infants.
Subject(s)
Complement System Proteins/immunology , Female , Humans , Immunity, Innate/physiology , Immunity, Maternally-Acquired/physiology , Infant, Newborn/immunology , Male , Neutrophils/immunology , Risk Factors , Sensitivity and SpecificityABSTRACT
Os rotavírus (RVs) do grupo A (RVs-A) são os principais agentes de gastroenterite infantil e uma significativa causa de morbidade e mortalidade entre crianças menores de 5 anos nos países em desenvolvimento, e um importante fator de morbidade no mesmo grupo etário nos países desenvolvidos. Constitui-se característica marcante nos países em desenvolvimento a ampla diversidade antigênica e genotípica das amostras circulantes. Este estudo objetivou a caracterização dos sorotipos/genotipos de RVs-A provenientes de neonatos hospitalizados com e sem diarréia; de crianças menores de 5 anos com diarréia aguda, admitidas em hospital ou fazendo uso da terapia de reidratação oral; e de crianças participantes de ensaios clínicos com as vacinas anti-RVs...no período de 1990 a 2003. As amostras fecais foram coletadas no período de 1990 a 2003 e os espécimes fecais sob análise foram caracterizados com base em testes imunoenzimáticos e moleculares, incluindo a semi-nested-PCR e o seqüenciamento de nucleotídeos. Das 437 amostras de neonatos, 51 foram positivas (11,7 por cento) para RV-A. Destas crianças, 42 (82 por cento) desenvolveram infecção nosocomial assintomática, 5 (10 por cento) diarréia nosocomial e 4 (8 por cento) quadro diarréico adquirido na comunidade. Vinte e sete amostras de neonatos... Paralelamente, todas as G2 pertencendo às linhagens llb, llc e lld. Infecção mista pelo genotipo G foi observada no neonato NB-150...A análise genética das proteínas NSP4 e VP4... embora 7 amostras tenham sido mais similares aos protótipos humanos (linhagem P[6]-la) e 7 denotando maior identidade às sublinhagens suínas Ib e Ic. No estudo com a RIX4414 em Belém, Brasil, o genotipo P[8]G9 predominou na primeira metade da pesquisa representando 64 por cento das amostras, enquanto que, foi observado que o genotipo P[8]G1 emergiu como o mais comum com 57,6 por cento das amostras genotipadas durante o restante do estudo. As infecções mistas pelos genotipos G e P representaram 12,8 por...
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Diarrhea , Phylogeny , Infant, Newborn/immunology , Rotavirus/immunology , Viral Vaccines/analysis , Brazil , GenotypeABSTRACT
OBJECTIVE: To determine and to compare the levels of secretory immunoglobulin A in samples of colostrum and milk of mothers of term and preterm neonates. MATERIAL AND METHODS: The levels of secretory immunoglobulin A of 10 mothers of term neonates and 10 mothers of preterm neonates were determined from 5mL of colostrum or milk collected on the 1st, 4th, 10th and 15th days of the puerperal period, using the radial immunodifusion technique. We employed anamnesis, as well as physical and gynecological exams in women in the puerperal period. All the patients were attended at the Januário Cicco Maternity College. RESULTS: The secretory immunoglobulin A levels were significantly higher in the colostrum and milk of mothers of preterm neonates when compared with the levels found in colostrum and milk of mothers of term neonates (Mann-Whitney test, p<0.0001). There was a significant decline in the secretory immunoglobulin A levels of the colostrum and milk of the mothers of term and preterm neonates during the four periods (Kruskal-Wallis test, p<00001). CONCLUSIONS: The secretory immunoglobulin A levels in colostrum and milk of mothers of preterm neonates were significantly higher than in the mothers of term neonates, demonstrating immunological adaptation in preterm neonate breast-feeding.
