Oxidative stress in multiple organs after sepsis in elderly rats.

Aging is a dynamic process, in which morphological and physiological changes occur at all levels, making the body more vulnerable to acute events. Elderly people are at greater risk of sepsis developing than younger people. Sepsis is a set of serious manifestations throughout the body produced by an infection, leading to events that compromise cell homeostasis as oxidative stress and is associated with organ dysfunction. The aim of this study was to evaluate multi-organ oxidative stress in old rats in an animal model of polymicrobial sepsis. Adult (60d) and old (210d) male Wistar rats were submitted to sepsis by cecal ligation and perforation (CLP) and control group (sham) only by laparotomy. The experimental groups were divided into sham 60d, sham 210d, CLP 60d and CLP 210d. Twenty-four hours after CLP, myeloperoxidase (MPO) activity, oxidative damage to lipids and proteins, superoxide dismutase (SOD) and catalase (CAT) activities were evaluated in the lung, kidney, liver, heart, spleen, quadriceps and diaphragm. Aging potentiated the increase in MPO activity in the after sepsis in the lung, liver and spleen. Lipid oxidative damage occurred in all structures analyzed in the CLP groups, while only in the lung, liver and diaphragm the lipid peroxidation was higher in the CLP 210d group compared to 60d. Regarding protein damage, this potentiation happened only in the lung. The SOD activity in the lung, kidney, spleen and diaphragm there was a significant decrease in the CLP 210d group compared to the sham 60d group while in the CAT only in the lung and kidney. The findings in this study indicate that increasing age potentiated oxidative damage in different organs after sepsis by intensifying the presence of neutrophils, which possibly increased the damage to lipids and proteins with reduced activity of SOD and CAT.

Aging influences in the blood-brain barrier permeability and cerebral oxidative stress in sepsis.

Sepsis is a set of serious manifestations throughout the body produced by an infection, leading to changes that compromise cellular homeostasis and can result in dysfunction of the central nervous system. The elderly have a higher risk of developing sepsis than younger peoples. Under the influence of inflammatory mediators and oxidizing agents released in the periphery as a result of the infectious stimulus, changes occur in the blood-brain barrier (BBB) permeability, with neutrophil infiltration, the passage of toxic compounds, activation of microglia and production of reactive species that results in potentiation of neuroimmune response, with the progression of neuronal damage and neuroinflammation. The objective of this study is to compare BBB permeability and the development of oxidative stress in the hippocampus and prefrontal cortex of young and old rats submitted to polymicrobial sepsis induction. Male Wistar rats grouped into sham (60d), sham (210d), cecal ligation and perforation (CLP) (60d) and CLP (210d) with n = 16 per experimental group were evaluated using the CLP technique to induce sepsis. The brain regions were collected at 24 h after sepsis induction to determine BBB permeability, myeloperoxidase (MPO) activity as marker of neutrophil activation, nitrite/nitrate (N/N) levels as marker of reactive nitrogen species, thiobarbituric acid reactive substances as marker of lipid peroxidation, protein carbonylation as marker of protein oxidation, and activity of antioxidant enzyme catalase (CAT). There was an increase in the BBB permeability in the CLP groups, and this was enhanced with aging in both brain region. MPO activity in the brain regions increased in the CLP groups, along with a hippocampal increase in the CLP 210d group compared to the 60d group. The concentration of N/N in the brain region was increased in the CLP groups. The damage to lipids and proteins in the two structures was enhanced in the CLP groups, while only lipid peroxidation was higher in the prefrontal cortex of the CLP 210d group compared to the 60d. CAT activity in the hippocampus was decreased in both CLP groups, and this was also influenced by age, whereas in the prefrontal cortex there was only a decrease in CAT in the CLP 60d group compared to the sham 60d. These findings indicate that aging potentiated BBB permeability in sepsis, which possibly triggered an increase in neutrophil infiltration and, consequently, an increase in oxidative stress.

Fatores de risco para o desmame aos quatro meses em bebês de mães adolescentes / Factors associated with weaning at four months in babies of adolescent mothers / Factores asociados al desmame a los cuatro meses en bebés de madre adolescentes

Objetivo: Apresentar os índices de aleitamento materno exclusivo e verificar os fatores associados ao desmame aos quatro meses, em mães adolescentes. Método: Estudo transversal com amostra composta por adolescentes de 13 à 18 anos e seus bebês; os nascimentos foram em hospitais amigo da criança, na capital Belém do Pará. O trabalho foi realizado com uma amostra de 92 adolescentes. A pré-seleção das adolescentes era feita na maternidade. A segunda etapa foi no quarto mês pós-parto, mantendo-se contato com as adolescentes, por telefone e verificado o tipo de alimentação que se encontrava o bebê. A análise descritiva foi apresentada mediante frequência simples, percentual e razão de chance. A relação entre o desfecho e o tipo de alimentação foi avaliada por regressão logística. O teste de Wald foi utilizado para testar a significância das variáveis. As diferenças foram significativas quando p<0,05. As características das mães e das crianças foram comparadas pelo teste de Pearson e foram significativos se p<5%. Resultados: O aleitamento materno misto aos quatro meses foi de 22,82%, desmame de 17,40% e 59,78 % foi de aleitamento materno exclusivo. Os fatores escolaridade, estado civil, trabalha fora, companheiro não incentiva o aleitamento estão significativamente relacionados negativamente ao aleitamento materno exclusivo. Conclusão: O índice de aleitamento materno exclusivo no quarto mês de vida dos bebês foi baixo, os fatores associados ao aleitamento materno exclusivo foram: baixa escolaridade, estado civil sem companheiro, mãe que trabalha fora de casa e o companheiro que não incentiva o aleitamento (AU).

