Yellow fever outbreak in a rural-urban mixed community of Espírito Santo, Brazil: epidemiological aspects.

OBJECTIVE: To describe the epidemiological aspects of an outbreak of yellow fever (YF) that occurred in the state of Espírito Santo, Brazil, from 1 January 2017 - 31 July 2017. METHODS: A descriptive, quantitative, retrospective approach analyzed secondary data obtained from the national notification systems, Information System of Diseases Notifications (SINAN), Laboratory Environment Manager (GAL), and the Espírito Santo Health Secretariat (SESA). RESULTS: From 1 January 2017 - 8 July 2017, a total of 824 cases were reported in Espírito Santo, 307 (37%) of which were confirmed as YF. Of these, 95 (30.9%) died from the disease. Men were those most affected, corresponding to 244 (79.5%) cases, and women to 63 (20.5%) cases. The greatest incidence rate registered was in the city of Santa Leopoldina (380.2 cases/100 000 inhabitants). The outbreak evolved rapidly and a response was possible due to a multidisciplinary group created specifically to tackle the YF outbreak. CONCLUSIONS: The data were received and analyzed quickly and the response, consisting of immediate treatment of the cases and a blocking vaccination strategy, was developed to halt the progression of this fatal disease. In spite of these efforts, the case fatality rate of yellow fever remained high.

Development of a microfluidic system structured on a modified polydimethylsiloxane device for the selection of bovine epididymal spermatozoa.

Microfluidic systems are on the rise in several studies that evaluate reproductive cells. However, the material used for manufacturing can still be considered relatively expensive. The objective of this study was to develop a new microfluidic device, using a modified polydimethylsiloxane ((PDMS) Silpuran®), test its viability and carry out a selection of bovine sperm. Sperm was collected from epididymis (n = 10) and evaluated at different incubation times (60 min, 120 min, 180 min) to assess polydimethylsiloxane toxicity, where a tube was used as a control and the microfluidic device as treatment. An additional ten epididymis were used for the sperm selection test, which utilized four types of solutions: in vitro maturation medium (IVM) with and without oocyte, progesterone and saline solution (SS). The Percoll gradient was used as a control and the microfluidic device as treatment. The kinetic parameters of sperm were evaluated using the computer-assisted semen analysis (CASA). Morphology was performed with Bengal Rose, the integrity, and viability of the sperm using the hypoosmotic test and fluorescent microscopy probes, respectively. Mann-Whitney test was used in the first experiment, Kruskall-Wallis variance analysis tests with post hoc and Student-Newman-Keuls used in the second experiment. Regarding the non-toxic effects, most motility parameters demonstrated the superiority of the microfluidic device compared to the control. In the second experiment, the sperm showed equivalence between the microfluidic device and the Percoll gradient Silpuran® PDMS was not toxic to the cells and can be efficient for selecting bovine sperm, achieving better results in a medium for IVM with or without oocytes.

[Primitive reflex in premature healthy newborns during the first year]. / Estudo dos reflexos primitivos em pacientes recém-nascidos pré-termo normais no primeiro ano de vida.

UNLABELLED: A non-controlled, prognostic cohort study was performed with the aim of establishing markers of neurological development and defining a clinical and epidemiological profile of preterm newborns at 3, 6, 9, and 12 months of gestation-corrected age in terms of primitive reflexes evolution. RESULTS: At 3 months old of corrected age, all primitive reflexes were present. At 6 months old, all children showed plantar grasp and 2.7% still showed Moro and palmar grasp. Plantar grasp was the unique primitive reflex found at 9 and 12 months of corrected age. CONCLUSION: It was possible to evaluate the occurence, as well as the disappearing of primitive reflexes in preterm newborns. The results show delay in the disappearing of primitive reflexes even with the use of corrected age.

[Vigabatrin in the treatment of epilepsy in patients with West syndrome and tuberous sclerosis]. / Vigabatrina no tratamento da epilepsia de difícil controle em pacientes com síndrome de West e esclerose tuberosa.

PURPOSE: To report the efficacy of vigabatrin in seizures control, as well as the electroencephalographic abnormalities in children with tuberous sclerosis and West syndrome. METHOD: Retrospective study, with clinical, neuroimaging, and electroencephalographic data. RESULTS: Seven patients were followed, and the median time of follow-up was 10 years. Four of them were females and all were white. The mean age of seizures onset was 3.4 months. All patients used antiepileptic drugs associations, at least 2 drugs each therapeutic scheme, each one of the patients have used at least two different schemes. Vigabatrin as monotherapy or adjuvant was started in a mean age of seven years or 4 years after the onset of symptoms. Five from seven patients on vigabatrin became seizure free. CONCLUSION: Vigabatrin was efficient in seizures control, leading to a better prognosis.

Influence of intracranial hemorrhage and neonatal seizures on the neurological and psychomotor development of premature infants at Hospital de Clínicas de Porto Alegre, Brazil.

UNLABELLED: This study compared the results of neurodevelopmental examination at 6 months' corrected age of premature infants with neonatal seizures and/or intracranial hemorrhage and normal premature infants. There was a statistically significant correlation (p=0.000007) between intracranial hemorrhage and seizures in the group of 68 premature infants seen in the neurodevelopmental outpatient service at Hospital de Clínicas de Porto Alegre, Brazil. Intracranial hemorrhage was significantly associated with multiparity (p=0.02). The neurodevelopmental examination at 6 months' corrected age revealed that patients who suffered neonatal intracranial hemorrhage and/or seizures had inappropriate muscle tone, strength and reflexes, as well as delay in head control. CONCLUSION: We compared the results of neurodevelopmental examinations of two groups of premature infants at 6 months' corrected age. The difference in neurological development at 6 months' corrected age was statistically significant when comparison was corrected for premature infants who had neonatal seizures and periventricular hemorrhage.

Cerebrovascular disease in pediatric patients.

Although rare in childhood, stroke may have a serious impact when it happens in this stage of life. Also, it may be the first sign of a systemic disease. We report 12 cases of patients with stroke treated in the Neuropediatrics Unit of Hospital de Clínicas de Porto Alegre (HCPA) from March 1997 to March 2000. All patients, from term infants to 12-year-old children hospitalized in the Pediatrics Unit of HCPA, had clinical suspicion of stroke, which was later confirmed by radiological studies. Patient follow up ranged from 1 to 6 years (mean = 3.4 years). Presenting symptoms were hemiparesis in 9 patients, seizures in 7, deviation of labial commissure in 3, and loss of consciousness in 1. The increase in the number of cases of childhood stroke identified and later confirmed by noninvasive methods had helped in the determination of different ethiologies of stroke: the most frequent being hematologic, cardiac and genetic diseases. However, our study included 6 newborns with stroke whose ethiology was not identified. Seven children with seizures received phenobarbital. Six term infants had neonatal seizures secondary to stroke and restricted to the first 72 hours of life.