Subject(s)
Female , Humans , Colostrum/immunology , Immunoglobulin A, Secretory/analysis , Infant, Newborn/immunology , Lactation/immunology , Milk, Human/immunology , Infant Nutritional Physiological Phenomena , Infant, Premature/immunology , Neonatal Screening/methods , Radioimmunoassay , Statistics, NonparametricABSTRACT
OBJETIVO: identificar los agentes infecciosos causantes de sepsis neonatal en el Hospital de la Mujer de la ciudad de La Paz, a partir de hemocultivos y orientarnos en la conducta terapéutica. DISEÑO: estudio descriptivo. LUGAR: Servicio de Neonatología. Hospital de la Mujer. La Paz-Bolivia. MÉTODO: se estudiaron en forma prospectiva durante 5 meses, todos los neonatos con diagnóstico presuntivo de sepsis neonatal, mediante dos hemocultivos seriados por paciente para su posterior análisis. RESULTADOS: durante el periodo de estudio se documentaron 77 neonatos, de los cuales 41 (53.25%) tuvieron hemocultivo positivo, de estos 22 (54%) fueron prematuros, 38 (49%) presentaron ruptura prolongada de membranas, 22 (54%) no tuvieron control prenatal y 50 (51,2%) fueron sometidos a métodos invasivos. A mas horas de vida, mayor cantidad de hemocultivos positivos (p < 0.000), cuya edad promedio fue 122.4 horas con DE de 157.3. No se observó correlación en los parámetros de células blancas y proteína C reactiva con el hemocultivo positivo. Encontramos S. epidermidis en 12 (29,26%), Acinetobacter spp en 7 (17,09%), S. aureus en 4 (9,75%), K. oxytoca, Candida spp y Enterococcus spp en 3 casos respectivamente (7,32%), Pseudomonas spp y K. pneumoniae en 2 (4,87%), E. coli en 1 (2,45%) y otros en 4 (9,75%). CONCLUSIÓN: El perfil de microorganismos aislados en el servicio de neonatología, concuerda con los antecedentes y factores predisponentes del recién nacido. La relación entre hemocultivo positivo y la edad del recién nacido en el momento de la toma de muestra, nos orienta a pensar en infecciones de origen nosocomial.
OBJECTIVE: to identify the infectious agents of neonatal sepsis in the Hospital de la Mujer of La Paz, taking blood cultures to help us determine the therapeutic approach. membranes, 22 (54%) did not have prenatal care and , 50 (51,2%) had invasive procedures. The older the patient the more positive blood culture found (p<0.000), the average age was 122.4 hours with SD of 157.3. There was no relationship between white cells, protein C with and positive blood cultures. We found S. epidermidis in 12 (29,26%), Acinetobacter spp in 7 (17,09%), S. aureus in 4 (9,75%), K. oxytoca, Candida spp and Enterococcus spp in 3 cases each (7,32%), Pseudomonas spp and K. pneumoniae in 2 (4,87%), E. coli in 1 (2,45%) and other bacteria in 4 (9,75%). DESIGN: descriptive study PLACE: neonatology Unit. Hospital de la Mujer. La Paz Bolivia METHOD: in a prospective way and during 5 months we took two blood cultures to patients with the presumptive diagnosis of sepsis for posterior evaluation. RESULTS: during the this period we enrolled 77 neonates and 41 witj positive blood culture (53.25%) were positives to the blood cultures, 22 (54%) were premature, 38 (49%) had prolonged rupture of CONCLUSIONS: the microorganism found are in accordance with the predisposing factors of the newborns studied. Because of the relationship between positive blood culture and age of the newborn led us to suggest in nosocomial infections.