Objective: To present the exclusive breastfeeding indexes and to verify factors associated with weaning at four months in adolescent mothers. Method: A cross-sectional study with a sample composed of adolescents aged 13 to 18 years and their infants; births were in baby-friendly hospitals in the capital city of Belém, Pará. The study was carried out with a sample of 92 adolescents. The pre-selection of the adolescents was done in the maternity ward. The second stage was in the fourth month postpartum, staying in contact with the adolescents by telephone and verified the type of feeding the baby was receiving. The descriptive analysis was presented by simple frequency, percentage and odds ratio. The relationship between the outcome and the type of feed was assessed by logistic regression. The Wald test was used to test the significance of the variables. The differences were significant when p<0.05. The characteristics of the mothers and the children were compared by the Pearson test and were significant if p<5%. Results: Mixed breastfeeding at four months was 22.82%, weaning from 17.40% and 59.78% from exclusive breastfeeding. The factors schooling, marital status, work away from home, companion does not encourage breastfeeding are significantly related negatively to exclusive breastfeeding. Conclusion: Exclusive breastfeeding in the fourth month of life of infants was low; factors associated with exclusive breastfeeding were low schooling, marital status without a partner, mother working away from home, and companion who did not encourage breastfeeding (AU).

Objetivo: Presentar los índices de lactancia materna exclusiva y verificar los factores asociados al destete a los cuatro meses, en madres adolescentes. Metodo: Estudio transversal con muestra compuesta por adolescentes de 13 a 18 años y sus bebés, los nacimientos fueron en hospitales amigo del niño, en la capital Belém do Pará. El trabajo fue realizado con una muestra de 92 adolescentes. La pre-selección de las adolescentes era hecha en la maternidad. La segunda etapa fue en el cuarto mes post parto, se mantuvo contacto con las adolescentes, por teléfono y verificado el tipo de alimentación que se encontraba el bebé. El análisis descriptivo fue presentado mediante frecuencia simple, porcentual y razón de probabilidad. La relación entre el desenlace y el tipo de alimentación fue evaluada por regresión logística. La prueba de Wald fue utilizada para probar la significancia de las variables. Las diferencias fueron significativas cuando p <0,05. Las características de las madres y de los niños fueron comparadas por el test de Pearson y fueron significativos si p <5%. Resultados: La lactancia materna mixta a los cuatro meses fue del 22,82%, el destete del 17,40% y el 59,78% fue de lactancia materna exclusiva. Los factores de escolaridad, estado civil, trabajo fuera, compañero no incentiva la lactancia están significativamente relacionados negativamente con la lactancia materna exclusiva. Conclusión: El índice de lactancia materna exclusiva en el cuarto mes de vida de los bebés fue bajo, los factores asociados a la lactancia materna exclusiva fueron: baja escolaridad, estado civil sin compañero, madre que trabaja fuera de casa y el compañero que no incentiva la lactancia (AU).

Fatores relacionados ao Aleitamento Materno Exclusivo em bebês nascidos em hospital amigo da criança em uma capital do Norte brasileiro / Factors related to Exclusive Breastfeeding in Babies born in a child-friendly hospital in a capital of Northern Brazil

RESUMO Objetivou-se determinar os fatores relacionados com o Aleitamento Materno Exclusivo em bebês nascidos em hospital amigo da criança na cidade de Belém, capital do Pará, e verificar se os escores da Escala de Autoeficácia na Amamentação encontram-se dentre esses fatores. Estudaram-se 414 binômios mãe-bebê, cujos bebês nasceram em 2016. Utilizaram-se questionários socioeconômicos e obstétricos, aplicando a Escala de Autoeficácia na Amamentação no momento da alta hospitalar. A média do escore de amamentação foi 61 pontos; 32,45% das mães tinham entre 19 e 23 anos; 36,56% delas possuíam 2º grau completo; 43,34% percebiam até um salário mínimo; 62,95% eram amasiadas; e 17,92% trabalhavam fora do lar. Os fatores relacionados ao Aleitamento Materno Exclusivo foram: faixa etária e escolaridade materna, mãe com trabalho fora do lar, estado civil materno, incentivo do companheiro quanto ao Aleitamento Materno e o escore da escala de autoeficácia.

ABSTRACT The objective of this study was to know the factors related to Exclusive Breastfeeding in Infants born in a child-friendly hospital in the city of Belém, Pará State capital, and to verify whether the scores of the Self-Efficacy Scale in Breastfeeding were among those factors. We studied 414 mother-baby binomials which babies were born in 2016. Socioeconomic and obstetrical questionnaires applied the Self-Efficacy Scale in Breastfeeding to mothers at their hospital discharge. The breastfeeding score mean was 61 points; 32.45% of the mothers were between 19 and 23 years old; 36.56% of them had a high school diploma; 43.34% received up to a minimum wage; 62.95% lived an informal union with their partners; and 17.92% were employed. The factors related to exclusive breastfeeding involved the mother age and schooling, the fact that the mother is employed, her marital status, the partner incentive to breastfeeding, and the self-efficacy scale score.