Subject(s)
Humans , Infant, Newborn , Sepsis , Neonatology , Infant, Newborn/growth & development , Infant, Newborn/immunology , Infant, Newborn/metabolism , SepsisABSTRACT
PREGUNTA DE INVESTIGACIÓN ¿Cuál es la sensibilidad, especificidad y valores predictivos de la prueba diagnóstica del índice I/T en el diagnóstico de infecciones neonatales en recién nacidos pretérmino, término y post-término? OBJETIVO GENERAL: determinar los valores de sensibilidad, especificidad y valores predictivos en la prueba diagnóstica del índice I/T para infecciones neonatales en niños atendidos en el Servicio de Neonatología del Hospital de la Mujer de la ciudad de La Paz - Bolivia DISEÑO DE LA INVESTIGACIÓN: estudio de Test diagnóstico LUGAR IINSAD, Servicio de Neonatologia del Hospital de la Mujer, Instituto de Genética POBLACIÓN 268 recién nacidos, que provenían del Servicio de Neonatología del Hospital de la Mujer, los años 2002 a 2004 MÉTODOS Se tomó la muestra de sangre venosa de la región antecubital previa antisepsia de la piel, en un volumen de 3 mL: 2mL para hemocultivo de acuerdo a normas estandarizadas en el Laboratorio de Bacteriología de INLASA. 1 mL con anticoagulante (EDTA) para el hemograma y el recuento total de leucocitos y plaquetas, análisis de los cambios morfológicos del citoplasma de los neutrofilos identificando la vacuolización y granulaciones tóxicas. Se obtuvo información clínica de los pacientes con relación al peso de nacimiento, sexo, edad gestacional, complicaciones maternas y durante el embarazo y se anotó el puntaje de Apgar. RESULTADOS: la sensibilidad obtenida en el nuevo test, con gold estándar, hemocultivo y clínica nos muestra 55 y 63% respectivamente, para la especificidad 64 y 70%, en valor predictivo positivo 36 y 63%, en valor predictivo negativo 79 y 71%, lo cual demuestra que el índice I/T es más especifico y sensible cuando se relaciona con el diagnóstico clínico. CONCLUSIONES: conociendo la sensibilidad, especificidad y valor predictivo del índice I/T, es una prueba que ayuda al diagnóstico clínico de sepsis neonatal por ser prueba rápida y de bajo costo.
RESEARCH QUESTION: which are the sensitivity, specificity and predictive values of the I/T ratio of immature to total neutrophils in neonatal Sepsis of preterm, term or post term newbornsg? METHODS: we collected blood samples for cultures and for I/T relationship, we follow the protocol of the National Committee for Clinical Laboratory Standards on Cellular Morphology. Clinical informationwere collected from each neonate including birth weight, sex, gestational age, maternal complications, intrapartum complications and apgar scores. RESULTS: the sensitivity obtainedf with the new test, the gold Standard, blood cultures and clinical signs was 55 and 63% respectively. OBJECTIVE: to determine the sensitivity, specificity and predictive values of the I/T ratio of immature to total neutrophils in neonatal sepsis. DESIGN: diagnostic test PARTICIPANTS: 268 preterm, term and post term neonates attended in the Neonatal Service of the Hospital de la Mujer with the clinical diagnosis of neonatal sepsis during the year 2002-04. PLACE: INLASA, Genetic Institute and IINSAD UMSA The especificity was 64 and 70%. The positive predictive value was 36 and 63% and the negative was 79 and 71%. So, the I/T index is more specific when it is related to the clinical signs. CONCLUSIONS: The sensitivity, specificity and predictive values of the I/T test helps in the diagnosis of neonatal sepsis; it is a low cost rapid test.
Subject(s)
Humans , Infant, Newborn , Sepsis , Infant, Newborn/growth & development , Infant, Newborn/physiology , Infant, Newborn/immunology , Infant, Newborn/metabolism , Apgar Score , Blood Specimen Collection/classification , Blood Specimen Collection/statistics & numerical dataABSTRACT
OBJETIVO: Verificar a influência do tipo de parto sobre a concentração das imunoglobulinas (Ig) A, G e M no colostro materno. MÉTODOS: Foram selecionadas 82 puérperas com idade cronológica entre 21 e 41 anos, idade gestacional de 37 ou mais semanas, paridade até IV gesta, bom estado nutricional e sem patologias associadas durante a gestação e o puerpério. Foram também critérios de inclusão para os recém-nascidos: peso > 2.500 g, escore de Apgar > 7 no primeiro minuto e aleitamento materno exclusivo durante o período da internação. As puérperas foram divididas em três grupos: A - parto vaginal; B - cesárea precedida de trabalho de parto; e C - cesárea eletiva. O colostro foi colhido manualmente entre 48 e 72 horas pós-parto. IgA, IgG e IgM foram dosadas pela técnica de ELISA RESULTADOS: Não se observou diferença significativa entre os tempos de coleta do colostro nos três grupos maternos estudados. Quanto menor o tempo de coleta, maior foi a concentração de IgA no colostro materno; quanto menor a paridade, maior foi a concentração de IgA e IgM no colostro materno. O grupo de puérperas submetidas a cesárea precedida de trabalho de parto apresentou concentração mais elevada de IgA no colostro do que o grupo de puérperas que havia dado à luz por parto normal. A concentração de IgM e IgG no colostro materno não foi influenciada pelo tipo de parto. CONCLUSAO: A ocorrência do trabalho de parto, somada ao estresse cirúrgico, induz a uma concentração mais elevada de IgA no colostro materno na puérpera submetida a cesárea precedida de trabalho de parto.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Middle Aged , Colostrum/chemistry , Delivery, Obstetric , Immunoglobulins/analysis , Immunoglobulins/metabolism , Infant, Newborn/immunology , Birth Weight , Cesarean Section , Colostrum/immunology , Enzyme-Linked Immunosorbent Assay , Gestational Age , Immunoglobulin A/analysis , Immunoglobulin A/metabolism , Immunoglobulin G/analysis , Immunoglobulin G/metabolism , Immunoglobulin M/analysis , Immunoglobulin M/metabolism , Maternal Age , Postpartum Period , Time FactorsABSTRACT
Con una muestra de 70 pacientes sanos inmunizados con BCG al nacimiento, se determina el grado de reactividad a la administración de PPD a uno, dos y tres meses de vida; se define la sensibilidad de la prueba. La reactividad media fue de 0.17, 2.7 y 5.1 mm a uno, dos y tres meses de vida. La sensibilidad del PPD se obtuvo de 5.7, 62.85 y 91.42 por ciento respectivamente sin considerar la magnitud de la respuesta; al examinar los que dieron 5 mm o más de induración la sensibilidad bajó a 0, 38.57 y 87.14 por ciento. El PPD es una prueba útil para el diagnóstico de contacto con Mycobacterium tuberculosis; sin embargo, en el estudio casi 13 por ciento de los pacientes presentaron una mala reactividad al PPD, significando factiblemente una respuesta negativa a la inmunización con BCG, o la existencia de un periodo prealérgico mayor en este grupo de edad.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , BCG Vaccine , Infant, Newborn/immunology , Tuberculin Test , Immunization/methods , TuberculosisABSTRACT
Desenvolveu-se um micrométodo simples e sensível utilizando a cromatografia líquida de alta eficiência, com detecção ultravioleta (CLAE-UV) para a quantificação de vancomicina plasmástica. Foram necessários 250 µL de amostra biológica. O fármaco e o padrão interno ("beta"-etil-hidroxiteofilina) foram eluídos em sistema isocrático após 5,6 e 9,8 min, respectivamente, utilizando coluna CLS-ODS, fase móvel constituída por tampão fosfato 0,05 mol.Lðû pH=4,7: metanol:acetonitrila, e detecção em "lâmbda"=230 nm. A validação analítica evidenciou os limites de confiança referidos a seguir: sensibilidade de 0,5 µg/ml, linearidade de 1-200 µg/ml, e precisões intra e inter-dias, consideradas adequadas no controle...
Subject(s)
Humans , Infant, Newborn , Anti-Bacterial Agents , Infant, Newborn/immunology , Infant, Newborn/blood , Sepsis , Vancomycin , Blood Chemical Analysis , Biological Specimen Banks , Chromatography, Liquid/methodsABSTRACT
La capacidad de respuesta del sistema inmune (SI), no es la misma a lo largo de la vida, se ha observado que las infecciones son más frecuentes durante el primer año de vida que en la vida adulta, lo cual parece indicar que los neonatos son incapaces de desarrollar una respuesta inmunológica eficaz, durante la etapa de los retos inmunológicos primarios. Se han descrito diferencias fenotípicas y funcionales entre el SI del neonato y del adulto; con base en ellas se piensa que el SI del neonato es "inmaduro". Sin embargo, también se han realizado acercamientos experimentales que demuestran una capacidad similar de la respuesta celular, en neonatos y adultos. De estos ensayos se concluye que la inmadurez observada en el neonato, no es inicialmente debida a defectos cualitativos (por la capacidad de respuesta de las células); sino a las condiciones en las que se realiza el estímulo inmunológico. El presente artículo pretende proporcionar información actualizada sobre la naturaleza y desarrollo de la respuesta inmunológica en el neonato.